So my 5.5 week old never acts satisfied coming off the breast, he just acts hungry. Or if he falls asleep on the breast he wakes up screaming to eat. Because of this I did a weighed feed with an LC today and he only got 1.4 ounces. We nursed for 30 mins and he appeared to be done. At daycare he eats 3 ounces every 2 hours at home he eats every hour and I've never gotten a night stretch longer than 4 hours more like 2-2.5.
What would you do? Do you think he's getting enough?
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What did your LC say? I knew LO wasn't getting enough because she was crying after each bfing session and then instantly would be satisfied with a few ounces of formula when I supplemented.
When we started giving bottles and supplementing she was a different kid - she started sleeping more, was happier, going longer between feedings...
In the end bfing AND supplementing ended up being too much work. She would nurse for 30-45 minutes then we had to prepare the bottle and have her drink it (another 20 minutes). I started EPing and it's much faster to give her one bottle of either pumped milk or formula depending on wha I have in the fridge.
GL...I know how stressful it is wondering if your baby is getting enough to eat!
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@char54: the LC said to just keep feeding him on demand, he'd get enough. Not helpful! The other night he nursed for 40 mins on each side and then guzzled 3 ounces of milk.
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What are your BF goals?
Did you see an IBCLC or just a LC? There is a difference. If you saw the latter my advice would be to see an IBCLC becasue they would never have sent you off without a plan and a clear direction. -
Are you sending breastmilk to daycare? So you're able to pump enough to cover his needs there? If so, I wonder if he has a transfer issue, like a weak suck or something...
Based on the amount he got (although weighed feeds taken out of context versus over a 24/48 hour period can be misleading) and his behavior after, it sounds like he's still hungry...can you try supplementing with a bottle of pumped milk after you nurse to see if he'll take it/
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The only problem with doing a single weighted feed is that it only tells you about that one feed - sometimes baby's snack, sometimes the guzzle the milk!
Are you supplementing at the moment at all? How is your LO's output - plenty of wet and dirty nappies? Can you give us more background info?
Fwiw, it is normal for some babies to want to feed round the clock, particularly in the first twelve weeks when your supply is still regulating.
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@hilsy85: The other night he nursed for 40 mins on each side and then guzzled 3 ounces of milk.
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@jetsa: when you say guzzled, are you doing a paced feeding? It should take him AT LEAST 20 minutes to drink about 2-3 oz of milk--and IME 3 oz plus maybe 1-2oz from the breast is a lot for a newborn!
How has his weight gain been? Are you giving BM or FOrmula in the bottles at daycare?
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@jetsa: that was always my LCs advice too: "she's getting lots! Just keep putting her to the breast!" She then wound up with jaundice, dehydration in the NICU and I said enough and started supplementing on my own.
BFing was never a huge desire I had, so giving it up to pump and supplement wasn't that hard of a decision and I don't regret it. I did go on domperidone which boosted my supply and helped my pumping output.
She was SUCH a slow eater on the breast (though in hindsight she just wasn't getting all that much to eat). I felt like we would just finish and she'd be hungry so soon afterwards and we'd have to start all over again.
For us, bottle feeding is more of a bonding experience than bfing ever was. But like I said - I was more in the "I'll give it a try" camp rather than the "Ill do whatever it takes" camp. If bfing is really important to you I would probably seek out a different LC!
ETA: just for reference (since our LOs are the same age) C drinks 4 ounces (for the most part, sometimes 3 and sometimes 5) and it takes her about 25 minutes each feeding. She eats more frequently during the day (every 3 hoursish) and then does one long stretch (7-9 hours) overnight.
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@jetsa: has your LO been checked for lip or tongue tie? It could always be a transfer issue rather than supply...
Are you pumping at all and doing paced feedings with the bottle?
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@Kemma: He has about 6 wet and poopy diapers per day. I supplemented so I could start daycare, I can almost produce enough for daycare, I'm an ounce or two short right now.
@Ms.SK: My BF goal was a year, but I don't want to starve my kid. I think just an LC at my local hospital. I'll look up a IBCLC.
