Poor milk transfer?

Kadyra · December 2012

Ds2 was tongue tied and we had it clipped. It made a lot if difference for us. He is also a preemie and has been bottle fed at least three bottles of fortified BM a day since he was able to eat. We use dr browns preemie nipples.

He used to get his fortified BM overnight. But he gets it during the day now I'm back to work. I nurse him from 530 when I get home until 620 the next day when I leave for work. Dh says he takes 2 maybe 3oz at a time for a total of around 18oz a day. He sleeps for two or three hours at a time. During the day. At night, he'll nurse until I can't keep him awake any longer. I blow in his face, do Newman compressions, tickle his feet, etc. I'll put him down and I'll maybe get an hour of sleep out of him. He's 10 weeks actual, 18 days adjusted.

He takes the breast fine. Maybe a little fussy at first when I get home. But he nurses well and I think does a lot of sucking for comfort. I just don't think he gets enough from me at a time to keep him satisfied longer. Tuesday night I got a combined total of 2 hours of sleep. He especially likes to eat nonstop from about 330am until about 7am.

My pedi, who I usually love, said to Ferberize him because at 8lb11oz, he should be sleeping at least 5 hours. I'm not going to do this. At least not now. A pediatrician friend of mine told me to ignore this idiotic advice.

So last night, he took about 2oz while I pumped to keep my supply. He wanted a bit more when I was done so I nursed him. Put him in the rnp. This was 1130 ish. He was up at 2 to nurse and again at 3. From 3 to 530, he nursed nonstop. I finally put him down and had to walk away. He screamed and cried. At 6, dh gave him his morning bottle of 2 oz. he slept until 815 ish. I fed him on one boob while I pumped the other and switched. He was awake and content until about 9. I fed him again. He slept until maybe 10. He nursed again. 11 he nursed again.

Do you think it could be poor milk transfer from his tongue tie? Did they not clip enough? Because he sleeps well after a bottle. Never 5 freaking hours, but well. My pedi friend told me to check for residual tongue tie and she'll write me a referral to correct it. But do you think the milk transfer could be the issue? I know my supply is good because I pump more than he eats by 1 or 2 oz. thanks for any input.

ncbelle · December 2012

A few things...

I think it's worth getting the tongue tie checked just to be sure. An IBCLC should also be able to help you do a series of weighed feedings to see what he is getting from you.

You are right to ignore the ridiculous advice to Ferberize him - Ferber doesn't even recommend such a thing at this age! That would be a pedi switch for me, regardless of how much I liked this person otherwise.

Really what you are describing sounds like a normal newborn. He's only a few weeks old adjusted - and that's a very typical newborn pattern. It's also likely that he's reverse cycling - he misses mama and wants mama time.

Have you considered bed sharing or at least co-sleeping? If you can learn to nurse side lying in a safe sleeping space, you can sleep and he can get mama snuggles. It also makes a huge difference for your sleep if late night nursing doesn't involve getting out of bed (and waking yourself fully making it harder to go back to sleep).

Kadyra · December 2012

We bed share either all night or the second half. I'd love to get him into his own bed though. We didn't bed share with ds1 and it's really not for us. But means to an end.

He has difficulty side lie nursing. He spits out my nipple a lot from that position and then gets mad if he can't find it. So I prop up two pillows and kind of recline on them. Works fairly well.

I had thought that the neurological stuff like sleeping, smiling, socialization, etc went by adjusted age. His physical abilities are somewhere in between. You want to trust your pedi but with something like this, it's hard to.

I'm fine with riding it out, but dh is taking a negative attitude about how effective Breastfeeding is. He's used to stress, emotions, and drama, but it has been a real struggle since day one with this kiddo. I wonder if he is over it. I'm not. But it's hard when my support is dwindling.

Rynna · December 2012

Fire your pedi and find one that knows something about newborns. NO newborn should EVER cry it out, and the Ferber book even mentions that you should NEVER try it until about 4 months. He's a newborn, and it's incredibly difficult in the first few months.

Kadyra · December 2012

Thanks ladies. Advice much appreciated.

ncbelle · December 2012

Sorry you aren't feeling supported. Have you talked to your DH about this? I think it's super important - for reasons you've stated - that partners both be on board with breastfeeding and understand the challenges and how to meet them.

It's also worth considering - or conveying to your DH - that even if you weren't nursing, you'd still be dealing with the sleep issues more than likely - that's just normal for his age (whether you go by actual or adjusted) - was your oldest more of a sleeper? Maybe DH is considering his behavior the norm and not realizing that there's a wide range of normal when it comes to sleep?

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