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Sabine

Ideal_Rock
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Aug 16, 2007
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I know Fiery had a thread recently, and I will read through it when I get a chance, but I''m looking for any immediate advice if you girls have any.

I just had Jackson via c-section on Friday. From the start we''ve had breastfeeding issues, and we''ve also had nurses, pediatrictions, and lactation consultants telling us different things to do.

Jackson''s first issue was that he would latch on, but didn''t know how to suck. The first day, the nurse told us to just practice latching, and we would see the lc tomorrow, but by the middle of the first night he was so hungry that he wouldn''t stop wailing that we gave him a tiny little bit of formula from a bottle.

The next day we saw the lactation consultant. She wasn''t able to get him feeding, but she saw right away that his problem wasn''t latching, it was sucking. So she suggested we again try to get him to latch as much as possible, but when he gets too fussy to try anymore, use the S & S system (formula fed through a TINY tube) attached to a FINGER to feed him supplemental formula and practice sucking on the finger. Then, I was pumping to help stimulate the milk production. We did this throughout the day because the pediatrictian also wanted us to supplement because of how quickly he was losing weight.

The second night, we had a nurse who was really good at helping us breastfeed. She told us not to use the finger feeding, but got him to successfully latch and nurse for 30 minutes 3 times in a row by just squirting a bit of formula on my nipples and in his mouth at the beginning. I would pump the opposite breast that he didn''t nurse on. We did finger feed him once through the night to get him to sleep after he nursed for 30 minutes because my milk hadn''t come in yet.

Yesterday, we saw the lc again, and she had us use the s & s taped to my breast. This worked to get him to nurse once. But then Jackson was taken to be circumsized, and he was so irritable after that that he wouldn''t nurse, he just wanted the immediate gratification of the finger feeding. He would latch on to my breast, notice the formula coming out, and instead of nursing, just swallow what was coming out of the tube. Both the day nurse and the lc came throughout the day whenever we fed, and when he wouldn''t nurse they just blamed the circ. and had us finger feed him and had me pump. I was getting less and less colustrum throughout the day when pumping.

Here''s the real problem: My breasts are becoming engorged because my milk is starting to come in, but isn''t in yet. Now, when I go to nurse, Jackson will latch on and suck for a moment or two, but isn''t getting instant gratification like he is used to, so just stops and WAILS. The night nurse just came in and helped me try to get him to latch on both sides just to relieve the engorgement a bit, but he wouldn''t suck for more than a few moments. I''m so worried that he won''t be willing to nurse now because he is so used to instant gratification. We didn''t finger feed him this morning because he basically fell asleep again, so we''ll try again in an hour or if he wakes up on his own. But the nurse really suggested we no longer supplement if we want him to nurse. But she just left for the day, so I have no idea what the pediatrician will say today, or the new lc that is coming. Plus, I''m being discharged at noon today.

So, any suggestions on getting a baby to nurse on engorged breasts that aren''t producing milk yet when he is already used to instant gratification from formula???

They keep telling me it will be better once my milk comes in because then he will get gratification from his first few sucks, but I''m still really worried. If no one has advice, at least thanks for letting me vent!
 
so sorry you''re having a hard time. Personally I wouldn''t stop supplementing because they do tend to lose weight quickly and if he''s hungry he needs to feed. I didn''t have the issue about sucking with my first 2 (I have 3 kids) but I did have the latching on issue. My first was really hard to latch on and only would with one breast. From the beginning with all 3 kids I BF and FF (I''m on meds for medical issues and didn''t want to exclusively BF because of this). They never had nipple confusion like many LC told me they would. I would wait to see what the Ped says but it''s frustrating to get diff. info from the diff. medical staff on what to do.

I used to get them to want to suck with rubbing my nipple on their lips (when there was milk coming out)...it really helped.

I wish I had great advice but I just wanted to write since I know the frustration of starting BF with a newborn. GL..I hope it works out
 
Personally - I would keep using the SNS on your breast only (not finger feed) to supplement him until your milk comes in. Your milk should be in soon - then it should get easier! Also - if your breasts are engorged, are you sure your milk isn't in?? He will learn that he has to suck a little longer to get the letdown. It will just take him a little more time to figure it out, but he will!
 
