Breastfeeding your newborn questions? Check in? 2/7

[mmheartspb]

Tell us how old your baby is? 1 month

How is nursing going? Great! She gained 1.5 lbs from her birth weight

What's something you struggle with that maybe we could help with? Just struggling with thrush right now. Just want it gone already. I know it isn't my fault but I wish I could have prevented it.

Is there anything you can tell another new mom that you think would really help her out? Beat compressions. Do them!

What do you wish someone would have told you before you started breastfeeding? That thrush happens.

[ellabee]

Feb 7, 2015 22:10:40 GMT -5 casey said:

boxerrrmama85, I had a similar schedule with my LO, although I was only away twice a week until about 6m. For the stash: pick a time of day that works for you, and pump at same time every day. Morning is good for supply, but I was more relaxed in evening when DH was home to help. Don't pay attention to what you get. It might only be 1/2oz or oz at a time. That's fine. You'll get more when you are pumoing to replace rather than pumoing in addition. Our schedule: on demand overnight, nurse at 6am wakeup, nurse at 6:50am out the door, pump 9, pump 12, pump 4 [oops - meant 3], nurse 5:30 in the door, nurse on demand overnight. You'll need to pump 20 minutes at least every 3 hours when apart. Be firm about your time -- it's easier to do that than be lax and then try to get the time back. If pumping is going well, you can lighten up later. Don't skip feeds once back to work no matter how tempting.

 boxerrrmama85, This was exactly my schedule too. Nurse right before work and right when I got home and pumping at 9 12 and 4 (give or take 1/2 hr depending on meetings). I maintained this 3x pumping schedule until DD was 10 months, although as she got older it was less of a concern to nurse immediately before/after work.

[Deleted]

mapetitefamille
For your overactive let down high supply xnd shallow latch are you trying other positions when nursing? Gravity speeds the flow so anytime you can get baby's head higher than breast that will slow the flow. Laid back nursing helps because baby is above the breast and that slows the flow and gravity helps to pull baby into a deeper latch.

Some find they need to pump or hand express til let down and let the highest fast flow go into a towel or the pump. Only once the flow slows a bit do they put baby to the breast also if you have really high supply it's usually best to stick to one side per feeds and block feeding is the next step after that to lower supply to more closely match baby's needs.

[Deleted]

ladybug15
With really fast weight gain plus baby eating short feed times at the breast with some green poopies it's very likely that you have oversupply with excess foremilk.
This happens to a lot of moms when they start out nursing on both sides per feeding their body thinks they have twins. One sided nursing or block feeding may be necessary if the oversupply continues esp if there are other issues like lots of spit up fussy gassy green frothey stools and baby isn't very happy.

At certain ages and stages and even certain times of day it's normal to have more foremilk and a green poop or two. But if it starts to bother baby we can talk about options to help get supply more in line with baby's actual needs.

[Deleted]

Feb 8, 2015 11:38:50 GMT -5 jmcbick said:

I know there's no hard and fast rule on this, but how soon is too soon to start pumping? LO is 10 days old. And what's the best way to go about it? I already feel like I have A LOT of milk, to the point where it takes LO a few tries to latch because my breasts are so full, so I don't want to cause an oversupply situation.

I just want to make sure this one is covered well

If you are very full and engorged in the first few weeks pump just to get a teeny bit of relief only.
If you pump too long you signal your body that you really do need all that extra milk over top of what baby is eating and you'll continue to struggle with engirgement and need to pump and it becomes a vicious cycle.

Right now you want baby's nursing pattern to set he pace of where your supply should be. Not too much or too little. So in the initial weeks pumping might cause oversupply which comes worth stomach issues for baby and link to plugged ducts and mastitis for mom. So pump or hand express minimally during this time period.

Sometime after three week growth spurt settles down you can try pumping once a day if you want a stash. And begin to offer bottle to baby and pump again at that time of day.

[Deleted]

Feb 8, 2015 11:12:36 GMT -5 hollydfromtn said:

Tell us how old your baby is?
DS is 10 days old

How is nursing going?
Nursing is going, that's about it. He's gaining weight just fine and my supply is great. I'm just waiting on the "I enjoy breastfeeding phase" to kick in.

What's something you struggle with that maybe we could help with?
I have very shallow nipples, which is causing DS to have a very shallow latch and lose interest quickly. We were given a shield at the hospital but not really told how to use it, for how long, or how to start weaning from it. I've been trying to take it off during every couple of feedings once my nipples are a little more erect. DS will latch and then slide back really shallow. It's excruciating and makes me want to use the shield forever, but I know that's not practical and will lead to me giving up too early.

