posted
I know there are some breastfeeding gurus on the board, so here it is.
Space Space Baby is on the verge of being hospitalized again. After his reflux was diagnosed and we began supplementing with formula to add extra calories, he began putting on weight. However, at the dr. yesterday we found out that he dropped 6 ounces during the last week. The dr. asked me to wean him on the theory that for whatever reason he did better when he was getting more formula. We compromised by setting a weight check for tomorrow, and having me "pump and dump" till then while feeding SSB only formula. At this point SSB is 6 weeks old and only 3 ounces above birth weight; it's starting to get scary.
Any ideas? I've got plenty of milk and nurse on demand. One thing I can't argue with is that since beginning only formula SSB is actually sleeping more like a normal infant. Before he was only sleeping 2 hours out of every 8. I've tried taking dairy out already. Thanks.
posted
SO, I have no experience and no suggestions. I wish you and baby all the good luck and good health you can stand.
Posts: 8355 | Registered: Apr 2003
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I wish that I knew what to advise you. I'm wishing for the babe to grow strong and healthy. Maybe not every mom can nurse all their babies. If mother's milk was always clear-cut best for the baby, I don't suppose that there would be baby formula. Or wet nurses.
Posts: 10397 | Registered: Jun 2005
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posted
I've emailed a friend of mine who may have some advice; I'll let you know what she says (or she might--I sent her a link to the thread).
I'm sorry that Space Space Baby is having these problems; I wish that there were something that I could do to help you guys. Keep us posted--I'll be thinking about you.
Posts: 16059 | Registered: Aug 2000
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Is it regular formula you're giving him? If so, the problem isn't dairy. Although it could be some other allergy or intolerance that's contributing to the reflux.
I never understand why a child would do better on man-made formula than on the milk a mother produces specifically tailored to help that child grow. (The same mother that gave him life, no less!) It makes no sense, and must be frustrating and disappointing for you. Posts: 1522 | Registered: Nov 2005
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I was going to say, with Jenna, that it may be something you eat that he's allergic to or intolerant of. Corn? Soy? Who knows, there are so many things that are ubiquitous in our diet that can cause problems. I assume he was given a newborn screening, since he was born in the U.S., and probably had a more complete metabolic workup when they first noticed the problems; it could still be something obscure, though, have they conferred with a pediatric endocrinologist or geneticist or another expert? I'm really at a loss, but I hope they figure it out, and that he gets better. (((hugs)))
Posts: 21182 | Registered: Sep 2004
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I have no advice for the baby, but maybe you could donate the milk so it doesn't feel like a total waste?
Posts: 289 | Registered: Jan 2002
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Just thought of something-- a lot of babies with Celiac disease are FTT and have feeding problems. Has he been tested?
Posts: 21182 | Registered: Sep 2004
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Hey there, SO. It's been awhile since I checked the forum, and I am glad to hear that there is a diagnosis on SSB. That is a good start.
I don't have any good advice for you, but if formula seems to be working best for your baby, then that may be the only way to go. It may be some kind of allergy or other sensitivity, something just not in the textbook. But I do applaud your efforts on trying to find the culprit. You may succeed and go on to breastfeed successfully. If it doesn't work, know that you are doing what is best for your baby with what you know.
(Originally posted as Porter! Ooops. I'm on his laptop since my puter died.)
Posts: 7050 | Registered: Feb 2004
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How often are you nursing on average? For how long? On both sides or just one side at once? Does SSB nurse constantly or tend to fall asleep? Does he latch on eagerly or is he pretty mellow throughout?
I'm sure most of what I have to say was mentioned previously, but here are some of my ideas. YMMV.
Nursing longer on one side will bring out the "fatty" hind milk, but if your baby tends to get distracted or fall asleep, it might be better to switch sides to wake him up again so that he's interested again.
Nursing on demand, while my preferred method, might not be enough if SSB hasn't been gaining enough weight. Try to be sure to nurse him every two hours for ten-fifteen minutes a side (Assuming you're not having any trouble letting down, and SSB is nursing well, fifteen minutes usually is a good amount of time to get both fore and hind milk)
There is a "myth" that babies sleep better through the night on formula because formula takes longer for babies to digest and makes them feel full longer, so perhaps you are seeing that?
