Starving surrounded by abundance.

[rivka]

So, despite my confidence last Friday that we had the whole nursing thing worked out, Li'l Alex continues not to gain weight. At Monday's weight check, she had lost an additional ounce over the weekend. Today, she was steady with Monday's weight. This isn't good.

Yesterday I took her to the lactation clinic at a local hospital. The women there were just phenomenal. They spent two hours with me, despite the fact that my consultation fee only entitled me to an hour's help. They weighed Alex before and after a feed to see how much she ate (1.3 ounces, perfectly respectable for an eight-day-old baby), watched us nurse and made adjustments, and came up with the following diagnosis:

My tits are too big.

They're heavy, which makes them prone to drop out of position while she's nursing. One is larger than the other, and on that side she has trouble getting her mouth around enough of the nipple to get a really good latch. That side is therefore not draining completely when she nurses, which means that it stays engorged, which makes it harder for her to get the damn thing into her mouth. I've developed a nasty crack in the skin on that side from her improper latch. My small arm is also creating minor positioning difficulties, which they helped me work out.

But seriously: it seems that she's not gaining weight because I'm too well-endowed. They fitted me for a nursing bra? Size 36J. I bet you didn't even know that size existed. If it weren't for the fact that nursing bras are the ugliest damn things in the world, I'd belong on the cover of a porno mag. It's a wonder I don't tip forward when I walk. 36J. I know other women who are probably J-cups, but for heaven's sake, they don't have a 36-inch chest.

In addition to the massive support garment, the nice women at the lactation clinic supplied me with a nipple shield, which provides a more well-defined target for Alex to latch on to and also protects the cracked nipple. They rented me a hospital-grade breast pump, at least for the first month, so that I can (a) pump out the extra milk that's staying in the breast, and (b) supplement her breastfeeding with bottles of expressed milk. That's already helping with the engorgement, and hopefully it will allow her to put on a few quick and easy ounces.

Best of all, my involvement with the lactation clinic appears to mean that I am exempt from receiving any further stupid breastfeeding advice from the nurse practitioners at my pediatrician's office. (Latest sample: "don't nurse more than ten minutes on a side, because she'll burn more calories nursing than she'll take in.")

I go back for a re-check tomorrow. Please let her have gained some weight.

(Yes, I am considerably more worried than this post makes me sound. I am actually sick with worry that I am starving my baby, and that even though she is nursing and filling diapers and looks well to me she isn't getting adequate nutrition and it's all my fault. I cried all over the lactation clinic ladies yesterday, and expect that I'll do the same tomorrow. But we'll get by.)

Comments

[redbird]

You are not starving your baby.

With the help of the lactation consultants and the fine technological devices they have give you, you are going to raise a fine and thriving human being.

[eeyorerin]

*looks down at chest*

Damn. I'm going to have the same overabundance problem if and when I get pregnant. Better keep that in mind.

You will work it out. She will gain weight and have adorable pudgy baby cheeks and baby legs and a baby tummy etc. (She probably already has those, but they will become even more abundant.) I am confident that you can find a solution.

[mactavish.livejournal.com]

I'm glad you didn't listen to the pediatrician's nurses' advice. I'm glad you have good lactation consultants.

Dang, your boobs sound like a regular food-producing extravaganza. :)

[zeldajean.livejournal.com]

I am so glad that, in light of the situation, someone has recommended something useful (breast pump) instead of something stupid (10 minutes?). Partway through this post I wanted to recommend the breast pump, as that's what was recommended to my best friend from high school when her baby wasn't nursing well (note: said baby will be one year old in july, and we're decidedly out of high school).

From my distant and untrained eye, I do not think you are starving your baby. I do think she'll start putting on weight now with supplementing with expressed milk. Unfortunately, I'm not surprised this wasn't the dr's first suggestion, given this country's love affair with baby formula.

Although I understand that my opinion means diddly, I'm basing it off of the newborns that I've been around (including Munchkin, who turned 9 a few weeks ago). *toasts you & Li'l Alex* Here's to someone who's opinion counts giving both of you the Healthy Stamp!

*cheers wildly in your corner!*

[datagoddess.livejournal.com]

If the nice ladies aren't worried, then you shouldn't. They see all kinds of babies, and if there was cause to worry I'm sure they'd know. You're not starving her, you just still in the figuring it out phase. She'll be fine, and so will you.

It's gonna be OK.

[jonquil.livejournal.com]

Something that helped me with engorgement was hot showers and pressing on the engorged glands. You can hit targets with the milk!

[klwalton.livejournal.com]

Yep! Isn't it fun? :):):)

[erikted.livejournal.com]

Would you believe me if I said that I had a friend in South Africa who had a very similar problem? You can't get 36J nursing bras in South Africa; so I ended up hand-importing for her from here. My sister also, actually, although I think she may only have been H cup...

None of which is to minimze the stress and anxiety you're experiencing, but perhaps to sound a note of encouragement that it's not just you and other women have gotten through this and have thriving babies!

[klwalton.livejournal.com]

I had the same problem with Megan, and thanks to a wonderful La Leche League volunteer, I was able to pump and supplement with breast milk and avoid formula and we were able to go back to full-time nursing within a month.

