Eat-Sleep-Love | Maryland DC & Virginia Sleep Coach, Baby Planner, Maternity & Child Consultant

Maternity & Parenting Center

Don’t tell me to relax

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I REALLY hate when people just tell me to solve a problem by “relaxing.” When we were trying to get pregnant, that was a phrase worth murdering over. I mean, seriously, if someone told you they had a blocked artery and were on the verge of having a heart attack, would you tell them “relax and it will go away?” Sometimes, there are real problems and “relaxing” just doesn’t make them go away (especially when “stress” isn’t the root of the problem). When we were trying to get pregnant, if I had just “relaxed” instead of actively seeking help, we still wouldn’t be parents. I don’t think seeking help and answers is stressing . . . it is being proactive.

Well, now that I have a baby, my current challenge relates to Micah’s eating issues. We have a real problem – it isn’t being caused by stress, so I’m fairly certain that “relaxing” won’t fix the problem. Problem #1 – Micah doesn’t latch well or nurse efficiently. So, we have to use a nipple shield to get him to latch, but he still doesn’t nurse efficiently. As a result, we have Problem #2 – a low milk supply. Because he doesn’t nurse efficiently, my milk supply is low -which makes it more difficult for him to nurse efficiently. Can you see the catch-22 we have? Then, add in Problem #3 – Micah doesn’t have appropriate hunger cues. When left to his own devices, because of the inefficient nursing, he will nurse himself into a state of exhaustion . . . at which point, he is in such deep sleep that he won’t wake up to let us know he is hungry and nurse again. Because he doesn’t then nurse often enough and efficiently, it affects my milk supply, so then I don’t have enough to feed him when he is nursing, etc., etc.

So, I’m in this endless cycle. I can’t just follow his cues and let him feed on demand, because he doesn’t demand enough, and I don’t make enough. We need to increase demand to increase supply, but he isn’t capable of increasing his demand. So, I have to help him get the energy to increase the demand. We have to limit his nursing sessions so he doesn’t get so exhausted, and we have to help him nurse more efficiently by using techniques like breast compression so he can maximize output in the shorter time. I have to pump after each feeding to increase demand, and I have to actively wake him up and make sure he is eating at least 8 times/day (some say 10-12, but hey – I’m lucky if I can get this guy to eat 8x/day).

Now, the next problem. He also has to gain weight at an appropriate rate – which requires a certain caloric intake. Since I don’t make enough milk, we have to supplement with whatever pumped breast milk we can get plus formula. So – a rational person asks how much formula, right? Well, we can’t “use the baby” as our guide – he’ll fall asleep after a feed even if he hasn’t eaten enough . . . and stay asleep for 4-5 hours. So, the only other thing we can do is go by number of ounces of intake. How do you determine how much a nursing baby is getting? Well, you have to weigh him before and after each feed. And, unlike formula-fed babies, a nursing baby can take in vastly different amounts of breast milk with each feed. Micah can take in anywhere from 1 ounce to 2.5 ounces in a feeding on the breast. If he gets 2.5, I do not have to supplement, but if he only gets 1 ounce, I need to supplement. Hard to just “relax” and “wing it” with that kind of range. We tried to just offer him bottles and see if he would take them. The answer is, he will – even if he ISN’T hungry. If he is full and he over-eats, he then vomits, which also isn’t good for him.

So, we are stuck in this awful cycle. Or I should say I am stuck in this cycle. Feeding Micah is a real chore, and I have no clear feedback for how much and what he needs. I cannot trust his cues because apparently, he has been suppressing his hunger cues due to exhaustion and self-preservation. So, somehow I need to get him to latch better, nurse better, and increase my supply, and to do this, he needs to be adequately fed NOW, and I have to figure out what that means with no cues from him. And to do all that, the only guide I have is how many ounces he is taking in at each feeding. How, exactly, am I supposed to just “relax?” If I don’t pump after each feeding, my supply crashes. If I don’t weigh him, I don’t know how much to supplement him. If I’m by myself, the process of feeding Micah is horribly challenging – nursing now takes 30-40 minutes, then the diaper change, and the weight checks, and the bottle supplement, and the pumping (and try pumping with a baby who wants to be held after being fed). It just isn’t easy to do all alone. But hey . . . maybe if I just relaxed, the baby wouldn’t cry, my boobs would pump themselves, he will miraculously start latching and nursing efficiently, and my supply will overnight reach the sustainable level.

