tandem question and foremilk/hindmilk - Mothering Forums
 
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#1 of 12 Old 05-02-2005, 08:22 PM - Thread Starter
 
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If my 2 week old ds isn't getting enough hindmilk (he's gaining poorly, pooping rarely), and I want to let 2 yr old dd nurse off the foremilk first, how long should I let her nurse? Count to twenty? 10 minutes? I have no idea when it switches.

Also, been trying to pump out some hindmilk to supplement with, but can't get much out (maybe an oz, and it ain't hindmilk). Is this a common problem for tandem nursers? I've always had an oversupply issue.... until now maybe??

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#2 of 12 Old 05-02-2005, 09:29 PM
 
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Very good question, but i'm going to give you a kinda silly answer.

Until you feel that it's not much foremilk anymore. I would get the older one to move sides when i felt it was OK. Sometimes it seemed like a minute, sometimes much longer. And if i was tight, i waited until the tightness went away.

Happy Tandeming!
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#3 of 12 Old 05-02-2005, 11:41 PM
 
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just as an "i-hate-to-see-mamas-fret-over-things-they-needn't" sort of thing:
babe is only 2 weeks - what are the reasons you say weight gain is poor? are they legit or is it that new baby paranoia that we all get? not looking to dismiss your concerns, just truthfully hoping they are not valid, honestly. b/c if they aren't, everybody in your trio is good, you know?
how big was baby at birth? are you making any assumptions based on comparison to your first child? 'not pooping alot' - what do you mean in numbers of diapers? any chance more than one poop is hiding in a diaper between changes? how is baby's demeanor? sleeping well with adequate alert times in between? peeing plenty? are stools yellow/seedy or greenish? is baby quitting nursing before long to fall asleep? can you wake him up to get more milk in him? are you eating well and resting all that you can with a newborn and toddler?
just some food for thought in hopes that you are getting yourself worked up for naught b/c you are surely tired beyond reason!
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#4 of 12 Old 05-03-2005, 02:13 AM
 
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I'm with crunchy mom above. One of my hats is a trained breastfeeding educator, but I've also nursed 6 kids (some longer than others).

for one thing, if he was getting too much foremilk his poop would be copious, gassy, green and frothy. "Not enough hindmilk" isn't "poopy rarely." Also low weight gain... that's hard to define because all babies gain at different weights. There is so much more to it.

I would NOT counsel you to let the toddler nurse first, nor to pump first. Just put the baby to the breast. Watch him for his cues, encourage him to nurse every 1 1/2 hours. Make sure you have a GOOD LATCH... I find that moms who have been nursing toddlers have sometimes forgotten how to position a newborn. Make sure you hold him close in to you. My favorite latch technique for the struggling baby:
Get him up and close
in, his bum under your arm, his back along your forearm and his head in
your hand, and hold your breast with the other hand. Touch your nipple to
the point right between his eyes at the bridge of his nose, and then as he
roots up to it, he should open REALLY wide and his tongue should
protrude-- just bring the nipple right down the bridge of his nose to his
mouth and bring him into the breast quickly. The nipple should be aiming
for the spot in the back of his mouth where the hard palate and soft
palate meet.

Use breast compression when he's on... watch him nurse, and listen for swallows. As soon as you see him change to a flutter suck, go in with breast compression-- basically you'll be hand expressing milk into his mouth. Get him swallowing again.

Here are some little known facts about foremilk and hindmilk:
1. "Foremilk" is the hindmilk left over in the breast from the previous feeding, but enzymes have worked on it to break up the fat (so the fat can't coagulate and clog the ducts) and concentrate the proteins and immune factors and water the milk down a little. Foremilk has more sugar, protein and immune factors than hindmilk.

2. Foremilk "switches" to hind milk within 30 seconds of the start of a feed, generally. Of course the longer the feed, the more changes to the composition of the milk, to suit the baby's nutritional needs based on his own choice of sucking pattern. IOW, your body can "read" his nursing habit and the milk will change to suit his habit so that he gets the nutrition he needs.

3. Generally, babies who nurse for shorter periods of time more often will gain weight faster and mom have more milk than babies who nurse for extended periods less often. (I have lost my reference for this. I am working on getting all these references back in a handy place.)
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#5 of 12 Old 05-03-2005, 04:41 AM - Thread Starter
 
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Quote:
Originally Posted by crunchyconmomma
just as an "i-hate-to-see-mamas-fret-over-things-they-needn't" sort of thing:
babe is only 2 weeks - what are the reasons you say weight gain is poor?
Not back to birth weight (9 lbs) at 2 weeks (today). He's 8 lbs 12 oz. All the LLL's say this is a red flag.

Quote:
Originally Posted by crunchyconmomma
'not pooping alot' - what do you mean in numbers of diapers?
Other than the first 2 days of meconium poops, he's pooped twice. Period.

Quote:
Originally Posted by crunchyconmomma
any chance more than one poop is hiding in a diaper between changes?
Uh, no.

He cluster feeds for about a a 5-7 hour stretch every day, then nurses every 2 hours. Long, leisurely slow nursing.

Quote:
Originally Posted by tryinghardmomma
for one thing, if he was getting too much foremilk his poop would be copious, gassy, green and frothy. "Not enough hindmilk" isn't "poopy rarely."
Yes, actually, foremilk has a lot of water and hindmilk has the calories; he pees a lot, he's not dehyrated, so he's getting milk, but not enough hindmilk; i.e., not enough calories. Several LLL's have confirmed this as the likely situation.

I have not forgotten how to latch on a newborn, but I can't force him to open his mouth wide. He just doesn't do it, no matter how much I tickle, angle his head favorably, or what. I have huge nipples and he has a tiny little mouth, and he's just gotta grow a little bit.

