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Family Forum / Pregnancy / Breastfeeding / October 2007New Mama With Questions
Hi All, I just gave birth to my son on Sunday and I while I've lurked in this group for a long time, I guess I'd like some encouragement now that I'm actually in the thick of learning to bf a newborn. My milk came in with a vengance today. We are still learning to nurse properly, and while there are times that he feeds contendedly and well, they are definitely not the norm. More often we have latch-on-latch-off-repeatedly type sessions where he gets a few good sucks and then tires out or yells for awhile. Should I be doing anything to get rid of the engorgement, or will things even out on their own? He was 8lb 9oz at birth and discharged from the hospital at 7lb 15oz. They want him for a weigh-in on Thursday...hopefully we can get some good feeds in between now and then, but should I expect that he will lose more weight this week? Thanks for any advice! --Jod > I just gave birth to my son on Sunday and I while I've lurked in this > group for a long time, I guess I'd like some encouragement now that I'm > actually in the thick of learning to bf a newborn. Congratulations on your new baby! > My milk came in with a vengance today. We are still learning to nurse > properly, and while there are times that he feeds contendedly and well, [quoted text clipped - 3 lines] > anything to get rid of the engorgement, or will things even out on their > own? If the engorgement makes it very difficult for baby to nurse (my nurse compared it to nursing "from a beach ball"), try pumping a bit first. Otherwise, it should even out by itself. Meanwhile, I would stop the nursing if it's a latch-on-latch-off situation, re-open baby's mouth wide, and try to relatch properly. I hope you are not timing his feeds. Nurse him for as long as it takes for him to latch off on his own or he falls asleep (after a proper nursing, not falling asleep within a minute or so). > He was 8lb 9oz at birth and discharged from the hospital at 7lb 15oz. > They want him for a weigh-in on Thursday...hopefully we can get some > good feeds in between now and then, but should I expect that he will > lose more weight this week? My pediatrician said to expect regain to birth weight in 2 weeks. It sounds like your baby will be fine. -- Anita -- Irrational wrote: > Congratulations on your new baby! Thank you! > Meanwhile, I would stop the nursing if it's a > latch-on-latch-off situation, re-open baby's > mouth wide, and try to relatch properly. Well, that's the thing...he'll latch on well, take a few sucks and pop off and yell, or just pop off and root around again. I know I have milk coming out and that he's getting it, but it's like he gets impatient or something. This is the hardest to deal with when we are all tired and I can't seem to get him on to stay for very long, but he is definitely hungry. Last night he got downright mad when he was trying to nurse and I'm not sure why. > I hope you are not timing his feeds. Nurse > him for as long as it takes for him to latch > off on his own or he falls asleep (after a > proper nursing, not falling asleep within a > minute or so). No, I don't time them. He has a much harder time staying awake to nurse during the day. I'm hoping this gradually changes as he gets used to being outside of the womb. > My pediatrician said to expect regain to birth > weight in 2 weeks. It sounds like your baby > will be fine. I know he will be fine, I think I'm just new-mom nervous about him getting enough to eat often enough. --Jod > Irrational wrote: > [quoted text clipped - 12 lines] > to get him on to stay for very long, but he is definitely hungry. Last night > he got downright mad when he was trying to nurse and I'm not sure why. My DS did this when he was a newborn and it can be very frustrating. Do you think the milk is coming out too quickly causing him to come off the breast? I know that was a problem I had with both kids. I used to hand express a little first which seemed to help. Also, that latching on and off can be a bit frustrating ... and painful .... and my kids used to have trouble re-latching when there was milk and slobber everywhere so I would dry both me and the kid with a clean cloth nappy / towel before re lataching - and this made a big difference to my patience, their latch and also it meant I never got sore nipples. > > I hope you are not timing his feeds. Nurse > > him for as long as it takes for him to latch [quoted text clipped - 12 lines] > I know he will be fine, I think I'm just new-mom nervous about him getting > enough to eat often enough. I can vaguely remember trying to keep my DD awake long enough to have a decent feed when she was a very sleepy newborn. I would undress her a little which seemed to help her stay awake long enough for a decent feed. This problem didn't last very long though. It does get a lot easier with time. Amanda FlowerGirl wrote: > I can vaguely remember trying to keep my DD awake long enough to have > a decent feed when she was a very sleepy