[Peppermint Poppies]

This is a long story, so bear with me, but it might be helpful to provide some background to my breastfeeding problem.

DS was born via c/section, 3 days after my waters broke (another long story which I won't go into, but he was transverse, and wasn't coming out, despite all my best efforts). He weighed 10lbs 11 oz. On day 3 PP, I pulled one of my internal stitches, through my abdominal wall and it came to rest on a nerve, leaving me in excruciating agony. I was prescribed morphine for the pain. I chose to leave hospital early, and came home in a wheelchair as I was unable to walk.

Initially, breastfeeding was fine. DS had his first feed 20 mins after he was removed from my belly, and we fed on demand from then on. I saw a LC in hospital, who thought his attachment was great, no problems there. Over the first few weeks, he gained weight slowly, about 50g/week. I wasn't too concerned, as he was a big boy to start with, and it would have been difficult for him to maintain growth in the 98th percentile. However, he was an extremely fussy baby, and would scream for hours and hours on end, totally inconsolable.

At about 3wks of age, he started refusing the breast

Screaming, arching his back, kicking, scratching, refusing to attach or feed. Usually this would start about 1-2 mins into the feed, I'm assuming after let-down.

At about 5 wks of age, he weighed 200g less than he did at 2wks. Now, while I wasn't concerned about slow weight gain, weight loss was another matter entirely. I started topping-up his breastfeeds, with about 1-2oz of EBM/formula, which was heartbreaking. I seem to have very low supply (I think due to PCOS, c/s, traumatic recovery and morphine drugs) which is made worse by DS's refusal to suck for longer than a few minutes. The paed prescribed me motilium, and suggested that I express after every feed too, to try to build my supply, and to be able to comp his feeds with EBM, rather than formula. With the top-up feeds, DS's temperament changed almost overnight - he started to have some happy, awake times, slept better, and it made it clear to me that he must have been terribly hungry for a lot of the time.

5 weeks on ... the breast refusal is continuing. It hasn't really gotten worse, but seems so much worse because I am feeling emotionally battered by DS's continual rejection of me. It feels very personal. I have seen a private lactation consultant, I have been to a breastfeeding day-stay. All say that I am doing everything possible to make breastfeeding work, and that I should just continue. I have tried everything - every technique, a supplemental nursing system, switch feeding, rollover feeds. His top-up feeds are now normally somewhere between 2-4oz. Because of my low supply, I can never manage to express more than 1oz after each breastfeed, which is demoralising.

Currently, each feeding session consists of a breastfeed (both breasts), top-up through the supplemental nursing system (he will usually only accept about 1oz), feeding him the remaineder of the top-up feed in a bottle, sometimes preparing additional top-ups if he's still hungry after the first, then expressing for 10mins each side. All up, each 'feed' is taking about 1.5 hrs. We have no time to play.

We do this 8 times a day. This, combined with the breast refusal, is seriously wearing me out, I'm depressed, I hate breastfeeding, DS appears to hate breastfeeding, and now I am starting to feel anxious each time he signals that he is hungry, because I have to start the whole process all over again.

I was so disappointed that I didn't get the natural birth I had planned for. To have breastfeeding not work out, despite my best efforts, is heartbreaking.

At this point, I can only see 3 possible futures:
(1) wean completely from breast and EBM ... fully formula fed
(2) continue how we are going currently - combination breast, SNS, bottle, expressing, and continuing stress and depression
(3) ditch the breastfeeding, continue expressing and bottlefeeding

Is (3) my best option? I honestly don't think I can continue for much longer the way things are going. For many weeks, I thought if I persisted for long enough, and tried hard enough, that I would eventually be able to fully breastfeed DS, with no breast refusal and no top-ups. At the moment, this doesn't seem likely at all.

My concern with ditching the breastfeeding and pumping exclusively is that I have low supply anyway. Is this going to decrease it even further? There is no way that I can express enough for all of DS's needs, I accept that I will need to supplement, but will my milk dry up altogether if I stop breastfeeding?

