Again

Well, there are multiple breastfeeding posts I could have written if I'd had time in the last few days. The worried early post because although Junior was sucking really well, he was sucking constantly so presumably was hungry. The joyful post last Sunday morning when I had buzzy, lumpy breasts and could see that colostrum was changing into milk - I never had this clear a transition with Pob and didn't have as much. The starting to get worried post when his suck seemed to deteriorate. And the close to throwing in the towel post I feel like writing this morning.

Having started off as a great little nurser, on Sunday he started sucking less well. I could see his latch was poor and my nipples were already shredded, but whatever I did I couldn't get him to take a decent mouthful of boob. On Monday I said to H I wanted to start pumping when we got home as I was concerned his suck was no longer powerful enough to increase my supply. Then he got jaundice, which eventually required 18 hours under lights overnight on Tuesday, and bottles had to be used so they could measure the volume he was getting. I was able to pump all he needed bar 10mls, which I felt pretty good about. They weighed him and he'd lost weight to day 3 as normal, but had stayed flat after that so I thought that was a good sign things were turning a corner.

They sprung us from the hospital on Weds lunchtime, and I thought he was doing ok, but I was concerned enough to get a lactation consultant in on Thursday evening. By then he was having a top up after every feed, but only about 20-45 mls, and all expressed milk so not too bad. I was depressed to be pumping again but thought we should be able to fix this quickly as i seemed to have enough milk, he just wasn't getting it out of the boob well.

The lactation consultant was great - the first really well informed one I've seen. She told me to start the domperidone as I didn't have enough flow to keep Junior interested on the boob - there was very litttle 'productive sucking' when he was on the boob, and none at all if I wasn't doing breast compressions. So I started. She also suggested to start using an SNS rather than bottles as he was clearly developing a preference. So I struggled through thursday night trying to use the bloody SNS, which he kept spitting out, or milk would spill out of his mouth. By the end of the night I was using it to finger feed at least some of the supplement. Latching was still crap, and involved lots of screaming and pulling off constantly. That's continued through the last 24 hours, and last night the 2 feeds involved up to 90 mls of supplementing, meaning that for this morning's feed I had to finally supplement with formula as I was out of breastmilk.

And I weighed him and although it's the first time on our home scales and I know consistency in measurement is important here, he's lost weight since he was weighed on day 5.

The difference from last time is that Pob was refusing 1 breast completely at this stage - he's close to that but not there yet - and that she was having a lot more formula. Although by the end of week 2 I could mostly keep up with her so that's not far off where we are now.

I am angry and sad and not sure what to do. Because I'm trying to ensure he's fed very regularly - that was one of my many mistakes with Pob - and because the whole feeding process is taking about 2 hours by the time he's latched on and off lots of times, fallen asleep on the boob, had his nappy changed twice, I've pumped and finger fed until he's happy to settle etc., I have pretty much no time in between feeds to do anything, and I'm only getting about 3-4 hours of sleep. Which means very little time with Pob, which I hate.

Until some time last night I had the sense that this could really work if I tried hard enough. I thought I had more milk than I did this time last time, and he had started off being such a good feeder. I'm sure it's theoretically possible to make this work, andI remember last time by about 4 months how happy I was that I'd persevered with breastfeeding, but I'm not sure it's worth trying that hard. I cannot do what I did with Pob, it's not fair to her. So I dunno. It's all a bit crap really.

Comments

[Hairy Farmer Family]

Oh honey, I'm sorry it's so hard! I have no personal useful advice to proffer, my early production was all 100% breast pump: Harry was a week or more being introduced to boobs.

I know it's grim, though, I vividly remember the pain of the pump, let alone the mashy refusal-to-open-wide gums. Perhaps give it a few more days of trying hard until you see if the domperidone makes a difference? As you say, there's absolutely no reason this can't work for you.

Perhaps it might be useful to have a mental goal of, say, giving breastfeeding every last possible chance and effort until a set day, and then relaxing about it with a clearer conscience, knowing that you gave it 'X' many days full-throttle?

