Breastfeeding Question - San Marcos,TX

no NO NO! you want to avoid bottles while you work on the latch! she does not need to be sucking and swallowing at the same time. at first you have more milk so if you are pumping beofre each feeding you are not going to have a large letdown so she isnt going to need to suck and swallow, she will need to suck a few times and then swallow. I also had flat nipples and after baby sucks for a few seconds they pop out so try to stop with the pumping. good luck it does get easier!!!

It is not an acceptable answer for a lactation consultant to just say that she can't get her to latch any better, without giving you a care plan on how to proceed. Did she give you a care plan? Were you shown what normal "drinking" at breast should be like?

Some topics to go over with your LC in a follow up phone call or meeting:

1. Measuring her intake at breast will help you a lot being comfortable with her, perhaps not so perfect latch. If she is getting enough and breastfeeding is not hurting you, then her not so perfect latch may be good enough.

2. Is she gaining weight appropriately? She should be back to birthweight at 2 weeks old and gaining approx. 1 oz every day until she is about 5-6 months old, at which time her weight gain is closer to 1/2 oz per day.

3. Is she overall a happy camper - hungry before feeds and fully satiated when done? Having the appropriate output?

Reviewing all of the above and having a good understanding of what is normal, will help you learn more about your breastfeeding relationship with your baby.

Also check out some videos from Dr. Jack Newman. Google his web site and then take a look at the videos he has. Pay special attention to the ones titled: Really good drinking. Good drinking. Nibbling. Watching those 3 vidoes will help you to understand and see what normal breastfeeding behavior looks like.

Post back to this list and let us know how things are going.

L. J. I., IBCLC
All About Breastfeeding
http://www.aabreastfeeding.com

For the better latch... take your hardened nipple and areola between your pointer and middle fingers and squeeze together. This will make the area more flat and easier to maneuver into the baby's mouth. Also, position changes will help. Don't give up on the 'nipple sandwich' because it will take more than just a couple of tries to successfully do it.

As for the swallowing... suckle, suckle, suckle, suckle, GULP is very normal. The reason for the 5-6 suckles before the swallow is probably because of her incomplete latch. really really work on the latch... it will improve!

Don't offer a bottle until you and the baby have a completely successful latch and your milk supply stabilizes (4-5 months). It's great you have already started stocking up on frozen breastmilk - you never know when that will be in handy!! If you are home with her most of the time - there is no reason to confuse her with a bottle. Wait until it's a necessary thing before giving her a bottle - since this usually creates nipple confusion and messes up the latch again - called lazy latch.

Kellymom.com has a nifty tool to calculate how much a bf baby would typically eat in a bottle based on baby's weight and how often they nurse during a 24 hour period. But at 6 weeks probably only a couple of ounces.

You might actually consider waiting a bit to introduce the bottle given that she has some latch issues. Bottle feeding is far easier for baby and you don't want her to get lazy at the breast. But when you do intro a bottle try the playtex slow flow latex (brown) nipple. It is very similar to the breast as it is super soft.

Keep in mind that what you are pumping in the beginning is the very thin, watery foremilk and doesn't contain the fatty hindmilk that will keep her satisfied. So it's ok to experiment with a bottle with this but know she will probably get hungrier sooner than with a normal feed.

Even if her latch isn't very good now keep at it. She will only get bigger, stronger and more adept and this whole breastfeeding thing!

Babies don't have to swallow with every suck especially since you are pumping off the initial let down which comes faster. As she gets older and stronger try to see what she does without pumping first. Perhaps even try to manually draw out your nipples rather than pumping and see how she does.

I would feed her at the breast first....and then offer her a bottle...have 4 oz or so in the bottle....if she drinks all of that then you can offer more but I doubt she will drink that much after nursing at your breast first. Be sure and burp her well after bottle feeding....they get more air when using a bottle and need to be burped so they don't get uncomfortable!!
I am not sure about the swallowing...it makes sense to me that she is only swallowing when she has enough breastmilk in her mouth to NEED to swallow...but I am not sure what is "normal"...if there IS a "normal" in breastfeeding!!! Each baby is SO individual...

Six weeks is a good age to introduce the bottle. A great resource for breastfeeding is kellymom.com.

As for the swallowing, no she doesn't need to do it with every suck. My daughter does during letdown, but she's swallowing less often before and after that. As long as she's gaining weight and having plenty of wet diapers, she's getting enough.

Best wishes,

I agree with the previous poster...NO bottles until you your baby learns to latch properly. Babies latch on to a breast much differently than they suck from a bottle. Your lactation consultant should have told you this. Babies do not always have to swallow with each suck. It could depend how much she is drawing out with each suck and waiting until her mouth is full enough to swallow but you should see her suck and swallow and not just continuously suck. My third child had a weak suck that caused so many problems: he wasn't gaining weight, my milk supply was diminishing, and I had to supplement with formula because he suck never improved. Is she gaining weight? This is the only good indicator that she is indeed getting milk. Is she producing soaking wet diapers? Having bowel movements? Is she coming off of your breast satisfied, do your breasts feel "soft" after a nursing session? These are things you should be looking for and things your ped and lactation consultant should be asking you. It's good you are pumping so you don't lose your milk supply should her suck be a permanent problem.

Every child is different and it takes time for them to learn and grow and become a breastfeeding pro. She's young and will do better as she gets older. If you use a bottle, it will take longer for her to get the hang of it. be patient and hang in there. I BF all 5 of mine and one of mine took FOREVER to figure out how to latch on quickly. It took her so long to latch on that once she finished, I couldn't get her to let go. She'd hold on for dear life...LOL It took about 8 weeks but I never supplemented or bottle fed. I ended up nursing her and my others for 2 years. I now have an 8 month old and he's a biter. I've had 2 weeks of biting, pain and sore sore soreness. But now he's over that and doing better. It just takes patience and consistancy.

My girls would never take a bottle, but I don't think it's a good idea to start a bottle, until you check to see how much she's actually getting. Your LC can weigh her before and after a feeding, to determine how much she's actually getting.

In the beginning, my girls would occasionally have trouble with latching (they were both preemies). There were a few times that I used a nipple shield. It helped them to latch, and helped to draw out my nipple, when I was engorged. It's not good to use one long-term, but might help in the short-run.

swallowing pace is normal

offer about 2oz @ a time w/a bottle so you don't waste any milk. Also save it for when you make her cereal in a couple months.