Weak suck

Ben has such a weak suck I worry. I have a really hard time getting him to
make the big fishy lips and then doing any nutritive sucking. He will latch
and suck, just not those long nutritive sucks and I almost always have to
adjust his latch/lips. His sucking is short and choppy and do not feel
strong.

He did not have any bottles the first week but then I started supplementing
(EBM) with three top ups a day of 1/2oz and now I'm supplementing with 4
tops offs a day of one ounce. He is slowly gaining now but was still 5oz
short of his birth weight at 2 weeks. He slept a lot and was quite weak in
general but that seems to be improving since I started with the 4oz/day.

I suppose it could be the bottles causing the less then perfect latch and
suck but it was the same the first week so I'm not sure. I'm hoping that
the supplements will get him back to his birth weight and that once he is
stronger his suck will be stronger too. Milk supply was an issue the first
week or so but I don't think it is any longer.

Any advice is appreciated. I was wondering specifically if there was

1) Any way to improve his latch and suck? I have not seen a lactation
consultant but I could ask for a referral. The doctor didn't think I needed
it but????

2) He is supplemented 4 times a day with one ounce directly after a
breastfeed. Is this the best way to supplement?

3) I had been waking him ever two hours to nurse. This week I was going to
try letting him go 3 hours. It is really hard to wake him up after 2 hours
and those nursing sessions are so pitiful that I think he may get more milk
by the end of the day by waiting the three hours so he nurses stronger and
longer. Any thoughts? I don't mind nursing him every two hours if that is
better. He does wake on his own at times too.

Thanks!!


--
Nikki, mama to
Hunter 4/99
Luke 4/01
Brock 4/06
Ben 4/06

"Anne Rogers" wrote in message
...
1) Any way to improve his latch and suck? I have not seen a lactation
consultant but I could ask for a referral. The doctor didn't think I
needed it but????

is it the latch or the suck that is the main problem? my DS was a similar
gestation (37+4) and I only retrospectively realise that he had a weak
suck,

I'm 100% sure his suck is weak. I'm not sure how much of a problem the
latch is. I think he could suck more efficiently if I could get those fish
lips going and get his tongue further down and out. He does get milk and he
doesn't hurt me so it must not be to awful but it could certainly be better.
I'm usually very strict about insisting on a perfect latch but I just can't
get him to do what I want and if I re-do it to many times he won't nurse.

2) He is supplemented 4 times a day with one ounce directly after a
breastfeed. Is this the best way to supplement?

sounds about right to me, I think when Leslie had to supplement Lorelei,
she set fixed times, but that was with an older baby a top up after a feed
sounds ideal.

The thought was that he would always know he had to work for his milk and so
far he hasn't fussed about breast feeding so I'm glad about that. When he
is older and we do the practice bottles (for when I go back to work) I may
switch that to replacing a feed with a bottle. That would be easier for me
as I have a hard time knowing when to pump right now.

The only thing I would try and do if you can is do it by a different
method,

I know! My aunt, whom I thought was very pro-breastfeeding, turned out to
be rather difficult to deal with this go around ;-) She did the supplements
and he bulked at the spoon (Brock did fine with it) so we went with bottles.
I don't want to give the bottles myself so Hunter will have to do it while
dh is at work and he'll need a bottle. Hunter has given a couple. Very
adorable. :-)

As it's only an ounce, a syringe would probably work quite well.

That is what I was going to do and the doctor said anything would work (cup,
bottle, dropper) but not to use a syringe. I'd never heard that
recommendation but my aunt wouldn't touch one after she heard that, lol.

what are Brock's rough timings?

We don't have much of a schedule yet. He'll go 2-3 hours. I think it will
be easier to tandem if I let Ben sleep for three hours. If we can manage to
keep the same in the early part of the day we do better towards the end as
well. Yesterday they managed to be about an hour off most of the time. A
lot of time was spent nursing. They are both rather fast nursers for
newborns. Ben might just conck out but Brock is always done in 20-30
minutes.

If you
can feed them together,

I can manage that and I like to whenever possible. Not only is it a time
saver but I think Ben gets the benefit of all Brock's hard work because the
milk lets down a little faster for Ben if Brock is also nursing. Brock has
a strong suck.

Do you use one side of each
each feed, or do they both get both sides, or what?

If they are both nursing at the same time I just keep them on their own side
for as long as they'll nurse. If Ben finishes first I'll sometimes move
Brock over. If they nurse seperately but I think they'll be one right after
the other I keep them on their own side. If they end up with their feeds
spaced then I'll offer them each side but try to vary which side they start
on. That sounds complicated but it isn't really all that bad :-)

I think waking a baby is
something that needs to be done for some babies, but if they don't manage
to feed well when you wake them up then it's probably a set back.

I'm having a hard time figure which Ben is! He gets weighed again on
Thursday so we'll see how he's doing then.

Hope that helps

It does - thanks.


--
Nikki, mama to
Hunter 4/99
Luke 4/01
Brock 4/06
Ben 4/06

As Anne mentioned, I supplemented Lorelei at set times, and I gave
bottles completely separately from breastfeeding.

