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Martha in VA
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Posted: June 02 2009 at 9:28pm | IP Logged Quote Martha in VA

This may get long so bless you in advance if you get to the end.

Some of you may recall that Brayden was born 4 weeks early. He's now 6 weeks old (can't believe that!). Early on, he had issues with weight gain and his doctor asked me to nurse, pump, then feed him the rest in a bottle. He took to the bottle well and gained weight quickly. Two weeks ago, His doctor told me I could begin to wean him off the supplementary bottle feedings. I tried withholding one or two bottles the first day and he protested, LOUDLY.      

So I called the Lactation Consultant who advised me to put the pump away and cut him off of the bottles cold turkey. I did that. He was miserably. I was engorged for a day or two then my milk supply nearly dried up!   

I think the issue is that his suck just isn't strong enough to maintain my milk supply therefore requiring me to continue pumping. I'm also concerned that his latch isn't correct since it often hurts to nurse him. The Lactation Consultant suggested I make an appointment with them so they can observe his latch/suck/etc. Having been an OB nurse, I feel like I know what I need to do to retrain him in latching. Also, DH isn't too excited about shelling out $60 for the appointment.

Here's my question. HOW would you suggest I wean him from this dependency on the bottles? I really want to continue to nurse but he clearly prefers to suck from the bottle. It's easier and the flow is faster. I'm concerned that as time goes on, he will take more and more from the bottles and less and less from me. I'm afraid I already see that happening. When he's latched on he's comfy and cozy and often dozes off. When he's drinking from the bottle, he's wide awake and sucking like crazy.

What would you do? I know I can call the Lact. Consultant again but after the advice they gave me last time - and nearly losing my supply altogether - I'm afraid I don't completely trust what they say.   

Thanks so much for any advice you can give. It would be heartbreaking to lose him to the bottle.   

Martha in VA

UPDATE 6/6: Thanks, ladies, for all the great information and prayers. I finally feel like we're making good progress. I've been working with him on his latch and trying to nurse him at every opportunity. I think he's finally catching on and improving his suck. Finally, I have hope that this might actually work long-term!   

Thanks again!

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sewcrazy
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Posted: June 02 2009 at 9:44pm | IP Logged Quote sewcrazy

I had this problem with my now 14 year old, who was born 10 weeks preemie. What worked for us was a Lact Aide I would pump and then nurse him using this system. Over several weeks I reduced the amount I put in the Lact Aide until we didn't use it at all.

Good luck and hugs!

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mom2mpr
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Posted: June 02 2009 at 9:49pm | IP Logged Quote mom2mpr

What about those supplemental feeders with the little tubes that go in their mouth and they can get some pumped milk while they nurse.
Like this one
http://www.medelasuction.com/ISBD/breastfeeding/products/nur sing.php
It would allow you to keep him at the breast while you work on his latch on and also give him some extra milk.
Good luck!
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stellamaris
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Posted: June 02 2009 at 9:53pm | IP Logged Quote stellamaris

My twins were premature, and one of them was in the NICU and really had difficulties with nursing, both latching on and then sucking as well once he was latched on. One thing they had me do was set up a contraption (that's the only word I can think of!) that consisted of a small tube taped to my breast which was connected to a large syringe full of pumped milk. As he would sucking (be it ever so weakly), I would slowly press the syringe to deliver the milk. This was easier to do when my dh helped me. The idea was to keep him on the breast so he would be nursing as much as possible and so he would understand that the breast was the source of his nourishment, while still getting the milk to him that he needed. It wasn't a great solution, but it worked moderately well, even though we did have long-term nursing difficulty with this sweet boy and it turned out that he has low muscle tone and motor processing delays, so that complicated the problem. If all is normal with your baby, this technique might work for you. It does have the advantage of breaking the bottle "habit".

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MaryM
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Posted: June 02 2009 at 10:08pm | IP Logged Quote MaryM

As has been mentioned a supplemental nursing system (there are a couple types) might be an option to keep baby at breast but with a more rapid flow and measurable intake. There are also some bottle feeding techniques that can be used if supplementing is happening which make it "harder" to bottlefeed. With supplemental feeding by bottle the preference is that it not be too easy - that it more mimic what a baby needs to do at the breast - in order to help transition a baby back to the breast. I can post or send you specifics on those techniques when I get a minute.

Other suggestions in general for working with Brayden, are to have lots of skin-to-skin time, even if not trying to bring baby to breast.

Trying to offer the breast when heis just waking and not fully awake - suckling is instinctual in the active sleep state and babies often do better or take to breast more readily.

And working on retraining the latch as you indicated. If a bay takes a deeper well positioned latch he is met with a more rapid flow which will be encouraging for continued suckling.

