Friday, March 25, 2011

Joy's one month check-up appointment

Today Joy went in to see the pediatrician for her one month check-up. Her previous appointment was when she was 2 weeks old, and she weighed 6 pounds 14 ounces. She'd been gaining one ounce a day. I'd supplemented her for a few days after her very first pediatrician's appointment, and then I stopped. I thought she was getting enough breast milk because the pediatrician was satisfied with her weight gain. So I didn't do anything different.

And then I got something in the mail from Similac earlier this week. It talked about how frequently and how much milk babies should eat at each feeding. That's when I got concerned. I thought it was weird that some of her newborn clothes are still too big, but other people were saying she was getting bigger, so I figured maybe I just didn't notice it as much because I was spending all day every day with her.

When I was asked today if I had any questions or concerns by the nurse at today's appointment, I brought up my concern about whether or not she was getting enough food, especially when I heard her weight... she is only at 7 pounds 4 ounces, meaning she only gained 6 ounces since her last appointment 2 weeks ago! The nurse didn't say anything. But when the doctor came in, I talked to him about my concern, and he said she is definitely not eating enough. He told me she's not "malnourished," but she is "undernourished." And he said I need to supplement. But it's not something he wants me to do just for a period of time but rather for good.

I have been doing several things to try to increase my milk supply since learning she lost 11% of her birth weight between her birth and when she met the pediatrician 2 days later. I will keep doing them. But they just aren't really working enough. And now I feel like a terrible mother and a failure since I can't provide enough milk to give my baby all the nourishment she needs and I didn't recognize there was a problem and contact the pediatrician earlier to correct it earlier.

My poor baby! I feel so guilty and terrible!

9 comments:

Crystalbell said...

Debra,

E-mail me (crystal.bell.dancer@gmail.com), if you want. Supplementing your milk with formula will likely cause your milk to decrease and ultimately sabotage your breastfeeding. Pediatrician's are not the people to ask about your milk supply and they often make you feel guilty because they're so used to obese children who are on formula. Breastfed babies are healthy without being obese.

If you don't know where to go, please contact your local hospital's Lactation Consultant, Le Leche League International, or WIC to help you to understand that you have done nothing to feel guilty about! You're doing a wonderful job and your daughter only needs you to feed her on demand at this point. It sounds to me like she's thriving on your milk.

If you're worried about your supply, make sure to eat oatmeal every morning (seriously, it helps), I also like to use Mother's Milk Tea a lot for the first six weeks and then when I feel like my supply is low (due to baby eating a lot for growth spurts), I drink it then, too. I have heard of fenugreek (I think that's how it's spelled), although I've never used it.

You can have the breastfeeding relationship you want, how you want it. Really. I think you just need more support in this area and more information (no one truly prepares new mothers for this).

Sorry for the rant and unsolicited advice, if it's not wanted, please just ignore. it's just an area I'm passionate about and have a lot of experience in/with.

I hope you're well!

Love,
Crystal

Living Advent said...

Oh hon, I've been there. You can fix this. Please find yourself a good lactation consultant that is IBCLC. Your local Le Leche League (http://www.llli.org/)should be able to refer to you one of the better ones. There are so many different ways to build supply depending on your situation.

http://www.kellymom.com/ and http://www.lowmilksupply.org/ are great websites too.

It sounds to me like your ped is pretty typical in that they need you to educate them about breastfeeding. Many moms have to supplement for a while, most are able to stop supplementing after getting over a hump. If you end up to be one of the few (like myself) that have to continue to supplement, that's okay too... every drop of breastmilk is a gift filled with stem cells, antibodies and love that no formula can match. Praying for you!

Living Advent said...

Ditto Crystalbell's comment. I eat oatmeal at least 6 days a week and drink Mother's Milk tea when I'm trying to build my supply back up. Also lots of water is important. I tried fenugreek and it did not work as well for me as Goat's Rue.

Remember: your baby is gaining weight and that's your milk! Also some families are slower to grow.

Oh and remember Similac is trying to sell you something so they have a vested interest in you thinking that you have to supplement.

Debra said...

