Need some advice for nursing my almost 10 week old

iVillage Member
Registered: 05-22-2011
Need some advice for nursing my almost 10 week old
53
Sun, 05-22-2011 - 8:45am

A little background - I am 25 and this is my first baby, I have PCOS and had a breast reduction 7 years ago. My son was born at 36 weeks, 6 lbs 3 oz at birth. He was jaundiced and had a lot of difficulty nursing at first and one particular doctor pressured me into supplementing with formula and it's all been downhill from there. I started pumping as soon as possible in the hospital in hopes of increasing my supply. By our 2 week checkup he had lost an oz from the week before and he was still really jaundiced so he was readmitted to the hospital. He was there for 4 days and we got a lot of help from the nurses and the hospital's LC but still ended up having to slightly increase the formula supplements. Baby is now 9 weeks old. Since he's been home he's been gaining weight like a champ and I've seen a small increase in my supply, but we're still having to supplement either by using a supplemental nursing system or by bottle after the feeding or both. I would love to be able to cut out the formula and not have to follow almost every nursing session with a bottle or use the supplemental nurser.
I'm pretty sure my supply is still a bit low because I'm still having to use some formula, but most of the supplements he's getting now are expressed breast milk. Here's one point where I'm totally stumped in all of this, though. After nursing for at least 30 minutes (15-20 minutes on each side usually), he'll still act like he's starving to death, so I'll give him a bottle, but then I'll pump and get anywhere from 1-3 ounces. I know we still have issues with latch because it hurts when he nurses and my nipples are constantly sore and scabby, but I don't know how to fix it. I try to wait until his mouth is open wide, but he doesn't open very wide and I'm constantly pulling his lower lip out/down but he still seems to be tight-mouthing the nipple.
To make matters worse I started back to work this week so I can't just let him nurse all day. We've kind of got a system down but I don't know how long I can keep it up, it's exhausting. I am fortunate in that I work at a daycare so he's in the room right next to me and I get to feed him twice during the day, but each nursing break is only 30 minutes long.
Here's what a typical day looks like:
3 or 4 am - breastfeed about 30-40 minutes, 1-2 oz supplement by sns or bottle
Pump after nursing, usually get about 3 oz
6 am on workdays pump again, usually get 1-2 oz
7 am at daycare 3 oz bottle on workdays, weekends - breastfeed, supplement 1-2 oz and pump after, usually get 1-2 oz
10 am at daycare breastfeed, supplement 1-2 oz, in weekdays - hand express 1/2-1 oz, on weekends pump 1-2 oz after
1 pm at daycare same as 10 am
4 pm breastfeed, supplement 1-2 oz, pump, weekdays 2-3 oz, weekends 1-2 oz
7 pm breastfeed, supplement 1-2 oz, pump 1-2 oz
8:30 pm breastfeed, supplement 1-2 oz, pump 1/2-1 oz
sometime between 11 pm and 1 am breastfeed supplement 1-3 oz, hand express 1-2 oz

this schedule changes from day-to-day. He generally eats every 1 1/2-3 hours during the day and one 4-5 hour stretch at night.

I do my pumping right after nursing, should I do that or wait a bit? Any advice on getting him to nurse more efficiently? Any tips o latch and/or getting him to open wider?
I take Motherlove more milk special blend (goat's rue, fenugreek, blessed thistle, nettle and fennel) and drink Mother's Milk tea and LOTS of water. I talked to my midwife about taking domperidone but haven't gotten that figured out yet since it's a complicated process here in the US. I orederd some shatavari because I heard it's supposed to work just as well as domperidone so I'll start taking that as soon as it gets here. Is there anything else I should be doing?

Sorry for such an incredibly long post and thanks for reading through it. Any and all advice is greatly appreciated. and please forgive any typos, I'm typing with one hand while baby sleeps in the other. Edit/Delete Message

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iVillage Member
Registered: 12-21-2009

Hi and welcome. Your situation is likely to create some challenges with obtaining a full milk supply. There are a few case studies of moms who are able to get a complete milk supply after a reduction but when a mom has a breast reduction some of her breast milk making ability is taken away.