The reason I did that was that I did not want her thinking of the
bottle and the breast at the same time. I didn't want her to think she
shouldn't work hard to nurse--and she had to work very hard--because a
bottle was coming anyway.

I chose to treat the supplements as medicine she needed to help her
grow, thus the regular schedule for offering them.

I don't know whether all this applies to such a little baby--Lorelei
was four months old--but it worked for me. She never refused to nurse,
we were able to stop the bottles eventually, and she nurses
enthusiastically and frequently still.

Leslie

"Leslie" wrote
As Anne mentioned, I supplemented Lorelei at set times, and I gave
bottles completely separately from breastfeeding.

The reason I did that was that I did not want her thinking of the
bottle and the breast at the same time. I didn't want her to think she
shouldn't work hard to nurse--and she had to work very hard--because a
bottle was coming anyway.

I chose to treat the supplements as medicine she needed to help her
grow, thus the regular schedule for offering them.

I don't know whether all this applies to such a little baby--Lorelei
was four months old--but it worked for me. She never refused to nurse,
we were able to stop the bottles eventually, and she nurses
enthusiastically and frequently still.


I used the same method with my two from about 6 weeks old. Both were off
bottles by 6/7 months. DS is still nursing enthusiastically and DD weaned
about 6 weeks ago. However, the problem wasn't strength but supply.

Nikki, could you use an SNS? Are you feeding simultaneously?

Jean

--
LeinsterFreecycle Co-moderator
http://groups.yahoo.com/group/LeinsterFreecycle/

DD June '02
DS May '05

As it's only an ounce, a syringe would probably work quite well.

That is what I was going to do and the doctor said anything would work
(cup, bottle, dropper) but not to use a syringe. I'd never heard that
recommendation but my aunt wouldn't touch one after she heard that, lol.


wierd, I've never heard anything bad about syringes, the reason I suggested
it as that was what we were told to use by a lactation consultant when DS
decided that sleeping was a better thing than eating in the very early days.
He seems very similar to Ben, weak suck, ok but takes some coaxing latch, at
least you have plenty of experience, he was my first!

Given how similar they seem, I really do suggest you consider all methods of
supplementing without a bottle, DS was actually doing fine with weight gain
initially, it was later around 8 weeks when he was using a dummy and was
having occasional bottles that the problems started (I think he was the same
weight at 8 weeks as Brock was at birth though!). It's all a bit hazy to me
as I was so ill at the time (PND -(), but one thing that did eventually dawn
on me was to ditch the dummy, the bottles were infrequent at that time, but
later when I was working at the bottles were necessarily more frequent, we
again had problems, we couldn't ditch the bottles then, but we had to do
everything to minimise them, so I would drive across town to feed him at
lunch time on the day we had a full day apart.

Maybe I am excessively freaked out by early use of bottles, but then my own
experience tells me that nipple confusion is not a myth and the last thing
you want to do is end up EPing for him.

I just noticed all your children were born in April, you must be very
fertile in July! Funnily enough both my children had the same due date, both
conceived on 22nd September, their birthdays are actually 2 weeks apart.

Anne

Ben sounds alot like my Skylar. She had a very weak suck and didn't get
back to her birth weight until after she was a month old. We used a
disposable SNS that was given by the LC. It wasn't disposable to us. We
washed it and reused. I had used a regular SNS when I nursed my twins,
but hated it. It was to big and bulky. With the disposable one I could
use it in public with no problem. I would turn it on when she would
slow down or if she was very sleepy I would turn it on in the
beginning. I personally felt better, because I know I have supply
issues and by her getting it at the breast she was increasing my
supply. She would only take a small amount, but she perked up. She
wasn't as hard to wake and gradually her suck became stronger. We
supplemented for the first three months. Her pedi still wants her on a
bottle, but I have decided that she is just small. I hope you find
something that works for you both soon.

Tammy

"Leslie" wrote in message
ups.com...
As Anne mentioned, I supplemented Lorelei at set times, and I gave
bottles completely separately from breastfeeding.

The reason I did that was that I did not want her thinking of the
bottle and the breast at the same time. I didn't want her to think she
shouldn't work hard to nurse--and she had to work very hard--because a
bottle was coming anyway.

Ahh, that is a different way of thinking about it. I'll have to give that
some thought.

I don't know whether all this applies to such a little baby--Lorelei
was four months old--but it worked for me. She never refused to nurse,
we were able to stop the bottles eventually, and she nurses
enthusiastically and frequently still.

Good to know! Thanks for replying Leslie. I was thinking about you and
Lorelei but I couldn't remember the details. I'm terrible about not paying
very close attention unless something actually applies to me. That is so
self-centered, lol.


--
Nikki, mama to
Hunter 4/99
Luke 4/01
Brock 4/06
Ben 4/06

"Iuil" wrote in message
...
"Leslie" wrote
As Anne mentioned, I supplemented Lorelei at set times, and I gave
bottles completely separately from breastfeeding.