newborn. I would undress her > a little which seemed to help her stay awake long enough for a decent > feed. This problem didn't last very long though. Thanks for the well wishes and information, everyone! I'm responding under Amanda's post but I've read them all. We have two main problems: 1) waking up to feed and 2) latching I took him in for his weight check appointment today and they found he was 10% below his birth weight and sent me home with instructions to feed him every two hours, and bottles of formula for him to supplement with. They want to weigh him again tomorrow. I haven't used the formula as I'm able to pump a couple of ounces after each attempted feeding. I'm so frustrated because I can't feed him every two hours because is SOUND asleep. I undress him and tickle feet and use a wet washcloth and every trick in the book. Then, when he does wake up (usually around the 3-ish hour mark), I can't get him to stay on my breast for any substantial length of time. I work with him for 30-45 minutes and he does get some from the breast, but not very much. I read on kellymom that we shouldn't work too hard at latching and get him too frustrated because that will just cause an aversion. I get good let downs, but not too powerful, as they don't choke him. I am hoping he wakes up out of his sleepy newborn phase so that he will wake himself when he is hungry and be more agreeable to latching on. Every time my hubby tops him up with a bottle I feel like such a failure. :( He has had about 4 decent, long feeds with good swallowing directly from my breast. I know he (we) can do it, but I don't know why we aren't. :( Thanks again for the support, this is probably a really jumbled post as I'm feeling quite scattered right now. --Jod > FlowerGirl wrote: > [quoted text clipped - 32 lines] > > --Jodi You certainly aren't a failure!!! Its early days and what you describe isn't particularly unusual. I remember being really frustrated with bf for the first 5 days when bf my first child ... and then it started to come together and pretty soon it became a breeze! If I can count, he's on day 6 today? Its fairly normal to drop to 10% below birthweight in the first week. ...and at 8lb 9oz, he's not exactly a low birthweight baby so not a huge worry at this stage! I vaguely remember that they should start gaining weight again by about day 10 -14 (both my kids had lost 10% birthweight by day 4 but packed in on again pretty quickly ... but they weren't small at 7lb 10oz and 9lb 12oz respectively). I've also heard that they should regain their birthweight by 10 days which neither of mine did... they gained it back by the 4-week mark though. What's a "substantial length of time" for a feed? My DD would take 40 minutes to finish a side and my DS could be done and dusted with both sides at 20 minutes. ...and what makes you think he isn't feeding well? (remembering that they have really tiny tummies and its also quite hard to tell how much they are getting when breastfeeding so can you see milk at the corners of his mouth when he feeds? Regular swallowing?). How many wet nappies in a day? Is the urine pale? If he's got pale uring and going thorugh 6-8 nappies a day that's a good sign. Kellymom is a good source of info, and another good source it the Australian Breastfeeding Association: http://www.breastfeeding.asn.au/default.htm I'm no expert, but personally, I'd not be supplementing with formula at all at this stage, rather and concentrating on getting him to have efficient feeds when he's awake. Seeing a lactation consultant may help give you pointers and help give you confidence. Good luck and let us know how he goes over the next week or so. Amanda You are doing a great job. Hi -- Remember, it's just about impossible to measure what goes into a newborn. So don't even try! Instead, measure what comes out. Your baby should have at least 6-8 soaking wet diapers every day and at least one poopy diaper during the newborn period. Beyond that, just try not to fret. Unless the diaper count is too low, STOP topping off with bottles, even bottles of EBM. The important thing to to establish the nursing relationship and avoid confusing either your body or the baby, and bottles will confuse the situation. (If the diaper count is too low, then bottles of EBM are temporarily indicated, I should think.) The nursing DOES get easier, I promise. For me, it took about a month before I realized that it had become easy somewhere along the way. And with both babies the first week was really rough, for different reasons with each child. But the stress of the first week was worth it, in the long run, and I hope you'll find the same thing yourself. Congratulations on your new baby, --Beth Kevles bethkevles@gmail.PUT-THE-COM-HERE http://web.mit.edu/kevles/www/nomilk.html -- a page for the milk-allergic Disclaimer: Nothing in this message should be construed as medical advice. Please consult with your own medical practicioner. NOTE: No email is read at my MIT address. Use the GMAIL one if you would like me to reply. > (If the diaper count is too