Is there anything you can tell another new mom that you think would really help her out?
Be sure to work with your LOs latch before you fall into the routine of using a shield. I think I might have been more frustrated in the beginning if I had done this but the. I wouldn't be dealing with this "security blanket" of a shield right now

What do you wish someone would have told you before you started breastfeeding?
That it doesn't always come naturally. Everyone I had talked to about it had these amazing experiences where their LOs had great latches from day 1. I now call BS on that. Breastfeeding is a lot harder than I expected.

Check out options to help with shallow flat or inverted nipples like supple cups tonhelpbdrae them out more. Get help in person for latch issues. Try laid back nursing so gravity pulls baby into a deeper latch

A nipple shield never fixes a poor latch. It provides a layer if protection if baby has a poor latch that is giving you damaged nips. And it gives baby something to latch onto if you have flat or inverted nips. But if baby has a bad lat h he shield tends to interfere with them getting enough milk

That's why nipple shields should be used under he supervision of an ibclc.
And if anyone tries to help minimally and then hands you a shield without a lot more help, weighted feed to endure baby is getting enough milk with he shield and follow up appts then you need to go see someone else. The best most experienced LCs rarely suggest nipple shields at all and then only in conjunction with other things to improve latch and get nips to stand up if inverted or flat was the issue.

[Deleted]

Feb 8, 2015 8:06:29 GMT -5 FiliaRitae said:

Tell us how old your baby is? 10 days
How is nursing going? It's been a struggle. LO lost a lot of weight, so I've had to supplement a bit, but the formula seems to really upset his tummy. I had a terrible latch at first, and too much underqualified help. He's still not gaining weight at the rate they want, so they're pushing me to supplement even though my gut says that is the wrong call most of the time (there have been a few times where it seemed necessary to me).
What's something you struggle with that maybe we could help with? If it's a very long and involved problem it's ok to make a separate post. He falls asleep but continues to comfort suck... I think. I can't always tell. But if I break him off, he often wants to feed again ten minutes later.
Is there anything you can tell another new mom that you think would really help her out? Be careful who helps you. Just because they think they can doesn't mean they actually know what they're doing. And fix LO's lips. I reasoned that if it didn't hurt, it didn't matter that his lips weren't properly flared. And then he'd feed for five hours straight because he was so inefficient. Just because it doesn't hurt doesn't mean it's a good latch.
What do you wish someone would have told you before you started breastfeeding? It's really hard, and that's okay. You will need more hands than you have, but eventually you'll learn to carefully juggle and find a free hand. A good nursing pillow is gold.

How's it going?
If you give any formula at all you should be pumping to try to collect that amount of breastmilk. Then once you can do that then baby doesn't have to have the formula that seems to be bothering him.

Weight gain should be about 1/2-1 oz per day and counts from the lowest weight which usually occurred the day your milk came in. You might not have that weight if you were seen at day three ish of life but milk hadn't come in yet.

So keep in mind hat saybbaby lost six oz from birthweight it might take 6-12 days to regain and get above birth weight. Keeping that in mind can help you make sure there aren't any unrealistic expectations from your dr. It's common for a breastfed baby to take up to three weeks to regain birthweight.

You should of course see baby's weight gain going up by day ten or whatever day we are on now. Of. Purse when you are looking at 1/2 oz a day on the low end a good poop or a good feed before a weight in can vary the scale enough to make it looks bad or good for weight gain.

So part of what you look for is number of wet and poopy diapers a day. Your goal is a minimum of 6-8 diaper changes a day but if nursing is going well there might be 10-12. With a lot of poop ones in that count.

At 7-10 days a growth spurt starts where they need to eat all the time. Go with it. Nurse as much as you can. As much as baby wants. Expect they'll be a the breast nonstop for 3-5 days. This works to raise your supply to meet baby's needs.

[Deleted]

kcrosem
Some people think that any laying down nursing is dangerous because newborns are so small. So that might be part of it.
And sometimes it's harder to get newborns to latch side lying since they don't have neck support and they might tick their chin down into their chest and not open wide.
But it was a lifesaver for me!