Wait, wait, wait...was that the first week you were nursing again without supplementing with formula? I wouldn't be surprised if you had a slight drop in supply because of the formula supplements. Also, as good as pumping is, nursing is better for keeping your supply up.
Have you been supplementing with a bottle or with a drip feeder as he nurses? I would strongly suggest the latter.
*goes off to think and to ask another friend/coworker of hers*
Has the reflux been better on formula? Allergies are really hard to determine, and I don't really have any experience there. Posts: 1777 | Registered: Jan 2003
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My (non-technical, non-medical) advice is to go to formula. We spent four months agonizing over breast-feeding issues, losing sleep and feeling desparate. In the end our daughter did take to nursing, but looking back neither I nor my wife think it was worth the heartache and stress we put ourselves through to get there. If we have similar problems with our next I think we'll go to formula much earlier.
Posts: 2926 | Registered: Sep 2005
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Space Opera, Christy has some good questions for you in her post. My only disagreement is that the baby may need to nurse as long as 15-20 minutes per side. Watch the baby, not the clock.
Since your baby is having weight gain issues, make sure the baby is nursing FREQUENTLY, every two hours is a good benchmark. You may have to wake the baby to insure appropriate frequency. Remember that a normal infant nurses at least 10-12 times per day.
INSTEAD OF TIMING the feedings, though, watch the baby. Make sure the baby is actively sucking and swallowing while he is nursing.
Here's why: When a baby first goes to the breast at each feeding, he sucks hard for a few seconds to trigger the letdown reflex. Then the milk starts flowing rapidly into the back of his mouth, triggering the swallow reflux and the baby will actively suck-swallow, suck-swallow. At this point the baby is getting the thin foremilk, which quenches his thirst, but is fairly low in calories.
As the baby continues feeding, the milk transitions into the fatty, high calorie hindmilk. At this point, the baby may be swallowing after every second suck or every third suck.
Your baby needs this hindmilk to gain weight, so make sure he continues nursing and gets this milk.
If the baby seems sleepy, you may have to encourage him to stay awake and nurse actively by talking to him. Skin to skin contact is helpful to, as it is stimulating to the baby. Uncover the baby down to a diaper and cover both of you with a blanket to keep the baby warm.
When the baby seems to be sucking and not swallowing, sucking lightly, or falling asleep (assuming the baby has nursed for at least 10 or 15 minutes on that side), that is the time to burp the baby and switch him to the other side.
Here is a good article on nursing a baby with reflux issues:
I would strongly recommend that you find a local La Leche League Leader, who can speak with you on the phone or in person and help you work through your particular issues.
I hope you manage to work this through. Feel free to contact me by email if you wish - I am a board certified lactation consultant and have access to lots of info and resources that might be helpful to you.
Posts: 5771 | Registered: Nov 2000
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I can't add to Ela's wonderful info, but I have been down that road. It's hard, but we had a pediatrician who was 100% behind my breastfeeding. One thing that worked in the end ( consult your LC) was to use only one breast per feeding. Livvie just couldn't get two boobs worth of hindmilk at a time. She nursed for three years, the first 11 months exclusively. I am glad I stuck with it because she had a very hard time switching to any solids. SSB may not have any allergies, but, he could too.
Posts: 2711 | Registered: Mar 2004
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I had to give up chocolate while breastfeeding Superstation. It took a while, but we finally determined that was what was causing his eczema flare ups.
We will keep SSB in our prayers.
Posts: 399 | Registered: Sep 2002
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Inkling spent a week in the NICU for reflux and issues similar to what SSB is experiencing.
Want to know what marked his turn-around? One of the nurse's switched the brand of his nipple. He started eating, his reflux faded. . . miraculous, $0.99 change.
posted
Yeah, my mom sees a lot of that working with kids with clefts. In fact, one of my first thoughts when I heard he was doing better on a bottle than the breast (this is assuming that you haven't tried a bottle full of pumped milk, and that the results would be the same) was "sub-mucous cleft". But I figured that would have been picked up by now. I've heard in cases like that, breast shields can be helpful...
Posts: 21182 | Registered: Sep 2004
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posted
This is pretty unbelievable. Space Space Baby's weight today was 9 pounds 14 ounces - a weight gain of ONE POUND 7 OUNCES in a 48 hour period. So the good news is that he put on weight! Thank goodness there isn't a serious health problem. The possibly bad news is that he did it on all formula and no breastmilk. I would definately prefer to breastfeed but I'll definately formula feed if that's what keeps him healthy. His weight is going to be checked again on Monday.
