Nursing Advice

This post has a specific purpose, which is to ask advice from my readers who have successfully (or unsuccessfully) nursed babies in the past. If you haven't, you're still welcome to read, but consider yourself warned.

I nursed S-Boogie for an entire year before she weaned. I generally felt that things went well, although she did not gain a lot of weight very quickly. With Little Dude we got to about four months or so before I realized that his extreme fussiness was probably related to hunger and we switched to a bottle because I couldn't get the supply back up. There were a lot of things going on in my life at the time, including a major move and his emergency delivery, so I'm not surprised that my body flaked out on me. Since then, however, I've been doing a little research on hypoplastic breasts, which are basically those that don't have enough milk-producing tissue. A big sign of that is the fact that they don't change size during pregnancy (mine don't), but generally they don't produce any milk at all. Mine do, even if sometimes it's not very much. Now that I think about it, though, with the other kids I was probably just too eager to get them on a routine. We used a pacifier for both of them and I was pretty strict about feeding them only every two or three hours and then putting them down in bed with the pacifier to suck on. This time I've decided to do things differently, and now ten days later I'm realizing the pros and cons.

We aren't big on the pacifier and have been trying not to use it very much. I've also been nursing 'on demand' for real this time and trying to feed the baby whenever she's hungry, even if it's only been an hour or so since the last feeding. This seems to be working out well in a lot of ways. My milk came in pretty quickly and I think I'm making more than I have in the past. I've had some soreness, but things seem to be evening out generally. I also feel like she's generally happier and more content at this point as well.

However, every night I start having panic attacks about continuing nursing. I think part of the problem is that her schedule is mixed up, so we need to work on adjusting that as well as regulating the feedings. During the mornings and early afternoons things go well; she nurses well and I feel like I have a lot of milk for her. She usually eats every two or three hours and then sleeps. But starting about eight or nine each night she gets really fussy. I'll feed her on each side, change her diaper, get her ready to sleep, and she'll act like she's starving to death. Even if I feed her again she'll start up fussing again. We end up spending hours with me nursing her, listening to her fuss, and nursing her some more. It's very frustrating. Last night I finally decided to make her a bottle at about three AM and she drank a bit before calming down a bit. After a while I start to feel like I need a break just to get the supply up (doing some more research I found a few sites that mentioned that smaller breasts may make the same amount of milk, but their storage capacity is not the same--that makes sense to me).

So, I guess my questions for anyone who has advice are:

How do you gently reset a newborn's schedule so they are sleepier at night and more awake in the day?

What does 'on demand' feeding mean to you and how do you tell when your baby is really done and satisfied?

Any tips on helping a baby learn how to sleep in their own bed? I don't want to debate cosleeping; for a variety of reasons we've decided it's not for us. But she's the first kid we've had that hates being swaddled and placed in the bassinet after eating.

Hopefully some of my readers have some experience with this and can help me out. Thanks.


marlaquin said…
FoxyJ, I'm just a lurker and I know as soon as I comment that someone will give me the expert smackdown and tell me all my advice is wrong, BUT...I pretty much give my babies whatever they need for the first six weeks. If they need to nurse for a few hours, so be it. I know this takes a lot of time, I don't know the science behind it. I have very large breasts and make plenty of milk, but still my boys especially have needed to nurse quite a bit for the first six weeks or so. At that age I can only tell if they are full by their happiness.

I think the biggest thing with a schedule has to do with activity and light. During the day, keep the nursery light and things noisy while you nurse and she is up. At night, keep things dark and quiet and they usually seem to adjust well.

The book "Babywise" offers many suggestions to help with routine.

My current baby was not a swaddler, so I had to rock him to sleep for a few months, but he adjusted after that. He has always been a cuddly baby and always wants me to hold him.

Does that help? Just remember you can't spoil a baby under a year and you'll be fine. Just do what works!
Jenny said…
My friends have used the mothers milk tea to help with supply and have been happy with the results.

Babies typically have a three and six week growth spurt for a day or two, maybe that is baby P's deal. All my kids have been fussier in the evenings the first few weeks and want to eat every hour or so at night for a few days at a time, so I will feed on demand except if they are not actually eating and using me as a human pacifier or if I've fed them within 60-90 min I will have my husband deal with the fussiness so I can get some rest and the baby knows no milk will be forthcoming, and we learned that fussiness isn't always because of hunger.

