Newborn feeding

[Barb_]

My cousin is 33 and just had her first baby. I used to babysit her when we were children and she is like a little sister to me. She is bright, competent and used to fixing things, so this newborn thing is really throwing her for a loop. She's finding it difficult to accept that with newborns, you just have to let them set the pace and basically just sit around, nurse them, look at them, and nap when possible. You really can't fix a newborn to make him predictable.

 

Anyway, she went to see her pedi. because her son wouldn't poop. Now, I've been breastfeeding for the past 21 years, my mom breastfed back in the 60's when NObody did it, and my aunt breastfed my cousin for over two years. Suffice it to say, the women in our family are pretty cruncy and very knowledgeable an supportive regarding breastfeeding. Sigh. But she trusts doctors. So off she goes and the doc fusses at her because her son is gaining way too much weight. He tells her she has enough milk for three babies and that she should only feed him on one side every three hours. A three week old! Which means that if she doesn't pump, she will be going six hours on each side between feedings.

 

So tell me how to tactfully explain to her that this isn't a good idea. She lives in FL and I live in AZ, so I can't really casually bring it up in conversation. Her mother in law is a crazy pushy lady who had my cousin giving the baby prune juice when he was "constipated" and bathing the baby fully immersed at a couple of days old. Her own mother has more sense, but has advice that is completely opposite of the crazy MIL and the husband is just shell shocked and trying to help but is pretty well led by his mom. It's not a good situation. I don't want to be one more voice in the chorus, so I've been holding back the past few days. I just keep worrying about this baby. I know she won't let him starve, but it's so hard to stay quiet.

 

So do I say something? Or just shut up and let her handle it? Support or meddling?

 

Barb

[Harriet Vane]

Can you gently point out how very, very little training doctors have on breastfeeding issues and ask her to please talk to a certified lactation consultant? Perhaps the official nature of the expert might make her feel good about listening to such advice, especially if you mention that most hospitals have one on staff?

[Barb_]

Can you gently point out how very, very little training doctors have on breastfeeding issues and ask her to please talk to a certified lactation consultant? Perhaps the official nature of the expert might make her feel good about listening to such advice, especially if you mention that most hospitals have one on staff?

 

For some reason, she really likes and trusts this doctor. She had a lactation consultant at the hospital that my aunt says was fantastic. She told her just to go to bed and cuddle the baby for as much of the day as she could. "It's good to for baby stay close to the kitchen." :D How do I say this without coming across as insulting her doctor, which will may make her tune me out?

[SonshineLearner]

Can you say "Mastitis" That's what her Dr is prescribing for her. What you may want her to know is about hindmilk. She can try feeding all the milk on one side... till it's gone. Or, what I sometimes did was a bit from one side, and then finish all the way on the other side. I had tons of milk. I actually regulated myself the second time, because I had too much milk with my first. I demand fed.... she would drink too much... and then spit up and be happy to drink more. I had no problem nursing all the time (and she burped fine) but I got mastitis. With my second, I had to stay an extra day, so I took a bottle and was expressing full bottles right away. (full by newborn standards... at least 4 ounce... can't remember exactly.) Anyway, I pumped with an Avent, and froze tons of bottles. I then tried to "even myself out" ... and it sounds weird, but it worked. No problems like the first time... dried up enough that I wasn't dripping ounces out each time I nursed... (I got the little lily pad like things... so it caused pressure so I didn't leak) Anyway, I never went 6 hrs till my baby was months old. (And he was 10lbs 3 oz) I'm not really sure, that under normal circumstances... babies can gain too much weight on bre*st milk.

Good Luck!!

[SonshineLearner]

KellyMom :)

[Barb_]

Can you say "Mastitis" That's what her Dr is prescribing for her. What you may want her to know is about hindmilk. She can try feeding all the milk on one side... till it's gone. Or, what I sometimes did was a bit from one side, and then finish all the way on the other side. I had tons of milk. I actually regulated myself the second time, because I had too much milk with my first. I demand fed.... she would drink too much... and then spit up and be happy to drink more. I had no problem nursing all the time (and she burped fine) but I got mastitis. With my second, I had to stay an extra day, so I took a bottle and was expressing full bottles right away. (full by newborn standards... at least 4 ounce... can't remember exactly.) Anyway, I pumped with an Avent, and froze tons of bottles. I then tried to "even myself out" ... and it sounds weird, but it worked. No problems like the first time... dried up enough that I wasn't dripping ounces out each time I nursed... (I got the little lily pad like things... so it caused pressure so I didn't leak) Anyway, I never went 6 hrs till my baby was months old. (And he was 10lbs 3 oz) I'm not really sure, that under normal circumstances... babies can gain too much weight on bre*st milk.

