Is there still a chance for me?

[apreslaube]

OK so here is my story.

My baby was breech, so I had a scheduled C section. I did not go into labor. The colostrum came in and he had NO difficulty latching or feeding, but looking back, he was not eating enough at the hospital. On his 3rd day I believe, they weighed him and saw that he had lost 8.8% of his birth weight (7 pounds 4 ounces). They said basically, keep feeding, and we will check him again. Next day he was weighed again and was now down 10%. They said I needed to start pumping and supplementing with formula. I thought this was a big deal and was scared for my baby and didn't know any better, so I agreed to it.

At first, I was pumping about half an ounce. When I got home I started dealing with PPD, which I expected. My supply was not increasing, and I basically had stopped breastfeeding because he was freaking out at every feeding.

I saw lactation consultants. Most were total crap, but finally I went to a good one who was basically like you have low supply, we can work on this. I tried pumping and fenugreek but my supply went up and down. I was up to an ounce a pumping but my pump broke. I just got the new one in the mail. It's a medela pump in style. I went on PPD medication.

So baby is now 5 weeks. my supply has majorly plummeted. I mean, I am getting about 1 or 2 ml per pumping. Eddie actually breastfed without a nipple shield today for a few minutes which was great, but it was after he had had about 4 ounces of formula.

Since Friday (so 4 days now) I have gotten back on track and am REALLY trying to get my supply up so I can BF, but I haven't seen a change and I'm feeling like maybe it really isn't going to happen. I'm about ready to give up. I am eating lactation cookies, oatmeal once a day, more water, pumping 8-10 times a day with one "power pump" session a day, and went back on fenugreek 3 pills 3 times a day.

I am going to try going back to the lactation consultant or at least call them. I almost don't want to, because I feel like they are going to be like, well you tried but it's not going to happen.

FYI - I can't go on that prescription because of the potential side effects. I have a thyroid condition but I am not hypo or hyper at the moment.

Please let me know if you have known someone to be successful this far post partum, if it seems like there's not hope, if there's a time frame for all this, etc. I'm just... lost. Thanks

 

[noon_child]

I have seen babies go back on the breast after 3 months. It can be done barring your medical conditions physically stopping you from making enough milk (but your thyroid sounds controlled so let's ignore it for a second).

1) did they definately remove all placenta during the section? Have you had particularly heavy bleeding or lots of clots - as these. An be a sign something is left behind and this really affects supply.

2)nipple shields can really affect supply for some women. Can I ask why you are using them and what help you have available to stop using them?

3)now that he is a healthy weight you have a bit more leeway with techniques you use to encourage him to feed (I mean it is less of a big deal if he doesn't feed every 2hrsso you don't need to resort to formula as soon as he refuses the breast). So something like spending the day in bed with him on your stripped down chest might work well for you. The skin to skin will help your hormones, calm him down and stimulate his breastfeeding reflexes. If he gets peckish your boobs are right there and a laid back bf position can help babies who fuss a lot and struggle to get a deep latch. Hopefully one feed will bleed in to the next quite naturally without you needing to count them or time them, and he'll be working little and often on your supply. However if he doesn't feed, keep on with pumping every 2hrs (and through the night if he isn't latching then either). Also obviously if he is distressed then feed him expressed milk.

4) I know it is agony to see them hungry, but all babies get a bit hungry during growth spurts and return to the breast frequently to increase your supply. You are now going to be having the equivalent of a mammoth growth spurt while you try to get LO to increase your supply, and it's actually a good thing if they get hungry frequently as that means they feed frequently and build your milk.

5) if you are at all concerned that the issue is that he cannot extract milk effectively, you will need to keep supplementing him (either bm or formula) until that issue is sorted, because no matter how much milk you have, if he can't get it out he will drop weight.

6) if he can extract milk, but you still want to supplement a little to settle him while your supply increases, try to limit it to around 1oz. If he won't latch because he is too frustrated by his hunger to work for his milk, cup or syringe feed him a few ml to calm him.

7) don't forget to talk to your baby through all this. We get so task focussed during these stressful times, we forget we already have relationship with these beings and they know the sound of our voice.

