My third baby is on donor milk, need support and help - Mothering Forums
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#1 of 12 Old 06-16-2012, 08:15 PM - Thread Starter
 
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It's been some time since I posted on MDC but what better place to turn for support and hopefully ideas.  I exclusively nursed my 2 dds who are now 6 and 4 for a total of 6 years.  I had nipple piercings for 10 years before I had children and when both daughters eventually refused my left breast that was a low-producer I figured it was due to slow flow and scar tissue.  I do mom to mom bf support and will sit the exam next month to become a lactation consultant.  It is dreadfully ironic that with the birth of my third baby 5 weeks ago I seem to no longer have the ability to nurse.

 

The first 2 weeks were a whirlwind of weight loss and no bowel movements, pain and engorgement, supplementers and multiple pumps, milk bank milk and domperidone, pediatricians and cranial-sacral therapy.  My ds was just 6lbs 7oz with a very small tight mouth and torticollis.  I have seen a number of lactation consultants, many of whom are friends and include 2 LCs who have written the very books I've been studying from.  I have seen breastfeeding doctors and 2 breast surgeons.  There has been no shortage of expertise but no one seems to have an answer.  WHen a friend let me borrow her baby scale I realized that ds was only getting about a TENTH of an ounce from each breast.  I sobbed when I realized his fussiness had been because he'd been HUNGRY!  I was not surprised he'd gotten such a small amount from my smaller, lower producing breast --- but I was devastated and shocked that he was receiving essentially nothing from the breast that nourished 2 babies for 6 years!!

 

Where we are at now --- he gets 20+ oz of donor milk a day in a bottle.  He latches comfortably, though perhaps a bit shallow on my smaller breast but at least we can do a lot of nursing for comfort, sleepy time and hopefully a bit of milk.  His neck seems to have improved.  I hand express from both breasts but I quit pumping when I realized my right - good producing breast - was getting dreadfully swollen and seemed to have a large blister covering nearly the entire face of my nipple. (not a bleb - and I tried many pumps and shield sizes) When I pump, express, nurse or even just have a let down this area fills with milk that cannot escape and white milk can be seen under the skin.  The skin is thicker than that which usually covers a blister  I can hand express milk from other openings elsewhere on that nipple but for some reason, ds cannot get the milk out.  Latching hurts me and frustrates him.  The blister area on my nipple may be a galactocele, though in some ways it differs from a true galactocele (it has some drainage and is on the nipple as opposed to inside the breast).  I had it aspirated yesterday and had high hopes that we would instantly nurse and everything would be normal but nothing has really changed.  We are seeing an ENT on Tues to rule out any sort of posterior tongue tie, but his tongue seems to have lots of movement.

 

This is my last baby and I am devastated that I may not be able to nurse him.  It is such a slap in the face to have engorged breasts dripping milk as I feel the tingle of let down and be giving my newborn a bottle with another woman's milk in it.  I am of course super grateful I have been able to keep him off formula, but still desperately want to nurse my baby.

 

I need some love and support -- if anyone has any ideas I'd love to hear them.


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#2 of 12 Old 06-16-2012, 09:51 PM
 
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I just want you to know I understand how it feels to successfully nurse a previous child and not be able to do that with this one.  My situation is different than yours, but it royally sucks.  I feel like I am really letting my son down by not being able to nurse him.  *hugs*
 


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#3 of 12 Old 06-17-2012, 07:42 AM
 
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I'm sorry you are having so much difficulty.   I'm sure you've already tried breast compressions...but what about trying to actually hand-express into his mouth *while* he is latched on?  That may take an extra set of hands, so it may not be feasible.

 

I actually think you have a really change of moving onto succcessful full-time breastfeeding in a little while (maybe a few days to a few weeks).   It sounds like your baby does latch on and your are producing milk.  Those are the two biggest obstacles to breastfeeding...so I do think that as long as your keep latching him on and keep your milk production up (by hand-expressing, if you can't pump) that sooner or later (hopefully sooner!) he'll get big enough and strong enough to get the milk out on his own.

 

I know nothing about nipple piercings, but I'm guessing you haven't had anything in your nipples since before you had your first, is that right?  Did you put anything back in after weaning your 4-yo and before giving birth?  If so, I wonder if perhaps new scar tissue could have formed or some other irritation happened to cause you to develop more scar tissue.  But, if you haven't had any piercings in since before having your first, that seems pretty unlikely.

