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Old 04-21-2012, 09:10 PM   #11
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Re: Help with Ameda pump and increasing supply

Oh, no Hope you can get your supply up!! Skin-to-skin! I should have asked earlier, are you keeping baby skin-to-skin as much as possible? Keeping baby against your chest does a lot for supply, even a hand on the breast - our lactation consultant mentioned in a wrap or such to tuck a little hand inside the bra as that will even help. I would let baby dose on my chest skin to skin. You might get more letdowns pumping with baby in arms, even if it is single sided to make it practical

Are you doing the massaging/compressions while pumping? (http://newborns.stanford.edu/Breastf...roduction.html)
Also, have you tried hand expression? With my first I had luck with hand expression before the pump was very effective... Might be worth a shot to see if you get anything.

Have you been seeing the same lactation consultant the whole time? Do you feel she is helping you solve the problems? I obviously don't know the situation, but I do know that there is a huge range in lacatation consultants... If you don't think you're getting the support you need, can you find someone private to help you ASAP? The first couple of weeks are are so critical in getting everything going, if you aren't getting the support you need, go somewhere else!! From what you've said, your little one isn't latching properly - your nipple isn't coming out nicely rounded after he nurses, you're having pain, etc - yet they're telling you your little one is not nursing efficieintly, that sounds inconsistent to me.


The main concern with projectile type vomiting is pyloric stenosis, where there is a narrowing going out of the stomach, so hard to get food through.

But from what you're saying, your little one is gaining weight alright - the ped was pleased and ok with the weight gain - so that sounds encouraging! From my understanding the bad milk allergies or the pyloric stenosis result in weight gain issues.... Hopefully you're dealing with a feeding issue and with the right help can get that corrected!!!

My first - who nursed well, would puke a lot, but gained fine - would puke a bit and then fuss cause she'd want more to eat :P Don't know if yours is doing that, but wonder if it is similar, it was like she didn't feel as full and felt she needed more...


Since you don't have any real evidence that there is a milk protein allergy, I'm not sure stopping giving him breastmilk for a couple weeks while it gets it out of your system really would solve anything. Get the nursing problems fixed and then see how things go would be what I'd think.....


And remember - you are doing awesome, you are doing all this for your baby, you are exhausted and sore and doing this for your baby. Get the help you need to get him nursing well!

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Old 04-21-2012, 09:22 PM   #12
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Re: Help with Ameda pump and increasing supply

Saw some of your comments on the other thread - in terms of how much they NEED it is 160 mL per kilogram body weight per day (so that divided by the number of daily feeds is how much per daily feed). Weight doesn't seem to be a huge concern by the docs for your baby, so perhaps that isn't the biggest worry right now?

Not being satisfied at the breast may be related to getting more from a bottle quickly and easily. Will your little one stay at the breast and dose/comfort suck?

You mentioned about tongue-tie, I just remembered another technique the hospital lacatation consultant mentioned, let baby suck on your finger - do you feel the tongue all the way along or can you feel the bottom gums against your finger? You should only feel the tongue and not gums, if you're feeling bottom gums then that is indicative of being tongue tied.

It sounds like you've been given a lot of different information.... can you find someone private to get help tomorrow??? Someone who will sit down with you and watch baby nurse and help you with HOW to latch him on properly (without just saying to repeatedly take him off...)
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Old 04-22-2012, 06:13 AM   #13
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Re: Help with Ameda pump and increasing supply

Weight honestly isn't my biggest worry right now, he's gaining so I feel like that's fine. It's the not being satisfied that I'm concerned with, and that started before we introduced a bottle, it was part of the reason we did introduce a bottle. He will stay and comfort nurse as long as I let him and fall asleep at the breast. I just can't do that right now because of the pain/bleeding/blisters.

I actually read about the sucking on your finger method last night, and tried to test it but he won't have anything to do with sucking on my finger lol, so I wasn't able to find anything out. I will say, in all the times he's cried and pushed his tongue out etc, I have never seen it extend past his gums.

How would I even go about finding someone private to sit down with? Who would ultimately evaluate and treat a tongue or lip tie if he does have one?
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Old 04-22-2012, 07:46 AM   #14
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Re: Help with Ameda pump and increasing supply

A lacatation consultant would definitely be able to help with determining if he is tongue-tied. If it is to the point where they'd want to snip, then a doctor would do that I'm pretty sure. Sometimes there are other suggestions of how to latch if it isn't bad.

