More pumping advice, please

[cherryvalance]

Guys, I'm at a loss and I don't want to give up, but I feel that day is approaching.

If you recall, I was pumping incorrectly and got great advice here. I started pumping regularly, 20 minutes per session. DS started having bright green, frothy poop from the milk, so it seems I have an oversupply. I was pumping when I could and was going too lon between sessions.

I started a strict schedule of pumping every 4 hours. We also started supplementing with formula to get some fat into DS just in case he wasn't progressing well with the milk. At his 1 month check up, his weight, length and head circumference were all good and normal.

I started to drop the formula supplementation to just nights, to keep him asleep and full, and give him only breastmilk during the day. However, he's still having bright green poop whenever I remove the formula.

I don't get it. I see three distinct layer in my milk--thick cream on top, opaque in the middle, and bluish white on the bottom. Everything I'm seeing online seems to suggest my milk is good, but it's still hurting him.

Sorry this is so long, but I don't know what else to do. I feel like I'm doing my best and it's still hurting him, so I might as well give up and move to formula. I hate that, though, because I'm obviously producing. I'm waiting on an appointment to go in to the lactation consultant, but when I spoke with them.on the phone, they just suggested nursing more and block feeding.

[pooh8402]

I don't know the answer to this one... definitely talk to your LC! I can see block feeding helping though.

Once I had the oversupply, I stopped giving formula altogether. He didn't need it. I then worked through the bright green poop and oversupply. So that's what I would do in your shoes.

[loira]

Is he uncomfortable? He seems to be gaining weight just fine. I was given a poop chart from the hospital, with a wide range of 'acceptable' poop colours, including green. The only poop they said I should be worried about was very dark or white and chalky. I combo fed A from very early on, though, so I'm definitely not an expert in BM only baby poop. I will say that for me, when the problems with pumping outweighed the benefits, I did wean off and went EFF.

[satsuma]

Are you assuming that you're hurting your baby because of the color of the poop? Green stools can be fine. I wouldn't self-diagnose an oversupply just based on that. Even if it is an oversupply, which is certainly possible since you've been pumping lots, it will not necessarily cause problems for baby. Babies of moms who overproduce tend to chunk up quickly. Sometimes it causes stomach discomfort. The larger problem is to the mom who is at an increased risk of clogged ducts and mastitis. I mean this kindly, but I believe you're making things too difficult for yourself. If the formula gives you peace of mind then continue. But it's not really needed to make up any deficiencies in your milk. Since it takes longer to digest and can change gut flora, it's not unexpected that poops look different on formula than off (usually green poop is that which has passed through the GI tract faster). I'd ignore what your milk does in the fridge; it can vary from pump to pump and separate more depending on how long it's been in the fridge. Focus on how you feel and how baby is doing. The LCs who are telling you to block feed, have they actually seen you in person before?

[cherryvalance]

Thanks for the insights, guys! This will be long as I work through the questions .

pooh8402, how did you work through it? Friends of mine are suggesting dropping to 15 minute pumps instead of 20 minutes. I'm waiting for the lactation consultants to call back with an appointment and I'm not opposed to moving back to nursing, but from our phone consults (they have a "warm" line), they don't seem to have much advice for exclusively pumping and I'm afraid that if we go that route, we won't have guidance.

loira, I was willing to pass the green poop off as a fluke at first, but he has been super uncomfortable during/after feeds and with pooping. His pedi says his symptoms could be due to a milk imbalance OR reflux, but that it definitely sounds like something is going on. She told me to start with Gerber probiotic drops to see if that helps.

satsuma, I fully believe I overthink things, lol! I would definitely prefer him to be on breastmilk solely. Here's my concern--his poop was bright, lime green, not a darker army green. He had explosive poops and screeches in pain during/after feeding (when he poops most often), he throws himself backwards during/after feeding, and lots of gas and hiccuping. I described it to the lactation consultant and she also said it could be oversupply, reflux, both or neither, and suggested I pump out an ounce and then nurse. But DS is frustrated by nursing and still has latch issues, so that's not really working for us right now until we can get in and get some help.

My pediatrician's office doesn't really have anyone on staff experienced with lactation, so I've been in contact with the lactation consultants at the hospital. They worked with me daily during our stay, so probably 3-4 days, but I had to get a prescription to see them again, so I'm waiting for an appointment. I do speak with them weekly, though, since they have the warm line.

I guess I'm just scared that he's in pain; his eating is much different since I started formula supplementing. I think it doesn't help that I don't know what's normal for babies and that I have a LOT of anxiety over his eating. When we returned home from the hospital he had lost 10% of his body weight and another pedi at the practice terrified me that I was basically starving him. He did beef up after I started pumping, to be fair, but it's always in the back of my mind.

[loira]

cherryvalance, I also had (even continue to have sometimes) anxiety over how much A eats because she was so small at birth, then lost a ton of weight. I totally feel you. It's terrifying. I'm sorry he's uncomfortable. I hope you can find a solution.