I would really appreciate some advice, particuarly from people who have had to make the same decision. At what point do you accept that breastfeeding is not working, and move on?

 

[RootSnort]

I'm so sorry that you've been through so much!

I am sure you are going to get different opinions on this, as we all have our own biases.

Since I've been EPing for almost 15 months, you can guess what I'm going to say. If this is wearing on you, I would focus on pumping for a bit, and try reintroducing the breast again in a week or so, when you are better rested. I would keep at it, dc may catch on at some point, but keep things low-key, try not to get upset, and when dc gets upset, back off so there aren't negative associations with the breast. But once you're rested again, offer VERY FREQUENTLY.

I am wondering what is going on with this baby. Have we ruled out GERD? Or perhaps some Moms here have some advice about block feeding and tricks for strong letdown. What did the LC think was going on?

As far as the pump goes, there may be a more efficient and effective pump out there for you to try. I have managed to sustain my supply pretty well for a very extended period of time, sop with the right pump (or combination of pumps) it IS possible. Everyone seems to have a favorite, I think it varies based on shape and size and letdown profile and things we can't even comprehend. What pump have you been using?

I'll keep up with this thread and let us know how you are doing!

 

[bri276]

I EP'ed for 21 months because my daughter was born with a cleft palate. So while I certainly can't say I've been through what you are going through, I have been down the EP'ing road, and I really really REALLY hate to see anyone do it if they have any other choice at all. You become a slave to a piece of machinery, and if you don't exhaust every single other option possible I will guarantee you months from now, if you are hooked up to the pump exhausted and crying because you hate it so much, you WANT to know it was the ONLY way to go. I say this out of love- trust me!

Quote:

However, he was an extremely fussy baby, and would scream for hours and hours on end, totally inconsolable. At about 3wks of age, he started refusing the breast Screaming, arching his back, kicking, scratching, refusing to attach or feed. Usually this would start about 1-2 mins into the feed, I'm assuming after let-down.

first thoughts: possible reflux? has the screaming and arching stopped completely since this supplemental feeding began? does he ever have a stuffy nose or sound hoarse?

Quote:

Because of my low supply, I can never manage to express more than 1oz after each breastfeed, which is demoralising.

actually, that's normal. are you positive that you have a low supply? was your son having enough (at least 6) wet diapers each day before you began "topping off"?

here is a great link about supply that I give everyone that can help determine if your supply is truly low

http://www.kellymom.com/bf/supply/lo...ly.html#supply

Quote:

All up, each 'feed' is taking about 1.5 hrs

how long is he on each side- until he appears done, or do you time him?

many, many mothers say their newborns BF all day and all night- it's a GREAT way to bring up supply, as uncomfortable as it may be- it is more important than playing anyways.

Quote:

My concern with ditching the breastfeeding and pumping exclusively is that I have low supply anyway. Is this going to decrease it even further? There is no way that I can express enough for all of DS's needs, I accept that I will need to supplement, but will my milk dry up altogether if I stop breastfeeding?

literally no one can answer this for you. there are women who have successfully breastfed normally and had a perfect supply, and then tried to EP for the next child and their supply tanked right away.

It depends on how well you respond to the pump. It depends on what kind of pump you have (hospital grade rental is the gold standard), and it depends on strict adherence to pumping schedules. This starts out at 8-10 times per day, 20 minutes per session at least, for the first 3-4 months. After that, most are able to drop to 7 times a day, then a few months later 6 times, etc etc- but some are not able to decrease without noticing a major supply drop.

what I think is important to first establish is whether these toppings off are really necessary, or if you really do have a low supply (I'm not saying you do or don't, but I have lost complete faith in pediatricians and even, unfortunately, most LCs to know the difference).

kudos to you for trying so hard and doing so much to try to make this work- whatever happens, you will not regret giving it your best shot, I really think you can make this work. hang in there mama

 

[Peppermint Poppies]

Quote:

Originally Posted by RootSnort I am wondering what is going on with this baby. Have we ruled out GERD? Or perhaps some Moms here have some advice about block feeding and tricks for strong letdown. What did the LC think was going on?

