WWYD re: supplementing

[2 in August]

http://www.mothering.com/discussions...d.php?t=522083

Here's a link to a thread I started in Life with a babe about our issues with supplementing.

Basically my baby is gaining very slowly (stayed at same weight for first 3wks and just only passed birth weight at 5wks) and I've started to use formula to supplement with (along with pumping). My biggest problem with the formula is that when he was only getting 2oz a day, it did not seem to bother him. Then we worked up to 4oz and he started having problems with his tummy being really rumbly, he didn't poop for days (used to poop at least 4 times a day). I finally had to give him a suppository to make him poop after close to 4days and him screaming in pain for a couple days. Now I'm scared to keep giving him formula. He was on Enfamil Lipil. I just got a sample of Good Start from our ped. Good start worked well for dd when I needed to supplement her. So I didn't give him any formula for 24 hours to make sure he would poo on his own and to see how he was as far as crying, etc (wanted to see if it was really a formula issue). He did good and pooped today back to normal consistency, if not frequency. So I gave him some of the Good Start (didn't really want to, but I'm paranoid about him gaining since the ped is keeping such a close eye on his weight). He ended up with another screaming session. Now I'm torn about giving it to him again, although I should once more to see if the same thing happens.

I just don't know what to do. If I don't supplement, he's not gaining weight. But if I do supplement and use too much it upsets his stomach. It's choosing between 2 evils and I'm not sure which way to go. I am upping my oatmeal consumption, I can't swallow pills (awful gag reflex) so a lot of the meds are out. I pump when I can, but honestly if dh isn't home to help hold ds and if ds starts crying when I put him down, I can't sit there and ignore his cries in order to pump.

I guess I'd like some BTDT type stories and/or advice on how to make the best decision. Is there anything I'm not thinking of? WWYD??
Thanks!
Jennifer

[Plummeting]

Your baby might be allergic to cow's milk. I certainly would NOT continue to give him regular formula if it makes him miserable. If you need to supplement and can't get banked milk, have your doctor give you a prescription for something like Nutramigen, which should be okay for an allergic baby. Sometimes it isn't and the baby would then need something like Neocate, but usually Nutramigen or Alimentum would work. I absolutely would not give soy formula, but it sounds like you may know that, because you didn't mention it as an option. Maybe you could discuss banked milk with your doctor. I think most insurance will pay for it if you have a prescription.

You could make tea with nettle leaves, fennel or fenugreek - or a combination of the three. If nothing herbal works to increase your supply, Reglan can be made into a syrup, so you wouldn't have to worry about the pills. Reglan causes problems with depression in many women, though, so that would be something to keep in mind.

I'm sorry your baby isn't feeling well and I hope you get it all sorted out soon!

[2 in August]

Thanks for the ideas! I didn't know that there was anything wrong with soy formula. The only reason I was avoiding it was because I was worried about switching from milk to soy and it causing any more problems. Is there a specific reason soy formula should be avoided.

I'll check out the tea idea. I have a horrible time taking pills but tea is my kind of thing. Thanks for the suggestion.
Jen

[jenny-g]

Hi-
There are many reasons not to suppliment with soy formula, among them thyroid problems and soy allergies.

While cow milk allergies are rare, it certainly seems that trying a hypoallergenic cow's milk formula like the other poster mentioned would be a very good idea. They do have higher levels of other non-ideal things (especially Alimentum) but it certainly seems this is worth trying in your case.

I"d also suggest going on domperidone- you can crush it and eat it in pudding (then there is no taste. If you use applesauce.. then you can usually taste it. Pudding coats the drug better!). There's plenty of info about dom on this site as well as the kellymom site. Hopefully you're also working with an LC on supply issues! I have them too and have to suppliment- goodstart worked fine for us, though, I think she had the normal amount of baby tummy issues. (She only got very bad when she had thrush, which when treated, solved all problems.) -j

[jarynsmom06]

We tried Good Start and it hurt his tummy, so I went straight to Similac Allimentum. We are currently having some financial problems and since DS only takes a formula bottle maybe 3-4 times a week, I called the Ped and asked if they would give me some samples. She said they didn't have any of the Allimentum, but they had tons of Enfamil Neutramagin and it was very close to the Allimentum. She gave me 4 cans. Anyway...got a little off subject there. The Allimentum and now the Neutramagin work really good, he doesn't get a tummy ache and he rarely spits up after a formula bottle. But man does formula stink...yuk...every time I come home and he has had a formula bottle I wanna dunk him in the tub. BM breath smells so much better . I know....I'm wierd. Good luck though...

