Exclusively breastfeeding after supplementing?

imagine7696030614 · October 2014

Hello, I'm usually on Oct.14 but have been having issues with breastfeeding/baby not gaining enough, so I was hoping to get more advice here. My baby is 3 weeks old and at her 2 week appointment found that she wasn't gaining enough weight back (born at 8.10, discharged at 7.15, and at 2 weeks 8.1) so Dr. Told me to supplement with pumped breast milk/formula after nursing. I feel like her issue of falling asleep at the breast has gotten even worse after introducing the bottle (though her weight gain has been great!) I've seen a lactation consultant and I'm trying the methods to keep/get baby awake but I feel like she's not getting enough from me because it's sooo much work getting her to actively eat for the 30 minutes. She'll usually take 3-4 oz of a bottle after nursing...Anyway, is there any hope that down the road we can get back to exclusively breastfeeding, or have we pretty much ensured that she'll be dependent on the supplemented milk for the long haul? Just looking to see if anyone has any stories of hope...thanks so much!

imagine7696030614 · October 2014

Thanks so much. I did go to an LC and she looked at the latch. She helped me get her on the right way, and I think I'm getting her latched on well, but guess I can never be 100% sure??I've got another appointment with the LC on Friday. Just seems like this dream of breastfeeding her is slipping further and further away from me. Tried to breastfeed her this morning and she didn't even swallow once..just right to sleep even though she had just been crying. Sooo, got the bottle and of course, she drank all 3 oz. I'm probably not pumping enough because of various appointments lately. But I'm trying to pump after giving her a bottle, though it may not be for a while after the bottle. Is it vital that you pump right after giving the bottle for timing purposes? No idea how that works..anyway, thanks again.

surpriseaddition · October 2014

Yes, you can definitely get to 100% EBF after having to supplement. I have BF 3 kids. The first two I didn't have any weight issues beyond the normal BF weight loss, but #3 lost 12% of her body weight when she finally bottomed out at day 5. She started gaining, but it did take her 3 weeks to get back to birth weight. During that time, I was supplementing with pumped BM and an occasional 2oz bottle of Similac for Supplementing ready made formula if I didn't get enough pumping. Once she was back to birth weight, I stopped the pumping and just kept her on the breast basically all day long, and was 100% EBF by 6 weeks. From 3-6 weeks if she was really frustrated at the breast and wasn't getting anything, I would give her an ounce or 2 of formula to satisfy her, but that was it and only after she had been sucking awhile and not getting anything from the breast to stimulate my supply. It's super important to have LO nurse almost constantly the first 6 weeks to ensure you have a good supply. I agree with @casey78 that the slow flow nipple is super important. I used the ones that came with the ready made formula that was meant to be a slow flow newborn nipple, but I'm sure any slow flow will do. You also want to stop the bottle every 1/2 oz, and burp, and making the bottle take just as long as a nursing session. Babies definitely will take the easy way out since it is more work to BF versus the bottle. You can do this! I'd keep your appt. with the LC just in case there are other transfer issues like a tongue tie, etc. that may be contributing, but don't think that because you supplemented early on you can't get back to EBF. GL! ETA: To help with the sleepy baby, strip her down to her diaper and even use a wet washcloth to stimulate her awake so she'll nurse more.

opheliainwaders · October 2014

Ditto @surpriseaddition‌'s advice - good stuff there! My DD went from 5lbs 10oz to 4lbs 14, and had some serious latch issues plus jaundice, so we had to supplement at the beginning. She's now 16m and still nursing. She did have some formula periodically due to some health issues I had, but the supplementing at the start didn't sink us!

Key things:

- Ask the LC for advice on weaning from the supplement/ guidance on a weight that will be ok to start.
- ask for specific steps you should take for how to do that.

In the meantime:
- rent a hospital grade pump (insurance should cover this with a prescription from your pedi), and pump every time you supplement. This part suuuucks, sorry!

- Never supplement without pumping or you will not be able to build up supply b/c your body won't know it needs to make more milk.

- Pump in 6 min cycles of the "letdown" setting (2min) and the "normal" setting (4 min) to stimulate repeated letdowns.

- if you can, for the next couple of days, clear your calendar. Stay in bed/on couch/wherever and hang out skin-to-skin, and nurse whenever you can get her to latch. Encourage constant nursing, clusterfeeding, etc.

Good luck, mama, and keep at it!

CNYBride05 · October 2014

We were heavily supplementing from 0-6ish weeks, and continued to supplement some until about 9 weeks. My girls then were EBF until we introduced solids at 7ish mos. They are now 15 mos and still nursing. It's definitely possible! Are you pumping each time you give a bottle so your body knows to make more milk? Tbh, if she's gaining well,and has enough wet diapers, I'd just cut the bottles and see how she does. She'll nurse if she gets hungry enough!

