Breastfeeding/pumping related questions

[hillarywhitney]

Hi. I gave birth my my baby boy on July 23rd. Breastfeeding has been a bit of a challenge. I had a c-section (which apparently can have an impact on breastfeeding according to what I've read). My supply of colostrum is pretty good, but my baby has a poor latch. The lactation consultant said he is "disorganized". He latches, but he doesn't open his mouth wide enough. I re-position, pull his chin down etc. But only a few times has it worked. I'm using a nipple shield because I apparently have flat nipples. 

I've started pumping because ds doesn't seem to get enough from breastfeeding. We've been using a pipette to feed him (something a lactation consultant showed us) hoping we could avoid using bottles. But it's not a really good long term solution. So, I think we're going to try bottle feeding. 

My questions: 

1. If you bottle fed your baby breast milk, how much did you give him? Did you just feed him til he seemed done? Was it a certain amount? Did you follow the formula guidelines? 

2. If you bottle fed breast milk, were you able to eventually breastfeed as well? 

3. Any recommendations for a hands free bra? 

4. Any and all advice/suggestions is welcomed. I am feeling very emotional and worried. I'm willing to try anything. 

Thank you so much. 

[zarapipe]

I'm sorry your having a hard time. I started pumping early, like day 5. Dd took Playtex drop ins. I think we started with 1 or 2 ounces. I also used a nipple shield and saw the lc a few times until dd latch had gotten better. Eventually we did bf, always with the shield, we never weaned off of it which was a pita but it worked for us. She eventually did end up preferring the bottle to bf and self weand around 9 months or so I think. I continued to pump till a year. Can you see the lc again?

[AmyRI]

First, congrats! I hope you're feeling well other than the feeding troubles.

1. If you bottle fed your baby breast milk, how much did you give him? Did you just feed him til he seemed done? Was it a certain amount? Did you follow the formula guidelines? 
I did a combo of nursing and bottle feeding right after when DS was 4 days old, and a bottle every couple days after for the rest of maternity leave. I encourage you to continue to nurse first even if you add a bottle after. 

Any chance you can see an LC again and do a weighed feed? It's when you weigh the baby before and after nursing. The difference in weight in ounces is the same as the number of ounces he took (1 fluid oz of breast milk = 1 oz). This helps you know how much he's getting at the breast (or if there's a milk transfer problem) and will also help you know how much to supplement with (pumped milk or formula). 

Breastfed babies take between 20 and 30 oz in 24 hours, but that's a big difference and it varies by baby. Also, it might very well be lower than 20 oz on day 3 and that's ok - I would expect to be up to 20 oz by a week old or so. 

How is his diaper output? How much weight has he lost, and do you know if he's still losing or started gaining? 

How is your pumping output, and how often are you pumping? 

2. If you bottle fed breast milk, were you able to eventually breastfeed as well? 
I did both, and to encourage this, try to continue nursing as much as possible. It's harder to go back to breast after exclusively bottle feeding than it is to just do a combination all along. Also, look up paced bottle feeding on kellymom.com to slow bottles down and encourage easier switching between bottle and breast. 

3. Any recommendations for a hands free bra? 
Simple Wishes, hands down. The other ones are all fine, but the simple wishes is actually comfortable. I didn't have one when I pumped for DS and it was one of the things I got before DD and it made SUCH a difference. 

4. Any and all advice/suggestions is welcomed. I am feeling very emotional and worried. I'm willing to try anything. 
Just keep asking questions and seeking help, here and IRL. It's an emotional roller coaster, for sure, but we're here to support you. Sounds like you're doing everything you can so far and your LC sounds like a good one (teaching you the pipette feeding is a great sign). 

[Jalapeñomel]

I'm sorry you are having a rough go of it.

When D was in the NICU, I pumped and bottle fed (until the last two days), and when he went home, I EBF for 6 weeks (with a nipple shield) before I started to pump for my stash.