Okay – I have to go walk and feed the dog so I can undress the baby, weigh the baby, nurse the baby, weigh the baby, change the baby’s diaper, re-dress the baby, bottle supplement the baby, burp the baby, get the baby to relax, and then pump. That ought to leave me about 20 minutes before I start all over again . . . is that enough time to “relax?”

Don’t get me wrong . . . I love being a mom – but I wish feeding him wasn’t so complicated. We’ve been doing this routine for one week, and I just don’t think this is a workable long-term solution. And please . . . no lectures about just formula feeding or whatever else you think the solution is.

Love/Hate Relationship with Breastfeeding

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I would say I am having a love/hate relationship with breastfeeding – and I’m pretty darn sick of it! I kind of thought after having challenges getting pregnant, and then struggling through the pregnancy with morning sickness, UTIs and pre-term contractions, that once Micah was here things would get easier. Naturally, that just wasn’t the case. We had all those eating issues the first week. Then, once we got the issues under control and he started gaining weight, I figured it would be smooth sailing from there, right? Wrong again! Micah caught a cold last week, and we’ve been on this eating spiral ever since.

Last night, I thought everything was actually back to “normal” and okay. I figured he had been eating every 3 1/2 hours all day, and nursing for a relatively “normal” amount of time for us (20-40 minutes a side) and then falling easily back to sleep or staying contentedly awake for a bit before dozing off. No cluster feeding, and then we put him down at 1:30 or 2 and he slept until 6 am. We couldn’t believe how great things were going!

Before things normalized yesterday, I was still worrying about whether Micah was eating enough or gaining enough weight and if my milk supply was sufficient. I called an LC and was invited to join a semi-private class this morning. I gave a non-committal “maybe” thinking it depended on whether Micah slept or cluster-fed or what time his morning feed was. Since he woke up at 6 and the class started at 10, I actually figured that it might be pretty decent timing. I fed him from 6 – 7:30 (he fell asleep a few times, and we changed his diaper and his outfit) and I put him back down. At 9:30 when I picked him up, he was still out cold – I figured I had enough time to get to class to feed him, so off I went!

I was feeling pretty confident when I got to class. I was mostly interested in working on latching without the nipple shield and seeing if we were using the nipple shield correctly. I have to say, I was a bit horrified by the LC. She was incredibly scattered, and much of her advice seemed to contradict all the other LCs I’ve consulted thus far. And her 2 year old daughter . . . well, there is just no way to say this nicely, but she was OBESE. I mean I’d guess she weighed over 50 lbs. She had 3 or 4 chins, and her waist was bigger than mine . . . probably even when I was 9 months pregnant. This poor child could barely walk normally. And she spent the ENTIRE time we were there eating! She drank 3 8 oz glasses of chocolate milk (mind you, I was there for 1 1/2 hours), and then nursed for 20 minutes, then had some crackers, and then ate a sandwich. I had a hard time taking bf’ing advice from a woman who allowed her child to get that obese (yes, I’m passing judgment – I have no idea what is going on there, but I think an overweight child should not be consuming that much sugar and chocolate).

So after I got there, we set Micah up, and she weighed him, and we tried to get him to latch/nurse without the shield. He did for a bit, but then he was getting hungry and frustrated so I put the shield on. The LC suggested I try a smaller shield, and she gave it to me and just placed it over the nipple. When I asked her about proper attachment, she said she doesn’t bother with any of that. I was a bit surprised, but decided to set aside what other LCs had taught me and try and trust this woman and her methods.

She said he was nursing well at first, but then later she urged me to switch sides, then said he was nursing too long and thought he wasn’t taking much in. We weighed him after he’d been nursing for about 45 minutes or so, and he had consumed about 1.3 ozs. Not bad, but definitely not enough. I kind of lost it – this whole process has been so frustrating, and I just don’t know what to do next. I really think he was doing fine before he got sick, but now I’m not even sure of that.

I noticed that my nipple didn’t seem to be fitting as well in this shield as it did in the other ones, and I decided that perhaps the nipple shield was interfering with how he was nursing. I put my own shield back on, and re-latched Micah. He ate again for a while, and started to doze off. She re-weighed him, and in a shocked voice informed me he had eaten another .9 ozs – so 2.2 ozs total for the feed (about where he needed to be). Her concern was that it took him over 1 hour to get that much, and she felt my supply might be a bit low.