 

[Qmama79]

What great advice from noon_child! I wish you were there fr me with my first who was exclusively bf til 6 months, but not without worry and problems! He was a late premature baby (36 w) with no sucking reflex at first & ALWAYS has had very small appetite. He's 3 now & still underweight, but healthy as a trooper. Never ill! Food still doesn't interest him.
The second one is on the way fr me & I'm considering combifeeding from the start now (fluid retention issues - Menieres Disease) as an alternative. I'm hoping it'll give me a better & more relaxed feeding experience. In the end, it is whatever works fr you and baby! I live in Canada & bf is the norm here. Many of my friends bf until LO is about 2 yrs old! Frankly, I don't care what others think about ff. I've had a really difficult time getting LO to feed enough to gain weight, and maybe supplementing with formula might have helped. Whatever your outcome, do what works fr you and your family! Don't feel guilty if bf doesn't work out in the end. You are really giving it a go. Ff is not poison & millions of people have been raised on it!!
Xx take care!

 

[apreslaube]

Medical conditions - well, I saw a lactation consultant yesterday. She said I have "wide spaced breasts" which could mean less tissue in them for making milk. Besides the areola darkening, I didn't have breast changes during pregnancy.

1) I think all the placenta was removed. I had very little bleeding. Basically after the first couple days I just had spotting.

2)I tried nipple shields because he was so frustrated at the breast he wouldn't even try latching on anymore. It felt like he connected the breast to not getting milk, so as soon as he touched the nipple, he freaked out. It was working for about 2 weeks, but he stopped opening for it. I am trying to get him on the breast now with no shield, and he's latched a few times. Maybe he has forgotten about it?

3)I will work on number 3. These are good tips. For some reason, I have been doing skin to skin a lot less than before. I've been holding him just as much, but I've been clothing him and myself. I will work on upping the skin to skin back to where it was.

4) He is definitely hungry frequently!

5) I think he is able to extract milk. I think he's just so used to a bottle now that he is "lazy."

6) when bottle feeding him, he will cry instantly if the bottle is taken away before he is done eating, even if I'm just moving him for a second. I will try this though.

7) this is a good reminder

 

[noon_child]

Medical conditions - well, I saw a lactation consultant yesterday. She said I have "wide spaced breasts" which could mean less tissue in them for making milk. Besides the areola darkening, I didn't have breast changes during pregnancy.
[QUOTE/]

Ok I work with LCs (from LA Leche League) and other 'baby' professionals as part of a volunteer role I do, and I e never heard this. Maybe there was a research paper about it, but I can't see how it is relevant as ALL breast are different in their milk making capabilities. If breasts make less milk then baby adapts to feed more frequently in order to get enough.

By the way I have wide spaced breasts and had very little breast changes during pregnancy and while I struggled in the beginning, my supply was low because LO struggled to feed efficiently from me. When she finally got better at it I continued to make enough milk to feed her to 27months.

Breastfeeding is a system built on a relationship between baby and mum where all the hormones involved work together to make it successful whatever the size of breast tissue and size of baby. But baby has to feed to start the whole thing off and this is what you need help to work on. Find an LC who is willing to talk to you about that rather than trying to find reasons why it might not work (not helpful).

Did you know even adoptive mums who never had the hormonal changes of pregnancy can stimulate milk production?

 

[apreslaube]

My period started back today. Could that be connected?

 

[noon_child]

If it is a proper period then it may well cause a dip in production. However the fact that it has returned is probably an indicator that your body hasn't been getting quite enough direct breast/nipple stimulation it needs to keep up our prolactin levels (milk making hormone). This can be reversed though, and the fact that you have been getting baby to feed more directly without the shield is really positive. I have read (but can't remember where)that it is also possible that this isn't a "real" period. Some women have a single random bleed in the months following birth but it isn't classed as a period unless followed up by more the following month.

