Please help our anonymous guest poster with your compassion and suggestions!
Nursing mom picture via flickr christyscherrer
I can only talk about this if I’m wearing two breast pads on each side. My three-week old baby has nursed for more than a cumulative seventy-five hours so far and still has NOT regained his way back to his birth weight. WTF?! He is still about nine ounces down. C’mon kid.
My pediatrician recommended that we introduce two bottles of formula per day to help him beef up a bit. She suggested that I take a break while this bottle is going down (you know, sleeping, jet-skiing, shopping, whatever we worried moms like to do). I greatly appreciate her advice, but I want to know how to maintain and increase my breastmilk supply if I’m already dropping feedings. Help!
I have quite a bit of breastfeeding experience under my belt nursing bra already: I have nursed other floppy newborns; eleven-month olds who can also eat and drink other stuff; six-month olds with no attention span. I have done dream feeds with formula and breast milk combinations as well as pumped in dingy supply closets and on airplanes.
Even with all this experience, I’m feeling lost. Perhaps it’s the post-partum hormones or the sleep-deprivation, but I cannot figure out the rhythm of inserting these bottle feeds without experiencing massive engorgement. And if I spend the bottle feeding session, currently conducted by my superdad husband, with the pump, how do I achieve that “break” I’m supposed to be taking?
I was an exclusive pumper for my twins. What helped me turned the pumping time into me time was planning for the me time. I could pump hands free so I used that time (30 minutes) to read magazines, call friends, watch tv, surf the internet.
Hang in there!
I tried to incorporate pumping and relaxing activity like surfing the internet, watching tv, reading a book etc. I was able to pump a bit faster than my son would drink the formula, so I got a few minutes not being “milked”.
Ditto the “hands free” method. But I’ll have to say… I NEVER considered pumping “break time.” Pumping is work too. (And cleaning all the pieces are even MORE work!). Good luck!!
I’d suggest a visit to an IBCLC. If you’re needing multiple breast pads and concerned about massive engorgement, is it because you have too much milk? It sounds odd, but especially if you’ve nursed before, you might actually have an oversupply. It definitely can contribute to a baby not gaining weight. The nutritional breakdown of milk changes as the breast empties. The milk in a full breast is higher in sugar and protein, and increases in fat content as the breast empties. If a baby nurses from full breasts all the time, he or she might not be getting enough fat to gain weight.
There are different ways to manage the issue, but I’d seek some one-on-one help! I’m not dissing formula if that’s what you WANT to do, but it sounds like your concern is managing breastfeeding AND meeting baby’s nutritional needs. I’m hopeful that there is a way to do both with the right guidance.
Sending you many positive thoughts! I had a similar situation with both of my children. The problem for us was that my supply was late to start. To get caught up we used a combination of pumping & using formula. Rather that use a bottle, we used Medela’s Supplemental Nursing System (SNS). This helped my babies to get additional calories while providing stimulation to help my milk come in fully. It was convenient and easy! Definitely rest when you can and perhaps incorporate a bottle for night feedings so you can get extra sleep.
Best of Luck and Congratulations to you & your new little love!
i had to do this very thing. after my son regained his weight we moved to breastfeeding only. at seven months old i am still breastfeeding and loving it.
what i did …
for two feedings a day, i (or my husband) gave him organic formula and i pumped to keep my supply up. once i had enough pumped, i bottle fed him my own breast milk instead of formula (and continued to pump when he got the bottle). i also bought “organic mothers milk tea” i drank it twice a day (morning and night). in a very short time, his weight increased. my pediatrician was super happy and thought the idea of supplementing with my own breast milk was a great idea. if you are not producing enough, then stick to the formula and keep pumping in between breast feeding, you’ll get there. try to stay positive and know that you are lovingly doing the very best for your baby.
best of luck.
I am with Tonya on this one, since I have an oversupply problem. If you have engorgement issues, have you tried block nursing? It sucks to start with, but it absolutely works to reign the girls in.
