Update - eliminating supplements

Well we've backslid quite a bit this week, when I was looking forward to
getting some progress done, but there's a good reason.

Ian has been congested since birth. Lately its gotten a whole lot worse, to
the point that I took him to the doctor Wednesday. Things seemed to go well
on Monday, but on Tuesday things weren't so well. He slept 6 hours, for
one, the longest he had ever slept. Even more disturbing, though, was that
he hadn't wet his diaper during that time. He wasn't interested in
breastfeeding either - I wonder if it was because he was so congested. He
seemed to have an easier time with the bottle, so he got more of it than
ever before to help ward off dehydration (along with pumped BM from any
missed or incomplete feedings) which has continued until today. He had
drops prescribed for his congestion, but due to a pharmacy screwup, he only
started to take them tonight.

I wonder if some of his breastfeeding problems have been due to his
congestion. Saline drops and using the aspiration bulb have done little for
him, since its so high in his sinuses. He was less sniffly tonight and the
latching during this last feeding was better in my opinion.

Another good thing about the doctor's visit was that I got an updated weight
on him (that I can also use as a baseline to make sure that I'm not
eliminating too much formula from his diet too quickly). He was born at
10lbs, which he regained by his 2 week appointment. As of Wednesday (13
days later), he was 11lbs, 5oz! That was a lot more than I was expecting.

Now that he's on medicine, we are going to restart the supplement
elimination. My plan is to only give formula when he is still hungry after
I can't nurse anymore (either due to sore nipples or extreme frustration) as
long as he's having enough wet diapers. Hopefully over the next couple of
weeks, my nipples will get used to the extra feedings, he will improve his
latch which will decrease sore nipples to begin with, and my frustration
level will go down (either through improved latching or increased patience).
If I don't give him a full feed, I will pump what I can and give that to him
before any formula. Is this a good plan? I also plan on not using the
pacifier unless I am suffering extreme frustration.

I do have a Medela nipple shield but its a pain in the butt to use, so I
don't anymore (I did use it a couple of weeks ago before my flat nipple
resolved itself enough for Ian to latch onto). My problem is that I can't
get the thing to stay on. Ian has such a strong suck that it usually flips
off after a minute or two. I've tried using Lansinoh to help make it stick
on, but that doesn't help.

Here are some issues that I could use advice on:

- His latch usually starts out quite well, but by the end of the nursing
session he tends to slip down to the end of the nipple. How can I encourage
him to stop this? It usually ends up in a battle and leads to frustration
on both our ends. He gets very mad if he's still hungry and not being fed,
which doesn't help his latching, which leads to my nipples taking the brunt
of frenzied bad latching and relatching.

- How can I encourage him to open his mouth wider? He doesn't respond well
to my modeling or "open wide" yet. The only solution I've found is to wait
until he opens wide enough (which makes him more frustrated and angry in the
meantime) or to press down on his chin (which I have problems doing at the
same time that I'm shoving enough nipple into his mouth).

- Is 6-7 hours too long for a baby his age to sleep at once during the
night? He doesn't seem to have a problem with it and I've been so short on
sleep that I admit that I've let him do it since Tuesday. He's always done
4-5 hour stretches, but since we started swaddling this week (my husband put
him down that way), he's slept longer. Should I set an alarm to take care
of things every 3 hours or let it slide and be appreciative that he is
sleeping that long?

- What can I ditch the bottles for? I'm not familiar with using a cup for
feeding.

- Joanne
DS Ian 11/6/03

jjmoreta wrote:


I do have a Medela nipple shield but its a pain in the butt to use, so I
don't anymore (I did use it a couple of weeks ago before my flat nipple
resolved itself enough for Ian to latch onto). My problem is that I can't
get the thing to stay on. Ian has such a strong suck that it usually flips
off after a minute or two. I've tried using Lansinoh to help make it stick
on, but that doesn't help.

If you WANT to use it for feeds that are making you sore, try wetting it
with hot water and using it wet. flip the outer flange towards the
shield nipple, align the shield over your nipple and "press" into place,
then flip the flange back over your breast. And you may need to hold the
outermost edge in place with your finger.

