intro - very long - help needed

Hiya All.

I'm pretty much at wits end, so I thought Id introduce myself, and get some
advice from the group.

To be brief, my son Sam was born 5 weeks premmie. He was quite heavy (7
pounds one), and was allowed on the ward with me. Unfortunately, after the
second day it was obvious that latching and feeding was too difficult for
him, and he had to go to the Special Care Nursery. He was tube fed, and
because I wasn't producing enough milk, he was also given formula in
addition to whatever EBM I could produce. He had to change formula after a
day or so when it became evident it didn't agree with him, and we were very
keen to get him back solely on EBM.

He developed jaundice, not uncommon in premmies I understand, and required
treatment for a few days. I might point out I am in Sydney, and have no
family here, so it was a difficult time. During this same week, my
grandmother had a massive heart attack and died, which didn't really help
things - I was unable to go home (interstate) for the funeral, and had to
help organise it from the hospital. Being separated from my son, having a
close family member die, and being somewhat isolated was very difficult.

Sam ended up being in hospital for 3 weeks, with me being discharged after 9
days. I continued to pump every four hours, and was put on Motillium
(Dopermine?) to assist with my milk production. Eventually he began to wake
up a little more, and we worked on breastfeeding. Initially we used a
shield, but have with perseverance, graduated from that. We haven't used
formula since before he left hospital.

My current problem is that I still have a low supply, and Sam tires easily
and doesn't seem to be getting enough to eat. At the moment I am also being
encouraged to pump after every feeding session (some of which can be as
frequent as every 2 hours). He has developed an upset stomach and very
watery stools, which the support group from the hospital (midwife etc) is
monitoring closely. They suggest it is because he is getting primarily
foremilk, and not enough hindmilk. Currently I have to top him up with EBM
after every feed, which is very depressing, and I am also in deficit at the
moment - using the EBM I stored when I was pumping but while Sam was on
formula, since the pumping I am doing now is not very effective (not that it
ever was...) Fortunately even though we are bottle feeding the EBM after
each feed, Sam hasn't developed an aversion to the breast, and still seems
enthusiastic to try.

I really want breastfeeding to work out for us, but after 4 weeks (Same has
been home a bit over a week now), I am beginning to wonder if I am in fact
one of those few people who genuinely can't produce enough milk.

So far we have tried (with no discernible effect):
Motillium (I'm on my third week of script, and it finishes this week)
Double pumping
Pumping every 3-4 hours
More sleep
More protein/carbs/substitute your favourite food preference here
More fluid
Stout
Oatmeal
and tears.

Does anyone have any suggestions? Apart from the exhaustion, having Sam
piteously wail, even after being fed is heartbreaking, and having him demand
feed every 2 hours, and still seem to be hungry is really breaking our will
to continue with breastfeeding. Not to mention it is exhausting him.

I might add the hospital has been fantastic, but I've seen 3 lactation
consultants now - who all agree my latch and technique etc isn't the
problem, so I am running out of 'experts' to consult with, and its wearing
us all out.

Lee

Can you feed him mor frequently? My newborns ate every hour, perhaps the
increased frequency will help stimulate more milk production.
I dont know what they recommend, but every 4 hours for a newborn doesnt seem
enough to me. Can you get one of those thingies that drips/delivers milk
into his mouth as he nurses? That way he is sucking and also getting
expressed milk. And perhaps try pumping at the end to concentrate the hind
milk, so you are using that to supplement.
Have you tried hand expressing, that works better for me than pumps.
Good luck


"Lee" wrote in message
u...
Hiya All.

I'm pretty much at wits end, so I thought Id introduce myself, and get
some
advice from the group.

To be brief, my son Sam was born 5 weeks premmie. He was quite heavy (7
pounds one), and was allowed on the ward with me. Unfortunately, after the
second day it was obvious that latching and feeding was too difficult for
him, and he had to go to the Special Care Nursery. He was tube fed, and
because I wasn't producing enough milk, he was also given formula in
addition to whatever EBM I could produce. He had to change formula after a
day or so when it became evident it didn't agree with him, and we were
very
keen to get him back solely on EBM.

