Anxiety over breastfeeding- q's

ktnicole · September 2012

LO has been great since coming home- super easy to soothe and sleeps well at night (mostly bc she was early she just sleeps ALL the time). But I have serious concerns about BF. She was in the NICU and while I pumped I was doing a great job of getting enough expressed through pumping for a whole feeding. Now (day 10 and really since day 8) I have noticed that my breasts are not "about to explode" they feel heavy and she is definently getting something from them. I would even say they feel emptier, softer? after she feeds. However the day after our hospital release we had very few diapers, so I started pumping following feedings and giving that too her and/or formula to supplement. I am pumping now about 20 ml total and she will usually take all of that. Same is true for formula, about 10-20 ml after feeding. We are having plenty of wet dipes now, so my questions...

Does it seem like I am having a supply issue or just over sensitive/reactive FTM?

LO is at breast for usually 30 min, what is a "normal" range for time that LO eats? Sometimes we spend an hour waking, BF, changing, waking again and supplementing her, do your feedings take as long?

THANKS ladies!

KarBear · September 2012

That all sounds pretty normal, but everyone is different. Eventually, your breasts do stop being engorged all the time. 30 minutes is normal, and I wouldn't base your pumping output on what your LO is getting by BFing. As long as you're getting weight gain and 5-6 wet diapers (per kellymom) I'm sure you're doing great!

If you continue to be worried, you can up your water intake and start eating oatmeal daily which can both help with your supply.

BakerMommy · September 2012

Your feeding routine sounds pretty normal for such a new babymy DD always took forever to eat. I was worried she wasn't getting enough, and it really eased my mind to do a weighed feeding with a LC our hospital had a drop in class. The could convert the change in DD's weight to the number of ounces she'd injested. Does your hospital offer the same kind of thing? Do you have a LC you can call?

Also, after the initial engorgement, I rarely felt the dramatic change in my breasts pre and post feeding. Like you described, there was a difference, just not as dramatic.

Good luck! Hope that helps!

MeatballEsq · September 2012

I'm not BF (exclusively pumping) so I cannot offer first-hand advice, but the NICU told me that I could BF 1-2 times a day and when I do to offer a bottle afterwards just to be sure he was getting enough. Sounds like if you're doing that and she is done eating when she eats her 10-20ML from the bottle, she is doing fine!

And like Mands said, have you tried weighing her? We weighed Connor recently just on our own scale (by weighing ourselves and then weighing outselves with him). I also thought about just weighing him on the food scale Wink

3monkeysmama · September 2012

mands629:

And you're sure she's not falling asleep at your boob? Sometimes, I would undress L to keep her awake at the boob.

I was just going to ask the same thing. We had to undres DS2 during his feedings for the first three weeks or so!

ktnicole · September 2012

I'm trying to feed her about every 3-4 hours, closer to 3 but occansionally I just can NOT get her to wake until 4 hours. Typically I strip her down completely before feeding to wake her and then after feeding do the diaper change to rewake her before giving her the bottle. I had read online that I shouldn't base her feeding on my pumping output but I should continue to pump to encourage my breasts to make more.

She is falling asleep at the boob, I usually have to either act like I'm pulling away or adjust her to remind her that she is eating. This is all supposedly normal for a "late preterm" baby. They prefer sleeping and don't eat real well. The LC is out tomorrow for labor day and I wanted to have an additional day to monitor wet diapers when I called her but I will ask about them doing a weight check before and after feeding. Or get a scale of my own, that would probably make me feel better.

Thanks ladies

stella_blu · September 2012

Sounds like you are doing great! Was she on iv fluids in the hospital? That could also affect the diaper situation as well as your supply. It will all regulate and you will be so happy you stuck with it! Good luck momma and great job!

jangelopoulos · September 2012

Thank you for posting this. I am going through the same thing right now (my son was in the NICU for a week and a half) and I am BF then supplementing after with bm. He also is falling asleep while BF and I was scared to fully undress him since he was so small until talking to the LC. I thought that I was failing at BF but I know now that this hopefully will be temporary and I can eventually stop supplementing every feeding with a bottle. We will get through this!

stella_blu · September 2012

jangelopoulos:
Thank you for posting this. I am going through the same thing right now (my son was in the NICU for a week and a half) and I am BF then supplementing after with bm. He also is falling asleep while BF and I was scared to fully undress him since he was so small until talking to the LC. I thought that I was failing at BF but I know now that this hopefully will be temporary and I can eventually stop supplementing every feeding with a bottle. We will get through this!

