Diaper Swappers

clarinetb · 05-01-2012, 10:11 PM

If you are considering the domperidone option, here is a great article written by Jack Newman, who is an internationally recognized expert on breastfeeding (his book is great BTW!) for you to have a look at: http://www.facebook.com/note.php?not...33955666638379
You can take domperidone with the herbs (fenugreek, blessed thistle, goat's rue) if you wind up going that route and get your supply up, you can always vary it up to see what you need to continue taking, if anything.

Best suggestion for the nippleshield I was given is to put lanolin on the back of the flat part to kind of glue it to the breast :P They are a bit fiddly but that at least kept it in place (I was an hysterical mess trying that WITH the tube to supplement at the breast, tricky for one person :P ) If you can get that going and he'll go for it, you might want to try the feeding tube at the breast, you can get the tube going in behind the nippleshield, I found I need to seal around the side with lanolin on the side of the tube so there wasn't air coming in to the part where your nipple is, but if you can do it, it would give more stimulation to the breast even while he is getting formula.

The alimentum has nothing to be allergic to, completely broken down, so that is interesting that he is having problems with that. I know they use that formula for babies with severe allergies and milk protein allergies because there aren't any proteins to react to...

I'm glad you finally got someone to really talk with you. Personally, once life is under control again, I'd file a complaint about the LC at the hospital. The advise has been ridiculous and definitely doesn't sound like an IBCLC to me, plus if they say they're away a week and to get in touch the next week, I'd figure I had an appointment! not to be continually brushed off to call back "in case" she has time the next day. I am so sorry to hear you're been treated like that.

I agree with others, sometimes you need different people to see/talk to in order to get somewhere (it is unfortunate! Cause if someone says they are an LC and you talk to them, you expect to be getting good support!!) I did a google search and found a couple IBCLC listed for Richmond, VA... might be worth calling. Someone good should be able to help look if there are abnormalities that would cause problems nursing as well as help with latching, etc and actually SIT with you and watch and help in person!
http://www.lowmilksupply.org/lc.shtml (search for Richmond on the page and there were two)
http://www.wellness.com/dir/2871306/...s-llc-rn-ibclc (she is listed above as well, says RN and IBCLC, I have a slight bias towards people with nursing experience as well if you think there is something else going on - lady who was our big help was an RN and LC for 35 years so knew her stuff!)

Hand expression: http://www.youtube.com/watch?v=6ZViuYKX5LU
What you're describing is probably normal, the suggestion is usually for something fairly wide to collect the milk in, for a reason :P

It is wonderful to hear that you are able to get your little guy latched on part of the time and are still working on that.

clarinetb · 05-01-2012, 10:19 PM

Oh, and because sometimes you begin to forget and need someone to say it to you: you're doing amazing. I'm sure life is beginning to feel a bit muddled with all the feeding craziness! You're obviously a very strong woman and an awesome mom, no matter what happens in the long run with feeding, never forget that!!

Connor · 05-01-2012, 10:35 PM

Quote:

Originally Posted by clarinetb

Oh, and because sometimes you begin to forget and need someone to say it to you: you're doing amazing. I'm sure life is beginning to feel a bit muddled with all the feeding craziness! You're obviously a very strong woman and an awesome mom, no matter what happens in the long run with feeding, never forget that!!

Agreed

Connor · 05-03-2012, 08:30 PM

How are things going Mama?

Lizmarie · 05-03-2012, 08:50 PM

Impeccable timing lol, I had just pulled up the thread to look at it.