We put a boppy pillow on or around our babies that didn't want to be left alone and that helped them, and they were in the room with another sibling with a fan for white noise, and at 6pm we darken and quiet down the house for night time and give the baby a bedtime routine, so when she goes down for at 7 or 8 pm, all the wake ups after that we try to keep dark and quiet so they don't stimulate her and if she's awake and not fussing we leave them in the bassinet or crib.

I like the happiest baby on the block book about soothing fussy babies, and the Orem library has some books on fussy babies and colic that I also liked, like why is my baby crying (or something) and another one).

The kelly mom website and the nursing mother's companion are really good breastfeeding helps also.

Also, my 2nd child only wanted to sleep on my chest for months and was so clingy to me and is still clingy. We had to lay him on his side with rolled up blankets for bolsters around him so he felt all snuggled with mom for a few months and I was terrified someone was going to throw me in jail or he would die of SIDS. It sucked.

Hang in there! IHC also has a lactation clinic if you want to speak to an actual nurse.
Em said…
I'm not much help on the resetting schedule thing....both mine just sort of automatically reset at about two weeks. With Bee we did a bath/nurse/sing routine (she hated being swaddled, too), but with J we didn't have the luxury. His "routine" at night was pjs, nursing, and snuggling with a blanket.

With both mine, I nursed them almost whenever they were fussy, even if it was only for a couple of minutes. I had similar concerns as yours about supply issues, and I think it really helped to just let them nurse into a drunken stupor....and I'm a big fan of comfort nursing. (I know a lot of people don't go for that, though...and there are plenty of good reasons for not.) I was really worried about getting Bee onto a schedule (the whole going back to school when she was four months old thing) and so I didn't comfort nurse her as much. I didn't have classes anymore after J was born, just teaching, so I could nurse him a little more frequently or when it was just a comfort thing. He was a much happier baby, and I didn't have as many supply issues. With Bee it was a guessing game for me as to when she was full...she just stopped nursing, and I called it good. With J, he would pull off the breast with this very dramatic "smack!" sound. If they seemed fussy really quickly after that, I always asked Ben to give it a try, and the kids would soothe better for him since nursing wasn't an option!

My only advice on the bedtime thing is what we did with mine (so there's no science behind it, and YES I KNOW that letting babies sleep with blankets can be linked to SIDS). I slept with a small, lightweight blanket so that it smelled like me (I know, children are not puppies, but it seemed to help), I would hold them until they were starting to nod off and then put them in bed on their backs with the blanket to hold. It worked pretty well (it's what I still do with J).
Julie said…
I don't usually worry too much about a schedule at such a young age. First month to two I feed them whenever they want and get them to sleep however I can. (I've even slept babies on their stomach because it was the only way I could get Ryan particularly to stay asleep.) I've heard of babies eating a lot at night (tanking-up my mom calls it.) So if it was me, I would do the best I could for a 6 weeks to two months, then start working in more of a feeding routine and making them cry it out for a while at night, etc. I've heard of people doing a bottle of formula at night right before bed to help keep a baby full for longer.
Becca said…
On demand feeding is okay as long as she is getting a full feeding each time. A full feeding usually takes at least 10 minutes of nursing. Some babies drink faster and don't need as much time. Baby and Mama don't thrive as well when there is a lot of snacking (nursing for less than five minutes each feeding.)
The book Babywise has been very helpful for me and I used it for both of my kids, but I always make sure I feed a hungry baby.
Desmama said…
Yeah, I wanted to make really sure my baby got really full so I committed to nursing for 15 minutes on one side, then burp, then trying for ten minutes on the other side. I figure if I at least tried diligently for that long (and given the baby wasn't have big problems nursing) then she was probably getting as much as she wanted.

Maybe give her a bottle before bed, along with nursing as much as you can. "I want her to be burping it up," my friend used to say, and I can say it's probably a good idea.

And yeah, she's still pretty new for a real set routine, so do the best you can and I think something will probably start to fall into place in the next few weeks (I wish I had known that with my first. I freaked out that she wasn't on a schedule by like Week 2. So silly). Eating every hour seems frequent, but she's growing fast and again, just make sure she's getting a really full feeding. I got through a lot of books when I was breastfeeding for that long each day. ;) Pretty soon you'll get a feel for how long it really does take her to get a full feeding.

I sure hope you're able to figure out something that helps. No fun to panic at night. ;)
Lisa said…
Here is my uneducated opinion...breast feed during the day, at night give her a bottle and pump milk (so that you will keep producing milk).
Evelyn Theresa said…
It took a few weeks to reset Evelyn's day and night schedule, so it may just take time.