He developed jaundice, not uncommon in premmies I understand, and required
treatment for a few days. I might point out I am in Sydney, and have no
family here, so it was a difficult time. During this same week, my
grandmother had a massive heart attack and died, which didn't really help
things - I was unable to go home (interstate) for the funeral, and had to
help organise it from the hospital. Being separated from my son, having a
close family member die, and being somewhat isolated was very difficult.

Sam ended up being in hospital for 3 weeks, with me being discharged after
9
days. I continued to pump every four hours, and was put on Motillium
(Dopermine?) to assist with my milk production. Eventually he began to
wake
up a little more, and we worked on breastfeeding. Initially we used a
shield, but have with perseverance, graduated from that. We haven't used
formula since before he left hospital.

My current problem is that I still have a low supply, and Sam tires easily
and doesn't seem to be getting enough to eat. At the moment I am also
being
encouraged to pump after every feeding session (some of which can be as
frequent as every 2 hours). He has developed an upset stomach and very
watery stools, which the support group from the hospital (midwife etc) is
monitoring closely. They suggest it is because he is getting primarily
foremilk, and not enough hindmilk. Currently I have to top him up with EBM
after every feed, which is very depressing, and I am also in deficit at
the
moment - using the EBM I stored when I was pumping but while Sam was on
formula, since the pumping I am doing now is not very effective (not that
it
ever was...) Fortunately even though we are bottle feeding the EBM after
each feed, Sam hasn't developed an aversion to the breast, and still seems
enthusiastic to try.

I really want breastfeeding to work out for us, but after 4 weeks (Same
has
been home a bit over a week now), I am beginning to wonder if I am in fact
one of those few people who genuinely can't produce enough milk.

So far we have tried (with no discernible effect):
Motillium (I'm on my third week of script, and it finishes this week)
Double pumping
Pumping every 3-4 hours
More sleep
More protein/carbs/substitute your favourite food preference here
More fluid
Stout
Oatmeal
and tears.

Does anyone have any suggestions? Apart from the exhaustion, having Sam
piteously wail, even after being fed is heartbreaking, and having him
demand
feed every 2 hours, and still seem to be hungry is really breaking our
will
to continue with breastfeeding. Not to mention it is exhausting him.

I might add the hospital has been fantastic, but I've seen 3 lactation
consultants now - who all agree my latch and technique etc isn't the
problem, so I am running out of 'experts' to consult with, and its wearing
us all out.

Lee

Wow! How did they date the pregnancy? That seems REALLY heavy for 34ish
weeks.

They dated it through ultrasound measurements, but we are also darn sure
about the dates, since my husband travel a lot and when trying to conceived
we had a diary and charted every time we had sex. Not romantic I know, but
accurate never-the-less. The hospital pointed out that the last month is
when they tend to gain most of their weight, so I probably would have given
birth to a right heifer if he'd gone full term... And no I am not diabetic,
which is the other thing most people ask...

Watery stools are normal for a breast fed baby, depending on HOW watery.
Describe them more and someone here is likely to be able to tell you more.
What
do you mean upset stomach? Vomiting?

Green pesto like and sticky.

His stool wuld be green, I think. Do they have any idea why he's not
gettiing
hindmilk? I wonder if you're not letting him nurse long enough before
supplementing?

He falls asleep and gets exhausted mostly. And yes, the stool has been green
for almost 36 hours now. Though today it was heading back towards yellowish.

Currently I have to top him up with EBM
after every feed,

How long does he nurse? does he nurse both sides?

Between 5-15 mins all up depending on how tired he is. And the hospital has
been encouraging me at the moment to just nurse the one side, to let him
drain in (to help with supply), and to pump after feeding.

I dunno. But I think someone here can likely help you more htan me, and I
suspect the first comment will be that the supplementing may be
contributing to
low supply, since you've always done it.

The alternative is him not getting enough, or having to use formula, which I
am not keen on.

What if you do the Nursing Day, and just take him to bed wth you and some
movies
and just nurse him all day? Have you tried that?
Nursing is the best stimulus, I;m sure you know. Pumping is inferior.