[FiliaRitae]

Feb 10, 2015 11:21:10 GMT -5 @amyg said:

Feb 8, 2015 8:06:29 GMT -5 FiliaRitae said:

Tell us how old your baby is? 10 days
How is nursing going? It's been a struggle. LO lost a lot of weight, so I've had to supplement a bit, but the formula seems to really upset his tummy. I had a terrible latch at first, and too much underqualified help. He's still not gaining weight at the rate they want, so they're pushing me to supplement even though my gut says that is the wrong call most of the time (there have been a few times where it seemed necessary to me).
What's something you struggle with that maybe we could help with? If it's a very long and involved problem it's ok to make a separate post. He falls asleep but continues to comfort suck... I think. I can't always tell. But if I break him off, he often wants to feed again ten minutes later.
Is there anything you can tell another new mom that you think would really help her out? Be careful who helps you. Just because they think they can doesn't mean they actually know what they're doing. And fix LO's lips. I reasoned that if it didn't hurt, it didn't matter that his lips weren't properly flared. And then he'd feed for five hours straight because he was so inefficient. Just because it doesn't hurt doesn't mean it's a good latch.
What do you wish someone would have told you before you started breastfeeding? It's really hard, and that's okay. You will need more hands than you have, but eventually you'll learn to carefully juggle and find a free hand. A good nursing pillow is gold.

How's it going?
If you give any formula at all you should be pumping to try to collect that amount of breastmilk. Then once you can do that then baby doesn't have to have the formula that seems to be bothering him.

Weight gain should be about 1/2-1 oz per day and counts from the lowest weight which usually occurred the day your milk came in. You might not have that weight if you were seen at day three ish of life but milk hadn't come in yet.

So keep in mind hat saybbaby lost six oz from birthweight it might take 6-12 days to regain and get above birth weight. Keeping that in mind can help you make sure there aren't any unrealistic expectations from your dr. It's common for a breastfed baby to take up to three weeks to regain birthweight.

You should of course see baby's weight gain going up by day ten or whatever day we are on now. Of. Purse when you are looking at 1/2 oz a day on the low end a good poop or a good feed before a weight in can vary the scale enough to make it looks bad or good for weight gain.

So part of what you look for is number of wet and poopy diapers a day. Your goal is a minimum of 6-8 diaper changes a day but if nursing is going well there might be 10-12. With a lot of poop ones in that count.

At 7-10 days a growth spurt starts where they need to eat all the time. Go with it. Nurse as much as you can. As much as baby wants. Expect they'll be a the breast nonstop for 3-5 days. This works to raise your supply to meet baby's needs.

It's not going wonderfully. He was nursing constantly over the weekend and I expected to see a gain at his appointment on Monday, but he was actually down again. He was born at 8lbs10oz, dropped to just below the 10% loss mark (I forget the exact number), got back to around 8 when we supplemented the first time, and was at 7 lbs 14oz yesterday. He went Monday through Thursday without pooping at all, spent the Friday and Saturday pooping about 4x a day, but always a chocolate brown, and is back to not pooping. So by all markers, he is not getting enough when I'm breastfeeding alone. He's having plenty of wet diapers, and he's not longer showing signs of dehydration on that front, but it's still not really enough.

I pump when I can, but I'm also suffering a severe sleep deficit as it is so I just can't pump as much as I should be right now (among other things, a certain amount of sleep deprivation really, really triggers my anxiety and depression, and then I'm not good to anyone). When I do pump, I'm generally getting about an ounce and a half between the two breasts, and that's generally soon after a feeding. I've been asked to supplement with formula until his Wednesday appointment, at which point they may "allow" me to go back to supplementing with breast milk, at least when I have it. We've switched formulas, and that seems to be helping, but I still hate how it affects his digestive tract.

As far as I can tell and have been told, my latch is good. It started out bad, but between reading and having some one-on-one with people who actually knew what they were doing, it has improved. The fact that the only pain I experience is for a few seconds after he latches on supports this.

I do have some postural concerns, and am wondering how much that is hindering him. I don't have a great setup, so I often end up excessively reclined against pillows in bed, and his chin is often closer to his chest than I would like. I'm making a real effort to ensure now that he is positioned properly and that I am as well supported as possible, but my back is still not happy with me. On our priority list is chair shopping, so I can get a better setup, but in the meantime I'm making do as best as I can.

I'm having a public health nurse out today to set me up with a supplementary feeding system so I can at least give him the supplement at breast instead of with bottle. That might also allow me to see what's going on with his suckling--is he actually eating effectively, or not? He does seem to fall asleep and stop productive suckling fairly frequently, which I suspect is part of the problem. I do my best to wake him, but it's sometimes near impossible... until he asks for food twenty minutes later, anyway!

