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

[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.

[tammylc.livejournal.com]

Excellent. That all sounds great.

We never had the slightest problem with nipple preference with Liam (although he started on bottles a little later). As far as he's concerned, if it's got milk in it, he's there - bottles, my boobs, somebody else's boobs - all the same to him.

One of my neighbors, who is an OB nurse, thinks the whole nipple preference thing is bunk. The Hispanic women she sees in the hospital don't believe in nursing until the milk has come in, so they use bottles until that happens and then transition to breastfeeding no problem. But then I've heard from other people who have had problems, so...

[geekmom.livejournal.com]

It's a preference. That's pretty much the key. Some kids can develop a lousy latch or some bad tongue habits from the things, which are a pain to fix. Most babies can do just fine switching from one to the other, though.

[mactavish.livejournal.com]

One of my extended relatives was with his older sister in a supermarket -- he was 3ish, she was 16ish -- and he stared at the checker's chest, wide-eyed, and said, "Oh my, what enormous milk!"

His older sister turned magenta and skedaddled out of there at record speeds.