Breastfeeding in Jeopardy- help!! *UPDATE

[Monzter79]

Well, Im going to try and make this quick...

Baby was born (2 weeks ago) with low blood sugar and we had to put him on the breast and give formula immediately. After that, he was jaundiced. My schedule at the hospital was breastfeed, bottle feed what I expressed, formula feed from bottle, then pump. Rinse and repeat as often as possible.

My nipples cracked immediately. I have since tried APNO cream & lanolin, shields, taking breaks and bottle feeding him pumped milk, "powering through" etc. Everybody told me to stick to it and it would get easier. It hurts every time and sometimes I break down and just cry.

He was just diagnosed with tongue tie yesterday and had a procedure to correct it today. Doctor wasn't happy with his weight. Hasn't yet resumed birth weight and only gained 2.5 oz in the last week. Lactation consultant said my latch looks great and I'm producing well, but baby can't get the milk very well. Hoping the procedure will help.

We have resumed supplementing with formula. I'm BFing with shields 15 min/ side, then pumping 15 min a side, feeding him the pumped milk and topping off with formula if he doesn't seem satisfied..

I'm concerned that I also have a yeast infection because of the pain. I don't quite know what my question is... If anyone has any experience with this or any ideas that may help me- please share! I'm so tired of feeling like I'm failing him.

 

[impatient1]

Sounds familiar. I would get to your doctor and get a prescription for thrush if that is what you have and the sooner the better. I have no experience with shields but the prescription will definitely help with the pain and make it much easier to get through a feeding. Also make sure to put lanolin cream on before and after each feeding or pumping session and change breastpads often.
We had the same schedule in the beginning when my dd2 was born due to low blood sugar and low birth weight. I was able to cut out formula early on though due to my supply so just had to top up with a bottle of bm after breastfeeding.

 

[ButterCup17]

I don't have experience with tongue tie, but from things I've read in here, getting the procedure def helps, hopefully that's all it was. In regards to the pain, it sounds like you are doing a great job with keeping with it! I know it's easy to want to quit, I've been there with the pain! As pp said, change breast pads very frequently! My ds and I had thrush before. If you have it I'm pretty sure ur lo would too. Have you checked his mouth for white patches anywhere? It is usually inside their lips, inside cheeks, on their tongue or roof of the mouth. If you have thrush, it won't go away without a prescription so you might want to get that checked out. Hope it all works out! Hang in there xx

 

[noon_child]

If you have only just had the tie snipped today you will still have pain from the damage already caused, however it should feel better as your nipples heal. If it doesn't it might be thrush or the latch is still problematic however "good" it looks from the outside.

Are your nipples flattened or pinched or angled when they come out of LOs mouth?

The poor weight gain looks to be linked to the tongue tie too. Everything you have said is all symptomatic of tongue tie.

Is the 15mins each side LOs choice or are you timing feeds then swapping him over? If you think it would be better for your pain, you could try feeding from one side only at each feed, it would give your nipples more healing time, and LO might get more of the fatty milk that is produced nearer the end of a feed. I know that block feeding like this can be used to reduce supply BUT that won't happen unless there is more than 3-4hours between feeds and as long as he isn't taken off the breast before he is ready.

Alternatively if the pain gets unbearable the longer LO is attached you could do switch feeding (swapping him back and forth from one breast to the other) as one side gets too painful. However this requires lots of latching, so you may not like the sound of it.

Either way "timed" feeds that restrict how long baby feeds are not really recommended in terms of baby weight gain, however I totally understand if this is all you feel you can cope with because of the pain. Any amount of bf is something to be proud of and if you need to use formula to give your breasts a chance to heal so that you can resume breastfeeding then this is a valid choice too!

 

[buddyIV]

I second what pp said above ^^^^

I've no experience with tongue tie, but I really hope that things get less painful now it's been treated. I do, however, have experience with thrush as I had it with DS1. Its horribly painful...I really feel for you! If you suspect you might have it, get to the Dr for a prescription and make sure they treat both you and baby. At home, you should boil wash your bras and towels, and change breast pads after every let down i.e. every time they get moist as the moisture helps the yeast to grow. I used to only feed from one breast at a time as it gave the other breast a break, and was topless at home to let the air get to my nipples. I also cut back on sugar and ate active pro-biotic yoghurts (I have no idea if this helped, but it wont hurt either!) Hopefully you'll be BF pain free really soon!

 

[Monzter79]

Thank you all for the replies. I'm really in a pickle now... I'm only pumping 1oz at a time... I BF him earlier and then only pumped 1 oz. but decided to pump and bottle feed the next two feeds due to pain. Only pumped 1 oz ea time. Normally, I pump 2 oz. if I have not BF first.