 

I hope things turn around for you, and very, very soon! 


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#4 of 12 Old 06-17-2012, 09:56 AM
 
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MY 3rd baby couldn't transfer milk either, and I had pretty successfully nursed my first two...it was agonizing with the weight loss, enogrogment, eventually low supply, painful damaged nipples, on and on...she was tongue tied. Lots of people saw her before she got diagnosed...in fact I mostly did it on my own through googling "posterior tongue tie" and reazlizing we had all the symptoms.

 

If you think there is any chance that is going on please look into it... www.kiddsteeth.com is probably the most useful site I have found, lots of articles and pics. You can check out my blog too - this is a link to pics of my DD's mouth http://birthboobsandbabes.wordpress.com/2012/06/07/tongie-and-lip-tie-pictures/ and you can read "psoterior tongue tie" parts 1 and 2 to get some of our story...

 

*hugs* I know how frustrating it is when you feel so well set up, like you know everything, and then all of the sudden run into major issues!

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#5 of 12 Old 06-18-2012, 10:29 AM - Thread Starter
 
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Thank you for the replies.

 

I have tried breast compressions and hand exp into mouth.  My low producing side seems to not improve much with these.  And at this point I have given up (temporarily) latching him on good producing side with blister/galactocele type thing as he gets frustrated, it hurts me and it gets more inflamed and there is no milk transfer.  seeing TT doc tomorrow.

 

i only had the piercings pre-children.

 

lilmomma i have looked through your blog and it was helpful.  is it awful to say i'm hoping ds has a TT released tomorrow?  i will udate.....

 

thank you!!
 


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#6 of 12 Old 06-18-2012, 05:02 PM
 
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Please do update...and not awful at all! While it's not an instant fix for everyone (for some it is), it's just great to have an answer and know things can improve dramtically from getting the problem solved!

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#7 of 12 Old 06-18-2012, 09:30 PM
 
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I was tandem nursing my second and third babies, had something similar to a blister on my left nipple and was in tremendous pain.  I was a lactation consultant so this wasn't supposed to happen to me.  I felt like giving up.  The pain was so intense.  In addition to the blister not resolving easily, my daughter did not latch on or suck properly which created more pressure and pain, and then because the milk couldn't release I had plugged ducts, mastitis, etc.  I was fortunate my second daughter was still nursing and as a toddler could eliminate some of the engorgement.  While I am no longer a practicing LC, I saw your post and thought I may be able to offer you some support and encouragement. 

 

First, please don't stress about being an LC with breastfeeding challenges.  You will find that once you get through this you will truly understand some of the most difficult challenges of other moms so much more.  So look at it more as a part of your lactation education for both you and your baby. 

 

Second, definitely have your baby's tongue checked for tongue tie and even ineffectual movement (baby should try to draw your finger inward).  My daughter actually had a very long tongue, although somewhat tight frenulum (not short, just not very flexible), but would suck her tongue in the back of her mouth which interfered with the nipple being drawn into her mouth, causing the friction and subsequent blistering of the nipple.  We spent several weeks training her tongue with tongue exercises (walking back on the tongue, and drawing her tongue down and forward and letting her suck on a finger while rolling it gently from side to side to help her tongue gain side to side mobility).  I know that not all LC's believe in tongue training, but I was at a point where I would try anything, and for us it worked.  By three months she was doing much better with her tongue control and my nipple had healed.  I used a supplemental nutrition system (SNS) also at times (approximately 1 month) and finger feeding, especially when my nipple and breast was so very sore. 

 

Third, I would suggest an Avent silicone breast petal insert and a hospital grade Medela breastpump to help you to continue to produce milk and increase your supply for baby.  I have a case study that I am working on publishing about a mom who was unable to get the baby to the breast for the first 6 months.  Baby lost 25% of her birthweight in the first 2 weeks.  Mom's milk dwindled very quickly and we had to re-establish her milk supply.  Mom used an SNS with breastmilk exclusively for the first 4 months, baby then refused the breast and the SNS and was exclusively bottlefed breastmilk for 2 months until at 6 months we were able to introduce the Breastflow bottle system and return her to the breast within 2 weeks of starting that bottle system. She used the Avent silicone breast petal at my request as trial to see if it would help to stimulate the breast to produce more milk.  She literally could not get out but drops at first and when the baby was 6 months was getting 7 to 9 ounces a breast.  The petal was significant in re-establishing her milk supply and then producing more milk by 2 ounces within a 24 hour period. 