Sorry, I should have mentioned in my original post that the paed has diagnosed DS with reflux. Not initially, as she said that a hungry baby can often mimic a reflux baby, and didn't want to medicate him unecessarily. So our first step was to commence top-up feeds (I think you call it comp feeding in the US?), which definitely reduced the screaming and all-day-crankiness. A few weeks later, when he was about 8 weeks old, we started Zantac for the reflux, as there was still a lot of crying and very little awake-and-happy time. The Zantac has definitely helped too, which is somewhat disappointing, because I really hate medicating such a young baby. He even sleeps during the day now, which was a non-event previously.

The LC thinks that DS is a lazy sucker, hence us trialling the supplemental nursing system (supply line), which I absolutely hate. To be honest, I haven't used it as much as I probably should have, because DS hates it, I end up with milk all over myself, and he only drinks small amounts from it anyway, so I end up having to give him the remained of the feed in a bottle anyway.

Quote:

Originally Posted by bri276 and if you don't exhaust every single other option possible I will guarantee you months from now, if you are hooked up to the pump exhausted and crying because you hate it so much, you WANT to know it was the ONLY way to go. I say this out of love- trust me!

ITA

I wouldn't even be considering it if I could see a light at the end of the tunnel otherwise. At the moment, I'm breastfeeding, bottlefeeding, AND expressing, so it seems like cutting one thing out of the equation (breastfeeding) might make things a little easier, but my preference would be to get rid of the expressing/bottlefeeding and just exclusively breastfeed. I just can't see how that is going to happen at the moment. Maybe I'm too close to the situation to see clearly

Quote:

Originally Posted by bri276 first thoughts: possible reflux? has the screaming and arching stopped completely since this supplemental feeding began? does he ever have a stuffy nose or sound hoarse?

Yep, it seems like reflux is a factor, however, his screaming and arching (while breastfeeding) have continued, despite the comp feeds and the reflux meds. It seems that it's just my breasts that he hates

I have tried staying calm, rescue remedy, not pushing him to continue feeding once he's refused, feeding in the bath ... the breast refusal continues.

Quote:

Originally Posted by bri276 are you positive that you have a low supply? was your son having enough (at least 6) wet diapers each day before you began "topping off"?

I guess not 100% sure. I was basing it on the fact that DS was losing weight while demand feeding. Over the last week, he's had about 5-6 wet nappies (sorry, diapers

) per day, usually 5, and because he was losing weight I assumed that he wasn't getting enough from me. The LC seemed to think this was reasonable, although I'll be really interested to hear if others agree or not. I'm so confused I don't know what to think anymore.

Quote:

Originally Posted by bri276 how long is he on each side- until he appears done, or do you time him?

At the best feeds (middle of the night), about 8-10 mins on my right breast and 4-5 on my left. At the worst feeds (early evening), total refusal to even attach. The middleish feeds, usually about 5-6 mins on my right breast, 1-2 on my left. His breast refusal seems to coincide with the times when I understand supply to be lowest, and he feeds best at times when supply is supposed to be highest (middle of the night). I don't time him .. I know he's done when he starts kicking, screaming and pulling away. You would swear I am killing the poor child, not feeding him lol.

Quote:

Originally Posted by bri276 It depends on what kind of pump you have (hospital grade rental is the gold standard), and it depends on strict adherence to pumping schedules.

I've hired a Medela Lactina (hospital grade), and am currently pumping 10mins each side (so 20 mins total), after every breastfeed (so about 6-8 times/day).

Thank you so much both of you for your time taken to respond. I would really like to make sure I've done everything possible to make breastfeeding work before pumping exclusively.

 

[letniaLynne]

Quote:

Originally Posted by Peppermint Poppies I would really appreciate some advice, particuarly from people who have had to make the same decision. At what point do you accept that breastfeeding is not working, and move on?

