Feeling totally overwhelmed, help please?

Discussion in 'The First Year' started by SaraSatin, Apr 20, 2011.

  1. SaraSatin

    SaraSatin Well-Known Member

    Ok, my girls are a whopping 6 days old and I feel like I'm failing already. They get considerably more formula than breastmilk right now, but they are so tiny that I can't not supplement until we figure this out. Here is what is going on...

    Hope was born at 4lbs 7oz unexpectedly, I was 37 weeks and we were expecting a 5 pound and a 6 pound baby at least. She had to go to the NICU for 2 days for blood sugar issues due to her weight and I did go and try to nurse a few times but it was hard after the c-section.

    Ariel was 5lbs 13oz and stayed with me the whole time. She nursed as much as I could get her on but also supplemented because I was having trouble getting her to latch.

    I have met with the lactation consultants in the hospital who helped me get both girls to latch, they helped me get set up with a pump and start pumping and my milk actually came in while I was in the hospital. I was able to get up to getting half an ounce one time but am having the hardest time forcing myself to pump. The girls are so tiny they tend to get my nipple but not much areola. I relatch them as much as possible, but if I keep doing it they will give up and start flipping out crying. My nipples and breasts are very sore right now, I have been fighting tears while I pump today and I've only managed to pump 3 or 4 times and get a whopping 5 ounces all day long.

    I met with a lactation consultant at the pediatrician's office and she said the best thing to do would be to keep putting them to the breast every feeding and helped me get them to latch while I was there. My problem is that I can't get them to repeat it without a lactation consultant there to help. Ariel nurses maybe 2 or 3 times a day but that's it and always seems to take an entire ounce of formula afterwards even though I hear her sucking and swallowing. I know she stops before she should, she gets tired. Hope doesn't seem to have the energy to trigger a let down and often gives up before the milk actually starts flowing. She is just over 4 pounds right now and absolutely tiny.

    I'm giving them the breastmilk I can get out and I'm offering them the breast as much as possible, but I really don't know what to do right now. I am so overwhelmed, they are so tiny and I really need them to gain weight but I want to nurse them. I am just so defeated feeling, I don't want to pump right now because I'm just in pain but then I'll miss a feeding and I've done too much of that and now I need to up my supply again. It's Passover so I can't make any lactation cookies until next week Wednesday.

    I am sorry this is so long, but I need some advice/encouragement. I don't want to stop giving them breastmilk. I told myself from the moment I found out it was twins that I was going to be ok with giving them everything I could and that I wouldn't beat myself up... but when the best that I can do seems to be a quarter or less of their food I feel like a total failure. My oldest daughter didn't poop for days because she wasn't getting enough calories when she had trouble nursing. I don't want that to happen again so I'm giving them what they need to gain weight, but I really want to feel like I did a good job of giving them my breastmilk which I know is best for them.

    HELP! Please? I can't sit here crying anymore, I don't want to end up depressed again there isn't time to deal with that and 3 kids 3 and under!
     
  2. cheezewhiz24

    cheezewhiz24 Well-Known Member TS Moderator

    Sara.

    :hug: s to you.

    There's a lot going on here- but the great news is they are *only* 6 days old. It's a lifetime when you are feeding them (or attempting to) though.

    Ok- firstly about your pump. I'm wondering if your horns are big enough? if they are too small your nipple chafes against them while pumping which hurts. Are you slathering on the lanolin? That stuff didn't take away he soreness completely for me but it did help. I used 2xs my normal amount when I pumped, too, as pumping felt more irritable to my breasts.

    Latching. I had a 5 1/2 pounder that dropped down to 4.10. Tiny is ok as long as she eats. It sounds like she's getting tired- mine did not wear clothes for the first week reliably. This was because every time they ate I unswaddled, changed diapers, rubbed (vigourously!) their head/neck/feet, startled them with a cool washcloth, anythig that would work to keep them awake for a full feed. But back to latching. I didn't do it for the first 2 weeks. I am NOT mechanical. My DH watched the LCs do it and did it for me for the first week if not more. It finally clicked for me when he showed memthe motion I needed to do (make hand into a C with thumb down and rotate clockwise). See if your DH or a friend who has breastfed a baby can stay with you to assist- with mine it was hard to see them, initially, under a large breast!

