nectarine / 2086 posts
Thanks ladies! She just had another wet diaper - this is how they have looked for most of today. Still some urate crystal but very small amounts.
Thank you for looking at pictures of my baby's pee haha!
coconut / 8472 posts
I'm going to say again, I think the urate crystals are a big deal. I would try offering formula an ounce or so after each feed for a day or two. If she doesn't want to eat or she spits up a ton afterwards, then she likely doesn't need it. But I had this happen with my son, and he wasn't getting enough from me. He'd eat but he would get so tired he'd fall asleep. Then he'd wake up screaming and eat a little more, and the cycle would continue. We supplemented for a little bit and the urate crystals went away.
hostess / wonderful persimmon / 25556 posts
I found pediatricians like to push formula while a lactation consultant can help you figure out how much the baby is getting. If you go to an lc, you can rent a scale from them. They will have you weigh the baby, feed the baby, then weigh again to see how intake is going. You can then do this at home to make sure the baby is getting enough. If you have pumped milk stored, offer it after a feed until you can see an lc. If you don't, offer formula.
@ShootingStar: I appreciate your comments. We did feed her an ounce of forumula last night which she immediately spit up. I'm not going to offer formula through tonight and see how her diapers are in the morning. If I haven't seen an improvement there I may try a little formula again.
bananas / 9229 posts
We started doing a similar routine around 3 weeks after LO dropped a lot of weight and was really slow to regain. I would nurse 10-15 max per side, feed previously pumped milk and if she was still hungry formula and then pump. We only needed formula once or twice because the pumping was helping. LO has also slept through the night since almost day 1. There was one week where I was waking her once in the middle of the night after 4 hours to help her gain. Other than that, I've just nursed her during the day whenever she needs it? Hang in there though! It's still so early and baby's weight will go right up!!
grapefruit / 4291 posts
I'm going to suggest that if your LO is still having crystals in her urine and hasn't yet transitioned on to "normal" breastmilk poo then she perhaps isn't getting quite enough to eat.
I would eliminate any paci's or artificial nipples and aim to nurse at least twelve times in 24 hours, lots of skin to skin and keeping baby close should also help. You could also try breast compressions and making sure that your wee babe is actively sucking and swallowing while ate the breast. Hand expressing might also increase your pump yield.
Hang in there, Mama, you're doing great!
grapefruit / 4455 posts
@buttermilk: no advice but that seems promising! Dd was jaundice and her whole diaper looked orange when we dealt with that. Bf didn't work out for us though. Hang in there & good job!
cherry / 203 posts
Our LO lost 12% birth weight and had trouble latching in the beginning so we supplemented formula at the advice of our pediatrician. I think it helped keep him from getting dehydrated but we used bottles and within a few days he was refusing to nurse at the breast. Not saying this will happen to you but just wanted to share my experience. It took me until 4-5 weeks and using nipple shields to get him back on the breast.
As for the crystals I would definitely keep an eye on them. Feel baby's mouth to see if it feels dry and feel her soft spot to see if it's sunken in. There are a few other signs of dehydration to keep an eye on as well so just Google them. Our LO was dehydrated only a little bit and bounced back quickly but I know a few people have ended up in the hospital if it goes on too long.
pomelo / 5000 posts
It can feel like so much pressure and things to consider in the beginning!
I would supplement if my pediatrician recommended it. I'm comfortable with this bc I know he's very pro breastfeeding and an IBCLC--he has my full trust. You have a full plate right now, but if you are questioning his recommendations at this point, you may want to consider if he's the best doctor for you all.
I did supplement the first week when her weight gain wasn't where they would like it to be. It was fine and didn't cause any problems.
cantaloupe / 6610 posts
I would supplement if my child was not gaining appropriately. It is what it is, and I would absolutely follow the advice of the pediatrician.
I get what you're saying about establishing supply, and that's unfortunate that it may be affected in some way, but if my ped thought my lo was failing to thrive and had me jumping through hoops like that to help LO gain, I would take it VERY seriously.
pear / 1657 posts
My only suggestion is to let her feed on one side until she is done, then offer the second side. If she gets sleepy while feeding undress her or tickle her feet to keep her awake so she keeps going for at least 20-30 minutes. At that age DS would often nurse 45 minutes to an hour. Also my LC said that feeding every 2 hours was from start to start, so if you nurse at 10am, even if it takes an hour, you offer again at noon.
pineapple / 12793 posts
I'd supplement and then swap in your pumped milk when you have enough.
BFing is so hard in those early days.
You're doing a great job!