The reason I did that was that I did not want her thinking of the
bottle and the breast at the same time. I didn't want her to think she
shouldn't work hard to nurse--and she had to work very hard--because a
bottle was coming anyway.

I chose to treat the supplements as medicine she needed to help her
grow, thus the regular schedule for offering them.

I don't know whether all this applies to such a little baby--Lorelei
was four months old--but it worked for me. She never refused to nurse,
we were able to stop the bottles eventually, and she nurses
enthusiastically and frequently still.


I used the same method with my two from about 6 weeks old. Both were off
bottles by 6/7 months. DS is still nursing enthusiastically and DD weaned
about 6 weeks ago. However, the problem wasn't strength but supply.

Nikki, could you use an SNS? Are you feeding simultaneously?

I could I think or at least I don't see why not. I'm not sure if that would
accomplish much??? Supply isn't an issue at this point as far as I can
tell. He just doesn't suck well enough to get what he needs to gain. I'm
unsure if the weak suck is just him or because of the bottles...hmm. Food
for thought. He's 2.5 weeks now and I was planning on starting bottles at 4
weeks anyway because he'll need them when I go back to work.

I do feed them both at the same time if they will cooperate. That helps Ben
because the let downs happen easier when they are nursing at the same time.


--
Nikki, mama to
Hunter 4/99
Luke 4/01
Brock 4/06
Ben 4/06

"Anne Rogers" wrote in message

at
least you have plenty of experience, he was my first!

I am soooo glad these two are not my first!!

Given how similar they seem, I really do suggest you consider all methods
of supplementing without a bottle, DS was actually doing fine with weight
gain initially, it was later around 8 weeks when he was using a dummy and
was having occasional bottles that the problems started

Things got totally screwed up in the first week. My helper wasn't much of a
help in the breast feeding department :-P. Had I been totally alone I doudt
we'd be having any of these problems right now. I had introduced a pacifier
for very limited use. My helper decided she was going to try and stretch
out their night feeds to some ungodly amount of time and was walking and
soothing them with a pacifier. I imagine they basically just wore out and
went to sleep, which she took as her doing a good job but was actually my
poor babies going hungry :-(. You can imagine how this affected my supply
and their strength. I had to get down right ****y with her. She supports
breast feeding in theory but is very entrenched in schedules and formula
feeding/bottles. I'm very very upset about that first week. Upset with her
and mostly with myself. My supply has corrected itself but Ben is just
taking a lot longer to get his strength back up there.

later when I was working at the bottles were necessarily more frequent, we
again had problems, we couldn't ditch the bottles then, but we had to do
everything to minimise them, so I would drive across town to feed him at
lunch time on the day we had a full day apart.

Maybe I am excessively freaked out by early use of bottles, but then my
own experience tells me that nipple confusion is not a myth and the last
thing you want to do is end up EPing for him.

Ugh - that would be the *worst*. I'll have to see. I work as well (but
not until 12 weeks) and so need him to eat while I'm gone. I had one that
refused a bottle so I'm probably excessivley freaked out about that, lol.
Still, if the bottle is what is causing the poor suck, that would be
terrible.

I just noticed all your children were born in April, you must be very
fertile in July!

Ha - I love summer!! I'm actually in a good mood, lol.

Funnily enough both my children had the same due date, both conceived on
22nd September, their birthdays are actually 2 weeks apart.

Luke is the 19th and Hunter the 26th. The twins were born on the 7th but
the original due date was the 23rd. That would have been kind of cool.


--
Nikki, mama to
Hunter 4/99
Luke 4/01
Brock 4/06
Ben 4/06

See a special needs lactation consultant. I had three LCs tell me Alli's
latch was great, keep going, it's fine, while she lost more than a 3rd of
her birthweight and started to dehydrate, even though I could feel that she
wasn't really sucking. In her case, even most bottle nipples didn't work at
first-at the beginning, it was more like let the milk drip into her mouth at
a rate that she could handle swallowing it-which meant that feeds took
forever, and I was spending most of my time feeding the baby or pumping for
the next feed (fortunately, I had a resident grandma for the first 6 weeks,
and by that point, her sucking strength had improved enough that she could
at least take a preemie nipple). However, it took a special needs LC to
figure out the problem and to work with me on establishing supply via
pumping so I could adequately feed her.

In my case, I never got nursing established, but I also stopped really
trying to nurse her because she was fighting me so much on it-and since I
was recovering from a C-section with complications after a complicated
pregnancy and some PND, I just couldn't stand having her scream at me when I
was trying to nurse her. If he's willing to nurse non-nutratively, that's
definitely something to keep up, because it increases the chance that he'll
pick up on nutrative nursing when his suck improves (if it's a suck, as
opposed to a latch issue).




--
Donna DeVore Metler
Orff Music Specialist/Kindermusik
Mother to Angel Brian Anthony 1/1/2002, 22 weeks, severe PE/HELLP
And Allison Joy, 11/25/04 (35 weeks, PIH, Pre-term labor)