[2 in August]

I think Allimentum/Nutramigen will have to be our next shot. Yesterday I decided to give him the Enfamil since in smaller quantities it had not produced any side effects and this time it gave him trouble and he ended up crying on and off for over 3 hours. I'd nurse him to sleep and a few minutes later he'd suddenly start screaming and crying again. I agree with you Jarynsmom, formula does stink. I had to use it with my dd and kind of got used to it, so I was actually worried with this baby his first few weeks because he smelled so differently.

There are only 2 LC's in our town (one at each hospital). I've seen them both. One has a walk in group on Weds afternoons. I went last week and I'm going to go again today.

We have 2 health food stores in town too so I'm going to see if they have the mother's milk tea and other herbal stuff. We are on a super tight budget too, so I have to choose carefully what we get. I did the same thing with formula, instead of going and buying some Good Start, I called the ped office to see if they had any and they did. I'm so glad that I didn't have to waste $12 on it. I'm going to do the same thing today and see if they can't give me some of the nutramigen to try. That's definately too expensive for me to just go grab a can to try.

Thanks for the help mommas!

[aussiemum]

Originally Posted by 2inAugust

It's choosing between 2 evils and I'm not sure which way to go. I am upping my oatmeal consumption, I can't swallow pills (awful gag reflex) so a lot of the meds are out. I pump when I can, but honestly if dh isn't home to help hold ds and if ds starts crying when I put him down, I can't sit there and ignore his cries in order to pump.

I agree with what PPs have in terms of overcoming the gag reflex. Regarding pumping, I did it a lot with my kids, but I always had them at the other breast- so they sucked at one whilst I pumped the other. You don't have to put your bub down to pump.

[twinsarefun]

Soy formula is very high in manganese (mercola.com). Infants get 400 times higher than human breastmilk (mercola.com). The infants liver is not mature enough to excrete the manganese and accumulates in the brain and other areas of the body. High levels are believed to contribute towards ADHD (mercola.com). Another thing with soy, is it causes hormonal shifts. Infants fed with soy are believed to go through puberty quicker. One friend of mine told me that her nephew developed at the age of 8 due to the soy formula. You can go to google.com and find numerous articles on this subject. I have been supplementing with the SNS. The brands of formula that I have found to be the lowest and closest to human milk in manganese have been Similac and Kirkland (Costco brand). Also, these formulas use cows that have not been treated with RBST. I have ditched the Lipil which uses RBST and is high in manganese. Allimentum is the better of the two. It is made by the same company as Similac and is lower in manganese than the other brand. The other brand makes Lipil. I asked my pediatrician about the study of manganese. He is not too sure about that. I figure better safer than sorry.

[Fi.]

As someone mentioned, Domperidone is easily crushed or well hidden in a yogurt with fruit. They're about the same size as birth control pills. I'd give them a try.

[2 in August]

Twinsarefun -- thank you so much for the info on soy formula and the comparisons between the others. I had not heard any of that before so I am very thankful for the info and the links so that I can learn more about it.

Fi--Thanks for the info on the dom pills. I didn't realize they were that small. Birth control pills were the only things I could get down because they were so small so I may be able to do them without a problem. I guess I always assume that pills are going to be huge.

[2 in August]

Hi I forgot to add that even with all the problems that we've had this past week he weighed 3oz more at the bf support group that I just found out about and started attending. I was sooo happy. The downside is that's all he's gained in 2wks, but it has been a rough 2wks, so I'm being optimistic and celebrating the fact that he gained at all!

[twinsarefun]

I would also look into Dr. Jack Newman's web-site (the birth den) and his book, "The Ultimate Book of Breastfeeding Answers". It is an excellent book. I wish I had it in the beginning of nursing my twins. It would have spared me months of trouble. Your baby might have a latch problem which could be affecting your supply. Have you worked with anyone to check the baby's latch? Are your nipples still hurting while nursing? If they are, baby may need to latch correctly. A correct latch will up your supply. Even if baby is not latching correctly, he can still get milk, but it may not be as much as if he was latching better. As baby latches better, the supply usually increases. At the Drs. web-site, you can watch videos that will show the correct latch and some other helpful info about supplementing until baby catches on better. Also, stay away from paficiers. It will train the baby to have a poor suck. Also, with the SNS, first nurse without the tube, then if baby is done and does not seem satisfied, then slip in the tube to finish off. Never use the tube through the whole feeding. The SNS directions are not correct in saying that baby will eventually take less and to use it through the whole feed. If you do that, baby will get hooked on the tube and have a hard time going off. Dr. Newman's web-site will show using the tube correctly. I do think using these gadgets through the whole feeding also train for a poor suck. It is just not the same as baby just latching at the breast. That is why it is better to use the tube for finishing off. I have written Madela regarding their SNS directions. They are going to look into that and I hope change the directions. It has sabotaged many womens babies who would nurse soley at the breast. Nursing through the whole feeding is mainly for adoptive mothers. I wish you well!