If you're thinking that might be an issue, then you want him latched on as deep as possible, you want the chin into the breast more. This is easier to do if you are more reclined, find a chair that is more reclined, or a soft sofa and sit farther forward and put a pillow behind your bum. It gets them a bit more 'on top' rather than just in front of the breast. You can let them latch themselves a bit more this way too and keep gentle pressure on the upper back to keep the chin in deep. If they're latched like the they are going to be more efficient and have a deeper latch, both of which would be good in your situation, plus if the tongue doesn't come out as far this would be of benefit. There unfortunatley aren't a lot of videos of this option, but if you look at "biological nurturing" or "laid back breastfeeding" that would give you an idea.

What made you/them think that the fussing was not getting enough to eat (unless there was large weightloss)? (I'm not meaning to sound snotty, hope it doesn't sound that way, just hard to discuss when you're not face to face :P ) Cause the fact that he won't take a finger to suck, plus would suck and sleep at the breast makes me wonder if he just wants to suck a lot, hence being unsettled. Just a thought.
Who said to introduce the bottle to make him more satisfied? When did you start? Cause the first few days they eat very, very little cause you are producing more colostrum, by introducing a bottle and giving them more you wind up getting them used to filling up on more, so then they feel they need that much to be 'full' which can sometimes be an issue.

I'd try searching online for people's web pages for their business that are lactation consultants - some may also be doulas or child birth educators - or a local forum.

Are you healing now?? The lacatation consultant that helped me with this baby and her crazy eating issues swore by calendula cream and she'd make little 'donuts' from tissue, roll it/twist it up and make a donut shape. She said put the cream on generously, then put the 'donut' over the nipple, and put your bra on as usual, you want so you're not 'squishing' the nipple down and you're keeping it a more moist environment to heal, cause drying it all out can actually be harder on the cracking. I didn't have cracks but was very sore and this felt WAY better than other things I tried.

Hope you can find someone to help you get healing and baby latched properly
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Old 04-22-2012, 08:04 AM   #15
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Re: Help with Ameda pump and increasing supply

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What made you/them think that the fussing was not getting enough to eat (unless there was large weightloss)? (I'm not meaning to sound snotty, hope it doesn't sound that way, just hard to discuss when you're not face to face :P ) Cause the fact that he won't take a finger to suck, plus would suck and sleep at the breast makes me wonder if he just wants to suck a lot, hence being unsettled. Just a thought. Not snotty at all The nurses at the drs office and the initial nursery nurse at the hospital. The first two night he was here we were having latch issues and so when he went through a period both of those night that he was screaming for an hour, I was told that it was because he was hungry and we hadn't figure out how to latch him consistently. But, I think you are correct. I didn't realize that until I got worried about feeding him too much formula and got stubborn in trying to soothe him other ways. and he did settle down within a few minutes with other methods, and pretty much immediately with a pacifier (I know, this should never have been introduced )
Who said to introduce the bottle to make him more satisfied? When did you start? Cause the first few days they eat very, very little cause you are producing more colostrum, by introducing a bottle and giving them more you wind up getting them used to filling up on more, so then they feel they need that much to be 'full' which can sometimes be an issue. Nurse/dr at the pediatric office again here. We went in when he was two days old since we only stayed in the hospital overnight. I was told that since he wasn't acting satisfied after feeding that he wasn't getting enough and I needed to supplement.

I'd try searching online for people's web pages for their business that are lactation consultants - some may also be doulas or child birth educators - or a local forum.

Are you healing now?? The lacatation consultant that helped me with this baby and her crazy eating issues swore by calendula cream and she'd make little 'donuts' from tissue, roll it/twist it up and make a donut shape. She said put the cream on generously, then put the 'donut' over the nipple, and put your bra on as usual, you want so you're not 'squishing' the nipple down and you're keeping it a more moist environment to heal, cause drying it all out can actually be harder on the cracking. I didn't have cracks but was very sore and this felt WAY better than other things I tried. Yes and no. I can heal up just fine if I take a day off of latching him and just pump, but as soon as I latch him again the problems comes back immediately because I haven't corrected the cause.