Thanks to everyone for the kind thoughts and advice. I called the hospital's lactation consultant today (I had called a La Leche leader yesterday but she didn't have any "new" suggestions for me) and this was her thinking: I have the supply, but the problem is with the transfer. So her suggestion was to begin pumping every 2-3 hours and give SSB the breastmilk in a bottle, followed by however much formula he'll take. After a week or two, begin using the breast instead of the bottle, followed by formula, then eventually just the breast. Of course, there would be very frequent weight checks during this.
SSB is *very* hard at times to keep awake on the breast, even with the usual tactics used on sleepy babies, including switch feeding. The other night I tried repeatedly to nurse him and he would nurse 5 minutes and fall asleep (repeat several times) - finally I offered a bottle of formula and he took 5 ounces without falling asleep, then slept all night afterwards. So, the consultant is hoping we can slowly train him to be more aggressive on the breast and actually take advantage of the milk that's there. Thoughts?
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Nathan was very difficult to keep awake to nurse when he hit two weeks old. He'd literally fall asleep and off the breast - Turned out that he had RSV. He couldn't breathe AND eat at the same time. I had a pediatrician at that time who was NOT supportive of breastfeeding, and totally missed the RSV. That took an ER visit. And then three weeks of intensive care. Nathan also (after all that) had reflux. We learned to nurse in alternative positions. Prior to all that, he had a "suck-swallow" disorder. (And did I mention the extreme jaundice at three days old which prompted a few days in PICU under bili lights?) In short, he sucked his tongue rather than his thumb in utero and had to be taught how to suckle. It's actually easier for babies to suck a bottle. Less work.
However, we made it through and he continued to nurse. I have never regretted the time and work. And it was work - the first few months were hard. But it was really so very worth it. But there's no denying it was tough - an emotional rollercoaster, bone-tiring, frightening.
Ela has excellent information for you. She is quite the Hatrack resource!
My question for you (based only on my memories of walking through similar stuff): What are you doing to care for you during all of this? One important thing to remember is that if you are stressed, it can affect the nursing relationship. Can you have a soothing cup of herbal tea? Soft music? I knew a woman that nursed all 12 of her children, and she swore by the one dark beer she had a day. Is there a reassuring and supportive friend or family member that can stay close for the next several days and help you stay calm and relaxed?
Best of luck - stay patient. You and SSB will be just fine.
posted
I have a question that I think has already been asked: Did he gain weight because his reflux was better when he drank formula? And if so, do you know whether it's the formula itself or the bottle that is helping? Because as was suggested to you, if it's just the bottle you could try pumping and feeding breastmilk in a bottle. Although that takes twice as long.
I had yeast which made it very painful to nurse, so for about a week I just pumped (less painful than nursing!) and fed it to him in a bottle. My son could suck a bottle dry in 5 minutes, when it would take him 20-30 minutes to nurse, falling asleep every time. After about a week on the bottle he got used to getting a full belly and when we re-introduced the breast he was quicker at it.
Posts: 1522 | Registered: Nov 2005
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Has anyone mentioned cup-feeding? Much more time consuming than bottle, in the short run, but easier in the long term to go back to breast.
Posts: 2711 | Registered: Mar 2004
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I'm sorry about the nursing problems. Although I didn't have the same problems, I had problems none the less. No matter what I did to increase my milk supply, nothing worked. I just couldn't produce more than 2 ounces a feeding. We had to supplement. We used a syringe for a while, then a drip system, a cup, and finally a bottle. Slowly he got the idea that I just couldn't fill his belly. About a month ago, he would only nurse in the middle of the night, and just this week he's started sleeping through the night and not nursing anymore. He'll be 4 months old this week. It's sad for me. And hard not to have that time anymore. But I wish you more luck than I had!
Posts: 161 | Registered: Jul 2002
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You may be able to establish a good breastfeeding relationship eventually. A friend of mine has a little girl who wouldn't nurse. She pumped and bottle fed. While it was a pain in some respects, the whole family had a great time taking turns feeding her.