[2 in August]

Originally Posted by twinsarefun

I would also look into Dr. Jack Newman's web-site (the birth den) and his book, "The Ultimate Book of Breastfeeding Answers". It is an excellent book. I wish I had it in the beginning of nursing my twins. It would have spared me months of trouble. I haven't read the book but I have read the website and watched all the videos. They are really helpful.Your baby might have a latch problem which could be affecting your supply. Have you worked with anyone to check the baby's latch? I've seen 2 different lc's and they both said he had a good latch. So as far as I know it's ok. Are your nipples still hurting while nursing? If they are, baby may need to latch correctly. A correct latch will up your supply. Even if baby is not latching correctly, he can still get milk, but it may not be as much as if he was latching better. As baby latches better, the supply usually increases. At the Drs. web-site, you can watch videos that will show the correct latch and some other helpful info about supplementing until baby catches on better. Also, stay away from paficiers. It will train the baby to have a poor suck. Does it matter what kind? He has a nuk that he will take only about 25% of the time. Mostly though he will only suck on my finger tip. Also, with the SNS, first nurse without the tube, then if baby is done and does not seem satisfied, then slip in the tube to finish off. Never use the tube through the whole feeding. That's what I've been doing. It didn't seem right to me to add the supplement while he was getting enough milk. The SNS directions are not correct in saying that baby will eventually take less and to use it through the whole feed. If you do that, baby will get hooked on the tube and have a hard time going off. Dr. Newman's web-site will show using the tube correctly. I do think using these gadgets through the whole feeding also train for a poor suck. It is just not the same as baby just latching at the breast. That is why it is better to use the tube for finishing off. I have written Madela regarding their SNS directions. They are going to look into that and I hope change the directions. It has sabotaged many womens babies who would nurse soley at the breast. Nursing through the whole feeding is mainly for adoptive mothers. I wish you well!Maybe they should make a distinction between supplementing and relactating.

Thanks for your ideas and help!

[2 in August]

Well ped is now officially "very concerned". Said we may have to put him on just formula to see exactly how many calories he's getting. Yeah right!!! So we are supping with Gentle Ease unless it has side effects over the weekend then we'll do Allimentum.

I've also upped my oatmeal and started mother's milk tea. So send some get bigger by next Friday and got momma off the hook vibes our way!

[twinsarefun]

I'm so sorry to hear about the pediatrician visit. I know how disheartening those can be! How about tonque tie? Did the LC check for that? How is the pallet of the baby's mouth? Is it high? Sometimes there are issues that iron out with time. I would try and ditch the pacifier. There are some good articles on La Leche Legue's web-site about that. Also, there is a good forum there with some good moderators who can help regarding these issues. I hope that things go well. I know how hard it is in those early weeks when this is going on. Let us know how things are going and what you find out.

[2 in August]

Thanks, I don't think he's got a tongue tie. Dd had a mild one and his tongue is not like hers at all. Not sure about the pallet. He sucks on my finger all the time, I just don't know how to tell. He pretty much refuses the paci most times. I really wanted it mainly for dd to give him in the car or for dh to give him while I'm in the shower, etc. but he hasn't taken it in days. He really only likes my finger. Sometimes if I try to nurse him and he starts screaming then I just let him suck on my finger. Otherwise I let him nurse more. I've not yet checked out the LLL forums. Thanks for the tip.

The thing that bugs me the most is that if the dr wasn't telling me how awful it is that babe isn't gaining weight, my impression would be that I have a perfectly normal, healthy baby. And that's what bothers me so much. Yes I know babies are supposed to gain 1/2-1 oz a day, but in order for that to be the avg, doesn't it mean that some will gain 1/4 oz or less and others will gain more than 1oz? In that case could it not be possible that my baby is in the slower group? Nobody has to answer those, it's just me ranting.

[Sharondio]

This might help. http://www.drjaygordon.com/development/bf/scales.asp

[2 in August]

Thank you so much for that!!!

[2 in August]

Updated!!

Update -- Baby gained 4oz this week!! He's 8wks today and is 7lb 7oz. Dr was happy with him gaining that amt too. Yay!!

Thanks everybody for your help and support.

[MaryJaneLouise]

Originally Posted by 2 in August

Update -- Baby gained 4oz this week!! He's 8wks today and is 7lb 7oz. Dr was happy with him gaining that amt too. Yay!!

Thanks everybody for your help and support.