Hope you can find someone to help you get healing and baby latched properly

So with all of this said. Do I just stop supplementing and trust that he's getting enough? Do I only supplement a certain amount and try and slowly lower that? Or do I continue to do as the nurses had mentioned and supplement until he seems satisfied? I'll be perfectly honest and say that while I was told to do this, I only did so for a day or so because he will eat 3oz or more in a feeding if I do this and it just seemed like WAY too much for a baby who is feeding consistently every two to three hours. It's one thing if he's gone longer between feeds, but it just seemed like overfeeding at that point so I've been capping him at 2 oz. of formula if that's what he's getting. I don't want to starve or underfeed him but I don't want to overfeed him either.
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Old 04-22-2012, 01:11 PM   #16
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Re: Help with Ameda pump and increasing supply

Gah! This is frustrating to read "I was told that since he wasn't acting satisfied after feeding that he wasn't getting enough and I needed to supplement." if that is the only reason - without big weight issues, etc! Our friend's little one put no weight on between 1 and 2 weeks old, they tried things to get supply up and feeding more often, then started to supplement at that point because of weight gain. At two days old your milk isn't in!!! The amount of colostrum is very small that they get - but they're designed to only be getting small amounts. And sometimes babies fuss and just need to suck. I remember the first night with my first, she was the one that wouldn't open wide enough so was hard to latch, I went down to the nurses station because I couldn't get her to latch properly and she was fussy. The nurse held her while I went to the washroom and after she said she was pretty sure my baby was just sleeping and looking for comforting, cause she yawned and seemed to want to relax, and wasn't frantically rooting. Cause I seriously thought I wasn't feeding her and she needed to be fed and I couldn't work out why she wasn't actually 'eating' when I tried to latch her...

I'm not an expert, but from what others have said, they have done 'cold turkey', hopped into bed with baby for the day - no soothers, bottles and skin to skin contact as much as possible and if baby ate for ages, go for it, if they want to comfort suck, go for it, as it will increase your supply more effectively than many other things! However, it sounds like physically you may not be able to do that due to the nipple trauma... And if you don't think the latch is correct now, than it might not solve the issue. Solving the latch issue is probably the biggest priority!

If he is healthy, has gained alright so far and you have access to being able to monitor weight while you try to cut out supplementing, it might be the way to go. You seem to have good sense about your own baby, like you were saying he was eating more at the bottle because it was easy and not because he was hungry!

How much are you able to feed at the breast at the moment? When he latches, are you seeing the good jaw movements, the pauses and swallows? Do you think that part is working well? (Google Jack Newman and videos to see examples of good latches and what to look for to know they are eating and swallowing if you're not familiar, I found it really helpful to SEE examples!)

And it will get better! It will pay off later dealing with all this sooner rather than later to get your baby eating well and you healed. Hugs mama!! I should be easier to get good help to get baby eating properly!
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Old 04-22-2012, 01:12 PM   #17
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Re: Help with Ameda pump and increasing supply

Gah! This is frustrating to read "I was told that since he wasn't acting satisfied after feeding that he wasn't getting enough and I needed to supplement." if that is the only reason - without big weight issues, etc! Our friend's little one put no weight on between 1 and 2 weeks old, they tried things to get supply up and feeding more often, then started to supplement at that point because of weight gain. At two days old your milk isn't in!!! The amount of colostrum is very small that they get - but they're designed to only be getting small amounts. And sometimes babies fuss and just need to suck. I remember the first night with my first, she was the one that wouldn't open wide enough so was hard to latch, I went down to the nurses station because I couldn't get her to latch properly and she was fussy. The nurse held her while I went to the washroom and after she said she was pretty sure my baby was just sleeping and looking for comforting, cause she yawned and seemed to want to relax, and wasn't frantically rooting. Cause I seriously thought I wasn't feeding her and she needed to be fed and I couldn't work out why she wasn't actually 'eating' when I tried to latch her...

I'm not an expert, but from what others have said, they have done 'cold turkey', hopped into bed with baby for the day - no soothers, bottles and skin to skin contact as much as possible and if baby ate for ages, go for it, if they want to comfort suck, go for it, as it will increase your supply more effectively than many other things! However, it sounds like physically you may not be able to do that due to the nipple trauma... And if you don't think the latch is correct now, than it might not solve the issue. Solving the latch issue is probably the biggest priority!

If he is healthy, has gained alright so far and you have access to being able to monitor weight while you try to cut out supplementing, it might be the way to go. You seem to have good sense about your own baby, like you were saying he was eating more at the bottle because it was easy and not because he was hungry!