I just got back from the ER with LO :/. I called this morning to figure out the next step for the cystic fibrosis testing, as the two sweat tests we've done have come back inconclusive, and while I was on the phone I set up an appointment for tomorrow morning in reference to what I think is increasing reflux in LO. I did this at 9am this morning.....at 4:30 this afternoon, the dr calls me and tells me I need to take him into the ER immediately because of his recent workups and the now wheezing/gasping sound he's making. The wheezing/gasping sound was me trying to describe the sounds he makes when he's refluxing, and is very inconsistent. It's not an active difficultly breathing, but I guess they were concerned about aspiration (funny, I was concerned about this two weeks ago when I first mentioned it to the dr), and CF in general. So I just spent the last five hours in the ER with him, doing a chest xray (that showed a spot, but they said it wasn't aspiration that they were concerned it was something viral, so they tested him for RSV and didn't provide me with results) and a pyloric stenosis study (negative, thank god). And guess what - he has severe reflux......which is what I tried to tell them at his two week appointment......just saying. The dr made me feed him while I was there (his supplemental formula) because she wanted to "see him vomit" (because she didn't believe me) and then sent us for the study - which required him to drink another two ounces of liquid during the ultrasound. So, not only as he already having reflux/vomitting from the formula, he now had an additional two ounces of liquid in him, and they made me have him on his back on the stretcher and wouldn't stop long enough for me to even burp him....so he vomited during the test and started full out choking because he was on his back. Scariest moment of my life

.

But, we also found out that he's just now back at his birth weight. He hits four weeks on Saturday. I'm so confused about this because they were happy with his weight gain at his two week appointment and he had hit 8lbs 4 oz then. Now, he's 8lbs 8oz. How has he only gained 4 oz in two weeks?!?! If that's the case then he was doing better before we even started fully supplementing?!? And, he was doing better with the original enfamil formula rather than this hypoallergenic alimentum formula that's leaving him only pooping once a day or every other day and spittig up even more. Or, does that just mean that the reflux is now full blown and he's LOOSING weight and it has nothing to do with the formula?

Either way - on the breastfeeding front. I still can't figure out his latch. I feel like it's maybe a little bit better, but it still hurts alot to latch him for more than one consecutive feed. I don't know if that means I have to go through the initial pain again since it's been so long since I latched him consistently or if it means his latch is still way off. He does latch better on the left than the right, and I think that may be because I have more scar tissue from my piercings in the right side, and my right breast/nipple is just bigger in general. I was also wondering if having scar tissue from prior piercings is part of the reason why he's not transfering milk as efficiently as he should?

I still don't know about a tongue tie, I'm going to inquire about it tomorrow when I see the pediatrician for the reflux. He does seem to be sucking better in general, both when latched, and on his pacifier/my finger. He seems to have the actual act of sucking down better where before he was just chomping with his gums, so that's probably a step in the right direction.

I started the more milk plus special blend the other day, and I've noticed maybe a slight increase. I think it would be more, but my pumping schedule has been all jacked up between the sweat test yesterday and then five hours at the ER tonight. I'm also trying to do compressions when pumping and when he's latched as I read that might speed up the flow a bit. It does seem to get him back into a regular sucking motion when he slows down, but he still seems to kind of peter out and act like he's done, and then I pull him off to burp and he's screaming for more, so Idk. I can't tell whether he's still hungry and not getting enough, or if he just looking to suck on something w/o actually needing further nutrition. The pacifier does seem to calm him down in most cases, but it takes a few minutes. If I could figure out the latch issues and resolve the pain/cracking then I would just let him stay on the breast and it wouldn't matter if he needed more nutrition or just to suck, it would solve the problem either way and probably help increase my supply as well!

I am totally convinced at this point that we never needed to supplement, and supplementing itself is what's caused the majority of our problems. I just needed to stick it out. He was getting enough milk, we just needed to get a helpful LC to solve the latch/efficient milk transfer issue to solve my pain/cracking/bleeding and we would have been fine. So frustrating now that we're stuck in this horrible cycle!

Connor · 05-03-2012, 09:45 PM

Quote:

Originally Posted by Lizmarie

I am totally convinced at this point that we never needed to supplement, and supplementing itself is what's caused the majority of our problems. I just needed to stick it out. He was getting enough milk, we just needed to get a helpful LC to solve the latch/efficient milk transfer issue to solve my pain/cracking/bleeding and we would have been fine. So frustrating now that we're stuck in this horrible cycle!

I agree with you on that Mama!! Not glad that he has reflux but glad that it's nothing more serious. So happy that he's getting "better" at nursing, that's def a good sign. Keep taking the MMSB and nurse as much as possible. If you can wean off the supplements I think the reflux, weight gain, and bowel movements will improve. I so hope that you can look back on this in a few months (with a beautiful nursing relationship) and be so proud of yourself and your determination

Lizmarie · 05-04-2012, 11:02 AM

So we went to the follow up appointment with the pediatrician after the ER visit last night.