[AlpineSlide]

Jul 27, 2014 12:40:40 GMT -5 hillarywhitney said:

Hi. I gave birth my my baby boy on July 23rd. Breastfeeding has been a bit of a challenge. I had a c-section (which apparently can have an impact on breastfeeding according to what I've read). My supply of colostrum is pretty good, but my baby has a poor latch. The lactation consultant said he is "disorganized". He latches, but he doesn't open his mouth wide enough. I re-position, pull his chin down etc. But only a few times has it worked. I'm using a nipple shield because I apparently have flat nipples. 

I've started pumping because ds doesn't seem to get enough from breastfeeding. We've been using a pipette to feed him (something a lactation consultant showed us) hoping we could avoid using bottles. But it's not a really good long term solution. So, I think we're going to try bottle feeding. 

My questions: 

1. If you bottle fed your baby breast milk, how much did you give him? Did you just feed him til he seemed done? Was it a certain amount? Did you follow the formula guidelines? 

2. If you bottle fed breast milk, were you able to eventually breastfeed as well? 

3. Any recommendations for a hands free bra? 

4. Any and all advice/suggestions is welcomed. I am feeling very emotional and worried. I'm willing to try anything. 

Thank you so much. 

Congrats on your baby! You're doing a great job!

1. I gave 1.5 oz at first, every 2-3 hours. Then after a few weeks he started wanting another 1/2 to 1 oz.

2. yes, I had a baby that had trouble removing milk from my breasts (undiscovered tongue tie) so i was putting him to the breast every feeding, then giving a bottle, then pumping after that. It was hell pumping 8 times per day, I won't lie. But once he was almost 2 months old, I guess his tongue got stronger (we never had it clipped) or something but from that point on he was able to exclusively nurse. He's 8 months old and EBF.

3. n/a

4. the hormone crash is worse with a c-section apparently (i had a c/s too). be kind to yourself! i cried several times per day and felt like a looney person. everything made me cry, so that's normal. and it is normal to worry. only allow supportive and helpful people to be around you and the baby right now.  just stick with it and things will even out. good luck.

[Jalapeñomel]

Oh and as for a hands free bra, the best thing that worked for me is to cut the nipples out of an old sports bra and use that. The pumping bras suck, IMO.

[andthentherewere10]

1. If you bottle fed your baby breast milk, how much did you give him? Did you just feed him til he seemed done? Was it a certain amount? Did you follow the formula guidelines?  The NICU gave him about 1.5 ounces at a time as a newborn.  By 6 weeks and now I still just given him 2.5 ounces if he's taking a bottle.  Bottles happen 1x every other day or so.

2. If you bottle fed breast milk, were you able to eventually breastfeed as well?  The NICU gave him a bottle before I ever could breastfeed (middle of the night is when he was allowed to start eating).  He never had any issue switching back and forth to my great relief.  

3. Any recommendations for a hands free bra? No, I'm in search of one myself.

4. Any and all advice/suggestions is welcomed. I am feeling very emotional and worried. I'm willing to try anything.  
The NICU nurses said most babies don't get nipple confusion and it isn't an issue.

[winemaker06]

1. I was pumping and supplementing with formula in the hospital because DS was a preemie and they made me ::sigh:: I did not actually get milk from the pump until day 5, and even then not very much. He didn't need a lot though, maybe 2 oz max every 3 hours, formula or breastmilk.

2. Yes, I was giving a bottle within a week but am now hitting 6 months exclusive breastfeeding this week.

3. I like my Simple Wishes pump bra. Just grabbed one from babies r us.

4. You're emotional because you just had a baby! Then breastfeeding issues on top of that made it so much worse. Just keep reminding yourself, and have your husband also, that you're doing your best.

We had a LOT of issues from the start. I don't think DS's latch was disorganized, it was just horrible. We worked with 3 different LCs and eventually had tongue AND lip ties cut, which helped but not a ton.
In the hospital we were supplementing using a string or the Medela SNS. Once we got home we were so exhausted we switched to bottles. This may have caused nipple confusion but I don't regret it because we just did what we had to do to stay sane at the time. I supplemented with formula and pumped milk for 3 weeks, when the baby made it to birth weight. I would pump 2-3 times a day and never missed a feeding.

