Medela SNS/ This is my final attempt.

laurblum

I posted a couple of weeks ago during LO's first week home asking for help building my supply. Since that discussion I have had LO's tongue & lip tie corrected and rented a hospital grade pump. My supply is still lacking. I go to a lactation support group every Tuesday and Thursday where they do a weighted transfer so I can see what the baby is getting. The most I ever got was 1.2 ounces in a 30 minute feeding last Tuesday. Today LO only got .3 ounces!!! So disheartening!!! Obviously, we have had to supplement because I am not giving her nearly enough. I try to pump as much as I can, but some days I only get to do it once or twice because as soon as I finish nursing, I have to give her the formula supplement and then usually burp and change her. She only wants to be held so the second I put her down she goes bonkers and I have to hold her again and not pump. It is so frustrating. The most I've ever gotten in one pumping session is 1.5 ounces. DH helps as much as possible and is very supportive, but as we all know the BFing falls on me alone no matter how much DH tries to help. My pediatrician feels that the issue is LO's size. She was 9lb14oz at birth and just regained her birth weight as of today (2 weeks 4 days old). Basically she's saying that she wants more to eat since she's a bigger baby. She takes anywhere from 3-4oz of formula for a feeding after nursing. Occasionally she'll stop at 2.5oz, but usually at least goes for 3. Isn't that a lot for a newborn?? I don't want to keep from feeding her if she's hungry, but I just don't know what's going on. Today at lactation support they recommended I try the Medela SNS to get her to feed longer at the breast and hopefully stimulate me into making more milk. Do you guys think this problem can be turned around this far into it? I really hope so, but I am feeling so discouraged. I have never felt engorged, my breasts don't leak, I don't feel a let down when nursing or pumping.. I don't know if any of that matters, but I am not experiencing any of the things normal BFing moms are experiencing. Does anyone have experience with the SNS? I am going to order it tonight, but if this doesn't work I guess I'm done. I don't know what else I can do that I haven't already tried. This realization completely breaks my heart. I will be crushed if it turns out I can't BF anymore, but at the same time I feel like I am always hitting a wall and I just want to have a happy, satisfied baby and have feeding not be this constant source of stress. Hopefully one of you has some positive experience with SNS or a low supply situation that got corrected. Please tell me there might be light at the end of this tunnel.

ErinO21

Hang in there mama. You're still in survival mode. Those first few weeks are super tough. As for your supply, it is still regulating and you will see an increase if you get those pumps in. I know it's hard but you just have to find a way to do it. At that point I was nursing every 2 hours and pumping right after because we were battling a huge weight loss and slow gain. Even throughout the night. If we weren't dealing with weight issues I still would have had to pump on that schedule. Also, When my LO was about 7 weeks old I went to a support group to do a weighed feeding. I felt like things were going great and he nursed for 30 minutes. He transferred 0.0 ounces in that 30 minutes. 3 months later he transferred almost 5.5 in one feeding. Nursing takes lots of practice and patience. Breastfeeding in general takes a lot of patience. There is still hope though. We didn't have nursing down until he was 4 months old. Never in my life did I imagine it taking so long but I am so glad I stuck it out. Hang in there! You can do it!!

opheliainwaders

Hey, mama - first of all, breathe! You're doing great! A few questions, and a few thoughts:

- Do you have anyone else home with you? Could you have someone come in to do the bottles so that you can pump more regularly? You say that your DH is helping as much as possible - has he gone back to work yet, or is he on leave?
- Have you seen an IBCLC one-on-one? You say that you had a lip/tongue tie corrected - has an IBCLC reevaluated your DD's latch after that?
- When you do the weighted feeding, are you changing to a clean diaper beforehand, and then keeping any wet diaper ON at the end?
- How frequently are you nursing? For how long? Are you letting LO nurse on demand, and for as long as she wants to stay latched?
- Before you started supplementing, was your LO having enough wet diapers? Was the concern just slow weight gain, or also that she wasn't wetting enough?

I also have never felt letdown, rarely was engorged, and struggled with supply at the beginning. So! These things alone are not the end of the world, I promise. That said, it sounds like the challenge here is that you won't be able to ramp up your supply when you don't have the time to pump every. single. time. she gets a bottle. Every time you supplement without pumping, you are telling your body not to make more milk.

If I were you, I would:

- See an IBCLC one-on-one to discuss whether an SNS is even necessary, evaluate your DD's latch, and discuss supply issues. You can find an IBCLC here: https://www.ilca.org/i4a/pages/index.cfm?pageid=3432

- Take a nursing vacation: literally spend the next 3 days in bed, shirtless/skin to skin, with DD on you. Nurse whenever she wants to nurse, even if that is 20 hours/day. If she is getting enough wet diapers, don't supplement, just keep her nursing (my hunch is that you will need to supplement at first, less as the days go on?). If you supplement, then you *must* pump every time she gets a bottle. Someone else needs to give her the bottle so that you can pump, whether that is DH, or your mom, or whoever.

