Need encouragement… Dr wants me to stop BF, close to failure to thrive, slow gain

@kars I’m so sorry, you might have to supplement with formula for a little while, while you build supply. Let baby nurse as much as they want, supplement with formula and power pump often.
 
@kars You’re story is almost identical to mine except we were triple feeding for 6 weeks and then after moving to breast milk only for weeks 7-10, fell off the growth charts and only gaining 0.25oz body weight per day on average. We are back triple feeding for half of the feeds and the other half are either formula or breast milk + tsp of formula to be a “gainer shake” lol.

LO was totally happy and had no indications of being starving. But I skip a triple feed at night when supply is lowest to have my husband do a bottle & I power pump from 5-6p.
 
@kars Pumping is still feeding from the breast, and allows you to monitor intake and maintain supply. I’m in the middle of this now with my 2 month old. Holding on to hope. I still bring her to breast multiple times a day but I don’t count it as a feed. Since I started pumping and making sure she gets at least 24 oz a day, she has put on about 40-45 grams per day.

She was diagnosed with failure to thrive and we were hospitalized at 4 weeks. I am continuing to work with a lactation consultant and holding hope of increasing her intake direct from breast soon. Once she started gaining, taking larger bottles with more time in between feedings, triple feeding didn’t feel as difficult.

Solidarity because this is hard AF.
 
@kars Please look into the Medela sns system, then you can still breastfeed your baby, keep that connection to the breast and the good stimulation for you and baby. I used it when I was in a similar situation with my little guy in the beginning of the year. We still breastfeed.
 
@kars Neither LCs nor peds are trained in identifying oral ties. I highly suggest seeing a pediatric dentist or an ENT for a proper eval.

If no ties, is there a suck/swallow issue? Have you done any weighted feeds?

You say babe is gaining slowly, but are they having a normal amount of diapers? Some babes just gain slow, but without knowing birth weight etc. I can't say for certain yours is one of those.

What kind of gain does ped want to see, if the improvement over the past 2w isn't "enough?"

Ultimately, you'll need to think about how able or willing you are to continue troubleshooting, in order to keep breastfeeding.
 
@maxx55 She seems to have a great latch but just isn’t getting enough, I updated my post with the weighted feed info we’ve done. Ped didn’t say what she wants for weight gain just that she’s not where she needs to be
 
@kars Please get your ped to define "enough weight gain". I saw your other comment with a growth curve. Getting back to the original growth curve may not be realistic, but it looks like LO has found a growth curve and following it.

Also, does LO have any indication of a food intolerance? Extreme fussing/colic, constant diarrhea (totally liquid poo, normal baby poo is the same consistency as peanut butter or yogurt), gassiness, rashes? Problems with food can be shown in weight gain bc their body doesn't process and absorb the nutrients properly. My daughter has a gluten intolerance that caused some problems early on.
 
@kars It took us 5.5 weeks to get our FTT baby back to birth weight. I spent two weeks exclusively pumping while baby was in the NICU (partially for the FTT). Then we moved to triple feeding once discharged from the hospital.

If doctor would like the main feeds to be bottles, what about comfort nursing? Once discharged, I did the main feeds every three hours per their instructions but we did comfort nursing absolutely whenever it was warranted. That seemed to keep a positive association with the boob and we did eventually transition to exclusively BFing around 2.5 months old.

It is doable. But it is ridiculously mentally taxing. You have worked so hard already by the sounds of it!!! Your baby is lucky to have you!
 
@kars Both of my babies were born at 35 weeks and on oxygen. My pediatrician advised to do bottles from birth. First kiddo was fully on the boob by 8 weeks. Second kiddo will be 7 weeks on Sunday and we are so close to being fully on the boob. Second baby we’ve also dealt with supply issue (supplementing needed) as well as bottle preference. It’s definitely doable, lots of work and patience. But remember, all that matters is your baby is fed
 
@kars Have you had your thyroid checked ? That can effect your milk supply, also so can low iron levels? Also, each feed should be at least 60 ml I think by that point.
 
@kars Any chance baby is showing signs of an intolerance/allergy? My baby seems to have a dairy intolerance (we’re still working it out) and she also slowed in weight gain after a few weeks. The first sign for us was mucousy poops.
 
@kars I pumped for the first month and then was able to EBF by the end of the second. I had an LC and the ped said no tongue tie. And then I saw a difference IBCLC and a pediatric dentist and found ties. Such a game changer. So maybe Go to a pediatric dentist!
 
@kars I just also want to add in, pumping milk and feeding it to your baby is still breastfeeding.

As a suggestion, feed the pumped milk to your baby and make sure she is eating enough. Then comfort nurse afterwards, she might even get some extra calories this way.
 
@kars Hey, it very well may be temporary! Lots of people (myself included) EP for a while and are eventually able to get baby back to breast.

The other advantage to EP-ing for a while is you'll be able to see not just how much baby is eating, but how much you produce. So that can help you work out whether you have a transfer issue or a supply issue (or something else going on with baby if she eats plenty but still struggles with weight gain). That said if you underproduce while pumping it doesn't necessarily mean you have a supply issue since not everyone responds well to the pump, but if you have a good supply while pumping you can be pretty sure that is not the problem with nursing.

What was involved in the tongue tie assessment? Most pediatricians and many LCs are not very well educated about tongue ties and what to look for.
 
@teresacr That’s good to hear! And that’s true. I’m thinking it’s a supply issue but I’m not sure, I guess if I EP for a bit instead of triple feeding maybe I can fit in some power pumps 🤞

All they did was look at inside her mouth and poke their fingers in there and feel around (with a glove)
 
@kars Yeah, I would consider taking baby to a pediatric dentist who specializes in tongue ties. They should do a full evaluation that includes checking her latch and evaluating symptoms. I don't remember what everything is they ask about but it's way more than just looking in the mouth. I know a couple very common signs are dribbling a lot when taking the bottle and "clicking" (losing suction) on the bottle.

I triple fed for a while too but never for every feeding. I would pump and we would bottle feed round the clock but also I'd put her to breast before bottle feeding just a couple times a day. That already felt like a lot to me. But it helps the baby stay comfortable with the breast and can also help boost/maintain supply while pumping. So hopefully your ped would be okay with that, if not now then soon.
 
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