More feeding q's

[jojo2324]

Hi there...I am breastfeeding, but I feel like I am doing it incorrectly. We have no trouble with latch-on and he's definitely getting enough given the number of diapers he goes through and weight gain. My real problem is with how to do it. The hospital told me to nurse on one side for ten minutes, burp, and then move to the other side. I've read several times that you should let the baby decide when he is done with the breast, not to look at the clock. My baby takes about 20 minutes at the breast and then really doesn't have much interest in the second one. Should I cut his time at the first breast, or should I just pump the second one? I am going back to work soon and am not able to pump there (I'm a waitress.)so I do need to start building up the reserves. My only concern is that if I do pump, there will be no milk for him at the next feeding.

My other issue is with burping. I sit him up after each feeding and hold his chest, pat his back, then put him over my shoulder and pat him again. Nothing ever comes up until about twenty minutes later. The ped told me to sit him upright after each feeding for up to an hour. I can do this during the day, but at night, what am I supposed to do? He has a swing that we put him in, and he likes that, but once you try to transfer him, forget it. We don't have a craftmatic crib and I am very likely to fall asleep while holding him upright at that hour. How have you all dealt with this?

Also, last night he could not get enough (he is going through his three week growth spurt). Every hour he was looking for some boob, but like I said before, if I try to feed him on both sides he won't take it. We finally had to give up and give him some formula because I just don't think he was getting anything and also I was in tears I was so tired. Then I started bawling because I felt like an insufficient mother. I am all about breastfeeding and he's only had formula three times since he's been born, but I still get this overwhelming sense feeling of guilt. I even start to get upset when I watch Baby Story and I see babies with formula. I wish there was a more happy medium between using breastmilk and formula so I wouldn't feel like a failure. Anybody else had crazy guilt issues?

Sorry so long. Thanks for your help. joanne

[nina]

Joanne,
As a first time mom also breastfeeding (baby is 8 weeks now), I completely understand how you feel. First off, don't feel guilty. One thing I've learned is that though there is literature out there highly supporting breastfeeding, no one ever really discusses how 50% of women who start, never go beyond 3 weeks. I think breastfeeding is one of the hardest things to do. That does NOT make you a bad mom, nor does that mean your child will grow 2 heads. But I do understand the guilt. I have to say that I almost quit at the point you're describing, but I kept with it, and now it's been 8 weeks. I will be returning to work soon too, and eventually I will stop. Don't know when yet.....I just know I can't do it for a year. So if your baby needs formula to be full, then so be it. As long as he's getting mostly breastmilk, it's totally fine.

Anyway, as for your questions...I"m sure more seasoned moms can support this, but I was told that you should let your baby decide when he's done. If he takes 20 minutes on one, and then doesn't want the other, that's okay. You should keep him there until he's done because that way, he gets the hindmilk. Then pump the other boob.

As for pumping: I started pumping an hour after I fed him at the same time each day (in the morning). At first I would get piddly amounts of 1 oz at best. Eventually, I started getting more...and built up a supply.

Burping: I think that 1 hour is way too long.....esp in the middle of the night. Sometimes babies don't burp. Sometimes my son won't burp, but then when I put him down to change the diaper, and then pick him up, he does. They say that's when the gas is in the intestines and not the belly.

Hope this helps.....hang in there

[egoldber]

Joanne, first off, I would really recommend that you go to a lactation consultant, breastfeeding support group (my hospital had one) or a LLL meeting. There are very knowledgeable people that can help you figure out if you are really having a problem. If nothing else, it will help to reassure you. He may only want one breast, but if he still seems hungry and won't take the other one, then it is worth it to figure out what is happening.

Is it always the same breast that he wants (and the same breast that he doesn't want). If so, this is not really uncommon. There may be something that is giving him a preference (slower letdown on that breast, faster letdown, inverted nipple, the angle you hold him on one side, etc.) A support person will be able to help you figure it out.

I went through some of the same issues. Sarah (we found out later) has a very high pallette (roof of her mouth) and had a hard time sucking even when latched on properly. So even though she would nurse 20 minutes at each breast, she was not really getting sufficient milk. I had been so pro-bf prior to her birth and so determined to not use ANY formula that when we ended up supplementing her with formula, I also felt horribly guilty, like I was some kind of failure. Finally, talking to my ped and being in tears, he gave me some great advice. He told me that the best gift you can give your baby is to be a happy, well rested mother. A little formula was not going to adversely affect my child's development, but being stressed out, feeling overwhelmed and depressed could, and this was far more important than my feeding choice. I took his words to heart and I really believe it. Make sure you baby gets the nutrition he needs (even if that means supplementing a little) and work with a lactation consultant to make your bf relationship more satisfying.