As for pumping, I find that I can pump faster than the kid can eat, so I do get some me time. However, now I mostly pump at work. I keep my blackberry in one hand so I can stay involved with work (helps me relax to feel like I’m not slacking) and it also helps me not clock and/or bottle watch. Next thing you know, my time is done, and I get to wash up my pump parts and get back to my desk.
to add to the, when to rest issue. i use a double pump and set a timer for 10 minutes (therefore, insuring and am getting fore and hind milk). after 10 minutes i would excuse myself to the bedroom for a nap, or take a hot shower … whatever i needed to do for a little down time.
Heres what I did with number four. Nurse non-stop, until you feel that the baby is restless, or hungry, then pull out the bottle. That way you can keep and increase your supply, but still push the fluid and nourishment that the baby needs. After a few weeks of doing this, we were able to reduce and then eliminate formula. (not that formula is bad!)
While your husband is feeding the bottle to your little baby, take a shower or bath. That’ll help relieve a little pressure, and give you a break.
It sounds like your baby just needs a little leg up, and I wouldn’t worry about your supply too much.
Tonya makes lots of sense. Perhaps you can try pumping some before you nurse so he gets the higher fat content milk before he fills up on the high sugar and protein. Over engorgement can also make the baby feel like he’s drowning which will make him not feed well. If you do turn to a bottle stick with wide neck bottles that have the wider, thicker and firmir nipples like an Avent or a Born Free. These bottles help avoid nipple confusion so your baby is less likely to refuse your breast after a bottle feeding. Best Wishes in figuring out what the problem is.
I agree it sounds like an oversupply issue (something I dealt with and is likely what contributed to my skinny firstborn). I’d try only nursing from one side at a time and not pumping beyond what the baby can eat (or just releasing a little to relieve engorgement). Your baby needs the fatty hindmilk that comes later in the nursing session.
I would go to a lactation consultant. I agree with Tonya about engorgement issues and breast milk composition, but the baby could also not be transferring milk properly from the breast. This occurred with one of my friends and she had to breastfeed, pump, and then re-feed with a bottle for 7 weeks until finally her little guy got it. The point is, a good lactation consultant can help you pinpoint the exact issue and develop a plan of attack. Don’t hesitate to contact La Leche League, request a recommendation from your OB/midwife/pediatrician, or reach out to Lamaze class (often they can point you in the right direction).
One last thought –
Have you tried pumping for a minute or two before you feed? That might possible help to get to the calorie dense hind milk … Just a thought.
Yes what Mandy just said is what I meant – pumping for just a little to help your little one get to the hind milk faster and to ease the pressure that over engorement causes so the milk isn’t gushing into his mouth too fast.
Just wanted to echo the recommendation to make an appointment with a lactation consultant (most hospitals have them on staff and you can typically get in in a day or two). We can all offer advice but there is nothing like a professional who can really help you figure out what’s going on and provide ongoing support as you work through it. It’s a lot easier to “relax” when you know you’ve getting the best advice and support possible instead of having to try to figure it all out yourself.
You sound like an awesome mom. Congratulations on your baby, and know there are more of us who have been where you are than you’d think. 🙂
Wow – Just wanted to add a quick voice of support. My first didn’t nurse until he was almost 3 months old (GACK!) so yeah….the pumping thing…I know it too well. All of the advice I could give has been mentioned above (read while you pump, get your butt to see a lactation consultant, etc.)….but really, you gotta trust your gut on this one. Despite the weight gain/loss of the baby, do a gut check: do you think there’s a problem? Or do you think fundamentally that he’s fine? I’m not saying to ignore your doctors, but a good doctor should be listening to you, also. And if you think the kiddo’s OK…there’s a decent chance that he is. In my experience, some doctors tended to stress me out by freaking out over weight charts, while the lactation consultants (and one veeeeerrrry old, I’ve seen it all kinda doctor) were all heavily in the “the kid is fine” camp. Not that I did much differently (still pumping, pumping and more pumping)….but it took some of the pressure off. Which is always good.