(Latest sample: "don't nurse more than ten minutes on a side, because she'll burn more calories nursing than she'll take in.")

That's the dumbest damn thing I've ever heard. Yeesh.

[janetmiles.livejournal.com]

Okay, we all know that I don't know a whole lot about babies, but I do know about math.

She started out at 8 lbs, 4.8 oz, right? She's lost 15 ounces. That puts her at 7 lbs, 5.8 oz, which seems to me to be a perfectly respectable weight for an 8-day-old baby.

I feel certain that with the help of the lactation consultants (who I am sure have nice absorbent shoulders), Alex and you will do fine.

[almeda.livejournal.com]

Also, I recently ran across in other contexts the fact that 'standard weight-gain' charts were compiled in the 50s from formula-fed white middle-class babies. Making them 'normal.' Apparently it is well known that breastfed babies gain weight a little slower but are at the same place at one year of age.

Though probably the lactation consultants already knew that.

Big baby

[(Anonymous)]

Alex started out big; she'll be fine. Buy a good baby scale and weigh her before and after every feeding and write it down. (At the hospital in Finland where my half-Russian granddaughter was born they required all the nursing mothers to do this every feeding.) As I mentioned in an earlier post, make sure her lower lip is pushed out and not over her lower gums. Pump, pump, pump.

Here's some other expert advice for your enjoyment. Apparently there is some checklist for autism that suggests that improper pronoun use can be suggestive of autism. Well, when afore-mentioned granddaughter, completely bilingual, was around 4 years old and in a pre-school here in the US, her English pronouns were sometimes a bit off because of the difference between English and Russian. So, despite this kid's being a class leader and the most social child you've probably ever met, her parents were told that the school was quite concerned about what her pronoun use might portend!

[kalmn.livejournal.com]

you have those fine women at the lactation clinic to be worried for you. until they start worrying, you don't have to.

*hug*

[therealjae.livejournal.com]

Just so.

*hugsfrommetoo*

-J

[lcohen]

knowing nothing about nursing and lots about hugging, i offer the latter.

*hughughug*

sounds like you got lots of good advice, sweetie. bet that things look much better a week from now.

[pegkerr.livejournal.com]

It can take a whie to get it figured out. My babies nursed pretty well, but I kept calling back when I had questions, and there were times, three months on and eight months on when things changed, and I had more questions. Let yourself be reassured. It's worth sticking out this I'm-not-quite-sure-I'm-doing-the-right-thing-am-I phase, because the benefits of nursing are sooooo good. Not just better for baby, better for you, too. I loved being able to soothe cranky baby on the spur of the moment in a crowded shopping mall without having to worry about dashing off somewhere to mix a bottle.

FWIW, I pumped, starting at three months, and supplemented with expressed milk. I nursed each baby more than two years.

[wiredferret.livejournal.com]

I assure you that both lactation consultants and midwives are very used to being cried on. Mine used to dig out the tissue for me every visit.

You're doing fine. It doesn't sound like Alex has any failure-to-thrive symptoms, and you're doing what you need to get her fed. It's fine.

(Also, I did not gain much boobage when I got pregnant/nursed, which is good, because I'm hovering around FFF, or in other words, I. I found that the football position worked well early on to avoid my excessive mammaries from eating the child, instead of vice versa. I'm sure the consultants tried that.)

[kcobweb.livejournal.com]

Oh, I so so so so hear you. (Except for the J-cup, because my breasts are topping out at somewhere between a B and C cup, and I think that's huge. For me it is.) I have a nipple shield, which has pluses and minuses in my book. I have an electric double-pump (which is fun in some ways - you can make it a contest with yourself: how many ounces will I pump *this* time?).

Seriously, as you know from my posts, the EB has had weight gain issues since she was born. Every time they check her, they say "well, she looks great, she's very healthy... she just is so tiny." (My current theory, based on that pattern and her genetics: she is just destined to be a Small Person.) We have been supplementing nearly every feeding with a bottle since 4 days old - first with formula because I had no milk to give, since then with the milk I pump. I nurse her first, and then galagan gives her the bottle while I pump. (And with the acid reflux issue, they have me limit each side in terms of time because otherwise she gets worn out and won't get needed calories from the bottle. This theory seems to be working, actually.)

And I'm so happy (and lucky!) that my hospital provides the lactation consultant free of charge - I can walk in any time during her office hours and stay as long as I like. In the early days, when she would only feed properly at her office, I would threaten to come in for every feeding..... But the LC and I are getting to be good friends. We have all kinds of theories about what's going on with her. But after 6 weeks of worrying about her weight, I feel pretty good - whether she is gaining or not, I feel that she is nevertheless *healthy* and that's what counts. Hang in there.

[jmhm.livejournal.com]

Your baby will be just fine. You'll express, her mouth will get bigger, your tits will get smaller, you'll use the shield, it'll be fine.

The first weeks are a controlled panic under the best of circumstances. You're handling what comes up.

Hell, of course you are. You're a mom.