Ditto to TanDog, but you may also want to try a nipple shield. I had to put a couple of drops of fromula on the shield and she would start sucking to get more. Continue pumping to get that milk in! It will be there soon, promise! The nipple shield is a pain, but it got her sucking. I had to wean her off of it after a few weeks, but Jackson may not even need it for that long.
 
forgot to add..if your breast are engorged, your milk may be in..you can try a breast pump to start the flow and ease up on the engorgement
 
First of all, congrats on your new baby!

If you have no medical issues that would prevent you from nursing and you WANT to nurse exclusively, I would absolutely STOP supplementing now. I'm kind of shocked you were told to supplement within the first 24 hours. Babies do not need milk in the first few days. If they did, our milk would come in sooner than it does. Colostrum is exactly what your babies needs right now -- the concentration of immune factors in colostrum is much higher than in mature milk and this helps protect your baby's GI tract and boosts his immune system. In addition, the only way you are going to establish a good milk supply is to NURSE, NURSE, NURSE as often as you can! A newborn baby's stomach capacity is about the size of a marble -- they don't need much at all, so don't be discouraged if you hardly get anything when you nurse or pump. Keep track of his wet and dirty diapers and trust your body (again, assuming there is no medical reason you can't nurse; the VAST majority of women have plenty of milk. I think many doctors and nurses become so obsessed with the number on the scale that they don't give a woman's body the chance to do what it was intended to do.

I realize you don't know me, but if there is anything I can do to help or support you during this time, I would be happy to do so! I had every breastfeeding problem known to womankind and, with support from other women and qualified breastfeedings experts, somehow I made it to the other side. Good luck and take good care! Your son is beautiful!
 
I'm with Kennedy. Get that baby on the breast, and keep him there. give him plenty of time to 'get the hang of it'. I wouldn't confuse him with a whole bunch of equipment, syringe feeding etc or formula, your breasts are engorged, get him on them! Of course the pumping is great for relieving the pressure, and if you store the milk it does wonders for your confidence (as in 'there's a backup')... hot pack applied to the breast can also help get the milk flowing easily. Hot packs have been very helpful to me with a painful engorgement, as it can actually stop the milk from flowing.

If you are absolutely desperate you could always top him up with a syringe feed from the expressed milk once he's knocked himself out on the breast.
The whole 'twenty minutes a side' thing is out of date. Now's the perfect time to sit back and watch your favourite movies in your jammies! But be careful with nipple care at this stage!

But of course, we don't know you, and all babies are different. But I would say perservere, and give him time to perfect his technique. Soon he'll be a pro!

My little boy was a little lazy, it does help if the baby is an aggressive feeder, but I think a baby can learn. One thing that was differnt for my lazy boy was that the nurses had me looking at the clock a little more, stretching the feeds out a little so that he was hungry when he was introduced to the boob. And of course having the milk squeezed on the nipple to help him start.

Like hot packs, massaging the breast, and squeezing the breast from the outside towards the nipple helps speed up the milk and empties the ducts into his mouth, helping the process as well. I always do that, to this day, as you know the breast is truly emptied (good for future supply, and the baby likes it) ...
 
Kennedy is right about the colostrum, but if he''s not sucking then he''s not getting any. Same thing happened with us. It only takes 5 ml of formula to fill up that tiny tummy. Put Jackson on the breast as much as you can, maybe try the half shell nipple shield they have now. It allows skin to skin contact and will get him sucking.
 
I agree to put Jackson on the breast as much as possible. Maybe try pumping a little beforehand too. Eases the engorgement (ohhh how painful that is)and will get the foremilk out of the way so he can get the hindmilk right away. Sometimes it takes babies longer to nurse at first. Let him stay on as long as he wants. When the kids got older, they were like, power suckers, but it wasn''t unusual for me to spend an hour or 1 1/2 hours per session!