Ok I am trying to get your time line straight....Can you give me more info about what happened between week 3 & 5, you said the breast refusal started at week 3 and you began to supplement at week 5, did the breast refusal get worse between then? Also did you begin supplementing with the SNS first an then add the bottle? Could you tell me more about any temperament changes that coincided with the introduction of each device.

My gall was born totally naturally,not even an IV until after birth; I was loosing alot of blood and my placenta would not release so they gave me pit to help my uterus clamp down. But other than that things looked beautiful. BFing was started right after birth and all seemed well, until the crazy pain started and tons of bad advice came my way. It turned out that I had a breast infection that went undiagnosed for 8-9 mths,it even hurt to pump. Lots of tears were shed in pain

:. My DD also had a bad latch and my nipples became cut. A supposed LC, one of over 10 that came to see me told me to supplement to let my nipples rest. I did not know any better and I was crying from all the BFing pain. Well my DD became nipple confused from the first bottle, she arched, screamed, cryed, refused to latch and my supply was in the crappier because I was also told not even to pump while my breasts were healing and she was being bottle fed formula for at least 2 days. Did I mention that all this happened not even 2 days PP.

What I am trying to say is that I know where you are at. We seem to have gotten there be different roads but I totally know what it is like to try to BF, pump, supplement and then do it all again seemingly mins later. I was sooo tired and crying all the time from the emotions and heart breaking feeling of knowing I was failing at BFing no matter what I did. I went everywhere for help but no one could seem to fix our nipple confusion or my pain. Basically after about 2 mths of trying I gave up to EPing. Around 4mths PP I tried again to get her to BF but by then their was really no hope for us since she LOVED her bottle and her latch was GONE.

Am I right to say that your babe will only stay on while you have a letdown and/or when you are at your fullest and will not latch most evenings since your supply is at its lowest. I know this started because of low supply but your babe has also learned that "food comes fast" and is no longer willing to suck if the flow is too slow. That is the basics of nipple confusion. It is not the classic kind but it has the same symptoms.

looking back on my situation i had really bad advice and by the time I found semi good advice it still was not good enough for our situation and I was mentally wasted. But looking back with a clear mind and 16mths of EPing under my belt I know how horrible EPing is and I am not closed that I tried everything to get her Back to the breast so I am not at peace with my decision. I think if EPing had been easier I might have come to terms with the decision that "I did everything I could to get her to BF" long ago but since it is HORRIBLE and I would not wish this kind of life on anyone it has been hard emotionally every day. Just a thought.

I have to go right now, my 30min buzzer is up on my pump so its time to rejoin real life. Just one last thing before I go...keep going forward, set goals for yourself, ask your hubbie to wash pump parts, make you dinner, clean, diaper change when he is home. Your job is to just make milk and to feed yourself so you can make more milk

. I have a couple of ideas of things to try but I will wait for you reply in case I am off in left field with my assumptions.

OH also i saw RootSnort mention taking a break from BFing and then starting up a week from now. I think this is a very very bad idea unless you never want to start up again. Your babe is already on very slippery slope and if you take the breast away for a WHOLE week and show him other ways to get milk full time I would bet the farm that he will never BF again. If I was you I would not take that risk unless i was OK with EPing or Formula feeding full time.

HUGE HUGE HUGS!!

 

[Peppermint Poppies]

Thanks so much for your reply BakerALM

Quote:

Originally Posted by BakerALM Ok I am trying to get your time line straight....Can you give me more info about what happened between week 3 & 5, you said the breast refusal started at week 3 and you began to supplement at week 5, did the breast refusal get worse between then? Also did you begin supplementing with the SNS first an then add the bottle? Could you tell me more about any temperament changes that coincided with the introduction of each device.

