Very confused need lots of help! Pleasssseeeee

[Ale2ndtimemum]

I don't know where to start. I'm a second time mum. Baby Elisa was born at 34 weeks and 10 day stay at the hospital  she weighted 2.3 kg I guess that is less than 5 pounds  Not sure
I came home with her to a caothic scene. My almost 8 year old spent those 10 days I was hospitalized with a new Nanny I barely knew while my husband was away on a bussines trip. To make story a bit short I was under a lot of stress plus lack of sleep for the first month. Confuse by mixup memories of my first expirience with a premie and by the advice of my pediatritian that was a little against my "La Leche League" consultant, I end up doing a lot of accidental parenting. I decided to let my baby sleep on top of me to be able to take some rest during night and day.  After a couple of weeks I noticed that she wanted to hold her and carried her all the time. So  I consult with a couple of friends and family and I ended up buying Tracy's book. I read some parts and a couple of posts here and I started to observe my now almost 4 months old baby and wrote down everything I could.  I've been trying to follow an EASY routine and I think she can handle 3hr routine now but every couple of days doubt clouds my mind in regard the E part. At first I was breast feeding her put my production lower because of stress and now I'm concern she's not getting enough breast milk so sometimes I feed her with 4 Oz of formula (the last couple of days) at least 1 or 2 botles a day.
We had workers at home last month so the 4 of us had to share a room for a week, so she got used to fall asleep while suckin mum's breast. Ok. Today, after 3 days trying to get her to nap and sleep (on top of me) without my breast she is kind of getting there. She is resisting a little less at a time. We got to 20 minutes resistance nap for 30 minutes, another 10 minutes resistance and nap for another 20 to 30 minutes.
I don't have the stamina to try teach her to sleep on her crib but I know I need to. The other Issue is I keep confusing her cue's because I keep worrying If she's had enough to eat. Please help. What do I fix first?
I thank in advance for quickly replies and your help!
Ale2ndtimemun

[becj86]

Hi, welcome to BW

You've a rough few months!

I imagine she'd be about right for 3hr EASY at this point given she was prem. Can you write out your EASY, just the last day or something for us?

I think probably the important thing is to understand that tired cues and hungry cues look a lot the same at this point. The idea with the EAS sequence is to when those cues come up again at 1:20 or so after her feed, you know she's fed. Is she gaining weight, producing wet nappies, etc. fine? What are you worried about your supply? I wonder if you've hit a growth spurt?

Don't beat yourself up about not having her sleeping in the crib - we can work towards that. The first thing to do is get confident that she's getting enough food - hence questions about her weight gain and nappies. After that, we can work out a routine that helps her get enough sleep, then we can work on the sleep training knowing the basics are sorted out. Sound ok?

[Ale2ndtimemum]

Thank you so much for your quick reply. I feel so much better already 
She is gaining weight ok and she is weting nappies alright, but since each day is diferent I get confused and insecure about my supply. For example, todays EASY
E 7:17 L breast 5 min R breast 8 min
A 7:30 diaper change, play @ bouncer and excercise routine
S 8:20 she wants mum's breast to sleep have to sh/p and after 15 min falls asleep on top of mumy she woke up after 20 min and had to sh/p to get her back to sleep
Y 😕
E 10:24 breast feed 27 min, diaper change
A 10:51 playing on mat, some talking and playing w/mumy
S 11:44 nap on mumy, she resists for 10 min. Tries to wake up after 30 min, get her back to sleep
Y  😐
E 14:10 bottle feed 2Oz looks sleepy
A 14:20 put her at bouncer so I can eat. very quiet not realy interested in toys. Bath
S 15:20 nap on stroller
Y 😯
E 15:50 bottle feed 1.5 Oz
A 16:00  calm on her crib  watching mobile. We go to her big sis ballet recital
S 17:10 nap on dad awakes at 18:00 she is calm
Y
E 18:20 bottle 3.5 Oz riding back home
A 18:40 laying on baby carrier w/toy
S 19:06 fights for mum'breast for 15 min

