Feeling discouraged...

My girls are just over a week old and we have been struggling with breastfeeding because of weight issues.. we had our first doctor's appt today and they said that we needed to up the amount we are supplementing to see if we need to "change our course of treatment" as the doctor said. I've been breast feeding for about 20 minutes each and then now we give them 60 mL's of formula and then I pump.. I feel like we are working so hard!!!!

Do you all pump after each feeding? I'm still wondering if my milk is fully in yet. It's still a yellow color and I've yet to feel the "let down" sensation that everyone talks about! Any advice??? Thanks ladies!!!

 

I'm not one to really give advice... but... I remember nursing sessions taking 45 min. in the beginning...

what are you doing with the pumped milk? are you giving it to them too?

I hope someone else has some better ideas... keep up your good work. And I would try to keep up the pumping for a while after most feeds if you can. it will help to establish your supply.

Have you had a lactation consult? where they weigh the babies before and after feeds to see what they are getting?? I did that at 1 week and it was good.

have the girls not regained their birth weight? I think they have until 2 wks to regain...

 

Can you give us more info on their weights?

How often are you feeding them? The best thing you can do, both for their weight gain and your supply, is to feed them more frequently. 20 minutes also sounds pretty short for a nursing session at that age. I'd try to keep them on longer, and try to make sure they're actively nursing and not dozing off - keep them awake, strip them naked if need be, stroke their cheeks and under their chins to stimulate active sucking.

Ditto pp's advice to talk to a LC.

There's a wide range of "normal" milk colors - yellow doesn't mean that your milk hasn't come in yet. Mine was often yellowish in the beginning.

One thing I'd talk to the doctor about - I think a smarter way to supplement would be to add extra calories to the supplemental bottles they're getting. (There are "recipes" out there on how to add the right amount of extra formula powder to bring it up to 22 or 24 cal/oz.) If you want them to nurse well and get your milk supply going, filling them up from bottles isn't going to help. Might as well maximize the calories they're getting from supplements instead of maximizing volume.

You can do this! Some babies take longer than others to get back to their birth weights, and I guarantee you that this is just a tiny bump in the road, or less. It shouldn't be long before you can phase out the supplements and just nurse.

 

I don't have much to add, but would agree as PPs said that 20 mins sounds somewhat short for nursing sessions at that age especially if you are trying to increase and then maintain your supply. Letting the babies nurse as long as they need to is much better than a pump any day (pumping helps too though, of course). Settle in and make breast feeding your one and only job. Have someone else change them, feed you, etc so that you can just focus. Spend lots of time skin to skin with the babes as well as that will stimulate your production and encourage them to feed more often which will increase your supply.

I agree that you can do it and get your babies onto the breast exclusively if you work at it

Good luck!

 

You've received some excellent advice. I agree that 20 minutes doesn't seen like enough at this time. :hug: The first 6 weeks can be very difficult, but if you stick with it, it gets easier and so worth it!!! You have given your babies a HUGE gift, even breastfed this week! :good: Way to go!!!

 

What irritates me about most LCs and nurse advice in the hospital is this 20 minute rule. It's total bunk. If you want to build your supply you are going to have to let the babies nurse for as long as they want to, and as often as they want to. It will be exhausting. And since you are supplementing already, and weight gain is an issue you will have to keep supplementing and slowly drop down the amount of supplementing each day. I've done it with singletons, but honestly I didn't know enough with my twins to get it done with them. The easiest thing to do, if you are really determined is to get a baby scale and then you can check them at home and avoid being yelled at by the doctor. (you still have to see the doctor, but the scale allows you to monitor the situation yourself and adjust the amount of supplementing you do.)

You will not feel much let down in the beginning because your supply trickles in as you need it...and by trickle I mean your babies are probably getting 1/4 of an oz at a clip. you sound like you are in the category of women, like myself, who do not have gushing milk supplies from the get-go. But if you do nursing marathons, slowly wean them off the formula, you will be able to build your supply. It takes me a full 2.5 weeks to get my singletons gaining weight/build my milk supply enough. I'm not sure how long it would've taken if I had known what I know now for my twins. Unfortunately, my twin dd couldn't handle going back and forth between me and the bottle, so she refused to bf after 7 weeks. At that point I decided to get a baby scale to try to make it work for my ds...and 3 ebf babies later I've done the same thing each time.... nurse, nurse, nurse, nurse... as long as you can as often as you can...eat lots...drink lots... supplement only if babies are continuing to lose weight, and then supplement the bare minimum to get them to stabilize their weight...after that drop an oz of formula a day and nurse through it to build your supply.

Hope any of this makes sense... my brain is tired today... I've got tons of milk now but my 15lb baby hasn't yet figured out that it's okay to NOT eat at night! zzzzzzz...

