Why can't breastfeeding be easy?

Hi Meals I've been following your threads, but have never really commented much. I just wanted to say that even though I do not know you personally, you are truly an amazing mother and a credit to us women out there! I know it can seem like a loosing battle and you may have felt like giving up many a time. The main thing is that you have not given up on your baby. That is amazing! I'm am lucky enough to be able to breastfeed my DD, and enjoy it, but I get my moments when all you ladies on EW who are struggling to breastfeed pop through my mind. I always say a quick prayer so things may become easier for you all. I don't have a lot of advise, just wanted to say well done!

Meals! Don't feel sorry in the slightest! The only people who you need to take into account are your son and you! And in any case we all know you've gone over and above the call of duty to make sure your little one gets the absolute best start in life. Preemies sometimes need a bit of extra help - nothing to do with you or him, just the circumstances of his birth - and you have indeed done amazingly well and I have no doubt that you will continue to do meet his needs and more, breastfeeding and/or supplementing as he needs. Don't feel that you need to stop breastfeeding unless you are ready to - it is in no way all or nothing. Breastfeeding is more than nutrition, so even if he is getting some of his nutrition from a bottle, breastfeeding can continue alongside this. I am sure that you will find a way forward which works for you and your son. xx <em>edited by BFC on 28/06/2011</em>

Oh Meals - you have done an incredible job to breast feed him thus far - do not be feeling you are letting anyone down!!! To BF a prem is a different ball game. It is not something that can always be done even by Mums who are old hands at it, simply because their baby is a prem and they can have all manner of challenges (as we know!). Your perseverence with it is an inspiration and he has been so very lucky to have your milk for so long. I look back on BF my litte girl as one of the greatest achievements of my life because it was just so darned hard. When you've had some time I'm sure you'll feel the same. And I'm not surprised that with the bottle feeding it's taking him a while to get used to it. My DD also took some time to get to like it and to build up 'capacity' with bottle feeds and still won't 'guzzle' with it. I think her weight took a knock the first week (maybe two) that I introduced bottles and it was about the same age, then recovered. If you do continue to BF in part you may find that he goes through periods of reverting to BF - Emily has been teething and in the last 48 hours went back to the breast completely (I now look like Dolly Parton again - well in the chest area at least!). Hope the gorgeous little chap puts in a spurt for you this week xxx

I just find it amazing that these little babies have such powerful personalities. Having such strong prefereces shows that there is a sparky baby! Have you tried expressing out of the good side to make the flow on the unpopular side compare better. Random suggestion but if everything else is failing...

Hi Meals, how is J doing now? Still being as troublesome as ever?

DS has a fav side too. I used to always start on his least favourite to encourage him to take more. I think you should just let him switch when he wants to. It may be that the flow has slowed down a lot and he'll actually take a much bigger overall feed if he switches, which ultimately is what you want. When he is done with the second side try the first again.

Hi Meals just read some of the thread so apols if I'm missing bits - hang in there. It's a good solid gain he's made...I know you are despondent after working so hard for more. And I know we have to be on the ball with our preemies because they don't have so much to lose but if a content and otherwise well term baby (with, sure, a higher place on the wretched charts) did a full stop then put on 115 for a week no eyebrows would be raised. If there is an issue you, and the paed, are looking at all the options and may be some of those would be good, esp fortifier even for a short while to give a bit of a kick start. I don't know about you but I find it so difficult to up the ante on weight when there is a limit (I think) to what she can cope with. Emily does not make big gains and will be, I think about 6.3kg at 1 year old - I'm trying really hard for it to be more than that but in the face of being told "You must keep pushing/ momentum etc etc" I just think: "I am pushing - but if I go beyond what she can handle, she is sick/ constipated/ refuses and I don't want to damage her relationship with food. So I go with her and what she wants and try to fight our corner. I try to cancel out everything else and think, is she happy and do I think anything is really amiss. I do listen to the doctor and act on the advice and strategies I am offered but I also 'filter' and try to fight our corner a little. Sorry waffling now - you will get through this patch. Thinking of you and hope it is soon in the past and his gain picks up xx oh and ps re skin to skin - it's wonderful and certainly the best way to welcome your LO into the world - I did with DD1; it's also great for BF but don't beat yourself up if things are not that way. So much is made of it and people then feel terribly guilty if their birth experience does not go that way. I am as close as could be with my lovely prem daughter (DD2) and she was, until recently, exclusively breastfed. But we had a traumatic time at birth and I didn't get to hold her for days. I didn't even express until the next day as I was, rightly, told to rest. In the end I BF and certainly made up for the cuddles later! <em>edited by Muzza1 on 22/06/2011</em>

