losing confidence w/ BFing

[home alone]

I had difficulty latching on for the first 2 wks and it went well for the 3rd wk.
Though LO was on the breast for 45min+ and never satisfied. 
Then on the 3.5wks at the Ped's check up we found out that she lost a lot of weight and never gained her birth weight by this time.
I start to BF her every 2hr + and I started to get severe pain so I started to suppliment with formula and hired 2 lactation consultant.
Now I am BFing 20min each breast and finish off with  2oz of formula every feeding.
I would like to eliminate the formula all together during daytime at least but I am afraid that she might lose weight again.
I feel so unsure about bfing that I feel like giving up!

[Peek-a-boo]

{{{Hugs}}}  I don't know the answers, sweetie, but if I were you, I'd want to ditch the formula too!  Are you still working with the lactation consultants?  Can they help you come up with a plan for dropping the formula and monitoring her weight?

Perhaps drop the formula after just one feed for 3 days, then after another feed, and so on.  Can you drop by your doctor's office or the LC's just for a weight check once a week or every other week just to double check.

{{Hugs}}  It sounds like this is important to you and if so, definitely worth sticking with!   

Hoping somebody with more experience and advice comes along too. 

[Erin (redstarfalling)]

More {{{hugs}}}!

First, I would suggest contacting the LC again, if you haven't (where abouts in the world do you live, BTW? In some areas, there are some great supports in real life...).  When you talked about the pain while nursing so often, it makes me wonder if the latch isn't as good as it could be.  And if the latch isn't great, then your supply doesn't get stimulated as well as it should, the lo doesn't get enough milk, and so on...  I know with me (we had trouble latching at first), every now and then, I had to check the latch and work on it a bit, to make sure that we hadn't *slipped* and gone back to bad habits.

Here's some info on checking your latch:
http://babywhispererforums.com/index.php?topic=70305.0

Then, if you're worried about supply, this has some good info:
http://babywhispererforums.com/index.php?topic=65905.0

How has her weight gain been recently?  Are you pumping at all?  If you want to reduce the formula and maybe get rid of it (and I'd suggest doing it in consultation with a good LC...), you need to make sure you have the milk supply to take over for that formula.  One way can be to pump.  If you're feeding off both sides each time, make sure you do full feeds (and sometimes that could mean going back to the first breast again), then get the pump out and pump for 15 min. (If you don't have a good pump, you might be able to rent one). Even if you don't get anything, it works to stimulate your supply.  If you DO get any milk from it, great - you can give this instead of formula.  After a few days, you'll hopefully start seeing some improvement in your pumping, and you may have to supplement less and less.  Eventually, the idea is that you can stop pumping altogether because your lo will nurse that extra milk that you've made available.

You might be surprised at how many of us have wanted to give up breastfeeding at one time or another, but there are lots of supports to help.  Whatever you decide to do, you've given your daughter a wonderful start on life!  Let us know if we can help more and keep us posted!

[Lucie preciosa]

always do what makes you feel happy, you need to feel positive and happy to be able to look after your little baby. there are great alternatives to breastmilk these days. All the best

[Mum of 3 + 2 stepkids]

Hugs my luv, i really know just how you feel I had weight gain problems for most of the first 4mths and i made BFing for a yr so you really can do it

One thing you can do is to cluster feed. What it is is that you feed for 10 mins each breast every 1.5hrs through the day and then just feed on wakings at night. Your looking at getting in 10 to 12 feeds in 24 hrs and i did this for a week, my lo gained 8.5oz that week and with no suppliment

You really CAN do it just belive in yourself.

HTH
Kate x

[home alone]

Thanks so much for all the support.
Yes I used to pump 8pm 10pm for DF and 3 or 4am depends on when LO wakes ( I give formula then pump after.  She's extremely fussy and difficult to latch for more than few minutes.) But I start to pump while feeding as I read on other threads.
Pain used to be from latching but now she started to squirm and turn her head side to side with my breast in her mouth.  I take her off my breast gently and burp her then try again but this has been the case lately.
Past couple of days I've been trying to pump more and feed more and this also contributes to pain on my breasts too.
Her weight gain has been great since I top her off with formula.


Here are some more questions...
1. How long is a full feed?  How do you know?  Is it by length of time or how the baby reacts after?
2. Feed during btwn naps can be done with breast only and pumped milk but cluster feed is not possible with breast feeding no?
I am not clustering feeding by choice but LO takes full 4oz bottle at 4pm, 6pm,8pm.
 LC didn't think the supply was an issue but more that LO is not a efficient eater.  I hope that this would improve with time.
So, I associate every cry after BFIng with hunger.

LC's suggestion was that I ditch the bottle & soother. ( I rarely use soother)
I should feed off only breast on demand or every 2hrs for 3days  and sleep with baby on the breast.
She corrected latch position

When she suggested this DH was not home except to sleep so I couldn't possibly concentrate only on BFing.
Also with DD1 around this really is not possible.

MUM of 3 + 2 stepkids, To clarify, bf one breast for 10min then 1.5hr later I bf for 10min on the other breast? 