 

Thank you so much for your excellent advice ladies! It really makes me feel like I'm not alone in this. My little ones started out at 6 lbs 2 ounces (now at 5 pounds 14 ounces) and 5 pounds 4 ounces (now at 4 pounds 14 ounces)- that was their weights on Monday, anyway. I agree that 20 minutes seems too short. My larger baby will breast feed for 30-40 minutes and sometimes longer but right now my smaller baby is having such a hard time staying latched and interested for much longer than 5 minutes. She takes a bottle much easier and I find myself frantic that she's not getting enough calories and then I stop breastfeeding and give her the bottle. Meanwhile, these darn bottles (haberman) are starting to breakdown and they don't seem to work correctly anymore. We go to the doctor tomorrow again and I'm terrified that he's going to try to make me stop breastfeeding all together for now if they haven't gained the appropriate amount of weight. 60 mL's just seems like too much and they both have awful reflux after feeding now. I'll ask the doc tomorrow about adding more calories but not more formula- what a great idea!! Thanks again.

 

First of all, your pedi cannot make you stop BFing. Everything is confusing and overwhelming in the beginning, but your pedi is not some kind of holy guru, and 99 times out of 100, a pedi who tells a mom to stop BFing is wrong. Period. Pedis usually receive maybe one 45 minute lecture on BFing during their entire medical training, and that is the extent of their "expertise" on BFing.

I think a lactation consultant would be able to give you some wonderful help. She could take a look at their latch, see how much they're getting in a feeding, help you brainstorm ideas to keep your slower nurser awake and eating... Also, here is some info about normal weight gain for BF babies. My brain is too tired to do the math right now, but your babies' weights don't sound alarming to me. And even if there are any problems, all that means is that you need some help with BFing, not that you need to stop BFing.

Also, reflux is probably another big piece of the puzzle here. That alone can mess with their weight gain. Getting the reflux under control will also be a huge help.

Good luck - you can do this! And if your doctor is really unsupportive of BFing, you can always vote with your feet and find another who will work with you.

 

Anybody else sick of peds who are supportive of BF in name only?

 

I just wanted to send a word of encouragement your way. I was exactly where you are. It took a bit longer for my twins to gain back to their birthweight (than my older singletons). I was going crazy with nursing them, supplementing, bottlefeeding, on an every 3 hour schedule, etc (instructions from the Special care nursery). I was losing my mind. Luckily my pediatrician was very supportive and I told him how hard it was and at 2 or 3 weeks he just said, "if you want to just straight breastfeed...go for it! I think they will do great!" And you know what, they did! Once they got over that little hump, they started gaining more steadily. So maybe in a couple weeks you will see that too. Also, were your twins born early at all? Mine were born at 35 weeks (in Special Care for 9 days) I found it took them longer to be more efficient nursers. Here's some suggestions from my experience:

1) When they were first born, I exclusively nursed them for the first 5 days maybe?? (it's a blur!) Great latchers, great nursers! I was very surprised. When they weren't gaining enough, the nursery started supplementing after each feeding. (Extra calorie Enfamil Enfacare added to breastmilk) and I found that almost immediately they started struggling with nursing. So I freaked out! So they instead let me nurse 5 or 6 times a day and give the bottles-breastmilk/Enfacare for the other 2-3 feedings spread throughout the day.(I pumped during each of those feedings though to keep the supply up.) I think that helped because I only had to do the bottles a couple times a day and the babies seemed hungrier at their other feedings and seemed to nurse better. My husband would do one of those bottles at night. I would still get up and pump though but it was only for 20 minutes and I could go back to bed. Maybe that's something you could try?

2) When we came home from the hospital, they had the babies on a pretty strict feeding schedule of every 3 hours...but when we dropped the supplementing bottles, I decided to nurse them closer to every 2 hours during the day and then every 3 hours at night (if they would go that long). I remember my singletons nursed more often than every 3 hours so I thought maybe if I nurse more often that would bump their weight up. That seemed to help. They also started "cluster feeding" in the evening.....so like sometimes they would nurse at 7, 8 and 9:30pm. That helped too.

3) I was so fortunate to have a pedi who truly supported breastfeeding, but even with that I had a Lactation Consultant help me too and she was my LIFELINE!!! The LC from the hospital was nice enough to email me and talk to me over the phone a few times. Also, she had me come back in as an outpatient when I was having trouble during my first week home, so maybe you could see if your insurance would cover that. It didn't cover home visits but it was covered if I brought the babies to the hospital for an outpatient visit. Also, do you have a nurse practitioner at your pedi office? Sometimes they have a little more time to spend and are more supportive of breastfeeding....just a thought. Getting help was crucial for me....and I had breastfed two children before my twins. I also found the site kellymom.com very helpful for breastfeeding info (wight gain, tips, etc.)


So after dropping the bottles, I did spend more time nursing, but at least I was only nursing and not having to nurse, pump, AND bottlefeed two babies. I found it much harder to juggle all of that than just doing one thing. Whatever you decide to do, good luck. You are doing a great job and you will get there. I had the hardest time at the beginning, but after a while it got easier and now I"m just wrapping up nursing them at 15 months. I can't believe it. It seems like just yesterday I was exactly where you are.

