Author Topic: Evidence based breastfeeding for mustachians  (Read 26464 times)

little_brown_dog

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Re: Evidence based breastfeeding for mustachians
« Reply #200 on: August 29, 2017, 01:23:20 PM »
Unfortunately I think everyone is different on the post-baby boob changes. I know many women report a loss of “perk” or lift after experiencing pregnancy and breastfeeding. My understanding is that the increase in sagginess of the boobs post pregnancy and breastfeeding has to do with a loss of elasticity in the skin and tissue of the breast due to all that rapid growth and then subsequent deflation. Loss of skin elasticity is also exacerbated by the natural aging process.  For the floppiness or the boob itself, at only a month out, your breasts are still in the process of switching over their tissue structure, which can take months. You might find that once they go back to more fatty tissue that they develop a fuller, less-deflated appearance, even if they do ride a bit lower than before. I wouldn't panic just yet at only 1 month out....6 months from now you will probably have a more accurate idea of what your future boobs are more likely to look like.

My boobs stayed larger than my pre-baby days after I weaned despite losing all the baby weight, and they definitely are a bit saggier than before baby (not particularly obvious, but noticeable to me). With this 2nd pregnancy, they got huge fast and are now really big – much bigger than they were first time around at this stage. I’m emotionally preparing myself for the fact that I’ll probably never get those perky little boobs back from my early 20s, especially after 2 kids. Ah well.

Flyingkea

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Re: Evidence based breastfeeding for mustachians
« Reply #201 on: August 29, 2017, 05:36:07 PM »
With regards to the perkiness afterwards, the ABA counsellor that attended our meetings said that the sagginess was caused by pregnancy so there was nothing we could do to avoid it in the first place.
However, she did say that to help with reducing sagginess afterwards, to try to wean gradually if possible. I can't remember the full explanation why, but it was along the lines of allowing the skin time to adjust, and 'destretch' whereas if you wean quickly your body has a rapid change, which can lead to more stretch marks, + the skin hasn't shrunk as well.
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lifejoy

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Re: Evidence based breastfeeding for mustachians
« Reply #202 on: August 30, 2017, 04:40:05 AM »
I love this thread. I'm trying to catch up - so much great info!

I've been EBF for three weeks and it's been tough at times, especially the beginning. I've seen multiple LCs and received a ton of excellent support.

I've been consuming delicious lactation cookies: http://www.organicmamacafe.com/2012/07/flourless-lactation-cookies-monster-cookie-style/

One thing that stands out to me is that my husband meant to be supportive but it really felt invalidating (as said on a previous page) when he repeatedly suggested pumping or formula. He just wanted me to stop being in pain and be able to sleep more, but I wanted him to say, "You got this. And I'll support you in any way you like."

In fact, there was a great Kelly Mom article that spoke to this but I can't find it again :/

Great thread, thanks for creating!

dumbblond

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Re: Evidence based breastfeeding for mustachians
« Reply #203 on: August 30, 2017, 12:36:29 PM »
Thank you, all, for creating and reviving this thread! I'm due in November with our third, and I was unable to nurse either of my first two past their first week of life.

Reading through all of the posts just made more and more things about my experience make sense, and it's given me hope that maybe with my third we will be able to have more success with breastfeeding.

Chesleygirl

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Re: Evidence based breastfeeding for mustachians
« Reply #204 on: August 30, 2017, 09:38:37 PM »
Unfortunately I think everyone is different on the post-baby boob changes. I know many women report a loss of “perk” or lift after experiencing pregnancy and breastfeeding. My understanding is that the increase in sagginess of the boobs post pregnancy and breastfeeding has to do with a loss of elasticity in the skin and tissue of the breast due to all that rapid growth and then subsequent deflation. Loss of skin elasticity is also exacerbated by the natural aging process.  For the floppiness or the boob itself, at only a month out, your breasts are still in the process of switching over their tissue structure, which can take months. You might find that once they go back to more fatty tissue that they develop a fuller, less-deflated appearance, even if they do ride a bit lower than before. I wouldn't panic just yet at only 1 month out....6 months from now you will probably have a more accurate idea of what your future boobs are more likely to look like.

I am having to consider breast reduction surgery at this point after having 2 pregnancies. Losing weight has not helped, at all. They stay the same size. Doing chest presses at the gym doesn't help either. It's just given me really strong arms now.

The only thing that will help is surgery. Which insurance does not cover. I might consider getting surgery, though. And just paying for it. I can't deal with this!

lifejoy

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Re: Evidence based breastfeeding for mustachians
« Reply #205 on: September 01, 2017, 10:10:33 AM »
Can I ask a breastfeeding-related question here?

My right breast is having a sharp stabbing pain very infrequently. Since yesterday. Google makes me fear thrush or worse. The pain is very infrequent and not SO bad. If it got worse I'd go to the doctor. But maybe I should be doing something else?

NeonPegasus

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Re: Evidence based breastfeeding for mustachians
« Reply #206 on: September 01, 2017, 10:40:50 AM »
Can I ask a breastfeeding-related question here?

My right breast is having a sharp stabbing pain very infrequently. Since yesterday. Google makes me fear thrush or worse. The pain is very infrequent and not SO bad. If it got worse I'd go to the doctor. But maybe I should be doing something else?

I used to get that and it was so random. I don't think you have to worry about thrush, at least not yet. You can check your baby's gums and tongues for signs. If it's thrush, it'll be coated in white that doesn't come off when you lightly scrape. Your nipple and areola will also get red.

Keep an eye on it. Hang out with your flaps down when you can to make sure things air out. If you do suspect thrush, you can rub monistat directly on your nipples and it'll be fine for both you and baby.

I found that it was just one of those weird things that happened when I nursed. :/

lifejoy

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Re: Evidence based breastfeeding for mustachians
« Reply #207 on: September 01, 2017, 11:10:38 AM »
Can I ask a breastfeeding-related question here?

My right breast is having a sharp stabbing pain very infrequently. Since yesterday. Google makes me fear thrush or worse. The pain is very infrequent and not SO bad. If it got worse I'd go to the doctor. But maybe I should be doing something else?

I used to get that and it was so random. I don't think you have to worry about thrush, at least not yet. You can check your baby's gums and tongues for signs. If it's thrush, it'll be coated in white that doesn't come off when you lightly scrape. Your nipple and areola will also get red.

Keep an eye on it. Hang out with your flaps down when you can to make sure things air out. If you do suspect thrush, you can rub monistat directly on your nipples and it'll be fine for both you and baby.