I was crying at every feeding due to the pain, and in the middle of the night DH would do a full 2 oz bottle feeding and I would pump to give me a break from the pain that came with the latch issues. We had problems of some sort through 3-4 months (I also got thrush I couldn't beat). But as I said above, even with all that, I made it to 6 months! And it really is easy now, so it all seems like a bad dream.

So if it is something you really want to do, keep at it and lean on us all for support. But if you decide to go the formula route, that's perfectly okay too!

Good luck. Keep us posted on how things go for you.

[statlerwaldorf]

I had a c-section on July 14th and breastfeeding got off to a rough start. I had the same problem with ds not opening his mouth wide enough to get a proper latch. My milk didn't come in until day 6 or 7. It was gradual and I only really knew because I was pumping when I couldn't get him to latch.

Once my milk came in and ds was more alert, his latch improved a lot. He was completely rejecting the left side and had a shallow latch on the right. I went from pumping on the left almost every feed to every other feed to not pumping at all over a couple of days. The pain on the right is finally starting to not be so intense. I've been using Lansinoh Soothies and Medela gel pads which have helped a lot with the healing.

I used the pipette every time. I just fed him what I pumped although once I pumped 3.5 oz that was too much and he ended up spitting up after the first 3 oz.

Have you tried Medela soft shells? My LC recommended them to keep my nipples from rubbing against my bra, but they come with an inset for flat nipples.

Can you go see a lactation consultant again? It took a lot of working with a LC to get ds to latch.

I just cut holes in an old sports bra for hands free pumping with dd.

[hillarywhitney]

Thank you so much everyone! I will come back and respond more thoroughly when I can get some time. But I wanted to thank everyone. The responses and support mean so much to me.

[mandapanda18]

Jul 27, 2014 12:40:40 GMT -5 hillarywhitney said:

Hi. I gave birth my my baby boy on July 23rd. Breastfeeding has been a bit of a challenge. I had a c-section (which apparently can have an impact on breastfeeding according to what I've read). My supply of colostrum is pretty good, but my baby has a poor latch. The lactation consultant said he is "disorganized". He latches, but he doesn't open his mouth wide enough. I re-position, pull his chin down etc. But only a few times has it worked. I'm using a nipple shield because I apparently have flat nipples. 

I've started pumping because ds doesn't seem to get enough from breastfeeding. We've been using a pipette to feed him (something a lactation consultant showed us) hoping we could avoid using bottles. But it's not a really good long term solution. So, I think we're going to try bottle feeding. 

My questions: 

1. If you bottle fed your baby breast milk, how much did you give him? Did you just feed him til he seemed done? Was it a certain amount? Did you follow the formula guidelines? I started with 1-2 oz and fed until he stopped eating or fell asleep.

2. If you bottle fed breast milk, were you able to eventually breastfeed as well? Yes. I had the nipple shield on for a good 6 weeks solid, then would latch with it, sneak attack it off and relatch without it. We are still bf'ing morning and night

3. Any recommendations for a hands free bra? Simples Wishes - I got an ugly pale pink one on amazon for like $12, best investment ever!

4. Any and all advice/suggestions is welcomed. I am feeling very emotional and worried. I'm willing to try anything. It is hard, not gonna lie, but it is only hard for a while, you will get the hang of things or decide you want to go another route (either option is OKAY, your baby will be fed)

Thank you so much. 

[gingerjar]

Jul 27, 2014 12:40:40 GMT -5 hillarywhitney said:

My questions: 

1. If you bottle fed your baby breast milk, how much did you give him? Did you just feed him til he seemed done? Was it a certain amount? Did you follow the formula guidelines? 

It varied based on her age--- sometimes 2.5 oz, then 3, then 4 then 5 and the most we ever did was 6 per feeding.