Shannon

 

My two were low weight gainers and it was actually a LC who eluded that the doctor "might have me stop bf". Well, at 5 months it was time for me and I just couldn't deal with teeth and my two biters (which continued later on as well...) So back to their weights... the one STILL CONTINUES TO THIS DAY to be a low weight gainer. When I stopped bf and only on formula, when my mom was there to help me, when my dh was home for holidays..... yeah nothing changed her eating habits.

Trust YOU. It is about making the decision that you feel is best.

heather

 

I'm sorry you're having a rough time.

I never once felt the letdown that so many other breastfeeding moms talk about. I never felt like my breasts were full either.

I pumped after every feed for the first three months or so. It always amazed me that I could get a couple of ounces after a feeding session, but I almost always did. I believe that pumping helped with my supply.When I bf'd my first son, my midwife told me not to pump until 6 weeks and I never did have enough milk to bf him exclusively. I wish I had pumped from the start.

I would have the babies on your breasts as much as possible for the first couple of months. Don't worry about routines or habits right now.

You're doing great.

 

wow i am having some of the same problems i was really excited about breast feeding my twin girls until one of the night nurses told me that they were very dehydrated and that they had lost 9.9 percent of their birth weight...so i started supplementing with formula as of now i can tell you that you have to keep trying to put them to the breast as much as possible even if you just put them their for twenty minutes and then give formula like you are already doing...i say this because the entire time i was in the hospital all my body would produce is colostrum and i know that is yellow in color so it sounds like that is what you are making...however in just the three days that i have been home i see that i am producing milk it is white in color and the more i put them to the breast the more i make...i also pump after each feeding just to make sure that my breast are fully emptied out, and yes it is a lot of work but i just try to focus on how happy i will be when my milk finally comes in fully.

 

This thread has been so very helpful ladies. Thank you. I finally got my smaller baby to latch on her own- it really all seems to be about when she is alert and awake and wanting to feed. She will bf for about 15 minutes and then stop. I am so worried about not supplementing- my gut is to offer the bottle after bfing- and both of them take it. How did you all tandem feed? We've been able to do it a handful of times, but my DH works during the day and I can't get them to latch at the same time. The reason I ask is because we are spending so much time doing the breast feeding each baby seperately, supplementing and pumping. Sometimes I just feel like taking the plunge, like someone else said, and just going strictly to breastfeeding. Either way, the doctor did give us scripts for the lactation consultant and maybe she can help us work on the latching and tandem feedings...

 

Today we went in for another weight check and both babies are gaining weight. Our bigger baby, Avery, is well within normal limits but our smaller baby, Bryn is still below where she needs to be (still gaining, but not within the 20-30 gram/day range.. she was gaining 18 grams/day as of today). Surprisingly, the ped said that he would like us to cut out the bottle feeds for now and exclusively try to bf so that Bryn isn't wasting calories on efforts trying to bottle feed after breastfeeding... I'm out of my mind scared that neither baby will get what she needs through bfing only! How will I know? I will try to feed them whenever they want to. Now that we've taken the bottles away, will they want to feed more often? That is what I'm thinking.... I've got a call into the lactation consultant.. how will I know they are getting enough-? I don't want to have to wait until the next appointment to find out that she's dropping weight. Thanks!!!!!

 

My babies were ebf and they fed approx every 2 hours... so not sure how often yours are feeding... but yes they may become fussy and want to feed sooner than when you offered the bottle after the feeding.

I'm glad you went for the LC consult, hopefully they continue to have good answers for you. I think its great that your pedi gave the go ahead to exclusively feed ... you will not have to deal with or wash bottles and that will save you a lot of time.

My duo latched pretty good, but yes in the beginning doing tandem nursing was what we did... I just sat there adjusting the babies or stroking them under the chin to keep them awake. I spent MANY hours on the couch. I had a little old typing table that is on wheels and I put my laptop on it and had room for water and snacks and the TV remote control! and I would stay there for a long time. I have to laugh. I only started watching the show "Monk" when I had the babies 2 yrs ago. And within a good few months I'd watched most of the shows that they had ever aired!

Good luck! Sounds like its going great for you! Practice makes perfect, and just keep plugging away and those babies will start nursing like pros!

 

We JUST started renting Monk 1 or 2 discs at a time from Netflix... And sadly finished it last week. It was a great run.

 

Hey, that's great news!

It is a leap of faith to go to straight BFing, but I think in the end it will make life easier for everyone (no pumping, no bottles!). The best way to know if they're getting enough from day to day is to keep track of the diapers. If they're peeing and pooping enough, they're getting enough. You might want to make a little checklist to have by the changing table, because it's way too hard to remember who did what when over the course of the day.

That's great that you called the LC too. I hope she'll be able to help.

 

I'm glad you called the LC! The most helpful thing the LC did for me was to weigh the babies before/after I fed them. That let me see how much they were taking in at a typical nursing session and really bolstered my confidence. I think the pediatricians get way too hung up on weight gain sometimes. For me the best day was when mine were a little over 3 months old and I decided to just sit on the floor/couch of my sunroom and nurse the babies all day long. That was the turning point for us. Keep us posted on how things go at the LC!