HTH,

[Rachels]

I couldn't agree more. The help of a consultant or LLL can make an enormous difference. The advice to switch breasts on a schedule is outdated and mostly helps with engorgement. Nursing longer on one breast helps your baby get enough hindmilk. If he is doing that regularly, your milk supply will adjust to his style. My baby has a high palette, too, and I needed to use nipple shields for a few weeks until she was coordinated enough to latch on without them. I felt guilty, too, but my lactation consultant was amazingly helpful and reassuring, and now we're nursing just fine. You do what you have to do to take care of your baby. Having trained support, though, can make an enormous difference. Hang in there!
-Rachel

[laura_winckler]

I breastfed my first child for a year and am planning to do the same with the second (wish me luck). First of all, don't feel guilty about the choices you make to feed your child. Secondly, remember that you are still awash in hormones, so some of your anxiety, tears, guilt, etc, is likely due from lack of sleep/crazy hormones! This too shall pass.

As for your specific concerns, I would feed my child on one breast for as long as he wants it, then burb him and try to switch sides. If he only wants one side, that's fine. Just remember to start with that one next time. The longer he nurses on one side the more fatty hindmilk he gets. If he continually refuses the same breast, I'd see a lactation consultant. That's common and easy to correct. Pump that side until you can get him to nurse over there.

There are several burping positions to try: over your shoulder, with the baby sitting up in your lap (support his head under his chin), and lying on his tummy across your lap. My son burped best in the sitting position. He won't burp everytime.

As for your ped suggesting that he sit up for an hour, I'm wondering if your ped thinks he has reflux? You can buy wedges to put under his mattress in his bed that will help him sit up more when you lay him down. You might also consider switching off with your husband after you feed, if that's a possibility. After I nursed Eric, my husband would change him and rock him to sleep. He fussed if we put him straight back to bed. Otherwise, I would have been up nearly all night, and I just couldn't do it!

Sorry this is so long, but I hope it helps! Remember, if he's gaining weight and wetting his diapers, all is well!

[megsmom]

Applause for being a mom of a three week old! I think the first few weeks are the toughest as you try and figure out this person who can't really communicate other than crying, your wacky post-partum body and almost no sleep. I agree with earlier posts that a trip to a lactation consultant (if this isn't possible a phone chat might help ease some fears... we had a number into the hospital here called a "warm line" answered 7 days a week), a breastfeeding support group or new mom's group can work wonders for easing a lot of doubts.

My daughter strongly prefered the left breast because it had a really strong let down and she got her milk fast. I did pump on the right sometimes after a feeding just to keep up my milk and drain that side. Some things I learned from my lactation consultant: Some women experience a slight dip in the milk supply in the evenings that goes back up after midnight and some sleep. Hence, some babies tend to cluster feed (sometimes hourly) to make up for this. If your baby is going through a growth spurt, your milk may not have caught up to this yet and he's feeding a lot to stimulate your milk supply. My lactation consultant said that if I pumped right after feedings there would be plenty of milk there for the baby by the time of the next feeding. Also, you are constantly making milk so your breasts are never really empty. Worst comes to worst, you could give your pumped milk to the baby.

All that said, I only nursed my baby for about 6 weeks and do not claim to be an expert. I was/am very pro-breastfeeding and did not give it up because I was lazy, wanted to take the easy way out, etc. I ended up having some pretty severe post-partum depression where I was unable to sleep (even when my baby did), had terrible migraines every few days, and alternated between feeling utter despair and intense anxiety. I also was one of those folks who had a low milk supply and my days were consumed with trying to stimulate extra milk with pumping/cleaning the pump, running to the pediatrician for weight checks, etc. I did all of this with a very fussy daughter and it was just a really rough time. Giving up nursing was the hardest thing I've gone through since I had read all the articles which said all these wonderful things about breastmilk. I try not to but still feel bad sometimes because it wasn't what I wanted. In the end, we decided to wean her to formula to allow my hormones to return to some normal basis. I cried a lot feeling so bad that I had to give her formula. Thankfully my pediatrician, ob, and lactation consultant were all very supportive because in the shape I was in, I was hardly able to be a mother at all. Like Beth said above, this is actually more of a detriment to your child than baby formula. Giving a relief bottle of formula/or pumped milk here and there to give yourself some rest is OKAY. I know plenty of moms who did this and continue to have a great breastfeeding relationship with their babies. (I know I will catch some flack for this, but I think we moms have to be supportive of each other. I endured a lot of dirty looks and comments about bottle feeding my daughter. I know other breastfeeding moms who were given dirty looks for bf-ing in the mall, etc. so it seems we all can't win). Around 4 weeks is when most experts recommend introduction a bottle if you want to use one.

