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Marieke

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  1. #1
    Monchhichi
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    Marieke

    Thank you for your response. I have a million more questions for you now.

    Ok. She has done the before/after weight check, and they said he was getting an ounce or less from the breast. He is taking 1 to 2 ounces of EBM afterwards from the bottle. He is taking more now than he was from the bottle, but doesn't seem to be taking anymore from the breast.

    Marieke, you mention "By pumping and skimming the fat from the top and adding that to the ebm." How does she do this? The LC hasn't mentioned it at all. Her older son has an anaphylactic allergy to nuts, so I would think avoiding any possible allergens would be important.

    I had mentioned the supplemental nursing system to her when she was at the hospital (I had a friend that used it to help her milk come in), but the LC hasn't mentioned that either.

    I have a question about pumping, as well. Should she be pumping until she is empty, or pumping a bit more than he eats per feeding? The LC has told her to pump until empty after every feeding, which is translating to about 6 oz. However, he is only taking about 1-2 oz in EBM. Isn't this going to cause her to be engorged when he gets onto the breast since she is producing way more than he is eating?

    And finally, the LC has told her to feed every 2 hours. She was told to BF then feed EBM at one feeding, then to ONLY feed EBM at the next feeding. Shouldn't she be BFing at EVERY feeding? I don't understand the reasoning behind NOT BFing, since the ultimate goal is to get him on the breast full time.

    I know she REALLY REALLY wants to BF (or she would have given up ages ago). SOOO I really want to support her in any way that I can and help her to succeed. I was a total flop at BFing (ended up having to supplement from 2 wks with my first, and formula fed my second) so I may be asking you a bunch of questions over the next little bit.
    Mommy to two beautiful girls:
    Jordan (8) - dx: Asperger's Syndrome, SID/SPD, milk allergy
    Brooklyn (5)- small but mighty!

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  3. #2
    m(or)
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    Don't have time to post much now. To skim the milk, just let it sit in the bottle in the fridge and the fat will rise to the top. The EBM only feeds are to get him food without tiring him. Good in theory, but bad for breastfeeding. She needs to request the supplemental nursing system, not wait for it to be mentioned. Ask LaLeche on that too. She should pump for 5 minutes longer than milk comes out. That builds supply. Engorgement is uncomfortable, but not as serious as having enough milk. At the next growth spurt it will make it much easier to have the milk.
    M
    Wife to W Married 34 years
    Mommy to dd K 19 years old and
    ds M and dd C 16 years old


  4. #3
    m(or)
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    I'd have her tell the LC that her goal is to get rid of the bottles altogether. Have her ask the lc to evaluate the latch again. He may be getting lazy with all that bottle use. And definetly have her ask for the SNS. If the lc won't help this way, I'd get another. Is the LC board certified? She would have IBLC after her name if she was.
    M
    Wife to W Married 34 years
    Mommy to dd K 19 years old and
    ds M and dd C 16 years old


  5. #4
    Monchhichi
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    Thanks, Marieke. She sees the LC tomorrow and I specifically told her to ask about the SNS. I am hoping that the LC agrees. She is feeding every 2 hours now and pumping as well. She is getting a bit stressed, I think, because with feeding every 2 hours that is 12 feedings per day. Each feeding is taking about an hour, so she spends 12 hours a day feeding. After feeding, she is then taking 15 minutes to pump, then she needs to clean the pump, as well as the bottles. So, she only gets about 15 minutes to 1/2 an hour out of every 2 hours to herself. She is exhausted. She has a 7 yr old to look after and her dh has been working long hours, so she's at her wit's end. Of course, I probably don't need to tell you all this... you've been there!

    Anyway, I am hoping the LC will agree to the SNS tomorrow to hopefully work towards getting him on the breast...

    I'll let you know how it goes tomorrow.

    If she can't get a SNS from the LC, is there somewhere she can buy one? Or can she get in touch with the LLL? How much do they cost? (Unfortunately, cost is a factor... she is already paying to rent the pump, and she has NO income. She did home daycare, so she gets NO paid leave, and she hasn't worked for a month now, due to being in the hospital and on bedrest for the PROM... Her dh is working extra hours, but it doesn't make up for her lost income.)

    Thank you so much for the advice! I wish there was more I could do to help her. Unfortunately, my kids are sick with colds, so I can't even go over there to give her a break, for fear of exposing Colton!
    Mommy to two beautiful girls:
    Jordan (8) - dx: Asperger's Syndrome, SID/SPD, milk allergy
    Brooklyn (5)- small but mighty!

    Visit my online store!