I found that it was just one of those weird things that happened when I nursed. :/

The fact that that's an option is a total relief! Thanks :) I'll keep an eye on things.

little_brown_dog

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Re: Evidence based breastfeeding for mustachians
« Reply #208 on: September 01, 2017, 11:45:14 AM »
Odd sensations can be normal with breastfeeding – the key is to make sure it isn’t frequent/chronic or getting worse. If the sensation is in the breast itself and not the nipple area, it’s possible you might have a duct that is starting to clog up (one of the most common breastfeeding issues). If that’s the case make sure the boob is drained fully at every feeding (should go from swollen/firmer before feeding, to soft and floppy with practically nothing coming out if you hand express). You can also use some warm, wet heat (showers, bean bags or hot water bottles wrapped in damp facecloths, etc) and massage the area gently throughout the day to try to get ahead of the issue if you suspect it is a possible clog. Ducts clog when they don’t drain fully or sometimes when they get too compressed for too long (like if you sleep on your boob). A full blown clogged duct will often manifest as a really sore/tender area, often with flu-like symptoms such as low grade fever, chills, aches, fatigue. You’ll know it if it gets worse. I don't remember experiencing pain before my clogged ducts would appear, but I did have pain during them.

lifejoy

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Re: Evidence based breastfeeding for mustachians
« Reply #209 on: September 01, 2017, 03:01:43 PM »
Odd sensations can be normal with breastfeeding – the key is to make sure it isn’t frequent/chronic or getting worse. If the sensation is in the breast itself and not the nipple area, it’s possible you might have a duct that is starting to clog up (one of the most common breastfeeding issues). If that’s the case make sure the boob is drained fully at every feeding (should go from swollen/firmer before feeding, to soft and floppy with practically nothing coming out if you hand express). You can also use some warm, wet heat (showers, bean bags or hot water bottles wrapped in damp facecloths, etc) and massage the area gently throughout the day to try to get ahead of the issue if you suspect it is a possible clog. Ducts clog when they don’t drain fully or sometimes when they get too compressed for too long (like if you sleep on your boob). A full blown clogged duct will often manifest as a really sore/tender area, often with flu-like symptoms such as low grade fever, chills, aches, fatigue. You’ll know it if it gets worse. I don't remember experiencing pain before my clogged ducts would appear, but I did have pain during them.

Great tips, thank you!

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Re: Evidence based breastfeeding for mustachians
« Reply #210 on: September 05, 2017, 11:17:59 AM »
I occasionally got random "stabbing" sensations in my breasts during the time I was nursing (though not necessarily while my kid was actively feeding).  Like you mention, LifeJoy, they happened infrequently and they weren't that bad, but kind of weird.  Sometimes they seemed tied to thinking about my child or my child crying nearby, so I did wonder if it was some sort of production suddenly being stimulated.

I *did* get obviously clogged ducts a few times, just in one breast, and now that I think about it, that was the breast that got the stabby feeling more (it was also the breast that produced more milk when I pumped, and that my son generally seemed to prefer...).  I was lucky that I was able to get it cleared up quickly each time and never progressed into mastitis or a chronic occurance.  A hot washcloth and then lots of nursing did the trick the first two times, the last time the clog was actually right at the surface of the nipple and I wound up bursting it manually, which was crazy as I then had this out of control jet of milk going all over the place for a few minutes.  It was not something I would want to have happen regularly, but as a one-time experience, it was kind of cool.  Sort of like the satisfaction you get from popping a really big pimple, only moreso :)

lifejoy

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Re: Evidence based breastfeeding for mustachians
« Reply #211 on: September 06, 2017, 05:02:27 AM »
I occasionally got random "stabbing" sensations in my breasts during the time I was nursing (though not necessarily while my kid was actively feeding).  Like you mention, LifeJoy, they happened infrequently and they weren't that bad, but kind of weird.  Sometimes they seemed tied to thinking about my child or my child crying nearby, so I did wonder if it was some sort of production suddenly being stimulated.

I *did* get obviously clogged ducts a few times, just in one breast, and now that I think about it, that was the breast that got the stabby feeling more (it was also the breast that produced more milk when I pumped, and that my son generally seemed to prefer...).  I was lucky that I was able to get it cleared up quickly each time and never progressed into mastitis or a chronic occurance.  A hot washcloth and then lots of nursing did the trick the first two times, the last time the clog was actually right at the surface of the nipple and I wound up bursting it manually, which was crazy as I then had this out of control jet of milk going all over the place for a few minutes.  It was not something I would want to have happen regularly, but as a one-time experience, it was kind of cool.  Sort of like the satisfaction you get from popping a really big pimple, only moreso :)

Ha! Crazy story! And thanks for the tips :)

lifejoy

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Evidence based breastfeeding for mustachians
« Reply #212 on: September 06, 2017, 05:04:04 AM »
Regarding latch:

If baby is getting fed enough milk (as evidenced by weeks of great weight gain), if feedings are efficient enough, if my nipples are not in pain, is that a good enough latch?

I ask because sometimes the latch is not as deep as I know it could be, but everything else seems fine... wondering if I should constantly attempt to perfect the latch or if good enough is good enough.

iowajes

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Re: Evidence based breastfeeding for mustachians
« Reply #213 on: September 06, 2017, 06:31:31 AM »
Regarding latch:

If baby is getting fed enough milk (as evidenced by weeks of great weight gain), if feedings are efficient enough, if my nipples are not in pain, is that a good enough latch?

I ask because sometimes the latch is not as deep as I know it could be, but everything else seems fine... wondering if I should constantly attempt to perfect the latch or if good enough is good enough.

As far as I'm concerned: yes.

Daughter now transfers quite efficiently, is gaining great, is chunking up, I'm not in pain.  But her latch is shallow and sometimes it looks like she only has nipple not aerola.   Can't figure out what the point in trying to fix it is. She's happy, I'm happy. Who cares about textbook?

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Re: Evidence based breastfeeding for mustachians
« Reply #214 on: September 06, 2017, 07:02:00 AM »
Regarding latch:

If baby is getting fed enough milk (as evidenced by weeks of great weight gain), if feedings are efficient enough, if my nipples are not in pain, is that a good enough latch?

I ask because sometimes the latch is not as deep as I know it could be, but everything else seems fine... wondering if I should constantly attempt to perfect the latch or if good enough is good enough.

As far as I'm concerned: yes.