Yes, they are a total PIA. I guess I have your sympathy for having used
one for 14+ months now ;-)

Dawn

Here are some issues that I could use advice on:

- His latch usually starts out quite well, but by the end of the nursing
session he tends to slip down to the end of the nipple. How can I encourage
him to stop this? It usually ends up in a battle and leads to frustration
on both our ends. He gets very mad if he's still hungry and not being fed,
which doesn't help his latching, which leads to my nipples taking the brunt
of frenzied bad latching and relatching.


Once he's latched on well, hold his head against your breast pretty firmly
(with your hand or the crook of your arm, however you're supporting him), and
don't relax. That way he won't be *able* to slip down. If he does manage to
start sliding, unlatch him and start over, immediately. Yes, he may get
frustrated, but it won't take long for him to learn he *has* to do it right if
he wants to get fed.

This is another reason to ditch the bottles and supplements. By using them,
you're teaching him that if he is stubborn enough about refusing to latch onto
the breast, you will give in and offer a bottle instead. What you want to
teach him is that if he is stubborn enough about refusing to latch onto the
breast, he will stay hungry. Be more stubborn than he is. You have to be
willing to let him stay mad, and unwilling to allow him to hurt you, which I
admit is very, very, very hard. But if you can do it, the problem should be
solved within pretty short order. If you are getting into a frustrating spiral
of bad latch-unlatch-bad latch-unlatch and both you and baby are getting very
stressed out, just stop. Hand the baby off to Daddy, if possible, or just hold
him without trying to feed him, or put him down and walk away if you must, but
stop the feeding until you can try again in a better frame of mind. Don't
resort to formula; just give yourself ten minutes to calm down and start over
with the breastfeeding.

- How can I encourage him to open his mouth wider? He doesn't respond well
to my modeling or "open wide" yet. The only solution I've found is to wait
until he opens wide enough (which makes him more frustrated and angry in the
meantime) or to press down on his chin (which I have problems doing at the
same time that I'm shoving enough nipple into his mouth).

Opening your own mouth wide and pressing on his chin are good things to do.
Also make sure that you've got your nipple lined up with his nose right before
he latches on, not with his chin. For some reason that makes it easier to
shove it all in. :-)


- Is 6-7 hours too long for a baby his age to sleep at once during the
night? He doesn't seem to have a problem with it and I've been so short on
sleep that I admit that I've let him do it since Tuesday. He's always done
4-5 hour stretches, but since we started swaddling this week (my husband put
him down that way), he's slept longer. Should I set an alarm to take care
of things every 3 hours or let it slide and be appreciative that he is
sleeping that long?

A 6-7 hour stretch at night is absolutely fine. Ideally, he should still be
nursing at least 8 times a day total, which means it'll be a little more
frequently than every 3 hours during most of the day. But as long as he's
wetting enough diapers, don't fret if he sometimes only nurses 6 or 7 times in
a day. There will be other days when it's 15 times. ;-)


- What can I ditch the bottles for? I'm not familiar with using a cup for
feeding.

Any small, somewhat flexible cup will work -- the kind that comes with
children's medicine is ideal. Or use a syringe (without the needle, of course)
or a dropper. It *is* more time consuming than a bottle, but that's part of
the point. You want the supplemental feedings to be more work and less
satisfying for him than nursing at the breast is.

Best of luck to you!
Holly
Mom to Camden, 2.5 yrs
EDD #2 6/8/04

I have some thoughts on supplementing. I supplemented early on with
both my dds due to low blood sugars, poor diaper counts and
dehydration. With my first dd I supplemented her after every feed,
and with my second dd I only supplemented her once a day. I think
that the once a day method was better. She got all the formula she
could swallow once a day, and kept her hungry enough to work hard at
the breast the rest of the time. You could modify that to twice a
day. Once a day probably wasn't really enought, but I was kind of
erring on the underfeeding side because I so wanted bf to work. The
point though is that I think supplementing after every or many feeds
is bad for supply compared to supplementing few times.