The breast refusal started at around week 3. I've just had a really good think about it, and the most astonishing thing has just occurred to me ... it started on a single day, not gradually. I'd forgotten this, as the breast refusal has just become the norm atm, but I distinctly remember now that there was no breast refusal one day, and breast refusal the next. DS screamed for 12hrs continuously, by the end of the day, I was sobbing with despair. He was hungry, but too upset to feed. It got worse and worse and worse, with me trying to force him to feed (I didn't know what else to do - in retrospect it was a very bad thing to do), and him getting more and more and more upset. My mum eventually calmed both of us down, and got us feeding again. Looking back, I think that day was the beginning of his reflux.

Between weeks 3 & 5, I persevered. I went to a infant feeding drop-in clinic, where, of course, DS fed beautifully in front of the LC. They probably assumed I was a neurotic first time mother, making mountains out of molehills. I kept trying to feed. DS refused, a little bit in the mornings, lots in the afternoons. At this time, I wasn't supplementing at all. He was still gaining weight, albeit very slowly, and had plenty of wet/dirty nappies, and I figured that he was doing OK despite the breast refusal. throughout this time, however, he remained a very unhappy little boy, constantly crying all day, and refusing to be put down at all. He slept well at night (2-3 wakings only), but during the day was either crying, screaming or feeding. No in-between.

At week 5, I took DS to the paed for a check-up. I was devastated when we weighed him, and he'd lost weight. I know different scales weigh differently, but he was 200g less than he was at 3wks, and still 600g under his birthweight. That's when the paed suggested topping up his feeds with EBM, which I did, using a bottle. His temperament immediately improved ... still awake all day, and still very clingy (which is OK by me ... I just put him in the sling), but most of the screaming had stopped.

I didn't start using the SNS until he was 6.5 weeks old, after I consulted a LC. I haven't been very vigilant about persisting with this - I find it difficult to manage, like a need a third hand. I have large breasts, so positioning is tricky and I need two hands to breastfeed (1 to hold the breast, 1 to cradle DS). The tube on the SNS kept flicking outside of DS's mouth each time I tried to attach. If I managed to get it in, DS would drink about 20ml, leaving the remainder. His temperament didn't really change when we introduced the SNS. The breast refusal continued .... still bad, but I don't think really getting worse. I just got more and more worn out, and less able to cope with it, I think.

Quote:

Originally Posted by BakerALM Am I right to say that your babe will only stay on while you have a letdown and/or when you are at your fullest and will not latch most evenings since your supply is at its lowest. I know this started because of low supply but your babe has also learned that "food comes fast" and is no longer willing to suck if the flow is too slow. That is the basics of nipple confusion. It is not the classic kind but it has the same symptoms.

This is exactly it! He will only stay on while the flow is fast ... as soon as it slows down, the breast refusal starts. And this started 2 weeks before I ever introduced a bottle. This is also why the LC wants me to persist with the SNS .. so that DS will learn that continuing to suck will be rewarded with more milk.

Thanks again for everyone's suggestions and caring .... I desperately want to find a solution that means my baby is going to get breast milk, and I am not going to lose my mind in the process.

 

[melbb]

First off,

I was in a similar situation. My DD BF off and on the first 4 months, because of severe jaundice, weak suck, lazy nurser. Once I got her BFing at 3 weeks, she only BF for 2 weeks. Then she would scream at the breast. She did this for 2 weeks. It was obvious that she was going through a growth spurt, too. I was able to get her BFing again, but it wasn't smooth sailing. She was very fussy, wasn't fond of my right breast which had a weaker letdown and I could never read her signals. I had a LC suggest I block feed, and my supply tanked. That was the end. All I got for the next several months was screaming. So I understand the emotional strain and rejection you feel. I felt that, too.

I only took a "break" when it became obvious that we were not making any progress. Even night feedings became a screamfest. And Audrey was not a cuddly baby, refused to cosleep, only wanted the breast to eat and not for comfort, etc, so I had no options available for wooing her back.I think by 5 months I thought there was probably no hope, but I tried from time to time. Then I didn't try for several months and at that point, she didn't scream, but didnt' know what to do. I even tried when she was a a year old, and she screamed. Anyway, I EP'd for 16 months. It is not fun at all and I never got over the rejection.