Daughter now transfers quite efficiently, is gaining great, is chunking up, I'm not in pain.  But her latch is shallow and sometimes it looks like she only has nipple not aerola.   Can't figure out what the point in trying to fix it is. She's happy, I'm happy. Who cares about textbook?
Sometimes my baby has just a little more than the nipple in his mouth, sometimes he has a giant chunk of boob. I'm with iowajes - as long as I'm not in pain, he's draining the boob and he gets happy and satisfied, I'm very happy and satisfied :)

lifejoy

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Re: Evidence based breastfeeding for mustachians
« Reply #215 on: September 06, 2017, 07:09:42 AM »
Yay! Good enough IS good enough!

little_brown_dog

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Re: Evidence based breastfeeding for mustachians
« Reply #216 on: September 06, 2017, 10:55:31 AM »
Yay! Good enough IS good enough!

Yup. The pragmatic definition of a good latch is one that: 1 – effectively transfers enough milk and keeps baby satisfied and gaining well, and 2 – one that is comfortable, not painful for mom and does not result in damage or harm to the nipple/surrounding tissue. If you meet both criteria, then you have a good latch even if it doesn’t seem to be exactly the same as some of the “perfect” latch demos you might see in breastfeeding resources. Every mom and baby are different in terms of baby’s mouth structure/size/ability to open, and mom’s nipple size and breast shape. As a result, a perfect latch varies widely because the exact “hardware” is different for every breastfeeding dyad.

chaskavitch

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Re: Evidence based breastfeeding for mustachians
« Reply #217 on: September 06, 2017, 11:49:01 AM »
Yay! Good enough IS good enough!

Yup. The pragmatic definition of a good latch is one that: 1 – effectively transfers enough milk and keeps baby satisfied and gaining well, and 2 – one that is comfortable, not painful for mom and does not result in damage or harm to the nipple/surrounding tissue. If you meet both criteria, then you have a good latch even if it doesn’t seem to be exactly the same as some of the “perfect” latch demos you might see in breastfeeding resources. Every mom and baby are different in terms of baby’s mouth structure/size/ability to open, and mom’s nipple size and breast shape. As a result, a perfect latch varies widely because the exact “hardware” is different for every breastfeeding dyad.

The only reason I can think of to try to "perfect" your latch is plugged ducts/mastitis.  My kid has one of these good enough latches, but all of the three plugged ducts I have had progressed to mastitis, and only one of them cleared up without antibiotics.  I felt (perhaps wrongly) that if he had a deeper latch, he might have been more able to clear the plugged duct during nursing, and I might have been able to avoid the awful week of fever and pain each time. 

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Re: Evidence based breastfeeding for mustachians
« Reply #218 on: September 10, 2017, 06:14:40 PM »
Sigh, I've ended up with a plugged duct. Best strategies for fixing it? I figured a hot shower & pumping while massaging, I've also been using different holds with my baby to hopefully get his suck to clear it out. Is there anything else helpful I can do?

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Re: Evidence based breastfeeding for mustachians
« Reply #219 on: September 10, 2017, 08:26:01 PM »
https://www.breastfeeding.asn.au/bf-info/common-concerns–mum/blocked-ducts

This is from the ABA.
I have also heard some mums get good results from massaging with electric toothbrushes, or vibrators. (Haven't tried it myself as I've never knowingly had one)
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Anatidae V

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Re: Evidence based breastfeeding for mustachians
« Reply #220 on: September 10, 2017, 10:36:53 PM »
https://www.breastfeeding.asn.au/bf-info/common-concerns–mum/blocked-ducts

This is from the ABA.
I have also heard some mums get good results from massaging with electric toothbrushes, or vibrators. (Haven't tried it myself as I've never knowingly had one)
Thanks for that, I forgot about checking there! I probably shouldn't have pumped, I hope it doesn't increase my supply, but it cleared the milk & then the lump shifted as soon as baby had a feed. Holding a heat pack on my boob was tricky but I'm pretty sure it helped, and I couldn't have held it while he was feeding, I suppose.


NeonPegasus

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Re: Evidence based breastfeeding for mustachians
« Reply #222 on: September 11, 2017, 02:32:45 PM »
If you keep having trouble with plugged ducts, some moms have had success supplementing with soy lecithin. If you're able to dislodge it okay and don't develop mastitis, it probably wouldn't be worth the effort.

chaskavitch

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Re: Evidence based breastfeeding for mustachians
« Reply #223 on: September 12, 2017, 06:16:14 AM »
If you keep having trouble with plugged ducts, some moms have had success supplementing with soy lecithin. If you're able to dislodge it okay and don't develop mastitis, it probably wouldn't be worth the effort.

A million times yes to soy lecithin if you can't get rid of the plug.  I think I put this in upthread too, but I really truly believe it was the deciding factor the first time I got mastitis (after constant massage, two types of antibiotics, heat and cold packs, hot showers, immersing my breast in a bowl of hot salt water because I was willing to try ANYTHING, dangle feeding, feeding exclusively on that side, and vibration (I decided it was worth it to at least try, lol)). 

Anatidae V

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Re: Evidence based breastfeeding for mustachians
« Reply #224 on: September 12, 2017, 06:41:23 AM »
If you keep having trouble with plugged ducts, some moms have had success supplementing with soy lecithin. If you're able to dislodge it okay and don't develop mastitis, it probably wouldn't be worth the effort.

A million times yes to soy lecithin if you can't get rid of the plug.  I think I put this in upthread too, but I really truly believe it was the deciding factor the first time I got mastitis (after constant massage, two types of antibiotics, heat and cold packs, hot showers, immersing my breast in a bowl of hot salt water because I was willing to try ANYTHING, dangle feeding, feeding exclusively on that side, and vibration (I decided it was worth it to at least try, lol)).
I'll keep this in mind, there is some in the Milo I have been drinking a lot of, but I suspect it's very low amounts.

My LC sent me this video:
https://m.youtube.com/watch?feature=youtu.be&v=GnBY3w9aVyo
Thanks for that, I will be watching it a few times!

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Re: Evidence based breastfeeding for mustachians
« Reply #225 on: September 12, 2017, 08:00:03 AM »
My son is 15 now and I still remember the pain of mastitis...happened at the end of weaning...thank goodness it didn't happen all year long! (first experience was hard, second easy)    My daughter (12 now) didn't cause any problems.

I remember being told to point his chin toward the clog and to make sure to manually express it entirely...it was gross - he wasn't that interested and when I manually expressed it all out - it was clearly pus so no wonder he hesitated!   Hot showers and definitely take care of it as soon as you notice!