Kathy Kuhn IBCLC ivillage lactation consultant Grammy to Brennan, Elias, Elianna, Tahlia, Makenna, Maura, Silas, and Charlotte

iVillage Member
Registered: 05-22-2011
Thanks for the advice Kathy, especially the "description of latch" post. I've been trying the "open wide" game and it seems to be helping a little bit.
I've kept track the last couple days of how much he's eating and how much I'm pumping and I figured out that I'm getting just about enough for him so I think we just need to work on his latch some more.
I'm going to be going to a lactation consultant this Saturday, so hopefully we'll get this all cleared up!
iVillage Member
Registered: 12-21-2009
Let us know how the visit goes!

Kathy Kuhn IBCLC ivillage lactation consultant Grammy to Brennan, Elias, Elianna, Tahlia, Makenna, Maura, Silas, and Charlotte

iVillage Member
Registered: 05-22-2011
So we saw the lactation consultant today, she was very encouraging. She says I'm doing all the right things but she thinks Benjamin needs some help with his jaw. She said that his mouth was probably too small for my nipple to begin with and even though he's grown into it, he got used to sucking on it wrong. And that in combination with bottle use trained him to tight mouth the nipple. She gave me the names of some osteopaths to have osteomanipulation done to loosen his jaw. She also gave me some tips to help my nipples heal - saline soaks and gently "brushing off" the dead skin with gauze, extra Lansinoh, and the name of an antibacterial cream my Dr. can prescribe if they don't heal soon.
iVillage Member
Registered: 04-13-2008

Sounds like she has a lot of good ideas to tackle the situation. Hang in there.

Teresa

iVillage Member
Registered: 06-10-2008
I'm so glad you went to the LC and she was able to give you some helpful tips.
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iVillage Member
Registered: 12-21-2009
Let us know how things progress. Glad you felt the visit to the LC was helpful.

Kathy Kuhn IBCLC ivillage lactation consultant Grammy to Brennan, Elias, Elianna, Tahlia, Makenna, Maura, Silas, and Charlotte

iVillage Member
Registered: 05-22-2011

Things are not going well, in fact it's getting worse. I'm seriously considering giving up on nursing all together and pumping as much as I can and going exclusivelyy to bottles. Breastfeeding isn't supposed to make you feel like a total failure as a mother, right? It's supposed to be a pleasant bonding experience, not make you resentful of your own child... Benjamin is 12 weeks old today and I've tried so many different ways to fix his latch and to increase my milk supply I've lost count. And I don't get any time to actually enjoy being a mother. If I'm not struggling to feed him, I'm pumping or washing the mound of dishes associated with feeding him and pumping. I get maybe 2 or 3, 5 minute windows of time to actually enjoy my child each day and that is just not enough. If I had any hope that it would get better, I would keep going, but after 12 weeks and everything I've tried I really don't have any hope left. Thank you for trying to help, you gave some great advice and hopefully someone else will be able to put it to good use.

iVillage Member
Registered: 12-21-2009

I'm so sorry things aren't going well. Did you end up having another visit with the LC? IF so what happened re; your latch.

I don't blame you for wanting to stop bf with all the difficulty. It's not a cut and dry situation though. From what I gather your baby has been getting mostly breast milk either via bf or from supplements of breast milk. That is a HUGE accomplishment in your situation and you should feel very proud about that and not defeated at all.

I'm glad you are

Kathy Kuhn IBCLC ivillage lactation consultant Grammy to Brennan, Elias, Elianna, Tahlia, Makenna, Maura, Silas, and Charlotte

iVillage Member
Registered: 05-22-2011

Thank you for the encouragement, I was really feeling down the other da, but I haven't given up completely.

I'm still nursing but I've stopped using the SNS because it seems that Benjamin was realizing that the milk was coming out faster from the tube so he'd lose his grip on the nipple and try to suck the tube directly. Nursing still isn't going much better, but we have an appointment with the osteopath next week to see about getting him to open wider. I haven't been back to the LC yet but if the osteopath doesn't help I'll go back or see if I can find another LC. the LC seemed to think that the problem was a shallow, pinched latch that would get better with the osteomanipulation.

To complicate things even more, I have a cyst that has been causing a lot of pain this week. I ended up in the ER Tuesday night and have been using pain killers (breastfeeding safe) and now have a day surgery scheduled for July.

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