Good Luck!!

 

Good point. Mastitis. I will bring that up. He probably looked like he'd gained a ton of weight because he hadn't pooped in three days and she probably had just fed him.

 

Barb

[HeidiKC]

Oh, gosh. This is a hard one! Well, I don't think the main concern is the baby's health, but her milk supply. I was nursing my baby every 2.5-3 hours from birth and at one month he'd gained nearly 4.5 lbs. Sounds like her baby is doing well and is healthy, and if she is only feeding him every 3 hours he'll probably eat more from the one side...? It does seem scary that a doctor is concerned about a breastfed baby gaining too much weight! I've never heard of that.

 

Anyway, I'd be more concerned about the milk supply - and this would be a perfect way to bring up the lactation consultant. Without dissing the doctor, maybe you could relate some experience of your own (even if it has to be a tiny white lie) about how your milk supply was shaky in a similar situation, and that it can be hard to reverse the problem if your supply drops. Praise her milk-making ability and quality product. You could say something about how you're so glad the doctor is a keeping an eye on the baby, but that milk supply is the lactation consultant's specialty and she should get in touch with her, etc. Surely once she talks to the lactation woman, she'll tell her the doctor's advice might be risky to her milk supply and maybe the baby.

 

So I'd go at it from that angle - a story from your own experience and your milk supply. And if she seems receptive, I'd work something in there about keeping that baby full from the get-go! I sure hope it works out.

[Barb_]

Oh, gosh. This is a hard one! Well, I don't think the main concern is the baby's health, but her milk supply. I was nursing my baby every 2.5-3 hours from birth and at one month he'd gained nearly 4.5 lbs. Sounds like her baby is doing well and is healthy, and if she is only feeding him every 3 hours he'll probably eat more from the one side...? It does seem scary that a doctor is concerned about a breastfed baby gaining too much weight! I've never heard of that.

 

Anyway, I'd be more concerned about the milk supply - and this would be a perfect way to bring up the lactation consultant. Without dissing the doctor, maybe you could relate some experience of your own (even if it has to be a tiny white lie) about how your milk supply was shaky in a similar situation, and that it can be hard to reverse the problem if your supply drops. Praise her milk-making ability and quality product. You could say something about how you're so glad the doctor is a keeping an eye on the baby, but that milk supply is the lactation consultant's specialty and she should get in touch with her, etc. Surely once she talks to the lactation woman, she'll tell her the doctor's advice might be risky to her milk supply and maybe the baby.

 

So I'd go at it from that angle - a story from your own experience and your milk supply. And if she seems receptive, I'd work something in there about keeping that baby full from the get-go! I sure hope it works out.

 

Okay, let me think some more about how to address that angle. She will need to keep her milk supply going in order to pump...which I'm hoping she is doing now. She has to return to work because her husband is in seminary. She will be leaving the baby with her boundaries-challenged MIL which will be a whole other problem. :001_rolleyes: I gather she doesn't want to confront her and is getting ticked at her own mom for suggesting maybe she needs to. I personally think the more weight her son gains now, the better. Breastfed babies are notoriously difficult to train onto a bottle and his weight may dip a bit during the transition.

 

Barb

[Barb_]

Thanks for helping me think this through. I need to talk in order to organize my thoughts, but it's late here and I really should be sleeping like everyone else in the house. I'm still :bigear: if anyone else has any thoughts!

[ChrisOR]

It doesn't sound so different than kellymom's advice to regulate forceful letdown and foremilk imbalance. In fact, this is what I successfully followed with my colicky newborn, who cried at the breast, didn't comfort nurse, and who also gained a ton of weight really fast (not saying weight gain is bad, but it was one symptom among the others that indicated the foremilk problem). She nursed for 18 months, and my milk supply was fine. I did not pump between the blocks, and it only took a couple of days for my supply to regulate itself. I followed a two-hour block, feeding as many times as she wanted to on the same side before switching sides. I also weighed her weekly for 6 weeks to make sure everything was fine.

[Barb_]

It doesn't sound so different than kellymom's advice to regulate forceful letdown and foremilk imbalance. In fact, this is what I successfully followed with my colicky newborn, who cried at the breast, didn't comfort nurse, and who also gained a ton of weight really fast (not saying weight gain is bad, but it was one symptom among the others that indicated the foremilk problem). She nursed for 18 months, and my milk supply was fine. I did not pump between the blocks, and it only took a couple of days for my supply to regulate itself. I followed a two-hour block, feeding as many times as she wanted to on the same side before switching sides. I also weighed her weekly for 6 weeks to make sure everything was fine.