I agree, you need to keep your babe familiar with the breast. But at the same time you need to keep the breast a happy place. And you need to be emotionally well. I would keep trying to breastfeed, but don't force it. As soon as there are signs of distress, stop. I would try to use an alternative feeding method other than a bottle. Or at the very least, use a Haberman feeder.

 

[elizabethrose]

i ep'd with my 2nd baby for a year,and while it is no picnic, it seemed to me less stressful than the emotional agony I was going thru fighting my baby to bf. I know what you mean abt the personal rejection, it hurts. I also know what you mean abt the lack of play time. I still feel to this day that I did not bond with my dd as easily as I did with my other dc bc of that pump. It still hurts to think abt it. The pump becomes your life. I don't have any advice, you've already received more wisdom and insight I could ever give you from these wonderful ladies, but just wanted to let you know, I understand a bit of what your going thru, and my thoughts are with you. Hang in there mama! You are amazing!

 

[elizabethrose]

just wanted to add, fenugreek really helped me keep my supply up as a pumper.

 

[alegna]

Personally, I would make a HUGE effort to get all bottles out of the picture for a few weeks to see if it improves things.

good luck!

-Angela

 

[RootSnort]

Quote:

Originally Posted by Peppermint Poppies A few weeks later, when he was about 8 weeks old, we started Zantac for the reflux, as there was still a lot of crying and very little awake-and-happy time. The Zantac has definitely helped too, which is somewhat disappointing, because I really hate medicating such a young baby. He even sleeps during the day now, which was a non-event previously.

Zantac/Axid/Pepcid are really pretty innocuous, as drugs go. The reason you're seeing more sleeping is probably that the baby is more comfortable now. It is unlikely (though not impossible) that the Zantac is making anyone sleepy. We gave ds Axid for some months, as he was a GERD baby, and he didn't need it anymore after about 9 months. He's always been the happiest baby anyone has ever seen, so I'm certainly a satisfied Mom.

As far as my suggestion to take a week off, I see that someone says that's a bad idea. Since I'm an EPer, I defer to her! Is there some way that you can get help with other tasks so that you don't feel quite so worn out? Or just let some housework go!

 

[bri276]

I think the reflux might be the key to all of this, and the best advice you'll get on here would be mothers of babies with reflux who had bf'ing issues, maybe start another thread to specifically focus on that? because I know there are a LOT of knowledgable reflux moms here- they'll know a lot about it

 

[letniaLynne]

Quote:

Originally Posted by RootSnort Since I'm an EPer, I defer to her! Is there some way that you can get help with other tasks so that you don't feel quite so worn out? Or just let some housework go!

Hey Me too, I am still pumping at 16mths PP.

BUT I truly have lived with and read EVERYTHING I can get my hands on regarding nipple preference so I do feel comfortable giving friendly advice regarding the topic.

Peppermint Poppies I definatly think also that the reflux may have started all of your problems along with your diagnosis of a "weak suck". You should find out if your babe does have a weak suck. You sounded a bit hesitant toward that diagnosis and it does not sound like you are doing anything to remedy it. Even if you fix the breast refusal/nipple preference you will never have a full supply if your babe cannot fully remove the milk from your breasts due to the "weak suck". It could be the reason for your "low supply". If your breasts were not properly situlated and the milk removed they would have begun to hault production.

Here is another way to supplement, it is a more on the fly sort of supplementer, requiering less set up. I have used it and it is easy to do if your baby is creating good suction at the breast. You can also adapt your sns to do this. It also works great to make the babe work for the milk and realize that milk does flow if you suck but NOT as fast as a bottle. Just take the bottle and put it on the floor so they have to suck hard to move the milk up the tube. (My LC recomended that one

) Here is the handout explaining it in detail.

Also breast compressions are a great way to induce another letdown or just get the milk flowing a bit faster. Here is a handout on how to do it. Their is a video on how to do it below.

all of these videos are GREAT, and from a very reputable doc(ask around mothering). Many directly pertain to your situation and how to increase milk, watch the baby drink/swallow, and how to supplement.

