Author Topic: Burning more calories than he takes in while breast feeding  (Read 1554 times)

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Offline MakingMischief

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Burning more calories than he takes in while breast feeding
« on: September 25, 2015, 19:15:04 pm »
My new baby is having trouble getting enough milk. He was preterm (born at 37 weeks) and had been slow to gain weight (averaging half an ounce a day).

I saw a lactation consultant who said he's slightly tongue  tied but also that while his latch is good, he's not coordinating his suck very well and not getting much milk.

What puzzled me is she told me to take him off the breast once he stops swallowing because at that point he's expending more calories than he's taking in. I've been letting him comfort nurse to his heart's content up until now - he never gets frustrated at the breast but does always want to nurse. The LC recommended pumping after he stops swallowing abs giving him what I am able to pump in a bottle.

Has anyone else heard about this? It just surprised me because she's also concerned about my supply since he hasn't been emptying the breast effectively, and I thought that comfort nursing is good for supply - I never heard of it being bad for the baby before.

Offline becj86

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Re: Burning more calories than he takes in while breast feeding
« Reply #1 on: September 25, 2015, 20:49:12 pm »
What was his birth weight? 100g per week / 3.5oz per week isn't as fast as suggested but its not drastically slow. How old is he?

Did she suggest having the tongue tie divided while he's little and that can help him transfer the milk better? Did she suggest breast compressions to help him get a bit more milk - if transfer is an issue, that might work better than pumping and bottle feeding.

Have you done a weighed feeding so you *know* what he is actually transferring?

f he's not emptying the breast effectively, yes, I would try pumping just to avoid mastitis and maybe have a bit on hand for growth spurts, etc or build a stash if you so desire but really, if he's struggling to transfer milk, you want what he does take to be as nutrient dense as possible, so stimulating an oversupply is probably not a great idea.

What was this lady's qualification? I'm not qualified in this area, however I would have thought it would be best to address the physical issues of tongue tie and swallow coordination - yk, address the cause and not just treat the symptom so to speak.

Offline ENMS

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Re: Burning more calories than he takes in while breast feeding
« Reply #2 on: September 26, 2015, 00:15:43 am »
Hi! I had similar issues with my DD2 and the LC did tell me the same as you. She said my DD was so weak, because she was not getting enough milk, that sucking without receiving milk was too much for her. She had lost a lot of weight.

First, I would definitely look into getting the tongue tie divided as pp recommends.

We had to wait a month to get the tongue tie divided, and in the meantime, I was told to do breast compressions as soon as she was swallowing less than 1 in 3 sucks - so suck suck swallow that was fine, but when it started being suck suck suck swallow then I would start the compressions. I would move my fingers around so that I would compress all areas of the breast.

Also I switched breasts a lot. As soon as I would not get this 1 in 3 sucks swallowing even with breast compressions, I would switch her over. The allows you to get more letdowns. I would give her 4 sides at each feeding that way.

HTH
Elise



Offline MakingMischief

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Re: Burning more calories than he takes in while breast feeding
« Reply #3 on: September 26, 2015, 02:12:32 am »
He's 4 weeks now (1 week adjusted). 6 pounds 5 ounces at birth, up to 6 lb 11 oz now.

She did suggest breast compression, and that helped, but he still wasn't swallowing all that often. We weighed him after a feeding and he had taken in 1 oz from one breast and half an oz from the other. After he fed I pumped and got another oz ( I tried following that up by hand expressing but didn't get anything else). The concern was that since he hadn't been effectively emptying the breast, my supply would drop.

She's an IBCLC. I should have clarified - she did say we can get the tongue tie clipped but said it was fairly minor, and that as he gets bigger he'll get more efficient at breastfeeding and we may not have to. She thinks most of the issues are just because he was preterm and still catching up as far as development. So it might just be a case of feeding/pumping for a little while until he catches up. I haven't ruled out clipping the tongue tie but I'm skeptical that it will be a silver bullet.

Offline ENMS

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Re: Burning more calories than he takes in while breast feeding
« Reply #4 on: September 27, 2015, 01:21:02 am »
I know nothing about preterm babies and breastfeeding but I can tell you that tongue ties can be very tricky so I wouldn't rule it out just yet. It is hard to diagnose adequately and it is more a matter of whether baby is able to transfer milk than what the tongue looks like. My DD's tongue looked not that bad but she just could not transfer milk on her own.

I would also definitely pump after feeds to empty the breasts to avoid a drop in supply.
Elise