low, > then bottles of EBM are temporarily indicated, I should think.) supplements of EBM rather than bottles, Beth, there are numerous ways to get milk into a baby without resorting to a bottle. I suggested supplementing by an alternate method regardless of diaper count because at this age and being sleepy, there is a possibility of jaundice and jaundiced babies don't regulate the amount they eat so well, yet it's intake of breastmilk that helps them get passed the jaundice, so a small amount of supplementation, say 10ml via syringe, might give him the boost he needs to get beyond being too sleepy to feed well and fully establish breastfeeding. Anne > I took him in for his weight check appointment today and they found he > was 10% below his birth weight and sent me home with instructions to [quoted text clipped - 19 lines] > Thanks again for the support, this is probably a really jumbled post as > I'm feeling quite scattered right now. Oh, you poor thing, how undermining your doctor has been. He's 5 days old if I'm counting correctly, which is the exact time you'd expect him to be at the max below birthweight and 10% less than birthweight is absolutely fine. Most doctors use 10% as a threshold, but it's debatable whether it's really necessary as long as other signs of health are reassuring. Weighing the next day is incredibly unreliable, most people weigh babies undressed and the weight can depend on when they weed and pooed, he could by the scales have lost weight tomorrow, yet really have gained. Do not give any supplements of formula, they are entirely unnecessary from the information you have given. You can check that he's doing ok by monitoring hydration based on nappy output, which for a newborn should be 6 wet nappies a day. It's possible that a little boost might help him, which you can do with your own breastmilk, you said you were engorged, so you should be able to hand express into a cup, then give it to him by any method other than a bottle, don't let a bottle anywhere near him until you have fully established breastfeeding. You don't mention any details about the birth - if you received IV fluids for any length of time, the babies birth weight can be higher than it really would have been and weight lost is simply loosing fluids that were never even supposed to be there. I really wouldn't go back for the weight check tomorrow, I'd watch to see that he's hydrated, on the off chance he isn't supplement without using a bottle with your own milk, but still don't go and get him weighed. Continue to watch for hydration and only go get him weighed when your curiosity gets the better of you! Anne Anne > Oh, you poor thing, how undermining your doctor has been. He's 5 days > old if I'm counting correctly, which is the exact time you'd expect [quoted text clipped - 8 lines] > pooed, he could by the scales have lost weight tomorrow, yet really > have gained. Well, I went in today and he had gained an ounce and a half. In just over 24 hours. Plenty of wet and pooey nappies. Yet they still insisted he needed to come in tomorrow since he was still at 9% weight loss. I don't think we're going to go. It is the "mother/infant clinic" at the hospital, not even his regular ped. It seems to be a standard procedure when they discharge to have a weight check 2 days later and then "as needed" after that. It seems ridiculous. Especially to have the same policy for bf vs. ff infants at this point in their life. > Do not give any supplements of formula, they are entirely unnecessary > from the information you have given. You can check that he's doing ok > by monitoring hydration based on nappy output, which for a newborn > should be 6 wet nappies a day. I didn't give him any of the formula. His nappies are good. > It's possible that a little boost might help him, which you can do > with your own breastmilk, you said you were engorged, so you should be [quoted text clipped - 6 lines] > than it really would have been and weight lost is simply loosing > fluids that were never even supposed to be there. I did have IV fluids for about 6 hours before he was born. I didn't even think of that aspect. > I really wouldn't go back for the weight check tomorrow, I'd watch to > see that he's hydrated, on the off chance he isn't supplement without > using a bottle with your own milk, but still don't go and get him > weighed. Continue to watch for hydration and only go get him weighed > when your curiosity gets the better of you! Thanks for the advice. The doctors seem to be doing their best to stress out this post-partum mama!! --Jod > Well, I went in today and he had gained an ounce and a half. In just > over 24 hours. Plenty of wet and pooey nappies. Yet they still [quoted text clipped - 4 lines] > later and then "as needed" after that. It seems ridiculous. Especially > to have the same policy for bf vs. ff infants at this point in their life. You are doing just fine and you are a well-informed Mama. Trust your gut. I'm with you; I don't think you need to go back in 2 days, especially if his nappy counts are good. -- Anita -- > Anne > [quoted text clipped - 15 lines] > to come in tomorrow since he was still at 9% weight loss. I don't think > we're going to go. It is the "mother/infant clinic" at the hospital, There's the problem! The first health nurse I ever visited demoralised me so much. She suggested that DD was not gaining enough on my breastmilk and I'd need to supplement. Thank goodness I ignored her.... I think they get training on how to make new mothers feel inadequate, (although you do find the rare wonderful ones who just fill you up with confidence and have logical answers when you need them.) I'd ignore the next weigh in ... especially if his nappy count is good and they didn't suggest jaundice when you were there yesterday. I think weighing too often can be misleading as weight naturally fluctuates throughout the day. Just make the best use of all his hunger cues (rooting reflex, sucking on hands or lip, a little "eh eh eh" sound). You are doing fine. Give yourself and your baby time to get used to breastfeeding. Amanda > It seems to be a standard procedure when they discharge > to have a weight check 2 days later and then "as needed" after that. It > seems ridiculous. Especially to have the same policy for bf vs. ff infants > at this point in their life. Well, for what it's worth it's a fairly new recommendation of the American Academy of Pediatrics (not sure about other countries) that all newborns have an exam at 3-5 days of life. While the increase in breastfeeding rates is wonderful in almost every way, one of the very few problems associated with it was a rise in severely dehydrated newborns who'd been going for days on end with little effective food or fluids. Sometimes the breastfeeding isn't working and the parents don't realize that. Diaper counts are useful information but not always that reliable. The other thing that we're supposed to check is for jaundice. I think that properly executed the policy should support breastfeeding because it will allow for earlier intervention when things aren't going well. Unfortunately many pediatricians aren't well trained at supporting breastfeeding and may not have easy access to lactation consultants for their patients, so that's not how it's always going to work. Sounds like things have turned around for you now so that's good. I know few doctors -- or lactation consultants, for that matter -- who wouldn't recommend some form of supplementing with formula or EBM for a baby that's 10% down from birthweight so I don't think they were being terribly unreasonable. Unless it's really a huge burden on you I would think a weight check in a day or two could help put your and their minds at ease that things are now solidly on the right track, but of course it's your choice. Kate, ignorant foot soldier of the medical cartel (pediatrician) and the Bug, 4 years old and something brewing, 4/08 > Sounds like things have turned around for you now so that's good. I > know few doctors -- or lactation consultants, for that matter -- who > wouldn't recommend some form of supplementing with formula or EBM for > a baby that's 10% down from birthweight so I don't think they were > being terribly unreasonable. I really thought it was unreasonable to send me, someone who is 5 days post-partum, home with a bunch of formula, and very little instruction (basically, "feed him this after you breastfeed"). If I didn't know what I know about breastfeeding, supply and demand, etc, etc...it could have totally sabotaged my supply. I would think, anyway? They didn't even say anything about the possibility of supplementing with EBM. > Unless it's really a huge burden on you > I would think a weight check in a day or two could help put your and > their minds at ease that things are now solidly on the right track, > but of course it's your choice. It's not a burden to get him weighed. The burden is that even after I got him weighed yesterday, and he was gaining, they want me to come back *every day* until he is at 5% loss from birth weight. That is their protocol. Oh, and just a general reply to everyone's comments: he is not jaundiced at all. He had good bili levels on discharge and he's very pink. The nurses do make note of that when we go in. We are getting better at feeding, although I do try to see what I can pump when he's done if it seems like he didn't get "enough" time on both sides (sometimes he's a little sleepy on the second side). Usually it's less than 20ml (and I know that I can pump ~2 oz from each side if he hasn't eaten at all, so I think he's getting the good stuff out). Thanks to everyone! I think I am at least turning an emotional corner on this stuff now that I can get him to latch well (even if it takes awhile for him to do it, I know he *will*). --Jod > > It seems to be a standard procedure when they discharge > > to have a weight check 2 days later and then "as needed" after that. It [quoted text clipped - 8 lines] > newborns who'd been going for days on end with little effective food > or fluids. But at 3-5 days pp the mother's milk is generally just coming in so