 

It's not the limit to one side thing that bothered me because I've done the same. I was more concerned that he was telling her to feed him on a three hour schedule. So feed on one side, go three hours, then feed on the other. By the time she's back to the original breast, six hours have gone by.

 

ETA: not to mention, while I realize a feeding is determined from start time to start time, I'm fairly certain her doctor didn't specify this. So I think he's waiting three full hours to be fed again. I'll have to clarify, but that's what I understood from the conversation.

[Cera]

It sounds similar to what was recommended when my first was little though the interpretation was different.

 

The lactation consultant recommended a 3 hour schedule but she meant that for the first three hours anytime my little one wanted to nurse she should do so on the right side, then during the next 3 hour block any time she wanted to nurse it was on the left, etc.

[Mama Geek]

If she is in central FL, they have horrible rates for breast feeding. Most mom's don't exclusively breastfeed nearly as long as they would like to due to ped's pushing formula or giving bad advice. My OB was great and gave me a heads up on this so I knew what to expect and what was healthy even though the ped's disagreed.

[pfamilygal]

Oy, that is mastitis in the making!!

 

And my EBF babes sometimes went almost 2 weeks without stooling. Breastmilk is so good, most of it is absorbed.

 

Did you tell her that doctors generally have less than 1 hr of education on nutrition for children/infants?

[NanceXToo]

KellyMom :)

 

Yes, this! Tell her that many doctors are really NOT knowledgeable about breastfeeding and unfortunately often give bad advice when it comes to feeding, and that you highly suggest the Kellymom website which is run by an International Board Certified Lactation Consultant and which is extremely helpful on all breastfeeding and feeding issues.

 

ETA: It's also normal for breastfed babies to gain more in the earlier months than formula fed babies do, but it slows down. My son was at the top of the charts through his six month checkup and at his nine month one it was slowing down quite a bit to more mid range and he's just been average in regard to growth since then (he's almost 6 years old now and was breastfed exclusively until about 9 months and then started eating table foods here and there, too. I did try introducing baby food at 6 months but he wanted nothing to do with it).

[Paige]

It doesn't sound so different than kellymom's advice to regulate forceful letdown and foremilk imbalance. In fact, this is what I successfully followed with my colicky newborn, who cried at the breast, didn't comfort nurse, and who also gained a ton of weight really fast (not saying weight gain is bad, but it was one symptom among the others that indicated the foremilk problem). She nursed for 18 months, and my milk supply was fine. I did not pump between the blocks, and it only took a couple of days for my supply to regulate itself. I followed a two-hour block, feeding as many times as she wanted to on the same side before switching sides. I also weighed her weekly for 6 weeks to make sure everything was fine.

 

This is what I've done too. If she has oversupply and a forceful letdown it can cause a lot of tummy and feeding problems. My only concern is doing block feeding w/ a 3 week old. I don't think it is usually recommended until closer to 6 because the milk supply is just getting set. Maybe if she only did it for a day or so, but not for more than 2-3 days, max.

[ktgrok]

She needs to feed as often as the baby wants to eat. Breastfed babies gain fast early, then slow down. Dieting a newborn seems silly. Can you phrase it that way, that she is putting a newborn on a diet? Or link her the Dr. Sears or another ped's website about breastfeeding on demand?

Maybe even deflect any issues by saying, well, I'm sure the Dr.'s advice works, but since he probably never had to pump, he may not have taken into account your need to keep up your supply :)

[HeidiKC]

Okay, let me think some more about how to address that angle. She will need to keep her milk supply going in order to pump...which I'm hoping she is doing now. She has to return to work because her husband is in seminary. She will be leaving the baby with her boundaries-challenged MIL which will be a whole other problem. :001_rolleyes: I gather she doesn't want to confront her and is getting ticked at her own mom for suggesting maybe she needs to. I personally think the more weight her son gains now, the better. Breastfed babies are notoriously difficult to train onto a bottle and his weight may dip a bit during the transition.

 

Barb

 

Yes, I agree that the more weight the baby gains the better - but you might not be able to convince her if she thinks the doctor is so great. That's why I thought maybe the lactation consultant/milk supply angle might be good - plus I'm sure once they talk the lc will straighten her out about not restricting baby's access to milk!

