April 2014 Moms

Lactaction Consultant vs Pedi - who do I listen to? Help me.

I need some help.  At the hospital, we had the LC come in and she went through her little spiel.  We thought we had a good understanding and have been doing what she recommended since getting home from the hospital on Friday.  Then today, we went to DD's first pedi appointment and she basically said the opposite of what the LC said for us to do.  Now, I am so confused and I don't know what to do.  I even mentioned to the pedi that we were told different stuff from the LC.  I just don't want to do anything to jeopardize my milk supply right now.  So, here are some of the key things they both said.  Who do I listen to?  What are you ladies doing and what is/has worked for you?  I know everyone is different, I am just starting to panic a bit.

LC @ Hospital:
1. Wake to feed every 2-3 hours.
2. Do not give a paci for at least 1 month to avoid nipple confusion.
3. Once milk comes in, pump on the breast to "let down" for about 15 minutes to help build up supply and for storage.  (I am going back to work at the end of May/beginning of June, so this is a concern for me)

1. Do not wake to feed.
2.  Paci is ok.  DD needs to learn to soothe and comfort herself.
3. Do not pump right now.  I need to pump to feed the baby only.

I have been breastfeeding and that has gone fairly well, but yesterday DD had a couple latching issues and unfortunately, both of my nipples are pretty tore up and were bleeding.  The pump still hurts, but not anywhere as bad as DD when we nurse, so I pumped this afternoon to feed her.  I am fine with pumping and her getting my milk from a bottle.  I do love nursing, but I literally was seeing stars this morning when I nursed her due to it hurting so bad.  So, I was trying to give them a break!

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Re: Lactaction Consultant vs Pedi - who do I listen to? Help me.

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    I personally like your pedi's advice. It's what I've always done and worked out fine. I've found that LC's can give too much info and always seemed to make things much more complicated than it needed to be. It was always better for me to go about things the easy way and if it doesn't work, THEN find an alternative. I've never woken a sleeping baby or had any issues with pacifiers. In fact, they never really got into them until they were a month old or so anyway. #3 I am not sure about but I'd think if you started right away you'd end up with too much in storage.

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    I'm siding with the pedi also. Unless baby is well under her birthweight or had a medical issue like jaundice I'm not waking to feed at night. And we gave DD #1 her paci the night she was born. It was clear she needed the sucking to soothe. She was a good latcher. We didn't give it to DS and he never latched on so I don't think that always matters. And I think the pumping is up to you. I never stuck with BF long enough to need a stash and I will try again so I don't know what I will do.
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    Can I just add that if you're not having supply issues right now, pumping before feeding can actually lead to an oversupply.  Now, if you're pumping a bit to soften your breasts before latching or prevent overactive letdown, that is different, but it doesn't sound like that is the case for you.
    Chase was born 4/23/2011
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    Yeah I'm really surprised by the LC's advice (other than the paci part -- that seems like an LC Standard).

    I wouldn't wake to feed unless baby is still under birth weight. I also wouldn't pump a ton at this point while your supply is establishing if your goal is to continue nursing.

    The paci is totally a personal preference. I don't really believe in nipple confusion with pacis since they aren't receiving milk from the paci, but I know many people do think it can cause issues. If your nips need a break and you know LO is just suckling for comfort, I'd offer the paci to give yourself a break.
    DD 2/21/2012 & DS 4/1/2014
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    I agree with your ped. Mine doesn't even advise waking unless they are having issues gaining, not even if they are below birth weight. I start pacifiers from day one and have never had an issue.
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    My LC told me to " pump until empty"...now I'm dealing with over supply. Trying to cut my supply down I got a plugged duct. If I could go back , I would have stopped pumping when we kicked the jaundice.
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    I opened this thread ready to be all "listen to the lc, duh" but actually I agree with your ped for the most part.

    Same here!! Other than the remark about pacifiers being okay because DD needs to learn to self-soothe. A newborn doesn't need to be taught to self-soothe. They're still an extension of you. Don't forget about the fourth trimester! I mean the pacifier could be an extra sense of comfort for her but don't get upset if she doesn't want it or still needs you to soothe her!

    I'm really surprised your LC gave you that advice about pumping. I don't know about your specific situation but I now for me and probably in most "normal" situations that's just asking for a world of supply issues (oversupply, over active letdown, engorgement, plugged ducts, etc). I've always been told by my LCs NOT to pump for several weeks unless I'm pumping for comfort and only then it's just to relieve the enforcement. Or if I'm pumping to replace a feeding/let someone bottle feed.

    Married 3.14.09
    DS born 8.20.10
    MC 7.11.11
    DD born 5.24.12
    #3 EDD 4.02.14
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    ITA with the majority of the replies here. The initial LC plan seems a little over zealous. I would add that doing a lot of pumping/bottle feeding seems to sometimes backfire and change LOs latch or get them accustomed to the faster flow of a bottle. As much as it hurts I'd keep trying at the breast and see a new LC to evaluate latch. If you need that break then check out kellymom.coms suggests on cup or syringe feeding of read the article on bottle feeding a breast fed baby. Good luck! TONS of nipple cream is your friend!
    BFP#1 9/14/10 (EDD 5/21/11); no fetal pole 6w6d, 7w4d, d&c 10/8
    BFP#2 3/16/11, beta 138; 4/12 Baby/HB DS born 9/10/11 at 29w4d due to partial abruption and PTL
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    BFP#3 8/19/13 Another boy! 17P, modified bedrest and Nifedipine helped us have a termie! DS2 born 4/19/14 at 38w5d.
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    My LC and Ped agreed. Both said wake to feed until she hits BW and my supply is established. We also have very mild jaundice to deal with. Both agreed to no paci for first month and LC did say to pump after feedings if I felt I was still pretty full but only for 5-10 minutes each time. I don't think I would pump before nursing.
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    You know your baby and your situation best.

    We were also told no paci until 4 weeks, but we gave it to him on day 3 and he's been just fine.  We don't use it all the time (he doesn't want it very much), but as PP said, sometimes it's clear that he just needs to suck on something to soothe himself (like when he's just been fed and is still fussy).  He hasn't had any nipple confusion, but I've been blessed with a really good latcher/feeder. If he had latch issues, I probably wouldn't use the paci.

    As for pumping, I kind of feel like if it ain't broke, then don't fix it.  My supply is fine right now (good letdown, no engorgement), so I'm not going to start pumping until closer to when I go back to work, and even then I only plan to pump enough for while I'm at work plus maybe a very small stash.  I REALLY don't want to mess up my supply right now by throwing pumping into the mix.   But again, you know YOUR situation best, so do what makes sense TO YOU.   If your nipples are really sore and pumping is more comfortable than BFing, then go for it -- but probably best to only pump enough to feed the baby and not worry about a stash just yet. 
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