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Breastfeeding
RebeccaR17
member
Need help/encouragement - problems BFing 2nd baby
RebeccaR17
member
I apologize in advance for this being long, but I'm really struggling to EBF my son (second child), who is 22 days old.
Background - My daughter is 2 yrs 5 months, born after 10 years of miscarriages, failed adoptions, and IVF/FET with a whole bunch of other stuff added in. She was born at 38w0d (C-section for a minor placental abruption), lost 11% of her body weight within 24 hours (7 lb 12 oz down to 6 lb 14 oz), on-call pediatrician at hospital insisted we start supplementing with formula, all the nurses at the hospital gave conflicting guidance on how to BF. Once we got home, I called a lactation consultant who helped with her latch and shortly after she reached 3 weeks, we were able to completely wean from formula. From that point until she turned 1, the only liquid she received was BM (nursing when we were together, pumped BM in a bottle when she was at day care). I didn't have any supply issues at all and was easily able to pump what she needed.
She gained weight slowly - I don't remember all of her numbers off the top of my head, but I know she did not double her birth weight by 6 months (I think it took about 8), and she did not even come close to tripling her birth weight by 1 year. Since she was gaining some and was reaching all of her milestones appropriately, the pedi wasn't concerned about it. Now at 28 months, she's 27 pounds. We have family of all sizes, so it's hard to say if it's genetic or not - my father-in-law is 6'7" and was *very* slender for his first 40 years or so, my mom was 5'10" and also very slender until later adulthood, but my mother-in-law is 5'1" and has always been on the plump side, and my dad was 5'10" but very stocky. DH is 5'11" and is skinny, I'm 5'7" and have always been on the plump side. So it's hard to say which genes the kiddos have.
This time around - Another FET, also born at 38w0d, this time a scheduled C-section, he lost 11% of his body weight within 36 hours (7 lb 7 oz down to 6 lb 10 oz), on-call pedi again insisted on supplementing with formula. This time, my milk came in around 48 hours (it was 96 hours with my daughter). We left the hospital after 3 days and stopped supplementing immediately. At 4 days old, my son was back up to 6 lb 13 oz, although that was on a scale in the Pedi's office rather than the hospital scale. 2 days later, on the same scale at the Pedi's office, he was back down to 6 lb. 10 oz. The pedi elected to postpone his circumcision because he wasn't comfortable doing it with my son's weight still dropping. We also started supplementing with formula and called the lactation consultant, who was able to come over when my son was 10 days old.
She immediately examined him and determined that he had a pretty significant tongue tie, which neither of the 2 Pedi's in the hospital nor our regular pedi had pointed out. We also did before/after nursing weighings, which I continued to do after the consult, and he was only taking 0.5-1 oz total combined from both sides. I offer 1 side, wait until he gets to the point of nibbling, then switch to the other side, usually with 2 burping sessions per side. He spits up a little bit, but not anything that strikes me as a lot - my daughter spit up a lot more than he does.
We got his tongue tie treated on Tuesday (17 days old), and since then, he takes between 2-4 ounces at a nursing session (still offering both sides), most often in the 2-3 ounce range. I had been nursing him, then my DH or mom was giving him a bottle while I pumped. I can usually get about 2 ounces out of the left side and 1 ounce out of the right during each pumping session.
Since his intake from nursing had increased so much, we decided to try to stop the bottles again on Friday. The problem is that he's still acting hungry after every nursing session except the ones where he takes in 4 ounces, which usually only happens once a day.
I'm trying to nurse every 2 hours (from start to start) during the day, but it usually takes about an hour for him to get the 2-3 ounces, then he's awake for a few more minutes (or longer if he's feeling really fussy). Then once he falls asleep, it's pretty much immediately time to wake him up again and start over. Sometimes when we stick to the 2 hour cycle, he doesn't wind up taking enough to register anything at all on the scale, so sometimes I let him sleep and stretch it to 3 hours. I have to wake him up during the night - he doesn't wake up on his own.
I feel like we're in a catch-22 - since he's still hungry after nursing, we're having to give him bottles, which is making him even less interested in working to get what he needs from me. (If I keep him on the breast beyond an hour, he will latch on but pretty much just nibbles and doesn't get anything more out, at least not enough to register on the scale. And our scale has been exactly spot-on with both the pediatrician's and the lactation consultant's scales.)
So at this point, I don't see how we're going to get away from bottles, other than letting him scream from hunger after each nursing session, which I don't want to do.
Overall, I feel like I’m not getting nearly enough sleep (especially because he tends to be fussiest at night and getting him back to sleep after he feeds takes 1-2 hours on top of the 1 hour of feeding time). At this point, I’m averaging about 4-5 hours of sleep a day on a good day, plus sometimes an hour or so if I fall asleep with him during skin-to-skin during the day. Both DH and I have come down with a cold (sore throat, runny nose, low-grade fever), so I haven’t tried to switch his night feedings to a shorter schedule like 3 hours, because if I do that, I literally won’t get any sleep time at all – by the time he’d finally fall asleep, it would be time to start nursing again. I'm worried that the lack of sleep will start to affect my supply.