Nope, I haven't tried that (I am amazed there is something I haven't tried),
I'll add that to the list of things to try,

I'm sure someone else will have better hlep than I do, but I have to pipe
in and
offer you congratulations on getting him off the formula and for your
dedication
to keep trying!

Its ironic really. We always wanted to breastfeed, and never even considered
an FF as an alternative, but having him come so early, and then require
intervention really threw me. I was really proud for getting rid of the
nipple shield, since I felt that would be a disincentive in the long run to
me feeding him easily, but the low supply is still a problem.

New news:
Ive just had the lactaction consultant around. Sam has gained 260gms in 6
days, which they are very pleased about, since his weight gain was very slow
last week. She watched me feed, and Sam had a good session, and she again
reiterates that the technique latch is fine. Im now advised to only
supplement him with what I express after the feed, and only if he really
demands it, otherwise Im to stick with feeding him when he can cope with it.
Im still to express after every feed, to help stimulate supply.

I guess I just have to hang in there and believe it will get better.

Thanks for the 'nursing day' suggestion, I'll see how I can incorporate that
in.

Lee

SNIP
It's so hard just having him
there for 1 week. I don't know how I would have held up for 3 weeks.
Kris

I guess I was lucky, Sam was one of the heavy 'old' ones in the nursery -
there were lots of twins who were 26 weeks onwards. Some of the parents had
been coming in for *months*, and there babies were still tiny, in cribs,
wired up tube fed etc. I found the few weeks Sam there to be terribly
depressing, so I would hate to think how I would have coped for months on
end, especially when in our case, Sam is fine, and many of the other tinies,
will have ongoing health problems for some time to come.

Lee

Lee wrote:

Watery stools are normal for a breast fed baby, depending on HOW watery.
Describe them more and someone here is likely to be able to tell you more.
What
do you mean upset stomach? Vomiting?

Green pesto like and sticky.

Not watery enough from that description to be worrisome. Pesto like, i assume,
includes some curdles or flecks.

His stool wuld be green, I think. Do they have any idea why he's not
gettiing
hindmilk? I wonder if you're not letting him nurse long enough before
supplementing?

He falls asleep and gets exhausted mostly. And yes, the stool has been green
for almost 36 hours now. Though today it was heading back towards yellowish.

That's good.


Currently I have to top him up with EBM
after every feed,

How long does he nurse? does he nurse both sides?

Between 5-15 mins all up depending on how tired he is. And the hospital has
been encouraging me at the moment to just nurse the one side, to let him
drain in (to help with supply), and to pump after feeding.

Well, if you gave him BOTH sides, then BOTH breasts would get stimulated, and
he'd get full. THEN you could pump. Someone may correct me on this, but it
seems odd to hold back a full breast and then supplement with EBM, when supply
seems low.

I dunno. But I think someone here can likely help you more htan me, and I
suspect the first comment will be that the supplementing may be
contributing to
low supply, since you've always done it.

The alternative is him not getting enough, or having to use formula, which I
am not keen on.

Or give him that other breast.

Im now advised to only
supplement him with what I express after the feed, and only if he really
demands it, otherwise Im to stick with feeding him when he can cope with it.
Im still to express after every feed, to help stimulate supply.

I don't understand this. He will be more efficient than the pump, so why not
let HIM express the milk longer and call it a feed. Feeding the baby EBM
expressed right after he nurses seems counterproductive with low supply because
your breasts won't be getting the stimulation of the baby nursing. If he
demands more after you've nursed him and you can express for the pump, why not
plug him back on? He's still hungry, you still have milk, you need the
stimulation, he needs the hindmilk.

Dawn

"Dawn Lawson" wrote in message
...


K.B. wrote:

"Dawn Lawson" wrote in message
...


Lee wrote:

Hiya All.

I'm pretty much at wits end, so I thought Id introduce myself, and
get
some
advice from the group.

To be brief, my son Sam was born 5 weeks premmie. He was quite heavy
(7
pounds one),

Wow! How did they date the pregnancy? That seems REALLY heavy for
34ish
weeks.

My son was 35 weeks and was 7 pounds 12 ounces.

Again, how did they date the pregnancy? Ultrasound? LMP? Ovulation?
Were you GD?



