Supplementing with newborn

[Deleted]

Mar 27, 2017 16:20:38 GMT -5 bricco said:

Sorry! One trick pony!

Pediatrician wants us to supplement 10ml formula per feeding due to excessive weight loss. She dropped from 6lb14oz to 5lb14oz in 3 days. My milk is not in yet.

What's the best way to do this but still promote the breastfeeding relationship? I'm thinking of doing a syringe?

Any tips?

The supplemental nursing system that you tape to your boob?? I'm not a bfer, but I tried that with DS.

[macmars45]

We had to supplement for DS because he was tiny (5lbs 7oz when we left NICU). We just used Dr Brown 4oz bottles with newborn nipples. That's probably not helpful as we combo fed from the beginning and switched to all bottle feeding at 2 months.

[lala]

I would try the syringe or supplemental nurser - I used one w/ all of my kids b/c I had a specific issue. I made one myself w/ the help of 2 different LCs. It's basically just a thin gavage tube stuck through a nipple. It would be super hard to use w/ a 3 day old, though. I used them at 2-3 weeks on.

So, that said, I think the syringe is easier.

You can do a bottle w/ a newborn nipple, too.

[loira]

You could try cup feeding. That's what a nurse did when we supplemented for A. I just used the bottle and did paced feeding. 10ml seems kind of stingy given your milk isn't in yet, but take this with a grain of salt because I still have a lot of trauma from A's weight loss and bfing experience.

[pooh8402]

Breastfeed first, offer 10-15 mL formula after. You can use a bottle and do paced feeding, or a supplemental nursing system (SNS). The syringe works just fine, but I have no personal experience with it. I did the SNS when I was home alone with E (I ordered the medela one through Amazon Prime), and when DH came home in the evenings, he offered a bottle after I nursed. I didn't mind offering a bottle since I knew that he would need the bottle anyways once I went back to work.

[browneyedgirl9]

We did a syringe at first. And offered the formula after nursing.

[ohgillian]

We supemented maybe the first month with a bottle. Actually,his first few feeds may have been from a bottle. I wa so sick and out of it post delivery. None of it interfered with nursing. I think my milk came on day 4? I nursed exclusively once we stopped supplementing and nursed til 15 months.

[starryfish]

I had to give formula once in the hospital bc I didn't have anything coming out even after hand expressing. We did a ready to feed bottle of formula with the brown rubber nipple that came with it. After we were home we bought the dr brown preemie nipples and used those for bottles.

[imojoebunny]

My DD was SFGA and IUGR, they thought she would gain/grow once born, but did not. I would BF, then supplement with a bottle, as much as, she wanted, then pump after that at every feeding when she was a newborn, at first formula, then once I pumped enough, BM. It worked fine, and eventually she was on BM entirely, until she started having weight gain problems, again around 8 months. She was a very fast eater, and we had to poke extra holes in the nipples at some point, with a straight pin, which is more how a breast works, liquid spraying all around, not just in one spot. Obviously, all kids are different, but many kids BF and get bottles, it is not nearly as uncommon, as people are led to believe.

[noodleoo]

We had to supplement a little with DD before my milk came in. We just used the RTF bottles that the pedi gave us that came with newborn nipples. But we only had to give her a few and my milk came in on day 5. I don't think it had any effect on BFing. How did the pedi say to do it?

[Susie]

Hobbes had Medela bottles/nipples in the NICU (of pumped colstrum/milk, but the point is it wasn't boob) and it didn't complicate BFing at all. Maybe we were just lucky.

[satsuma]

10 ml is so little that I would use the syringe. Have you been shown how to use it? I would also see if the Dr can give a more concrete amount per day vs supplement after every feed. If your baby nurses 8 times a day she's getting over an oz less than a baby who nurses 12 times. Obviously under supplementing is bad but giving too much could make her less enthusiastic to nurse.

[satsuma]

I also don't think bottles are detrimental if you have to supplement larger amounts. I just found syringe less wasteful when we were doing small feeds.

[mae141]

The LC at the hospital had me use a syringe with a curved tip and hold it in DD's mouth while she was nursing. When I could see she was sucking, I pushed it a little so it was like she was working for it. It was similar to using an SNS, but it was a little more simplistic. I would finger feed with it when my nips needed a break. DD1 had a similar weight loss but was back up to birth weight within about 10 days and I was able to stop supplementing.

[mekia]

bricco, I'm sorry you guys are struggling. How is your letdown? She may be frustrated waiting for the letdown. Could you try pumping or hand expressing until you get the letdown and put her on the breast?

[Mrs.flang]

Good luck at your appointment! I hope you find some comfort either way. It does sound frustrating but you are doing great!

[pooh8402]

Mar 29, 2017 9:44:25 GMT -5 mekia said:

bricco, I'm sorry you guys are struggling. How is your letdown? She may be frustrated waiting for the letdown. Could you try pumping or hand expressing until you get the letdown and put her on the breast?

This is what I was thinking. That's why I did drops of formula on the nipple, or used the SNS, to keep him latched until my milk let down.

[cari]

Mar 29, 2017 9:40:00 GMT -5 bricco said:

I thought we were doing better. My milk has come in and she latched really well once last night around 9pm. She was definitely getting something. Then, she hasn't latched and stayed on since. She roots for it, finds the nipple, gives 2 or 3 sucks, then pops off and cries. Over and over again. She seems panicked.