 

Make sure you have help!  If you don't have a postpartum doula or some help during this time, you will want to bring someone in to help with your other children and your home so that you can free yourself to heal and help your newborn. 

 

Fourth, the torticollis and very small mouth can be huge contributors to the problems you are having, individually and as a combination.  My third child had a twisted atlas (C1)-- her vertebra was turned 270 degrees and she also had hip dysplasia (diagnosed at 4 months).  A chiropractor was able to help with the atlas issue and hip dysplasia.  The cranial-sacral should definitely help as well. 

 

Because you successfully fed both of your older children without these types of challenges, it is more than likely the nipple piercings were not a factor in your baby losing weight and having difficulty feeding.  From my own experience, I would say it may be more the position of the baby's neck and chin due to the torticollis (and unfortunately we can't ascertain whether the latch on position is causing muscle spasms, but if baby is trying to feed and the neck is having muscle spasms, baby isn't going to be able to suck appropriately). 

 

Hope something I said here helps and encourages you.  My best advise-- practice taking deep breaths and healing breaths and focusing on your baby's beautiful features while you are feeding him.  Don't give up.  This may seem huge now, but keep reminding yourself that your goal is for your baby to regain health and well being and for you to heal.  Sending you lots of positive energy. 

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#8 of 12 Old 06-19-2012, 10:35 PM
 
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Originally Posted by Mom4Mom View Post

 

Third, I would suggest an Avent silicone breast petal insert and a hospital grade Medela breastpump to help you to continue to produce milk and increase your supply for baby.  I have a case study that I am working on publishing about a mom who was unable to get the baby to the breast for the first 6 months.  Baby lost 25% of her birthweight in the first 2 weeks.  Mom's milk dwindled very quickly and we had to re-establish her milk supply.  Mom used an SNS with breastmilk exclusively for the first 4 months, baby then refused the breast and the SNS and was exclusively bottlefed breastmilk for 2 months until at 6 months we were able to introduce the Breastflow bottle system and return her to the breast within 2 weeks of starting that bottle system. She used the Avent silicone breast petal at my request as trial to see if it would help to stimulate the breast to produce more milk.  She literally could not get out but drops at first and when the baby was 6 months was getting 7 to 9 ounces a breast.  The petal was significant in re-establishing her milk supply and then producing more milk by 2 ounces within a 24 hour period. 

 

 

 

 

Sorry to hijack this thread, but why have I never heard about these??  So I can order the silicone breast petal inserts and they will fit my medela shields?  I'm struggling with EP'ing for my 8 month old.  I'm only getting about 14oz a day.  If this would help that would be amazing!!


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#9 of 12 Old 06-19-2012, 11:47 PM
 
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They do fit the Medela breast shields.  Unfortunately you have to buy the entire Avent pump to get them as they are not sold separately.  Ameda/Lansinoh has a silicone insert that also helps, but the difference in the production between the two for the mom I mentioned was significant with the Avent being much greater.  The silicone shells that fit the shields compress against the breast and may stimulate the milk ducts to release more.  Obviously research needs to be done to provide more information.  However, I began using these in my practice about 1994 and found them to really help to stimulate milk supply.  Also an early morning pumping can sometimes stimulate more milk production.  Between 4 and 6 am if that is not a time that baby normally feeds you might try that and see if it works.  I'd be very interested to know if either of these work for you. 

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#10 of 12 Old 06-20-2012, 02:09 AM
 
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#11 of 12 Old 06-20-2012, 12:07 PM
 
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You actually can buy the Avent massage petals...just call Avent customer service and ask for a "replacement massage petals" :-)

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#12 of 12 Old 06-20-2012, 09:45 PM
 
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The link is for Ameda / Lansinoh silicone inserts and they do help.  My experience has been that they are not as effective as the Avent, but they definitely do help.  The ratio on the mom in the case study was while the one breast would get 3 ounces with the Ameda, the breast that had the Avent petal was at 4.5 ounces.  Compare this to the 2 to 2-1/2 ounces with just the regular Medela breast sheild.  When I began recommending the silicone inserts I initially began recommending the Ameda, which clearly helped a greater percentage of moms collect more breastmilk.  Disclaimer:  Every woman is different and there is no guarantee that she will respond to pumping or to the silicone insert with significant change. 

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