I had a meeting with the consultant Saturday and she was awesome - she came to our house and stayed for 3 hours watching us feed weighing her before and after each feeding and by the end of our session she was up to 7lbs, 7.4oz. She did notice that I have Low Milk Supply so we rented a hospital grade pump and she recommended that I feed Nicolette for 20-25 minutes on each side every 2 hours, and then pump for 15-20 minutes and then supplement feed her with 1 oz of pumped breast milk (either with a Supplemental Nutrition System* or a Bottle every 2 hours. This regimen was designed to help increase my supply. Its funny how the female body works - the signal for your body to produce more milk is triggered when the milk is being drained. Since Nicolette was a sleepy nurser and had latch issues that meant that the milk wasn't being drained regularly which further reduced my supply. It makes me wonder again how people out there can doubt that there is a divine and incredible God out there who designed this whole process!
Now this schedule might not sound TOO bad. When you do the math that's probably 45 minutes of feeding every two hours but that is SOOO not true. As I mentioned, Nicolette has a shallow latch so it takes quite a while to get her "on" and ready to go and then since my supply is low she falls asleep so those minutes where she isn't actively nursing don't count towards the 25 minutes. I found myself literally struggling to get it all done and barely had time to use the restroom & change her diaper before it was time to start all over again! I had to supplement with a bottle with 1oz of formula at one point on Sunday bc I didn't have enough pumped and I was in tears. I really didn't want to feed formula to my girl and it was disappointing not to be able to meet her needs but ultimately getting the girl chubby is the most important thing. She HATED the formula by the way. We tried it in a bottle and she kept kicking the bottle out of her mouth and when she would take it she would get her mouth full of formula and then spit it all out. Fun - keep in mind that this still has to fit into my 2 hour repeat feeding schedule. (sigh)
At one point late Sunday afternoon I sat pumping trying to relax (because relaxing while pumping and feeding is apparently so important - the milk literally may not release if you're too stressed out...uh oh that could explain a lot). I was actually feeling like things were going well. The LC had said to put a blanket over the pumps so that I don't obsess about how much or how little is being produced (who? me? obsess about something related to performance or production? she must know me pretty well already). So I had my blankie covering everything up. My timer went off after 15 minutes and I looked down and on the right side my shirt had barely gotten tucked up under the flange of the pump which means that all of that precious milk leaked out of the bottle and all over my shirt...are you kidding me...that bottle was totally empty and my shirt was soaking wet???? Cue hysterical tears.
Needless to say with all of this pump, feed, pump, feed, pump, I was a wreck. Keep in mind that since I was planning to exclusively breast feed I hadn't sterilized any bottles, nor read anything about how to prepare formula how to store breast milk, nothing. I felt totally unprepared to be thrown into this situation and literally had NO free time to read the instructions with anything. By Sunday night for her 1am feeding she wouldn't eat anything - she wouldn't take the breast, wouldn't feed with the SNS, wouldn't take breast milk out of a bottle and wouldn't take formula out of the bottle. I was in tears and so was she and the poor hubby didn't know what to do to console either of us! I tried to feed again every 2 hours and she wouldn't eat at all throughout the night. My nerves were shot and I was convinced that my child was starving so I called the doctor first thing in the morning to see if we could get in for a weight check. At 10am nervous, neurotic first time mommy and baby Nicolette were at the Doctor's office waiting for our weight check. Now during my time as a cheerleader for the Panthers I had countless weigh ins but I have to say that this was the first time that I was ever hoping to see the numbers on a scale go UP! They put her on the scale and I said a silent prayer and HALLELUJAH we see 7lbs, 11.5oz!!!!! That little stinker had somehow packed on nearly 5 ounces since her Friday appointment. The last time I felt this much relief was when I got the call from REACH letting me know that we were pregnant!
Dr. Chris reassured me that Nicolette is just fine he said that even though her weight was low last Friday that she was still gaining so we didn't need to worry about "Failure to Thrive" (which is associated with babies who continue to lose weight or stall and don't gain ANY weight). Failure to Thrive babies often face brain developmental issues, may grow to be short in stature and are prone towards mental retardation so you can understand why a new mommy would want to avoid having those terms ever associated with her little one! Dr. Chris also prescribed a medication for me to help increase milk supply - it is called Domperidone or Motillium. I started that today and we'll watch over the next 4-6 weeks to see if that helps.
I've spoken with the Lactation Consultant several times over the past 3 days and she recommended that we go to a 3 hour feeding schedule instead since Nicolette was obviously starting to put on some weight. We've also made additional tweaks based on what I'm finding from my sessions with Nicolette. I'll include our current protocol below in case anyone is struggling with the same issues and might want some ideas of how we're making it work...
- Wake Sleeping Beauty - change diaper (praying for poops as that means that she's getting plenty to eat and gaining weight). This takes 15-20 minutes to get her awake enough to nurse.
- Feed 1-2 oz expressed breast milk via SNS* (this takes anywhere from 15-20 minutes depending upon how hungry the princess is). We know it's time to stop when the princess is "milk drunk" - arms limp, eyes closed and totally zonked out! If she's not then she gets switched to the other side to try to nurse for 15-20 minutes. Keeping in mind that it can take 5-10 minutes to get her "on" and ready to go
- Put the princess down to nap and get ready to pump.
- Double Pump with hospital grade Medlea Symphony Pump 15-20 minutes...at this point since my supply is low I usually get about 30ml (1oz) but it varies...had one disappointing session with only 5ml and then an awesome one with 65ml. The LC said it's not about quantity at this point. The goal with pumping is merely to stimulate the milk production..."if you build it they will come" you might say.
- Find some time to snuggle with Sleeping Beauty - skin to skin contact between mother and baby is vital to breastfeeding success.
- I also take supplements
- Fenugreek = 3 610mg supplements 3 times per day
- Blessed Thistle = 3 390mg supplements 3 times per day
- And the aforementioned prescription
- Domperidone/Motillium = 1 20mg capsule 3 times per day
- Weekly weight checks with the doctor until 6 or 8 weeks to make sure that we're making progress.
We repeat every 3 hours. In between I have to wash all of the bottles, pump parts, etc as well as try to take care of myself so it's still a challenge but this 3 hour schedule is much easier than the 2 hour schedule we were on this weekend. Poor Nicolette was miserable and so was I!
*I prefer to try to feed with the SNS as that consists of a tube hooked to a bottle of either expressed breast milk or formula with the other end of the tube running down the breast so that the baby actually nurses AND gets the supplement at the same time so you don't have to worry so much about nipple confusion that may come with giving a newborn a bottle.
OK - so there is more than you probably ever wanted to know about breastfeeding. Sorry for the lengthy post. Hopefully there might be someone out there reading this who may find it helpful. I know that during my few minutes here and there of free time I was struggling to find information and people's real life experiences to try to gain insight into my own issues. As far as this goes I'd like to say where there is a will there is a way but the truth is that some women are not able to breastfeed as their supply simply will not increase...hopefully I'm not in that small minority but if so, we'll cross that bridge when we get to it and make decisions at that point.
As I finish this lengthy post I hear my precious little one tooting away...here's to praying that we have a nice full diaper. It's the little things...I literally celebrate every poop...means mommy is doing her job and helping her baby grow! Send prayers our way for lots of poop! (never thought I'd ask for prayers for poo). :)