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Breastfeeding
kat72883
member
doctor recommended switching to pumping
kat72883
member
Hi ladies
My LO is 2 months old. We've been struggling with his weight gain since his 2 week appointment. He was born at 8.6, went down to 7.13 and was only at 10.0 yesterday. We've been to the doc like 8 times between weight checks and regular appointments. But anyway.
The doc thinks Lucas is eating so frequently because he isn't getting enough at one time, and then my breasts don't have a chance to refill since it hasn't been long enough. She wants me to give him a bottle of pumped milk twice a day and pump, and stretch him out to 3 hours so my breasts have a chance to refill.
I did this twice last night, and didn't get anywhere near the 4 oz she wants him to have (and he ate with no problem). First time was much lower, and the second time was only 3 oz. How do I increase the amount I'm pumping? I started taking fenugreek and I'm really trying to up the water. Pumping really hurts me after a while, so I try to make it as long as possible before stopping for the pain (and I'm 99% sure I'm using the right size flanges). Or will I gradually get more as we do this process and my breasts have a chance to refill? I know milk production increases with the demand, is that based on time pumping or strength of the suction or what?
Please help me out - struggling a lot with the possibility of having to go to formula but I don't want to starve my kid.
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Re: doctor recommended switching to pumping
If you are both pumping and nursing, your body should soon signal that "hey! We need more milk". I disagree with "letting the breast fill". If you pump between feedings, or pump immediately after feedings AND between feedings, you are signaling to your body that more milk is needed. You may not hardly get any milk, but do it anyway. After a few days of frequent nursing and pumping between nursings, your body *should* start producing more. Don't overkill the water, either. Too much can actually impede milk flow. Drink to thirst. If you have to wake up in the middle of the night to pump, do it (I do because my baby pretty much sleeps all night and my supply goes down if I miss that night feeding)
If all this does not help at all, you may need a medication like Reglan to get the production moving. But everyone is different on whether they would consider that route or not. I did and had great results.
Thanks for the reply - I recognize that some of what the pedi said goes against what I've read from the La Leche League, etc. However, I'm not having luck doing it that way so I have to try some other options. I had/have so many questions and I didn't want to keep her in there all day.
I was pumping twice a day after feedings to start to build up a freezer stash (so luckily I have plenty to help until the supply picks up). I was able to pump about 50 ml most recently (it was more before I got suck a couple weeks ago). Should I still be pumping after feedings then? Or should I just pump the 2-3 times/day that I'm giving him a bottle? I also started fenugreek so hopefully that will help, too.
My first, and most important, piece of advice is to meet with a lactation consultant ASAP. They can do a weighed feeding for you to see how much your LO is eating in a session. They can also check for a poor latch, which might be hindering your LOs ability to transfer milk, even if they are eating frequently.
I do question your pediatricians advice. If you are having issues with low supply, then waiting longer between sessions will only make matters worse. The key to increased milk production is to feed frequently and keep the breasts "empty". This will signal your body to produce more milk. Your breasts are continuously making new milk as well, so you never have to worry about them truly being empty.
Here is some great info from kellymom on supply-related issues-
https://www.kellymom.com/bf/supply/index.html
This should be read first -
https://www.kellymom.com/bf/supply/milkproduction.html
One final thought. Checking with Kellymom, it appears that your LO is on the slow side for weight gain, but not unreasonably so depending on how many weeks it took your LO to go from 7.13 to 10.0. The average breastfeed baby is expected to gain anywhere from 5 to 8 ounces per week. If your LO gained 35 ounces in the course of 7 weeks, then I would say that is reasonable. If that 35 ounces were spread over 9 weeks, then there would be more need for concern.
https://www.kellymom.com/babyconcerns/growth/weight-gain.html
According to the Kellymom growth calculator Lucas is gaining about 4.4oz a week. The Average is 5-7 so he is close enough that I wouldn't worry about him.
I do worry about your doctor. I am not an LC but you need to see one. Until about 2 weeks ago, my son was still eating every hour during the day and my LC said that was normal. If you stretch your feedings to every 3 hours it can hurt your supply because each time LO is brought to the breast it signals you to make more milk. You feed him less often, it signals to make less milk.
How much you pump doesn't show anything supply-wise. My son get 3oz when he eats (I've weighed him) and I am luckily to pump 1oz.
If you talk to an LC and find out you really do have supply issues, then she can give you some suggestions like a supplemental nursing system, domperidone etc.
Don't worry too much. My son didn't gain any weight for 6 weeks. I do have supply issues. I pumped and took domperidone and used a SNS and though I do have to give him a bottle of formula every night (not recommending this for you, this was what we had to do after trying a bunch of stuff) he has jumped from the 5% to the 90%. Their bodies have the ability to play catch-up if they were hungry before.
3 lbs of weight gain doesn't seem bad. Is he making plenty of wet diapers or shows signs of hunger?
Here is info on how milk production works - https://www.kellymom.com/bf/supply/milkproduction.html Feeding more frequently can help you increase your supply. How are you judging now on when your LO is finished? My LO gives horrible cues and I usually base it off how empty my breasts feel, the time, and if she seems happy.
Women make different amount of milk during different parts of the day, so 3 oz at night is not bad. If I pump and give LO a bottle and she is still hungry, I will let her nurse. She will usually get more milk that way. Babies are more efficient at getting milk out than the pump.
Also - try breast compressions while pumping. - https://newborns.stanford.edu/Breastfeeding/
Pumping shouldn't hurt. Is the suction too high?
Do you have access to a LC? Some doctors know little about bfing.
It's not necessarily frequency that signals more milk production, though, right? It is how much milk is taken out. So if he takes out 2 oz every 2 hours it would be equivalent to 4 oz every 4 hours (more or less)? She said that she's not super concerned since he is still developing well, but knows that I am worried about his weight, I guess. She didn't recommend the formula, except after we talked about what will happen when I go back to work (unfortunately I have to go back on Jan 10 and in my job I don't think I'm going to be able to pump as frequently as I need during the day (I work 13 hours shifts).
8.6 on 10/11
7.13 on 10/13 and 10/14
7.15 on 10/21
9.4 on 11/30
9.12 on 12/5
10.0 on 12/14
There were some other measurements in there but I can't remember at the moment.
I asked if she thought I should talk to a lactation consultant and she didn't really answer . . . but I'm going to anyway. Thanks ladies.
That weight gain doesn't look bad and you said she is not that concerned. It looks likes he is gaining a good amount of weight recently.
Some babies are just on the smaller size. My LO has perfectly followed a lower percentage growth curve. She is developing normally, has really good muscle control, and sleeps 6-9 hours at night.
I have been having similar issues with slow weight gain although my supply is fine.
I broke down and bought an infant scale so that I could weigh LO before and after nursing so that I would know how many ounces he was getting each time.
When I met with the LC, she said that he should be getting at least his weight times 2.5 in ounces of breastmilk each day. For a 10 lb. baby, that works out to 25 oz.