BTW, the Baby Story really doesn't give the full parenting picture. I watched WAY too many episodes when I was on bedrest and had thought a lot things would be different becuase it all looked so rosy and easy on TV. I'd like to see these parents at 3 am with a screaming 2 weeks old infant. Who knows why you see babies bottlefeeding (I've seen several moms nursing), maybe the moms have had feeding difficulties or just don't want their boobs on TV (hard to imagine since they let a strange camera crew and the nation see their deliveries!)

I guess I never worried too much about burping when I nursed since my daughter was never that gassy with nursing (different story with the bottles). I also never worried about keeping her upright at night, but I know one mom whose baby had reflux did have to do this. I would consult your pediatrician who may give you alternative suggestions (ie the crib wedge above, sleeping in the car seat, etc.) so you and your husband can get some rest. Don't know if this was helpful, but I wish you the best.

[twins r fun]

On the issue of keeping your son upright after a feeding, we were told to do that by a doctor at the pediatric ward of our hospital after our son was diagnosed with reflux. He reccomended having him sleep in his infant seat, which is what we did. We were also told to elevate his crib matress for when we slept in the crib, which seemed pretty ineffective since he always slipped and ended up sideways and thus not elevated! Again these were both to help the reflux and burping/not burping was never brough up.

Nicole

[KathyO]

Everyone else has done a great job on the technical issues, so I just wanted to add that crazy guilt issues... are going to be part of your way of life for the next several years!! In my Moms' group we have "Bad Mother Confessions", where we spill the tales of our heinous motherhood crimes ("she fell off the curb and bloodied her lip because I didn't catch her fast enough!!!" or "why didn't I realize right away he was lactose intolerant???") and give each other absolution.

My daughter would only ever do one breast per feeding. She is now a healthy, happy (give or take a couple of molars about to pop through) one-year-old. I think that one of the really neurosis-making things about breastfeeding is that you CANNOT TELL how much the baby is actually getting. We'd all be so much happier if there were calibration markings on our breasts! I also think that babies have trouble figuring out what to want at first. Nursing eases hunger pangs, they think, so maybe it will help tummy cramps or missing the womb? So they try it, and it doesn't work, and they fall back to crying again, and you assume it's because there's something wrong with your milk. As long as the wet diapers keep coming, and baby is gaining, you're probably fine.

On the pumping front, a friend of mine, whose baby also only ever nursed on one side per feeding, would pump the other side DURING the feeding to save time. Once you feel more comfortable you could try it.

And speaking as someone who cried at certain hardware store commercials during the postpartum period, I'd say being in tears from time to time is totally in line. Be kind to yourself.

Many good thoughts coming your way!

Hang in there,

KathyO

[AugBaby]

I have to agree with the previous responses, but want to add a couple of things. If you are okay nursing frequently, let him nurse for as long and as often as he wants. It doesn't mean that he isn't getting enough, just that he is, as someone else mentioned, stimulating your body to produce the milk he will need as he goes through the growth spurt. Your breasts are always producing milk. He may just get a little frustrated at times because the flow may be slower, or he's working out some gas.

Our dd had reflux and had difficulty with dairy. I didn't realize the dairy connection until we were into the second month. Although you didn't bring that issue up, I'd try to go without dairy if possible. In the beginning when things are tough enough as it is, who needs to add the possibility of difficulty digesting dairy? Our dd nursed for an hour at a time sometimes, and then I had the half hour (what was recommended to us) of keeping her upright. It does get better soon! We didn't burp her at night, and during the day she didn't always burp when we gave her the opportunity.

We solved the night dilemma of keeping her upright by propping her on a pillow between us when she wasn't nursing. Yup, we sleep with her :-). Night nursing helped with what seemed like endless nursing in the beginning. And, you won't always be keeping him upright! It all gets better soon.

DD wasn't gaining in the beginning, so I was pumping right after feeding her and then supplementing her with what I had pumped by eye dropper. I'd suggest starting to pump once a day in the morning when you can, in order to get your body used to letting down to the pump. Then you won't feel pressured to build a supply in the freezer, either. If you feel that you want to increase your supply, post again, and I'm sure people can recommend what worked for them (herbs), or as others said, call a LC or LLL.

You're doing a great job. Just hang in there :-). After having a rough bf start, dd measured in the 95th and 90th percentiles, and is still nursing strong as she's turning one. Be kind to yourself. You're a great mom to be so concerned!