She agreed that he definitely has reflux, and we're starting zantac 75mls 2x a day today.

She also agreed that it sounds like he's doing worse on the alimentum than he was on the enfamil, so said we could switch back if we were more comfortable. I think we'll go back to enfamil,but we'll go to the gentlese version to see if that helps with his gassiness.

She did look at him for tongue tie/lip tie and said that he looks fine. Definitely no tongue tie that she could see, and while he is slightly lip tied, she doesn't feel that it's enough to warrant clipping as it doesn't seem to be causing an issue at this point.

Then, she walked me over to see the lactation consultant who works out of that office! Apparently the person at the front desk is simply an idiot, who didn't know what she was talking about when I called to speak with her initially and the front desk person told me she didn't know when she would be back in or her schedule. She's there monday-friday form 7-4 unless she's on TDY for something. She sat down with me and watched me latch him. Gave me a few pointers on positioning - I had worked pretty much everything out after reading the book and talking to the LLL consultant, but she did have me bring him a bit further around me to make my life easier. She looked at his latch, and said he looks like he's latching perfectly. She asked me whether it hurt, and I explained that it doesn't hurt at this point to get him initially latched, or while he's on (unless he starts his gymnastics

), but that I have creasing still and pain/cracking/creasing/bleeding if I latch him for EVERY feed rather than every other or every two feedings as I've been doing. We came to the conclusion that it's likely due to scar tissue from having dual piercings in each nipple, and that there's not much we can do about it. It may or may not resolve itself, but he is latching correctly now, and he is sucking correctly now both of which are huge improvements over where he was. Now, it's just a matter of whether I want to attempt to latch him every time, deal with the pain and hope it resolve eventually or if I want to continue pumping instead.

I'm going to try latching him every feed and treat pre-emptively with lanolin, gel pads, etc as much as possible for now and hope it gets better. I'm hoping that by doing this I can nurse him and then pump right after and get my supply back up? In the meantime, she suggested I nurse then supplement about an oz until I can hopefully resolve the supply issue. The oz is really just a guesstimate because w/o a scale at home we don't know how much he's getting. She also said I can bring him in whenever for a weight w/o an appointment.

I also think I'll go back to the support meetings at the hospital. The LCs weren't helpful really but its an easy avenue to be able to weigh, feed, and weigh again to see how much he's transferring.

Any other suggestions on how to to treat the pain and cracking that is likely to come back with a vengeance?

Connor · 05-04-2012, 12:34 PM

I think you have a pretty good plan with nursing then pumping to "re-establish) your supply. I don't know that I would supplement an ounce after every feed, maybe an oz after some feedings or a half oz after feedings. Also, just because he will take a bottle after nursing does not mean that he was still hungry and didn't get enough at the breast. Most babies will easily gulp down a bottle, when bottle feeding it's really easy to overfeed. Not that you are overfeeding just explaining that he will likely still gulp down a bottle and that it isn't an indication of anything. Any way you could take like 2-3 and do constant skin to skin contact, warm baths together, and just nurse, nurse, nurse? I really think it would help!

Oh, and I'm glad you were finally able to sit down with an LC! Yay.

clarinetb · 05-04-2012, 12:42 PM

You are amazing mama!! Wow! I'm sorry to hear you feel (and probably rightly so.. ) that the supplementing was the mistake the medical community suggested and probably make things harder

This is why many of us get so upset hearing all the stories - because it shouldn't be this hard! It can be hard to learn the dance with your baby, but the medical community shouldn't be making it harder!!

