Unable to breastfeed and milk supply

[riehlism]

Hi Ladies, I am having issues with feeding my son. He is one month old but has spent 3 weeks of it in the hospital. He has had to be on the bottle because they had to measure how his intake (GI issues at birth). I have been pumping and bottle feeding, and supplementing with formula. I have seen 5 lactation consultants but I have been unable to sustain their plans because he kept getting admitted.

My milk supply is rather low and the stress of it all is really affecting it too. I know that nursing helps with milk supply. But my son has gotten so used to the flow of the bottle, he gets angry and fights me on the breast. I don't feel comfortable strong-arming him to make him feed on the breast. I am using a nipple shield because, on top of everything, I have flat nipples.

Anyone have these issues?

[m]

I pumped for my daughter for about 3 or 4 weeks and then ended up using a nipple shield for a really long time and finally was able to breastfeed her without it. When we transitioned off the bottle, we would try breastfeeding first at each feeding and then supplement with the bottle until she got the hang of breastfeeding. I had low supply for a while and my doctor prescribed Reglan, which helped.

[blythe]

I'm sorry you're dealing with breastfeeding issues on top of everything else!

I pumped for 9 weeks before getting my firstborn to breastfeed (then didn't wean him until he was 2 1/2 and I was pregnant with my second) so I hope that gives you some hope that it's possible. I didn't have flat nipples though... But no matter what happens, you've done fabulous pumping this long already and getting him as much breastmilk as you can!

I'm glad you've got LCs to consult, maybe now that Luke's health issues are resolving you'll have more luck with their ideas. Good online resources I've seen are
http://www.breastfeedinginc.ca/products ... ng=English - Dr. Jack Newman, an early proponent of breastfeeding and has even devised ways for mothers to lactate and breastfeed their adopted babies. One note - he's from Canada and prescribes a drug for lactation that is illegal in the US so we can't recommend it here. Instead, I've also heard about Reglan being prescribed in the US for lactation and re-lactating, and a lot of my friends have had amazing increases with supply when taking Fenugreek - though everyone says it makes their skin smell like maple syrup for a while.

Maybe try lots of skin-to-skin time? Even if he doesn't want to actively nurse? My firstborn wasn't happy with the transition from bottle to breast at first, but he decided it tasted better coming straight from me so I got lucky. He never would take a bottle again, though, so I ended up having the opposite problem when I left him with a babysitter.

Good luck with whatever you try and whatever you decide - even if you decide to switch entirely to formula that is perfectly okay!

[michelarea]

With my first daughter Viola It took about two months for her to actually breastfeed (she spent 5 weeks in the NICU). My supply was not enough so I always gave her formula as well but in the end I was very happy to nurse until her first birthday and I think it was beneficial. Not easy, I remember myself pumping and crying more than once, so I don't blame at all people who stops, preemie and small child make breastfeeding very complicated

[laughinggirl127]

My daughter was born at 32 weeks and was never able to latch on. I pumped for 6 months till due to life stress my milk dried up. Don't beat yourself up if you never get your baby to latch. If you want your baby to have the breast milk and the only way is through a bottle then it is better than the formula. One of the girls I work with was unable to get her son to latch as well. She pumped for 7 months but had a good enough supply that she gave him breast milk though his first birthday. Remember to take care of yourself. Good nutrition and plenty of water will help your supply. I know that having a sick baby we sometimes forget about ourselves but it will affect your supply. If you didn't want to get a RX for reglan you can also get a couple of supplemets sold over the counter that will help. There is a tea called mothers milk or you can get a supplement from walmart called fenugreek that you take four times a day. It has helped my sister double her supply.

FYI- for all of the nursing mothers out there thought I would share a tip on how to save money on a hands free bra for pumping. Would have been handy while I was pumping as I spent many hours doing so but will help for next time. I came across the idea on craigslist. You buy some relatively inexpensive sports bra's and cut a slit in the correct area just big enough for the end of the breast shield to come through. The bra will hold the shield in place and you can connect the rest of the bottle etc. This works best on the type of pump like the Medela where the end of the shield comes completely off.

Hope that you are able to nurse as it is clearly a desire that you have. And if it doesn't work out then just do what is right at the time for you and your baby whether it is continuing to pump or to use formula. Good luck

[aajatwins]

I had supply issues with my twins (due to my bra being too small and me not realizing it). I took the Fenugreek and I think I only took 1 or 2 a day. It worked really well and had no side effects that I'm aware of. The only downside was myself and really the whole house smelling like maple syrup It wasn't a bad smell, just an odd thing.