Recently she decided that she would accept the breast as well! She is nursing now. You just never know.
Whether it is the bottle or the formula that is working for her at the moment, those things could change in the future. If you continue with the pumping and keep your supply, things could work out eventually.
Posts: 7050 | Registered: Feb 2004
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Mr. Opera and I had a long talk last night and decided that we just couldn't put anymore stress on our family. Space Space Baby's problems have affected all of us and the older kids have been virtually ignored for 6 weeks. We were also scared enough by SSB's failure to gain weight previously to not want to put him at risk again.
Right now I feel incredibly guilty and sad. Thanks everyone for your help.
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I know how you feel. When I was having problems nursing my first, I was almost ready to wean but I felt really guilty. I looked online for ANYTHING that would tell me that it was okay; that for some families, nursing is NOT best for the baby. But all I found was, "Nursing is best for the baby. Breastfeeding gives the baby the following advantages ... blah, blah, blah." So for your sake, let me say:
NURSING IS NOT BEST FOR EVERY FAMILY. Do what you know is best for your WHOLE family, and for the health of that sweet little baby who (for whatever reason) is growing better on formula. Take the time to sit down and cuddle him while you feed him just like if you were nursing, and you'll both thrive. Posts: 1522 | Registered: Nov 2005
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I'm so sorry it didn't work out for you. Please try to take some time out for yourself. Your kids know this is a hard time, and I know you are a very loving family. They'll be okay.
Be well. ((Opera family))
Posts: 1777 | Registered: Jan 2003
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I know I've said it before, but I had to NOT breast feed and I made it hard on myself because I allowed myself to feel guilty. After doing all you can do,(which you did) allow yourself the comfort that you ARE doing what is best and it will be okay. Enjoy your beautiful family and hang in there. Hugs to you!
Posts: 697 | Registered: Nov 2005
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Space Opera, I have been reading your threads but have no experience to contribute so kept quiet, but just wanted to say that you are so OBVIOUSLY trying to do what is best for this baby and your entire family, please don't feel guilty and just feel joy as your baby starts to thrive! Hey, if the formula's working it's working!
Posts: 3149 | Registered: Jul 2005
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My father would have died without formula. He was (and still is) totally lactose intolerant, including to his mother's milk. They put him on an early soy formula that was still in the developmental stages. Without it, he would have died. Now they've got other lactose free formulas but at the time, that was the only thing left to try and they weren't sure if it was going to work even then, since he'd lost so much weight. (And my grandmother was an RN, so you can imagine how helpless she felt at the time.)
You didn't just have an ordinary fussy baby, you had a medically diagnosed failure to thrive baby. There is a huge difference. So don't feel guilty about what giving your baby what he needs in order to gain weight. There is a time and place for everything or we wouldn't have formula to begin with.
posted
I am so sorry you have had to go through this. I only know of one person in my whole circle of friends and family who is really successful at breastfeeding. My cousin's son had nipple confusion and her daughter has a variety of skin ailments, some possibly caused by lactose so neither of them were breastfed past 2-3 months. My daughter was weaned at 2 months when I developed a severe case of bursitis in my shoulder and had to take steriods. The breast pump I used didn't work well enough so my milk dried up. My friend's daughter didn't breastfeed well since she had inverted nipples and she tried again with no success with her son. She was so depressed about it and it affected her relationship with her husband. Another friend had to go off all her OCD meds to carry the baby and wanted desperately to get back on them once her son was born so she made the difficult decision to not breastfeed at all so she could be healthy herself. Only my sister-in-law has successfully breastfed for almost a year now but even she had struggles and had to supplement her preemie.
All the babies I am speaking of are between the ages of 1-4 now and all are healthy and happy. None of them have any ill effects from not breastfeeding. I missed having the bonding time with my daughter when we stopped breastfeeding but we still bonded in other ways. My favorite was taking a warm bath (my way to relax) letting her rest on my chest. It was soothing and comforting to both of us. Good luck and God bless you and your family.
Posts: 1319 | Registered: Jul 2005
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Space Opera, I don't know if they have checked this yet, but...
When my nephew was born, he had terrible problems with reflux and choking. He was hospitalized at Brenner's Children's Hospital and every test they could think of was run. They tried all sorts of medications and nothing seemed to help keep his stomach under control. One night, while I was visiting, they had just fed him and he went into his problem. He choked so bad that they Code Blued him and brought the crash cart.