ooohh thanks for that tip! xx

julz a tip, they make pullups in small sizes, so if your baby can stand holding on to something, it is much easier than trying to pin her down :)

julz you must have one like mine, I have to pin him down with both my feet so I can have my hands free to change his nappy and my less flexible husband is nearly brought to tears when it his his turn :) lol, yup! shure do, lol. my daughter is 7 months tomorrow and less than 17 lbs, i freaked out when i found out, cause she was 15 lbs at 3months, but she is long so i guess thats where the bm has been going, to her length. all in all i am told not to worry, and she seems happy and continent, so i wont worry ant more. all babies are different.

PS This page might have some suggestions which may help? http://www.kellymom.com/babyconcerns/growth/weight-gain_increase.html

*Hugs* it must seem very dispiriting to put in such hard work for what seems like little gain. Please don't be so hard on yourself - I think you are doing brilliantly. Have a look at these weight gain charts; hopefully you'll agree that J's current weight gain isn't bad at all! http://www.kellymom.com/babyconcerns/growth/weight-gain-metric.html Remember that weight gain slows down after 4 months or so; the two often-used ranges for acceptable weight gain between 4 and 6 months are 92 - 126 grams per week and 113 - 142 grams per week - 115g falls within both of these. Obviously every child is different and you and your need to establish what is acceptable for your son, but hopefully you can relax a bit until your next appointment. A few months on, many mums find it helpful to revisit the basics of breastfeeding management; as babies grow, optimal positioning and attachment is sometimes lost and it may help to play with positioning a bit. Also techniques like breast compressions, if you're not still using them, might be something to try again if they helped in the early weeks. If you do end up seeing Dr Delphine or another LC, they might be able to suggest other techniques or approaches which might help make breastmilk intake more efficient. I know how hard you have worked to get this far, and I am in admiration of you. Mums of preemie babies have challenges all of their own, and your son is very luck indeed to have such a determined and loving mama. xx

But wasn't he gaining this much before when you were just BFing?, sounds like regardless of the method (boob or bottle) he is taking the same per feed. Have you been feeding the same number of times and topping up after or are you giving the top ups in between? Have you got all his weight measurements since discharge and plotted them yourself? how has his overall trend been (ie is he dropping significantly now or has the gain been steady but low)? I have cut and pasted below a copy of my son's weekly weight gain (grams per week) at a similar age, from 21-133 days old (we stopped weekly weighing around then). I'm only posting it because he followed the 50th centile weight line almost exactly during this time, so I assume that his was an "average" gain. Of course the pattern for prems could be quite different, and I know absolutely nothing about it so I'm def not suggesting your Dr is giving you bad advice in trying for a bigger gain, just trying to to reassure you than your boy is def not starving in the meantime:) 190 270 280 250 260 300 320 190 240 210 180 100 110 100 140 200

I am so sorry meals! I can only imagine how much work you're putting into this! :( I think considering everything you're tackling it amazingly well. Do have another word with your pediatrician. Hopefully you'll get more answers this time. and whenever in doubt, just look at your beautiful healthy little baby boy. He may not be big, but he's certainly healthy and hitting all his developmental milestones. Hang in there! FYI, the appetite stimulant that is given to babies/toddlers is called Periactin. You may want to discuss this particular drug with your doctor. xxx