    So I know there's more to your post I'll reply to later (iPod touch makes it difficult to see upthread); but one more word about pumping: 1. Google Jane morton hands on pumping 2. When you get a baby latched on, pump the other side. Don't waste time sitting and nursing on one side and not pumping.

    You can do this!!!!!
     
  3. momof6

    momof6 Well-Known Member

    I also had a tiny, tired eater! He would fall asleep after a few sucks and was hard to wake up. I did supplement with some formula for the same reasons. I agree with the PP... get your DH or a friend to help you. I honestly could not have done it with out my DH. He would keep my DS awake, rubbing stroking under his chin (to get him to suck) he would help hold his mouth so I could latch him. Honestly it was a two man job for awhile. If you want to keep your milk supply up and get some stocked up then I would pump after each feed for 10-15 min. That is what I did and yes, it is tiring and a lot of work but it really helps. Put your babies to breast as long as you can and then pump (offer a small amt of formula if you feel that they need it) or give them some of your expressed milk. You mentioned that they did not suck long enough to get your milk to let down. Try to pump for a few minutes before they go to breast so the milk lets down with out so much work from them. I was at the point of pure exhaustion and nearly gave up too, but it does get better. I have not had to supplement at all for a long time and only give a bottle of EBM if I am gone. You will be able to build your supply with pumping but remember the baby does better than a pump even if it does not seem like they are getting enough. My DS was 5lbs at birth and went down to 4 10 (I think) and now at 4 months is over 12 pounds! You can do it! Good luck!!
     
  4. miss_bossy18

    miss_bossy18 Well-Known Member TS Moderator

    :hug: hang in there! there's a lot to figure out right now. make sure to offer yourself lots & lots & lots of grace - remember, you have time to figure it out.

    have you tried a supplemental nursing system? it sounds to me like it might be a good option for you. here's some info from Dr. Jack Newman on using an SNS (he calls it a lactation aid) and here's the Medela SNS.

    also, have you thought about hiring a postpartum doula? they can be a huge help with everything, not just breastfeeding, and if you find one who's still working towards her certification, they'll often volunteer their hours, or do the work for a very reasonable rate. check out DONA (Doulas of North America) to start.
     
  5. Cjoy

    Cjoy Well-Known Member

    First, Congrads! I know it has been a very rough week, both emotionally and physically. It wasn't that long ago I was crying with them... as they were trying to latch and we were both frustrated and upset. I did the same thing that 'momOf6' mentioned above... I tried them at the breast everytime, priming myself with the pump so they did not have to work as hard. I also pumped after for 10-15mins to build my supply, and I supplemented if to make sure they were getting enough calories. (I counted it, I was topless for 12+hrs/day..between nursing-well, trying to, and pumping). I hated supplementing, as I felt it was a set back to nursing, but they needed it. Before long, I had a HUGE supply and they were gaining and latching a bit better... I then went to see a LC that has a private practice here locally, and 2 visits later- we were nursing champs, and haven't looked back(after 6 long weeks of pulling my hair out, wanting to give up). I just needed some tweeking to my technique. I also lathered on the lanolin and got bigger horns as 'cheezwiz24' mentioned...I think that made a big difference to my comfort as well...I was pretty raw from pumping all the time. It was day 4 and 5 for me when I was most uncomfortable and frustrated... I had a call into the peds office on day 4 (day 1 home from the hospital) regarding their nursing issues and a home care nurse come to help on day 5 (day 2 home). I had my mom with me full time (so thankful!) and DH when he wasn't working...I also do not have a toddler too...so that made it a bit easier to get rest and nutrition for myself so I could produce milk and focus on the nursing only. I wish you and your three daughters the best!! You will be tandem nursing in your sleep in no time...you just need to make it over this very difficult hump! I say, keep on trying at the breast, pumping and supplement when needed to get them gaining. Good luck!
     
  6. SaraSatin

    SaraSatin Well-Known Member

    Thank you for the encouragement! If anyone has any tricks to making yourself pump I would appreciate them. Right now we are putting them to the breast, letting them eat if they will and then letting them have as much formula from a 2 ounce bottle as they want. We were told not to limit them unless they got into the habit of eating too much and then spitting up. They are getting a lot of formula, but I'm trying. I'm avoiding pumping as we speak, but we were out for a feeding so I have to sneak it in there.

    I guess I'm just going to have to force myself to pump, I am doing a good job I think at putting them to the breast every time they need to eat (except at 3:30 am this morning when they were both screaming, I just couldn't wake up enough to do it) and giving pumped milk before formula where I can.

