Nursing - Sandy,OR

Have you heard of a supplemental nursing system. It's a little bottle that you hang around your neck. A little tube goes into the babies mouth and they nurse from you at the same time. This would avoid nipple confusion which it sounds like you might be having. You need to get to a lactation consultant pronto. They can make all the difference in the world.

Have you ever tried a Supplemental Nursing System? My lactation consultant helped me immensely with this device when my daughter was failure to thrive and would just push away from the breast and scream. It's a bottle that you can fill with formula (or breast milk if you have a stash) and it hangs on a string around your neck. Coming from the inverted bottle are 2 tiny tubes that you tape to your breast allowing them to extend to the nipple. You control the milk flow rate while the baby nurses at the breast. Baby gets more with less effort, but still is able to suck on the breast. It was a win-win situation for me. The stimulation from the nursing caused me to make more milk while my 2 month old got the nutrition she needed to gain weight and grow. Here's a picture of what I'm trying to describe:http://www.medelabreastfeedingus.com/products/breastfeedi.... For sore nipples, I recommend air dry after feeding (no wiping with breast cleaning wipes--neither necessary or healthy) and then apply Soothies. Soothies can be purchased at many drugstores. So glad you are continuing to breastfeed. It's not the easiest thing in the world, but it is good for both you and baby. Nurse Midwife Mom of 3

If he isn't an expert nurser, it's probably because you keep switching between breast and bottle, which require two completely different techniques. He isn't latching on properly, if you are getting sores on your breasts. I think it would be best for you to consult a lactation nurse or specialist to address these issues, because your situation sounds complex. Best of luck!

How old is he?

Did you ever see a Lactation Consultant? If not, do so.

Some babies, once they drink from a bottle, will then only want a bottle. Why? Because, a bottle is much easier to drink from.. the baby does not have to 'work' at it. A bottle is just by gravity. Versus, with a breast, a baby has to work at it harder, in order to get the let-down started and then to suck to nurse. For breastfeeding, it takes mouth/tongue coordination... and for some, the letdown can be slow, hence a baby gets impatient. Or the flow of milk, is slow or not enough. Or the supply of milk is not enough.

Nurse him... with both boobs, per session. Until you are empty. THEN, give him a bottle as a 'chaser.'
Otherwise, your milk supply, will decrease.

Nursing him for only a couple of minutes, might not be long enough... for him to get to the hind-milk and to keep your breasts productive enough.
Pumping, does not stimulate the nipples as much. Depending.

Do you have, ample milk or not?
If not, then maybe your baby is refusing the breast, because of that too.

You need to see a Lactation Consultant.

Is he teething?
When babies teethe, they often 'reject' breast, because their gums hurt.
But it passes.

How come you are getting sores on your breasts?
To me, this indicates, that he is NOT latching on, properly.
The ENTIRE areola, should be in the baby's mouth. Not just on the tip of the nipple. AND you should see and hear, the baby sucking and swallowing.

Who, 'diagnosed' him with low blood sugar? And that thus, he exerts too much energy, while nursing? I had never heard of that. Did the Pediatrician actually say this and to bottle feed him?

I pumped exclusively for about 4-5 months with my first and it was really hard. At the time I was fine with doing it and felt okay about it, but with my second child I just couldn't be that dedicated...so I feel you. Hang in there. My first order of advice is to tell you that you must do what makes you happy. Do not feel guilty if you never go back to the breast. Do not let others make you feel guilty for using a bottle. There are pros and cons to both breast and bottle feeding so do what is right for you and your baby.

As far as the sores...try lanolin. If you plan on pumping for a while I'd go to the pharamacy and ask a pharmacist to order you a full pound of it. It only costs like $10 and you get a giant jar that will last forever. If you rely on the tubes they sell in the baby aisle you'll go broke fast! ;) I would apply it to my nipples and I would also smear a bit onto the insides of the flanges every time I pumped. The lactation nurse actually recommended this so it is totally safe and it makes it a little more comfortable during pumping. I also used those Soothie pads sold at CVS, Walgreens, etc. They are also expensive but worth it. I didn't use them every day but when I was really sore they felt soooooo good!!!