Also I agree with Alegra on removing all the bottles, this will be very hard I know. BUT you definatly have nipple confusion, your babe knows that after a short time on the breast, once it slows down he will get off, SCREAM and you will give him a bottle. Dont underestimate your babe, he is very smart!

They learn patterns FAST and this is a very consistent pattern. The only way to break the cycle is just to do it and commit no matter what. BUT first be sure to have good support and find out about the weak suck issue or non issue. That could be a huge problem for your supply if not sorted out. Also try to get the supplementing at the breast down and also some other back up methods for those times where you need to just get him fed, like cup feeding or syringe feeding.

Ahh I feel like I could say so much more since I feel for you andyour situation so deeply, it opens up my wounds.

Hugs AGAIN!
Keep your head up. remember BFing is much more long term than the pain you are in right now. You can do it! We are pulling for you.

 

[twinsarefun]

I'm so sorry that you are going through this difficult time. I successfully bf two babies and then had my twins and was in real trouble. I went through pretty much what you described. Does your LC know about pallate issues or other types of problems that can cause bf problems? I know that PCOS is one of them. My babies ended up having a high pallate which made it hard for them to properly express the milk to gain right. The LC I saw just didn't know what the LC I saw at 10 mo. did. By that time, my twins were hooked to the SNS and wouldn't come off. They are now almost 18 mo. and still stuck on it. The really good LC that I saw said that if I saw her in the beginning, we could have trained the babies to suck properly so that we could have ditched the SNS. The bad LC I saw told me to use the SNS through the whole feed. That is what got them hooked. The fact that you are bf first without it, is good. I do think though that your baby is hooked on the bottle and prefers the fast flow. It takes a different suck pattern to use the bottle and the SNS. I would try and get the baby off of the bottle. First bf your baby first without anything. Then try to use the SNS. I would do this type of feeding however many times it takes to get the baby used to the breast. It may seems like a lot in one day, but once your baby gets used to not having the bottle, hopefully the baby will not need to be fed so many times during the day. If baby gets to the point that he will just bf and use the SNS, I would then try to go down to a smaller tube of the SNS. Try and work your way to the smallest tube. The smaller the tube, the more of your milk the baby will take. Always nurse first without the tube. If baby only takes the largest or medium tube for now, then go with that. Continue to pump with only a hospital grade pump after each feed for about 10-15 minutes. Don't despair that you are only getting about 1 oz. When baby is at the breast, that is all that you are going to be able to pump anyhow. I see that you are in Australia. How about the Australian Breastfeeding Association? Have you been able to contact them? They sound great. I wish you well. I hope that you are able to get through this. Remember, only 1 oz. of bm is worth 3 million germ fighting properties (kellymom.com). That is a lot! Whatever little you give is great!

 

[RootSnort]

Weak suck can change over time as the baby grows, right?
So would there be a benefit to seeing a LC again?

 

[twinsarefun]

Weak suck can certainly change over time. It all depends upon the baby. If the baby does not have many teeth, you can even suck train your baby by finger feeding to train with the sucking. Not for getting main nutrition since that would be hard, but just to train with sucking. Put the milk in the container of the SNS and put on your finger and let baby suck. If the suck is hard, then baby probably is sucking well. If the suck is not that strong, then the suck is probably weak. Nipple confusion will certainly alter the sucking patterns. I don't know where you are at with your baby and nursing, but if we know more, maybe we can help you with what we can.

 

[ErinBird]

Can I help you trouble shoot using the SNS? I hated it for about two months (and still have days where I'd rather chuck the whole thing out the window...), but I've been using it everyday at every feeding for 8 months.

 

[Peppermint Poppies]

Thank you so much everyone for your suggestions and support. After reading all your responses, I decided not to give up BF'ing without trying everything possible first. So, I thought I would let you know where I am up to now with everthing.