    I don't know, I'm just so confused about all of this. Thank God for daycare for my oldest, I don't know if I would even attempt nursing if she were home too.
     
  7. cheezewhiz24

    cheezewhiz24 Well-Known Member TS Moderator

    If you think of pumping as more of a bridge to nursing it might be easier. I never intended to pump FT- & was super annoyed that my lazy baby Sebastian needed me to. It just took some practice (& all of us figuring out how nursing works) for him to get the hang of it. For us it took less than 2 weeks- I want to say about 9 days when he caught on.
    :youcandoit:
     
  8. Cjoy

    Cjoy Well-Known Member

    You are doing a great job! I made sure I pumped every time they ate if they were getting bottles. Do you have a double pump? Do you have a hands free pumping top? If not, you may find it handy. (Or maybe buy a cheap sports bra and cut holes in it-I think it would have to be a size smaller to be snug enough). You may be able to pump and feed with a bottle at the same time...if the baby is in a bouncer or propped up next to you. If you have two bouncers, you can sit in the middle on the floor and pump while bottle feeding them while wearing a pumping top. That could save some time too. I felt like I was married to my pump for months, but it also allowed for some down time. My LC suggested (before the babies were born) that I rent a hospital pump to get my supply up, then use my own pump after the first month... if you find that your supply is an issue, you could always try that for a bit.

    Pumping feels like a chore after you have bottled, but it will increase your supply so when they latch on good...there is plenty for them! I made a plan when I started nursing. I was using nursing shields, I was pumping, priming myself and using glucose water & formula to entice them to latch on. I slowly stopped priming myself, then I stopped using the water & formula and that really made them work for it. Then I got rid of the shields, and shortly after that I was BFing exclusively and tandem. This plan took about 6-8 weeks to really get them to be great at nursing. I even did a nursing marathon for 3 days...I had help and I nursed nonstop.

    Do your best! Supplement when needed, pump as often as possible.
    Hang in there!!

    Here is a link to a hands free pumping top.
    http://www.mommygear.com/easy-expression-bustier.htm
     
  9. E&Msmom

    E&Msmom Well-Known Member



    These things are key. If you attempt a nursing session and at the end you "top them off with formula" then you need to pump too. Everytime they eat from somewhere other than you, you need to pump so your body knows it should still be making more milk. Otherwise your body thinks the feeding is over and the babies got everything they needed. Its exhausting in the beginning to say the least but its necessary and it get significantly better. the first 2 weeks of constant breast stimulation/milk removal are what set you up for the LONG term. I also had 37 weekers. One weighed 4#13oz and one was 5#4oz. My larger one could nurse like a champ but the smaller one needed a breast shield for a good 5 weeks. Have you tried one?

    Be sure your horns for your pump fit properly and really massage, rub, compress while you pump to help get he maximum amount of milk out of there.
     
  10. Heathermomof5

    Heathermomof5 Well-Known Member

    I never have had any luck with the pump. With my girls, I used the SNS system and that worked wonderful. By the time they were 6 days old, I was taking my pain pills, not for c section pain but for breast pain. If I were you, I would go to the hospital and ask the lactation consultant for an SNS it will help you. With the SNS, I had a bottle of formula that I clipped to my shirt collar and a thin tube that I taped to my breast. The girls had both my breast and the end of the tube in their mouths so they nursed but also got some formula. We did that for the first 2 weeks. After that they nursed exclusively until I offered solids at 5 months and continued to nurse until 28 months they would not take a bottle. The SNS was a miracle!!
     
  11. SaraSatin

    SaraSatin Well-Known Member

    I have an SNS and need to take a look at using that. I got Hope to nurse on both sides for a feeding tonight! Of course Ariel refused to latch on that feeding, but it was the first time both breasts were nursed on for a feeding. I didn't get to pump afterwards, I tried. I did pump later after a fully bottle fed feeding when neither would latch and got another ounce out. I remember that being good last time with Naomi, I just hope it's not bad this time! I never had a lot of luck with the pump, I have a coworker who can get 12 ounces out twice during the work day!
     
  12. Heathermomof5

    Heathermomof5 Well-Known Member

    Yeah, I have a friend that could get so much milk out too. I never could. I even bought the same pump as she had. With this baby, I am thinking of renting a hospital grade pump just to see if that will work better. I want to bf him but my husband is feeling a little left out and would love to feed him every now and then! I won't argue LOL! But you should try the SNS, I am glad you have one!! It was great with my twins!!!
     