Also, one more tip if you continue pumping, you MUST get a hands free boustier. It is a game changer, for reals!! It enables you to strap on the pump and feed the baby (or read a book, work on the computer, drive a car...whatever) at the same time. It's amazing. It cut off a solid 30 minutes to my feeding times b/c I feel your pain of pumping, feeding, cleaning up the pump, etc. etc. You'll never get any sleep if you keep it up!!

Good luck!

Added....yes if you haven't contacted a lactation consultant you should. I met with lots of them!!! ;) You can call the hospital where you delivered and they can put you in contact with someone. They will talk to you for free but you can also pay a small fee (which is probably covered by insurance) to set up a private meeting/evaluation.

I advise contacting your local La Leche League. They were such a help for me!

He needs to re-learn how to nurse and you need to nurse him longer than a few minutes. Nurse him until you're *empty* so he gets that nutrient-rich hindmilk, THEN give him a bottle to 'top him up'.

If he is working too hard to get your milk, you might need to help him by getting the letdown there sooner. Another problem could be that your letdown is too fast and causes him problems.

Try Ching Wan Hung, a soothing herbal balm. I found it at a Chinese accupuncturist's place. It is made with sesame oil and beeswax and worked so much better than lanolin. Also, use the Lily Pad breast sheilds during the day or night. This will help heal faster, but you want to let your breasts breath for part of the time, as well. Using Lily Pads is a bit like putting gloves or socks on with lots of lotion or ointment when your hands or feet are dry and cracking. I got my ointment at Wei Li Acupunture at 10303 NE Weidler in Portland, their number is ###-###-####.

Get a copy of "Mother's Food for Breastfeeding Mothers," by Hillary Jacobson. It has a wonderful list of foods and herbs to use to increase supply and also a list of foods, etc., that decrease supply. The two things that helped me most with sore nipples were the ointment with Lily Pads breast sheilds and this book.

Good luck to you and stick with it if you can, it will get better as he grows.

My son was only 5 pounds when he was born and dropped down to 4.8 when he came home. Although we didn't have the blood sugar problems he did lose to much weight and we had to give him formula on top of breast milk. I too had serious pain when breastfeeding. I used Earth Mama Angel Baby Nipple butter, which is just awesome stuff! It also took me awhile to figure out that he needed to have his tongue clipped. I am fortunate to have found a doctor in Seattle whose is a Breastfeeding Dr. That is all she works with. She really helped me. Of course this was almost 4 months into breastfeeding. It took a little while to get him going but we were able to eventually get it and he nursed until he was 3. One thing that I did was use supplemental nursing for a bit and a nipple shield. I used a nipple shield for quite a long time because he was destroying my nipples. I also took him to see a cranial sacral therapist who worked miracles with him and breastfeeding, again I waited too long for that and kick myself for not going sooner. So my advice, get his tongue checked to make sure it isn't too short causing him to have a bad latch, Earth Mama Angel Baby Nipple Butter for your nipples to heal, a nipple shield and a cranial sacral therapist. Good luck to you! When he gets a little more weight on him I bet he will start nursing better, my son did.

I supplemented with all my children and it worked out just fine. For the sores try lanolin - it's a natural oil that will help lubricate and ease the pain! Also, take Fenugreek pills for milk production - this helped immensely with my twins! My first son liked nursing for the comfort so I didn't have a problem there, but one of my twins was really frantic and preferred the bottle. He ended up nursing better as he got older, but in the beginning I would give him a bit from the bottle and then nurse him, then give him the rest of the bottle. I have talked to a LOT of professionals about nursing and they all agree that nipple confusion is a myth so it's probably just that your son wants food and he wants it NOW! For the record, I am a diagnosed hypoglycemic and I know exactly what it's like to have low blood sugar and want/need to eat immediately! You want to get as much food in as fast as possible so your breast probably doesn't cut it, which is why I'd try giving him a bit of bottle first to ease that crappy feeling you get when your blood sugar is low. Then nurse. As long as he's getting some breast milk it's fine. Good luck with it! Nursing is not easy for everyone no matter what people say. :-)

Get a nipple shield until you can stop the bottles... his lazy latch due to the bottle will hurt your nipples until you can stop the bottles. I do not recommend you to stop nursing, for that skin to skin and suckling time is very important... but you may have to use those shields until he's off the bottles and just on your breasts.