I hate this--not the nursing, but that the nursing isn't working. I hate that I'm not enough for him and I don't know quite what I'm doing wrong or how to fix it. But I am nothing if not stubborn, and fully intend to do whatever I can to make it work. It's difficult sometimes to wade through in person advice and figure out if it's good or bad--I've had some bad advice from people I trusted to be right, and it caused issues. But at this point I just want a healthy kid.

[sgio7485]

Tell us how old your baby is? 3 weeks today

How is nursing going? Pretty good. Dr in hospital said he had a tongue tie, my pediatrician says no, overall he has a decent latch, gained 1lb from hospital release at 5 days to appt at 2 weeks and has plenty of wet and dirty diapers. My nipples no longer hurt, but my right side seems to have a very fast letdown that causes him to choke some, so we are working on different angles and positions...

What's something you struggle with that maybe we could help with? I'm thinking about pumping once a day once we get through this week (definitely a growth spurt right now), but the pump totally intimidates me. I'm trying to learn as much as I can here!

Is there anything you can tell another new mom that you think would really help her out? Take advantage of the nurses and LCs in the hospital!!

What do you wish someone would have told you before you started breastfeeding? That it isn't always as scary as some people make it seem! I was so nervous at first.

[things]

@amyg - I messaged you on LS, but thought I'd try reaching you here.

LO is not in the newborn stage anymore. She will be 11 weeks on Thursday. My question is regarding Domperidone. I should be receiving it any day now. I used it with my fourth baby when I was pumping and trying to establish a supply while working through tongue/lip tie issues. I was taking other supplements, too. I definitely saw a huge increase, which could have been from the assortment of galactagogues I was taking.

So, LO only nurses from my left. My right side is out of commission. I don't have a full supply on my left side. I supplement to make up the difference of what she's not getting from my right. She gains steadily on 25-26 oz a day, and my left produces about 16 oz based on weighted feeds. I supplement the rest. I want to try to reduce how much I supplement. Can the Dom help increase my supply by just nursing more frequently and reducing how much I supplement, or do I need to nurse + pump to see a noticeable difference? Pumping my left isn't a challenge, but I'm curious if just nursing more often and decreasing supplement amount will help?

Her first bottle is usually around 11am, sometimes 12pm. She gets 3-3.5 oz. They're spaced about 4 hours apart and she nurses in between bottle feedings. So 11am, 3pm, sometimes 7:00pm (I've been skipping this lately), and the last between 10:30-11pm. If I only do three bottles a day the first two are usually 3.5 oz and last 3 oz. A lot of times she sleeps through the third bottle feeding time, so she skips that one. Could I keep this routine but reduce the amount to 2-2.5 oz allowing her to take more from me, thus working to increase my supply?

[boxerrrmama85]

This thread has been massively helpful to me and I really appreciate all the support. Part of me feels bad for asking so many questions and not being able to provide help back, but know that I am with all you sleepless ladies and am sending good thoughts your way.

I am really struggling with seasonal allergies today (we live in TX and with good weather comes budding trees and grass). I have tried gargling
with salt water and have been inhaling cough drops. I am so tempted to take a half dose of loratadine but wanted any input/feedback with taking OTC Allergy meds. I am so concerned with messing with my supply this early into BFing but am also pretty miserable with coughing and nasal congestion.
Thanks in advance!

[kcrosem]

Thank you ladies!! I am doing ok on day 5. My doula suggested a private lactation company as through the hospital it was going to be next week at the earliest and now Friday so I have reached out . They do home visits for newborns . We are supplementing once per day at the rec of his dr to get his weight up, but now that I have milk, he is happier.

My advice is do what works. In desperation we are supplementing a bit, I am going to start pumping, have used a nipple shield and a pacifier. I think the key is to know the challenges that these things can bring and make a decision that works knowing it may make things harder later.

My DH is struggling with not helping to feed DS because he did with ds1 because of his reflux issues so I may get going on pumping for that as well as I think it will help my confidence to see how much I am producing. Hopefully.

[firelizard8367]

Feb 10, 2015 13:55:38 GMT -5 boxerrrmama85 said:

This thread has been massively helpful to me and I really appreciate all the support. Part of me feels bad for asking so many questions and not being able to provide help back, but know that I am with all you sleepless ladies and am sending good thoughts your way.

I am really struggling with seasonal allergies today (we live in TX and with good weather comes budding trees and grass). I have tried gargling
with salt water and have been inhaling cough drops. I am so tempted to take a half dose of loratadine but wanted any input/feedback with taking OTC Allergy meds. I am so concerned with messing with my supply this early into BFing but am also pretty miserable with coughing and nasal congestion.
Thanks in advance!