- If your DD gets a bottle, make sure that the person giving it to her is doing a paced feed - it should take at least 20 minutes for her to get that bottle. Right now, it sounds like she is eating a LOT for a newborn. Kellymom.com has directions for how to do a paced feeding. If you don't already have it, the bottle should have the slowest nipple you can find.

- Food and water! You didn't mention your diet, but: you should be drinking tons and tons of water. In addition, eat steel-cut oatmeal with ground flax seed for breakfast, and see if you can get your hands on some brewer's yeast (the loose yeast seems to work better than the tablets, but I think it's gross. Sorry...). My lactation consultant also had me drink RRL tea and nettle tea (I just brewed a big pitcher of them, iced it, and drank it that way, since it was summer). Eat at least 2500 fatty calories a day and see what happens (nuts, avocado, whole milk/yogurt/cheese, etc. doesn't have to be junk food, but I once saw a huge supply increase on a day when I ate 2 donuts).

- Finally, and this is the WORST thing to say, I know it, but try to relax. Maybe watch TV while you nurse, or something - the more stressed you are, the less easy it is for your body to get a letdown. I have a MUCH harder time letting down for the pump, even now, and I have to distract myself to do it at all.

Whew. I know that was a novel, but I think this is still do-able, but you need support, and a little time and space to make it happen. Your DH may not be breastfeeding, but at the newborn stage, nursing is a 3-person job (you, baby, AND partner).

Pankers

I'm 14 weeks in and I only started working on increasing my supply at 8 weeks. Not too late in my opinion. I was ff before due too weight/ latch issues.

ETA- I only get 1-2oz when I pump an LO gets between 1.5 and 2.5 when I do weighed feedings, so it just means more frequent feeding for me and LO. This is both breasts at a time.

Aliki

First, take a deep breath and know that you are doing a great job! What you are providing for LO is still amazing and don't for a second think that you aren't trying!

How old is LO currently? You say today her weighted take was 3 oz., what does your LC or lactation group suggest she needs to reach?

My LO was born 9 lb 10 oz, also had tongue tie, suffered dehydration and significant weight loss (she lost 1 lb 7 oz.) and didn't regain her birth weight for 2 weeks, I think, if not 3 weeks? It is normal for bigger babies and there is no reason to think you can't succesfully breastfeed her! My first DD was 9 lb 8 oz at birth and was EBF for 6 months (until introduction of solids) and then continued to only take BM until 1 year when she self-weaned. Big babies grow big with breastmilk!

Here is what worked for me to get back on the right track:

- Pump 6 - 8 times a day. You have to make time to put yourself on the pump. If LO needs to be held and DH is around, he needs to hold her. If DH or another person is not around, then put LO in your lap while you pump.

- Power pump at least once a day. There are many ways to power pump, but my way (and the way my LC recommends) is you put on a 30-minute TV episode with commercials, and leave the pump attached to your breasts. Every time the commercial comes on, turn the pump on and leave it on for duration of commercials. Turn off when program comes back. It's not about how much milk you get (you could get nothing because you just nursed, this is OK) but it will stimulate spkes in your hormones to increase you mlk supply

- SNS helped a lot for me. this way whenever I supplemented, my breasts were always cued that I needed to make more milk for her. It's troublesome and hard to operate, and I gritted my teeth and cursed under my breath a lot with the SNS, but in hindsight it was worth it

- Order Fenugreek, Shatavari, and Goat's Rue on Amazon.com right now. Take 1 pill each 4 times a day.

- Increase your water intake. I drink about 160 - 180 oz. a day now!

- Holding your LO as much as possible is actually very helpful for making more milk.

Good luck.

BootsOrHearts

Hang in there. I could have written the same post a few months ago. Sounds like it might still be a latch issue as a result of tongue/lip tie. Check out youtube videos on how to get a deep latch. Try laid back nursing position, literally lean back on pillows and put baby face down on your chest, she will bob up and down until she finds a nipple and latch herself, gravity helps get a good latch that way. It's awkward at first but keep trying.

And yes it sucks to pump but for now you have to do it at least every 2 hours. If you nurse, just finish off on the pump, 10 minutes or so. Definitely get or make a hands free bra. I could never get the hang of pumping and bottle feeding at the same time but at least with the bra you can play and talk to baby or even hold  her while you're pumping.

Hang in there it WILL get better! I hope you can get her to transfer milk better, it might just take practice. And your supply will go up and become established, hopefully you can ditch the pump then!

