difficulty breastfeeding

i've been breastfeeing my son since he was born, he's now 2 and half monthes old. i went back to work when he was 5 weeks so i've been giving him pumped milk in bottles. But now he seems to only get enough to eat when i give him a bottle. i know i produce enough at one time to make a full bottle for him, but when i feed him he doesn't eat it all, he starts tugging or un latching and trying to latch back on or he just starts smiling and acting so cute you can't keep trying to make him latch on.. i know i have the option of just giving him the bottles with my milk but its to hard to find the time to pump inbetween giving him the bottles, and also i dont want to do that because i get clogged milk ducts often. Does anyone have any advice? Also if i do end up just pumping how will i end up producing more milk when he starts eating more than 6 oz at once

 

It's hard to tell how much a babe is getting (and how fast they are getting it) while they're nursing.

Also bottles are usually easier for the babe to get milk from.

Just keep nursing him ON DEMAND when you're with him. If he wants to eat for 45 minutes let him, if he wants to eat for only 5 minutes, that's fine too.

I would shy away from bottles when your with him for your sake and his.

When my oldest was a babe, I too went back to work at 5 weeks. I was a pumping QUEEN!!

Are you pumping while you're away from him? You should be pumping whenever he'd "normally" eat. Or maybe every three hours or so. That will keep you're milk supply up to par.

 

My son absolutly will not eat from a bottle, when he was little younger I got him to a couple of times, but with much difficulty. It would be so much easier for my wife and I if he would, so that she could go out with her friends and such.

 

This may be a bit of nipple confusion or a plain old nursing strike. Steer clear of bottles when you're home, just put him to the breast. Offer the breast often. If he keeps latching and unlatching and getting distracted, try nursing him in a quiet, darkened room. Also, some breast compression should help to keep him interested when the flow slows.

*hugs* You're doing great! Keep it up!

 

sounds like nipple preference to me, too. try www.kellymom.com for lots of great information!!

 

Sounds like Classic Nipple Confusion. This has nothing to do with "not getting enough" and all to do with "forgetting how to nurse properly, because the bottle is too easy to suck on."

(I am a Board Certified Lacation Consultant) My cure for Nipple Confusion. Get rid of the bottles. Babies can be fed with a medicine cup, and Medela makes a cup feeder, with a "bottle" attached, so you don't have to keep filling a tiny cup. With a medicine cup, the baby is placed on the lap and swaddled, then a bib is put on the baby. Fill the medicine or feeding cup half full, and just place the rim of it on the baby's bottom lip. DON'T pour the milk into the baby, just have the liquid parallel to the floor and let the baby lap it up, gently tilt the cup only as the baby drinks, don't give him "Sips" there should be an even flow.

Could you take some time off of work to work on this? I;ve worked with many mothers who are willing to do this, to save their breastfeeding relationship. Believe me, you don't want be exclusively pumping, it is a hassle and you have a good relationship with your baby, which just needs a little fine tuning.

If you absolutely can't get any time off of work, can the baby be brought to you for feedings? I'ved worked with thousands of mothers who use this option. MOST of them said "My boss would never allow that." at first, but realized that most bosses simply can't stop you. In many state you have a LEGAL right to pump OR feed your baby at work.

Talk to a La Leche League leader (www.lalecheleague.org) or a Lactation Consultant (www.breastfeeding.com or 1 800 TELLYOU for Medela, and you can find a Registered Certified LC.)

 

that's what i had to do with kai. she never ever took a bottle, but she would drink fom a cup.

 

With my oldest, the bottle/nipple preference (she was most certainly not confused about what she wanted LOL) was so bad we had to retrain her how to latch using a nipple sheild, and how to nurse using finger feeding. It wasn't much fun, but only took two or three days to get her back to the breast.

 

Good for you to persevere through difficult times. I can't tell you how many clients I have worked with who had less problematic breastfeeding and just gave up.

Props to you, Mama. Hugs and Love. You won't regret the hard work.

 

lately my baby has been having a hard time latching on again. it's bizarre. everything looks fine, she latches on, it feels right to me, but then while she sucking she breaks the tension and ends up swallowing air. i'm confounded, really.

 

that sounds more like thrush. Does she have white patches in her mouth? Do you have any nipple pain or other signs of candida/yeast anywhere in your body?

sorta OT - story of the breastfeeding ordeal with my first child We had a really rough time of it but somehow made it through. I don't regret a bit of it, even though it was the hardest thing I've ever done in my life. She'll be five in April. I had absolutely no problems at all nursing her little sister, even though both girls were born tongue-tied.