How old is he, again? *I am not his pediatrician* but that strikes me as on the low end of adequate weight gain - but not necessarily inadequate - it sounds as if you're doing really well! That said, you're right to keep an eye on his weight gain as preemies can have particular difficulties and it's obviously really important to make sure he's doing OK. If you want to continue breastfeeding as much as possible, you might find a consult with Dr Delphine Dupuis helpful alongside your regular appointments with your pediatrician. She is a family doctor with a particular interest in pediatrics and is also an IBCLC so she can assess his weight gain, work with you to ensure that breastmilk intake is maximised, and can also suggest intervention such as the ones you mentioned if it is warranted. xx

How frustrating, but give it a couple of weeks before you decide if its working or not, maybe ask her how much she thinks he should be gaining per week as again, that is about what my DS was gaining weekly at that age. (but he is back-achingly giant)

julz you must have one like mine, I have to pin him down with both my feet so I can have my hands free to change his nappy and my less flexible husband is nearly brought to tears when it his his turn :)

i bf my daughter, and have been very happy to do so since the very beginning of her little life. once 2 and a half months hit, i felt like i have been doing this my whole life, and now i feel like i have doing through all m life and past lives. and since i can lay down and feed her comfortably bf has become one of the easier parts of my days, changing a 6+ months old diaper is soo much more difficult ;). I admit, today i am feeling some pain in one of my ducts, (and if it persists i will get it checked out), the lack of sleep makes it tough, and the weight gain even harder, she hasn't grown in her teeth yet, i am sure this will bring on a few troubles) but i am at a point where i am reading posts and talking to other moms about weaning and its making me sad, i cant imagine how hard it might be to stop bf my DD, even through the few uncomfortable moments bf brings, her comfort and happiness are so worth it! my guess is i will try to do this till she is about a year and a half more or less...

I am breastfeeding and have no clue about weight and growth charts and never have. same here Anon

I am breastfeeding and have no clue about weight and growth charts and never have.

Meals I was apparently 98th centile for height and weight as a baby,(and that was BF on the old Formula charts) I am certainly not amazonian these days and before I got pregnant was only 55kg ( its fair to say I'm a little more cuddly post-baby) , DH was on the 50th (FFed) and is now 6 foot 2, so I'm not sure they reflect all that accurately anyway. I'm sure they are a good guideline and resource for Drs but DS has def not stuck to the "normal" pattern. People often seem to think the centiles are like a score where 98 is the most desirable and anything less than 50 is a fail, or worry because the height and weight are different centiles. Don't start doubting your milk, just feed as often as you can manage, and if you do go the way of frequent feeds rather than top-ups, do what I did and host a playgroup, BF can restrict you socailly a bot, esp in the middle east but having people at yours makes the feeding aspect more simple (and there is something lovely about a room full of women all feeding their babies together, however they are doing it :)) I think if you are giving bottles a lot, its easier to buy loads of them, chuck them in a bucket of soapy water post feed and sterilize the whole lot together once a day, (DH can do it when he gets home from work :))if you're going to be pumping a lot, give yourself a break and buy a double pump (if you haven't already) <em>edited by kiwispiers on 20/06/2011</em>

Kiwi - Awesome Rant. You rock and make me feel better. I am only 16 weeks preggers and I'm looking to you guys for all this lovely advice early on. Thanks so much ladies for preparing me for some more trials and tribulations that await me upon delivery of this bundle!! ;) Hey question: how many of you had skin to skin right after birth? for longer than 5 mintues? Do you think it helped or not with the BFing? Thanks all and good luck with everything. I wouldn't blame you for anything. You already made a miracle happen ;) DS had a bit of a difficult arrival so was taken to NICU straight away. He wasn't brought back to me for 4 hours but started sucking straight away. I remember saying to DH that I couldn't believe how DS already knew what to do...thank god one of us did! Kiwi - great post! Meals - you are doing a fantastic job and I admire your strength :)