Late Start

[hfs1998]

I just had my fifth baby.  I nursed the first two without many issues, but then with #3 and #4 I had a lot of problems - low or no weight gain, reflux, food sensitivities, failure to thrive, etc.  My third barely made 11 mos nursing and my fourth was switched to formula at around 7 months.  When I found out I was expecting #5, I just decided that was IT.  I didn't want the stress and upset again.  I decided to just formula feed right from the beginning.  I was absolutely obstinate on the issue.  My fifth baby was born via c-section (we had a scheduled c-section but I went into labor 3 days prior to my appointment) and was diagnosed with "small for gestational age" and asymmetric IUGR.  He was healthy but TINY.  I stuck with my resolution not to nurse until Day 5 when my milk came in with a vengeance.  Apparently my body didn't get the memo that we weren't nursing.  My baby also didn't get the memo that he was supposed to take a bottle and started dive bombing my chest so I reluctantly put him to breast.  He is now 2 weeks old and is combo fed but is sliding more and more towards being EBF.  I feel okay about that now (and am wondering if I had some sort of pre-partum depression because now I can't understand exactly why I was so opposed).  Now I would like to get him off the bottles (which he doesn't like and has a hard time with anyways) but I don't have the confidence that my milk is 100% in due to a lack of stimulation and half hearted nursing. 

So what I am looking for: has anyone else succeeded in getting baby EBF despite a really crappy start?  Any hints or advice?  (I am already putting him to breast as much as possible, skin to skin, cosleeping, etc)  Also I suffer from hypothyroidism and am on synthyroid medication, I read that some herbs like fenugreek are not suggested for people who have thyroid issues.  True?

[slvrbtrfly]

You are right about the fenugreek. But you can still take milk thistle and fennel. Also oats are good. But really, you are already taking the best steps by nursing often. I would completely ditch the bottles and just let him eat. Breastmilk metabolizes faster than formula, so he may need to eat more often, but thats good for your supply. If you don't have one, get a sling. It'll make your life so much easier! Congrats, and good luck!

[maggiemom2000]

All you need to do is keep nursing more and give fewer bottles. Your body will step up to make the milk. That said, the sooner you get him off the formula the better, ad you have a bit of a window when your body is primed to "set the bar" for milk production, and that window closes at around 3 weeks. It is still 100% possible to increae and build your supply after that point, but your body will respond more quickly in the first few weeks.

What worked really well for me in reducing supplements when I induced lactation for my adopted baby (talk about a late start, I had NO milk when she came home, not a drop!) was to delay the first supplement of the day. For example, if you usually give some formula at around 8am, wait. Just nurse, nurse, nurse. As long as baby is content to keep nursing, or falls asleep, don't give the supplement. Let baby nurse as long as he wants on the left, then offer the right, then the left again, then the right again, etc. Maybe you can go until 10am w/o giving any formula. Tomorrow maybe you can go a little later, etc. until you are down to one bottle in the evening, and then that will be the last one to go.

You'll know baby is getting enough becuase he will have at least 6 wet diapers every day, and will be gaining at least 4-7 ounces per week.

With baby 3 and 4, were you being treated for hyopthyroid at that point? If you had untreated hypothyroid, that would explain the low supply with them.

Your production *should* be okay since your thyroid is being treated.

[hfs1998]

THanks for the advice!  I will check out the herbs.  He nursed all night long last night and never fussed for more than whatever he was getting so I think that's a good sign.  Another good (?) sign is that he doesn't do very well with the bottle.  At most, he will take an ounce but usually only a half ounce.  He fusses and doesn't seem to know WHAT to do with the bottle nipple whereas he seems to latch on the breast just fine now (after some initial fussing last week).

As far as the thyroid, no I wasn't being treated with #3.  With #4, I had a horrible period of about 2 months of stress (dh in the hospital with a cancer scare, moved ILs into assisted living, etc) and I wonder if that somehow impacted my supply.  Also that baby was a particularly placid baby (though a sassy toddler these days) and I'm sure it didn't help.  I really lost all confidence when she failed to gain ANY weight in a 2 month period.

[azpreemiemom]

I wouldn't worry too much about the lack of stimulation in the beginning. During the first few weeks, your milk production is hormone driven, by prolactin. After, your supply will be supply and demand driven. Right now, I don't see an issue with dropping the supplements. and keep an eye on growth and output, especially since he doesn't even seem to like the bottles.

I didn't breastfeed my 3rd until she was 7 months old due to medical issues that she had. She was premature and had a trach and would aspirate on thin liquids. She also needed it fortified with extra calories for growth. I understand the late start :)

[hfs1998]

Would it be a bad idea to go in for a weight check tomorrow?  It will be 6 days since his last weigh-in and 7 days before his next scheduled appointment.  The dr offered that we could go in at any time so that we are using the same scale.  I normally wouldn't be so concerned but the late start coupled with his IUGR is troubling me.  Plus I don't think he is wetting enough diapers.  It is so hard to tell with disposables!  My friend told me that I could weigh the diapers on my digital food scale to see.  What do you think?