[johnpalmer.livejournal.com]

Just a quick reality check to go along with what other folks have been saying, darlin'... the baby's eating lots, you're noticed and are working to fix the problem, everything's going to turn out fine. The absolute worst case scenario here is you have to supplement with formula.

And, I won't say "don't worry" because I don't know if a new first-time parent can not worry, but remember you'll probably have a natural tendency to be more worried than you have to be, for a while.

[the-siobhan.livejournal.com]

FYI, you are the forth person I know to have a baby this year, and every single one of those babies lost some weight immediately after birth, but regained it later.

And I know this because all the mothers worried horribly.

You'll both be fine. *gentle hug*

[saoba.livejournal.com]

You are not alone. You and Alex and Misha are surrounded by highly qualified folks who want you to succeed at nursing. And all across this wide green world there are people who care and are sending you tons of loving thoughts.

You're tired, you're physically drained and you are feeling overwhelmed. I know, and a lot of other mothers on your friends list know, just how you are feeling.

You are also bright and motivated and a Good Mother. This will work out. And until it does, lean on us and the lactation folks and the fine women at the midwife practice. It's okay to cry. It's okay to not be sure what you are doing. It's okay to give yourself and Alex time to get the hang of this.

You guys are loved.

[annafdd.livejournal.com]

My mother went almost crazy with worry for the same reason when I was young. Everybody was telling her that I was fine and she ended up feeling worried and mad that nobody was taking her seriously. But that was almost forty years ago, and I did have a reaction to formula (on which I was, of course, put as soon as possible), and back them mothers were considered emotional little darling morons and laughed off.

Worry all you like, you're a mother - you're supposed to worry. :-) But you're also a doctor and perfectly able to recognize chronical mommy anxiety from something really the matter. You're smart and you have competent help.

(tickle tickle tickle on wee Alex's tummy)

[pecunium.livejournal.com]

Many years ago I was an au pair. The friend for whom I was doing this was large busted before she got pregnant (and on a 36" ribcage, a large D) and was positively huge after.

We went to get her fitted for bras; nice shop, no longer in business, and it was... you guessed it, a J.

Different story on the subject of bad nursing advice on nursing.

My mother chose to nurse me, back in '67 when it was less common (a point in my aunt's favor, who nursed her kids, starting in '58). I was, as those who know me will find not in the least surprising, a long, lean and light baby.

The nurse told my mother she was starving me. The doctor came in, and asked some questions as he looked me over, "How often does he eat?" "Does he cry after feeding?" Is he gaining weight"

He's a fine boy mother, don't worry about it.

It will get better. It isn't your fault. Go back to the Lactation Clinic and cry some more. They'll help.

Good luck with the problem, you will be able to deal with it.

TK

[dafna]

You might find out whether they can rent you a good scale for a month or so, as well. My friend Maggie had similar concerns when her twins were born last year and decided she didn't care if people thought she was paranoid, being able to weigh the kids herself made her feel much better.

[aranel.livejournal.com]

My mother's doctor told her to wean me when I was nine months because I wasn't gaining weight the way the chart said I should. He thought I would eat more solids if I didn't get breastmilk.

I continued to eat little and stayed in the lower-end flat parts of the weight-and-height bell curves for my entire childhood.

I am still not tall, but I am 5'2" and weigh 115 pounds--well within anybody's definition of normal. I have never suffered an illness that required hospitalization. I turned out fine.

There's every probability that your baby will too. Good luck!

[almeda.livejournal.com]

It occurs to me that, of necessity, half the population lies below the line marking the precise mean.

And not all of those are, well, problematic. As you know personally, aranel.

[minnaleigh.livejournal.com]

Of course you're worried sick, how could you not be? But the experts are on the case and your daughter is going to be fine.

Your baby is not going to starve. It sounds like you're making copious amounts of milk so the pumping and bottle feeding will keep her going until you sort out the problems with her getting it straight from the tap. And the great thing is that her mouth will get bigger! It's built right into the design plan. You know all that, of course, but I feel like I have to do something!

*hugs*

[tammylc.livejournal.com]

Sounds like you're having some fairly typical getting started troubles with the breastfeeding, and are getting excellent advice on rectifying the situation. As you know, I had my share of problems in the beginning, so I know just how worrisome making it all can be. I found that time fixed a lot of it - Liam just needed to get a little bigger.

The only thing I'm slightly concerned about in your post is using bottles to supplement. Some (by no means all) babies will develop a preference to the quicker easier flow from the bottle and start rejecting the breast. And while exclusively pumping and bottle feeding is possible, it's not something most people want to do... Alternate methods of feeding include finger feeding with a feeding syringe, or cup feeding (Medela makes infant feeding cups, I believe). Just some things to be aware of if Alex begins to show a preference or if you're concerned about that happening.

Hugs.

[rivka.livejournal.com]

The only thing I'm slightly concerned about in your post is using bottles to supplement.

At the lactation clinic, they told me I could use one of two kinds of bottles. Both have nipples designed to be demanding of babies - milk doesn't just drip out, it needs to be sucked out with vigor. Hopefully this will keep her from developing a preference.

They also gave me syringes, so I can syringe-feed her if it looks like we're developing a problem.