Since then I have had DS's reflux meds re-evaluated, as he started going downhill again. He's now taking Zoton, a proton pump inhibitor (similar to Losec), which has made a huge difference in his temperament, and I think, a slight difference in his breast refusal. He now falls asleep at the breast (before he's full, but because he's exhausted ... more about that in a minute) instead of finishing every feed fighting, kicking and screaming. Whilst he's not feeding for any longer than he was previously, I am not as upset at the end of a feed, as it doesn't feel like he is rejecting me any more

I also went back to see the LC again ... and this time, she referred me to a speech therapist to assess DS's suck/swallow/breathing coordination. That was the best thing we could have done! I wish I had seen the speech therapist in our first week of breastfeeding, as I'm certain we could have fixed the problem then and not been in this situation now. It turns out that DS isn't coordinating his suck/swallow/breathing. This means that during let-down, he is struggling to swallow without drowing in milk and can't breath at the same time. Then, when letdown finishes and he can breathe again, he is exhausted, and won't continue feeding because he's too tired to suck harder to get the rest of the milk out. He also doesn't have a strong tongue movement in his suck, doesn't had fat pads on his cheeks to 'seal' the attachment to the breast (so air leaks out the sides) ... thus he doesn't suck strongly, no milk comes out, he is tired from trying to breathe during letdown etc. Poor little guy

It also means that my low supply is due to DS's weak suck and poor coordination, as he is not emptying the breast efficiently. It's not really low supply, I guess ... it's just my supply matching his low demand IYKWIM.

I'm also going to stay in a residential mother-baby unit for 5 days to try to get the SNS worked out. They have LC's there around the clock, and my DH can stay there too. My meals are all provided, my room cleaned ... everything is taken care of, and all I have to worry about is breastfeeding. I'm hoping it's a very positive experience ... I have heard good things from others who have been there to stay.

And, I went to see a psychologist, to talk about my depression related to breastfeeding, because I'm sure it wasn't helping my milk supply being so stressed about it all the time.

Quote:

Originally Posted by ErinBird Can I help you trouble shoot using the SNS? I hated it for about two months (and still have days where I'd rather chuck the whole thing out the window...), but I've been using it everyday at every feeding for 8 months.

That would be great! I'm using a very simple SNS which was loaned to me by my LC ... it's just a small bottle that I tuck into my cleavage. It's lid has a hole drilled into it, through which passes a very fine tube (I clean it with a 3ml syringe) that I then tape to my breast and as close to my nipple as possible. I really struggle with using it .... when I latch DS to my breast, I point my nipple towards his nose, and kinda slide the whole lot downwards into his mouth. It means that he ends up with a lovely flared bottom lip, and I can adjust his top lip. But when I do this, the SNS tube just won't go into his mouth at the same time as my nipple, and I then find myself try to poke it into his mouth, after he's attached, which doesn't work well anyway, but completely mucks up the attachment. Then I end up with milk going everywhere, which makes my breast and his face slippery, and then he can't maintain the attachment. I'd love to hear what worked for you ErinBird - I am in complete awe that you have managed to feed via SNS for so long.

I've just had a thought ... I wonder if I taped the tube underneath my breast, whether that would work any better?

So, at the moment, I'm still breastfeeding, still expressing, still comping feeds with EBM/formula .... and I'm feeling proud of myself that I've reached 3 months of breastfeeding despite all the setbacks.

 

[addis_mommy]

I just want to tell you that I think you are an amazing mama to have gone thru all this and still be pushing forward. That is one lucky baby you have.

Breastfeeding should be such a blissful experience. Who knows why it's so hard for some. I've had some trouble but nothing compared to what you've endured.

Is your pumping output up any? Do you think you'll be able to ditch the formula?

 

[Peppermint Poppies]

My pumping output seems to have stayed about the same ... pumping after nighttime/early morning feeds yields about 2oz, pumping after lunchtime/early evening feeds yields about 1oz. But I'm giving DS about 2-3oz top-up after each feeds, so unfortunately I'm still having to give him some formula. And he's still gaining weight slowly (only 20g over the last 2 weeks), so I'm hesitant to cut out the formula altogether.