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need help quick!

post #1 of 10
Thread Starter 
I'm writing to see if I can get help for my sister-in-law who is having supply problems.
SIL had baby, conceived with the use of fertility drugs. She was breast feeding, baby seemed happy, wet diapers but did not regain birthweight after two weeks. Pediatrician did not share concerns until two week appointment. What followed was formula supplementation and a ten week attempt to build milk supply. Baby labeled a lazy sucker. When baby was twelve weeks SIL went to formula due to no improvements.
Current situation-
SIL has new baby, 9 days old. She saw a lactation consultant in the hospital, and has seen one since. She has been pumping after nursing and using an SNS. At first she did not get anything pumping but now is getting an ounce at most. The baby is tiny, I believe she was 6lb4oz at birth and under 6lb when they brought her home. SIL has very large breasts so there is concern about baby's ability to get a good latch. Baby is very, very sleepy and difficult to wake and get to nurse.
I talked to SIL today and she was crying, saying that she is worried that the baby is starving and going into a mini-hibernation to conserve energy.
My heart is breaking for her. She is so committed to breast-feeding. She was so proactive this time around and it still does not seem to be working.
If anyone has suggestions or information thay may be helpful please share them so I can pass them on. My SIL is losing hope.
post #2 of 10
I would continue to see an IBCLC until all possible problems were ruled out or corrected. Maybe she needs to try another one if the first one didn't offer much help. My twins were very sleepy at first and the LC at the hospital suggested massaging their jaw, ear lobe, and palm to help stimulate the sucking reflex even if they seemed to be asleep. It is normal for many babies to lose something like 10% of their birth weight and it can take a couple of weeks to get back up. Also, many moms can't get much with a pump, so that isn't a good indicator of supply. Keep encouraging her to look for other sources of info and assistance. Is there an LLL group nearby? If not you might want to pm Daryl. Your sil is lucky to have you around.
post #3 of 10
My DD was full term and did not eat for the first three days. She was a very very tired, sluggish newborn.
It sounds like your SIL is very unconfident... if she lacks trust in her body and baby and begins supplementation, she will produce less and less milk, until she finds herself totally formula feeding. It's a classic case. It's normal to be full of worry in the first few weeks... but try to keep her confidence up. Her baby is not going into "hibernation mode". Both of my babies were extremely sleepy the first few MONTHS of life. How can I put this without sounding radical? Her baby and body knows what it is doing. Have you ever wondered why women are so "leaky" those first few months of breastfeeding? Because the breasts are hyperactive, to ensure that the baby has enough to eat while figuring it all out.
Ask her to keep her house nice and chilly. Avoid supplementation, unless the baby is obviously starving to death, which I honestly doubt will happen if she keeps on trying. Tell her that every two hours, she should strip the baby down to the diaper, lay a cool, damp washcloth on her, whatever it takes to liven the baby up. Then she should tickle the baby's lips and cheek with her nipple, teasing its mouth open until it is gaping. Then "ram" the open mouth onto the nipple. She just has to keep trying and trying and trying. It literally took me three months of constant struggle before DD "got it"... and trust me, she did not starve! Just really, really, really honestly steer her away from bottles and supplemental systems. If baby gets "spoiled" by how easy bottles are, she may never work hard enough at the nipple to get sufficient milk. Then its all downhill from there:
post #4 of 10

nursing baby right now after supplementation

I'm typing one-handed as I nurse my 1-month-old. Nursing has presented a lot of challenges for me. The first was that my baby didn't latch on or suck. I was opposed to supplementing, but the lactation consultant at the hospital helped us do it in a way that enabled us to nurse successfully.