Has anyone talked to you about a SNS (Supplemental Nursing System)? They can really help babies who don't associate the breast with milk and they allow for breast stimulation but with the combined reassurance of supplemental milk. It isn't quite as effective at stimulating milk production as standard breastfeeding so you will probably still have to pump, but I think if you feel strongly about breastfeeding it is worth a try.

 

[BunnyN]

I think the Supplemental Nursing System is a good idea. I've read posts from other mums who had success feeding in the bath or just after a hot shower as it can really help with letdown.

Sometimes doctors make a bigger deal out of weight gain goals than it needs to be. DD dropped 10% and took 6 weeks to get back to her birth weight. I didnt have supply problems like you, it turned out to be allergy issues (she had other symptoms too). Other than the allergies and weight she was a very allert, healthy baby and strides ahead with her development. Eventually her weight caught up and she is big for her age now.

 

[apreslaube]

This is a weird period, TMI but it's very... clotty. I've never had that before. But it hurts the same as a normal period?

My pumping is a *little* better. I still sometimes pump 1ml, but I've been getting a good 5 or 6 ml per pumping mostly. Sad that that's an increase...

I ordered the lact-aid deluxe. I should receive it tomorrow, because I did it through Amazon prime. I can't wait to try it out. I'm hoping it works with my formula. I didn't end up buying the strainer.

Eddie is latching a few times a day. I do hear a bit of swallowing, but most of the time it feels like he is just biting for comfort. I'm giving him one bottle (2 1/2 ounces), burping burping burping, lol, and then putting him to breast. It's really awesome whenever he latches, even though he only stays on for like 8 minutes. He only likes the right breast, which possibly is because the right basically makes all the milk?

 

[noon_child]

Massaging your breasts before getting him to latch (like you would to prep for hand expressing) can speed up letdown which may makie him latch easier.

When I was supplementing I was told to only do so after LO had been on my breasts not before, but I realise if you can't get a distressed baby to latch at all then they need alternative feeding. However I wonder if you gave him 1 - 2 oz instead he wouldn't be starving but he may feed longer on you, which will increase your supply. If still unsettled after that, you could give him the remaining 1oz in the bottle.

Also, always trying your breasts first means you don't "miss" Any of the times when he is prepared to accept your breast without a fuss.

 

[BunnyN]

The constant air swallowing was so fustrating with DS. I had to stop and burp him so many times in the middle of a feed. I only ever managed to express 5 or 6 m even when my supply was fine, my body just didnt respond to it. I was told it would improve but I gave up because supply wasnt a problem with my 1st and DS had already started feeding better by the time I tried.

DS felt more like he was biting a lot of time when he fed. I think its because he couldnt suck very well he had to squeeze the milk out instead, lol. He wouldnt except a deap latch no matter how many times I tried. Eventually he would just cry and refuse to latch on so I didnt have much choice but to use a shallow latch which was uncomfortable. Those things improved greatly after his tongue and lip were clipped.

 

[apreslaube]

So two lc's now have told me that it looks like I have insufficient glandular tissue. I'm just not going to be able to really breastfeed. And now that he's already 6 weeks, anything I do to increase supply is only going to be a little effective. I feel like I've tried so hard and it and me are worthless.

 

[BunnyN]

Sorry to hear you haven't come up with a better solution but you have done a wonderful job and have tried everything you can. Unfortunately many times mums give up way to early because of lack of support or bad advice so everyone first reaction is to tell you just need to stick it out, spend more time feeding to increase supply etc. Some women really can't produce enough milk. It isn't your fault in any way. Now that you know your problem maybe you can seek some advice about what to do next. Even if you have no choice but to supplement it doesn't mean you have to give up on breastfeeding altogether if you don't want to. Even a small amount of milk can be beneficial and breastfeeding can still be comforting for your LO.

 

[noon_child]

So two lc's now have told me that it looks like I have insufficient glandular tissue. I'm just not going to be able to really breastfeed. And now that he's already 6 weeks, anything I do to increase supply is only going to be a little effective. I feel like I've tried so hard and it and me are worthless.

