Need lots of advice on nursing problems and eliminating supplementation

When my son Ian was born 3.5 weeks ago, he suffered from pathologic jaundice
due to blood group incompatibility. He wasn't doing very well and my milk
was coming in slowly, so my doctor decided to push fluids through him at the
time, using only a finger feeder so as to monitor his food intake exactly.
I expressed my breast milk using a pump, so he did get it at least, but
since then we haven't been able to stop using the formula.

It seems like we're backsliding from my plan to breastfeed exclusively and
avoid pacifiers. When he spent 48 hours under the bili lights, adding a
pacifier helped soothe him between feedings. I didn't want to keep using
formula out of the hospital, but we did and it seems like we're using it
more and more, especially at night because I have a hard time staying awake
for feedings. I've been delaying stopping the formula because its too
darned convenient. *sigh*

One of the reasons its been so convenient is because I have had nursing
problems from the get-go. The nipple soreness was terrible at first, but
resolved itself within a week. One of my nipples was inverted but now its
just about normal. Out of the hospital, we started having problems with the
finger feeder. Not only did it take FOREVER to feed him (I know that's good
but it was a lot slower than my breast would be), but my fingers would go
numb and hurt (I have nerve problems) and he started refusing the breast.
He would actually push away my breast and go for the fingers on the hand
that was trying to aim the nipple into his mouth. We switched to a bottle
and that improved things. We're using a slow-flow Pur nipple that my sister
said the LLL recommended to her for EBM bottles, but now we're getting mild
nipple confusion (but nursing is still better than from the finger feeder).

Now when he nurses, it feels like he's licking the nipple which I can't
stand. This leads to frustration on my part because the sensation is
annoying and actually painful after a while. I get upset, which upsets my
letdown. He also will slide down the nipple until he's only suckling on the
tip which adds to the discomfort. When I unlatch him repeatedly to try to
fix the latch, then he starts getting upset (he's a very calm baby EXCEPT
when he's hungry and not getting fed immediately) which makes things more
difficult (and leads to clamping which leads to more pain). Often it ends
up that I'm too sore or frustrated to nurse anymore, so he ends up getting a
bottle which doesn't solve the problems.

He's also a sleepy nurser. Five sucks and his eyes close. A couple of
swallows and he's out. After five minutes I have to stimulate him by
rocking or stroking his back (skin to skin does not cure this although I do
nurse skin to skin as much as possible). Burping is more of a "wake up"
activity than getting air up. Sadly the only time I get really effective
nursing is when he's been crying. So much for learning to anticipate his
early cues. *sighs*

Another problem is that the formula gives him horrific gas. I feel like
crying myself when he's crying and scrunching his face and legs up in pain
because I gave the formula to him. We've gone through almost an entire
bottle of Mylicon in the past 2 weeks. We've even taken to dosing his
formula as a preventative measure, which is horrible. He also spits up
horribly with the formula, which he NEVER does with breastmilk. Eliminating
the fluoride water used to mix it has helped, but hasn't eliminated the
problem.

So I set today as the day that I would start taking him off of formula and
pacifiers, starting when I got up with him at 4am. I did well mostly
through the day, but I resorted to a pacifier around noon because he was
wasn't really nursing but would scream if I took him off of the breast. It
allowed me 15 minutes to fix myself some lunch which I sorely needed. And
then at 2:30 pm I had to resort to 2 oz of formula because I was sore and
frustrated after 2 hours of almost solid switch nursing and I was getting
upset (he had gotten plenty from his previous feedings today so I don't know
why this one took so long).

But he finally got enough and fell asleep, which has allowed me some rare
computer time, which I've spent trying to look up some information on fixing
our problems. I plan on going to a local LLL (unfortunately I have to drive
45 minutes to the nearest one) and getting their book (I have the bf book by
Sears). What would really help though is advice or tips you can offer me on
how to get back on bf exclusively and build up my supply. I have this
constant worry that I don't have enough for my hungry 10lb+ mooseling. I
haven't even been able to build up any reserves of milk for babysitters or
when I go back to work (not until a minimum of 4 months though).

I also want to post this link, which really made me feel better when I found
it since its exactly what I'm going through. It helped me realize that I'm
not going to be able to do this in one day (what made me think I could take
him off formula and pacifiers cold turkey??) but I'm confident now that it
can be done.

http://www.lalecheleague.org/NB/NBNovDec02p217.html - "A Valuable Lesson"

- Joanne
DS Ian 11/6/03

Something to think about. Right now you are doing two things: Supplementing (1)
and giving Formula (2). Start thinking of it as two things, that will help you
focus on which you want to eliminate first. Which is going to be the Formula.
Do you have a serious electric pump? If not, you need it. Rent or borrow. Do
you have a time of day when you have a lot of milk and a happy baby? That's
when you pump to create your supply for later THAT DAY. Forget about building a
stash for months from now. Work on today. If the last feed at night is when you
are just out of milk, use the expressed BM. Work on building up your supply.
You can do it. Sue