Thanks for letting me know that foremilk changes to hindmilk in 30 seconds. If this is true, it actually answers my question. Thank you.
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#6 of 12 Old 05-03-2005, 01:58 PM
 
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A couple of things...

Are you feeling let down while he's nursing? If you are then he is getting the hindmilk. If not I think it would be a good idea to have your older dc nurse until you start feeling let down and then put him on.

It sounds like he's a really slow nurser too so I'm wondering if you can sling him so he can just keep nursing and nursing as long as he wants/needs while you can still be up and about. A good ring sling that isn't too big and bulky will allow you to put his head at just the right position so that your breast is not getting pulled on at all.

I know you said he just won't open his mouth wide. I think it's a really good idea to still keep at it though. Maybe just do it until he opens the widest for him so he will be used to opening wide first. I just worry that if he gets too used to his current latch that even if weight gain is no longer an issue down the line hurt nipples could be, kwim?

Sorry if this is all stuff you've already done or are already doing. I'm just trying to think of anything to help. I'm sorry to hear it isn't going as easily as you probably had hoped.
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#7 of 12 Old 05-04-2005, 02:24 AM
 
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Ooohh.. .I totally have that problem too. Why do we have to have these humungous honkin nipples? NONE of my newborns have regained birthweight until closer to a month... and I've given them supplements of formula. So go figure. I couldn't get my youngest to latch on worth anything for at least 3 weeks.

So, now that I have more info I can tell you what I did... For the first 3 weeks I pretty much finger fed her. I pumped every 3-4 hours, and nursed my toddler several times a day, and finger-fed my pumped milk (and if it wasn't enough some donor milk) to the baby. I used my finger to really get her suck-trained to open up wider. I also offered my breast, as much as she'd take it, but she hurt my nipples since she'd only barely get the thing into her mouth and just chaw down on it. It took about 3 weeks of finger-feeding her, teaching her to open wider, and her growing a bit...

She was 7 lbs 12 oz at birth, then she yoyo'ed up and down from 7-7 to 7-9 for 2-3 weeks, then started gaining a bit so that at 4 weeks she was 7-15.

It can make you crazy, those first weeks.

I guess all in all, my LC told me that I was doing everything perfectly-- exactly like she'd have told me to do-- so to keep going with my instinct and training. (I was going more on instinct than training though... postpartum brain and all...)... She let me come in and weigh Belen as much as I wanted, which I did 1xweek. She called me to check on me too.

It was nice that my toddler nursed and helped keep up the supply and help me get letdowns for pumping.

They both ended up nursing just fine once she got the hang of latching. He's mostly weaned (had weaning party a month ago but 3 days in a row now, after a full month of no nursing, he's asked to nurse each evening... for a minute or less....) and she's still nursing all the time. She's 16 mos and he's 45, almost 46 mos.
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#8 of 12 Old 05-04-2005, 02:33 AM
 
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If you don't mind my adding a P.S. ..... I'm still inclined based on my experiences both with myself and working with other moms, to say that it's not "not enough hindmilk" as much as it's "just not enough milk." You didn't say if you were doing breast compression??? Does the idea of fingerfeeding appeal to you at all? It is a PITA, but being able to help use your finger to teach her to take something larger in her mouth was helpful for me. I also found using a Playtex Naturalatch nipple (the soft brown latex nipple, not the firmer clear silicone nipple) to be an acceptable alternative during this early time.

OH... and if you do pump, make sure to get an extra large flange! Standard ones that come with the pump are like 24mm, and I need a 30mm.

Hope that helps.
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#9 of 12 Old 05-04-2005, 07:26 PM
 
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I have one question to add...are you switching sides or nursing on just one side per feeding (or per 2-3 hour time period)? It may help to nurse baby on only one breast per feeding. That way baby is sure to get lots of hindmilk and not a "double dose" of foremilk....and this should also help with oversupply.

to you!

Mama to A (12), Z (11), H (9), C (5), A (3) and 4 angels. 

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#10 of 12 Old 05-04-2005, 08:04 PM - Thread Starter
 
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nak

Thanks mamas. He seemed to turn around once I started doing breast compression last week. I saw LC yesterday, and that was great. I ws especially gratified (as she watched me leak all over the place) that I don;t need to worry about my supply, I can nurse my toddler on "her" side as much as I want, and that "his" side will self regulate over time, which makes a lot of sense to me.

All my instincts tell me he is doing just fine-- he's bright eyed, pink and juicy, his fontanel isn't sunken, he has a dozen wet dipes a day, has cheerful alert periods, he looks healthy and beautiful and he's very content-- not hungry anymore. We continue to work on his latch and I'm sure we'll figure it out. I've heard enough stories from friends both online and in real life to feel comfortable that his pooping pattern is just what he's doing right now.

Sometimes you just have to stop thinking so much, have some faith and keep your own counsel, iykwim.

love
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#11 of 12 Old 05-04-2005, 09:30 PM
 
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Quote:
Originally Posted by Ubertulip
Sometimes you just have to stop thinking so much, have some faith and keep your own counsel, iykwim.
Abolutely! I'm so glad to hear things are going well.
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#12 of 12 Old 05-08-2005, 02:28 PM
 
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do you nurse your kiddos at the same time? when my ds2 was a tiny baby (he's one in two weeks!) he would do the slow leisurely nursing, but when I let ds1 get on the other side, his fast toddler nursing would get the milk flowing like crazy. If your baby can keep up with the speed, I found that to be a great way to get a lot of milk into the little one.

anyway, it sounds like you are feeling better about the whole situation. I think it sounds like he's doing fine. Also, it is hard to not use your first as a yard stick. my first pooped several times a day. my second, only once ever 2-3 days. I was convinced he wasn't getting enough to eat, but he just had a diff. pooping style

enjoy your baby!
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