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Large Areola/nipple

1900 Views 10 Replies 6 Participants Last post by  Bellejar
We have been struggling with low milk supply for a while now. Symptom of low milk supply was it took her 3 weeks to get my DD above her birth weight only after supplementing her at 2 weeks. We supplemented with formula for about 2 weeks and started the usual... pumping, domperidone, fenugreek, non-stop nursing, etc. I stopped the forumula two weeks ago and now her weight gain may be slowing down.

I was reading some of causes of low weight gain in Nursing Mother's Companion and it mentioned large nipples which is what I have. Quite frequently nursing comes with a slight pinching feel even when she is swallowing so I know she is getting milk but not with the best latch. When her latch is good, there is no pinching.

I can pump out just 1- 2 ounces of milk between feedings (combined both sides). I do have large sized flanges but maybe they aren't big enough? HOw much of the nipple and areola is suppposed to be in the tube? I am just all nipple in the tub and I thought that nursing comes from the baby pumping stimulating the area just beyond the nipple.

And only recently do I feel a let down when she nurses, as in triggered by her sucking. I used to only feel a let down between nursings.

If I have to go back to adding formula, can I supplement with goat's milk? I was adding no more than 6 ounces a day when I was supplementing though she is much older now though.

so many questions... this is so much work.
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No good advice for you mama but keep up the good work! You are doing great and your DD would thank you if she knew how to talk
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She is a 8.5 weeks and weighs 10.00.8 lbs. Her birth weight was 8.2. I haven't figured out how to read the growth charts to find out just how off she is. We have a 2 month visit next Friday for vaccines but I am SO on the fence about them that we are probably going to cancel the appointment until DH and I can find some compromise or solution but I want the Ped to evaluate her but I don't want to see him if we are going to skip vax right now as I do not want to have to explain or defend myself right now. So I really need help on just how off we are. I am seeing working with the lactation consultant at the hospital in her support group but there are so many moms there and only so much time to address this.
Hang in there, you're doing a great job! The first few months can be hard especially when you're having problems, but the hard work you put in now to solve those problems will be worth it.

I encourage you to take your baby to her doctor's appointment even if you decide not to vax right now. Your baby's health is too important to miss a doctor's appointment when you're concerned about weight gain just because you want to avoid explaining your decision not to vax.
I had a quick look at the growth charts, and your baby has certainly dropped in percentile. This by itself may not be a problem, but you really need to have your baby assessed by your ped to help you determine if there is cause for concern. Better to find out sooner rather than later.
To answer your question about supplementing, if it becomes necessary to supplement, then you should supplement first with any expressed milk you have, and if necessary, with formula. Your baby is too young for you to supplement with goats milk. Also, what you are able to pump is not indicative of your milk supply.
If you are finding it difficult to get the help you need with the LC at her support group, then consider hiring an LC for one-to-one help. An LC should also be able to tell you whether the flanges for your pump are big enough for you.
If your baby's latch is still not perfect, then it is something you need to continue to work on with the help of an LC. Since you have large nipples, it may take a little bit of time for your baby's mouth to grow big enough for her to latch on properly, but continue to work on it. You want to make sure that she has the best latch possible so that she can transfer milk effectively.

The above link has some good info on ways to increase weight gain in the breastfed baby.

Please see your ped, and let us know how things are going!
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monkeysrus, how much is she off? Can you point me to a growth chart? The one I found on WHO's website was hard for me to read. Maybe they are all like that. I think I will call the consultant and ask her about the flanges. Even so, it might be a problem until as you say, her mouth gets bigger.

how freaked out should I be?!

eta: i found a couple of sites, one on babycenter and one here , where you plug in the numbers and it give you the percentage. She is not as bad as I thought, in the 20-25% depending on which site's calculator. I was really afraid she would be in the 5%. But still, how freaked out should I be?
mom, how are the diapers?
i have large aerola (sp?) also my flange covers the entire brown area save for a little rim , my nipple dosen't touch the flange at all if it is centered

Originally Posted by nikihodges View Post
my nipple dosen't touch the flange at all if it is centered
This is what you want. Nipple should not touch the flange, ideally there is a little space. I would see if you can get her to open her mouth wider every time. This may take some work with someone from LLL or and LC. If she latches correctly every time, and hopefully you can get flanges that fit, your supply should go up and be fine. I guess you have a medela pump? You can order larger flanges online and usually your local hospital will carry the larger sizes too.
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from what you all described and from what digging I did, my flange fit is too tight. My nipple most definitely touches the walls. I am already using the 27mm and could go up to 30mm or 36. I am thinking 36 since from 27 to 30 is only 3 mm which would just give my nipple breathing room but not provide any extra space around it since that is really only 1.5 space around the nipple to give me a total diameter of 3 extra mm.

Think I should go for the 36?
i have the will make a bi did for me
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Also helped me a ton!!! Good Luck and lots of support in your direction!!!
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