Hang in there!!!!
I agree to see a lactation professional. I had a similar issue and it was due to oversupply. My lacatation consultant told me to pump a little before breastfeeind to relieve some pressure and the huge gushes of milk my poor baby was getting. (he was practically choking it would come out so fast.) This really helped a lot and he seemed to feed much better from that point onward. I also felt so much better and not too long after that my milk supply ‘self-regulated’ and I no longer needed to do this. 13 months later and I am still breastfeeding a few times a day.
Here’s what this lactation counselor says (CLC, not IBCLC though):
If baby is spending adequate time on the breast but is not gaining weight or having enough wet and dirty diapers, there’s got to be a milk transfer issue, especially if you’re engorged. It means the milk is there, he’s just not properly getting it out. And the more engorged you get, the harder it will be for him to latch on and get that good milk out of there. I highly recommend you consult a lactation counselor about this. She will look at the latch, she’ll look at his tongue, she’ll look at position. All of these things are important yet it can often be fixed with a small correction.
I don’t know if you’re necessarily overproducing as some of your readers suggested. Is he sputtering when he’s at the breast? Does he refuse the breast in general? Does he have gas? Are his BMs green and foamy? Those are signs of oversupply (or what some people call foremilk/hindmilk imbalance).
Are you pumping to relieve the engorgement? If you are, are you pumping for a few minutes or are you pumping for 20 minutes? If you’re pumping to relieve engorgement, you only want to pump for a few minutes or enough so that your breast softens. However, if you are pumping to provide milk for him, you should pump as much as you need. I doubt your pediatrician told you this but if you are supplementing, you should be pumping for every session he’s not getting at the breast.
I would like to hear more about the sequence of events too. When did you start getting engorged?
Chances are it’s both things but I think you may have oversupply due to his inadequate transfer of milk. The first thing to do is fix the transfer of milk while pumping to keep up your supply (and giving him that milk instead of formula). Engorgement will can very quickly lead to a lower supply of milk because your body thinks you aren’t using it.
I’m not sure why your pediatrician thinks giving your son formula is better/fattier for him than breastmilk. If he’s not latching on, pump and then give him the breastmilk in a bottle, not formula. That is (almost) always the first and best choice for fattening up a baby and her recommendation of offering formula is a sign that your pediatrician doesn’t know too much about breastfeeding.
Just read the excellent comment by Danielle, above. I was going to say a lot of what she said. (If your pediatrician is very pro-breastfeeding, they probably wouldn’t recommend what they did.)
I’m not a LC, but I’ve learned a ton with baby #1 who had latching problems, and I then had low supply (pumped 8x/day for a month…unpleasant but worth it), and every other problem in the book; and baby #2, for whom I’m currently addressing oversupply-related issues.
The absolute best thing you can do is meet with a lactation consultant. Our pediatrician referred us to a great one, who came to our home. It was worth every single penny. After doing so, with baby #1 I was able to nurse for as long as I hoped (>1 yr). With baby #2, we’re getting things worked out, and my LC responds to my worried e-mails and text messages quickly, and calms me down.
Sending good thoughts your way! You can do it!!
I think that Danielle’s advice is excellent. A very close friend of mine just had a baby in August and was having this exact problem. She would nurse the baby and then after each daytime feed, pump until she got at least 2 ounces and then give the baby the breast milk bottle. Her little guy gained 8 oz in 3 days doing this. She also sought out the help of a lactation consultant and it turns out her little guy was having latch issues.
Best of luck to you!
With my firstborn, I had a hard time with milk supply so I would nurse and then supplement after nursing with organic formula. For whatever reason, through lots of tears, heartaches and feelings of failure, I just wasn’t making enough milk and he wasn’t gaining enough to make my doctor happy. With my second I found hand pumping while watching a movie to be preferable to my Medela electric. One thing I was told by my doctor is that babies don’t digest formula as easily so they stay full longer. Really not sure if it’s true or just what I observed, but if we gave our baby a bottle of formula after nursing he slept longer at night. Good luck.