Okay we decided to supplement just a bit with formula via syringe today. How much? 1/2 an ounce maybe? Her pees are much better but I really wanna see a poop now. It's been 8:30pm on Friday since her last poop and it was still black.
GOLD / wonderful pomegranate / 28905 posts
It sounds like your supply is just fine so I personally wouldn't supplement right now. I definitely agree with your doctors assessment of feeding every 2 hours during the day and waking every 3 at night. When they're this young they don't really know to wake up in hunger yet. Also at this young age they are very sleepy and sleep a lot. You have to work to wake them up enough to nurse.
P.S. I supplemented regularly with my first because we needed to so I have no problems with doing so! It just doesn't sound like you need to.
kiwi / 556 posts
@buttermilk: their tummies are tiny so you are right to think 1/2-1 oz increments. Start with that. If she is still fussy/acting hungry offer 1/2-1oz more since your pediatrician recommended up to 2oz. Burp after 1/2 oz-1 oz which should help with spit up!
Like someone said, aim for feedings every 2 hours. If you start at noon, even if you supplement, I'd start again at 2pm with nursing and then supplementing. It won't feel this demanding for too long! Just until her weight and pees/poops stabilize
Thanks guys! She just took 2mL shy of a full ounce of formula. I feel okay with this decision, esp via syringe! Def not introducing a bottle now.
So she needs to feed again in an hour. If she is too full and won't BF, should I just pump instead?
I've also been letting her stay at the breast for longer until she seems finished which has been more like 20 mins ea side
cherry / 188 posts
I'm really glad to hear you're supplementing - I agree with the PP who said the urate crystals are concerning. With regards to early supplementing having a negative impact on your breastfeeding relationship, it seems like studies are showing that early supplementing is fine and won't prevent you from breastfeeding exclusively down the road. Emily Oster writes about this in Slate, citing two studies: http://www.slate.com/blogs/expecting_better/2013/09/13/when_to_give_your_newborn_baby_formula_the_first_big_decision_i_had_to_make.html
@KatieBklyn: thanks for sharing that article. I feel good about this decision. I'm sure it will be temporary!
persimmon / 1179 posts
@buttermilk: I experienced a very similar scenario with my first. I had student nurses in the hospital who "checked" LO's latch, and said feeding 5 or so minutes per side each feed was "great". Fast forward to 2 days PP when I had my first actual nurse and she about lost her mind. She was livid that no one had actually helped me because LO was losing weight, wasn't latching well during feedings and I wasn't waking him often enough (because I didn't know I had to). She intervened with a crash course on latching, how often to feed, watching for swallowing etc... And as soon as I got on the more frequent feeding schedule, which was 2 hours during the day and 3 at night, he quickly gained the weight back and I never had supply issues after that.
I would give your new feeding plan some time to work before moving to supplementation, especially since you feel strongly about that. I am not one to care much one way or another regarding formula but I do think it will be easier to establish a strong bfing relationship if you don't supplement and at this point, her weight loss doesn't strike me as enough to panic just yet.
My suggestion is the same as others, wake to feed for at least a couple of weeks, skin to skin as much as you can, especially 100% during feedings since your body will respond better to feeling baby's warmth and let R stay on the breast as much as she wants. If she falls asleep there, leave your nipple in her mouth and enjoy the cuddles. She will instinctively suckle every few minutes which will continue to signal your body to keep making milk. You're doing great!!
@buttermilk: Sorry missed the latest updates, sounds like it's going well!! I would definitely pump if she's going to be too full for a feeding. In my experience, it's easier to meter your supply back down if it gets too high rather than try to get it up.
@getjazzy: thank you!! I'm gonna supplement via syringe for as short a time as possible. Hopefully she weighs in well enough tomorrow!
pear / 1788 posts
@buttermilk: hugs! Keep up on your herbs/vitamins. I'm liking upspring milk flow fenugreek and blessed thistle drink mix. Keep pumping. You are doing a great job with the "triple feed" of bf, supplementing, pumping. I agree try to do a weighted feed if you can with your ped or an LC. And I'm sure your mom means well, but you and DH will decide what is best for your family and little R! Remember, your HB ladies and August '15 mamas are here to support you!
cantaloupe / 6669 posts
First rule is to feed the baby. All the LCs I saw said that to me and they all encouraged me to supplement while working on my supply issues.
I agree that you should see an LC who will do a weighed feeding with you and see how much your LO actually transfers. That will really help you understand what is going on. But I do think in your situation I would supplement a little bit to make sure that your baby is gaining and healthy. As long as you are nursing every 2 hours and pumping until you are dry (I would recommend renting a hospital grade pump which will really suck out every last drop!) it shouldn't affect your supply.