While I can't substitute your dr's advice here (who you ultimately should ask), I will tell you what I'm doing. I am on a full dose (10mg/day) of loratadine, and have been my whole pregnancy too. I am also on a whole bunch of steroids to control my asthma, which is caused by my allergies. My allergist said I should continue taking whatever I did during pregnancy because 1)I gotta breathe! And 2)my body and his will be used to that so it won't affect my breastmilk.

[melody330]

Feb 10, 2015 13:55:38 GMT -5 boxerrrmama85 said:

This thread has been massively helpful to me and I really appreciate all the support. Part of me feels bad for asking so many questions and not being able to provide help back, but know that I am with all you sleepless ladies and am sending good thoughts your way.

I am really struggling with seasonal allergies today (we live in TX and with good weather comes budding trees and grass). I have tried gargling
with salt water and have been inhaling cough drops. I am so tempted to take a half dose of loratadine but wanted any input/feedback with taking OTC Allergy meds. I am so concerned with messing with my supply this early into BFing but am also pretty miserable with coughing and nasal congestion.
Thanks in advance!

Don't worry - soon enough you will have some advice to dish out! It happens quicker than you think!

[boxerrrmama85]

firelizard8367 -- this is definitely helpful info. I called the nurse line and they said loratadine was safe but it could effect my supply. In the past I have taken loratadine with much success but now I am so concerned about LO especially since I think she is going through a growth spurt-- but like you said, I gotta breathe!!!

[casey]

Feb 10, 2015 19:20:29 GMT -5 boxerrrmama85 said:

firelizard8367 -- this is definitely helpful info. I called the nurse line and they said loratadine was safe but it could effect my supply. In the past I have taken loratadine with much success but now I am so concerned about LO especially since I think she is going through a growth spurt-- but like you said, I gotta breathe!!!

boxerrrmama85, It's a common misperception, but Claritin, Zyrtec, and Benedryl are safe to take and they do NOT lower supply.  Decongestants can lower/dry up supply.  Take just the plain one -- not the one that has "D" in the name.  You gots to breathe.

kellymom.com/bf/can-i-breastfeed/meds/cold-remedy/

[hollydfromtn]

Ok let's talk poop. I've never been so concerned over the color and consistency of someone's poop in my entire life. We had a few days of the "yellow-seedy" stuff that I was expecting to see but the past couple we've been seeing more and more green that is super runny. Any advice? I'm really hoping it's not a dairy intolerance.

[Deleted]

hollydfromtn,
How old is baby? Looks pretty young from your ticker. It is unlikely to be milk intolerance. It is more likely to be oversupply and a bit of foremilk/hindmilk imbalance. Consider making sure baby gets all they want from side 1, burp and if it wasn't a long feeding on side 1 reoffer side 1 with breast compressions and massage to help get more hindmilk. then burp and offer side 2. or they might not even want side 2 if they get more hindmilk. Of course if you are drinking a ton of milk or ice cream you could cut back a bit and see if that helps any.

[Deleted]

Feb 10, 2015 19:45:18 GMT -5 casey said:

Feb 10, 2015 19:20:29 GMT -5 boxerrrmama85 said:

firelizard8367 -- this is definitely helpful info. I called the nurse line and they said loratadine was safe but it could effect my supply. In the past I have taken loratadine with much success but now I am so concerned about LO especially since I think she is going through a growth spurt-- but like you said, I gotta breathe!!!

boxerrrmama85, It's a common misperception, but Claritin, Zyrtec, and Benedryl are safe to take and they do NOT lower supply.  Decongestants can lower/dry up supply.  Take just the plain one -- not the one that has "D" in the name.  You gots to breathe.

kellymom.com/bf/can-i-breastfeed/meds/cold-remedy/

Yes what Casey says is right on! Claritin is considered the safest antihistamine for allergies, because it's commonly given to young babies.

[Deleted]

Feb 10, 2015 14:20:14 GMT -5 kcrosem said:

Thank you ladies!! I am doing ok on day 5. My doula suggested a private lactation company as through the hospital it was going to be next week at the earliest and now Friday so I have reached out . They do home visits for newborns . We are supplementing once per day at the rec of his dr to get his weight up, but now that I have milk, he is happier.

My advice is do what works. In desperation we are supplementing a bit, I am going to start pumping, have used a nipple shield and a pacifier. I think the key is to know the challenges that these things can bring and make a decision that works knowing it may make things harder later.

My DH is struggling with not helping to feed DS because he did with ds1 because of his reflux issues so I may get going on pumping for that as well as I think it will help my confidence to see how much I am producing. Hopefully.