2. If you bottle fed breast milk, were you able to eventually breastfeed as well? 
I did breastfeed for approximately 3 months but I was also pumping. I switched to EP when I realized that BF wouldn't be efficient (baby had a bad latch and took an hour to BF).

3. Any recommendations for a hands free bra? 
I just wore soft racerback sports bras and they pumping parts fit right into that and it was hands-free, so no need for another hands free bra.

4. Any and all advice/suggestions is welcomed. I am feeling very emotional and worried. I'm willing to try anything. 

If you decide to EP, feel free to PM me with any questions, I did it for a year. Also, see a LC if you have access--- it can be so helpful to get that kind of guidance and support.

[urbancowgirl]

I don't have any advice, but I wanted to send some hugs. Hang in there!

[SKP82]

Jul 27, 2014 15:43:17 GMT -5 Jalapeñomel said:

Oh and as for a hands free bra, the best thing that worked for me is to cut the nipples out of an old sports bra and use that. The pumping bras suck, IMO.

I disagree.  I hate having to take off my top and bra to put on the sports bra.  Also, I thought it didn't hold the flanges as well. 

OP, I have the Pump Ease Hands Free Bra, which I really like.  I think I bought it on drugstore.com for $20 (with FSA$$ maybe?).

www.toysrus.com/product/index.jsp?productId=18778116&KPID=14740866&mr:trackingCode=AA3BB466-7315-E311-A497-90E2BA285E75&mr:referralID=NA&mr:filter=56910016246&camp=PLAPPC-_-PID14740866&mr:ad=35201245606&mr:device=c&mr:match=&mr:adType=pla&cagpspn=plab_14740866&mr:keyword=

I don't have advice on the other issues, but I'm sorry you're having a hard time.  Nursing is so, so hard at first.  But, it did get better for me.  I feel very lucky to have had access to a good LC who encouraged me to contact her whenever I needed.

If you can, I would suggest seeing the LC again.

[Jalapeñomel]

Jul 28, 2014 21:03:56 GMT -5 SKP82 said:

Jul 27, 2014 15:43:17 GMT -5 Jalapeñomel said:

Oh and as for a hands free bra, the best thing that worked for me is to cut the nipples out of an old sports bra and use that. The pumping bras suck, IMO.

I disagree.  I hate having to take off my top and bra to put on the sports bra.  Also, I thought it didn't hold the flanges as well. 

I had the opposite problem; the flanges kept falling out of the hands free bra, and they stay put in the one sports bra. I also think that I might have had a pumping bra that was too small. It was constantly rolling down, and the zipper was a pain in the ass.  

Also, I never take my top off; I just pull the sports bra over my shirt. 

Goes to show that you may just have to figure out what works best for you and your tatas, probably through a little trial and error. 

[sent]

1. If you bottle fed your baby breast milk, how much did you give him? Did you just feed him til he seemed done? Was it a certain amount? Did you follow the formula guidelines? We started with 1 oz at each feeding, but it quickly became clear she needed more so we moved to 2 oz each feeding. Eventually she went to 3 and 4 and she's been at 4 oz bottles ever since, even now that we've switched over from BM to formula.

2. If you bottle fed breast milk, were you able to eventually breastfeed as well? No, but I believe this is because DD was a preemie who came home at 4 lb 4 oz and had reflux issues that weren't treated until she was about 10 weeks old. We tried nursing for about 7 weeks after she came home and it was becoming a miserable experience. I saw/spoke to 6 LCs and eventually decided on my own that EPing was the best route for our sanity. We all did very well with EPing. Now that I am done, I realize that it costs a lot of time but I didn't mind it, there is a lot to read on GBCN to make the time go by. I did it for 6.5 months. I stopped because my baby was becoming mobile and impossible to watch and pump at the same time and she was also outdrinking my dailly production. I only wish I had found the EPing FB group someone on here pointed me to much much sooner. That would've really helped me more than any of the LCs.