I worked out the other day that if my baby is the same size as his brother
at birth, 10lb 8oz. Then if he gains about the average per week (according
to some website I can't remember) for the last six weeks he'd be seven
pounds plus by now 34 weeks.

I don't have GD either, just have a damn big husband. Unfortunately I'm not
from a big family myself so I look a bit like a Manatee on legs at present.
Kind of sucks that the baby gets his size genes but at least they're big and
healthy!

Judy

Well, if you gave him BOTH sides, then BOTH breasts would get stimulated,
and
he'd get full. THEN you could pump. Someone may correct me on this, but
it
seems odd to hold back a full breast and then supplement with EBM, when
supply
seems low.

They were concerned that he wasn't draining one, and then just getting
foremilk on the other I think.
If he is awake enoough I am now offerring the other breast, but he is
normally out for the count after only feeding one side (and not draining
it), and wont respond to the normal waking techniques. We had a period of
him snacking a little on each breast every hour or so, which the consultant
felt was non productive. It certainly didn't help my supply.

Or give him that other breast.

Yep, still trying that, but I guess Ive got to trust in the consultant and
at least give it a go for a while. Either way today he fed from both, so we
will see what effect that has on how full he got - when he next wakes, do I
need to top him up etc.

I don't understand this. He will be more efficient than the pump, so why
not
let HIM express the milk longer and call it a feed. Feeding the baby EBM
expressed right after he nurses seems counterproductive with low supply
because
your breasts won't be getting the stimulation of the baby nursing. If he
demands more after you've nursed him and you can express for the pump, why
not
plug him back on? He's still hungry, you still have milk, you need the
stimulation, he needs the hindmilk.

Sorry, Im probably explaining this poorly. He might be more efficient than
the pump (well yes, actually he definately is), but if he can't be woken to
feed, then no matter have efficient he might be, if he can't do it he can't
do it. And if I have to bottle feed him to top him up, then I want it to be
my expressed BM (no matter how much I am growing to hate the electric pump)
rather than formula. And if pumping gets my supply up, again its better than
relying on formula and losing what little I have.

I'll hang in there I guess. I have contacted my local Breastfeeding
Association, to find out what is local, and tomorrow I meet my contact at
the local childhood centre, so at least I am getting some contacts. And
today weight gain, and good feed went a long way to making me feel like we
are making progress, albeit very slowly.

Thanks for your input Dawn, its nice to know there are people out there to
talk to...

Lee

Lee wrote:
Hiya All.

I'm pretty much at wits end, so I thought Id introduce myself, and get some
advice from the group.

To be brief, my son Sam was born 5 weeks premmie. He was quite heavy (7
pounds one), and was allowed on the ward with me. Unfortunately, after the
second day it was obvious that latching and feeding was too difficult for
him, and he had to go to the Special Care Nursery. He was tube fed, and
because I wasn't producing enough milk, he was also given formula in
addition to whatever EBM I could produce. He had to change formula after a
day or so when it became evident it didn't agree with him, and we were very
keen to get him back solely on EBM.

He developed jaundice, not uncommon in premmies I understand, and required
treatment for a few days. I might point out I am in Sydney, and have no
family here, so it was a difficult time. During this same week, my
grandmother had a massive heart attack and died, which didn't really help
things - I was unable to go home (interstate) for the funeral, and had to
help organise it from the hospital. Being separated from my son, having a
close family member die, and being somewhat isolated was very difficult.

Sam ended up being in hospital for 3 weeks, with me being discharged after 9
days. I continued to pump every four hours, and was put on Motillium
(Dopermine?) to assist with my milk production. Eventually he began to wake
up a little more, and we worked on breastfeeding. Initially we used a
shield, but have with perseverance, graduated from that. We haven't used
formula since before he left hospital.