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@jetsa: if you're pumping enough to produce enough to send to daycare, then it doesn't sound like a supply issue, it sounds like a transfer issue...I definitely recommend seeing an IBCLC and having your LO evaluated for a weak suck and tongue/lip tie. Does he seem fussy or gassy? Does his latch hurt?
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@hilsy85: Nope, what is a paced feeding? The doctor's office didn't say anything about that when I called feeling like he wasn't getting enough, just said max of 2 ounces of formula in a bottle. He weighs 9 pounds 15 ounces now, he was 8 lbs 3 ounces at birth. He got formula the first day at daycare and now he gets breastmilk, as long as I pump enough. He drinks 3 ounces of breastmilk, 2 of formula.
@Kemma: I'm only pumping when I'm at work. I can't get ahead when I'm with him, if I do he crys and acts like he's starving while still on the breast, so I give everything I pumped back to him.
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Based on your pump output I agree with @hilsy85: that it's possibly a transfer issue rather than supply based and you should definite have your LO checked for ties!
Just as another thought, how many ounces is your LO drinking at daycare and how many hours are you apart?
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@jetsa: http://kellymom.com/bf/pumpingmoms/feeding-tools/bottle-feeding/
sOmetimes using a bottle can cause babies to drink more than they really need/want, because the liquid literally falls into their mouths, and it's a reflex to swallow. Doing it slowly is really important so they don't overeat, and so they don't come to prefer the easier/faster delivery system of a bottle.
Again if you can pump enough to give him 3-4 bottles of breastmilk while you're at work, it sounds to me like your supply is ok...
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@hilsy85: Latch hurts on the right side, but I still have healing cracks from the beginning and I was told thats why it hurts. He's fussy and gassy.
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Honestly, weighed feeds are such an inaccurate measure of how much a baby is really transferring.
Weight gain and diaper output are better measures. How is he gaining? You say 6 diapers a day - do you mean total? That does seem a little low for a baby that young. Does he have more diapers on the days he's at daycare?
I agree with the recommendation to seek out an IBCLC. You may also want to consider supplements: fenugreek and blessed thistle capsules - 3 of each 3x/day.
Otherwise, yeah, keep bringing that baby to breast to get your supply where it needs to be, but make sure the weight gain is happening.
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@Kemma: He drinks 8-9 ounces and we're apart 8 hours.
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@jetsa: read this and see if any of it rings true for you...definitely get him checked for a tongue and lip tie!!!
http://boards.hellobee.com/topic/high-needs-colicky-acid-reflux-babies
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http://kellymom.com/bf/pumpingmoms/feeding-tools/bottle-feeding/ - Here's a link to info about paced feeding! As a general rule baby should be drinking 1-1.5 ounces of breastmilk for each hour he's away from you and total ounces over 24 hours would be between 24-36.
Another thought for you is that there's nothing wrong with mixed feeding (formula, pumping and nursing) if that works for your family and your situation!
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@hilsy85: snap!!
@jetsa: that amount sounds about right but it does sound more like a transfer issue. Is your LO's tongue heart shaped at all? Can he poke it out at all?
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@Kemma:
@jetsa: also, does his upper lip look like this:
http://boards.hellobee.com/topic/lip-tie-tongue-tie#post-454593 -
@Kemma: his tongue is always out of his mouth and its super long. Thats everyone's first comment, so I don't think that its a tongue tie.
@Kemma: @hilsy85: I agree that I think its a transfer issue not a supply issue, if I can pump it he should be getting it plus a bit I thought.
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@jetsa: can you flick his upper lip up? Does he lose suction at the breast and make clicking noises when nurses? My girl could poke her tongue out but not lift it up (tongue tie) and constantly lost suction due to her lip tie.
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@jetsa: are you coping ok with the frequent night nursing and the disrupted sleep? I was just thinking that there would be no harm in topping your LO up with 2-3 ounces of formula before bed at night until you get the transfer / supply issues sorted if that would make life easier for you!
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@Kemma: Idk about the upper lip, but he doesn't seem to have problems keeping suction because he'll pull my breast out when he's latched on and I've never noticed any clicking noises. I've truthfully gotten used to the exhaustion, won't I be messing with my supply if I supplement at night?
Per the webpage the nearest IBCLC is an hour away and so I've definitely just been seeing LC's
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@jetsa: yes it can mess with supply but it's important that you're coping and looking after yourself too!