Anyhow, some parts of motherhood will sear in your brain forever! 

Good luck
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« Reply #226 on: September 24, 2017, 04:57:34 PM »
My baby girl was born on the 15th, we are breastfeeding but are off to a rough start. First we had latch issues, I have very soft short nipples and she had an uncoordinated suck (but strong!). I was given a nipple shield to use, she had bruised one of my nipples right off the bat. Additionally, within hours of birth her blood sugar plummeted. We had to supplement with formula to bring it back up. Fortunately we had a great lactation consultant that set us up with a supplemental nursing system (SNS) which worked decent with the nipple shield since you can just run the tube under the shield. She had me start pumping every 3 hours (hand expressing before and after too) and baby girl was given some supplemental formula at the same 3 hour interval. We followed a set of guidelines for how much to supplement for each feed daily which increased each day. We would give expressed breast milk as the first part of the necessary volume of supplement and then formula to reach the total. She also nursed anytime she asked (in addition to the 3 hour feedings.) Her blood sugar improved and we left the hospital on this regimen. She lost weight, started at 9lbs and was 8lbs 7oz at discharge. At her 72 hour appointment with her pediatrician she had lost even more weight and was 8lbs 4oz. The pediatrician wasn't concerned as it was still less than 10%. But he was concerned about how long she was nursing for (45ish minutes each? And I was pumping every 3 hours, super tired momma). He said she should only spend 10 minutes per breast and I should pump for 10 minutes after. He said we should stop supplementing too. I did tell him I was concerned with her latch but he felt there wasn't anything that bad. We met with the office's lactation consultant and she tweaked my nursing position a bit (both football hold and cross cradle) and said we could come back it 2 days to double check her weight.

I broke down and cried that afternoon because DH was frustrated and I was frustrated and she'd cry if she didn't eat for longer. The doctor specifically said he thought she was using me as a pacifier so I cried about that too. My husband suggested going to a bottle so I cried about that.

We had a home visit from another lactation consultant (3rd one involved if you're keeping track) the next day. My milk came in the day before (so much! I looked like I had a bad boob job) and I was told that I could stop the every 3 hour pump and just pump to comfort. This consultant gave me a and my husband a fabulous pep talk. We were officially off formula too! I continued to let her eat as she wished but she gets sleepy so we worked on that.

On Friday we took her in for another weight check and she'd lost another 2 oz. :( At this point she is right on the edge of a 10% drop. I had a bit of engorgement so I used cabbage to help (thanks for the pro top lifejoy! It only took 2 20 minute treatments). They basically told me to keep doing what I am doing and to come back in Monday for another weight check. We figured we'd have a nice weekend of baby wearing and nursing and cuddles and hope it helps.

Well I let DH take the first sleep shift last night, but she went down for a bit so I got in an hour and a half of sleep. I woke up to feed her again before he took over so I could get a decent stretch of sleep. I started feeling really cold but grabbed an extra blanket and tried to sleep. After an hour I was still completely freezing with chills. DH brought me a dose of 800mg Motrin an extra blanket and socks. Not much help. I asked him to check my temperature and it came back 101°F. We triple checked it but saw the same result every time. I called my OB and she said I needed to go to the ER. (details in the pregnancy thread) Bottom line baby got a bottle this morning because I didn't want her in the ER exposed to all the yuck. It wasn't as slow a flow bottle as I thought, DH said she took down 4oz of pumped breast milk in 10 minutes (two 5 minute sessions.) She went straight into a milk coma and slept for 4 hours straight, I had to wake her up to get her to eat again.

I'm on an antibiotic now (infection of some kind, not mastitis),  but was told it was safe for breastfeeding and encouraged to continue breastfeeding.

Baby girl has been inconsolable unless she's on my breast the rest of this afternoon, I have had no sleep since midnight last night (it's nearly 4pm now). I just threw in the towel and am supplementing with her with pumped breast milk with the SNS at the nipple. She only ate a half oz and hit milk coma status.

At this point I'm still concerned we have a latch issue though the lactation consultants think it looks like I'm doing what I can. I need to sleep to recover, I'm reaching the point of going to bottle to recover but I don't want to lose the potential to breastfeed.

I guess let me know if you have any advice, sympathy is appreciated too.

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Re: Evidence based breastfeeding for mustachians
« Reply #227 on: September 24, 2017, 05:24:26 PM »
And she's awake and screaming... Forgot to mention while she's having enough wet diapers, she hasn't pooped since Wednesday...

Supplemented another half oz, but tried to make it flow faster. She's out again.

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Re: Evidence based breastfeeding for mustachians
« Reply #228 on: September 24, 2017, 05:33:26 PM »
I'm so happy your LC was/is a great support!! And I'm thrilled that the cabbage leaves helped - omg so soothing, amiright? But be conscious that it can reduce your supply maybe, so use only as needed.

I'm surprised your babe is only supposed to eat at the breast for ten minutes? I'm going to watch the clock but I'm pretty positive that sometimes my baby feeds for longer. However sometimes she has a very shallow latch. It has definitely been getting better over time.

In the early days I was so depressed and distraught and every time she would latch on I would yelp in pain because it HURT. It is now week 7 and has been getting better all the time! Like week four it was maybe markedly better? I can't remember. But we're at a pretty good place now.

Try not to lose hope. You will be amazed at how quickly things can get better, however you decide to proceed. It is really really hard to function and keep up hope when you're sleep deprived. If you aren't already, let everything else slide so that you can sleep. Make your partner be sleep deprived if possible, because he can down coffee like crazy! And he can nap whenever!

Ok thinking of you and hoping your infection goes away asap and that you get some sleep <3

Let me know if I can help in any way! It gets better, all of it, I promise.

iowajes

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Re: Evidence based breastfeeding for mustachians
« Reply #229 on: September 24, 2017, 06:43:23 PM »
Breastfeeding is not easy, so while your struggles may be unique to you, struggling at first is normal.

A 10 minute limit surprises me. That seems very short. There might be some concern she is burning more calories than she is getting for food, and getting her supplemented is more important, but if she is just using you as a pacifier, so? What's the problem with that? Your nipple is as good as a dummy, as long as she isn't hurting you. Calming and cuddling is one of Mom's jobs.

Do you have any breastfeeding clinics near you? Our hospital has a free one once a week and I was a regular the first 3 months. It was good to have regular check-ins with the LC, and the opportunity to do a weighted feed. Before her tongue tie was clipped, she would often only transfer a half ounce in 30 minutes. After it, she can do 2-3 ounces in only 5 or 10. We never had weight gain issues because she was on so much formula at first, but the weighted feeds really helped e trust her to know when she had enough when supplementing stopped.