My current problem is that I still have a low supply, and Sam tires easily
and doesn't seem to be getting enough to eat. At the moment I am also being
encouraged to pump after every feeding session (some of which can be as
frequent as every 2 hours). He has developed an upset stomach and very
watery stools, which the support group from the hospital (midwife etc) is
monitoring closely. They suggest it is because he is getting primarily
foremilk, and not enough hindmilk. Currently I have to top him up with EBM
after every feed, which is very depressing, and I am also in deficit at the
moment - using the EBM I stored when I was pumping but while Sam was on
formula, since the pumping I am doing now is not very effective (not that it
ever was...) Fortunately even though we are bottle feeding the EBM after
each feed, Sam hasn't developed an aversion to the breast, and still seems
enthusiastic to try.

I really want breastfeeding to work out for us, but after 4 weeks (Same has
been home a bit over a week now), I am beginning to wonder if I am in fact
one of those few people who genuinely can't produce enough milk.

So far we have tried (with no discernible effect):
Motillium (I'm on my third week of script, and it finishes this week)
Double pumping
Pumping every 3-4 hours
More sleep
More protein/carbs/substitute your favourite food preference here
More fluid
Stout
Oatmeal
and tears.

Does anyone have any suggestions? Apart from the exhaustion, having Sam
piteously wail, even after being fed is heartbreaking, and having him demand
feed every 2 hours, and still seem to be hungry is really breaking our will
to continue with breastfeeding. Not to mention it is exhausting him.

I might add the hospital has been fantastic, but I've seen 3 lactation
consultants now - who all agree my latch and technique etc isn't the
problem, so I am running out of 'experts' to consult with, and its wearing
us all out.

Lee



Lee

Sounds like you have had a very difficult time of it but at least things
are improving.

The Australian Breastfeeding Association has been a great help to me
both for advice and just for the company of like-minded mothers.

The first few weeks are the worst, you have already made it this far,
well done! Really, it does get easier.

It sounds like you are trying all the right things. Have you tried to
keep Sam awake to increase the length of his feeds? A damp face cloth
on the face or head, tickling his feet etc. sometimes this helps prolong
the session. As he grows and has more awake time this should resolve itself.

I am 1.5 hours north of Sydney. If you want to talk on the phone, email
me, just remove spamoff from the email address.


Larissa
DD Feb99
DS Mar01
due early Dec

Dawn Lawson wrote in message ...
Lee wrote:

Well, if you gave him BOTH sides, then BOTH breasts would get stimulated,
and
he'd get full. THEN you could pump. Someone may correct me on this, but
it
seems odd to hold back a full breast and then supplement with EBM, when
supply
seems low.

They were concerned that he wasn't draining one, and then just getting
foremilk on the other I think.

Ah, could be.

Or give him that other breast.

Yep, still trying that, but I guess Ive got to trust in the consultant and
at least give it a go for a while. Either way today he fed from both, so we
will see what effect that has on how full he got - when he next wakes, do I
need to top him up etc.

Oh wait...when you say this....so you nurse, he falls asleep, he wakes and you
offer him a bottle of EBM?

I don't understand this. He will be more efficient than the pump, so why
not
let HIM express the milk longer and call it a feed. Feeding the baby EBM
expressed right after he nurses seems counterproductive with low supply
because
your breasts won't be getting the stimulation of the baby nursing. If he
demands more after you've nursed him and you can express for the pump, why
not
plug him back on? He's still hungry, you still have milk, you need the
stimulation, he needs the hindmilk.

Sorry, Im probably explaining this poorly.

S'ok, just asking. ;-)

He might be more efficient than
the pump (well yes, actually he definately is), but if he can't be woken to
feed, then no matter have efficient he might be, if he can't do it he can't
do it. And if I have to bottle feed him to top him up, then I want it to be
my expressed BM

Well, yes, agreed. But how do you "top him up" if he's asleep? And if he
isn't, why not put him back to the breast?

(no matter how much I am growing to hate the electric pump)
rather than formula. And if pumping gets my supply up, again its better than
relying on formula and losing what little I have.

I don't think you have too too little. If he's gaining, even with the large
amount of foremilk, he must be getting nearly enough, since he's not getting as
much of the fattier hindmilk as he might. And you've just had word that you can
stop supplementing, so you must have enough, or so nearly so as not to worry the
consultant....YAY YOU!!!