This is a great source of info
https://www.llli.org/llleaderweb/lv/lviss2-3-2009p4.html

Make sure you truely believe their diagnosis though. As is say, my breasts are widely spaced and hardly changed during pregnancy and I was able to bf once my baby learned to suck properly. Latch issues are far more common than breast issues, however if this diagnosis is correct, please don't beat yourself up. You have tried so hard, and it is not your fault.

 

[apreslaube]

I am getting a hospital pump. My insurance is paying for 12 months of it. I will be going on domperidone once I get a prescription. I'm going to ask my OB for one tomorrow at my 6 week. If she won't/can't prescribe it, the LC gave me some info on people that will in town. I am hopeful that these things will help. I know that my baby will latch better if I have more milk, so I'm more aggressively working on the milk rather than the nursing. Nursing is just so stressful, so I'm trying to just have him there at the breast random times and working hard at relaxing.

I feel better today. I was a mess yesterday. I still am very upset at my body and myself in general. I'm angry at the previous LC's and the hospital for not helping me more in the beginning. They saw there was a problem and instead of working on all the possible reasons for it and following up with me, they just said pump with what you've got (the pump in style) and feed formula with a bottle. I'm a first time mom. I don't know what I'm doing. I had/have PPD and honestly could for the first 2-3 works couldn't do anything or think anything.

The LC did say there Eddie had a bit of a lip tie on the top lip but didn't seem too concerned by it. It doesn't hurt when he latches unless he obviously latches wrong. Speaking of, if he latches only on to the tip of the nipple, should I let him do that for now or take him off? I'm not really sure what to do in those instances, because I want him to nurse, but would having him do it wrong do more harm than good? I honestly don't care if it hurts but I know that can cause damage.

 

[BunnyN]

If you can get him to latch right it would be better but I know with DS it was a shallow latch or nothing. I could relatch him with a deap latch several times and he'd change it to a shallow latch until he got fed up with me messing and screamed. He had lip tie and we finally got it cut when he was 4 months old as by that point the shallow latch was causing me problems and he was slow gaining weight. The lactation consultant who did it agreed to clip his tounge too. She didnt think he had tounge tie but wasn't 100% sure he didnt so I wanted to cover all bases. It did make a big difference for us. It didnt cure things right away but within a couple of weeks feeding was 30% better I'd say, which was a huge difference for me. It might be worth to pursue the lip tie thing. If I was to do it again I would have gotten that done as soon as possible.

It sounds like you have a great plan of action in place. As far as the time that has passed it shouldnt matter too much for improving your supply. You might have to work a little harder but your supply can improve at any time. Of course if you have underlying issues that effect the amount of milk your body can produce that is different but if you are able to do it dont worry that the time that has passed means you have lost your chance. I really hope it works for you. Either way you will know you have given it every possible chance.

 

[apreslaube]

I just wanted to give a quick update. I just started my domperidone, and I started goat's rue yesterday. Tomorrow we are going in for a lip and tongue tie consultation with a pediatric dentist in Chicago. We will do the revision if the dentist recommends it at the same time. I have my Symphony Pump, and am pumping for about 10 to 15 minutes every 1 1/2 hours. I'm not really getting anything, but I just started the meds. Eddie is not latching, but he is wanting to all the time. He is constantly rooting and moving to the breast. He puts his mouth on the nipple and licks, but won't latch. I think everything is moving in the right direction though. Thanks everyone!

 

[lenorajoy]

I know this is a pretty old post, but I'm curious how goat's rue and domperidone worked for you, apreslaube. I've read goat's rue and alfalfa can both help develop breast tissue if there's a deficiency there, so I'd really love to know. I haven't been told I have IGT, but there's a chance I may considering none of the women in my family have successfully been able to breastfeed. I've made it much farther than any of them so far, and I have no plans to stop anytime soon. My supply issues aren't as severe as yours were, but DD was never able to get enough once my mature milk came in and she started losing weight fast. We had to supplement with formula to try to get her back to birth weight and we haven't stopped yet. Actually we've been fortifying both breast milk and formula to try to help her play catch up. I breastfeed exclusively if I can when I'm home with her, but while she's with the sitter, of course, she gets bottles and that's when we fortify.