3. Any recommendations for a hands free bra? I used Simple Wishes and it was fine.  The stupid LCs in the hospital should've told me to get one sooner since I was EPing at home in the beginning while DD stayed in the hospital for 2 weeks.

4. Any and all advice/suggestions is welcomed. I am feeling very emotional and worried. I'm willing to try anything. I will say that when I went to my breastfeeding group, it always seemed like the new moms of the normal term babies struggled for like 6 weeks and then suddenly it became "easy" for them.  Some tips as far as pumping - Store your pump parts in the fridge in between pumps so you don't have to wash them every.single.time.  Buy extra pump parts if you're going to be pumping down the line anyways like at work.  Use a bottle brush to scrub all the pump parts quickly when you do wash them - I like the Munchkin brush they sell everywhere.

Good luck to you and your baby.  

[statlerwaldorf]

Jul 28, 2014 20:32:51 GMT -5 @peggyolson said:

DD had a poor latch at the beginning and we bottle fed/pumped/supplemented because she was hospitalized overnight for jaundice. She was born 12/28. I neurotically tracked everything (see PIPs).

After many LC visits we were able to ebf (I pumped at work) until she self weaned around 15 months.

What app did you use?

[djc315]

1. If you bottle fed your baby breast milk, how much did you give him? Did you just feed him til he seemed done? Was it a certain amount? Did you follow the formula guidelines? I fed until he seemed satisfied. It wasn't much, it was less than the formula guidelines, I believe.

2. If you bottle fed breast milk, were you able to eventually breastfeed as well? Yes!  We bottle fed exclusively for almost an entire week, and with the help of the lactation consultant, we were able to get him back on the breast and BF until 18 months.

3. Any recommendations for a hands free bra? I used the Medela one

4. Any and all advice/suggestions is welcomed. I am feeling very emotional and worried. I'm willing to try anything.   BF isn't everything.  You are doing a great job, and using formula isn't "failing".  Set up an appointment with a lactation consultant.  Mine was a godsend and really was the help I needed.  Good luck!!

[AmyRI]

How are things going, hillarywhitney?

[GracieLouFreebush1]

Jul 27, 2014 12:40:40 GMT -5 hillarywhitney said:

1. If you bottle fed your baby breast milk, how much did you give him? Did you just feed him til he seemed done? Was it a certain amount? Did you follow the formula guidelines?  She's been taking 2-3oz every 2-3 hours since she started daycare at 8 weeks old.  Kellymom.com is an awesome BFing resource.  Here's a link talking about how much to feed.  kellymom.com/bf/pumpingmoms/pumping/milkcalc/

2. If you bottle fed breast milk, were you able to eventually breastfeed as well? We started out BFing and moved to bottles for daycare so I may not be much help here but I had to use a nipple shield the entire 7 months I BF'd DD1.  She never weaned off of it so I gave up trying to wean her since it wasn't impacting my supply.  It's a PITA to make sure there's a clean shield 24/7 but don't be discouraged by it!

3. Any recommendations for a hands free bra? I've used the Simple Wishes hands free pumping bra for DD1 and now that I'm BFing and pumping for DD2. 

4. Any and all advice/suggestions is welcomed. I am feeling very emotional and worried. I'm willing to try anything.   With both of my girls I noticed that their latch gets much better around 6-8 weeks as they mature; they need less help latching, staying latched, and are more efficient at eating so there's light at the end of the tunnel!

[MamaMaui24]

Something to try for the flat nipples - latch assist by lansinoh.

Lansinoh Latchassist Nipple Everter
by Lansinoh
Link: amzn.com/B00112EIWW

3. Simple Wishes hands free bra

[hillarywhitney]

Jul 29, 2014 8:27:09 GMT -5 AmyRI said:

How are things going, hillarywhitney?

Things are going ok. Still not able to get him to latch properly. Though, to be honest, I've been a bit hesitant to try. I offer my breast from time to time. It's just so hard to see him get so upset. But I am going to make an effort today to offer it more. 