I'll hang in there I guess. I have contacted my local Breastfeeding
Association, to find out what is local, and tomorrow I meet my contact at
the local childhood centre, so at least I am getting some contacts. And
today weight gain, and good feed went a long way to making me feel like we
are making progress, albeit very slowly.

The first while is always the hard part, and always the easiest to believe you
have problems ;-)
Be prepared that at 10-12 weeks your breasts are going to fairly suddenly feel
soft and "empty", but they are NOT, and you have to have faith in your body. I
had no supply problems, but even for me, knowing beforehand AND knowing I had
loads of milk, it was easy to doubt that my breasts were making as much as they
had the week before. A lot of women give up and give formula around that time,
just because they don't expect the change and don't understand what it means.

Oh, and your little one might be going into a growth spurt, which means they are
insatiable no matter what your supply is, and want to nurse 24/7. Might
actually not be a bad time for a "Nursing Day"

I'm gonna let someone with more information than I have take things from here.
But you've got my support for persevering at breastfeeding, and I'm betting that
you'll soon be a pro with no supply problem at all!! :-))

Dawn

Hi, you have received good advice so far, and I'd like to add the following
to it:

1.) Your body is adequate. It will produce enough milk for your baby as
long as you offer the breast whenever he wants anything by mouth. That
means don't give him EBM unless you just plain aren't around! The chances
that you do not make enough milk are so totally slim, even if you have only
one breast! It burns me up that our society makes women feel their bodies
are inadequate to feed their babies. As if we don't have low enough self
esteem from all the images in media, lower pay, and condemnation of both FT
mommies and working mommies, but I digress...

Here's how you can be sure women's bodies are adequate. Suppose you are a
baby. Your mommy is not (currently) making enough milk. Every time you
sense the breast is getting empty, you unlatch and cry. What is wrong with
this arrangement? As you grow, and need more milk to live, you will *never*
get that milk increase, because you are not stimulating mommy's breasts
more. A hungry baby will sit there and wait for that hindmilk to drip out,
drop by drop, like a leaky faucet, as it is produced. So the way you can
tell if the baby is really hungry is that they are like a leech, continually
sucking, for about 2 days, at which point, your milk *does* increase, and
the baby can ease off a bit.

2.) Big babies eat more. My first was 9lb, 9oz and ate every hour for
about 45 minutes at a time, and sometimes would nurse for 90 minutes or
more. Notice how far off that is from every 2 hours? 2 hours is not nearly
often enough if you are trying to increase your supply. Since yours is a
big, sleepy baby, maybe he needs more nursing time than average, and needs
you to keep him near so the breast is available whenever he's in a more
wakeful state. His tummy is teeny, so it can't hold much, so that means
very frequent, short nursings.

3.) It takes 2 days to increase/decrease your milk supply. So if you're
engorged for a couple of days, your supply will go down the third day.
Also, if you take the baby to bed for 2 days (and 2 nights!) your supply
will be up on the third day. So I think the Nursing Day is excellent
advice, but I'd make it 2 days, including nights. It's okay to get out of
bed, just make sure you wear a loose-fitting shirt and baby has access to
breast for 48 hrs. Make sure to sleep next to the baby, which will help him
and you sleep better through this time. Let me know if you need hints for
doing this. Newborns have great sniffers, since they can't see very well,
so if they are hungry the smell of a bare breast will wake them up and make
them eat. No, really!

Good luck, and don't hesitate to call someone from La Leche League
International, if they have that in your area. The LLLI leaders have
actually nursed babies, whereas lactation consultants might not even have
kids!

--Pam C. (4.5 yrs BFing, and counting)

Same with my 9 pound son in the ICU. He was so big and all the babies were
so sick and little. I found it to be hard to understand and accept why he
was there when he was so big and he was 37 weeks along. They wouldn't even
let me hold him the first few days. He had so many needles and had to have
a
spinal tap. It all started with a broken collar bone from being so big. He
went downhill from there. My most recent birth, my 4 month old, was the 35
weeker at 7. 12. They were watching his size anyway. They didn't want hm
to
get stuck like his older brother.
Why did they keep Sam so long? Was it from the jaundis?
Kris

Jaundice, weight loss, inability to suckle.