** remove "spamnot" to reply**

"Sue theo b" wrote in message
...
Something to think about. Right now you are doing two things:
Supplementing (1)
and giving Formula (2). Start thinking of it as two things, that will help
you
focus on which you want to eliminate first. Which is going to be the
Formula.
Do you have a serious electric pump? If not, you need it. Rent or borrow.
Do
you have a time of day when you have a lot of milk and a happy baby?
That's
when you pump to create your supply for later THAT DAY. Forget about
building a
stash for months from now. Work on today. If the last feed at night is
when you
are just out of milk, use the expressed BM. Work on building up your
supply.
You can do it. Sue



** remove "spamnot" to reply**

Thank you, that is very helpful. I have a pump, just not a very good one
(single Medela electric pump). And to be honest, I have no money that I can
use to rent one and I don't know who I could borrow one from. I'm not
getting a lot of milk with it, but I've still been using it after incomplete
feeds.

How often can I pump? (i.e. how long am I supposed to let my breasts
refill?)

- Joanne
DS Ian 11/6/03

On Mon, 1 Dec 2003 17:07:22 -0600, "jjmoreta"
wrote:

So I set today as the day that I would start taking him off of formula and
pacifiers, starting when I got up with him at 4am. I did well mostly
through the day, but I resorted to a pacifier around noon because he was
wasn't really nursing but would scream if I took him off of the breast. It
allowed me 15 minutes to fix myself some lunch which I sorely needed. And
then at 2:30 pm I had to resort to 2 oz of formula because I was sore and
frustrated after 2 hours of almost solid switch nursing and I was getting
upset (he had gotten plenty from his previous feedings today so I don't know
why this one took so long).

You are doing a great job. What the above sounds like is your DS is
trying to get your suppy up to where he needs it (the switch nursing).
How often is he feeding? Both sides? How long each side?

DD until she was nearly 6 months old would feed for at least 1 hour,
at first that was every 2 hours for 1 hour (meaning I would get a
break from feeding of 1 hour). Both sides approx 30 to 40 mins on one
side. This did get better as she got older.

Continue as you have today, if you can pump some breastmilk for that
afternoon/evening feed it would be better but not a must. Worry about
getting rid of either the supplementing, the formula or the dummy one
at a time (okay the supplementing and the formula may end up going
together).

Really it sounds like you will be able to get back to your plan of
breastfeed exclusively. ((((hugs))))))

Di

Instead of trying to pump after pump during. I only fed Katie on one side at a
time. I needed to make sure she was getting enough fatty hindmilk and we were
having problems with imbalance (ie green poop) so I pumped on one side while
she fed on the other. After a while (a week or so) I started getting much
better production both at the pump. Good luck. Sue

** remove "spamnot" to reply**

jjmoreta wrote:


Now when he nurses, it feels like he's licking the nipple which I can't
stand. This leads to frustration on my part because the sensation is
annoying and actually painful after a while. I get upset, which upsets my
letdown.

I *never* say this...but try a nipple shield. A big one, so that your
areola will be able to pull into the nipple part as well as the nipple.
Do you have a lactation consultant working with you?? ***The nipple
shield CAN cause supply problems***, but it can also save your nursing
if you (like me) cannot STAND the feeling of the flutter sucking,
especially at night. DS put on a LOT of weight when I tried the shield,
and I think it was because a) it didn't hurt excruciatingly every time
he nursed and b) I didn't have to feel the flutter sucking that I was
going insane from, especially at night. I had other issues, with
vasospasm and compression injury, but if your choice is trying the
shield or quitting because you aren't getting good letdowns and formula
is "easier" because of the sensation of bfding....it might be worth a
try. I use Medela's shield...the regular size, I think, but big is
better, never buy "small" even with tiny or inverted nipples. And
monitor your DS's weight.

VERY IMPORTANT: Use the shield as little as possible for as short a time
as possible...wean off it as soon as you can...I used it every feed and
by 3mo, DS was hooked. He sleeps holding onto the shield now...it's his
security thing...trust me, a blanky would have been far better in public
than a silicone "boob" ;-)
It's a REAL pain to have to find and use the shield, tho I have
persevered for nearly 15 mo now.....and if I had to chose between the
shield and not nursing, there was no choice.

It might get you thru the 3 wk spurt, anyhow. I'm happy to answer any
other quesitons if I can....email or here.

But he finally got enough and fell asleep, which has allowed me some rare
computer time, which I've spent trying to look up some information on fixing
our problems. I plan on going to a local LLL (unfortunately I have to drive
45 minutes to the nearest one)

DRIVE it. ;-) if they are your best source of support, you may have to
bite the bullet. They won't like the idea of a nipple shield. ;-) Have
you phoned them to see if someone can visit *you*?

and getting their book (I have the bf book by
Sears). What would really help though is advice or tips you can offer me on
how to get back on bf exclusively and build up my supply. I have this
constant worry that I don't have enough for my hungry 10lb+ mooseling. I
haven't even been able to build up any reserves of milk for babysitters or
when I go back to work (not until a minimum of 4 months though).