Also, I know this sounds odd, but have someone check under his tongue! If you lift your tongue backwards, that weird little flap of skin there-sometimes babies need to have that clipped a little bit. We''ve had a few new moms come in w/breastfed babies that are having a heck of a time-Dr clips the little flap under the tongue, and their tongue moves freer, so they can nurse better. It''s crazy sounding, but if they don''t have full range of motion for their tongue along your nipple, that makes it harder for them to nurse!
 
Sabine-your milk is likely on the cusp of coming in and Jackson WILL have a hard time nursing on a really engorged breast. So just express a tiny bit of milk first using the pump or your hand. That will help soften it for him.

Other than that just put him to the breast as MUCH as possible. Keep trying-it''ll get better. And I agree about the supplementing-stop if you can because it''s not teaching him the right thing IMO.

You could also try reading some of Jack Newman (sp?) stuff. He is a breastfeeding expert in Canada and is VERY helpful. He also answers emails I hear if you can''t find the info you want on his website.

Good luck dear! It''ll get better.
 
Sabine, I''m so sorry you''ve having trouble!

Since you are engorged, it sounds to me like your mild has come in, if not completely, then at least some. Have you tried hand expressing milk? Sometimes our breasts don''t respond as well to the pump as they do to hand expression. If you express some milk/colostrum into his mouth right before you have him latch, he may realize that there IS food there and he just needs to work for it. Also, by hand expressing, you''ll begin the let down which will help him not have to suck so much.

Hope this helps!

Mrs
 
Thanks everyone. Okay, so now my milk IS in but I am soooooo engorged and in pain! Jackson won''t latch on to my nipples at all now, so I''m pumping, supplementing a BIT with formula to what I''ve pumped, and we''re feeding him that. I''m afraid we''re on the road to exclusively pumping, and if so, so be it.

But any other suggestions for totally engorged breasts? I''m using hot towels on them before pumping and pumping one at a time to massage while pumping, and then using cold cabbage leaves and cold towels after to relieve some of the swelling, but it''s not really helping. Last pump I got 10 cc''s milk, which is half of what I''m feeding him.

How long does engorgement usually last?

We''re also pumping a bit to get my milk flowing, trying him on the breast, and then if he still doesn''t take it, I finish pumping while dh feeds him. We''re about to try that again, but my breasts are just so rock hard and my nipples are soooo big. We''re also trying the half nipple sheild to see if he''ll like that, but he wouldn''t use it for the lc so I don''t know if he will for us. He will latch on to any finger (doesn''t even need milk on it), the feeding tube, a bottle, a paci (we''re not regularly using these things though), just not my nipples!
 
Sabine I would try harder to get him to latch onto your nipple if he'll latch to everything else.

Pump a bit, or hand express a bit to get your breasts just a bit softer. THEN put him to the breast and give him a shot at it. Make sure that you pump long enough to get the breasts a bit softer or else it won't help him.

The worst of the engorgement will go away in a few days.

You really don't want to go down the road of just pumping if you can help it at all. Often you get so so much less BM while pumping than your LO would get normally. It'll be a PITA for you so I would do your absolute best now to get Jackson to latch on now.

Just keep going at it-he will get it.
 
Date: 8/3/2009 6:22:27 PM
Author: neatfreak
Often you get so so much less BM while pumping than your LO would get normally.

I''ve got to 2nd this. Jax is way more efficient at draining your breasts than the pump is, so I wouldn''t worry about the fact that you''re pumping less than what you''re supplementing with.

In addition to using your milk to get him to latch on, try using your finger (finger only) on the roof of his mouth to get him to suck before you put him on the breast.

I think engorgement never truly stops, but it happens less frequently once your supply regulates. For example, if I miss a feeding or 2 I get engorged if I don''t pump.

When he''s not sucking, is he awake and not sucking or asleep and not sucking? If he''s asleep try tickling his feet. If he''s awake, try massaging under his chin with one finger. They taught us that at the hospital. Call me any time night or day hun!
 