one wouldn't imagine that the babies were getting a lot of "food" before that time unless they were given formula. Amanda > Hi All, > > I just gave birth to my son on Sunday and I while I've lurked in this > group for a long time, I guess I'd like some encouragement now that I'm > actually in the thick of learning to bf a newborn. Congratulations!! The first couple of weeks are so hard. If you are very engorged he might be upset that it is hard to stay latched on such a firm breast and/or that he is getting more milk then he can deal with. The engorgement will correct itself but if you think this might be the problem you might want to pump or hand express enough to get past the first let down or enough to make your breast a little softer for him. And new born babies are just fuss pots some times. They are on a learning curve to and get impatient. Play some soft music and try to stay relaxed (I know it is hard when you are hormonal, sleep deprived, and worried all at the same time) and just keep plugging away at getting him latched on. Sing him a sweet song as soon as he is latched. I don't know if it did anything for my babies but I've found it almost impossible to be frustrated and singing at the same time. ;) Oh, and post as many times as you want. Sometimes it just helps to not only get input but just commiserate with other moms that know what you are going through!  SignatureNikki, mama to Hunter 4/99 Luke 4/01 Brock 4/06 Ben 4/06 > I just gave birth to my son on Sunday and I while I've lurked in this group > for a long time, I guess I'd like some encouragement now that I'm actually > in the thick of learning to bf a newborn. Congratulations! > My milk came in with a vengance today. We are still learning to nurse > properly, [quoted text clipped - 5 lines] > I be doing anything to get rid of the engorgement, or will things even out > on their own? It will settle on its own eventually, but that can be a loooong time! I suspect two things: 1. You are still learning your baby's hunger signals. Don't wait for him to cry before you put him to the breast. When they cry they sometimes become too overwrought to feed well. IF he starts mouthing, rooting, snuffling etc, try him then. 2. If your breasts are very full it may be hard for him to get a good latch. Try hand-expressing before you put him on. He needs to get his little gums onto your areola, and when you are really full it's a bit like trying to suck on a balloon! BFing is a bit like ballroom dancing -- both of you have to learn the steps, and learn to work together. OF course if you are in any sort of pain, seek help from your local breastfeeding support group. SignatureChookie -- Sydney, Australia (Replace "foulspambegone" with "optushome" to reply) http://chookiesbackyard.blogspot.com/ > Hi All, > [quoted text clipped - 17 lines] > > --Jodi Hi Jodi, I am a 22 year old mom of 2. Both breastfed. sounds like you are doin a great job. From experience, my babies gained after the hospital. My youngest is 4 months old and he weighed 6,4. He left the hospital at 5,14. By his 6 week checkup, he weighed almost 12. He dos the same thing at times..on and off the breast. Sometimes, its only a burp stopping him, other times it comes from the other side. Some older women have told me that boys tend be a little lazier at times than girls. AND NEEDIER! And they will never get enough mommy. So, hang in there! And enjoy the bonding! Desiree just to update everyone...what a difference a week makes! ds is doing great on feedings, latching well and eating every 3-4 hours. he has, um, excellent output. we stopped going to the weigh ins, once it was clear he was gaining (maybe not as fast as the nurses wanted to see, but he was healthy, peeing, pooping, having alert times). once we made the decision to stop going, it took so much pressure off of me and ds and we just got the hang of it! :) we have his two week ped appt tomorrow, and i'm actually kind of excited now to go and see how much he's gained. thanks for the support and advice...i'll probably be around for awhile asking more questions. --jodi, nak (yay! > just to update everyone...what a difference a week makes! ds is doing great > on feedings, latching well and eating every 3-4 hours. he has, um, excellent [quoted text clipped - 11 lines] > > --jodi, nak (yay!) Hooray! I'm pleased to hear that everything has sorted itslef out. Now just in case your nurses etc are using outdated information for growth rates .... here's a link to theWHOs software and charts using breastfed infants as the "norm" http://www.who.int/nutrition/media_page/en/ Let us know how he goes Amanda > just to update everyone...what a difference a week makes! ds is doing great > on feedings, latching well and eating every 3-4 hours. he has, um, excellent [quoted text clipped - 11 lines] > > --jodi, nak (yay!) Glad to hear it's all settled down! Good luck with the pedi appointment tomorrow. Kate, ignorant foot soldier of the medical cartel and the Bug, 4 years old and something brewing, 4/08 |
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