My MW still hasn't gotten back to me. Still no meds for the potential thrush. I went ahead and left another message with LC. hopefully she'll have time to see me tomorrow.

Baby seems to want 2.5 oz of breastmilk/feed. And he is hungry every 2 hours. Seems to want the same amount with formula. So, I already feel behind.. Now this! He's not yet back to his birthweight (9lb 14oz). He weighed 9lb 5 oz on Monday and only gained 2.5 oz that week.

I don't know how to supplement him without losing my supply. In fact, I need to INCREASE my supply. I'm drinking loads of water too. Of course, cutting back formula is out of the question right now. He isn't able to get the milk efficiently yet and clearly I'm not making enough and in pain. I don't know what to do...

It's SO important to me that I try to make this work!!!

 

[MommyJogger]

Okay, first, that's not a bad weight loss at all. I don't have a calculator, but that's close to 5%, 8% before the weight gain? Up to 10% is normal with zero breastfeeding problems and any weight gain is a fantastic sign. Are you in touch with an IBCLC or just a hospital consultant? Are they seeing you in person?
At 2 weeks old, your milk is mainly hormone driven-- that means if you're healthy yourself, your body will be making abundant milk and the job of frequent nursing and good milk removal right now is to build prolactin receptors that will determine your long-term milk production capacity.
Hungry every 2 hours for a two week old having zero breastfeeding problems is also really great-- many mothers find that they're feeding more often and it's not a sign of feeding issues.
Honestly, what I would do in your situation, since your LO's tongue tie was just clipped, is to:
1) stop pumping-- your LO's latch should be much better now, though you still have damage from your previous issues. Pumping can exacerbate the harm done to your nipples and as long as your LO's latch is good now, it will be less damaging than pump flanges.
2) stop the bottles and shields-- your LO is now learning to adjust his latch with full use of his tongue. Give him the chance to learn how to feed from the breast, rather than having him learn two different types of latches (one for bottle/shield and one for breast, because they're very different techniques) with his "new" tongue.
3) So early postpartum, without health issues of your own, it is an option to drop supplementation. What you have to then be aware of is to keep careful track of diaper output-- wet diaper output is the only reliable way to assess a breastfed baby's milk intake. You cannot look at the volume a baby takes from the bottle and assume that's the volume the baby needs to eat-- a baby that age is not able to control the flow, so they will take more liquid from a bottle than they actually need. Your body will also respond better and you'll let down easier if you remove the shield, so baby will get milk easier that way. Some women have no trouble using a shield, some women simply don't get enough stimulation through the shield and it will eventually cause problems.
https://kellymom.com/bf/got-milk/supply-worries/enough-milk/

The best way to increase your supply is to cut out the supplementation/shield and let the baby tell your body to make more milk at the breast. How is the pain 10 minutes into the feed if you haven't pumped in the previous hour? How is your pain without the shield? What do your nipples look like when the baby unlatches? Does baby have any white patches on the roof of the mouth/inside of cheeks or do you have bright red nipples/aureola? Has anyone been on antibiotics? Are you making sure baby has a wide open mouth when he goes to latch? Even though the tongue tie is fixed, you may need to help baby latch correctly because it's not something he's used to doing.
If you can at all stand the pain (and especially if the pain lessens after baby has been on for a while), just let baby nurse on his schedule-- don't time sides and then top up if he's not satisfied, just let him keep going. There is always milk being produced in your breasts-- if you let him keep nursing, your body will let down again and give him more.
You can do this. I've been there feeling like you're not producing enough and it hurts like a motherfucker and you just want a nice, satisfied, sleepy bundle. You will get there. You can do this.

 

[Ruth 1980]

If you have only just had the tie snipped today you will still have pain from the damage already caused, however it should feel better as your nipples heal. If it doesn't it might be thrush or the latch is still problematic however "good" it looks from the outside.

Are your nipples flattened or pinched or angled when they come out of LOs mouth?

The poor weight gain looks to be linked to the tongue tie too. Everything you have said is all symptomatic of tongue tie.

Is the 15mins each side LOs choice or are you timing feeds then swapping him over? If you think it would be better for your pain, you could try feeding from one side only at each feed, it would give your nipples more healing time, and LO might get more of the fatty milk that is produced nearer the end of a feed. I know that block feeding like this can be used to reduce supply BUT that won't happen unless there is more than 3-4hours between feeds and as long as he isn't taken off the breast before he is ready.

Alternatively if the pain gets unbearable the longer LO is attached you could do switch feeding (swapping him back and forth from one breast to the other) as one side gets too painful. However this requires lots of latching, so you may not like the sound of it.