 

After reading all the responses, I realize it must be rare that I fed about every 2.5 hours (at least) from start to start of feedings - from birth. I guess that's where I'm coming from that I wouldn't be overly concerned about the baby (although better not to put the poor thing on a diet!). My baby plumped up big right away, and I had a TON of milk, pumping off an extra 9 oz. every morning.

 

Good luck - you're so good to want to help!

[hollyh]

I had a ton of milk with my first and was advised to nurse on only one side by my lactation consultant.. two different ones I think. My crunchy mom and aunt had a fit because it wasn't what they were told to do when they nursed... It worked fine and helped. I still had tons of milk... gallons of it in my freezer.

 

However, if she is planning on going back to work, I would just encourage her to keep up whatever she is doing. (Or feed on one side while pumping the other to keep supply up). She may be unaware how much her milk supply may go down when working...

[justasque]

Can you look up her local La Leche League group, and let her know when they meet, etc.? That would be an ongoing way she could get local support for all the issues that are likely to arise with her situation. I know she's going back to work; sometimes there are evening LLL meetings where there are often a bunch of working mammas. It's a nice place for a new mom to make friends.

[kitten18]

 

However, if she is planning on going back to work, I would just encourage her to keep up whatever she is doing. (Or feed on one side while pumping the other to keep supply up). She may be unaware how much her milk supply may go down when working...

I agree with this. Pumping and feeding at the same time would be a great way to get a freezer stash and keep supply up.

Also, when the pump seems like it's not getting any more milk, she could let baby nurse on that side. He may be able to stimulate another letdown and get more fatty hindmilk.

[UnsinkableKristen]

Oy, that is mastitis in the making!!

 

And my EBF babes sometimes went almost 2 weeks without stooling. Breastmilk is so good, most of it is absorbed.

 

Did you tell her that doctors generally have less than 1 hr of education on nutrition for children/infants?

 

 

1. I agree, that is just begging for mastitis - OUCH!

 

2. Totally, OT, but I have never ever heard it called "stooling" and it has made me giggle for probably five minutes :lol:. I will be calling it that for the rest of my life.

[Barb_]

Thanks for all the advice! I just sent her a quick email to check in; I'll let you know what happens.

[2squared]

Just wanted to mention that my last 4 babies have nursed on one side per feeding, and we did it that way for the entire 12+ months each baby was nursed. I have never had mastitis or any other problems due to this nursing pattern. I do feed on demand and exclusively breast feed (no bottles either).

[thescrappyhomeschooler]

Can you gently point out how very, very little training doctors have on breastfeeding issues and ask her to please talk to a certified lactation consultant? Perhaps the official nature of the expert might make her feel good about listening to such advice, especially if you mention that most hospitals have one on staff?

 

:iagree:

[stripe]

Just wanted to mention that my last 4 babies have nursed on one side per feeding, and we did it that way for the entire 12+ months each baby was nursed. I have never had mastitis or any other problems due to this nursing pattern. I do feed on demand and exclusively breast feed (no bottles either).

And I too followed KellyMom's advice re feeding on one side, which contradicted the advice I was given about switching sides after 10 minutes, which is what most people tell you. Keeping to one side until drained actually helped reduce overactive supply very well, so I found it a great tip. It did not lead to mastitis.

[sleepymommy]

If she has a large oversupply of milk then I do think the one-sided feeding is probably best. I was severely engorged for the first 4 months (I had huge rock like lumps even in my armpits) and this was the method I did, it helped a lot. I didn't start it until after the first month though because that is when I learned about it. She could even just do the one sided feeding every 2 hours instead of every 3 if the baby is hungry quickly. It was more painful on the side that I had to wait with, but it does regulate itself after a week. For me, it was the only way to decrease my milk supply. I ended up breastfeeding for a little over a year, so it did not get rid of my supply it just normalized it since I was making too much.

 

If the situation is just that the baby is gaining a lot of weight but the mother is not severely engorged, then I would just continue to feed on both sides like normal. If she doesn't have an oversupply, then decreasing the amount could be detrimental to keeping up with her supply. Breastfed babies tend to be more plump then formula fed babies during their first few months and with so many more formula fed babies the doctor's are probably not as aware of this difference.

 

Ds7 went from 6 1/2 lbs when we left the hospital to 10 lbs at his 1 week appt. His Dr. was delighted, said I must have some magic milk! He didn't stay so large and in fact he is a tiny thing now, but it was just all the fat from the breastmilk at that time.