Lanolin - I personally would suggest the Medela Tender Care over the Lansinoh (I used it both times, but then got samples of the tender care and it is soooo much nicer to rub in, soft and smooth to rub in, the lansinoh is very sticky and you have to warm it a lot)
Our LC also swore by Calendula, a fairly natural option in cases where you don't need a medicated cream. Can't remember if I mentioned it before, excuse me if I did! but she has a nice method of protecting nipples to heal. She'd take a tissue, fold to make a triangle then twist either end (kind of like you'd twist the ends on a little candy) and keep twisting til you have a roll, then she'd make it into a circle, about around your two fingers, you want it a bit larger then your nipple as you don't want the circle touching and kind of "tie" it a little to keep a circle shape. She'd suggest putting the Calendula on generously on the nipples, then you're little 'tissue donut' over top, then the bra. The idea is that you want moist healing for the nipples (same idea as with lanolin) and the donut is suppose to prevent the nipple being squished flat, which can hurt and changes the shape. I found it worked real well!!

That is ridiculous about the doctor's office LC!! But glad you got to see her and chat with someone in person! Sounds like you have someone there you can follow-up with if things don't seem quiet right, which is nice.

Sorry your little guy is having such bad reflux! Scary and not fun, but is better than some of the scary options

That isn't good that he isn't gaining now - but the one slightly positive thing is that you KNOW it isn't the breastmilk and supply thing that is resulting in slow gain

You will likely have to repeat that to them later if he continues to gain slowly :P Hope everything turns out alright. Poor little guy, especially feeding on his back, ack! They KNOW babies tend to aspirate when you do that

Good luck with everything and hope you have some positive updates going forward.

clarinetb · 05-04-2012, 12:44 PM

Yes, very good point, just because he'll take the ounce doesn't mean that he didn't get enough at the breast, it is easy to take the bottle if he wants some more sucking

My little one would sometimes take the top up with the bottle and then fuss and we knew how much she got with weighing, etc, but I think the issue is that they get less sucking time with a bottle, so she'd eat quick but wanted to suck...

05-01-2012, 10:11 PM	#61
clarinetb Registered Users Join Date: Mar 2007 Location: Canada! Posts: 3,676 Ratings: 159 Feedback: 100% My Mood:	Re: Help with Ameda pump and increasing supply If you are considering the domperidone option, here is a great article written by Jack Newman, who is an internationally recognized expert on breastfeeding (his book is great BTW!) for you to have a look at: http://www.facebook.com/note.php?not...33955666638379 You can take domperidone with the herbs (fenugreek, blessed thistle, goat's rue) if you wind up going that route and get your supply up, you can always vary it up to see what you need to continue taking, if anything. Best suggestion for the nippleshield I was given is to put lanolin on the back of the flat part to kind of glue it to the breast :P They are a bit fiddly but that at least kept it in place (I was an hysterical mess trying that WITH the tube to supplement at the breast, tricky for one person :P ) If you can get that going and he'll go for it, you might want to try the feeding tube at the breast, you can get the tube going in behind the nippleshield, I found I need to seal around the side with lanolin on the side of the tube so there wasn't air coming in to the part where your nipple is, but if you can do it, it would give more stimulation to the breast even while he is getting formula. The alimentum has nothing to be allergic to, completely broken down, so that is interesting that he is having problems with that. I know they use that formula for babies with severe allergies and milk protein allergies because there aren't any proteins to react to... I'm glad you finally got someone to really talk with you. Personally, once life is under control again, I'd file a complaint about the LC at the hospital. The advise has been ridiculous and definitely doesn't sound like an IBCLC to me, plus if they say they're away a week and to get in touch the next week, I'd figure I had an appointment! not to be continually brushed off to call back "in case" she has time the next day. I am so sorry to hear you're been treated like that. I agree with others, sometimes you need different people to see/talk to in order to get somewhere (it is unfortunate! Cause if someone says they are an LC and you talk to them, you expect to be getting good support!!) I did a google search and found a couple IBCLC listed for Richmond, VA... might be worth calling. Someone good should be able to help look if there are abnormalities that would cause problems nursing as well as help with latching, etc and actually SIT with you and watch and help in person! http://www.lowmilksupply.org/lc.shtml (search for Richmond on the page and there were two) http://www.wellness.com/dir/2871306/...s-llc-rn-ibclc (she is listed above as well, says RN and IBCLC, I have a slight bias towards people with nursing experience as well if you think there is something else going on - lady who was our big help was an RN and LC for 35 years so knew her stuff!) Hand expression: http://www.youtube.com/watch?v=6ZViuYKX5LU What you're describing is probably normal, the suggestion is usually for something fairly wide to collect the milk in, for a reason :P It is wonderful to hear that you are able to get your little guy latched on part of the time and are still working on that. __________________ Lauren - Mama to our little poppet (21-01-07) and new cutie pie (23-08-11)!