Either way "timed" feeds that restrict how long baby feeds are not really recommended in terms of baby weight gain, however I totally understand if this is all you feel you can cope with because of the pain. Any amount of bf is something to be proud of and if you need to use formula to give your breasts a chance to heal so that you can resume breastfeeding then this is a valid choice too!

I couldn't have said it better than this ^^^
I also experienced the damage from a tongue tied baby, oh Lordy I hear you about the pain! I cried and cried through feeds. It will get better I promise, it's just so hard to see the end of the tunnel through that pain right?
Re: weight loss/gain, with a baby that size there really is no need to panic. (Mine were 9+pounders too) they are born with plenty of meat on them so if it takes a while to get back to that it's not too bad.
Keep coming on here to blow off steam, it helps. And know that you will get through this awful tough time, hugs x

 

[capricorn1]

There is some excellent advice above! I had a 6 pounder with a slight tonguetie that was rectified at 8 weeks after I had a horrific episode of thrush. The pain was almost unbearable all of the time and if anything worse during the start of a feeding session. I found holding a hot water bottle against my breasts helped to ease the pain until the meds kicked in. I hope you have managed to see a Dr as in my case it got worse very quickly.

If u can I would let bubs nurse for as long as he wants - be prepared this may mean an hour or so on the breast but this will really really boost your supply. During this time take him off, grit your teeth and help him re-latch if necessary. I'd stop expressing to give your nipples a break and to let your wee one do his stuff and help you get your supply established. It might be a scary prospect as you have been supplementing but I'm sure you will see a big difference in your supply within a few days and you'll probably feel less exhausted as it must be so tiring feeding and pumping. Also keep your fluids up especially if you decide to continue to express - you need to drink a lot when breastfeeding but even more when expressing (eating watery soups also helps ). As pp has said 9 lb is a great weight and fantastic that he is putting on even if it is a small amount at the moment. You are doing amazingly well, all the more so because of the pain you are going through you should be incredibly proud of yourself honey

I hope you feel better soon and the best of luck x x x

 

[Monzter79]

Ty so much for all of the thoughtful replies. This has just been so tough! Never imagined it would be so hard.

My little guy was born 9lb 14oz and dropped to 8lb 12oz in the hospital within 48 hours. I got him up to 9lb 2oz by the time we left the hospital and he only gained 2.5 oz after that. Putting him at 9lb 5oz at 2 weeks of age. Unfortunately, he did lose over 10% of his weight.

That weight loss combined with the low blood sugar (critically low), and subsequent jaundice (of course!), had the doctors and nurses wanting to take him to the nursery for the entire week of my stay (failure to progress, ended in section). The only way I was allowed to keep him by my side was to nurse him as well as my body could manage and supplement him with formula- sticking to a STRICT schedule- cycling through pump/feed/supplement. Thus, badly cracked nipples.

My hospital stay was like torture... they weren't managing my pain well and it was so hard to hold/feed him. I didn't trust the care at all and basically powered through so they wouldn't take my baby. It was hell.

Turns out, I do have thrush. (GBS+ and HOURS of IV antibiotics-ty induction!) I am taking diflucan for it and things are slowly healing.

His tongue tie was treated and he is able to draw more milk from the breast now. However, his technique will require time- and for now he's still injuring me further with repeated feeds... Even WITH shields.

And... LC discovered I'm having vasospasms. If all of this crap weren't happening to me, I wouldn't believe it were possible.

Going back to LC tomorrow. I've decided to do my best with BF still. But, I also need to heal and stay sane. What an uphill battle! TY for all of your support.

 

[OnErth&InHvn]

Call La Leche League. https://www.llli.org/

A counselor will help you for FREE!

 

[capricorn1]

Oh my goodness honey, what an awful time ... you are doing amazing and I really admire your strength!

I really hope things get better for you quickly, hoping the meds are beating the infection!

xxx

 

[Monzter79]

I finally healed enough to nurse. I limped along nursing on one side only, as the other side was more damaged and took longer to heal.

All this time I was pumping, feeding expressed milk from a bottle, supplementing with formula, and TRYING to nurse when I could tolerate it. (In a cycle of re-injury) I had to switch to an avent hand pump because I wasn't healing on the electric hospital pump. Not sure why!

I spent about a week making extra effort to up my supply, tracking my pumped "output" (not counting the amount nursed of course), and was averaging just over 20 oz/day. I attempted to cut out supplemental feeding and finally had a day with no formula!

Thursday evening, I stepped away from the pump, put baby to breast, and have EBF since. It's been very stressful- not knowing what he's getting, If I'm producing enough, or if he's able to nurse effectively with his lip tie. I never had his tongue-tie procedure revised either. Ugh!