Abenedict2011 · October 2014

We supplemented the first 3 weeks as well and had similar frustrations, but it just seemed to take LO a few weeks to figure out how to nurse effectively. We were ebf after a few weeks. I'll leave the detailed advice to pp bc they were very clear and concise. I will say I had to pump ASAP after nursing (often handing her to DH for the bottle while I pumped-- I didn't want to get to close to her next nursing session.) good luck and hang in there.

imagine7696030614 · October 2014

Thank you everyone! She actually wanted to cluster feed tonight which was awesome! She hadn't breastfed so vigorously in so long so I'm really happy. I didn't bother to supplement/pump because she nursed so long. The pediatrician seems to think maybe my supply is low which is why she wants the bottle. I'm not sure about that but I'm going to try lactation cookies (and Fenugreek, if I find out it's safe to take with hypothyroidism)..anyway, I'm a bit encouraged, thanks for the great information and support!

surpriseaddition · October 2014

FYI....I am hypothyroid too. I ate a lot of oatmeal (old fashioned kind) and that seemed to help with my supply. Glad to hear about the cluster feeding! That's the best thing to boost your supply.

opheliainwaders · October 2014

Seconding the oatmeal rec - but for me it had to be the steel-cut kind, instant didn't work. It was a long, hot summer of eating oatmeal

Aliki · October 2014

I had to supplement for 10 days with formula/pumped milk after her 1 week check-up due to significant weight loss.

You need to meet up with your LC again. Check latch again and check for tongue tie. Do a weighted feed to see how much you are transferring, to determine if 3 - 4 oz. supplementation after each feed is necessary. if you overfeed, she wont be hungry to nurse off you again (and she should be doing this every 2 hours)

Are you doing power pumps? That will increase your milk supply.

Have you tried supplemental nursing system (SNS)? Pain to set up but it signals your body to produce milk, in a way that supplementing from a bottle can not.

Are you pumping every time you are supplementing? You need to do this even if she just fed. This means if she nurses for 30 minutes, and then give her 3 oz of supplement in a bottle, you need to put yourself on the pump. This is the only way to signal your breasts that the amout of milk you are producing is not enough. If you do not put yourself on the pump, your breasts will think the amount you produced, which you gave to her at that nursing, was sufficient. Even if you get no milk from pumping (because you just nursed), what your body will hear is that you need more milk.

As for my story, after supplementing for 10 days (initially 2 oz. supplement after every feeding on the 1st day, and then gradually decreasing to 1 oz. supplement every feeding, to the 1 oz. supplement every other feedig, to then every 3rd feeding, ad by the 10th day, I stopped cold turkey). She was still hungry which made her cluster feed. After 10 days of supplementing, I just dove into the pool in a sink-or-swim mentality and EBF ever since. It's now 7 months and she wont take the bottle again, even though I've returned to work full time.

ldbryan · October 2014

I'm hypothyroid too...try adding blessed thistle in addition to fenugreek. I take 3 of each 4x/day. I started drinking lactation smoothies last week, too...they have oatmeal, Brewers yeast, and ground flaxseed. I don't like oatmeal, but I can handle it in the smoothies

imagine7696030614 · October 2014

@aliki I haven't tried power pumping. Doesn't seem to be any time. Everything went downhill from that one cluster feed session. I do try to pump when I give a bottle but it's such a long process. For instance, I just tried to bf her at 10:45 for 30-40 minutes, lucky if she got 6 swallows in the whole time, then bottle fed her still 11:30, now pumping at 11:57. Home alone so I have to do it alll myself...not sure how the gap between bottle feeding and pumping negatively affects supply but I guess I have no choice. I made lactation cookies and have been eating 6 a day..addictive! Don't really see change in supply yet though. I'm seeing the LC Friday but feeling hopeless. She checked for tongue tie and everything looks good. My baby just doesn't seem interested in BFing. I've been doing skin to skin, switching sides when she sleeps ( which is practically right away), trying to annoy her awake, etc. Nothing works. I don't think her latch is great though. My nipples don't hurt anymore but they do have a slight lipstick shape when she comes off. So hard to get a good latch because she won't open her mouth that wide. So depressed, feel like this is going to send me off into a bad case of PPD. Anyway, again, thanks for the support and advice everyone.

opheliainwaders · October 2014

OP, do you have a hands-free pumping bra? If not, buy the simple wishes one off Amazon, or cut 2 small holes in a sports bra so you can pump *while* you feed her the bottle. And if you can get anyone to come in and help feed her, whether DH, a friend, mom, etc., see if they can take shifts.

If you can get in to see the LC today or tomorrow, do it. Call her and tell her it's an emergency and that if she's not free, you need a rec to see a different person. It's OK to be pushy, you shouldn't have to wait until Friday to get help.

Also, ask her to show you how to massage baby's jaw and neck to improve her ability to open her mouth to get a good latch.

I know this is so brutal, and I'm not sure of the best way to do it by yourself - hang in there, mama. Hugs.

ETA: for me, particularly at the beginning, I needed to drink at least a glass of water per hour, and eat at least 2500 calories per day, with a significant proportion of fat, to produce enough milk. If you aren't feeding yourself along with baby, do the best you can to get some one-handed snacks. Granola bars, string cheese, apples, etc.

imagine7696030614 · October 2014

@AmyG*‌ thanks so much for taking the time to write such a comprehensive reply! I've already started on what you suggested to do. It's tough though, she wanted more bottled bm after the 2 oz...I'm doing the pumping but only usually can produce milk for about 7 or 8 minutes...so I went to 15...Anyway, I'm going to give it my all...getting up every 2 hours tonight will be a challenge though! K, thanks again!

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