How much are you able to feed at the breast at the moment? When he latches, are you seeing the good jaw movements, the pauses and swallows? Do you think that part is working well? (Google Jack Newman and videos to see examples of good latches and what to look for to know they are eating and swallowing if you're not familiar, I found it really helpful to SEE examples!)

And it will get better! It will pay off later dealing with all this sooner rather than later to get your baby eating well and you healed. Hugs mama!! I should be easier to get good help to get baby eating properly!
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Old 04-23-2012, 07:57 AM   #18
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Re: Help with Ameda pump and increasing supply

How are you doing Lizmarie? Hope you're hanging in there.
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Old 04-23-2012, 11:15 AM   #19
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Re: Help with Ameda pump and increasing supply

I am, I'm sorry I haven't gotten back on. No change really, still trying to pump consistently and still supplementing with formula, so things are about the same there. He doesn't seem to be any different on the alimentum formula than on the original one, spitting up-wise. I have a call into the lactation consultant now, to see if I can get a one on one sit down with her.

In the meantime, I'm latching him once or twice a day, and other than that it's a combo of formula and pumped breast milk. I'm still super sore, but able to manage the cracking/bleeding at least with this combo. His latch doesn't really seem to be improving. I don't believe that he is tongue tied after watching his latch on the bottle, or if he is, it appears very minor. But I'm pretty sure that he is lip tied and that's causing him to not flare out his upper lip at all when he latches. He also doesn't flare out his lower lip, but I honestly think that's more because he has such a small lower lip and his upper lip sticks out further than his lower normally anyway (if that makes any sense).

I don't see any pausing and swallowing like you mentioned, but he is swallowing when he's latched....The LC also helped me check for that when I saw her the first time. He'll go between gulping sometimes and just soft swallowing otherwise, but she made it sounds like as long as he IS swallowing then he's feeding.

I've looked at alot of latching videos and help sites and I've tried a few different things. I feel like I can occasionally get him to latch correctly now, but he won't STAY latched correctly. He pushes himself back to just the nipple, like it's almost uncomfortable for him otherwise. I've noticed he does this on the bottle too, he prefers to just have the tip of the bottle nipple in his mouth as well.

I thought about adding blessed thistle to the fenugreek as I read that sometimes they work better as a combo, but I'm having trouble locating it locally, so I'll have to order it.


Added to that, we just got set up for his sweat chloride test for friday since he tested positive for cystic fibrosis on his newborn screen .

I'll be perfectly honest, and admit that if we can't get the latch figured out this week, I'm going to have to go with just pumping or possibly even just formula. With my husband going back to work here shortly, I don't know how to manage all of this pumping to try and increase supply and getting him fed (and I work from home). It just seems like alot! If I could figure out how to get his latch corrected it would simplify things soo much.
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Old 04-23-2012, 12:34 PM   #20
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Re: Help with Ameda pump and increasing supply

If this lactation consultant isn't going to help you, you really, really need to find someone else!! If you want to PM me a location, I can try to search for you too, also contact the local LLL! This is stupid that they haven't actually helped you

Blessed thistle might help in combination if you can get it. Apparently it helps with letdowns more, so if it makes it easier for baby to start getting milk it might be encouraging to him!

It is encouraging that the alimentum is similar to the other formula in that it sounds like it would rule out a milk protein allergy.

What you said about the top lip sticking out makes sense, my little one was like that too, but the bottom lip should still flare out, the big issue is when they tuck the lips in rather than flare out.

Hugs about the sweat chloride test. We didn't have the newborn screen back yet, so they did the sweat chloride test for our baby, got a mid-range result (not normal) and re-did it with the same result. So we're dealing with the CF specialist to follow-up and do some blood work, though she doesn't likely have it but might be carrier apparently.... The one thing she said is typically at the beginning they eat like crazy and don't put on weight - since our little one the issue was that she wouldn't eat very much that explained the weight issue. So having put weight bak on once feeding normal amounts was pretty indicative that there wasn't CF. She also said that the stools are very characteristic in being very greasy and having greasy rings around them that can be fairly easily identified. Hope you get that resolved quickly (the test results take a day and a half from what we were told) so you don't have to think about it any more!!

Definitely get hold of local La Leche League to find someone more helpful. I feel for you, you shouldn't have to be fighting to get the right help! Sounds like you know what is going on with your baby very well and that you need help in getting/keeping a good latch!!
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