She was looking tired all day. It was an out of the ordinary day.
Mostly I breast feed, today I bottle feed a lot because of my older daughter's event.
I get insecure about supply because she sometimes spends between 20 to 30 minutes breast feeding and other times 10 minutes and 2 hours later seems like she is hungry again. Always wants to be attached to my breast to eat and sleep. Last couple of days I,ve been working on breaking that bad habit and I think we are getting better but still. She sometimes refuses the bottle. It seems she prefers to starve. She is bottle feeding but turning her head towards my breast.
I breast feed my older daughter for 9 months, my supply was off the charts. My breast felt so full all the time. Now, i felt like that the first couple of weeks, then something happend and started noticing that my baby wasn't satisfy after long feed so I pumped and got not even 1 Oz out of my 2 breasts. I spend 24 hours pumping 5 minutes each every hour to increase production. I was beyond tired and decided to keep feeding every hour and a half or two and if she look unsatisfide I gave her formula. Then I observe if I alternated breast and formula, my breast felt fuller. I gain a little confidence and decided to breast feed all day and only bottle feed before going to bed. And once more at 2 am. It worked fine for a few weeks. Then we had to share room with the whole family for about 2 weeks and all went down hill. To avoid disturbing our roomates (husband and older daughter) I had to let her breast feed to sleep. So now I'm working on reversing my mistake as I told you.

I think your plan sounds perfect. Thank you again.

[becj86]

Your breasts actually don't have to make as much new tissue when you're getting ready to make milk for your second baby, so they won't feel as full as they did the first time, just because some of the new tissue that was made for BFing the first child stays there so the difference isn't so obvious The other thing is that your body makes milk as the ducts become less full, so as you're feeding, more milk is being made - she'll not go without so long as you keep eating, drinking and feeding.

I wonder if part of her longer sleeps on you/dad is that she's more upright - being prem, its possible she has reflux - Reflux 101 - General reflux information She's really waking after quite short naps and I'd be surprised if its overtiredness. That could be another reason for wanting to be fed a lot.

I think if she's putting on appropriate weight, producing plenty of wet nappies and Dr is happy, you can be reasonably confident you're making enough milk and she's getting plenty. We mums definitely beat ourselves up more than we should. At some level, every day will be different because she's a tiny baby. At this age, even with an established routine, its rare for there to be a 'perfect' day more than once per week and it'd be normal to get maybe 2-4 'good' days - ones with only 1-2 naps gone awry and a few hairy days.

Something that might be worth working on is getting those A times a little more consistent - that may help get you more consistent naps and give you more confidence that she's properly tired when you put her down for sleep. Your shush/pat sleep training will be more effective then too. I think part of the rooting for the breast at sleep time might be that its a bit early and she's wanting to feed to sleep because she's not quite properly tired. I'd say start off with 1.5hr from when she wakes to when she falls asleep (aiming for that, of course you don't know how long she'll take to fall asleep at least initially).

[Ale2ndtimemum]

Yes, she is beeing treated for reflux.
And yes she has one day on late may she went to sleep at 8:30pm and woke up at 7:15 next morning but every day is diferent. Today she woke up at 7:34 I change diaper, clothes, gave her medicine and breast feed her she wasn't very interested on eating. After 10 minutes put her in her bouncer to have some breakfast and 15 min later she started to look tired yawning, pulling her ears, eyes puffed and red. After a few minutes I pick her up, take her to her room, follow the 4 S and she fights less than yesterday and falls asleep at 8:56. Takes like 9 minutes to help her sleep

[becj86]

I think then, that the reflux treatment might not quite be enough to take the pain away so she can sleep. Might be worth reviewing the dosage with your doctor. It has to be increased every 500g or so in weight gain so it remains effective and sometimes a med change is required around 3-4 months of age even when its previously been working.

Any skin issues - dermatitis? rash? Wonder if you're looking at a food intolerance/allergy in there as well. Eyes puffy and red is more in line with that then sleepiness as far as I know. Rubbing eyes, sure, but puffy and red isn't a typical tiredness cue. It could be perfectly normal for her but worth mentioning to your doc to follow up on.

[Ale2ndtimemum]

Hi!
She doesn't have skin problems or food allergies. What I meant is that her eyes look diferent when she is tired.
 I've been working on EAS routine the last few days. I feel things are getting better. Finally she accepts the paci and that is been great because it has been easier to follow the EAS, extend time between feedings, get her to sleep no needing shsh pat 😊.  I decided to do more bottle feeding than breast feeding to be sure how much she is taking in. I only breast feed her 3 times a day. The only thing is she still sleeps on top of me 🙈 naps and night time.
But we are going on vacation this weekend so I'm thinking on working on that till August. Would that be wise? 'Cause I feel I've introduced too many changes.

[becj86]

What are you wanting to leave til August? And why?

How is her EASY now?