At 6 months she eats anywhere from 5 minutes to 45. I know sometimes I'm a pacifier, and I have no problem with that. (She does take an actual pacifier at daycare, but we don't use one at home.)

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Re: Evidence based breastfeeding for mustachians
« Reply #230 on: September 24, 2017, 07:13:23 PM »
EY so sorry you're having these issues.  It sounds like we had very similar experiences (mine w DS when he was a newborn 3 yrs ago) -- latch issues, sleepy baby, nipple pain, and baby weight loss issues.  Oddly enough, my pediatrician ALSO wanted me to do no more than 10-12 mins on each side and then cut him off (he was kind of old school, not sure if this kind of advice is consistent with modern best practices).  When he told me that (at our 72hr appt I think?) I had already been nursing him for like 30-45 mins each side, so it seemed really odd to me that he wanted me to cut the sessions shorter.  He also wanted us to nurse every 2-3 hours even if baby was sleeping, and supplement with formula (and do the insane pumping regime that goes with that) until he started gaining more weight (or losing less).   The first 48 hours home were miserable - we were getting like no sleep, my milk hadn't come in yet, and to top it all off we had a major plumbing issue that resulted in basement flooding in the middle of our 2nd night home (not as bad as your ER visit but still we were like really???  this is happening NOW?).

Ultimately, a bunch of things happened that got us past the crisis mode.  My milk came in abundantly, so we were able to stop pumping; the lanolin nipple cream I was using started to help the excruciating nipple pain I was experiencing; and we figured out our own way of doing things that kept us relatively sane and got baby what he needed.  We rejected the 12 min limit but did generally try to keep it to 15 mins or so each side (this also helped my nipple pain).  We got better at positioning with the help of an experienced LC who did a home visit.  We tried to feed frequently but never got to the 10-12 sessions per 24 hrs that the pediatrician wanted us to do, and we also let DS sleep up to 4 or even 5 hours sometimes rather than wake him up.  In the end we settled into a good rhythm, DS stopped losing and started gaining weight, and we were able to get more chunks of sleep to maintain our sanity.  I still had nipple pain, especially right at the beginning of a feed, but that slowly and surely got better after 2-3 weeks postpartum (finally disappearing around 6-7 weeks I think? similar to what lifejoy was saying I think).  And even though the first few weeks were so exhausting, painful and hard, I ended up bfing until DS was something like 20-21 months old, mostly just because it was easier to keep going than out of any particular goal to go that long.

So I guess I'd just say, so many of us go through these kinds of issues, and hang in there (but also allow yourself to cry about it...I did a lot of that for sure!!!).  For most people it gets way better each day/week and you figure out a way forward that works for you (whether that involves supplementing or not).  Am sure LBD will chime in with her usual expert advice, as will others!  Just wanted to send you lots of sympathy and support - you're going through a lot and doing the best you can! Hugs.

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Re: Evidence based breastfeeding for mustachians
« Reply #231 on: September 24, 2017, 07:43:49 PM »
Have you tried giving her a pacifier while Dad holds her so you can get some sleep? The "mums mental health VS baby eating" was ROUGH for us for at least the first 2 weeks, and honestly still is at 5 months but, like Lifejoy, the actual breastfeeding was way easier around 4 weeks or so.

Maybe the ped wants you to keep switching sides of boob to help milk production? Other than that, I'm very sure we took 20 minutes per side to start with. I was also advised not to go longer than 4 hours, and to wake up baby if needed, because he had slight jaundice to start with. I can see why they want you to feed regularly, with the weight issue and initial blood sugar problem. Can you take 1 long break by giving a feed, you go straight to bed, then Dad does a feed, then you wake to feed or pump at her next feed time? Just today, to get some rest? Then see how you do tomorrow. I know skipping pumping/feeding isn't recommended way on for milk supply, but if you haven't had sleep you will start going actually crazy and won't be able to feed her anyway.

((((!HUGS))))))))

iowajes

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Re: Evidence based breastfeeding for mustachians
« Reply #232 on: September 24, 2017, 08:10:11 PM »
We were waking the baby up every 2 hours during the day and every 3 (eventually switched to 4) overnight.

Never wake a sleeping baby would not have worked for us. She was such a sleepy baby she would have starved.

KBecks

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Re: Evidence based breastfeeding for mustachians
« Reply #233 on: September 24, 2017, 08:38:44 PM »
Since my youngest is now nearly 9 years old, I'm going to skip reading 5 pages about breastfeeding -- it's no longer relevant to my life!

But as a mom of 3, I found that breastfeeding and supplementation worked very well for us.  I also found that my three children nursed differently, one in particular was better at nursing than the other two.  I decided early on that a happy medium between some breast milk and some formula would give us some benefits -- a lot less stress on me, the ability for my husband to help out, and no freaking out over production and latching and everything else.

I'm really glad that formula is available to help moms, and I'm really glad that many moms are also choosing to breastfeed.  I enjoyed the combo approach, feel zero guilt about it, and would recommend it to anybody.

KBecks

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Re: Evidence based breastfeeding for mustachians
« Reply #234 on: September 24, 2017, 08:43:34 PM »
And she's awake and screaming... Forgot to mention while she's having enough wet diapers, she hasn't pooped since Wednesday...

Supplemented another half oz, but tried to make it flow faster. She's out again.

Just empathy.  Newborns are very hard to live with.  But it gets better, you are in the hardest part right now and you can get through this.  About 8 weeks is when the cloud lifts.  Soon after you'll get the first smile and life will be a lot better.

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Re: Evidence based breastfeeding for mustachians
« Reply #235 on: September 25, 2017, 12:53:30 AM »
Hugs EngineerYogi, that sounds like a very rough start.

With regards to the latch, have any of the lactation consultants *actually* looked inside her mouth? Sometimes latches might look okay fom the outside, but they are hurting mum, are causing ineffective milk transfer etc. a common cause of this are ties, which are often overlooked. 
This ENT has an excellent blog on ties http://www.drghaheri.com

When you had her, did you recieve any IV fluids? Those can artifically inflate the birth weight, causing an apparent large drop on birth weight when baby then pees these excess fluids away. Some people are now advocating starting the measurements from 24hrs because of this.