05-01-2012, 10:19 PM	#62
clarinetb Registered Users Join Date: Mar 2007 Location: Canada! Posts: 3,676 Ratings: 159 Feedback: 100% My Mood:	Re: Help with Ameda pump and increasing supply Oh, and because sometimes you begin to forget and need someone to say it to you: you're doing amazing. I'm sure life is beginning to feel a bit muddled with all the feeding craziness! You're obviously a very strong woman and an awesome mom, no matter what happens in the long run with feeding, never forget that!! __________________ Lauren - Mama to our little poppet (21-01-07) and new cutie pie (23-08-11)!

05-03-2012, 08:30 PM	#64
Connor Registered Users Join Date: Mar 2010 Posts: 2,722 Ratings: 31 Feedback: 100%	How are things going Mama? __________________ Single Mommy to my 3 year old DS born all natural. We are a Cosleeping, Breastfeeding, Babywearing Non-Vaxing DUO!!

05-03-2012, 08:50 PM	#65
Lizmarie Registered Users Join Date: Nov 2011 Posts: 130 Ratings: 1 Feedback: 100%	Re: Help with Ameda pump and increasing supply Impeccable timing lol, I had just pulled up the thread to look at it. I just got back from the ER with LO :/. I called this morning to figure out the next step for the cystic fibrosis testing, as the two sweat tests we've done have come back inconclusive, and while I was on the phone I set up an appointment for tomorrow morning in reference to what I think is increasing reflux in LO. I did this at 9am this morning.....at 4:30 this afternoon, the dr calls me and tells me I need to take him into the ER immediately because of his recent workups and the now wheezing/gasping sound he's making. The wheezing/gasping sound was me trying to describe the sounds he makes when he's refluxing, and is very inconsistent. It's not an active difficultly breathing, but I guess they were concerned about aspiration (funny, I was concerned about this two weeks ago when I first mentioned it to the dr), and CF in general. So I just spent the last five hours in the ER with him, doing a chest xray (that showed a spot, but they said it wasn't aspiration that they were concerned it was something viral, so they tested him for RSV and didn't provide me with results) and a pyloric stenosis study (negative, thank god). And guess what - he has severe reflux......which is what I tried to tell them at his two week appointment......just saying. The dr made me feed him while I was there (his supplemental formula) because she wanted to "see him vomit" (because she didn't believe me) and then sent us for the study - which required him to drink another two ounces of liquid during the ultrasound. So, not only as he already having reflux/vomitting from the formula, he now had an additional two ounces of liquid in him, and they made me have him on his back on the stretcher and wouldn't stop long enough for me to even burp him....so he vomited during the test and started full out choking because he was on his back. Scariest moment of my life . But, we also found out that he's just now back at his birth weight. He hits four weeks on Saturday. I'm so confused about this because they were happy with his weight gain at his two week appointment and he had hit 8lbs 4 oz then. Now, he's 8lbs 8oz. How has he only gained 4 oz in two weeks?!?! If that's the case then he was doing better before we even started fully supplementing?!? And, he was doing better with the original enfamil formula rather than this hypoallergenic alimentum formula that's leaving him only pooping once a day or every other day and spittig up even more. Or, does that just mean that the reflux is now full blown and he's LOOSING weight and it has nothing to do with the formula? Either way - on the breastfeeding front. I still can't figure out his latch. I feel like it's maybe a little bit better, but it still hurts alot to latch him for more than one consecutive feed. I don't know if that means I have to go through the initial pain again since it's been so long since I latched him consistently or if it means his latch is still way off. He does latch better on the left than the right, and I think that may be because I have more scar tissue from my piercings in the right side, and my right breast/nipple is just bigger in general. I was also wondering if having scar tissue from prior piercings is part of the reason why he's not transfering milk as efficiently as he should? I still don't know about a tongue tie, I'm going to inquire about it tomorrow when I see the pediatrician for the reflux. He does seem to be sucking better in general, both when latched, and on his pacifier/my finger. He seems to have the actual act of sucking down better where before he was just chomping with his gums, so that's probably a step in the right direction. I started the more milk plus special blend the other day, and I've noticed maybe a slight increase. I think it would be more, but my pumping schedule has been all jacked up between the sweat test yesterday and then five hours at the ER tonight. I'm also trying to do compressions when pumping and when he's latched as I read that might speed up the flow a bit. It does seem to get him back into a regular sucking motion when he slows down, but he still seems to kind of peter out and act like he's done, and then I pull him off to burp and he's screaming for more, so Idk. I can't tell whether he's still hungry and not getting enough, or if he just looking to suck on something w/o actually needing further nutrition. The pacifier does seem to calm him down in most cases, but it takes a few minutes. If I could figure out the latch issues and resolve the pain/cracking then I would just let him stay on the breast and it wouldn't matter if he needed more nutrition or just to suck, it would solve the problem either way and probably help increase my supply as well! I am totally convinced at this point that we never needed to supplement, and supplementing itself is what's caused the majority of our problems. I just needed to stick it out. He was getting enough milk, we just needed to get a helpful LC to solve the latch/efficient milk transfer issue to solve my pain/cracking/bleeding and we would have been fine. So frustrating now that we're stuck in this horrible cycle!