I had issues with my supply from the beginning. My baby had a hard time gaining weight and is still small, though happy and content. Pump when you can, feed when you can, bottle when you have to. My husband and pedi said the best thing I could do for him would be to give up the guilt. Formula fed babies can still be president!
I second, third, whatever – all the comments about possible oversupply and block feeding, even expressing and ounce or two before putting him on the boob so he gets more of the hindmilk. My daughter never had a problem with weight gain, but had major gas/tummy problems due to my oversupply. At one point I was going through 5 or more breast pads PER BOOB a day. I started block feeding and if it was getting really painful I’d just squeeze out a tad in the shower instead of emptying. It evened itself out.
If your supply does get low, you can always take fenugreek or drink Mother’s Milk tea to help, but you should be ok. Whenever I did/do pump, I watched tv/got on the internet/read a magazine so I at least felt like I was getting something else done.
Definitely consult a lactation consultant to see if there are any latch issues too. And if after all that you need to supplement with formula for a little while, sobeit. I think in your situation anything all these ladies suggested should fix the problem, but at the end of the day your son’s health is what’s important no matter what you need to do to achieve it! Good luck mama 🙂
I had the same problem! My daughter took around a month to get up to her birth weight and beyond. Starting at a week or so of age, we supplemented with 3 bottles of formula a day, spaced out pretty evenly over 24 hours. I pumped at least two of those times to work on getting my supply up. I also tried really hard to eat and drink enough. Once she got up to weight, we cut back on supplementing, but we kept doing 1 bottle of formula per day right before we wanted to go to bed because then we got a long stretch of sleep!
I remember it being SO hard and worrying, so I feel your pain! Keep at it, it should get better! Good luck!
everyone else has offered great advice so i just want to let you know how great you are doing!! sometimes new moms dont hear that enough, but you are giving up so much to be able to maintain milk supply and do what is best for your baby.
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Like Jen F., no new advice here, but I am so impressed with your perseverance and your commitment to do what’s best for your baby. Best of luck getting the feeding issues resolved, and I hope you get that much-deserved rest!
I second Kesa’s comment… I had a similar experience with my son, and in retrospect, the SNS would have been the better solution (using pumped milk rather than formula). I don’t think my son was getting enough hindmilk – as he was sleepy all the time, and would fall asleep after getting the sugar-rich foremilk, he never got to the good stuff.
GET THEE TO AN LC ASAP! Or at the very least, to a La Leche meeting to commiserate!
We had to supplement for a few days with donor breastmilk. Our hospital has a milk bank and if I’d needed it after we’d gone home, I could have gone back to get more. Might be worth checking on! I would not have been ok supplementing with formula but the donor milk was a great option.
You need to see a lactation consultant, end of story. There are so many things that could be going awry here, and since this is not your first time breast feeding then you know what normal breast feeding looks like.
Pediatricians do NOT get ANY breast feeding lessons in their schooling. most of what they know if personal experience or what they heard along the line – unless they took personal time to seek out lactation consultant training. Many of them mean well, but they end up giving crappy ‘advice’.
I’m pumping right now! lol
I know this is late, but just in case any other struggling mom’s find this…I went through a very similar ordeal. Had trouble with the latch, baby down almost a pound at hospital discharge, went to a lactation consultant, breastfeed like crazy, and he still had a hard time gaining the weight. It took a bit over 2 weeks for him to get to birth weight.
1. Definitely see a lactation consultant. Some things that helped from that were power pumping to increase my supply (Pump for 10 min, rest for ten min…repeat for an hour…do this for 3 days)
2. Supplement! I used Yogi mother’s milk or w/e it’s called at first then switched to “Motherlove More Milk Plus” within 24 hours of starting the Motherlove product my boobs LEAKED for the first time.
3. I read a lot about the issue! This is a GREAT website
http://www.lowmilksupply.org/