Drink lots of water and EAT, you can't make milk if you don't have any food in you and I know it's hard but try to sleep whenever you can. Whenever baby sleeps, you need to (well pump first) then SLEEP! Forget about the dishes, the laundry, the bills, etc, all of that can wait or someone can do it for you, hopefully you have some help.

Hang in there you can do it!

laurblum

Going to try to answer all the questions you guys asked me. 

@gulickr DH is home most of the time, but he works from home so it is hit or miss as to whether or not he is available for feedings. Unfortunately, he has to go away for work the next two weeks which leaves me on my own. My mother is coming to help me, so I'm sure she will feed the baby if I need her to. I'm not really comfortable yet with people besides DH seeing me nurse or pump, yes even my mother. She can be kind of judgy about the whole issue anyway.

I have not seen a LC one on one, but I see them weekly at my support group. One of them did take a look at her after the procedure was done and said it looked better. 

Yes, we do the weighted feeding with a clean diaper and the same diaper stays on during the final weigh in.

Yes, I am nursing on demand. She can nurse whenever she wants for as long as she stays latched. How long and how often is unpredictable. Sometimes she eats every two hours, sometimes she goes as long as four. Sometimes she just wants to stay camped out at the breast for hours on end and I think I might lose my mind. 

I supplemented in the hospital on the last day I was there, so she was 2 days old. The nurse who was with me (not a lactation nurse) said she wasn't getting full and to "top her off". When we got home she was fussy and miserable. I would nurse her for hours and hours and then have to give her a little formula and she was still miserable and would be rooting for food. When we saw the pediatrician she had lost a good bit of weight and she told us we had to keep supplementing. To answer your question, the concern was both slow gain AND that she wasn't getting enough. She just never seems satisfied no matter how much she gets. 

@aliki LO is 2 weeks 4 days old. Her weighted take today was 0.3oz. They didn't tell me what she should be reaching, but like I said she takes anywhere between 3-4oz of formula during a feeding and sometimes still seems to want more! I don't understand why she eats so much. It is literally like a bottomless pit. 

What did you mean when you say the SNS is hard to operate? Is it not as straight forward as it looks? 

I forgot to mention that I am currently taking Fenugreek and drinking Mother's Milk tea. 

Thanks everyone for the encouragement. I am really trying to stay positive. I can't believe how unbelievably hard this has become. 

Edited for spelling. 

MrsBigTime

I think you've got some great information here! 

You are doing a great job, it's so hard now, but it really is worth it in the end, because soon, before you know it, nursing will be easy! It's hard to believe as you are in the trenches today, but you can get there!

I am a little concerned about what you said about your mom coming. You are doing so much to make this work right now, if she comes into your home, as you are tired, stressed and hormonal, is she going to be more of an asset or a hinderance to your breastfeeding relationship. If you think she will be the later, you need to protect yourself from anything that could potentially cause you to doubt yourself or fail. I don't know if that means explaining to her the situation and asking her to respect your wishes, or having her only come for a few hours a day, I don't know, but I do know that establishing a BF relationship in the beginning is hard for anyone, and when you have significant obstacles, it's that much harder. 

Anything that isn't a positive, helpful influence shouldn't be given the time of day. You are doing an amazing job, and anyone who comes into contact with you should be able to support you in your efforts! 

Aliki

3 - 4 oz. per feeding is WAY too much for a 2 week old! She is getting overfed! While it may seem like she is still "hungry" afterwards, remember that newborns will suck for comfort, to fall asleep, and many other reasons, and it's not just hunger. 

If you are not comfortable with anyone seeing your nurse or pump, that's OK. Give the baby to your mother or DH and have them hold LO while you pump. You need to get on that pump!

See a LC one-on-one immediately. Lactation support groups can provide support but are not the right place to seek help. LC consults are covered under Obamacare Act so your med insurance should reimburse you 100% for them without copayments.

https://www.medelabreastfeedingus.com/assets/file/ACA - General QA rev012113v3.pdf

The SNS was difficult for me (perhaps not for others) because LO was hungry (I used it when she was 1 week until she was 2.5 weeks old) and wobbly and wailing at me, and I really really recommend having an LC show you how to use it. You need to position the tip of the tube just flush with your nipple, and getting it in their mouth can be tricky. My LC has a trick where you use some tape (or band-aid) to help secure the tube, but doing all of this, plus getting LO to latch properly, plus having the tube hang correctly without any kinks, and flow properly.. it's quite a lot of finagling. It is worth it though!

laurblum

@AmyG No I haven't been evaluated and no one has suggested that I could be the problem. I will look into that though. Should I contact my OB or my PCP?