Also, that 10 minutes per side sounds pretty crazy to me. A lot of very young babies take longer than this because they are still learning to breastfeed and develop a co-ordinated suck. I have heard of it with very poorly babies as they don't want them to expend all their energy eating.

And babies breastfeed for so many reasons - for comfort, for food, so they can be close to mum, because they are tired, because they are cold, because they are hot, because they want to etc.

I heard this quote just after I had Sir Ed :
Quote
You are not a pacifier; you are a Mom. You are the sun, the moon, the earth, you are liquid love, you are warmth, you are security, you are comfort in the very deepest aspect of the meaning of comfort.... but you are not a pacifier!" -- Paula Yount
A kiwi in the land down-under, with 2 beautiful boys in her life.
Navigating through turbulence and toddlerhood

EngineerYogi

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Re: Evidence based breastfeeding for mustachians
« Reply #236 on: September 25, 2017, 02:28:13 AM »
Thank you all so much for the support.

I definitely pushed aside the 10 minute rule, and agree she's still a tiny baby she needs me. Some days this works fine others she wants to eat every hour after mommy only got an hour of sleep. :/

I don't believe I got fluids, I gave birth in less than 30 minutes after arriving at the hospital. But I was retaining an incredible amount of water (I lost 26lbs in a week after birth!) the last two weeks of my pregnancy.

I'll be seeing the lactation consultant again in the morning and possibly try to get in with the pediatrician before her 2 week appointment this Friday.

little_brown_dog

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Re: Evidence based breastfeeding for mustachians
« Reply #237 on: September 25, 2017, 06:06:31 AM »
Oh EY I am sorry it is so rough.

First – re-read this thread if you need too. You are NOT abnormal in your experience. So many highly dedicated, highly resourced moms have been through similar things. Breastfeeding isn’t just challenging, sometimes it is really freaking hard for some dyads. This isn’t your fault in any way, shape, or form. First time moms are particularly prone to problems.

Second, the continued weight loss or weight plateauing is a key indicator that your child is not eating enough. The fact that it occurred after you stopped supplementing is highly indicative of a child not getting their needs fully met by nursing alone. The fact that your baby is screaming all the time unless nursing or eating is also another big clue. If she settles better after supplementing with pumped milk or formula, then you have your answer. She wants and needs more food and she simply isn't getting enough from nursing alone right now. If she has not gained enough by her next appointment, you know what to do.

As a general rule, newborns should be gaining weight DAILY and after the first couple of days should never lose weight. If baby isn't packing on a few ounces per day, that is a warning sign. If she isn't back up to her birth weight (or better yet, over her birth weight) by her 2 week check, that will be a big red flag. If you get to your check and the baby is not at birth weight without needing supplementation, and you are STILL told you shouldn't supplement with pumped milk or formula, I would personally find a different medical team as they are ignoring standard medical guidelines. As it is, a baby isn't supposed to lose >7% of their birth weight (10% is the older, outdated recommendation - the AAP updated it to be 7% in 2012 because 10% was too risky and too many babies were showing problems at that threshold, so they lowered it).

Please understand that many well meaning LCs and pediatricians are so brainwashed by outdated and misinformed ideas like “milk supply problems are rare” and “mom always makes what babies need” and "all babies can nurse well, just keep practicing!" they sometimes can’t see the writing on the wall when a child is floundering. A baby who is not gaining well, who is inconsolable except when attempting to feed, who isn't pooping regularly, etc is usually trying to show us they need more food. So many providers are convinced that supplementation is the devil, they will try to kick you off of it asap, even before baby and mom’s bodies are ready. Babies who are truly just pacifying at the breast don’t have weight gain problems – sure their nursing behavior may be annoying or atypical, but they grow well. Babies who nurse all the time and don’t gain well are quite simply, underfed babies. I am glad you listened to your instincts and went back to the SNS.

Fingers crossed her weight check goes well!
« Last Edit: September 25, 2017, 06:30:35 AM by little_brown_dog »

NeonPegasus

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Re: Evidence based breastfeeding for mustachians
« Reply #238 on: September 25, 2017, 10:35:43 AM »
I am so sorry you're having these issues. I didn't thoroughly read the prior responses so I apologize if these have been mentioned before.

1. Your LC should weigh your babe before and after a feeding. This is essential. That is the only way you will know how much milk your baby is transferring at your feed. If your baby is at your breast for 45 min and doesn't gain weight, you are dealing with a milk transferal problem.

2. Your breasts should feel floppy after a feeding and you shouldn't be able to pump much. If you can pump a lot, then the baby isn't getting your milk.

3. Ask around in local mom groups for an LC (and possibly pediatric ENT) who has good experience identifying posterior tongue ties.

4. A fed baby is best. I nursed all three of mine. I believe in it. But until you get this sorted out, make sure you're getting food to that baby. This is why formula was invented. Don't feel bad if you have to do it. It doesn't have to be permanent. It won't wreck your breastfeeding relationship. It won't mean you messed anything up.

I never fed mine for only 10 min per side. I have met some moms who could but that wasn't me.

For the possible latch issue, did the LC talk about a nipple sandwich? Basically, you grab your boob and squeeze it behind the areola so that it is flattened a bit and easier to get in baby's mouth. Here's a diagram - http://www.indianastands.org/positioning-latch-on-and-the-babys-suck-latch-on-part-3/ If you are too engorged to flatten it, start your milk flow (squirt it right into a bottle) until you've softened enough to compress it for baby.

The first 6 weeks of nursing are the hardest by far. If you can identify and get through the issues, I promise it will get better. Not just a little bit, but exponentially.

EngineerYogi

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Re: Evidence based breastfeeding for mustachians
« Reply #239 on: September 26, 2017, 03:12:14 PM »
We got DD in with the pediatrician yesterday and she'd lost even more weight. She was officially  diagnosed as underweight. Way to break mommy's heart, my poor baby has lost a full pound since her birth. We are to supplement her now with as much milk as she needs/wants (my pumped breast milk first and formula if I'm out). Of course me being sick means my milk production plummeted and the small stock of milk I had was used up in just a few feedings. We're using a bottle for the supplementing too, she just isn't pulling milk from the breast efficiently enough, even with the SNS.

Very frustrating because the routine we were started on by the hospital LC was basically the right track, breastfeeding and pumping every 3 hours and supplementing her every 3 hours while allowing her to nurse on demand as well. The pediatrician told us to stop supplementing and only pump to comfort and his office's LC concurred.