Just involve DH as much as you possibly can with everything else.  Feeding isn't the only way to bond and care for baby and he knows that.  Remember what you can pump does NOT tell you how much milk you are producing.  The amount you can pump tells you how much you can pump.... If you are supplementing, a visit with an LC might be a really good idea so you know how much baby is getting at the breast and can supplement the correct amount. 1/2-1 oz per day of weight gain is normal--counted from lowest weight after birth--so if baby lost 5 oz for instance it would normally take 5-10 days to regain birthweight.

[hollydfromtn]

Feb 11, 2015 18:15:57 GMT -5 @amyg said:

hollydfromtn,
How old is baby? Looks pretty young from your ticker. It is unlikely to be milk intolerance. It is more likely to be oversupply and a bit of foremilk/hindmilk imbalance. Consider making sure baby gets all they want from side 1, burp and if it wasn't a long feeding on side 1 reoffer side 1 with breast compressions and massage to help get more hindmilk. then burp and offer side 2. or they might not even want side 2 if they get more hindmilk. Of course if you are drinking a ton of milk or ice cream you could cut back a bit and see if that helps any.

He'll be 2 weeks old tomorrow. That's generally our method of feeding. Side 1 until he stops, burp, side 1 again, burp, and then side 2. He will usually take about 20-30mins on side one and then maybe another 10 on side 2. How long does it usually take for your supply to even itself out?

[Deleted]

Feb 10, 2015 13:47:53 GMT -5 things said:

@amyg - I messaged you on LS, but thought I'd try reaching you here.

LO is not in the newborn stage anymore. She will be 11 weeks on Thursday. My question is regarding Domperidone. I should be receiving it any day now. I used it with my fourth baby when I was pumping and trying to establish a supply while working through tongue/lip tie issues. I was taking other supplements, too. I definitely saw a huge increase, which could have been from the assortment of galactagogues I was taking.

So, LO only nurses from my left. My right side is out of commission. I don't have a full supply on my left side. I supplement to make up the difference of what she's not getting from my right. She gains steadily on 25-26 oz a day, and my left produces about 16 oz based on weighted feeds. I supplement the rest. I want to try to reduce how much I supplement. Can the Dom help increase my supply by just nursing more frequently and reducing how much I supplement, or do I need to nurse + pump to see a noticeable difference? Pumping my left isn't a challenge, but I'm curious if just nursing more often and decreasing supplement amount will help?

Her first bottle is usually around 11am, sometimes 12pm. She gets 3-3.5 oz. They're spaced about 4 hours apart and she nurses in between bottle feedings. So 11am, 3pm, sometimes 7:00pm (I've been skipping this lately), and the last between 10:30-11pm. If I only do three bottles a day the first two are usually 3.5 oz and last 3 oz. A lot of times she sleeps through the third bottle feeding time, so she skips that one. Could I keep this routine but reduce the amount to 2-2.5 oz allowing her to take more from me, thus working to increase my supply?

things
ok so you have a weird tag or is it just me?

let's see...
I would give less by bottle at a time. yes Domperidone can increase your supply if you just nurse more often or pump more often or do both. Dom works by raising prolactin hormone level. If that is the reason for low supply it works to raise prolactin which raises supply, but to keep that going you have to pump or nurse to use/empty that milk out so that production stays there.

I've known moms who nursed for the whole time on just one side so that part is fine, but it does make it a bit of a challenge since you don't have a backup spare boob to help with supply etc.

You might find it extremely helpful during this time to rent a hospital grade baby scale. weigh before and after every feed and supplement if amount drops below your goal for the # of feeds in a day. If you supplement, you should pump to tell your boobs to make that amount more.

So you start the domperidone and figure that baby eats every 3 hours, so that's 8 feeds a day, avg 3 oz with a couple of bigger meals to get to that 25-26 oz a day that they seem to want.
right?
so you do a weighted feeding yourself before and after each feeding and if she doesn't get 3 oz you add in enough supplement to get to 3 oz and pump to collect that amount.  alternatively if she only gets 2.5 oz you nurse again in about 2.5 hours to reach your target for the day, but babies don't always cooperate with waking up and eating as often as you want them to. 

of course this will drive you nuts, maybe kicking in some OCD.  To account for that you do a full day of weighted feeds and then stay at that amt of supplement for 2 days (using slow flow bottle and paced feeds so baby has opportunity to refuse if they don't want that much) then do the weighted feeds again and see if there is improvement.

