Breastfeeding

We've been having trouble. It started off well. I have been using a nipple shield since the beginning because his tiny mouth could not keep a good latch. He would suck, and then stop and rest, then suck again all throughout the feeding. Each time stopped, he would have to re-latch. The nipple shield just made it easier.

At birth he weighed 6lbs 9oz. By day five - at his first trip to the pediatrician - he was 5lbs 14oz and no one was concerned. We breastfed on demand. He was a happy eater, eating every 1 1/2 to 4 hours. He never acted as if he wasn't getting enough to eat. Day 19 we returned to the pediatrician to discover his weight is 6lbs 1oz. Commence panic.

So we started an elaborate feeding schedule - breastfeed on each breast for 20 minutes (40 minutes total), feed bottle of 1 1/2 oz breastmilk (or occasionally formula), then pump for 15-20 minutes. Repeat every 3-4 hours. Thankfully I had my husband's help and my mother's help. By one month (last Thursday), he weighted 7lbs 4 oz and the pediatrician was again happy. He said I could return to just breastfeeding.

I've met with the lactation nurse at the hospital twice. She says his latch is good, but his suck is a bit lazy and ineffective. His pediatrician agrees that his suck is weak, but says it will improve with time. At the lactation nurses' office we weigh him, feed him, and weigh him again. He is getting about 2 - 2 1/2 oz over 40 minutes on his own. He needs at least 3 oz. So, I have kept supplementing 4-5 of his feedings per day with the 1 - 1 1/2 oz bottle.

The major issue is my production. I've been fighting to hard to increase my production. I've taken Fenugreek and Blessed Thistle capsules, and now am using More Milk Plus herbal drops (tasty!). The drops have helped, but my production is still very low. I tried Reglan for about 3 days, but felt awful. It made me so, so sleepy at first. Then after about a day, I just felt apathetic and numb. I guess you could call is medication induced depression. I also had blurred vision. Having stopped taking the Reglan, I feel much better and back to myself. I pump 5-7 times per day and I get an average of about 1 oz per time (from both breasts combined). This is a huge improvement from the first week I was pumping like this and getting about 1/4 - 1/2 oz each time.

Thankfully, there may be a solution. Estrogen! Before the FET, I took Vivelle Dot (estrogen) and Provera as part of treatment of my POF. Both my OB and the lactation consultant warned me to resume my hormones because estrogen will halt the production of breastmilk. I feel better on my hormones (my body doesn't really produce any on it’s own and as a result I don’t menstruate without them) but breastfeeding is so much more important. I went to see my Reproductive Endocrinologist (RE) on Monday and he asked if I had been having trouble breastfeeding. I told him I about all the trouble with production and he said he would expect me to have trouble with no estrogen in my system. It seems that it takes low doses of estrogen to produce prolactin and thus breastmilk. It was such a relief to discover there was a medical explanation for all the problems and that there was a solution. I started taking Estrace yesterday and am hoping the milk starts flowing soon.