Every two hours on days 2-4, we woke up baby using the undressing and washcloth method, tickled cheek & lip and tried to get him on the breast. If he ate 15 minutes in total, we were done. If not, I pumped the breasts 15 minutes and dh "finger-fed" baby. He attached a syringe to his finger with a tube, and using the finger to mimic a nipple, he fed the baby while tutoring him in proper sucking technique. Baby got all the pumped collostrum plus some (icky) formula for hydration, breasts got stimulation to fill, baby learned to suck. Gradually he nursed more and finger-fed less. We were able to stop supplementing by the 4th day, went over to strictly demand feeding. At the 2 week appointment, he was 7 oz. over his initial birthweight!

Though I have had other latch problems, like cracked and bloody nipples, etc. I am not sorry we finger-fed, because my son is now thriving on exclusively breast-feeding. And I think we are also finally getting the hang of the rest of it--every day it feels easier. I also have the proverbial big breasts--the obstacle to latch on wasn't anything physical about me or baby. We are just not a coordinated family
but we are a family with a beautiful, healthy breast-fed baby.
post #5 of 10
Thread Starter 
Thanks for the input. My SIL is pretty much doing what everyone has suggested, though massaging the jaw and earlobe may be new. I'll share that with her.
I think part of the fear is because the baby is so little. There is more of an urgency to put on weight. Her skin is still really wrinkly, which bothers my SIL. I don't know if that is really a problem for a baby under two weeks though.
Thanks again.
post #6 of 10
I had weight gain issues with DD also. ALthough, she was a very large baby (10lb 6oz). She lost about 7oz in the hospital, and didn't regain her birthweight until she was about 1 1/2 months. Her first pediatrician was very unfriendly towards nursing, and was terrifying me and trying to bully me into supplementing with formula. DD was completely thriving in every other respect.

Anyway, we fired the pediatrician, and hired a LC. She put me on an herbal supplement of Fenugreek and Blessed Thistle. This had a big impact on my supply. I also did breast compressions while DD was nursing. I would hold my brest between my thumb and fingers, squeezing whenever DD's suck became slow or she stopped. A little squeeze would get her to start actively sucking again. I would rotate my hand around my breast to get to as many milk ducts as I could reach. I also usually stayed on one side per feeding. By getting her to nurse on one side longer, she was able to get more of the fatty hind-milk.

This is what we suspected the problem was. She would nurse enough to get the initial let-down, but would start to doze and taper off her nursing after her initial thirst was sated. She was getting just enough to thrive, but not enough to really put on the weight.

I also rented a hospital grade pump and pumped every hour. I tried to feed her the pumped milk at the end of the day when I was really feeling tapped out. Unfortunately, I never was able to produce very much for the pump. On the other hand, DD (clever thing that she is) never liked the bottle, and, after a few months refused it outright.

I hope this helps!
post #7 of 10
My supply was low too due to a variety of factors. Blessed thistle and fenugreek (3-4 capsules each 3 times a day) was a big help. Domperidone (Motilium) is another alternative that is very safe (much fewer side effects than Reglan if it really, truly is a low supply problem as per a good lactation consultant she trusts. Only problem is it's not available in the US, it's only available from overseas, but it's not a big deal to get it. www.fourfriends.com I think has info about where to get it.

Definitely second the advice to get a good IBCLC certified lactation consultant. Also, has she gotten in touch with her local La Leche League for help and support?
post #8 of 10
I had the same problems with dd. She was 6lbs 4oz too and I also have large breasts. I found the cross-cradle hold to work for me alot better than any other. It allowed me to "guide" my breast into her mouth alot easier. It's worth a shot!
P.S. It took 2 months for us to "get it" but all is well now.
Good Luck and take care...
post #9 of 10
(typing w/one hand- nursing...)

knew someone at la leche league w/ same problem - sleepy tiny baby not gaining. the mom persisted with waking and using sns. never used formula. now both are fine... tell your friend to please hang in there! sheshould go to LLL meeting if one is in her area.

natural mom
post #10 of 10

bump--how's it going?

Hi mama joy, how is your SIL doing? did she succeed in getting her baby to demand more and eat more? Perhaps because I'm a new mom now I've been thinking about your SIL and how hard this must be for her, and I hope that the baby is okay.
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