So, I'm restarting the hospital LC's routine. Though I understand the 10 minute per breast recommendation now; DD gets frustrated quick because she isn't able to transfer efficiently and then she gets wore out and sleepy. Since we're giving her a bottle after being at the breast for 20 minutes total she's able to eat more and faster and I think she's getting more frustrated with the breast. I started using the SNS for each breastfeeding attempt and that seems to be enough to keep her on. In 20 minutes she's only able to eat a half oz via SNS on top of what she is able to pull.

I asked the pediatrician if he thought she'd get better at transferring milk and if this was temporary and he said yes. I'm wondering if I need to advocate for a referral to a specialist so I can have her latch evaluated?

iowajes

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Re: Evidence based breastfeeding for mustachians
« Reply #240 on: September 26, 2017, 03:52:44 PM »
When my daughter was having feeding issues we were referred to a speech language pathologist (part of a ENT clinic) for suck training.  He was the one who finally told us her tongue tie was serious enough to get cut. Everyone else was "it's just not that bad". 
« Last Edit: September 27, 2017, 09:00:34 AM by iowajes »

KBecks

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Re: Evidence based breastfeeding for mustachians
« Reply #241 on: September 26, 2017, 04:10:41 PM »
I'm sure you're heard this EY, but drink water and stay hydrated.  Also, I"m wishing you and baby a nice nap soon!  You deserve it!  Hang in there.

Anatidae V

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Re: Evidence based breastfeeding for mustachians
« Reply #242 on: September 26, 2017, 04:49:18 PM »
If her latch is that bad, I'd get a referral to a specialist now rather than waiting a couple of weeks.

I'm glad you went back to the hospital LC's routine, and she's eating more. It matches what I'm pretty sure 70% of the mums in my local mother's group did in the first couple of weeks, so it's been effective for others.

little_brown_dog

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Re: Evidence based breastfeeding for mustachians
« Reply #243 on: September 27, 2017, 06:36:20 AM »
I am so sorry her weight check did not go well. You are not alone in this experience, and you are certainly not the first mom to follow misguided breastfeeding advice that accidentally resulted in underfeeding the baby. I am happy that she is finally eating better and that she is now getting fed to avoid a more serious turn of events.

It sounds like you are on the triple feed regimen (nurse, pump, supplement) until further notice. Your ped is right in that most babies do go on to transfer better the older they get, so that is the good news. Many babies will show rapid improvement over the course of a week or two and can nurse decently well by 1 month old. I think you are right to look for a specialist’s opinion on her transfer issues, if for no other reason than to cover your bases and explore all possibilities.

The bad news is that triple feed regimens are extremely exhausting and are not usually feasible for long term usage >1-2 weeks because they are so time intensive and tend to cause moms to burn out. My recommendation is that as you look for a specialist to figure out her nursing issues, you also put a personal time limit on how long you are willing to do the triple feed schedule before switching to something more sustainable (be that just nursing and supplementing, or exclusive pumping for a bit and then trying nursing later, or whatever). Sustainability of breastfeeding and your enjoyment of it are just as important, if not more important, than breastfeeding a certain way. Now that baby is getting well fed, you need to focus on yourself too and make sure your breastfeeding regimen isn’t going to cause you to become so sleep deprived or depressed that you burn out and miss out on your new baby or enjoying breastfeeding.

jezebel

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Re: Evidence based breastfeeding for mustachians
« Reply #244 on: September 27, 2017, 08:34:08 AM »
I was in a similar spot with my first born - drop almost a pound from birth weight due to ineffective nursing and low supply (which are basically one in the same problem).  She was never "diagnosed" underweight - I think our doctor was unwilling to do that. 

After almost a month of SNS feeding (first) followed by pumping and bottle feeding (simultaneously) and using every supply-building suggestion and trick in the book, we were finally able to drop the SNS and continue a relatively normal BFing relationship until she called it off at 10.5 months.   We also fortified her breast milk bottles with formula so that she would take in more calories, gain weight faster, and become a more effective nurser (as it's all related). 

Not gonna lie, this routine was a lot of work for about four weeks, but I got a break  by just pumping during the day when I was at work (went back at six weeks), so it was manageable and worth it to me in the end.  And I don't think we used the SNS for overnight feedings, just nursed.

lifejoy

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Re: Evidence based breastfeeding for mustachians
« Reply #245 on: September 27, 2017, 08:45:19 AM »
I was in a similar spot with my first born - drop almost a pound from birth weight due to ineffective nursing and low supply (which are basically one in the same problem).  She was never "diagnosed" underweight - I think our doctor was unwilling to do that. 

After almost a month of SNS feeding (first) followed by pumping and bottle feeding (simultaneously) and using every supply-building suggestion and trick in the book, we were finally able to drop the SNS and continue a relatively normal BFing relationship until she called it off at 10.5 months.   We also fortified her breast milk bottles with formula so that she would take in more calories, gain weight faster, and become a more effective nurser (as it's all related). 

Not gonna lie, this routine was a lot of work for about four weeks, but I got a break  by just pumping during the day when I was at work (went back at six weeks), so it was manageable and worth it to me in the end.  And I don't think we used the SNS for overnight feedings, just nursed.

Wow. I am blown away that you managed all of that AND went back to work at 6 weeks!!

How did you keep hope alive? I find that positive mindset is key for my BF journey. It can be hard when you're sleep-deprived, though.

NeonPegasus

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Re: Evidence based breastfeeding for mustachians
« Reply #246 on: September 27, 2017, 08:50:04 AM »
I'm wondering if I need to advocate for a referral to a specialist so I can have her latch evaluated?

Yes. Do what you have to do to get your baby to a specialist. You need a pediatric ENT who has a reputation for being able to diagnose posterior tongue ties. Those are the hardest to dx so if s/he can find those, s/he should be able to find the rest. You may be able to get recommendations from a local breastfeeding group. Here is a link to one of the specialists in Atlanta so you can see what sort of background, certifications and interests you would hope to see - http://www.childrensent.com/providers/physicians/erik-bauer-m-d-f-a-a-p/.

One thing I've learned over 10 years with 3 kids is that your pediatrician is good only for general advice and first line assessment of issues. Once you have a problem, you really need to see a specialist to sort it out.

Sister C

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Re: Evidence based breastfeeding for mustachians
« Reply #247 on: September 27, 2017, 09:40:36 AM »
I'm wondering if I need to advocate for a referral to a specialist so I can have her latch evaluated?