Be careful about feeding for a time amount too. You want to make sure he gets to the hindmilk, so I''d actually let him stay on one side until he takes himself off or he stops swallowing.
 
When I had a similar situation, they advised me to pump just a few minutes to lessen the engorgement, then help him latch on. If he will latch onto everything else, he will eventually figure out to latch on to you!

Cabbage leaves helped me - engorgement only lasted a few days.

ETA: My first night home from the hospital was the hardest night I had with our son. One of the hardest nights of my life, in fact. I hope yours will be better, but if it's not, don't worry - it will get easier. Things got a lot easier for me after ~6 weeks.
 
I would suggest if you have a double pump, to pump until the aching full of cement feeling is gone from your breasts! Once you don''t feel like your breasts are going to explode, try to get him to latch on.
 
I''ve learned to massage my breasts while pumping...both at the same time. Work your hands from the bottom of the pump to the funnels and hold them against you while massaging around the funnels with a couple of fingers.

Hang in there! I know how hard it is when you can''t get your baby to latch right away.
 
I think you got a lot of great advise here. I would have to second what everyone said about trying to get him to latch again. Is there any way you can see another lactation consultant? Most mothers I know who only gave their baby pumped milk were not able to keep up with the baby once they hit about 3 months of age, and than ended up going straight to formula.
 
Sorry to hear you are having trouble feeding Sabine. With regards to the engorgement, one thing I found to be really helpful was to hop in a hot shower and hand express while under the spray. I know it probably seems like a waste of breast milk, but it does help soften the breast which may make it easier for your little boy to latch.

The most useful advice I was given about latching was from a male midwife (!) who told me to make sure the baby was making what he called a ''special K'' mouth around my nipple which meant that his lips were covering enough area to create enough suction.

Good luck Sabine, it does get easier with time.
 
Sabine, just checking in - how are things going today?
 
Well, we've made a decision to basically formula feed, but supplement with what breastmilk I'm able to pump. Our goal is to keep pumping to supplement for at least a month.

Basically, in order to bring in my supply enough to try to breastfeed, I would have to take a hot shower to get the milk flowing, pump, then use cabbage and cold compresses to get the swelling from the engorgement down. That whole process takes about an hour. I'd have to do that every hour. For us, that just wasn't possible. Jackson is sleeping well, but often he wakes up when we put him down, so we've been having to hold him while he sleeps. Even with my mom's help (she's here for 2 weeks), we just couldn't handle me not being able to do anything to help with Jackson for an hour every other hour.

Last night we had a good night. My mom held him until he was ready for his bottle around midnight. Then I took over and fed him, held him, and napped with him on the couch while dh slept, and I was "on duty" until about 4:30, when he was ready for his next bottle. I woke up dh, who took over until this morning while I slept. So I didn't pump at all overnight. I'll be trying to pump for the first time today soon, and I'm hoping I will still be able to get a decent amount.

Depending on how this first pumping goes, we will try to breastfeed again throughout the day today. We tried a few times yesterday while I was in the middle of pumping when Jackson was due for a feeding, and even with milk literally dripping from my breasts, the swelling was too bad for him to be able to latch on, and he wouldn't even try. The swelling has already gone down a bit today, so we're definitely going to try (and try with a nipple shield as well, although that hasn't worked yet either).

It was hard to decide to do this, but it's what we need to do to function right now. I know breastfed babies eat every 2 hours, but when a mom is nursing, that's a time when the partner can take a break. With pumping every 2 hours, I would basically have to be up for 24 hours in order for dh to get a break, and even then it's only a 1 hour break at a time.

ETA: On the advise of the lc, I had tried a LOT of the wonderful things suggested here...hot shower, massaging the breasts, hand expressing, starting pumping and then trying to get him to latch, nipple shields, etc. But basically, the engorgement was sooooo severe that the lc basically said it it was unlikely Jackson could "learn" to latch while they are that swollen. Nothing really relieved the engorgement yesterday. So her advice was to pump every 2 hours to both relieve engorgement, and keep my supply up enough that once the severe engorgement went down, my supply would still be enough to feed him.
 
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