Follow up on Breastfeeding II (5w5d)

The struggle continues…

My supply continues to dwindle. The herbal supplements don’t seem to help (neither the Mother’s Milk Plus nor the Fenugreek seeds) although I don’t know that I’m taking enough of the Fenugreek seeds because I don’t think I smell like maple syrup.

I’m averaging less and less with the pumping every day. Sometimes I’ll get over an ounce (30ml) combined, but like this morning, I got just over 10ml combined. That is SO frustrating, let me tell you. That’s a lot of time being tied to that pump for so little return. I’m working to increase the number of times I’m pumping though, in the hopes that I can bounce back.

Kieran is basically refusing the breast all the time now. Having to give him thickened feedings because of his acid reflux has necessitated using an even more open bottle nipple, which requires even less effort than a regular bottle nipple for Mr. Lazy Nurser. We give him the occasional un-thickened bottle with the tightest nipple we have just to remind Kieran what it should be like. We can tell that frustrates him. So when he’s offered the breast (even when I’m nearly engorged, so I know he could get a fair feeding outta me) he just fusses and squirms and cries and won’t nurse. We’ve tried giving him a half feeding with a bottle and then offering the breast when he’s not ‘starving’ – but Kieran is convinced that he’s starving until he’s full.

It’s disappointing on several levels.

  • I was SO INCREDIBLY looking forward to nursing Kieran. The bonding, the special time, the perfect nutrition that only I could provide, the easy-clean-up diapers.
  • The Cost. Even using some of the most inexpensive formula we can find (currently Target’s house brand “up & up” Partially Broken Down version) is gonna add around $60-75 a month to our budget that already doesn’t quite cover everything. And as he grows, that figure will only increase. (I can’t imagine if we had to stay on one of the name brands. The Target stuff runs ~$.46/oz whereas the cheapest you’ll find Simalac is ~$.89/oz at Costco or Amazon.)
  • Formula diapers are not as pleasant as BF diapers were. Just sayin’.

On the bright side though, Kieran is gaining weight like a champ. He’s still right at the very bottom of the growth percentage charts – but that mostly has to do with the fact that he was 3 weeks early and such a tiny peanut to start with. ~8lb is teeny for a nearly 6 week old baby. But then again, ~8lb for a nearly three week old baby is still small too. He’s gaining ~1oz a day, which is a very healthy growth rate – so his pediatrician is happy with that.

Truth be told, we’re a little concerned about him gaining weight too fast with the thickened formula – but we’re carefully watching Kieran’s signals and feeding him when he actually tells us he’s hungry, feeding him a set amount (currently 3oz + 1T of oatmeal cereal) and waiting to see if he asks for more 10 minutes later. Sometimes he does (and gets another 1-1.5oz + cereal) and sometimes he doesn’t. The oatmeal cereal added to his formula adds the nutrition/calories equivalent to another ounce of formula. So he’s getting what he needs to grow at the rate that works for him.

I’m bummed that Exclusive breast feeding hasn’t worked out. (Not devastated though, which is a VAST improvement over my mental status for the first 2-3 weeks of this adventure.) But I’ll keep trying with the pump, which we have rented through September and see how it goes. I’m comforted by knowing that any breastmilk Kieran gets is better than none, but that regardless he’s growing well and thriving.

Reflux (25d)

This week has been kinda rough for us all. Kieran’s sleep patterns changed to naps of an hour or less. His usual little bit of fussing after feeding increased to nearly an hour or more of arched-back screaming. He started spitting up, not just directly after feedings, but an hour or more later, and while he was asleep.

Kieran has always been gassy – literally from birth, but this was more than his usual gassiness. (I’m starting to notice that the tummy part of his sleep & play outfits is slightly more worn and pilled than the rest of the outfit from where I rub in firm circles for 20 minutes or so after every feeding.) I was really starting suspect Acid Reflux, which is really quite common in infants. (More and more pediatricians are thinking that what was diagnosed as “colic” in years past really was acid reflux.)

On the advice of the lactation consultant on Thursday, I made an appointment with the pediatrician to check Kieran out for reflux. I was able to snag a cancellation appointment at 3:45 yesterday afternoon, thank goodness. I didn’t want to go through the weekend with Kieran crying in pain after every feeding. (Talk about feeling helpless!) Dr. Alazard was pretty open to the idea of reflux when we presented all Kieran’s symptoms. He made a couple of suggestions for isolating the problem:

  • To confirm reflux vs. a food sensitivity (either to the type of formula he’s getting, or something I’m eating that’s coming through my breastmilk) he suggested giving Kieran two feedings of Pedialyte, which is basically neutral for allergens. If Kieran still did his back-arching, screaming routine with Pedialyte, that would confirm that it’s acid reflux causing his pain, versus a sensitivity to the formula.
  • He also suggested that we try a Soy formula, just to see if that makes any difference in how much Kieran spits up or how long he cries.
  • Lastly, he suggested we thicken Kieran’s formula with some Oat cereal – since there tends to be less allergies to oats than rice.
  • He also gave us a prescription for liquid Zantac once we confirmed reflux. Meds are supposed to be a last resort.
  • We came home after a long afternoon of the doctor’s appointment and then a trip to Walmart to actually purchase the Pedialyte and oat cereal and whatnot. Kieran got his bottle of unflavored Pedialyte and acted the same as he had been, but worse. I’d never heard him scream like that before. He was bordering on frantic, which is just heartbreaking to hear. Knowing that he’s in such pain and there’s nothing we can do to take the pain away.

    I decided to break the rules and give him the medicine then. I’m more interested right now in preventing my child from being in pain than figuring out what kind of formula to give him. The meds are supposed to be administered three times a day, 15 minutes before a feeding. It took until a third feeding for them to kick in, but when they did it was blissful. The 2:30am feeding was peaceful, with Kieran calm and relaxed, with nary a back-arch or squawk.

    We are also making sure we keep him vertical for at least 15 minutes after a feeding. Paul put bricks under the far side of the crib, so Kieran sleeps on an incline now too.

    So while we’re thrilled to have the meds in our arsenal, we’re kinda stuck now for checking out other kinds of formula or possibly altering my diet. We don’t want to stop giving him the meds, because we KNOW we’re dealing with reflux – so regardless of what he eats after we stop the meds, he’s gonna have pain and spitting up. We’d prefer not to have to change his formula, and REALLY prefer not to have to change my diet – especially cutting out dairy. We’re HUGE milk drinkers in this house, so cutting out dairy would be akin to cutting out water.

    I’m pumping as much as I can right now (a proper-fitting hands-free bustier thing is helping SO much with that) to build a several-feeding supply of breastmilk so that we can try to ‘reset’ Kieran from one formula to another in another day or two.

    We’ve started another tactic this evening with thickening Kieran’s bottle with some oatmeal cereal. OMG, if it’s possible for a baby to be drunk, we think we achieved it this evening. The nipple had to be enlarged so that the thickened formula could come out, and Kieran (Mr. LAZY nurser) loved just having this amazing elixir thrown down his throat! Here’s hoping the combination of Zantac and thickened formula will keep everything down – cuz Kieran has been urping formula all afternoon. (Maybe soy isn’t the best for him, huh? We’ll be switching back to the regular Similac formula on Monday or Tuesday.)

    So we’ve joined the ranks of parents of reflux babies. Here’s hoping the solution stays simple. We just don’t want our baby to be in pain.