It's so frustrating. Trying to do what's best but I'm getting worried. As of Monday, she had lost 14% of her body weight. I think she has lost more since then.

We have an appt with a lactation consultant at 2. If after leaving, I can't get a consistent latch, I think I'll be done.

All 4 of my DSs were/are like this and a nipple shield saved our nursing relationship every time.

[icedcoffee]

I'm sorry you're struggling. A LC should be able to help! Ditto cari on the suggestion of a nipple shield. It made things so much easier when he was really little.

[pooh8402]

Mar 29, 2017 10:10:15 GMT -5 bricco said:

Mar 29, 2017 9:51:13 GMT -5 pooh8402 said:

This is what I was thinking. That's why I did drops of formula on the nipple, or used the SNS, to keep him latched until my milk let down.

I tried the formula thing, didn't work.

She IS on now though.

She refused nursing, got her 10ml of formula, was still acting hungry, so I put her back to breast, and this time she's on and has been for about 20 minutes.

Hoping she's getting her fill. She's only had one (barely) wet diaper since 5 last night. And one dirty too. But that's it.

That's great! My LC said sometimes that's what you have to do--supplement first so baby isn't ravenous, then nurse once baby has some food in the belly. I've done this with newborns at work.


Edit:
And yea, you're right, that's not a lot of wets. How often are you giving the formula, and how much?

[momin2013]

DS wouldn't latch for the first four weeks so I pumped and bottle-fed (combo fed for the first week until my milk was in completely, at which point we switched to 100% BM). I kept trying periodically and around the 4 week mark he started latching and continued to nurse after that with no problems.

I know trying to latch the baby each time is best, but DS would just scream his head off when I tried, so I gave up on that. I'm pretty sure what worked for me to bring my milk in and get my supply going was renting a hospital grade pump; I used that for about the first month, I'd say.

[bostonmichelle]

Hugs bricco. I've been dealing with very similar issues. I started pumping and having DH syringe feed her that and then supplement with formula especially at night. Then I let her have the boob for snacks during the day. My supply still isn't up and I'm only producing about 1.5 ounces so I've been supplementing with bottled formula. I'm hoping my supply increases soon so we can go back to the breast. I found if she isn't starving she latches much easier so I'm hoping to start putting her back on the boob today for daytime feedings after giving her a bit of supplemented formula.

momin2013, I hope you don't mind me asking but how much did the rental cost and how much were you producing before and then after?

[momin2013]

Mar 29, 2017 10:39:57 GMT -5 bostonmichelle said:

momin2013 , I hope you don't mind me asking but how much did the rental cost and how much were you producing before and then after?

I rented it from our local major pharmacy; I believe I paid about $90 for the month, plus I had to buy a tubes/flanges kit for about $30, I think, which I kept and used afterwards with the regular electric pump I ended up buying (I'm in Canada; I imagine U.S. prices may differ a bit).

It was an Ameda, and worked like a charm. I started pumping the day after my milk came in (so like day 5); at first it was just drops in a bottle which I added formula to, but it increased a bit each day until by the end of the week I was producing enough to feed DS breast milk 100%. I actually ended up with a bit of an oversupply, which I had to work to regulate so I wasn't dripping milk everywhere between feedings (lol). 

[icedcoffee]

I don't think I would necessarily worry about her not waking herself up, but I would be waking her up every 3 hours. My doctor wanted us to wake and feed every 3 hours until DS got back to birth weight (which took 3 weeks for us).

I am so sorry you're struggling. DS and I really struggled for a while with BF. It got significantly better at 3-4 weeks, but it wasn't perfect until almost 12 weeks. I'm glad we powered through, but I'm not sure I could have done it with another kid to take care of and I often wonder whether I should have just enjoyed the first few weeks more and fed formula. I hope you can find something you are happy with!

Have you tried a nipple shield? I hate that thing (it can be messy), but it really did help our BF relationship. If she can drink from a bottle she should be able to latch to the nipple shield since it has a similar feel and basically requires no skill on their part. In fact, after we weaned off the nipple shield DS started to refuse bottles. LOL

[mccallister84]

Hugs. Your struggle sounds so similar to mine. E didn't really take to nursing until 9 weeks or so. We were offering the breast with nipple shield for 15 minutes then giving her a bottle while I pumped. She didn't really latch for her first two weeks and we had to wake her to eat all the time. The worse was when she lost more than a pound from her birth weight and we had to feed her every two hours. It took about an hour to actually wake her and feed her so we would only have an hour off.

I guess we are a success story since I am typing this as E nurses but I don't know if it was worth the cost. I don't have te fondest memories of E's first month of life, which included 7 visits to the pediatrician (many for weight checks) and a 4 day hospital stay for RSV.

I could not have done the nurse pump bottle routine with another little one running around and I won't do it again when we have a second.

For me, I wanted someone to give me permission to quit and no one wanted to do that. I know H would have supported me either way but he wanted it to be my decision.

Your relationship with the baby is the most important thing. And if nursing is interfering with that it's okay to stop. It's also okay to keep going. Please know you'll have the support whatever you decide to do.