I went through this struggle and I know how hard it is Remember that making sure your baby is healthy and thriving is your #1 job - not EBF!
@buttermilk: didn't see the update about the crystals but that would worry me too.
I supplemented my first born regularly and we BF till 25 m. Supplementing ended after she turned one when we introduced cows milk. I firmly believe supplementing is why we were able to make it through that first year. My pump output sucked and I worked full time. I just could not meet her demands.
The second time around as soon as my daughter started screaming at the breast be used she was hungry, DH went to hunt down formula to supplement. Many nurses and even our pediatrician gave us the colostrum is enough spiel. Thank you. We've been through this. Our first born literally screamed so much in the hospital people around the corridor heard her. She baffled the LC nazi. And we had an emergency ER trip at 4 days old because we were literally starving our child based off "expert" advice of the LC. So f*ck off. DH said that in not so many words to the one nurse who kept telling us we shouldn't supplement. Love that man.
Anyway, trust your mommy instincts. Not an LC, not the doctor, not your mom, not us. Trust yourself! None of us knows your baby like you do. We can only offer advice based off our own experiences.
grapefruit / 4355 posts
@regberadaisy: that was so us in the hospital! We were feeding DD all my colostrum and she was screaming uncontrollably in the middle of the night (at about 22 hours old). One nurse brought us formula and DD pounded over 2 ounces! Clearly she was starving. It made me no longer buy the "colostrum is enough" and stomach the size of a pea/marble/whatever stuff.
pear / 1696 posts
Just want to throw out there that lactation tea doesn't have a high enough dose of fenugreek, etc, to have much of an effect. I would highly recommend taking suppliment in pill/capsule form instead to help boost your supply.
Thanks! We have now had no urate crystals in the past six diapers so yay! It's still been 48 hours since her last poop tho. We've been supplementing with half to one ounce of formula with each feeding and so far it hasn't affected her wanting to nurse. DH got me the Mother's Milk Plus supplement and we will try to do weighted feed at her appointment tomorrow.
persimmon / 1273 posts
I've been following this thread a bit ...we had a similar issue when M was born. He lost 9% of his birth weight by day 3 & my milk didn't come in until day 4. We had to supplement formula and pumped milk over a two day period per the pediatrician. I was like you, no clue when to feed or how much. How can medical staff not tell us the most basic things!?
I can't take fenugreek because I have thyroid issues so My lactation consultant (she has a private practice & is amazing!) gave me this to take- Herb Lore Nursing Tincture. It tastes gross so I mix it with a shot of juice but I've noticed a huge increase in supply.
@buttermilk: that's great news on the wet nappies! FWIW my little guy stopped pooping on a daily basis when he was six days old and still only goes twice a week at five months old!
@Portboston: thanks I'll look into it!
@Kemma: oh really? It's crazy how across the board pooping seems to be. Like it's common to have many and also common to have one or two per week. I just read something that says BM is the ultimate nutrition and it may be so perfect for her that there is very little waste and so she doesn't need to poop. I like that explanation very much!
I will update everyone after our weigh in this afternoon.
Baby gained FIVE OUNCES in 3 days!!!! I am so fucking happy!!!!!
grapefruit / 4663 posts
@buttermilk: yay, momma!!
@buttermilk: woo! Great job mama! Also, you two are gorgeous!
@buttermilk: yay! What did they say to do next?
pomegranate / 3919 posts
@buttermilk: Just reading this thread now, but happy to see she gained well!! Glad you don't have to worry anymore!
I went through the same thing with LO after he lost 1/2 lb the day after we went home. I was in tears when the dr. told me to supplement, and I did for 2 days until my milk came in.
Just want to say that supplementing with a bottle of formula did not hurt my breastfeeding relationship at all, and I really needn't had worried so much!
grapefruit / 4441 posts
When I posted my first comment, I had missed what you said about the urate crystals. Given their presence and the fact that she hadn't transitioned to green/yellow poop, I would have advised supplementing rather than holding off. So I'm happy to hear that you have supplemented a little bit and that her pee looks better now. That is fantastic too that she gained!
pomegranate / 3577 posts
@buttermilk: Yay congrats! Great work, mama!
@buttermilk: Yay! Amazing work!
wonderful clementine / 24134 posts
@buttermilk: Congratulations! Thats great! She just needed time!
Yes, # poo is all over the place. It can mean nothing and it could mean an issue. Biggest thing is to look at # of wet diapers! Also remember you can always "supplement" with a bit of pumped breastmilk if you are getting some of that.
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