 

you know, my nips feel totally fine, but the back of her tongue is a little white. i'll have her lovely doc check it.

 

doctors are not the people to ask when you have breastfeeding questions! Seriously. Very few of them know diddly squat about human lactation, it is not taught in medical school, but the formula companies do send reps to teach them about infant nutrition...
The routinely prescribed medications do not work on most strains of thrush/yeast/candida anymore, because they have been overprescribed. I have never had a prescription work for me. I have better results with more natural methods of treating it, like dietary changes (no sugar, wheat or dairy), probiotics/acidophilus, and grapefruit seed extract.

 

We used gentian violet when we got thrush. I just put a little on a Q-tip and let Taylor suck on it, then I painted my nipples. You only have to do it once a day for a week.

 

You got it, mamaboogie, lactation is NOT taught in many med schools. And what doctors know about thrush is based on the much more severe cases seen in totally bottle fed babies. They almost always miss the more subtle signs in breastfed babies.

KC, do you have a really strong letdown? I wonder if you have Overactive Ejection Reflex. This is where the milk shoot out very strongly during ejection (let down) and it can cause some babies to have nursing problems.

I'll post a sheet about it, and you can maybe talk to a LLL leader or LC about it, if so. Or if you can't get to the bottom of the problem.

 

Here is an article I haven't gotten around to getting published yet, but it has had a lot of internet play.


Overactive Ejection Reflex (Letdown) and

Foremilk Hindmilk Imbalance

​

Diana thought there might be something wrong with her milk. Her 4 week old baby often choked and sputtered when her milk let down, her baby had frequent large stools that often squirted out with force making loud almost comical noises. They were sometimes green and had curds of undigested milk in them. The baby seems to often be “gassy” in pain after nursing and was starting to cry and pull away when put to the breast. Diana herself found that her letdown (or ejection reflex) was sometimes painful and if the baby came off the breast during it her milk would spray forcefully. She had also experienced a few painful episodes of plugged ducts.

She was told that her baby must be lactose intolerant or must be allergic to her milk. Diana sought help from her lactation specialist and learned that she was experiencing Over active Ejection Reflex (or OER) and that there were management techniques that could help both her and the baby and allow them to continue nursing and benefiting from the breastfeeding relationship.



Human milk contains a large quantity of lactose. Lactose is a milk sugar that not only is the perfect food for a growing baby’s brain, but also helps the baby absorb other nutrients in her mama’s milk. It is almost unheard of for a human infant under the age of two years to be truly lactose intolerant. Most cases of perceived lactose intolerance in a baby this age are really OER or Foremilk/Hindmilk Imbalance.



Foremilk is the watery milk produced at the beginning of a feeding to quench a baby’s thirst. It is high in lactose to be sweet and keep the baby interested in continuing the feeding while waiting for the hindmilk. Hindmilk is the milk that is produced at the later part of a feeding. It is high in fat and helps a baby to feel full and satisfied.



Both Fore and Hind milk are needed for a balanced feeding yet sometimes either the mother’s body or improper breastfeeding management can cause problems with this balance.



In OER the mama may have a very strong letdown, accompanied by discomfort and spraying. Some mamas say they can hear very loud gulping in the baby and sometimes even hear the milk hitting the baby’s stomach.



Symptoms in Mom:

· Strong painful letdown

· Often frequent plugged ducts

· Lots of leaking

· Spraying of milk, some mama’s can spray several feet during ejection



Symptoms in baby:

· Gasping, choking, gulping or trouble “keeping up” with letdown

· Green frequent stools

· Pain and “gassiness”

· Loud “tummy” noises

· Sometimes a rejection of the breast

· Rapid weight gain, conversely babies who get only foremilk and then are taken off the breast too early in the feeding may have low weight gain

· Spitting up large quantities of milk

· Lack of comfort nursing

· Some babies may appear to want to wean in the late first or early second year because of discomfort and lack of comfort nursing





The goal is to “tame” the letdown and allow the baby to ingest a better balance of hindmilk in each feeding.



You may use a technique where the baby feeds as often as she likes, but only offer one side for a three to four hour period. The baby may nurse 2 or 6 times or more, but she is only given the breast for all the nursings in the time period. Also, the baby is taken off of the breast during the first letdown (or ejection) in each nursing. The milk can be allowed to flow into a clean cloth diaper or burp rag. After the letdown has subsided (usually around 20 to 50 seconds) the baby is put back on the breast and allowed to remain there as long as she likes. There should be no timing or scheduling of feeds.