  13. slugrad1998

    slugrad1998 Well-Known Member

    So much good advice and pretty much everything i was going to say! I would definitely try a nipple shield. I had a tiny one as well and his mouth was too small so he just got frustrated. We used the shield for about 4 weeks until he got strong enough to nurse without it. I also had to use a hand towel rolled up under my breast to give it more support and help DS figure out the angle to latch.

    I was lucky that I had one strong nurser, so if one of your girls gets the hang of it faster I would feed her first to trigger let down. Otherwise "priming" with the pump can help. You do want to be careful about supplementing without pumping, because baby learns she can be lazy and still get what she needs It is much easier to get from the bottle than the breast, so baby takes less and less from you and your supply tanks. I would even go as far as suggesting that if there is a time of day they seem like they have more energy/nurse better, take that leap and do one or two feedings where you don't supplement.

    Also, remember that the first week is the hardest and you are recovering from major surgery. The post partum hormones are wicked with twins. It will get easier and you will see the light at the end of the tunnel! You can do it!!!!
     
  14. rosenschaf

    rosenschaf Well-Known Member

    I just wanted to say congratulations and Chag Sameach! Doing all this on Matzah is no fun, for sure, but so worth it! If you invest the energy in getting your supply up by pumping and teaching the babies to latch now, I promise you'll enjoy the breastfeeding so much. It might seem like a big hassle now, but one day soon, you'll be able to go out with just yourself as breakfast, lunch and dinner for you babies. No pump, no formula, no bottles to bring. Maybe picturing that can motivate you to sit down and do the (admittedly very aggravating) job of pumping? I used to pump just a bit before the kids nursed, for let-down but also to get the less fatty milk out. The hindmilk is much richer and if the kids fall asleep so quickly, them getting the good stuff faster will at least provide more nutrients. I second the feeding them in only diapers - mine used to fall asleep all the time and I massaged and rubbed and tickled through the whole feed.
    I wish you much luck and stamina - and a kosher and happy Pessach!
     
  15. SaraSatin

    SaraSatin Well-Known Member

    We went to the pediatrician today and talked about their weight (they are gaining finally!) and my nursing troubles. The lactation consultant we saw who is also a newborn specialist said that a healthy mommy is important and possibly more important than killing myself to breast feed. She was there for my oldest when her not gaining weight due to nursing issues was a major cause of my PPD. She said to put them to the breast as often as I can to let them try to latch, to pump whenever I could but if it wasn't every feeding then not to beat myself up about it... and to remember that every drop of breastmilk I give them is a gift because it takes so much physical and emotional energy to make it happen. It still makes me sad to think of supplementing with breast milk instead of the other way around, but remembering what it was like when I was trying to feed Naomi makes me realize she is right.

    So, I'm going to give the SNS another try tonight and I'm going to let myself love these babies and focus on them and the miracle of them. While I'm pumping, because I'm going to pump and bottle feed if that's all I can do.
     
  16. stephsoss

    stephsoss Well-Known Member

    Keep your head up, Sara! You're doing a great job. I had to pump and bottle feed for several months. My two didn't really learn to latch on and nurse well until about 4-5 months old. I had supply issues for awhile & we had to supplement with formula. I'm so happy I persevered, because they are almost 15 months old now & nursing like champs! Hang in there!! As you said, every drop of breastmilk is worth the work because of the benefit to your precious babies.
     
  17. SaraSatin

    SaraSatin Well-Known Member

    Happy Pesach! I am not eating too much matzah, I couldn't imagine dealing with the stomach effects just days after a c-section. Lots of fruits and veggies for this mama.

    I really appreciate the suggestions, I have changed the horns on my pump to 27mm (the 30mm ones hurt) and got about 2 ounces this last pump. I am not pumping every feeding, but I also know that after Passover I can make lactation cookies and they helped me last time with building supply so I can build it up and hopefully pump less often but get more.

    It's really encouraging to hear that some babies pick up nursing later on! I want to limit their formula as much as possible but right now I need to let them eat. Maybe by the time I go back to work at 8 weeks we will have a decent amount of breast milk in their diet? I'd be satisfied getting them to learn to latch so at least in the morning and at night we can nurse (I love the bonding time) and me pumping enough to keep at least half their diet BM.
     
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