I don't know about the nipple issues, but it would be best for your body if you can nurse a little... I think someone else said this, but if you can try to get him latched on for a few minutes before you give him the bottle it might help. Or if you can wait until your milk has let down or is already flowing (naturally or by pump), then he wouldn't have to work so hard at the beginning of the session - that might make him a little happier to nurse. Be patient with yourself (and your baby) if nursing is really something you'd like to do. All newborns have an adjustment period getting used to feeding and it's easy to see where he'd be frustrated with relearning. But it can be done!

Just a thought and I'm not sure how feasible it is: there is a thing that adoptive moms use when wanting to lactate for adopted babies that is basically just a bottle that hangs around your neck and a tube that hangs down on your breast... (Medela Supplemental Nursing System or the Lact-Aid Nurser Training System) baby latches on to the breast when mom isn't making milk yet, but gets milk through the tube and is fooled into thinking it comes from the breast. baby learns how to latch and mom starts to lactate. If you could do that to "supplement" with your own expressed milk, he'd get more milk and faster and still be learning to latch on. Does that make sense? I actually just looked it up and the Medela site and it says it's good for supplementing at the breast, so look into that!

[alexis]

I have severe low supply (PCOS/insufficient glandular tissue, finally officially diagnosed) and have quit breastfeeding both times because I have to supplement so much, but in the process, I did learn a lot about it. If he's fighting being at the breast, change the supplementation order. Give him part of the supplement first, to calm him down. Then, when he's calm, try latching him. LCs are starting to recommend this more. See: http://www.lowmilksupply.org/finishatthebreast.shtml

I found this to work a lot better than fighting with the baby to latch--also, the article is right that if supply is low, baby can get frustrated and you get stuck in a downward spiral, which happened with my first.

I've never used Reglan; I used the other drug we're not allowed to mention (in the UK it is sold OTC) so I can't give any information on that. Fenugreek and blessed thistle are widely recommended for milk supply. Here's the bad news: All these supplements work, or are thought to work, by boosting your prolactin level--there are a couple that claim to help build breast tissue, but this hasn't really been studied well. If the problem lies elsewhere (particularly if it is IGT) their efficacy is really limited. I'm saying this not to be discouraging, but so that if you find this is the issue (I think I remember you have PCOS? It's linked to supply problems) you don't beat yourself up that you did it wrong. We don't entirely understand why PCOSers have low supply (there's also a disproportionate number of PCOS women with oversupply). It can cause IGT but that's not the only factor--women with PCOS and normal breast tissue may also have supply problems.

[riehlism]

I had another Lactation Consultant appointment today. It's my first follow up appointment. Since I saw her, Luke was hospitalized twice. I caught her up on everything and told her I have been able to keep a meager milk supply through power pumping. At least it's more than when I first saw her. I am pumping about 1-2 oz every 2-3 hours, when the baby is now eating 3-4 oz of food per feed.

She suggested what Anna mentioned earlier, a SNS.



I tried it and he screamed and fought nearly the whole way through. She said to try it twice a day with my husband and continue what I am currently doing with other feeds. She said he's gotten really strong and stubborn, and that we are at a critical period for him right now in terms of learning how to feed. He's also getting hard to physically handle.

I am on supplements and she did mention Reglan and domperidone, which has fewer side effects than Reglan. She said the problem with that is I would have to find a compound pharmacist to make it, since it's not a US product.

I will give this a good heave ho, but I am feeling rather defeated at this point.

[caryn]

Getting some babies to latch is really a struggle, milk production is also very dodgy and the combination - well, this is why we invented wet nurses and formula, I'm quite certain.

I have heard good things about the SNS, but haven't tried it. I couldn't pump worth a darn - developed pump resistance within a week - and think your output is pretty awesome!

FWIW, my son learned to latch when he was too sleepy to argue with me about it, and not terribly hungry. Then I left him on the breast and let him nurse in his sleep to build my supply up. He's still a spitfire with a temper - sounds like you may have the same sort of baby.

Here's the FDA's comments on domperidone: http://www.fda.gov/Safety/MedWatch/Safe ... 154914.htm

(We don't particularly care if people mention it, I don't think - but have had people coordinating a way to subvert US law by shipping from out of country on the forums before, and obviously we cannot support that lawbreaking thing.)

[alexis]

Dr. *** just got FDA orphan drug status for domperidone for lactation. It is NOT approved, but this is the first step towards studying it well and hopefully getting it approved--which would be good. Reglan can have some nasty side effects, and the worst issues with domperidone involve giving it IV (I read up on it before taking it).