These instructions are not written in stone. A mama with engorged breasts may choose to relieve the engorgement by switching to the other side sooner than the prescribed time. Switching when very uncomfortable can help avoid plugged ducts. If mama feels discomfort she should do what she needs to to relieve the pain. The baby should be observed to make sure she is wetting at least 6 wet diaper in every 24 hour period. A baby over a month old may actually start to stool less frequently than before. This is normal and fine. The stools will probably be larger if less frequent. The green color should no longer occur if the balance is working.



Some mamas find nursing “uphill” to be helpful. The mama can lie or sit reclined propped up with pillows or a bed sitting pillow (the author found this type of pillow to be the easiest way to use this position.) The baby lies on top of her and can then push away easily if the flow of milk becomes too forceful. Gravity is also believed to help stem the flow in this position.



These techniques should help to promote a gentler letdown and also allow the baby to gain the advantage of receiving all the hindmilk she needs in each feeding. Some mamas can abandon the 4 hour per breast prescription after the problem seems resolved,(usually at least 2 weeks) some may need to continue it for a longer period of time or even use it for the entire months or years of nursing.



This should only be practiced after a mama’s milk supply is established when the baby is at least 3 weeks old. If mama has these problems in a younger baby nursing longer on each side and not being obsessive about using each breast at every feeding will help. She can always take the baby off the breast during letdown to reduce the lactose load and forceful filling of the newborn’s stomach. One breast per feeding is fine if the baby is wetting at least 6 wet diapers and having at least 3 stools in 24 hours and seems happy and satisfied.



Foremilk Hindmilk Imbalance





Foremilk Hindmilk Imbalance is a very similar problem, but instead of the condition being caused by the mother’s unique physiology, it is often caused by improper breastfeeding management. Timing feeds, scheduling feeds and switching sides too frequently can all cause a baby to not ingest enough Hindmilk. One may be so religious about trying to use each breast in each feeding and/or so tied to a set amount of time when one feels the feeding must end that the feeding is ended before the baby has had a chance to get to the hindmilk. The baby then only gets foremilk, gets a lactose overload leading to tummy aches, green stools and often very frequent hunger. This may happen because the feeding was ended before the baby got to the fat containing hindmilk, leaving the baby hungry and frustrated.



The symptoms are very similar to OER in the baby, but usually the mother herself does not have the symptoms listed above and may have a history of rigid feeding patterns or be following a “baby training” type program.



The best piece of advice in this situation is to let the baby finish the first breast first. Be in no hurry to switch to the other breast or end the feeding. Some newborn babies may take 20 minutes to even get to the hind milk. The information that “the baby gets all the milk in the breast in 10 minutes” is a complete fallacy! Most babies need a good deal more time than that at most feedings.



The baby will let you know when to take her off the breast. Most babies will fall into a satisfied sleep and detach from the breast naturally or show the “drunken sailor” look when they are done.



Keeping records of wet and stooled diapers and adequate weight gain (average is 4 to 7 oz a week during the first 4 months) will ensure that the baby is getting enough milk. (See the tear off sheet number00 Is My Baby Getting Enough Milk?) Following the above suggestions can help keep both mother and baby comfortable and satisfied.





See also Overactive Letdown:It’s Symptoms and Consequences and Finish the First Breast First, both published in Leaven October/November 1995

 

i think i do. when my milk lets down, it HURTS, like a cramp. and if i touch my breast my milk just sprays everywhere. when it gets all hyper like that, my baby goes to feed then bitches me out while milk runs out o fher mouth. what do you do for that? anything?

 

Read the above, sweetie. I think we cross posted. It sure sounds like OER.

Hugs,
Maggie

 

AWESOME! i definitely have that problem. i've never been able to live on any sort of schedule, much less a rigid one. i had stumbled upon the option of laying joey on me so she can feed because it soothed her. when i felt my milk coming down really hard, i milked myself because the milk would choke the baby.

i've also been tending to give joey only one breast per feeding because she's done & content. thanks so much. i'm going to send thi to my husband. he'll be thrilled, too.

 

Don't forget to try the 3-4 hour on one breast thing. You make sure the baby nurses ALL she wants, but ONLY use one breast (you can use the other if you get really hard, or the baby seems like he's getting frustrated) also don't forget to TAKE THE BABY OFF THE BREAST during the letdown every time. THIS alone works wonders. I've had to do this with ALL my kids.