Moo!: Questions about breastfeeding

Mighty_Baby was born almost two months ago at 11.5 lbs, which made her paediatrician decide to test her for increased levels of insulin just in case her size had been a result of me suffering gestational diabetes (I didn’t test positive for it though). She put the baby on formula to check for her glucose levels before and after feedings for 24 hours. Fortunately our baby was perfectly healthy, but after receiving regular food she wasn’t going to settle for whatever measly colostrum she was getting from me, and thus started our problems.

With much effort on my part I also nursed her, she wasn’t happy and seemed to prefer the bottle. Soon I started producing milk, too much in fact, so I decided to get her off formula even if that meant that I had to express milk for 6 months. Three things have happened since: Mighty_Baby takes the breast even less, I produce more milk (I have the freezer full of milk now) and I got some plugged ducts on both breasts. Nothing I did worked to unplug the ducts and after I ended up with huge build up on both breasts I went to see my gynecologists. She had to drain them with a syringe (you don’t want to hear about that), she also advised me to express milk more frecuently to avoid the same problem.

Now the problem is that I am producing even more milk and it’s getting very uncomfortable, plus I see that the plugged duct didn’t resolve in one of my breasts. I have two questions: I am taking the massage, hot showers, hot baths, lecithin and oatmeal approach but if the baby is loath to take the breast I will keep getting plugged ducts. How do I get the baby to switch from bottle to breast? And in case I can’t, what can I do abut the chronic plugged ducts?

Moo back atcha!

I don’t know beans about bfeeding, gave up early on w/my twins (long story). BUT I surf mothering.com quite a bit & the ladies there give amazing advice. I mostly lurk, and have seen them work through problems I thought insurmountable:

http://mothering.com/discussions/forumdisplay.php?f=27

No doubt you’ll find some helpful Dopers as well. Best wishes to you!

What are you doing when your baby refuses your breast?
Unfortunately, if you offer a bottle when it happens you are just reinforcing her preference although I know how tempting it can be when they’re howling and hungry and you just want to help. I don’t know what they’re called, but with my oldest I had a nipple cover thing that I used to transfer my son from bottle to breast–it was like a little plastic nipple to fit over your own and he seemed to like it better, maybe because he was used to the rubbery feel.
Also, are you giving breastmilk only, even in bottles? They can develop a taste preference too, so I’d suggest avoiding formula completely if you aren’t already, especially since you have such a stockpile of breast milk.

I’m actually surprised that you’re overproducing so much if she’s not nursing well. Usually it works the other way around. I had to really work at keeping my levels high enough to nurse exclusively, so I don’t have any good advice in that regard.

Worst case scenario, she won’t nurse and your milk will dry up over a few days of not nursing or pumping. That hurts, I won’t lie, but once you’re dry the plugged ducts won’t be an issue anymore.

My mother-in-law the lactation consultant recommends you stop giving that kid a bottle. You don’t necessarily need to go cold turkey, but you may have to put up with letting her scream for an hour.

Don’t worry, she will not starve. She’ll figure it out. OTOH, if you like pumping and giving her breastmilk, go for it.

You’ve earned your user name.

It’s called a nipple shield, and should only be used under the supervision of a doctor or lactation consultant. But it can be helpful.

What exactly is she doing? Is she latching on at all? Does she suck at all? Does she start to suck and then pull away, crying? If so, she might be A) frustrated that you don’t let-down right away. After all, the bottle gives her milk the second she gets on it. OR B) your let-down might be too strong for her, and she gagging because the milk is coming out too fast and in several streams pointing in different directions. The bottle nipple plays nice and consistent with only one to three straight-shot streams.

Either way, try pumping for a little bit BEFORE putting her to the breast. This will bring your milk to the front and encourage the let-down, and if your let-down is too strong, it will remove some milk and make the stream less forceful.

You might talk to her doctor about tough-love exclusive nursing for a weekend. She sounds big enough to me (but check with her doctor) to skip a few meals if she absolutely has to. It’ll be a tough weekend, but no bottles for two days might just convince her that the breast will have to do. Obviously, if she gets lethargic or stops producing saliva or tears, get her right to the doctor. But, if the doctor says it’s OK, maybe a weekend wouldn’t be too long, and you can take her in for a weight check on Monday.

(We’re having problems with WhyBaby refusing the breast for the bottle too. But I’m NOT producing enough milk, and she’s not even 9 pounds yet, so we *have *to supplement. But now the little brat wants to wait all day until her evening bottle, instead of nursing through the day like we talked about! Harrumph!)

I am using manual expression (I didn’t like how any of the two pumps I bought worked). From what I’ve read this can actually increase production.

The baby just does not latch, she doesn’t even try anymore. Before she would take the breast if she was sleepy enough not to notice the difference. Now she screams bloody murder if it gets anywhere near her. I have a fast let-down and have tried pumping before she takes it to control it but still she won’t take it.

Today I discovered another “cyst”, and as much as I have tried the duct is still plugged. I don’t want to see another needle again but would like to breasfeed my baby for another 4 months.