Thanks for the support. Perhaps I should add that the lactation consultant I met with told me I might have to supplement or even just formula feed because I have PCOS. I am taking Metformin to help treat that, and she did say that it can help increase your supply. I'd hate to see what my supply would look like without it.

My pediatrician didn't try to make me feel guilty or anything at all. And what he was saying and what my gut has been telling me is that the baby isn't getting enough ounces per feeding, which is why she seems constantly hungry and is almost always feeding or sucking on a pacifier. I have been pumping and pumping and pumping so much but usually can't produce more than an ounce each breast, and that's a good pumping session. Sometimes I'm lucky to get even half an ounce.

Living Advent said...

I'd encourage you to find a different LC. While it is true that 1/3 of women with PCOS have low supply most are able to fix it. For anyone to tell you that you would might have to formula feed due to PCOS shows their ignorance of PCOS and breastfeeding. The first LC I saw was so sweet but was no help at all... anyone can call themselves a LC so make sure you get a good one.

Honestly if after feeding your baby if you can still pump a whole ounce from each breast ever then your baby might have some latch issues as that is a good amount. When you are pumping in addition to nursing it is normal to have to pump several times to get one bottle. You should get more in the morning than at night.

Your baby absolutely needs to be supplemented somehow right now but there are many options for supplementing. Also anything over 1/2 ounce a day gain can be normal at her age so your not so far under that that you don't have hope. I wish all peds immediately refereed weight gain issues to a good LC... maybe someday.

My baby was actually loosing weight. I look back at the pictures and cry because she was so skinny. We had so many issues that low supply was sometimes the least of them. Through reading everything I could, working with different LC's, the support of Le Leche League and a lot of pumping, etc I finally got a full supply about the time my daughter weaned herself. I still pump for her and supply about 1/2 her intake... if she could nurse I would be able to supply all of it as babies can get more milk than the pump and they take in less breastmilk than formula. Sorry I'm rambling... I just know I was there thinking that I wouldn't be able to do it and if someone had given me more hope at 4 wks we might be in a different place now.

Jenny and Travis said...

Don't feel bad! There's no way you would have known, being a new mommy and all! And now you know and you can get her back on track. Good luck finding what works best for you both! Love, Jenny

The McKnights said...

I had the same problem with Sarah and she was baby #5. It did not matter how I feed her or what I feed her she was always hungry. I have never been big on scheduled feedings. I just fed my babies whenever they were hungry and wanted to eat.

I was heartbroken and felt like a bad mom because I could not help my baby gain weight. I tried different things to increase my supply but did not find anything that really seemed to help.

Finally a different Ped. told me not to worry because she was gaining weight and that is what matters most. Sure they would have liked it to be more but as long as there was a gain that was ok. They said that if that gain became a loss then they would worry. It took her a long time (it seemed like forever)to really start to make strides in her weight gain.

It sounds like you are doing all that you can to help her. In the end if you have to supplement her a bit there is NOTHING wrong with that. Nursing or not nursing your baby does not make you a good or bad mom. I know plenty of GREAT moms that we never able to nurse their babies. I did my best and that was an average of only 6 months with each baby.

I love you and you will be able to overcome this challenge. If you want to talk more you can always give me a call.

Emily

The Leithead Family said...

Don't feel guilty! Baby Scott only gained about 10 ounces from months 4 to 6 and fell nearly to the 25th%. He's 100% breastfed.

So, you're pumping *after* each time you nurse her? I can only get anything with a pump if he skips a feeding, so you're totally normal there.

Erin.

Melissa said...

hey I don't know you. just followed a link from somebody else's blog. just wanted you to know that after you've tried everything or even if you just get tired of trying everything it is actually (deep breath) okay to supplement. despite what these ladies who i'm sure are your friends tell you about how important breastfeeding is and how you can do it, it's possible that you can't quite. big friggin deal--just do what you gotta do. we supplemented my DD for her entire first year. at first it was after every feeding, then we consolidated to once a day. and guess what? i breastfed her for 15 months! and i never had to increase her supplement, just keep it steady. whatever is right for you is fine and if you find that you can increase your supply or that you can't increase your supply it doesn't matter. just focus on loving your baby. i just wanted you to know that it is possible to supplement and continue breastfeeding, lll notwithstanding.

good luck!!!