Our Breastfeeding/Breast Milk Roller Coaster

Lilwatz · November 2014

I thought I'd type out our journey so far (far from over) in case anyone is experiencing similar frustrations to me and wants to chat or see that they are not the only ones!

As a FTM I had no idea what to do or what it is supposed to feel like. My little girl was a late preterm baby (36 and 5) so they warned us she might have trouble feeding. She did seemingly well in the hospital. I needed the nurses to help her latch a lot, but that's pretty normal. She was jaundiced so we supplemented with formula in the hospital and she loved it. She sucked it down. (In retrospect this may have been telling...). At her one week check up she was the same weight as when she left the hospital. Not great. At her two week check up, she still was. She was feeding for 20-45 minutes usually until she fell asleep. Feeding has been painful since day one and continued to be. She's a very content baby so we thought all was fine. The low weight really floored us--we did not see it coming.

At this point, the NP referred us to another NP in the practice who is also an LC. She was wonderful! She had me start pumping after feedings to try to increase supply and to supplement with formula. We also determined my daughter was sucking a lot and only swallowing a little. Because of this I moved to bottle feeding my expressed milk to ensure she was getting the right amount. It was when I started EPing that I realized I had a low supply. The theory is that since my daughter was not actually sucking a lot of milk, my body was never told that it needed more. Makes sense. This was about 3 weeks in.

The NP/LC wanted us to see another LC who is a speech pathologist to have my daughter's latch evaluated. This LC is also wonderful! She identified that my daughter had a small posterior tongue tie. This combined with the fact that she was born at 36 weeks explains a bunch of symptoms we've been seeing: unintentional weight loss, 10-12 sucks before a swallow, pain in mommy's nipples, clamping while feeding (causing a crease across mommy's nipple) and jaw trembling throughout the feedings. She has been working with us to improve her latch through exercises and also referred us to a pediatric ENT to consult on getting her tongue clipped.

Here's the work we have been doing.

First, the exercises. We do paced bottle feeding with her. We tip the bottle to remove the milk source when she shows signs of fatigue or being overwhelmed by milk (typically 4-6 sucks). We wait until she begins sucking again on the nipple to tip it back. We wait a few sucks to teach her that milk does not always come at first (as it will not when she gets back on mommy's nipple). After the bottle feeding she has skin to skin time between mommy's breasts to reinforce that the milk she just drank came from mom's breasts.

Second, increasing my supply. I started pumping when she ate (every 2-3 hours) and taking fenugreek every time I pumped. This increase my daily total from about 10-11 oz to 15-16 oz. But for 2 weeks or so I saw no more gains. I had to supplement with formula about 1-4 oz daily. Somewhere along the lines, it has climbed up to 16-17 oz but not enough to feed my daughter without supplementation. Last week I rented a hospital grade pump as an LC told me it's the closest thing to a baby you can get. I did a "power hour" (pumping for 10 minutes, resting for 10, for an hour) and I spent a day pumping every two hours vs when she eats (every 3-4). I'd been taking fenugreek every time I pumped and I added in 3 cups of mother's milk tea 3 times a day.

Third, we did decide to get her tongue clipped. It was a really hard decision as the tie was small and so it may not necessarily fix her issues. It was *really* hard for us. She bled a LOT. From what I hear from other moms who have done it, we had a pretty bad experience in that regard. It likely was not tons, but mixed with her saliva is was streaming out the side of her mouth. There were tears and not just from her! She was not herself for about 6 hours. I was a wreck. Every cry I felt like I selfishly put her in pain to make breastfeeding easier for me. It was a HARD night.

Now that I am out of the stressful zone, I recognize that we made the decision not selfishly for me, but for US. There are enough benefits from a successful breastfeeding relationship for her that it was worth the risk. But, it's now a journey to get her back to the breast. Some people may just be able to do it, but I am pretty anxious about it after all we have been trying to do and the challenges we've faced. The LC gave us a solid plan that I feel good about.