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Angi
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Posted: June 02 2009 at 10:22pm | IP Logged Quote Angi

My advice, call an LLL leader. They will assist you for free. There are many possible causes for a poor suck/latch.
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Maddie
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Posted: June 02 2009 at 10:28pm | IP Logged Quote Maddie

FWIW:

My 7th was difficult for me to nurse and I almost dried up because she couldn't latch properly. I was desperate, I really didn't know how to mother a baby without nursing it, if that makes any sense. I did use some formula to supplement and hated doing it, but she was losing weight. I made an appointment with the lactation consultant (at Fair Oaks actually if you're in that area) and the consultant was wonderful and Catholic! She discovered that my baby had an an extra high palate which made latching on and pushing the ni**le up to the roof of her mouth very difficult. She taught me how to position her to make latching easier and I bought a my bre*st friend pillow, pumped, supplemented, prayed and within 6 weeks she was back to the bre*st entirely.I spent a lot of time in my bedroom without a shirt on and fed her the bottles nuzzled up to me and tried to encourage her to nurse from me when she'd let the bottle go. She weaned at 2 and a half.

I prayed a lot to St. Therese's mother, Zelie, as she suffered from not being able to nurse her babies. In fact, one died (a Therese right before St. Therese actually) from being neglected by the wet nurse. I knew she would understand my mother's heart to nurse my baby.

Just thought I'd share a success story with a lactation consultant, I was so glad I went. What's funny now, and humbling, is that when I was still in the hospital after the birth, the consultant had come in my room to offer advice. I laughed and told her it was my seventh, I knew what I was doing...

Praying for you to Zelie, I think she is Servant of God or Blessed now?


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LisaR
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Posted: June 02 2009 at 10:49pm | IP Logged Quote LisaR

Martha in VA wrote:


Here's my question. HOW would you suggest I wean him from this dependency on the bottles? I really want to continue to nurse but he clearly prefers to suck from the bottle. Martha in VA


Martha, my daughter was born toungue tied, and ended up having to be bottle fed, then after surgery she, too refused breast.
I went to a wonderful lactation consultant who was very blunt with me and told me to be prepared for it to take up to 6 weeks. (she was almost 3 weeks old at the time)
I had to pump every 2 hours, try breast first, then go to bottle, and then do the entire cycle over again, even through the night!
She strongly advised that dh take 2-3 days off, and that I confine myself to my room topless and kangaroo care Maria skin to skin.
I literally resided on our bed for about 3 days straight and dh brought me lunch and dinner!
It was amazing to witness the bonding and relatch process, although VERY difficult and exhausting.
all in all, it took about 3 weeks,(of the around the clock pumping, and very slowly weaning off bottle and onto breast) not 6, and looking back (I nursed for about 16 months) it was SO worth the work.
I will be praying for you and your son.
PS I recall she advised against the little tube things that can be attached to breast which allows bottled milk to flow as well, but now I cannot remember why...

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Martha in VA
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Posted: June 03 2009 at 7:34am | IP Logged Quote Martha in VA

MaryM wrote:
I can post or send you specifics on those techniques when I get a minute.



Please do post specifics when you get the chance, Mary. I've tried the suggested "contraptions" already without great success.

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Martha in VA
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Posted: June 03 2009 at 7:40am | IP Logged Quote Martha in VA

Maddie wrote:
FWIW:

I prayed a lot to St. Therese's mother, Zelie, as she suffered from not being able to nurse her babies. In fact, one died (a Therese right before St. Therese actually) from being neglected by the wet nurse. I knew she would understand my mother's heart to nurse my baby.



I never knew this. What a wonderful intercessor!

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Posted: June 03 2009 at 8:27am | IP Logged Quote CrunchyMom

I think that I would go to a lactation consultant or consult an LLL leader (or 2). I just think that their experience with mostly difficult cases gives them a wider knowledge base to draw from. I'm not discounting your experience as a nurse, I just think that their specialty is dealing with exceptional situations like yours!

It took a couple of sessions with a consultant to correct my latch issues with my first because he seemed fine at the beginning, it wasn't until later in a session his latch was bad.

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Posted: June 08 2009 at 8:10pm | IP Logged Quote Pilgrim

We had a little trouble with each of our twins in the beginning.

Dd was in NICU and on bottle for 4 days in her first week, and got used to the bottle. It took 2-3 weeks to get her to like the breast better than the bottle. She DID get much better though, and now doesn't even take a bottle well at all when offered one.

Ds had weak jaw muscles, and therefore had trouble getting a strong latch. It usually took 15 times each nursing session, of trying to get him latched on, he would just slip off. I checked for tongue tie. I took him to a lactation consultant. We agreed it was weak muscles, she encouraged me to just keep up the nursing, and supplementing with formula, when he just couldn't get enough milk from me.

Now both babies are fully on the breast. They are almost 4 mo, and are nursing and growing like champions. I hope this gives you hope. I really worried in the begining that we would never be exclusively breastfeeding, esp. because they each preferred the bottle at different times. But with time, lots of patience, and lots of work, and many prayers, they are both doing fine now.

Be at peace. Prayers are being offered for you and your precious Little Prince. You are doing a wonderful job. If your mother's intuition tells you something different than what the experts say, follow the Holy Spirit's guidance. Sometimes our intuition tells us things, God blesses us mother's to know what's best.

Keep your chin up!

It sounds like things are already going better!

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