Thank you so much again.
Monica

[Erin (redstarfalling)]

How long is a full feed - it's not usually a "time" per say, but until the baby is satisfied. When you're finished the BF session, your baby should look content and very sleepy for the first few weeks, but then usually fairly alert and interested in you for a short time, once she's older. For an efficient eater, if could be about 15 min at that age for a full feed, but if she's not an efficient eater, then it could be closer to 45 min.  Usually, when a baby is not very "efficient", it's due to a poor latch or something like a tongue tie - did the LC say anything about that?  BTW, do you have any sore SPOTS on your nipple -like there's a spot that keeps rubbing?  Any scabs or bleeding?  Your nipple should not look deformed at all when it comes out of her mouth, but should stay pretty symmetrical.

As for your question 2, I'm not sure what you mean....  Yes, you can cluster feed when just BF'ing, particularly in the evening when naps are a bit shorter - it really depends how long your lo is sleeping.  For longer EASY cycles, you nurse when she wakes and also right before a nap, but not nursing to sleep. The other way is to nurse, then as soon as your lo goes down for a nap, pump.

Yes, it's better not to use the soother, and bottles can be risky. Make sure to use a very very slow flow nipple on the bottle so the baby doesn't prefer the fast flow vs your breast.

I personally always liked double sided feeding, but regardless, breast compression can be really really helpful when she starts to slow down - it can make you more confident that she's really done.

[EllenS]

Cluster feeding is actually really good for bfing as it builds your supply!

Hang in there! 

[home alone]

Thanks for all the great support.
I thought I would try feeding 10min each breast every 1.5hrs but I got so exhausted betwn putting her to sleep and feeding that I gave up that plan.
So, now i'm feeding 15min each from both breast then pump for 15min right after then feed her with the bottle.  Hopefully this will boost supply.
Currently I am 1.5feed short.  Her nap has drastically improved today so I am hoping that my supply will go up fast with extra Y time.
I feel very hopeful!! Horay

[Erin (redstarfalling)]

Sounds great - keep us posted!

[EllenS]

Have a little more time to post now - I totally know what you are going thru - I was diagnosed with severe low supply when my dd was 5 days old, not sure of the cause, could have been poor latching, could have been some genetic factors (my mom was unable to bf but then again had no education/support on bf), or my thyroid condition, we'll never know for sure.

I had to do pretty much what you are doing - feed each side at least 15-20 minutes or until she stopped actively swallowing, then pump with double electric pump 15 minutes, and supplement with expressed bm or formula.  After we got going with it, I was usually able to give only ebm for the supplement (from the previous pumping session) and had it worked out so I could pump hands-free and give the bottle while pumping for the next supplement.

Using a tincture of fenugreek + blessed thistle helped a lot.  I also had to take a brief course of prescription meds that helped get my milk to come in initially.  We did this pumping regimen for about 6-8 weeks, gradually weaning her off formula and then gradually weaning off the supplemental ebm, so it really does work.  It was gruelling but there is light at the end of the tunnel!

Hugs and hang in there, don't worry about sleep training right now, just keep yourselves going and get as much rest as you can - resting and eating/drinking enough will help build your supply.  I also got a lot of benefit from eating a bowl of oatmeal every day, and one cup of coffee. (only one because of not wanting too much caffeine).  I have also heard some people get a supply boost from eating lentils.

If I had it to do over again, I would not worry about AP or EASY routines until eating was sorted out, it's just too much to focus on all at the same time.  (but that's me)

One final comment - I notice from an earlier post that you are having nipple pain when pumping?  This can be caused by the wrong size funnel on the pump - the "trumpet" part that goes on your boob comes in different sizes, if it is too small it can squeeze your areola too much and cause pain/soreness, it also reduces the efficiency of the pump, just as if the baby had a bad latch.  I had to go up 2 sizes to get a comfortable fit, the pain disappeared and my pumping output went up dramatically.

Hope this helps!

E

[home alone]

EllenS, LC also mention that i should go size up since she thought funnel looked little tight.  Also I should start having fenugreek tea that many recommended.  I didn't know about oatmeal.  Thanks .  6-8wks seems long but since I pumped for 4mth with dd1, it doesn't sound too bad. Didn't realize that it takes that long.
Thanks so much for the support! THis really helps a lot. 

[EllenS]

It may not take you that long, since you are already well into the process and seeing improvement.

hugs!

[Jocasta]

You've been given fantastic advice.  Just thought I'd ask if you've looked into an SNS (Supplemental Nursing System) at all?  The SNS is basically supplementing at the breast, therefore cancelling out the need for bottles (and the associated problems), and also stimulating your own supply at the same time.  Google it if you want to find out more - it can point you in the direction of where to buy one if you are interested...

[home alone]

Jocasta (CassieSam), someone mentioned SNS when DD2 was first born but i forgot about it and i think it's a great idea.

It's another problem but LO has been extremely fussy with all the feeding for the past couple of days.  A lot of squirming during feeding. 
With all the family visits I haven't been able to get all the things i need to get the milk production increased so I am hoping that will stop the fussiness.