Basically, we feed her skin to skin at my breast with the pumped breast milk (or supplemented formula). At least twice a day I do that but leave a quarter or half ounce off then try to breast feed with the nipple shield after she has had the majority from the bottle. I'll gradually feed her less from the bottle and more from the breast. Once she can feed wholly from the breast we will work on doing it without the nipple shield but as my LC astutely observed we are not ready for that yet.

I started this plan yesterday and the two breast feedings went ok. Not tons of sucking but she had just had a nearly full bottle and is getting used to the new way her tongue moves now and retraining all of her sucking muscles to work differently. I am hopeful we will get her back to the breast, but if not I am totally fine with pumping and bottle feeding or even switching to formula.

If you are still reading, thanks! Thanks for letting me share and if you have anything to share, feel free to!

FishyMom · November 2014

I am so glad you shared I am on day 2 in the hospital and am having a lot of issues with BF, our situations are different but I still find comfort knowing someone else struggled. Good luck and I think you are a Wonder Woman for how far you have come!

Carebella · November 2014

Nothing to add but I just have to say you are a rock star for working so hard to figure this out and trying to make BF work. SUPER impressed. I hope after all this work you get to enjoy BF your daughter and if it doesn't work you'll know you've gone above and beyond.

brianandkelsey · November 2014

Impressed with the commitment and work you've put into this! I really hope the bf-ing works out but if it doesn't, at least you know that you've done everything to make it work.

Lilwatz · November 2014

Thanks, everyone! At this point I feel like I've invested too much to quit! We'll see if that changes... :P

AnnieRoo13 · November 2014

You're amazing momma! I don't think a lot of people would have done all of the hard work that you have in order to keep breast feeding. That's a huge commitment. I hope she starts feeding better and things get easier. Regardless, you deserve to be commended for your effort!

wildflower75 · November 2014

What an amazing job you're doing!!! All positive and encouraging thoughts for you to continue in whatever is best for you and your daughter!!

megbanachek · November 2014

We are in a very similar boat to you!
Penny had her tongue tie snipped yesterday (at 10 days old) & we're trying to reestablish breast feeding now - with mastitis (yay), severe nipple trauma (after not noticing her shallow latch for 5 days) & a milk low supply.

Thank you so much for sharing this. I don't feel so alone x

Lilwatz · November 2014

megbanachek said:

We are in a very similar boat to you! Penny had her tongue tie snipped yesterday (at 10 days old) & we're trying to reestablish breast feeding now - with mastitis (yay), severe nipple trauma (after not noticing her shallow latch for 5 days) & a milk low supply. Thank you so much for sharing this. I don't feel so alone x

So glad it encouraged you! PM me if you ever want to chat. Good luck! Mastitis sounds TERRIBLE! Do you have a good LC to help you through the transition back to breast? Ours is invaluable!

megbanachek · November 2014

Lilwatz said:

megbanachek said:

We are in a very similar boat to you!
Penny had her tongue tie snipped yesterday (at 10 days old) & we're trying to reestablish breast feeding now - with mastitis (yay), severe nipple trauma (after not noticing her shallow latch for 5 days) & a milk low supply.

Thank you so much for sharing this. I don't feel so alone x

So glad it encouraged you! PM me if you ever want to chat. Good luck! Mastitis sounds TERRIBLE! Do you have a good LC to help you through the transition back to breast? Ours is invaluable!
----

We're lucky that our LC has been incredibly supportive.
We are doing our best & just so happy that she's being fed.

Sending positive thoughts to you & your little miss! I'm here for a chat any time xo

Eta: quote box fail

moroccojade · November 2014

My first nursing relationship was beyond tough. But we figured it out.

I'm much more relaxed with this one. I really had to change my expectations. I owe a lot to medela for their SNS. My girls just aren't into bottles. I take it as a compliment.

Thanks for sharing what you've been through. All you've done is to be admired. Good job!

mockingjay1 · November 2014

You are doing such an awesome job! Breastfeeding is so hard!

My son doesn't have a tongue tie, but we are having a hard time breastfeeding. In the hospital he did a great job, and the day after we got home I was super engorged and just couldn't get a deep latch even with a nipple shield. Pumping didn't seem to help a lot either, but I kept doing it every time DS would nurse (or attempt to) along with supplementing. I have PCOS, so I knew I was at a higher risk for a low milk supply.