  6. #5
    Monchhichi
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    As far as the LC being certified, I'm not sure... It's a clinic that the hospital sent her to. I will try and find out from her.
    Mommy to two beautiful girls:
    Jordan (8) - dx: Asperger's Syndrome, SID/SPD, milk allergy
    Brooklyn (5)- small but mighty!

    Visit my online store!


  7. #6
    Blues
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    You can by an SNS on line. It seems as if the LC 's advice is creating a lazy nurser.
    It is hard to do all of the pumping but it works. I would pump for five minutes before offering the breast and then fingerfeeding (same basic concept as the SNS) after the baby slows down. The child is then getting more of the fatty hind milk and then being topped off with the for milk if it is still hungry. I did this X2 and yes it was exhaustng but it wasnt forever. I used a curved suringe and put a finger in the mouth which still supported the correct motion for nursing and dripped the BM in. Other times I would put the syringe in the corner of the childs mouth and expell while he sucked at my breast. Hard to do while tandume feeding but can be done with a good pillow.

    Sucking from a bottle is WAY different than a breast. Aviod the bottle, even a cup is better. Using a bottle in that manner is just prolonging the process. Yes pumping will make more milk BUT the baby isnt getting the breast the way he should and by the time he is he will need that six ounces.
    When you cannot stand, He will bear you in his arms. Do not look forward to what may happen tomorrow.
    Our Father will either sheild you from suffering, or He will give you strength to bear it.
    ~St. Francis de Sales
    Blues-proud twin Momma


  8. #7
    m(or)
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    I personally think this baby should be back in the hospital getting nasall tube feeds. If he is awake 12 hours a day and feeding all that time he is burning to many calories to gain weight. We were told 30 minutes max for 4 ounces. If it took longer than that, they would tube feed. If they don't sleep they don't grow. In hospitals where babies take only tube and breastfeeds, the breastfeeding rate goes way up. She sould definetly consult a ped who has experience with preemies. Our NICU wouldn't let our babies come home until we had an appointment with one for the day after release.
    The ped should be able to get her a prescription for the sns and the pump. Many insurances will cover those for preemies.
    Last edited by m(or); 11-16-2005 at 12:19 PM.
    M
    Wife to W Married 34 years
    Mommy to dd K 19 years old and
    ds M and dd C 16 years old


  9. #8
    Monchhichi
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    Thanks for the responses.

    His weight was up today (thank God). He is up to 5 lbs 3 oz. I had told her to ask about the SNS, but the LC said that latching at the breast is taking too much energy and that's why they want to bottle feed half the time so he can put the weight on, then be strong enough to latch properly and BF properly. She didn't want to use a SNS since his weight is increasing and so she didn't feel it was necessary. To me, this sounds ludicrous. Yes, he is gaining weight, but at what expense? Maybe I'm wrong, but from my (limited) experience, I had a baby who was supplemented with the bottle (inadequate supply and I was never offered any options other than formula feeding with a bottle) and it wasn't long before she definitely preferred the bottle over the breast. Her intake on the bottle kept increasing, but my supply never did. I think it's so important that she continue BFing this baby (because he's a preemie and because there are food allergies in her family and more than anything because she really WANTS to) and worry that she will never get him on the breast at the rate they're going...
    Mommy to two beautiful girls:
    Jordan (8) - dx: Asperger's Syndrome, SID/SPD, milk allergy
    Brooklyn (5)- small but mighty!

    Visit my online store!


  10. #9
    m(or)
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    The weight gain is great. I don't agree with the LC, but all is not lost. My twins had to be weaned off of bottles. Mitch could switch between breast and bottle, but had trouble latching. Corie would forget completely how to latch after a bottle. We went cold turkey with her. With the peds permission and every other day weigh ins, we did breast only. The nipple shield helped a lot. She didn't gain for a week and a half, but the ped said she was healthy and her diaper count was good.
    I'm thinking that once he is more awake and can take that bottle more quickly with out tiring, he'll be able to get on the breast full time. Something I recommend is one feed breast only, the next EBM. By giving EBM after every breastfeed, he learns he can be lazy and hold out for the bottle. Also, keep a super slow flow nipple on the bottle. If it comes too easy, they have trouble sucking hard enough on the breast.
    Amber, you are a great friend. If you have the opportunity to breastfeed again, please let us help you.
    M
    Wife to W Married 34 years
    Mommy to dd K 19 years old and
    ds M and dd C 16 years old


  11. #10
    Monchhichi
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    Thanks, Marieke. I hope he will wean well from the bottle. Having been in that situation, I know how hard it is to get them off the bottle once they've been on it. At least she has a great milk supply, so that will work in her favour.
    Mommy to two beautiful girls:
    Jordan (8) - dx: Asperger's Syndrome, SID/SPD, milk allergy
    Brooklyn (5)- small but mighty!

    Visit my online store!


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