In terms of his diapers, he has 7-8 or more wet diapers a day, and usually at least 4-5 a day are poopy (at least the size of a quarter, but usually much, much more than that). They are mustard yellow and seedy - no green at all. (Green was pretty much all we had with our daughter for the first few months.) With the formula supplementation, he has been gaining 1.5-2 oz per day. After only BF on Friday, he was up only 0.5 oz from Friday to Saturday. Based on what I saw on the scale today, I suspect that in the morning, his Saturday-to-Sunday change may not be a change at all - he may remain flat, or even drop. But right now I'm most concerned about the fact that he seems to be hungry after most of his nursing sessions, and then slowed weight gain would be my next concern after that.
It's really important to me to nurse him. My plan was to do so for a year, like I did with my daughter, but the longer it drags on with formula involved, the more worried I get that my supply is going to decline and we're going to wind up strictly on formula, which I don't want to do if we can avoid it.
I've asked the lactation consultant to come over again this week, but any ideas you can share would also be welcome.
Thank you,
Rebecca
This discussion has been closed.
Re: Need help/encouragement - problems BFing 2nd baby
BFP#1 1/31/12, EDD 10/6/12 Harrison Gray born sleeping @ 18w6d. You changed our lives little guy.
BFP#2 EDD 10/29/13, C/P 2/25/13, Bye little Ish, we barely got to know you.
BFP#3 EDD 12/21/13, Baby Boots born 11/23/13 My rainbow baby!
January PAL Siggy Challenge: Good Advice
First, thank you all for the support, encouragement, and advice! It really does help.
Sorry it's taking me so long to respond to the questions - right now I'm not getting much computer time until he goes down to sleep after his late evening feed.
Pacifier - I give it to him (and sometimes gently hold it there, but don't force it on him harshly), but he doesn't seem interested in it. He'll suck on it a few times and then spit it out or just let it fall out. The LC said he was probably having a hard time keeping it in because of the tongue-tie, but even now that that's been fixed, he's still not interested in it. My daughter was a big fan of the paci (although thankfully she eventually weaned from it without much fuss). My mom says I always spit out the paci when I was a baby, so maybe he's taking after me in that respect.
Why I think he's hungry - In general, he's a pretty mellow, easygoing baby. If he takes 3.5 or 4 ounces from me, or gets that much from a combination of nursing and the bottle, after he's done with his intake, he's content to sit and look around or move on to other activities with me. But if he gets 3 ounces or less, he's immediately (within a minute or 2) crying, stuffing one of his hands in his mouth and gnawing on it, and if I lightly run my finger from near his mouth to the outer part of his cheek, he immediately turns his head toward it and his mouth makes a motion like he's searching for the breast. I try extra burping (even though we already do a lot of burping), patting, shushing, swaddling, rocking, putting him in the swing, etc. Sometimes we'll have success with the swing calming him down, but other times nothing calms him other than going back on the breast or a bottle. When he does go back on, he may stay on for another 30-45 minutes but not show any gain on the scale.
Today, his first 3 feedings (2 middle of the night feedings, and the first morning feeding), he took 3.5 ounces from me each time. It was a great night - he went right back to sleep in the crib after each of the middle of the night feedings, so we both got good sleep. After that, he only wound up taking 2-2.5 ounces from me per feeding. I was able to get him through most of the day without a bottle, but I did give him one after the last feeding of the day, since he only took 2 ounces from me and I knew he wasn't going to go to sleep without more in his tummy.
He was 8 lb 3 oz on Saturday, which was his 3 week birthday. He went up to 8 lb 3.5 oz on Sunday and was still at that weight today. (All 3 of those were morning weights, wearing only a clean diaper.)
Just to clarify: I agree with those of you who mentioned that the mustard yellow, seedy poo is a good sign and that green poop is not the ideal. That's part of what is confusing me about all of this - he's having an appropriate number of diapers and appropriate-looking poop, he's getting the amount of BM from me that is in the range of what I've read about (19-30 ounces between 1-6 months, with 1 month being on the low end of that range and 4-6 months being on the high end), and yet he still seems hungry and isn't gaining any weight to speak of without a bottle. Although looking on the bright side, at least he now seems to be at least maintaining his weight and no longer dropping when he's EBF...
Also, I don't mind if he wants to be on the boob a lot, my concern is just that he's not really gaining anything weight-wise even if he is on the boob all the time. (At least it does seem to offer him some comfort, although sometimes he'll also pull off and fuss.)