My lactation consultant wants me to breastfeed, pump, and supplement at every feeding. By the time you do all three and clean your bottles/pump parts it usually takes at least an hr if not 1 hr 15 min. It's a lot when LO is eating every 2-3 hours. I took a couple days off of breastfeeding and just pumped every time LO ate. He was eating 90-120ml at a time, and I was only pumping 30-45ml at a time. I was very discouraged (plus hormones is not a good combo). My supply has slowly started to increase (60-80ml at a time if I don't breastfeed first), but it's so frustrating when you feel like you're doing everything you can and it still isn't working how it should.

I met with lactation outpatient yesterday and did a weighted feeding. DS only got 45ml when he nursed (although he was super fussy on one side which isn't like him) and then I pumped 45ml afterwards which made me feel a little more positive about the situation. I started taking fenugreek yesterday, so hopefully that will also help my supply.

My nipples got really beat up from bad latching during engorgement, but they are healing and it doesn't hurt to nurse anymore (minus the first 10-30sec). It's still hard for me to offer the breast first at night when I know how little sleep I'm going to get if I do, so I still sometimes just bottle feed and pump at 2-3 of the feedings in a day. I'm really hoping I can get my supply up so I can stop at least supplementing after every feeding.

That ended up being really long (hopefully it's readable, like most of us with outside babies I feel like I'm in a fog), but I just wanted to let you know you're not alone in your breastfeeding struggles. Keep up the good work!

Lilwatz · November 2014

@dmo1371 Thank you for sharing! Breastfeeding is so hard! I hear you on the feeding, pumping, cleaning cycle taking forever. Thankfully, my husband is taking 12 weeks paternity leave along with my 12 weeks so it certainly helps to have that support/help.

I have a volatile relationship with pumping. Some days I love it and prefer it (although I have yet to figure out how to do it without bruised nipples). I've definitely strongly considered EPing and throwing in the towel on getting back to the breast. Other times, I am emotionally wasted and cry while pumping--the pain and the low supply really get to me. Sometimes I just feel like my breasts need a break!

Good luck with increasing your supply. The fenugreek really boosted me 1-2 days after I started taking it. I went from 10-11 oz to 16-17 oz. Then I sat there for awhile. I really expected/hoped it would increase more and was discouraged when it took so long to see more gains. Hope you have success!!!

KMW08 · November 2014

Just know you're not alone. My lil guy is 2w2d old (born @37w3d) and my supply is low.

I've tried just about everything to increase my supply, but it hasn't really worked. I've stopped pumping every 2hours and have went to every 4hrs and am getting 1-1.5oz of breastmilk. This is the max I've been able to get.

My plan & LC's agreed that some breastmilk is better than none and when I go back to work (mid Jan) I'll probably stop BM/pumping altogether. Right now I'm an EP'er as breastfeeding was a challenge even after getting his tongue tie fix.

My advice, stay positive and don't beat yourself up. The main goal is a healthy, happy baby. How your baby is fed has absolutely no reflection on you as a parent.

Lilwatz · November 2014

@KMW08 Thanks! I completely agree. My first priority is that she is fed. My goal is to get her as much breast milk as I can make (while staying emotionally sane). My hope is to get her back to the breast if possible. In that order. I *really* wanted to make it 6 weeks as I heard that most f the beneficial stuff is passed in the first 6 weeks, after that the benefits are more bonding based. She turned six weeks last Saturday. So, YAY! I met that goal!

rox825 · November 2014

I literally feel your pain. We've also been struggling with supply, latch, and supplementing. My supply has increased a little but it's impossible for me to pump immediately after every feeding so it ends up being more like 30 to 60 mins later and by then he wants to eat again. It's a struggle. We're supplementing with a syringe of pumped milk or formula with each feeding because he lost too much weight, we started with 2 but have been able to reduce to 1. Can't wait to stop altogether.