Luckily, he made it through and someone was watching close enough to realize the order of what was happening. He wasn't vomiting and then choking, he was choking and then vomiting.
It turns out that his problem was that his epiglotis (sp), the little flap that closes over the windpipe when you swallow, was not fully formed and so his formula would often go right into his lungs. Once they had scoped him there and were able to see the problem, they were able to take care of it.
He's now 8 and doing just fine.
Perhaps Space Space Baby might have a similar issue?
Posts: 2848 | Registered: Feb 2003
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posted
I just wanted to let you know that I think you made the right decision. There were a lot of FTT babies in the NICU and PCN and it's always best to go with the option that puts the weight on.
I wish there was more support for mothers who can't breastfeed. After 3 months of pumping, I've had to stop b/c of medication. Aerin is doing fine with formula, but I also feel frustrated and guilty and like I've failed my child. There's so much pressure to breastfeed that I'm finding it hard to find support.
BTW, kangaroo care is a great way to bond with the baby. Hold him, skin to skin, on your chest (and cover him w/ a blanket). He can feel your heartbeat and your body temperature will adjust to what he needs - if he's cool, your body will warm up and if he's warm, your body will cool down. Only mothers can do the temperature adjustment, but fathers can kangaroo just fine too. There's tons of clinical evidence backing up the benefits - they really encourage it in the NICU b/c it gets great results.
Posts: 3037 | Registered: Jan 2002
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Be assured you are doing what is best for your baby. I was only able to nurse one of my three. One of my sisters in law literally blacks out whenever she nurses. Its really weird and they can't figure out why but when she nurses, no matter what she tries, she starts to get dizzy and blacks out. They've checked iron levels and so forth. It may be related to her celiac but no one knows. She is going to try to nurse with this next babe but who knows. My other sister in law develops hives when she starts nursing. She will nurse as long as she possibly can (usually 3 mos or so) but the pain from the welts gets too intense. For some reason sometimes things just don't work like we expect them to and its okay if we have to go a different route. What is important is that you are doing all you can to take care of your precious babe. So give yourself permission to mourn not being able to nurse but then feel good that you are taking care of your sweet baby in the best possible way for him. (((((HUGS))))))
Posts: 1132 | Registered: A Long Time Ago!
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posted
I just came across this interesting chunk of information, and thought I'd share it with you. And, if you take the little test at the end, you can earn 3 education credits. Whoop-de-do!
Posts: 10397 | Registered: Jun 2005
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quote:I wish there was more support for mothers who can't breastfeed.
I could not agree with that more. Women who cannot breastfeed or those who just plain choose not to for whatever reason - like I chose not to with the twins because of the stresses involved with nursing two at a time and I just didn't want to put myself through that added stress when I was already having to adjust to quitting my job and being home with four kids (three in diapers) - those women, I find, do not get support. Often they are very hard on themselves and guilt-ridden. The medical community doesn't seem to get behind them at all and often friends and family will make them feel bad for what they've done.
So I will say, emphatically, Space Opera - I am behind you. I support you.
I'm glad you made a decision that was the right one for you and Mr. Opera and SSB and your other kids. I'm glad you are now feeding him with less stress and better results. I'm glad you can now establish a wonderful feeding relationship with SSB. Bottle feeding is not less loving, it is not a failure of you as a mother, it is not dooming SSB to a life of sickness or of not being smart or any other crazy thing. It's getting him wonderful nutrition that he needs. And I know you are not the type of mother that will prop up bottles, so I know he's getting tons of cuddling and loving while he feeds. You're a good Mommy. *hugs*
Posts: 14428 | Registered: Aug 2001
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quote:BTW, kangaroo care is a great way to bond with the baby. Hold him, skin to skin, on your chest (and cover him w/ a blanket). He can feel your heartbeat and your body temperature will adjust to what he needs - if he's cool, your body will warm up and if he's warm, your body will cool down. Only mothers can do the temperature adjustment, but fathers can kangaroo just fine too. There's tons of clinical evidence backing up the benefits - they really encourage it in the NICU b/c it gets great results.
This is what I've heard. I think it's a fabulous idea, and I love that it works. Posts: 26077 | Registered: Mar 2000
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