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View Full Version : What could I have done differently - reposting for the LC


regretful2009
01-05-2010, 01:14 PM
I am new here and hope that you can help me out without harsh judgment. Let me begin by saying I feel I did all I could do breastfeed my daughter, who is now 3 months, but failed. I also apologize for the long message but I need to figure this out to get closure and relief.

I had preeclampsia while pregnant (my chronic high BP was a risk factor which I wasn't aware of prior to pregnancy). The baby had to be induced at 38 weeks for her and mine safety (my BP kept rising and the placenta was starting to deteriorate). I was induced with pitocin, and had to take an epidural in the final stages of labor since pitocin made the pain too intense for me. This is my first child.

I let her nurse immediately after birth for about 30 min. She was so small when born. Her tiny mouth could hardly fit around my large nipples, her sucking felt weak although she did make swallowing sounds, spit up some colostrum after nursing, and often fell asleep at the end of nursing. She was only 6 lbs when born, and by the time we left the hospital she was down to 5 lbs 11 oz.

I was hooked up to IV's for a day due to my condition, so I couldn't have her room in with me. I felt horrible after giving birth, so jittery and unable to unable to sleep for almost a week. Thus she was brought to me for nursing every 3 hours by the nurses. All the nurses said the latch was good.

We went home and her weight dropped to 5 lbs 9 oz. She developed jaundice. I did not feel the milk come in until 3 days post partum. She kept being hungry even after nursing for 30 min on each side, screaming. Finally I tried giving her a couple of ounces of formula in a bottle to calm her. It worked. No more screaming.

I kept trying to nurse her every 2 hours during the day and every 3 hours at night, often I had to awaken her since she was lethargic due to the jaundice. She would always scream for that supplement every time, and started drinking more and more formula. I continued the "nurse first, then supplement" approach for the last two months, but she was asking for more and more formula after. Eventually she started refusing the breast, screaming instead of sucking.

I got a Medela Pump In Style breast pump after about 1 week of efforts and started pumping after every feeding. I was only able to get 2 oz *total pumping from all day* at my best level. It only went downhill from there. I tried fenugreek 3 tabs 3 times a day, oatmeal, more fluids, no avail. The only thing I didn't try was Reglan, I was too scared due to the depression side effect risk. I was already a mess due to sleep deprivation and did not want to risk it. I saw two lactation consultants and my OB, no help. I have pretty small breasts (between an A and a B when not pregnant/nursing), but was told this could not be the problem. No hormone level tests were performed. Now I had to go back to work and my supply has dried up completely. Ava will not nurse any more. I am grieving.

QUESTION #1: WHAT CAN I DO DIFFERENT/BETTER NEXT TIME? Use a hospital grade pump? Start the galactogoues right after delivery? Not supplement even if baby is losing weight and screaming? Supplement with a lactation aid instead of bottles (I did not find out about them until very recently and have not tried one yet)?

I had very little support at home, now no choice but to work full time since I am the sole breadwinner for the family. My husband is still a student. I would love to have another child in a couple of years when our finances our better and would love to know what I could do to successfully breastfeed the next baby.

QUESTION #2: IS THERE ANY THING I CAN STILL TRY THAT I HAVEN'T DONE? Should I try to force my daughter to a "nursing holiday" using a lactation aid to get her back on the breast for whatever drops she can glean out? Try other galactogogues? Keep pumping even though nothing comes out anymore?

I really appreciate your help.
Thank you.

BecomingMothers
01-05-2010, 02:23 PM
Hi,

I will answer your questions via integration to the question. I also want you to know that your nursing experience with a subsequent child may very different.

QUESTION #1: WHAT CAN I DO DIFFERENT/BETTER NEXT TIME? Use a hospital grade pump? Yes, the use of a breastpump that is also used in your local NICU would be the most efficient breastpump to use.

Start the galactogoues right after delivery? I would consult with an LC prior to starting galactogues as the reason for the low supply with Ava is related to the pre-eclampsia, the jaundice, and the poor suckling. A subsequent pregnancy and baby may not have these factors affecting the breastfeeding.

Not supplement even if baby is losing weight and screaming? Babies need to be fed and sometimes formula is part of the plan. Even when an infant is fed formula, a plan should be in place to increase mom's production.

Supplement with a lactation aid instead of bottles (I did not find out about them until very recently and have not tried one yet)? An SNS is a valuable tool as long as the baby makes a latch at the breast. By using the SNS, the baby stays at the breast and is encouraged to suck and swallow even if mom's production is a bit lacking.



QUESTION #2: IS THERE ANY THING I CAN STILL TRY THAT I HAVEN'T DONE? Should I try to force my daughter to a "nursing holiday" using a lactation aid to get her back on the breast for whatever drops she can glean out? Try other galactogogues? Keep pumping even though nothing comes out anymore?

It sounds like your production has ceased for Ava. One thing that was not done was an assessment of your overall health status (anemic?, alterations to your thyroid?, prolactin levels?). Your physician may want to to this lab work so that you have a complete picture of anything that may affect breastfeeding. Domperidone is a prescription medication that your MD may be comfortable prescribing.

Premature weaning is a difficult emotional state to be in for the nursing mother. If your sadness about how the course of nursing Ava continues, it may be wise to chat with a professional so that you can have the emotional closure that you are seeking.

Always know you are a wonderful mother to Ava, that the next nursing experience will likely be 100% different. Your nursing experience is not because you did not want to nurse Ava. The experience is one that was complicated with your health status and the jaundice during the first period of time.

I do suggest that you share your nursing history with a Lactation Consultant prior to the birth of your next baby. You'll have the support and the LC will have a plan so as to protect the breastfeeding experience.

Kind Regards,

Stephanie Moore, RN, BSN, IBCLC
Owner/Lactation Consultant
Becoming Mothers
Boulder, CO
www.becomingmothers.com