If there isn't improvement in how much baby gets at the breast, you may find that you need to do a week or so of dom plus nursing and pumping to boost supply enough so baby can just get the milk they need directly at the breast.  If you find you can pump extra after nursing but baby isn't able to get it with nursing, it may be a milk transfer issue on baby's part rather than "just" your supply.

Of course Dom might not fully work, but that's cause there are other reasons aside from low prolactin that might effect supply.  You've ruled out retained placenta fragments, right?  Teeny ones cause low supply but might not cause infection.  eventually your body will calcify and reabsorb them and supply will increase.  You've also ruled out thyroid issues with a full thyroid panel.  we don't realize it but thyroid is a hormone, and hormones effect supply in various ways.  Of course you can also check for other hormones out of wack, too high of testosterone or estrogen.  Sometimes a calcium and magnesium supplemet helps with supply issues due to hormones, so it wouldn't hurt to add it. 

[Deleted]

Feb 11, 2015 18:31:57 GMT -5 hollydfromtn said:

Feb 11, 2015 18:15:57 GMT -5 @amyg said:

hollydfromtn,
How old is baby? Looks pretty young from your ticker. It is unlikely to be milk intolerance. It is more likely to be oversupply and a bit of foremilk/hindmilk imbalance. Consider making sure baby gets all they want from side 1, burp and if it wasn't a long feeding on side 1 reoffer side 1 with breast compressions and massage to help get more hindmilk. then burp and offer side 2. or they might not even want side 2 if they get more hindmilk. Of course if you are drinking a ton of milk or ice cream you could cut back a bit and see if that helps any.

He'll be 2 weeks old tomorrow. That's generally our method of feeding. Side 1 until he stops, burp, side 1 again, burp, and then side 2. He will usually take about 20-30mins on side one and then maybe another 10 on side 2. How long does it usually take for your supply to even itself out?

at two weeks you aren't very far into this at all yet. Your supply is no where near evened out. about the time you think it's better you hit another growth spurt which raises it. right now you are likely to have just come past 1 week growth spurt and supply is extra over what baby needs.

I would continue as you are doing unless you have fussy, crying, gassy, spit uppy baby with green stools that are frothy and mucousy. At certain ages and stages and times of day it's normal to have a bit of extra green, so if baby isn't complaining I'd do what you are doing.

[Deleted]

things,
if you want/need more/follow up just start a new thread here on bfing board with all your details, weight gain, what you've tried, what you want to try next etc and we'll weigh in with even longer posts just for you. ok maybe not longer.

[Deleted]

FiliaRitae,
I think I missed your follow up. I will quote and reply, but you might want to do what I suggested to metaphysique
Start your own thread with alllllllll the long and assorted details of what's going on. So we can give you the more attention and specific hel that it seems like you really need.

[Deleted]

Feb 10, 2015 13:20:33 GMT -5 FiliaRitae said:

Feb 10, 2015 11:21:10 GMT -5 @amyg said:

How's it going?
--snip--

It's not going wonderfully. He was nursing constantly over the weekend and I expected to see a gain at his appointment on Monday, but he was actually down again. He was born at 8lbs10oz, dropped to just below the 10% loss mark (I forget the exact number), got back to around 8 when we supplemented the first time, and was at 7 lbs 14oz yesterday. He went Monday through Thursday without pooping at all, spent the Friday and Saturday pooping about 4x a day, but always a chocolate brown, and is back to not pooping. So by all markers, he is not getting enough when I'm breastfeeding alone. He's having plenty of wet diapers, and he's not longer showing signs of dehydration on that front, but it's still not really enough.

I pump when I can, but I'm also suffering a severe sleep deficit as it is so I just can't pump as much as I should be right now (among other things, a certain amount of sleep deprivation really, really triggers my anxiety and depression, and then I'm not good to anyone). When I do pump, I'm generally getting about an ounce and a half between the two breasts, and that's generally soon after a feeding. I've been asked to supplement with formula until his Wednesday appointment, at which point they may "allow" me to go back to supplementing with breast milk, at least when I have it. We've switched formulas, and that seems to be helping, but I still hate how it affects his digestive tract.

As far as I can tell and have been told, my latch is good. It started out bad, but between reading and having some one-on-one with people who actually knew what they were doing, it has improved. The fact that the only pain I experience is for a few seconds after he latches on supports this.

I do have some postural concerns, and am wondering how much that is hindering him. I don't have a great setup, so I often end up excessively reclined against pillows in bed, and his chin is often closer to his chest than I would like. I'm making a real effort to ensure now that he is positioned properly and that I am as well supported as possible, but my back is still not happy with me. On our priority list is chair shopping, so I can get a better setup, but in the meantime I'm making do as best as I can.

