Slow and lazy nurser losing weight when breastfed..advice needed

Amanda - posted on 02/14/2013 ( 2 moms have responded )

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Sorry this is so long but I desperately don't want to give up on breast feeding but I feel if she doesn't nurse soon I won't have the supply.
So I have a 3 and a half week old baby girl who was born 6lbs 12oz. She did great at latching on breast right off the bat and everything was fine till day 3 when she developed jaundice and started becoming impossible to wake up to feed. When she did wake up we would be nursing ALL day long as she would fall asleep within 2 mins of being latched. Once I removed the latch she would instantly wake up and cry so hard until I nursed again. At our first dr appt we saw she had lost a considerable amount of weight and we were told to stop breast feeding as she was using too many calories and it was causing a vicious cycle with the jaundice getting worse. I had purchased a medela pump online to arrive around due date but since she had come 4 days earlier it was not here yet. To keep up my supply and give her expressed breast milk I purchased a medela hand pump for the 3 days I had to wait. I had a lot of milk for her. I was able to pump 2 oz from each breast using the hand held each time and we fed it to her through finger feeding. After we verifed the jaundice was gone and her weight was up we got to clear to breast feed again within 4 days. Unfortunately she never wanted to latch again at 1 wk. We finally got her latched using a nipple shield which I quickly weaned within 4 days of using. We went back to the hospital lactation consultant and she was weighed before and after a feeding and took 2 oz! But it took her an hour to do it. We were sent home with instructions to only give her 20 mins a side.
Fast forward a week to her 2nd week dr appt. She lost all the weight she had gained and we were back to square 1. I started pumping exclusively for her but my supply was falling fast. I now can only pump 10-12oz a day. In the morning and in the early am hours I can get 2oz total but throughout the day its close to 1.5 and as the day goes on I go down to not even an ounce. We have been supplmenting with formula as she takes about 4oz a feeding every 2-3 hours except for two 4 hour naps a day. She has gained A LOT of weight and put on 9oz in 3 days. She now weighs 7lbs 10oz as shes gaining 2 oz a day while being bottle fed. She will latch and nurse but she fidgets and gets fussy cause the flow is not as fast as the bottle. The past 2 weeks we had her weighed before and after a feeding and she is still getting only 1 oz for an hour of effort. She does not suck very aggressively and takes lots of breaks. My question is should we go cold turkey tomorrow on the bottle and only make her nurse even if i'm not sure my supply will be there? I've tried raglan, fenugreek, teas, lactate support, oatmeal, power pumping, etc and nothing is increasing my supply. The only thing I've been told is to nurse nurse nurse. We bought a home scale so its easier now to monitor her for drastic weight loss but it's hard to use for monitoring feeding consumptions since it can be off up an oz each time. I desperately want to nurse and not lose my supply. Any advice? We also ordered domperidone which should be here in a week or two.
Btw we've already been integrating night and morning feedings when my supply is highest but it's during the day that needs lots of improvements. I don't know how to get her to be more aggressive on the breast even though her latch is correct and verified by a lactation consultant.

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Amanda - posted on 02/15/2013

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I do skin to skin usually for a couple hours at night to get her to sleep. Also she will latch contently the first 5-10 mins on each breast. Then she gets frustrated and will pull off and I keep switching from side to side while calming her in between for a couple of hours. It's exhausting. If I pull her off after 15 mins she would scream as if she's starving. My lactation consultant has suggested I don't have enough milk to satisfy her yet and to offer nursing sessions in the morning and night for now to avoid making her associate nursing with frustration. But I'm still questioning how to get my daytime/evening supply up. I still plan on offering her the breast through out the day and pumping after but so far I haven't seen an increase when I pump and she's still frustrated. If I keep doing this will it eventually go up in supply? I go back to work in about 2 weeks.

Lori - posted on 02/14/2013

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Are you spending any time skin to skin with her (kangaroo care). You topless, her in just a diaper. It won't be your miracle fix, but spending at least one hour a day skin to skin can do wonders for a baby. And one of the benefits is better nursing.

It sounds like you're doing all the things you should be doing, and you're working hard to do the right thing for you baby. Keep up all the good work momma!

My only other thought is to suggest you limit how long she's latched on for, but try to get her back to the breast again sooner. So say you let her nurse for 15 minutes, but then try to feed her again after 1 hour or maybe 1 1/2 hours rather than waiting for 2 - 3 hours. She may not be showing hunger signs yet, but she may be willing to latch on for a few minutes.

You didn't mention anything about it, but I wouldn't be offering her any sort of binki or pacifier either.

And please remember that the first 6 weeks are generally the HARDEST. It gets easier. Keep pumping, and keep offering the breast.

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