05-04-2012, 11:02 AM	#67
Lizmarie Registered Users Join Date: Nov 2011 Posts: 130 Ratings: 1 Feedback: 100%	Re: Help with Ameda pump and increasing supply So we went to the follow up appointment with the pediatrician after the ER visit last night. She agreed that he definitely has reflux, and we're starting zantac 75mls 2x a day today. She also agreed that it sounds like he's doing worse on the alimentum than he was on the enfamil, so said we could switch back if we were more comfortable. I think we'll go back to enfamil,but we'll go to the gentlese version to see if that helps with his gassiness. She did look at him for tongue tie/lip tie and said that he looks fine. Definitely no tongue tie that she could see, and while he is slightly lip tied, she doesn't feel that it's enough to warrant clipping as it doesn't seem to be causing an issue at this point. Then, she walked me over to see the lactation consultant who works out of that office! Apparently the person at the front desk is simply an idiot, who didn't know what she was talking about when I called to speak with her initially and the front desk person told me she didn't know when she would be back in or her schedule. She's there monday-friday form 7-4 unless she's on TDY for something. She sat down with me and watched me latch him. Gave me a few pointers on positioning - I had worked pretty much everything out after reading the book and talking to the LLL consultant, but she did have me bring him a bit further around me to make my life easier. She looked at his latch, and said he looks like he's latching perfectly. She asked me whether it hurt, and I explained that it doesn't hurt at this point to get him initially latched, or while he's on (unless he starts his gymnastics ), but that I have creasing still and pain/cracking/creasing/bleeding if I latch him for EVERY feed rather than every other or every two feedings as I've been doing. We came to the conclusion that it's likely due to scar tissue from having dual piercings in each nipple, and that there's not much we can do about it. It may or may not resolve itself, but he is latching correctly now, and he is sucking correctly now both of which are huge improvements over where he was. Now, it's just a matter of whether I want to attempt to latch him every time, deal with the pain and hope it resolve eventually or if I want to continue pumping instead. I'm going to try latching him every feed and treat pre-emptively with lanolin, gel pads, etc as much as possible for now and hope it gets better. I'm hoping that by doing this I can nurse him and then pump right after and get my supply back up? In the meantime, she suggested I nurse then supplement about an oz until I can hopefully resolve the supply issue. The oz is really just a guesstimate because w/o a scale at home we don't know how much he's getting. She also said I can bring him in whenever for a weight w/o an appointment. I also think I'll go back to the support meetings at the hospital. The LCs weren't helpful really but its an easy avenue to be able to weigh, feed, and weigh again to see how much he's transferring. Any other suggestions on how to to treat the pain and cracking that is likely to come back with a vengeance?