As for the latch issues, I just kept relatching over and over. I also
did have to hold her firmly in place and hold my breast in a sandwich
hold early on. I was getting back pains from all that holding of
everything. But, growth does solve all that, and before you know it
the baby is plenty big enough to get a great latch on their own. It
feels like forever though.

It is fine for the baby to sleep 6 or 7 hours, but it might not be so
good for your milk supply. If you cut out the formula, and make him
work for food :-) then I bet he will suddenly sleep less in order to
get enough food.

One more thing is that taking galactagogues might help you get off the
formula sooner by increasing your supply. Fenugreek and domperidone
are common galactagogues. Fenugreek is and herb and domperidone is an
Rx.

KC


"jjmoreta" wrote in message ...
Well we've backslid quite a bit this week, when I was looking forward to
getting some progress done, but there's a good reason.

Ian has been congested since birth. Lately its gotten a whole lot worse, to
the point that I took him to the doctor Wednesday. Things seemed to go well
on Monday, but on Tuesday things weren't so well. He slept 6 hours, for
one, the longest he had ever slept. Even more disturbing, though, was that
he hadn't wet his diaper during that time. He wasn't interested in
breastfeeding either - I wonder if it was because he was so congested. He
seemed to have an easier time with the bottle, so he got more of it than
ever before to help ward off dehydration (along with pumped BM from any
missed or incomplete feedings) which has continued until today. He had
drops prescribed for his congestion, but due to a pharmacy screwup, he only
started to take them tonight.

I wonder if some of his breastfeeding problems have been due to his
congestion. Saline drops and using the aspiration bulb have done little for
him, since its so high in his sinuses. He was less sniffly tonight and the
latching during this last feeding was better in my opinion.

Another good thing about the doctor's visit was that I got an updated weight
on him (that I can also use as a baseline to make sure that I'm not
eliminating too much formula from his diet too quickly). He was born at
10lbs, which he regained by his 2 week appointment. As of Wednesday (13
days later), he was 11lbs, 5oz! That was a lot more than I was expecting.

Now that he's on medicine, we are going to restart the supplement
elimination. My plan is to only give formula when he is still hungry after
I can't nurse anymore (either due to sore nipples or extreme frustration) as
long as he's having enough wet diapers. Hopefully over the next couple of
weeks, my nipples will get used to the extra feedings, he will improve his
latch which will decrease sore nipples to begin with, and my frustration
level will go down (either through improved latching or increased patience).
If I don't give him a full feed, I will pump what I can and give that to him
before any formula. Is this a good plan? I also plan on not using the
pacifier unless I am suffering extreme frustration.

I do have a Medela nipple shield but its a pain in the butt to use, so I
don't anymore (I did use it a couple of weeks ago before my flat nipple
resolved itself enough for Ian to latch onto). My problem is that I can't
get the thing to stay on. Ian has such a strong suck that it usually flips
off after a minute or two. I've tried using Lansinoh to help make it stick
on, but that doesn't help.

Here are some issues that I could use advice on:

- His latch usually starts out quite well, but by the end of the nursing
session he tends to slip down to the end of the nipple. How can I encourage
him to stop this? It usually ends up in a battle and leads to frustration
on both our ends. He gets very mad if he's still hungry and not being fed,
which doesn't help his latching, which leads to my nipples taking the brunt
of frenzied bad latching and relatching.

- How can I encourage him to open his mouth wider? He doesn't respond well
to my modeling or "open wide" yet. The only solution I've found is to wait
until he opens wide enough (which makes him more frustrated and angry in the
meantime) or to press down on his chin (which I have problems doing at the
same time that I'm shoving enough nipple into his mouth).

- Is 6-7 hours too long for a baby his age to sleep at once during the
night? He doesn't seem to have a problem with it and I've been so short on
sleep that I admit that I've let him do it since Tuesday. He's always done
4-5 hour stretches, but since we started swaddling this week (my husband put
him down that way), he's slept longer. Should I set an alarm to take care
of things every 3 hours or let it slide and be appreciative that he is
sleeping that long?

- What can I ditch the bottles for? I'm not familiar with using a cup for
feeding.

- Joanne
DS Ian 11/6/03