And noon_child and BunnyN, you seem to know quite a bit about breastfeeding and supply and latch issues through personal experience and volunteer work. If breastfeeding gets off to a bad start (mostly latch-related) and isn't really improved much until after that first 6 weeks or so after things have regulated, will that make it really difficult to improve a low supply? I suspect DD may have tongue and/or lip ties and I'm trying to see a LC through insurance, but there seems to be a huge hold up getting a local LC certified to participate in my insurance plan. I can't afford to pay for it out of pocket, so I have to wait. DD is going to be 5 months tomorrow, so I'm not sure if getting ties fixed will help much with breastfeeding at this point, but at the very least they can be fixed to avoid other issues for her in the future. Would a tie possibly be the main problem with my supply issues?

I've done everything they say to do and managed to increase my production some, but I'm still only getting about 7-15 ml per letdown on my left side, so it takes me an hour to pump with a manual pump on both sides to get sometimes not even a full 2 oz combined. It's much worse with the double electric I have (supplied by insurance), so I've pretty much given up on that. Oatmeal is the only thing I've found to give me a boost, so my first pump of the day may yield 3-4 oz, but it goes down from there. Needless to say, basically every pumping session is a power pumping session, so that won't help me any.

I've been taking fenugreek for two weeks now without any change and just added blessed thistle Wednesday night. I've been taking milk thistle and fennel as well as moringa and the milk thistle/fennel do help some as well as red raspberry leaf tea with the let downs being much improved, but I mostly still take the moringa to combat the constipation DD and I seem to be having. I found out when I started taking 3 of them 3x a day it gave us both diarrhea, so I started taking it again when I stopped and we both ended up constipated.

Sorry, that ended up being a REALLY long post, but I wanted to give you all some history so you know what I've already tried.

 

[noon_child]

lenorajoy - I really feel for women who have to go back to work so soon. It must be so hard getting past those early difficulties when you aren't able to actually stay wth your baby and feed them!! Pumping is hard enough and often affects supply even when breastfeeding got off to a good start, so when things aren't smooth going it can really compound issues. I'd say that a tongue tie is likely to have been contributing to your LO's problems. I know someone who had it reversed at 6months and their LO went from feeding every hour to every three hours and feeds were quicker too, so for her it as definitely worth it. She had been able to preserve her milk supply by directly feeding every hour but you are in that situation where you are having to use the pump instead. You're a superstar for persevering! Go you! Please don't feel like in some way you are to blame or your body doesn't work - lots of things beyond your control (including the maternity leave - or lack of it - situation where you live) have been working against you but you have been fighting against the odd to do what you feel is right for your child.

Are there any La Leche League chapters near you. These volunteer Breastfeeding Counsellors can help for free!

 

[lenorajoy]

I spoke with one LLL LC, but she went through everything I've tried and then she referred me to a LC that could assess a tongue tie, which meant a $150-175 consultation. We can't afford to pay for that out of pocket, so I'm kind of stuck for the moment. We have a weigh-in at the pediatrician's office tomorrow afternoon, so I'm going to ask them who they recommend I see to check for a tongue tie. I believe my insurance covers a frenectomy if it interferes with breastfeeding, so I would imagine they would cover costs associated with it as well, including a consultation. I really hope we can get this taken care of sooner rather than later, especially since nobody seems all that concerned with me being able to see a lactation consultant. I've been pestering the hospital that was supposed to be taking care of it with my insurance company and I haven't heard a thing...

I do feel as though my body has failed me, but I also know it's out of my control and isn't my fault. It's hard not to feel awful about it anyway, but it's more like I mourn what could have been and what I expected rather than blaming myself.

Maternity leave in the states is just pathetic! At the very least, I'm glad that our government is now providing 6 weeks for those whose employers don't provide any maternity leave at all with pay. You can take 12 weeks regardless, but it's without pay if your employer doesn't opt to pay you. Who can afford that if they actually need their paycheck? And I'd guess they wouldn't be working if they didn't need it, and they'll need it even more with a baby to take care of! It's just so dumb...