I was pretty upset at this point. I knew we’d been having issues, but it just sucks hearing it. And the options don’t thrill me. I can either supplement with formula (which will do nothing to increase my supply, and because I’m allergic to coconut oil, giving Micah formula and trying to nurse gives me horrible rashes). Or, I can go back to pumping every 3 hours – another thought that depresses me a bit. There is also no guarantee that pumping every 3 hours will increase my supply, either – or help Micah nurse more efficiently.

So, I’m stuck. I could just throw in the towel on nursing (and yes, I know there is nothing wrong with bottle-feeding babies, but with my allergy, I have a different set of concerns about using formula and how it will affect how I interact with Micah). Or, I could try and pump every 3 hours, and increase my supply, and work on shortening Micah’s feedings and teaching him to be a more efficient nurser AND teaching him how to latch without a nipple shield AND supplementing with pumped milk after each feeding until he can properly nurse on his own (which may never happen). So I’m stuck. I’m not sure if it is worth continuing to fight this battle (or even the smart thing to do). I’m tired of fighting, but there is a part of me that is just stubborn and I want to win this battle. My reluctance to bottle feeding formula really isn’t about bonding, or which way is “better” or anything like that. I really do think it is mostly about winning this battle because I hate not being able to make things work, and part of it has to do with my fears about my coconut oil allergy (and no, you cannot buy any commercial formulas that are made without coconut oil). And part of me is ready for this to be easy, and I know bottle feeding would be so much easier (with the exception of my contact dermatitis rashes I’ll have for the next 11 months because of my allergy).

So . . . that is my love/hate relationship with breastfeeding. For today, we are going to weigh him before/after each feeding, and try and supplement with pumped breastmilk to make sure he gets 2 – 2 1/2 ozs at each feeding. I’m going to pump after each feeding, and maybe in between, too, to try and increase my supply. We’ll see where we are and then try and figure out what to do next.

My baby is sick

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My poor little guy is sick . . . he is running a bit of a fever, and he is definitely congested. I can’t get him to wake up and eat today. I called the doctor, and there isn’t much I can do for him. I just hope he starts feeling better soon!

In good news, Micah did latch 2x in the past 24 hours without the nipple shield. He didn’t nurse that long, but he did latch, so there is hope that we’ll get off the nipple shield eventually!

Who would have thought I could love a nipple shield?

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Well, it has been another challenging 2 days. After coming home from the hospital, Micah slowly grew more alert. For our 6:00 feeding, he was willing to latch but not nurse, so for our 9:00 feeding, I decided to try the breastfeeding supplement contraption. I was amazed – on his 2nd attempt, Micah latched, took the supplement tube, and he nursed for about 30 minutes and ate all his supplement! I thought we were home free.

Once again, however, Micah refused to nurse at his 12:00, 3:00 and 6:00 am feeding. I had to give up on the breastfeeding supplement contraption and go back to the syringe. My mom and I covered the 3:00 and 6:00 feedings so that Elliot could try and catch some needed sleep. It was a frustrating time – Micah kept getting so hungry and so upset that he was really hard to calm down, and I just couldn’t get a successful latch at all.

We had to do the 9:00 feeding 1 hour early because we had an appointment to see the doctor. Unfortunately, Micah could barely stay awake for that feeding, and the breastfeeding didn’t work out again. In better news, however, we got a great evaluation at the pediatrician appointment. Micah had gained about 5 ounces, his color was better and he was quite alert! The doctor asked us to come back for another weight check on Friday, but he thinks the worst of the jaundice is behind us.

We made it home in time for his next feeding . . . and once again, no latch and tons of frustration. We finally gave in and did this feeding by bottle – I tried to nurse him, he refused, then we gave him a combination of breast milk and formula in a bottle. Ironically, Micah rejected the bottle, too – he just does not like to latch! After some pushing and persistence, we convinced him to take the bottle. We tried again to nurse after he finished eating (no luck), then I went on to pump. The feedings continued to follow this pattern all afternoon, so I spent the rest of the day trying to find a lactation consultant to help us out. By 5:00 pm, I scheduled an appointment for early this morning.

The good news is that overnight, Micah did try to latch and nurse several times. He clearly showed an interest in nursing, but just couldn’t seem to obtain and keep a latch. Even worse, when he has a good latch, he does not like the feel of it, so he closes his mouth down and uses his tongue and hands to push me out. I was a bit less frustrated because we had a system, but I was feeling disappointed that we just couldn’t get the hang of nursing. One of my friends suggested we try a nipple shield (thanks, Marisa!), so Elliot ran out to pick one up at Target, and we tried that. I was so hopeful, but the shield just seemed a bit too big for Micah’s tiny little mouth. Again . . . close, but no cigars :(.