Would love a photo when you have time! Love & Hugs A xxx

[sc]

I could only advise based on my own feelings with a similar experience. (Two children after much treatment, c-sections, first baby never really learned to nurse properly and received most breast milk from bottle after pumping.) After a jaundiced second child who also didn't do as well as she should have, after a heartbreaking return to pumping and exhausting routine, I chose to cut out the pumping entirely (I hated it) and accept that #2 would only get breast milk in a breast, that if I achieved a 50% formula/50% breast milk ratio, that would be grand. And I determined that what nursing experiences we would have would have to be pleasant, or at least not miserable. I supplemented (though cautiously, as babies can continue sucking supplements even when they are no loner hungry). I monitored weight -- but accepted that there would be stagnations and possible dips. And the point is not that it evolved into a fully successful breast feeding experience (although it did, but it might also not have), but that I found a way to make it livable, and that mattered very much.
I think you are enough like me in certain ways that it will be harder than you think to entirely give it up. Perhaps it is better to make a plan whereby you keep what you think you might later most enjoy, and cull?
In any case, it's more than a bit crap. And I am sorry for you, in that way that only those who have been through the nursing ringer can be.

[Carla Hinkle]

It can be so hard! Just do what you can do. Maybe wait a few days just to see if the Dom helps ... then just fiddle/adjust/try things until you get something that works for you. I ended up weaning my #2 when she lost all attention span for nursing at 7 mos because the alternatives (lots of pumping and/or night nursing to keep up supply) just weren't practical with a 2nd baby like they might have been with a 1st. If someone had told me that I might do that with #1, I would have shot them on sight. So. Things are different with #2, you will figure out a system that works for you ... go easy on yourself!

[Joy]

Ugh. I'm sorry it's so hard. I was one of those chirpy people who commented before that this time might be different... I of course meant this time might be easier/different. I have no advice. Just know that however you end up doing it will be what's best for Junior (and you, and Pob). I have been meaning to set my SNS on fire, how I came to hate that thing.

[calliope]

dang! so sorry you guys are having such a tough time. it has got to maddening. xo

[Betty M]

Sorry it is being so tough on you. You are doing everything you can though. I have no practical suggestions to offer just hope it gets better.

[Aurelia]

Ok, well, the most normal nursing baby on earth will lose weight until 7-8 days at least. They should start to regain after that, but won't regain their birth weight until at least two weeks old, and the time under the lights kinda delayed that even further. So stop worrying about that.

Ok, the domperidone should kick in soon. Are you taking enough? It should be at least 2 10mg tabs 4 times a day, and while it can kick in quickly, it might also take 3-4 days, and for maximum effect it might even take longer.

I'm also wondering if the SNS tube is too large and a smaller one, or a syringe might help instead of finger feeding just because it's faster.

http://www.breastfeedingonline.com/newman.shtml

If you scroll down on this site, there are videos and links to handouts with diagrams on exactly how to latch a baby and fix a latch that may have gotten a bit off. Fixing the latch really does work wonders for pain and other issues.

As for the screaming when pulling off the breast, he may be hungry, but he also might have reflux (some jaundiced babies do) and it might be worth it to try some Zantac (ranitidine). It works really fast and you may see a huge difference. In everything! My kids were much happier on the breast when they weren't in pain.

In fact, as I'm sitting here thinking about this, I'm wondering more and more if reflux might be it.

As for Pob, she will understand, and to be honest, whether you were breastfeeding or formula feeding, new babies take up a lot of time and first ones always get jealous of babytime.

Look, I know this is overwhelming, but you are sleep-deprived and post-partum and dealing with c-section recovery. Try some of this advice and give the domperidone time to work.

(And screw the pump, just keep putting him to the boob. He won't starve and a syringe full of formula if absolutely critically necessary won't kill him, but the domperidone will do way more for your milk production. And with less pump time you can sleep a bit.)

Email me if you need it, I will happily talk on the phone or email or chat or whatever.

