Paramedic having difficulties with satisfying son at breast who is used to bottle...

Amanda - posted on 10/27/2009 ( 5 moms have responded )

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My son was 4 weeks early and had many latching problems while we were still in the hospital due to the size of his mouth and lethargy. While in the hospital, my son's weight dropped from 7 lbs to 6 lbs 5 oz, and I was forced to supplement with formula in order to bring his weight back up. He had a small bought with jaundice and had to be under lights and on a bili-blanket, which caused him to become drowsy and dehydrated. We first tried the Supplemental Nursing System by recommendation of the lactation consultant, but it was very frustrating and messy for the both of us. Out of frustration and exhaustion (I was recovering from pre-ecclampsia and a classical-incision c-section) I gave him a bottle. During his first couple weeks I continued to try feeding him directly from the breast but had a lot of difficulty. My milk came in very early (by day 2 I was pumping 2 oz between the two breasts) so I could stop the formula, but I still had to give bottles to satisfy him. I tried the breastshield, and he wanted nothing to do with it for quite some time. I continued to pump and feed him expressed milk for many weeks following. At 6 weeks I had to give him formula for a few days to get rid of the jaundice...which surprisingly worked. He is now 12 weeks old and still prefers the bottle over the breast. He is satisfied only with the morning feed since he sleeps all night (about 7-10 hours), and I have a lot of milk available. We've been trying to do a couple of oz from the bottle then finishing on the breast, but it only works about half of the time. Here's my predicament...I work two 24-hour shifts as a paramedic, and he is given about 6-8 bottles in a row at least twice a week. This is also a problem because I don't get the chance to pump sometimes for 10 hours due to being out on a call away from my pump. Any suggestions? I would really like to exclusively breastfeed him while I am home so it is easier on both of us. It's getting very tiring pumping and feeding him like I do since I rarely have time to do anything else. He eats between 4-5 oz of milk every 3-5 hours, and I barely produce (by pump) 4 oz after 5 hours. Please help!

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Amanda - posted on 10/28/2009

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Thanks for helping, everyone. He's doing a bit better at breastfeeding. In fact, he rarely refuses it : ) I think the main problem is he isn't getting enough milk during a feed to fill him since he usually takes 4-5 oz of expressed milk. We're working on it though. I think my production is starting to slowly pick up again. Yay! Unfortunately, I can't stop working right now as my husband's income alone isn't enough. Also, work does not give actual 'breaks' as it is a 24-hr on-call deal. I've tried convincing them it is neccesary but they won't have it...if calls aren't being run they aren't making money. I am returning again next week (I was off 2 more weeks due to a wrist injury) so I may find more difficulty then. I have a very good pump (Medela pump-in-style) that I use religiously. I got it when I was expressing milk and giving bottles exclusively at the beginning. I'll also look into fenugreek as I hear a lot about it on the site and may consider cup feeding as well. I'm not sure about the SNS, but it won't hurt to give it a try again. Thanks again, everyone. I'll let you know how things are going soon...

Rebecca - posted on 10/28/2009

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I totally feel for you!!! I am a paramedic as well, although I work 4 -12hr shifts. There is no way you can take a pump into the ambulance to pump when you get a chance because there is no chance. If you are out of station you are either at a call or at the hospital with the patient (whom you cant leave until the hospital take over their care). Yes we do get "breaks" if you are lucky (thats the crappy part about being an essential service) I think when I start at 630 am I am lucky if I get "lunch" at 4pm!! I am worrying about your situation as well as I have to go back to work when my daughter is 9 months. She is EBF and is very passionate about it, as am I. Im worrying as well because my son self weaned himself at 13 months. I, like you am trying to change things this time as my goal is at least 2yrs (hoping for longer though). Im thinking of buying either the Medela Pump N Style or the Freestyle as they are both double pumps and are very efficient. I am hoping to at least get 1-2 good pumps in the 12 hrs.



Suggestions for you:

Get a really good pump for work (pump when you can, I know there isnt much time! :)

When you are home, try to only feed at the breast

Feed at the breast first before offering a bottle, then after he feeds pump for at least 10mins to make sure breast is empty and to stimulate them (pump even if no milk expressed)

Try the SNS again as this way he will get used to nursing strait from you again and not a bottle but will still get the milk he needs until your supply increases.

Take Fenugreek and Blessed Thistle capsules to increase your supply or even ask your Dr for a perscrip of Domperidone.

Make sure you drink alot of water, expecially at work!

Wear baby in a sling bra-less and top-less with baby just in a diaper to get lots of skin to skin contact and unrestricted access to the breast.

Co-sleep with baby as well so that he has access to nurse at night on demand, this will help your supply and he may be more willing to nurse as he is sleepy.



I hope I gave you some advice you can use! Take care and let me know how it goes!!!

Im rooting for you!

Tammy - posted on 10/28/2009

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You could try to feed your son from a cup instead of the bottle while you are at work. It's common for a baby to prefer the bottle - the milk flows from it MUCH more easily than from a breast.

See this page for a description, an references to a video.
http://www.drjacknewman.com/help/Finger%...

When you are working, are you not allowed breaks? You can store any pumped milk in a cooler bag with ice until you get off work. Even if you can only pump once in a shift, that should help keep your supply up.

*Fluffy Bunnies - posted on 10/28/2009

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Start with the breast instead of the bottle. When he's hungry he should want to suck. If he's frustrated because your breast is not as fast as the bottle then squeeze a little milk out so he can taste it. Stick with the slow nipples on the bottles while you are at work. I'm not sure how your job is, but I know they make pumps that you can plug into a vehicle. I don't know if that would help you any.

Jo - posted on 10/27/2009

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Do you really have to work right now? I don't know your situation, so if you're the only parent in the home, I totally understand why you're working. But if you have a second income, why not bite the bullet and stay home a few more months? Both you and baby will benefit from this, and you can focus on building up your milk supply by feeding on demand. Remember, under normal circumstances, the more you nurse, the more milk your body will produce. (My cousin was one of the exceptions to this--- her body never would produce enough, and she ended up having to go exclusively to formula so that her daughter had enough to eat.)



If you must work, why not always carry the pump in the ambulance? That way, if you are away from the station for that (hopefully rare) 10-hour stint, you may have the opportunity to pump elsewhere. There are also manual pumps which are much more portable than the double-pump systems (I've done both).



Another thing you might try as far as encouraging a larger milk supply is fenugreek. When I used to take it, it came in pill form as a supplement, and I'm told that it now is available as a tea. You'll have to see what's available in your area. It was very helpful for me. And remember to drink lots of fluids! Very important to milk production, fluids!!



Again, I don't know your circumstances, so I'm not trying to judge you. If I sound judgmental, I'm sorry--- I truly don't mean to sound that way! I am nursing my 3rd child, who is now 3 years old, and I'm very pro-nursing. I wish you lots of luck and success, and if it helps to know this, my aunt was successfully able to start her daughter on breastfeeding after a month in the hospital (cousin was a month premature in the early '60s) during which time Aunt was only able to pump her milk (they didn't much encourage breastfeeding back then). Consult your local hospital and ask for a lactation consultant--- they may have more suggestions as well. Keep trying!!