I went to a lactation group yesterday, but wasn't impressed. I didn't really love either of the lactation consultants at the hospital. So I'm going to call around to some others. Maybe see about having someone come to the house. 

Sometimes I feel ok with pumping/bottle feeding. And others I feel really sad at the thought I might not get to experience a nursing relationship with the baby. I know it's ok to not breastfeed. It's just something I really want to work. And I'm sure the hormones aren't helping. 

Thank you for checking in. 

And I keep meaning to come back and respond to everyone else. But it's hard to find time to respond. I've been reading everything though. 

Thanks again to everyone for their advice and support. I am so thankful for it all. 

A few things I think people asked about: 

DS has gained some weight back. As of Tuesday he had gained almost 6oz back. So that's good. We go again tomorrow. 

He eats every 2-3 hours (anywhere from 30-60oz). Sometimes he'll seem hungry less than an hour later, so we'll give him another 15 or so oz. I worry we are overfeeding him. But we try everything else first (changing his diaper, burping him, rocking, swaddling etc.) and then offer more food. And he usually sucks it down. So he's clearly hungry. 

We have a log of input/output. And he pees and poops quite a bit. So I feel good about that. 

I've used the nipple shield. And sometimes it works. And others it doesn't. He gets so frustrated/upset that he ends up knocking it off my nipple. 

I'm able to mostly keep up with him. We've had to use formula 2-3 times.

[AmyRI]

Wow, what a great update! 6oz of weight gain and only using formula 2-3 times sounds like your milk came in just fine!

I'm assuming you're really measuring in milliliters: 30mL = ~1 oz. Since I'm sure his little belly can't handle 6 cups at a time ;-) Assuming his intake doesn't go a lot above 900mL per day I wouldn't worry about overfeeding. It sounds like you're following his cues and doing everything right

If you do want to try to make the nursing relationship work, keep offering the breast as much as possible. Try to catch him and latch before he starts screaming (so try at the 1.5 or 2 hour mark instead of waiting for him to cry). Also, sometimes trying when they're calm and sleepy just to get them to comfort suck works. With or without the nipple shield - whatever works. Also, I've seen LCs latch a baby and use a thin tube on the end of a syringe to send milk into the baby's mouth to encourage sucking at the breast. It calmed the baby and encouraged latching to get milk and made being at the breast a positive experience instead of a frustrating one. It certainly takes a 2nd person to execute, but if your DH is around or you have more help it might be an option to work on latch.

And definitely keep looking for an LC you click better with. The 2 I met with when I had trouble with DS were both annoying to me, but each had their own little tips and tricks that were helpful to me. It wasn't until after I had DD that I met an LC that I really felt comfortable with.

I hope things continue to look up for you guys!

[hillarywhitney]

AmyRI

My supply seems pretty good. Now if he's just take it from the tap

And yes, I meant ml's.

He latched briefly today. A few times--for a few sucks. Using the nipple shield. When it's time for him to eat again I'm going to try to pump a bit and then offer him my breast. The pump helps make my nipple less flat.

I sent emails to 3 different lactation consultants. Hoping to hear back soon. And there's a different class on Friday I may try out.

Thank you again!

[D2M]

I am not a BF success story (I'm BFing plus supplementing with 2 oz formula or pumped milk) but one thing that's really helped my baby not get frustrated on the breast is to get her latched before she expresses hunger. So when she's nodding in and out in her swing after a decent nap, I'll pick her up and start feeding her as opposed to waiting until she's wide awake and crying. This doesn't work so well in the middle of the night, of course, but it helps during the day, for sure. Also, my LC said to start and end all feeds with the breast. In the beginning, she recommended switch feeding -- six minutes on one side, six on the other, six on the first breast, bottle (then burp, diaper change, etc.), and then finish for six minutes on the last breast. This seems crazy and it kind of is, but it was a good guideline in the beginning. I don't watch the clock so much anymore and just nurse on both sides until she seems satisfied, give the bottle, and then finish on a breast. For the bottle, I do paced feeding ala Kelly Mom.