:frowning:

For breast feeding infections the Czechs have a sure-cure: Tvaroh. It’s like half-way between dry cottage cheese and cream cheese. They smear it on their breasts and within 24 hours everything is fine. Watched my wife and her sister do it a few times- seems like a miracle cure. They look stupid while wearing it, but…

-Tcat

Sounds like it’s time for a visit to the lactation consultant. Try the hospital you delivered at, they should have one on staff. We met with one when WhyBaby was at that stage (wouldn’t latch at all, only screamed) and while it seemed to do nothing at the time, one week later she was nursing like a pro. At that point, I was giving her one fortified bottle in the evening (preemie), and all the rest of the time she was nursing. Only this week, the doctor told us to add a second bottle in the morning, and that’s thrown nursing into havoc.

Anyway, if I were you I’d take her to a lactation consultant and then take her to somewhere other babies are nursing (LLL meeting, Mommy and Me, etc.). After WhyBaby saw the lactation consultant, she spent two days watching an older baby nurse with her mamma, and then literally turned to me and dove for my nipple! It was amazing!

(And she was six months old to the day - two months “old” from her due date. When they say “sometimes it takes a while, but don’t give up!” they aren’t kidding!)

Thanks Whynot (btw, I followed the whole saga with your baby. I also have her pictures bookmarked).

You see, there are no lactantion consultants around here. And you would ask yourself what kind of third-world country I leave in, well, the fact is that this is a third-world country. The general, and very uninformed consensus, seems to be that “women have been doing that for centuries; you need no stinking lactation consultants”, but the fact is that comparatively few women breastfeed here (pulling stats out of my ass, but I say less than the US). That’s a damn shame.

Anyways, I only have my gynecologist to result to… and well, she knows what they know about it. There is a support group for lactating moms that meet at the clinic once a week. I might give that a try… unfortunately I am on my own here.

Live, dammit. Preview, preview, preview.

OK, then let me try to explain what my consultant did, with the understanding that you don’t have that option (anyone else reading this should not confuse this with qualified consultant advice! Go see your own lactation consultant if you can!)

Our problems were similar to yours - she used to nurse half-heartedly, but now she won’t latch on at all. Furthermore, I have very large nipples (no nipple shields large enough) and she’s a pretty tiny baby - it was hard just to get her to open her mouth wide enough for my nipple, nevermind the areola!

First, she had me hold the baby in the crook of my arm, with her head all the way in my elbow. On our own, the baby had her head down by my wrist, which was awkward. She also had me move the baby more toward the middle of my body, as I had been holding her too far to the side which housed the breast - with the l.c., her neck was by my breastbone.

Then the lactation consultant (l.c.) sort of pinched my areola while I guided the baby to the nipple. She had the bottle with expressed milk in her other hand, and dribbled a few drops on my nipple as the baby came close. Baby licked off those few drops before pulling away and crying. Lather, rinse, repeat. Sometimes, she would squirt milk over my nipple with the bottle, letting it drip into the baby’s open (but not latched) mouth.

We did this for about 15 minutes, then the baby latched on for just a few seconds. We praised her and cooed at her, and then gave her the bottle for about 30 seconds. This rewarded her for latching, instead of rewarding her for crying.

Then back to the dribble and dodge - l.c. would dribble milk, I’d guide the baby towards the nipple, the baby would lick or dodge it. Once she latched on again, she’d get the bottle for a few seconds after she came off.

This trick of rewarding her for latching, even for only a few seconds, was so obvious to me when I saw it, but not something I knew how to do on my own. By the end of the hour, she had latched on for about 5 minutes total, and no longer than 30 seconds at any one time. I was so discouraged!

But I took her home and tried the same thing: bottle with expressed milk in one hand, dribble, move her towards the nipple. Then she’d lay there with her mouth open around the nipple. Good. Dribble, dribble. Latch! Yay! Once she let go, I’d give her the bottle for 30 seconds.

It was exhausting, and harder to do with only two arms, but we managed it. (Honestly, the next feeding, I just gave her the damn bottle because I was so tired. We switched training and feeding sessions for that first day.)

After about a week of this, we went to stay with a friend, where, as I said, WhyBaby spent two whole days watching her and her baby nurse. All this time, I was still playing the dribble game at least twice a day (as well as pumping every three hours. Ugh!) Two days after we got there, WhyBaby just turned and dove for my nipple. Bingo. That was it - she’s a nurser! (With one bottle in the evening)

Unfortunately, she lost two ounces in that month, while she grew an inch and a half. So that’s why her doctor is having me give her another bottle in the mornings. To complicate things, she also discovered her fingers, which she’ll now happily suck on instead of the breast. Her hunger signal doesn’t seem all that strong.

Oh, and here’s a great page on nipple shields.

One of the most common uses for them is to transition bottle-preferring babies to the breast by giving them a bottle-like nipple to suck while they figure out where milk really comes from. I had no luck with them, however, because my nipples are amazingly, grossly huge, and wouldn’t fit in a shield.

“They” say you shouldn’t use them without a doctor or lactation consultant, but my l.c. said that’s because the OLD style, not used anymore, where made out of thicker latex and the lack of stimulation to the nipple could diminish milk supply if they weren’t used perfectly every time. Apparently not such a problem with the newer, thinner silicone, but the advice is still given.

They are available to buy off many websites, and are carried at Babies R Us around here. My l.c. prefers the contact nipple shield as it leaves more of your skin open for baby to feel and smell.