Came back to add that DD was in NICU for a week. They had me pumping after every feeding for that whole week and then I slowly decreased that after we were home. I ended up with an over supply and DD would only eat from one breast each feeding but it was totally fine. We made it to a year breastfeeding and never ended up supplementing with formula. It's totally and completely possible! Best of luck to you both!

Tampasomedaybride · September 2012

I agree that it sounds normal. After a week or so your breasts will begin to normalize their supply. It may take a little longer than that but it sounds like you were pumping. Pumps dont do as great of a job as stimulating the milk supply so they probably just normalized to the pump. I would suggest getting baby to latch on and nurse and letting her nurse for as long as possible. 20-30 minutes on each side is totally normal for a newborn just learning to nurse. Feedings for us took an hour because DS was early too and was very sleepy. She will get more efficient and quicker as she learns. I would probably try to stop supplementing with formula. Each bit of formula you supplement with is telling your body not to make that much breastmilk. If you MUST supplement then I would get a Medela Supplemental Nurser and supplement at the breast. That will stimulate your breasts to make more and will enable you to wean off of the formula.

I know its hard in the beginning, and its definitely a learning curve. But by 6 weeks or so it gets SO much easier and you will be so happy you stuck it out. Hang in there mama.

Tampasomedaybride · September 2012

ktnicole:
I'm trying to feed her about every 3-4 hours, closer to 3 but occansionally I just can NOT get her to wake until 4 hours. Typically I strip her down completely before feeding to wake her and then after feeding do the diaper change to rewake her before giving her the bottle. I had read online that I shouldn't base her feeding on my pumping output but I should continue to pump to encourage my breasts to make more.

She is falling asleep at the boob, I usually have to either act like I'm pulling away or adjust her to remind her that she is eating. This is all supposedly normal for a "late preterm" baby. They prefer sleeping and don't eat real well. The LC is out tomorrow for labor day and I wanted to have an additional day to monitor wet diapers when I called her but I will ask about them doing a weight check before and after feeding. Or get a scale of my own, that would probably make me feel better.

Thanks ladies

My son was born at 37 weeks 5 days. What you are describing is what we went through for the first 3-4 weeks or so. Once he hit "full term" he seemed to wake up a bit more. But it was incredibly frustrating for me until then. He was nearly impossible to wake up. I am surprised they are telling you 3-4 hours. I was told NO longer than 2 hours until he reached his birth weight (so maybe she has already). It was brutal. We would feed for an hour and I would lay down and try to sleep for another hour and then get up and do it all over again.

I dont understand the need for giving a bottle after she nurses. If she hasnt reached birth weight then I would say she needs to eat more often, 3 hours may be pushing it. But I would really try to wean off of "topping off" with a bottle because they work less with a bottle and are more easily overfed. Which can start a vicious cycle of wanting to overeat and possibly having a hard time keeping your supply up. I think you might also find that with a supplemental nursing system it might shorten your feedings a bit too since you can supplement while she is nursing if you absolutely must supplement. If it were me though I would each day (once she reaches birth weight) give her a little less in the bottle than the day before (or using the nursing system) to wean her off of that.

Because of DS's jaundice they made me supplement with formula and I blame that in large part for screwing up our nursing relationship in the beginning. I will not supplement this time unless it is using the supplemental nurser, so that even if I am supplementing he is still stimulating my breasts to make more milk.

bosha711 · September 2012

Everyone's different, but personally, I'd make each session almost twice as long. DS would feed on each boob nearly 30 min per session, for an hour total. If she's taking more after you BF, then she's still hungry, I think, so just keep her on longer. Supplementing will be a slippery slope b/c your BM supply is based on demand. Have you had pedi appts yet, what do they say about the # of dirty diapers?

eta - Sorry, I guess I'm confused - are you nursing 30 min total each session, or 30 min on each boob per session? I read you OP as being the former.

But in regards to keeping LO awake to nurse - besides stripping her down, try expressing a little milk onto her lips. Even if she's sleepy, it may be enough to get her to to start sucking instinctually.