I started noticing that he was moving toward a bottle preference, and I knew it was time to make the leap. That, and my DH is only home for MAYBE an hour of baby's awake time. Pumping was becoming impossible to maintain. Anybody who's been there KNOWS how brutal the pump/nurse/supplement schedule is!

So at 9 weeks I'm JUST experiencing the anxiety of not being able to see what he's eating. It's taken a considerable amount of willpower NOT to pump just to see, or add a few oz. of formula just in case. And to top it all off (ha! Punny) he's come down with a cold, so his cues are harder for me to figure out right now.

I'm still not sure if this will work out. But, if he thrives and I remain healed up- we'll be good to go. I'm just so scared though!

This whole situation has been incredibly stressful and painful beyond belief. I don't know how I endured this... And honestly, I'm not sure WHY I chose to keep going either. But, here we are.

I'm noticing that he is having less diapers (but still enough to classify as normal, just less for us) and he has a "dry spell" for several hours at night. Is it me? His cold? Age related? My wheels are spinning.

How do I just relax and have faith that everything is okay? NOTHING has been okay with his feeding from day 1 and it's been such a grind.

I'm just here by myself -staring at this little person- trying to keep my head straight!

 

[noon_child]

You are doing amazingly well! If he's pooing /weeing then he is eating. He'll tell you if its not enough! If you are worried keep using the support networks LLL or NCT for reassurance.

 

[AnonymousCAT]

That is quite the story! Good work. My DS also has a dry spell for the first half of the night too. So I think that's normal as they develop

 

[Beanonorder]

Monzter I'm sorry you've had such a hard time. I'm in a similar position - sore nipples, vasospasms, marathon feedings and supplementing, baby losing more than 10% of his bodyweight and severe jaundice. Unfortunately for me I am just one of those women with a naturally low supply. I've been working with a lactation consultant to increase my supply but haven't had much luck. His latch is starting to improve but I'm still very sore. I try limit the amount of formula given but haven't been able to cut it out. Also, I'm lucky if I pump half an oz in one session. Its tough going but I'm doing my best, just like you!

 

[Monzter79]

Started EBF at 9 weeks and by 18 weeks LO had only gained a lb. He slipped right off of his growth curve. He had the diapers, didn't "act hungry" ---whatever that means! Basically, he's a super stoic little baby.

I had to see the endocrinologist. My Hashimoto's has flopped back over to Graves' disease. My thyroid was crazy hyper. Explains a lot.... My letdown has always seemed difficult. Hyperthyroid keeps milk from letting down. Doesn't matter how much milk I make, if the baby can't get it.

My supply is in a radical dip at the moment, hoping it's just another visit from AF. I do everything to keep my supply up. Hydration, pumping, galactagogues, supplements including fenugreek. All part of my daily grind.

The bottles are back out. Once again, the box of formula sits there. I hate this- I fucking hate it!!! Sry. But I need to let it out.

The anxiety, the stress. I have wanted to give up a million times. I thought we'd made it. I thought he was just really excited that he learned to stick his tongue out at me... Nope. He was just really hungry. I thought he was having "sleep regression". Nope, just hungry.

I feel so bad!! I didn't know. I feel like he has suffered and it's all my fault 1) for not being able to do something that I'M SUPPOSED TO BE ABLE TO DO!! 2)For holding on so tightly to this "ideal" that I never even realized I had. 3) for not being able to read my own baby well enough to know what he needs.

It hurts so much. And you know what? There is like ZERO info out there to help me combi feed, while introducing solids etc. I'm out here, just treading water. And I feel so heartbroken and down on myself.

He's starting to understand and refuse me, because the bottle satisfies him. So it probably won't last much longer now.

 

[Beanonorder]

Big hugs! I felt like a failure with my first when this happened. I couldn't believe I couldn't do what everyone else seemed to be able to do! I was a lot more prepared for it this time. Still very sad but at least I know it's not me failing. I physically cannot make more milk so I know I am doing the best I can. I have now combi fed two kids so if you want any advice I'm very happy to share.

Please remember - you are doing a great job!

 

[noon_child]

If you have medical conditions that prevent letdown and restrict milk making you should feel extra proud of what you've achieved and not hold yourself up to unrealistic standards. If you need to combi feed to keep your baby healthy then you are nurturing your child the best way you know.

I don't know any diabetics who refuse insulin because their body is "supposed" to make its own! However I do know some who worked closely with their doctors to ensure they were getting the correct dose and mitigating any risk factors. That is just what you have done; you've worked with LCs and doctors to try to feed your baby in the most risk free way, but at the end of the day you want to feed him first and foremost, whatever the method. Sounds like you are a great Mum.

 

[AnonymousCAT]

Hugs to you! I second what the pp's have said. You've had so much to deal with and over come. You are amazing.