That's a good sign that he maintains suction and doesn't click!
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@hilsy85: I was going to attach the same link. Here is another one:
http://www.llli.org/docs/0000000000000001WAB/WAB_Tear_sheet_Toolkit/22_bfabreastfedbaby.pdf
@jetsa: You are doing an amazing job! You are feeding on demand, he won't starve. If you have a goal of 1 year or exclusively breastfeeding I am going to be honest with you. In my opinion any supplimenting is going to lead you down a slippery slope. I say that to be honest and not discourage you. For some it doesn not have to be an all or nothing. For me my goals was only mamma milk. Has he been maintaing his weight? Has the Dr. said they are worried?
I think you are getting great advice. If you can find an IBCLC they can help you diagnose a tongue/lip tie (sometimes even a peditrician has a hard time with them). You may need to pay out of pocket but with Obamacare those fees should be reimbursed from your insurance company. I spent $250 for my LC and she is the reason I am still EBF the twins at 15 months.
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Per Kelly mom he's gained a little below average, he's gaining 5.2 ounces per week, average is 5.5-8.5 ounces
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@Kemma: @hilsy85: he has a lip tie! What do I do?
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@jetsa: get it clipped!!! If he has a lip tie he almost definitely has a posterior tongue tie! They usually go together and affect baby's ability to transfer milk properly.
MY LO had both and they were clipped--best decision ever. It's a 2 second procedure and had amazing results. I really really recommend getting it clipped, especially if it's having an effect on your nursing. Your pedi might not be able to do it, or might not even know how to diagnose it. I would seek out a pediatric ENT, who can perform teh procedure.
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Like @hilsy85: my LO also had a lip tie and posterior tongue tie! I sought out a pediatric ENT, and the procedure was SO quick. It worked wonders for us!
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@grizz: @hilsy85: I'm so thankful to have figured this out! I can't wait to get it taken care of. Should I call his ped or go straight to a ent?
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@jetsa: I'd call your ped or an IBCLC and ask for a reference. Pediatric dentists do it sometimes too!
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@jetsa: boo on the tie but hopefully you now have a reason for your issues and you can get it resolved!
Definitely get it clipped and I agree with @hilsy85: that he probably has a posterior tongue tie as well, it really is a quick procedure that can make a world of difference!
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@jetsa: I would go see your pedi and see if they can refer you to a pediatric ENT. If not, I would just google pediatric ENTs in your area/insurance and ask them if they perform frenulectomies. Asking an IBCLC for a ref is also a good idea!
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Ped gave a referral so I made an appt with an ENT but he can't get us in until the end of the month.
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I found a different pediatric ENT and our appt is this afternoon. Is there any specific questions I should ask? I'm definitely going to ask about the posterior tongue tie even though, I don't think he has it.
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@jetsa: They'll basically do the tongue tie check and tell you. I couldn't detect a posterior tongue tie on my LO, but sure enough--she had one. Does this ENT specialize in tongue and lip ties? I mean, do they have experience with them?
When we took our LO in, the ENT confirmed that she had both a tongue and lip tie, offered to clip them right there on the spot (I sort of thought we were going just for a consultation), and then clipped them, LO cried for about 30 seconds and the ENT helped get her on the breast and told me to breastfeed immediately.
Sadly for us, it was not the cure-all I was hoping for, but I do know a lot of people whose breastfeeding relationship was helped a lot by doing this.
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@jetsa: yay! That is so great that yo'ure getting it done today. I would DEFINITELY have him check for a posterior tongue tie--they rarely appear without lip ties. I would also make sure to ask about exercises you can do with your LO after the procedure to make sure that 1) the ties don't reattach, and 2) to help your LO learn how to use his tongue appropriately (usually there are ways to encourage him to stretch his tongue out and put it in the proper position).
Like @Anagram said, they will do the procedure and then have you nurse or give a bottle immediately to get the breastmilk in the wound. I really hope this shows positive results for you!! BUT don't be discouraged if it still takes a week or two for things to get better either--it took time for my LO to learn to latch properly, and it may take a week or so for your supply to adjust to LO transferring properly.
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