Yes. Do what you have to do to get your baby to a specialist. You need a pediatric ENT who has a reputation for being able to diagnose posterior tongue ties. Those are the hardest to dx so if s/he can find those, s/he should be able to find the rest. You may be able to get recommendations from a local breastfeeding group. Here is a link to one of the specialists in Atlanta so you can see what sort of background, certifications and interests you would hope to see - http://www.childrensent.com/providers/physicians/erik-bauer-m-d-f-a-a-p/.

Agreed.  Now is the time to be seeking out a specialist, or specialists.

My son and I had similar and different issues- painful nursing, weight loss, slow weight gain which exacerbated newborn jaundice which resulted in a hospital stay.  After two months of terrible pain, decreasing BMI, fussiness, 45-60 minute long nursing sessions, three lactation consultants, one pediatric ENT who said "it's not bad enough to fix; sometimes breastfeeding just hurts," we found an experienced pediatric dentist who diagnosed and fixed a lip tie.  Immediately the pain went away and nursing sessions dropped to 20 minutes.  We still had supply issues due to 2 months of baby not being able to suck out as much milk as he needed but breastfeeding went much much much better after that.  I didn't do much with La Leche Legue for various reasons, but they are a good place to find referrals to lactation consultants, ENTs and dentists who are trained to rule out or diagnose lip and tongue ties.

I'm so sorry you are going through this!  Hang in there. [I mean hang in there emotionally- as for feeding, do whatever you need to do for the physical and emotional health of your baby and yourself.]

Links:

Dr. Kotlow, a pediatric dentist who is a national leader in diagnosing and correcting tongue and tip ties.  He trained the dentist we saw.
http://www.kiddsteeth.com/articles.php
http://www.kiddsteeth.com/breastfeeding.php

I wanted to add a link to Dr. Jack Newman's information about how to tell if baby is actually drinking on the breast, or just hanging out (which my boy did and which made time limits useless for us) but it looks like his site is down.  I used his breast compression technique to increase the amount of milk my boy was getting until we got the lip tie fixed. 

https://www.youtube.com/watch?v=56YzjsZr4hQ

http://www.breastfeedingmums.com/dr_jack_newman_breast_compression.htm

jezebel

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Re: Evidence based breastfeeding for mustachians
« Reply #248 on: September 27, 2017, 10:58:48 AM »
I was in a similar spot with my first born - drop almost a pound from birth weight due to ineffective nursing and low supply (which are basically one in the same problem).  She was never "diagnosed" underweight - I think our doctor was unwilling to do that. 

After almost a month of SNS feeding (first) followed by pumping and bottle feeding (simultaneously) and using every supply-building suggestion and trick in the book, we were finally able to drop the SNS and continue a relatively normal BFing relationship until she called it off at 10.5 months.   We also fortified her breast milk bottles with formula so that she would take in more calories, gain weight faster, and become a more effective nurser (as it's all related). 

Not gonna lie, this routine was a lot of work for about four weeks, but I got a break  by just pumping during the day when I was at work (went back at six weeks), so it was manageable and worth it to me in the end.  And I don't think we used the SNS for overnight feedings, just nursed.

Wow. I am blown away that you managed all of that AND went back to work at 6 weeks!!

How did you keep hope alive? I find that positive mindset is key for my BF journey. It can be hard when you're sleep-deprived, though.

I'm not sure, really.  It wasn't unusual for me to fall asleep on the couch right after work with the baby in my lap.  I was very lucky in that she slept through the night for the most part (ironically my large, nursing-champ second child woke frequently at night) and my husband and I took shifts at night (he brought her to me to nurse during his shift and then put her back down or stayed up with her), so I wasn't as sleep deprived as I could have been.  Plus my husband was very supportive. 

But mindset was key.  I took it one day at a time and tried to be very ok with it not working out.  After a couple of weeks, getting to one month without weaning was a goal, then six weeks, etc.  We were already supplementing and fortifying with formula as of a week from birth, so any desire/pressure to avoid it was gone and we could just focus on getting the baby to the point where it clicked.

On the top of tongue tie, we went to a pediatric ENT on the advice of our LC and he found nothing wrong.  So some newborns just don't nurse well initially for whatever reason.

Acorns

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Re: Evidence based breastfeeding for mustachians
« Reply #249 on: September 27, 2017, 09:53:23 PM »
EY, I just wanted to join the chorus sending you lots of virtual hugs and support. You are working your butt off to keep your baby healthy and fed, this mom thing is so hard, especially at the beginning! I'm no LC, but I have breastfed my three kids, using some formula supplementation here and there. A few thoughts in no particular order -

- Newborns are hard! I love my babies but the newborn stage is not my favorite for so many reasons! Hang in there, it gets better.

- I see you are in CA, this dr is in Portland and is supposed to be one of the best at treating tongue/ lip ties, http://www.drghaheri.com/, I *think* he does over the web consults as well. Definitely get checked out for a tie ASAP. My youngest had a tongue tie and it was clipped at our ped's office when he was just 2 or 3 weeks old. My ped is awesome and it was a minor tie so she didn't need to refer out. She highly recommended getting it done early because problems associated with a tie tend to get worse as the baby gets older. Plus bad nursing habits are hard to break.

- Get some rest! Pump or use formula, have your hubby give your LO a bottle and say "don't wake me up for at least 4hrs!" That amount of time won't wreck your milk supply, and you will feel so much better after some solid sleep.

- The 10min nursing thing sounds strange to me too. Newborns are terribly inefficient and have to practice a lot to get better at nursing. My first child in particular would nurse for WAAAAY longer, and that was fine. Which brings me to my next point...

- Don't feel guilty for offering a pacifier. Yes, it is mom's job to comfort and soothe the baby, but you CANNOT do it 24/7. My first child had a powerful suck reflex. At his 2wk appt, the ped took one look at me and said, "are you sleeping at all???" She said to give him a pacifier! I said, "but but but what about nipple confusion? And artificially satisfying him? And how will I know if he is really hungry?" She practically rolled her eyes (different ped than the one we have now, she was pretty old school) and said, "you'll know." And sure enough, gave him the pacifier and he was so happy and slept so much better and nursed until he was 15mo when he weaned on his own. My second child hated the pacifier and screamed at the sight of it, third was so-so. Each kid is different.

- Definitely try the soy lecithin for plugged ducts. I struggled with plugged ducts when I went back to work and had to pump 5 or so times a day (worked 12 hr days). Soaking the breast in a bowl of water also helped, but I obviously couldn't do that at work! When I started taking soy lecithin at the first sign of discomfort I found that pretty much eliminated the plugged ducts.