[satsuma]

I'll try to write more tomorrow but I just wanted to sympathize with you. DS lost over 10% of his birth weight and I was pumping and supplementing and he ended up seeing an OT to work on latching issues. The newborn period sucked for me and I felt guilty about it after dealing with IF. It gets better! I promise, no matter how you end up feeding your baby, things will come together.

[cherryvalance]

Thanks for the commiseration, loira and satsuma! It definitely makes me feel better that other people have struggled with the weight anxiety, and to know your kids are doing well now. I'm also glad we started seeing one of the other pediatricians at the practice and she's much less alarmist than the original, but you know the fear. At least with pumping, I can see exactly what he's getting.

Argh, motherhood isn't easy, huh?

[pooh8402]

cherryvalance, exactly like your LC said. Block feeding, and shorten your pumping sessions if needed. I didn't EP, so I don't have advice for that. I pumped in order to nurse.

E had the same symptoms with his reflux. We started treating his reflux before the bright green poop though.

Fair, I still have anxiety over E's weight, and he's 2!

[Chrysanthemum]

I EP'ed, only for three months though. Try exclusivepumping.com and they have a FB group, too I believe. C also had reflux and Zantac was the best thing every for him; I was really resistant to starting meds but am so glad we did. Night and day difference. Let me know I can answer any questions for you! Hang in there, you're doing a great job!

[cherryvalance]

pooh8402, thanks! I'm at least enjoying the even shorter pump times.

pooh8402 and Chrysanthemum, I didn't realize your kids both had reflux. It seems so many of my friends have babies with reflux! How did they diagnose the refux?

I'm going to check out exclusivepumping, also.

I knew you guys would all have the best recommendations, so thanks!

[pooh8402]

Symptoms and history, mostly. It wasn't even on my radar because he was gaining weight and didn't mind being flat on his back. He screamed so much, especially at his 2 month appointment. My doctor suggested it and I was all, nah.... A week later I was in his office in tears. After a few days on Zantac, E was happy and I was finally able to enjoy my ML.

[King26]

I have no advice on pumping but to say do what you thinking best. I'm currently.panicking about undersupply so we supplement with formula. J didn't gain any weight the last week so I worry about that. Stay on the LC, I've had to call numerous times to get in with one at our hospital and it's annoying but I need help. Hopefully you can get with one soon and they can help you out

[cherryvalance]

pooh8402, I'm glad he's doing well on the Zantac, poor baby! I'll keep my eye on DS's symptoms.

King26, I hear you. This time is so stressful because they can't tell you what's wrong or what they need, so you become obsessed with the measurements and poop output, lol. At least I do.

[thoseareradishes]

cherryvalance, reflux is pretty common because babies digestive systems aren't mature yet, so their stomach acid goes back up into their esophagus easily. I suspected E had reflux for awhile (some arching, pulling off her bottle, choking on spit up, swallowing down spit up), but I didn't medicate her until I felt like she was getting uncomfortable. My pedi was pretty surprised we were able to hold off on meds for as long as we did, since it's so common in preemies. She takes zantac twice a day.

Throwing himself backwards sounds like he might be arching - it can be a sign of reflux.

I hope you are able to get a hold of the LC and you can come up with a plan you are comfortable with and works for your boy.

[cherryvalance]

thoseareradishes, that makes sense. And a lot of that sounds like DS, too--choking while eating, swallowing spit up. I'll see how he does with these probiotics and her other recommendations (sitting up after eating, frequent burping, lying on stomach to sleep during the day), but at least I know there are options. I'm glad your baby girl is doing well with the Zantac!

[Chrysanthemum]

cherryvalance, I was starting to suspect reflux because C screamed while burping all the time. He always arched his back and you could see him swallow spit up sometimes. He'd also spit up HOURS after a bottle. He was diagnosed when he screamed throughout the entire 8 week appointment with the pedi. I didn't even have a chance to bring it up before she offered the prescription.

[cherryvalance]

Chrysanthemum, omg, poor baby!

[shauni27]

I know I'm way late to this cherryvalance, but I just wanted to commiserate. Our feeding issues were a bit different, but I ended up combo feeding because S wouldn't gain weight and he hated nursing. It caused me so much anxiety and stress and I overthought every little thing. It was so hard and there is no magic right answer. It's stressful to think that you are causing your baby pain or starving them, but know you are doing your best and you are feeding your baby. It might take a bit to figure out what works best for you guys (we are 7 weeks in and i *think* we just figured it out...but I'm not holding my breath!) but remember that it is temporary.

One thing that this group of women helped me realize was that just bc there are a million things we are told to do and not do, they are guidelines. We need to figure out which of those guidelines apply to our individual circumstances, whether it be feedings, sleep situations, tummy time, meds, etc.

Good luck!