[Girl Detective]

I am so sorry; that really sucks. But I echo Aurelia--you're sleep deprived, post partum and post surgery. Please be kind to yourself. You sound terribly punishing--"mistake" with Pob, and not enough time with her. She'll be OK, likely has lots of fun time with others, right? And remember, we only can make the best decisions with the light we have at the time, and you have more metaphorical light this time, but you need rest and care. Take care of yourself. Love, love, love.

[geohde]

Mate, I think you know my deal. Not enough milk for a rat, two babies, insane sleep deprivation.

Giving myself permission to cave in to the inevitable was something i wish I had done. I didn't. I howled about stopping the pretence with the pump, but then again, I never got anything. You are in a better position, but it;s hard, you're tired and you have Pob.

All I'd say is do give yourself permission to do whatever is best for your family, the beat up can be awful,

xx

g

[Summer]

After having gone through BF issues myself, I have some sense how you must be feeling right now. Try not to beat yourself up and do what you are able to do. Maybe it means just trying to get through this bad day and tomorrow will be better. Maybe it means you will not be able to BF Junior as long as you did Pob. And you know what? That is OK! Do what is best for you and your family, given your situation right now and that is the most anyone can do.

[Lut C.]

Your post brings back memories to my own struggle. I don't know if I could do it a second time around, especially not with a toddler around. I'm guessing not.

[electriclady]

Oh Thalia. I'm sorry that you're having a crap time again. I was hoping for you that it would be smoother sailing this time around. I'm still holding out hope that things will improve, esp with the domperidone, but I know how hard it must be with a toddler and a newborn. As others have said, be kind to yourself.

[Alexicographer]

No advice, just wanted to say I'm sorry you're having trouble and that I hope you find a solution, an answer, a plan, whatever those may be, that you feel comfortable about and that works for you.

[sarah]

of course you'll figure out what works for you and i pass absolutely no judgement on what anyone else chooses, but i think in your shoes i'd be pretty willing to bag it and maybe try strictly pumping (despite a STRONG abhorrence of my pump)? i can't imagine going through all the struggle with a toddler running around, needing my attention. it really might be a situation where the best thing for everyone is to make feeding junior as easy as possible on both of you. it would be hard to give it up, but i know you wouldn't take the decision lightly and without giving it heroic efforts, so i say give yourself permission to do what you need to do.

[Clover]

Ugh- I'm sorry you are dealing with this again. Thinking of you.

[Caroline]

No words of wisdom here - I just know how you feel. hang in there - one day, one feed, one hour at a time!!!

[fisher queen]

I'm not sure what an SNS is, so sorry if i'm being redundant- go get yourself a nipple shield!! I've used one for both babies- they never would have latched otherwise.

[bittermama]

Ugh... I wrote a long comment and it got lost. The gist of it was that I wonder if his development of poor latch after the first couple of days might be connected to the jaundice? My firstborn was jaundiced and it was such a struggle to feed him for the first two weeks or so because he was so lethargic and would fall asleep at the boob and would only suck half-heartedly when he was latched. We also had to do supplemental feeding/pumping and it's just ridiculously hard when the whole ordeal takes 1-2 hours. Maybe things will get better once he's over the jaundice?

[ms. planner]

Congratulations on Junior's arrival (sorry I missed it earlier)!!!

I can only imagine how difficult it must be to manage a newborn and a cute, high-energy toddler. And I do not have any advice about the b'feeding. But I know that you are a take charge kind of gal and I am confident that you will figure out a solution. Go with your instinct. Don't second guess your intuition on what is the best way to proceed. Thinking of you and, really, many, many happy thoughts for your lovely little family of 4 (!).

[motel manager]

Congrats on Junior's arrival! I started a new job and have been AWOL on blog reading (not like you were eagerly awaiting my comments, but still).

Breastfeeding is so hard with a toddler around! Yet, here I sit, about to hit six months with #2 when I only made it to four months with #1 (having had big supply issues like you). So I guess you never know. Junior will be fine whatever happens. It does just stink, though, when things don't go smoothly. And don't we deserve a full supply at this point? Bah.

But irrespective of all of this: CONGRATS!! I hope you are enjoying your new family of four. Yay, yay, yay!!!