A Lactation Consultant or IBCLC should be able to help you. Most hospitals have them - so if you call the hospital you delivered at (or where baby was in the NICU?) they will be the ones to help.

I'd also pump every 2 hours and after each feeding with your baby. Freeze the milk and use it in the bottles or SNS

***ADDED***

My son was in the NICU for 10 days... he had heel pricks every 3 hours for sugar levels, and was given TPN (liquid nutrition) thru a midline (IV that gets threaded DEEP into a vein to be near the heart) and also ended up with a nasal tube into his belly for tube feedings. His midline had to be moved twice and then he had a regular IV moved many times between hands and feet his whole stay. He had NO scars, so feel better about that part!!

My son didn't even suckle at ALL for 8 days - broke my heart because I'm a strong breastfeeding advocate. So I pumped extensively and got up a pretty good supply, which they would use in his tube feedings. On day 9 - the overnight Nurse talked me into trying something new and WHAM - he latched on and hasn't stopped since!!

Don't give up... it will happen. Just make sure you have some really determined and educated/experienced breastfeeding support professionals with you!! Also, as about the NICU LC qualifications, IBCLCs are Master degrees in lactation and Mother help, LCs can be someone who simply went thru a 5 day workshop. Don't be afraid to contact Le Lech League Leaders from your area to ask questions or have them come in to help you too!!

I would talk to a certified lactation consultant. Maybe a nipple shield would help, but you would want to pump and nurse as often as possible to keep up supply. You would also want to wean from the shield eventually. If you nurse him and then break the feeding instead of letting him try, maybe you need a different way to get him the extra boost he needs and also allow him to practice nursing/not get frustrated. If he's nursing just long enough for a let down, he might feel like why bother if it doesn't work? My sister has a preemie and she bottle feeds some feeds (pumping before) and nurses other feeds.

Lie down in bed and place him next to your breast mouth near the nipple. With the finger of your opposite hand stoke his outer cheek. He will root looking for the nipple and latch on. The trick is for him to find a milk gland and extract the milk. You have to relax and let the milk down.
Call LeLeche League they are the best at getting you and your child to nurse well.
Above all don't stress over it. He'll get stronger and suck harder. For the heel don't worry my daughter had many pricks on hers as she had a blood incompatiblity with me. Her heels bear no scars. I think I used comfrey salve on them.

I am going to fly in the face of all the other suggestions. Of course, try everything you can and use the suggestions of the others who have given great advice. BUT, if it just is NOT working and it is causing you a lot of stress and affecting you emotionally, it is ok if you don't nurse! Yes, breast is best but for some it just doesn't work out. I was sick after my daughter was born and was able to BF for maybe a week before it just became a constant stress to pump, breast feed, pump all while trying to heal myself. She did get a bottle in the hospital, no choice because I was sick and in surgery for the first 24 hours. Honestly, stopping BF was the best thing I did for the relationship with my daughter. I was not stressed anymore, I wasn't obsessing over pumping and feeding constantly so I was able to really focus on her and spend quality time feeding her without stress. I never felt any loss of closeness with her and I only used the bottle as I would breast (no leaving her with a bottle or teaching her to hold it herself until she was much older). We did tummy time, I held her skin to skin a lot and she would nap on my bare skin. I just hate seeing so many Mothers really miss out on quality time with their newborns being stressed and obsessed with being able to BF, especially when it just isn't working after trying everything they can. Even the lactation consultant working with me said it might be better to let it go and enjoy the time with my new daughter rather than keep trying when it just was not going to work. My daughter was raised on formula (my milk stopped after a week due to my own illness) and she is bright, normal and perfectly healthy with a fantastic immune system. It's not the end of the world.