Our LC has also suggested evaluation for a posterior tongue tie, he has a shallow latch so he squishes my nipples with every feeding and they're constantly scabbed. But after all of the poking and prodding that he had during his brief NICU stay even if he has one we've decided that we won't fix it, I have too much guilt to put him through anything else. The LC has us doing some exercises and trying to work on his latch and I'm trying to stick it out til 4 weeks to see if it helps before switching to EP. My hospital also has a weekly new mom support group led by a LC that I'm going to start going to Friday. It's so frustrating and disappointing when something that is supposed to be "natural" doesn't work.

I'm glad that things are looking up for you, it's so tough!

Lilwatz · November 2014

AmyG* said:

This is a reminder that most breastfeeding issues are fixable but may require mom to be very stubborn and push thru to find success. Don't give up.

Thanks, AmyG! What a great way of putting it. i like how you worded that and will remember it when I am down about this.

I am GREAT at being stubborn. :P

Lilwatz · November 2014

AmyG* said:

I literally feel your pain. We've also been struggling with supply, latch, and supplementing. My supply has increased a little but it's impossible for me to pump immediately after every feeding so it ends up being more like 30 to 60 mins later and by then he wants to eat again. It's a struggle. We're supplementing with a syringe of pumped milk or formula with each feeding because he lost too much weight, we started with 2 but have been able to reduce to 1. Can't wait to stop altogether. Our LC has also suggested evaluation for a posterior tongue tie, he has a shallow latch so he squishes my nipples with every feeding and they're constantly scabbed. But after all of the poking and prodding that he had during his brief NICU stay even if he has one we've decided that we won't fix it, I have too much guilt to put him through anything else. The LC has us doing some exercises and trying to work on his latch and I'm trying to stick it out til 4 weeks to see if it helps before switching to EP. My hospital also has a weekly new mom support group led by a LC that I'm going to start going to Friday. It's so frustrating and disappointing when something that is supposed to be "natural" doesn't work. I'm glad that things are looking up for you, it's so tough!
I understand not wanting to put baby thru anything else but a tongue tie can effect speech, ability to lick an ice cream cone, French kiss and contribute to tooth decay in addition to causing problems with baby's ability to latch and eat effectively. So keep in mind that a small snip now may keep baby from multiple procedures in the future.

To reinforce this, my husband realized that he has a tongue and lip tie through us getting our daughter checked out and fixed. His lip tie pushed his two front teeth totally apart. His mom told me the other day that the orthodontist refused to give him braces because of his tongue patterns (from the tie) pushing them and he would just push them back out. He he fixed the tongue issues through exercises and now has invisalign but that possibly could have been avoided with a procedure as an infant.

Having said all of that, you of course have to be comfortable with it. it was a tough choice for us! Even with the traumatic experience, I think it was a good choice.

rox825 · November 2014

AmyG* said:

I understand not wanting to put baby thru anything else but a tongue tie can effect speech, ability to lick an ice cream cone, French kiss and contribute to tooth decay in addition to causing problems with baby's ability to latch and eat effectively. So keep in mind that a small snip now may keep baby from multiple procedures in the future.

Or it could cause no issues, or he may not even have one. Our pediatrician did some exercises to test today and said that if he has one it's not apparent and he has enough tongue mobility that if he does it shouldn't interfere with speech. He's taking in enough milk and was back to his birth weight today so if he has one it's not impacting his latch so much that he's not getting enough milk. It was just 1 LC's suggestion to have it evaluated.

I also got the ok to stop supplementing, small victory.

Lilwatz · November 2014

rox825 said: I understand not wanting to put baby thru anything else but a tongue tie can effect speech, ability to lick an ice cream cone, French kiss and contribute to tooth decay in addition to causing problems with baby's ability to latch and eat effectively. So keep in mind that a small snip now may keep baby from multiple procedures in the future. Or it could cause no issues, or he may not even have one. Our pediatrician did some exercises to test today and said that if he has one it's not apparent and he has enough tongue mobility that if he does it shouldn't interfere with speech. He's taking in enough milk and was back to his birth weight today so if he has one it's not impacting his latch so much that he's not getting enough milk. It was just 1 LC's suggestion to have it evaluated. I also got the ok to stop supplementing, small victory.

--quote box fail--

Congrats!!! I feel like I will never get there...but hopefully I will!

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