Elliot & I went upstairs to try and sleep around 2:00 am. We had just fed, and Micah had latched and nursed for about 1-2 minutes after that. I still had this feeling he was hungry (he was not in his usual food coma) but we were trying to avoid increasing the formula, so we figured he didn’t need any more and was probably just more alert because he was feeling better. We crawled into bed, and I had about 2 hrs to sleep before the next feeding. Just as I drifted off to sleep . . .. . . the wailing begin! We tried comforting him, we changed his diaper . . . still crying. I asked Elliot to go down and get an extra 10 ccs of formula (we had been giving him 30 ccs ~1 oz – total combined with breast milk, and we were told he could take as much as 60 per feeding ~2 ozs) and we fed that to him. We figured with the extra food we could push his big feeding back 1 hour and get a bit more sleep. WRONG! He went right back to crying. He did much better when Elliot was cuddling him, but he still wouldn’t sleep. We guessed he must be hungry since at that point we were just over 2 hours from his last real feeding, so I tried breastfeeding again. He latched and suckled a bit, but nothing substantial, and then Elliot went and got another bottle and he sucked that down. At this point, it was about 4:30, so we returned him to the bassinet and went to bed.

Naturally, 15 minutes later, the crying started again! I told Elliot it was my turn to sleep and he should stay up with the baby. He was great! He didn’t get much sleep, but he spent the night cuddling and rocking the baby and keeping him quiet. The lactation consultant was scheduled to arrive at 8:00, and I was hoping to stretch Micah’s feeding until she arrived. Because I was too tired (and it was too close to my last session), I skipped the 4:00 am pumping session, so I went downstairs before the appointment and pumped. I got over 20 ccs this time, so my milk is definitely increasing!

Luckily, Micah stayed quiet until the consultant showed up. She was a HUGE help – she evaluated Micah, took his weight naked and with a diaper, she evaluated my technique, and we tried a few different approaches. Nothing was working. She quickly realized (like the others) that Micah does not like to latch. I mentioned to her about the nipple shield we purchased last night, and she said she thought that would be a good option to try. I told her I wasn’t sure if it was too big, and she told me she had smaller if we need it.

All I can say is who would think a little piece of silicone that covers your nipple needed special training to use? She showed me how to put it on, and she showed me how to get him to latch with it. It took us quite a few attempts, and we were just about to give up on the bigger size when he latched! He fed for over 1 hour! She showed me how to move into a more comfortable position (the LCs at the hospital told me I had to keep my breast mushed the whole time I was nursing and couldn’t “relax” at all).

In even better news . . . he has continued to latch and nurse at every feeding since the LC left! We had a rough time getting latched at the 1:00 pm feeding, but we did it, and he nursed for about 1 1/2 hrs! We nursed again at 4:30 and again at 7:30, and so far, each time it has gone perfectly. I tried supplementing after the 1:00 feeding, and he took maybe another 5 or 10 ccs. I pumped again, and got about 12 ccs. He was in a food coma after the 4:30 feeding, so I didn’t bother supplementing, and got just a little more from the pump to store. At this point, I can’t decide if the pumping after each feeding is necessary/a good idea. If we don’t need to supplement, it seems a bit much. Because I’m getting so little, I think Micah is doing a good job right now of draining my breasts, so I’m not sure the pump is really doing more to increase my milk supply. A “normal” breastfeeding mom would not need to pump with these feedings, so I’ve been a bit unsure what to do. I did just give Micah an extra 15 ccs after his 7:30 feeding because he seemed very alert after his last feeding, and last night that was a sign that he got famished about 30 minutes later. The extra breast milk has nicely placed him back into his food coma, so I think it was a good idea. I got so distracted, however, that I got all re-dressed and forgot to pump. I think I’ve decided to skip pumping this feeding – I’m just too darned tired and I’ve been pumping every 3 hours for 3 days straight now, and well . . . I’m SORE. I hope I’m not making a bad decision. Did I mention that I LOVE the nipple shield?

In other news . . . Micah’s umbilical cord fell off tonight. Well, it might have had a little help . . . thanks to kisses from the dog. It looks fine, but I’m a bit worried that it had a little help falling off. We’re planning to give him a bath tonight – should be interesting!

Tomorrow we go back to the doctor for another weight check. He is doing much better, but he is still pretty yellow. Hopefully all is progressing as it should – I will update again!