Don't worry about that (reserve milk) til you sort out the supplementing
issues. If you're supplementing with formula and freezing EBM, that
makes NO sense at all. Your DS needs the breastmilk NOW and could
likely cope with the formula better later if he does need it. You're
smack in the middle of the 3 week growth spurt, hence the constant
nursing. My advice would be to tough it out to 6 weeks however you can,
and then usually things sort of level out. As for supply, he's doing
his job...demand is the best way to bring up supply. More nursing.

LLL people may be able to help if the latch is not very good.

You could try pumping a little before he latches, if you have large or
engorged breasts relative to your nipple size..that would make it easier
for him to get a better latch and stay latched.

I hope some of this is useful.

Dawn

I agree with the nipple shield suggestion! We had major latching problems
in the hospital and with the shield she was as happy as a lark. They
wouldn't let us leave the hospital without having a feeding plan and I
refused to supplement with formula. We either pumped and DH bottle fed her,
or I used the shield.

Julia is 5.5 weeks old now and hasn't used the shield. I guess we got lucky
since she also doesn't have any nipple confusion between my breast and the
bottle!

Before she was born I was anti pacifier, but now we used it when we are
trying to go to bed. It calms her, I don't even take it out with me during
the days though! I don't want a paci-junki! LOL

Best of luck to the original poster, I'm sure you will have a breatfed only
baby in the near future!

Katherine

*Jen goes off on a tangeant*

"KR" wrote in message
...

. They
wouldn't let us leave the hospital without having a feeding plan and I
refused to supplement with formula.
Katherine



Ok, this line here really ****es me off! (Not that you said it Katherine,
but that you had a need to say it is what kills me)
These damn nurses and their know it all attitudes and this nonsense about
you need a frigging plan blah blah blah. I realize there are some people out
there that wouldn't know where to seek help,that would resort to the bottle
and give up BF by the time they left the hospital because they're either
ignorant (not meant in a bad way, just the not knowing way) or lazy (meant
in the bad way LOL)
Oh, yea, my point g
If a mother is determined to BF, you would think that knowing there is
formula available but choosing not to use it is a pretty good indication
that the parents DO have a plan. And who the hell are these nurses and
hospitals to tell parents they aren't *allowed* to leave the hospital! Give
me a break! You can't kidnap your own child for cryin out loud! (not in that
situation anyway) Frankly it's scare tactics they use to get you to conform
to what they think is best (or get out of doing their jobs) and it annoys
the hell out of me that they even try it! Instead of making threats they
should be going out of their way (even though it IS their job) to help you,
instead of telling YOU to "come up with a plan" they should be offering
viable suggestions (and no I don't consider telling you how to make a bottle
as viable) or asking if you'd like to see the IBLC on staff.

*shaking head* can't leave the hospital my ass! I would have LOVED for one
of the nurses at my hospital to tell me that because I would have told her
to shove it straight up her..........

Jen

jjmoreta wrote and I snipped:

How often can I pump? (i.e. how long am I supposed to let my breasts
refill?)

Just had to reply to this question.... Your breasts don't need to
"refill." As your baby nurses, the suckling stimulates your body to
produce more breastmilk. You're never truly empty. If you're
responding well to the pump, this happens during pumping too.

HTH,
-Patty, mom to Corinne [Mar-98] and Nathan [May-00]
and stepmom to Victoria [Apr-90]

I plan on going to a local LLL (unfortunately I have to drive
45 minutes to the nearest one) and getting their book (I have the bf book by
Sears).

Good plan, but you might also call the leader and ask if there is anyone who
might be able to visit *you*, or for a referral to a local LC. (Even if you
have to shell out a few bucks for a consultation with a good LC, it's worth it
-- much cheaper than a year's worth of formula!)

For that matter, tell us where you live and there may be someone on this group
near you who could help you out.

What would really help though is advice or tips you can offer me on
how to get back on bf exclusively and build up my supply. I have this
constant worry that I don't have enough for my hungry 10lb+ mooseling. I
haven't even been able to build up any reserves of milk for babysitters or
when I go back to work (not until a minimum of 4 months though).


Forget about months from now and take it one day at a time. Or one feeding at
a time, if a day seems too long!

How much formula are you actually using, per day, right now? How much ebm? If
you're not really using a significant amount of formula, it may be possible to
stop cold turkey; if it's more, you'll need to cut back gradually. And you
really need to ditch the bottles. Plan to do nothing but nurse for at least
the next few days. Recruit your husband and any family member or friend you
can get your hands on to take care of feeding *you* and do the minimum in the
way of housekeeping; don't do ANY of it yourself. Get topless, get in bed with
the baby, and let him nurse all day and all night. And don't feel guilty about
it.

Also, don't beat yourself up over the pacifer -- that's the last thing I'd work
on changing, and only if it really seems necessary. The risks of minimal
pacifier use tend to be overstated, IMO.

You *will* get better at this, and so will your baby. Sheer determination will
take you a long way. ;-)

Holly
Mom to Camden, 2.5 yrs
EDD #2 6/8/04