I'm having a public health nurse out today to set me up with a supplementary feeding system so I can at least give him the supplement at breast instead of with bottle. That might also allow me to see what's going on with his suckling--is he actually eating effectively, or not? He does seem to fall asleep and stop productive suckling fairly frequently, which I suspect is part of the problem. I do my best to wake him, but it's sometimes near impossible... until he asks for food twenty minutes later, anyway!

I hate this--not the nursing, but that the nursing isn't working. I hate that I'm not enough for him and I don't know quite what I'm doing wrong or how to fix it. But I am nothing if not stubborn, and fully intend to do whatever I can to make it work. It's difficult sometimes to wade through in person advice and figure out if it's good or bad--I've had some bad advice from people I trusted to be right, and it caused issues. But at this point I just want a healthy kid.

Can you get in to see an IBCLC lactation consultant? Or a La leche league leader/meeting? was the public health nurse any help?

Whe they are little they wear themselves out eating, especially if latch is not good.  They take a break to catch their breath and let the muscles of their mouth, tongue and jaw rest in between work outs but we think they are full so we take them off.  But they aren't done.  nag nag nag them to wake, rouse them up and put them on the other side.  repeat over and over.  Remember they are born with weak muscles and their stomachs are small.

Get help to fix latch.  there are videos online and we can give you ideas for positioningn and latching, but in person help is imperative.

sometimes a big poop right before a weigh in can make you freak out as weight will look low.  weight is also higher later in the day than it is earlier in the day.

I know this is very very hard!! It is for every new mom and any bumps in the road seem like mount everest.  But it is really really important that you do everything you can to pump every time baby gets a supplement.  rent a hospital grade pump, get hands free pumping bra, or make one (google) and figure out how to pump while you give the bottle.  It's a great idea to get a supplemental nursing system to give supplement while baby nurses and then pump afterwards. 

If you don't tell your body to make more milk, by nursing more often or longer and or pumping in addition to nursing if you are supplementing, then your supply will not grow to meet baby's needs. 

You can do this, but you really do need that in person help to make it work out. And keep asking questions and make your own posts to get ideas from other moms here who have btdt.

[mkateg2009]

Tell us how old your baby is? Twins 6 weeks How is nursing going? Its been a struggle...I posted a long thread earlier today. "Need support and advice trying to get supply back"
What's something you struggle with that maybe we could help with? long story short, I started to wean to stop bf after, a few hiccups and getting fed up/ exhausted from it. I didn't let my breasts dry up, I ended up pumping and giving my babies mostly beat milk during the day. But my supply is not at all where it was. I've gone from getting 6oz to 2oz per session. I called LC today and just felt discouraged after taking to her.
Is there anything you can tell another new mom that you think would really help her out? Don't give up on a bad day! And contact a LC early on in your bf struggles.
What do you wish someone would have told you before you started breastfeeding? Same as last answer.

[Deleted]

mkateg2009,
Hang in there, with a stubborn attitude and the right kind of help, you can regain your supply. It will be ok.

[mapetitefamille]

Feb 10, 2015 10:54:13 GMT -5 @amyg said:

mapetitefamille
For your overactive let down high supply xnd shallow latch are you trying other positions when nursing? Gravity speeds the flow so anytime you can get baby's head higher than breast that will slow the flow. Laid back nursing helps because baby is above the breast and that slows the flow and gravity helps to pull baby into a deeper latch.

Some find they need to pump or hand express til let down and let the highest fast flow go into a towel or the pump. Only once the flow slows a bit do they put baby to the breast also if you have really high supply it's usually best to stick to one side per feeds and block feeding is the next step after that to lower supply to more closely match baby's needs.

Thanks, @amyg. Laid back nursing has been really helpful, I think. If only I could lie down when we're out and about! She is still quite spitty and fussy, but I think that also has to do with the fact that we're in the middle of a growth spurt and she's only happy on the breast.

During this growth spurt, it's been tough to say when one feeding ends and the next begins. Since she'd normally be feeding every 2 hours, I've just been spending two hours on the right breast, then two hours on the left. I'm definitely less engorged this way, which has made her latch much better. That's one thing I'm really happy to report back on-- it really only took a couple of days of removing her and re-latching consistently for her to get the hang of the deep latch. Now we just need to work on the oversupply issue, which I feel is much more manageable and less of a threat to my sanity. Thank you for all of your help!