My sister in law would pump the foremilk into one bag, then when the hind milk (the thick white stuff) started coming out, she'd fill another container. Then, before bed, she'd give her baby the bottle of hindmilk. It's all fat and would really fill him up. He would sleep for double the normal time because he wouldn't fill up on the foremilk. She'd give him the foremilk in the morning so he still got all the nutrients he needed. Having the straight hindmilk at night though really helped fill him up so he could sleep.

I know that being stressed about nursing and getting it right can, paradoxically, make it harder for your body to produce milk. I have TONS of breastmilk and you are welcome to any of it. Maybe knowing that you've got a backup supply and you don't have to turn to formula will help you relax a little bit and make things easier. Just a thought. Let me know.
Evelyn Theresa said…
I just remembered about the SNS (Supplemental Nursing System) that might be exactly what you need. It's kind of like a bag that you wear around your neck with a tube that goes down your breast. You fill the bag with milk and when the baby nurses, she puts your breast and the tube in her mouth. When she starts nursing all of the milk comes from you, but if you run out before she's done, then she starts getting it from the SNS.

This way even if you're making enough milk but don't have enough "storage" that allows you to pump the extra milk when you are full but she gets to have bigger meals. The SNS is only like $20 and I can even pick one up for you. But this way you don't even end up with nipple confusion.
AmyJane said…
Okay, my sorta informed thoughts, based only on a ton of reading after my first horrific nursing child (I don't know if you'll remember the drama of the 4th generation mastitis, followed by a breast abcess and two drainage surgeries. Yeah. I was motivated to read up.:o) So. The first thing I know is that truly hypoplastic breasts are really VERY rare. Much more common is the small breasts=small storage capacity, not necessarily less production over all.
Secondly, I agree that for at least the first six weeks, I tried to just commit to complete on demand nursing. That did mean skipping the paci, mostly and did in fact lead to quite a lot of co sleeping. It wasn't my plan, but I really, really wanted to nurse successfully and I decided that I was gonna do what it took to both nurse and sleep for the first weeksa and that ended up meaning some careful cosleeping. In addition, I found that renting a hospital pump was really helpful in the early weeks in beefing up my supply. I had stress about the supply on the side that had been operated on and pumping after or in between feedings seemed to ensure that the supply was ample.
And yeah, as far as day/night goes at this age the only thing I've had success with is lighting and noise level. Like Jenny said I try to make it clear to the baby that we act differently when they wake up during the night and during the day. Still feeding for sure, but dark and quiet and non interactive at night.
Also, if you really want to nurse, I think you have to commit to avoiding most bottles in the early weeks. No, one won't wreck everything, but bottles all night probably would. A pump just doesn't provide the same stimulation that a baby does for a new supply. And really, who would rather pump AND bottle feed at night when you're exhausted?
Good luck with all that. As much as I can't wait to be not-pregnant I'm not really looking forward to the sorting out life with a newborn part. It's always kind of ambiguous and no one every really has all the answers for these tiny babies. Hang in there--I hope everyone gets more sleep at hour house soon!
AmyJane said…
Also, I did take fenugreek for several weeks when Kennedy was quite a bit older (maybe 8 months) and my supply was dwindling. It really helped when taken in the correct dosage, which is A LOT of it. Also tried Mother's Milk tea which was expensive and (I thought) quite disgusting. Didn't have as much success with it, but didn't stick with it for as long either.
Kristeee said…
I don't have a ton of experience - my one try at breastfeeding didn't go so well. My body wasn't ready for Kate to come and they had me on steroids for her lungs, so my supply was low. My favorite part was when the nurse in the NICU looked at my hard-earned 2 oz. I brought in from pumping and asked, "that's it??" (I burst into tears.)

Things we tried to increase milk supply:
1. fenugreek & blessed thistle - these taste kinda gross and make you smell like black licorice. Moderate success.
2. Feeding then pumping - they had me feed her every 3 hours, then pump for 20-30 minutes afterwards (yeah, that's fun). They made me skip a feeding at night, saying I'd produce more milk if I slept for a 6 hour stretch. (Then again, they had an NG tube in her, so I could skip a feeding without nipple confusion.)
3. Reglan - it's a prescription for GI problems, if I remember right, but a side-effect is more milk production. It doubled the amount that I got. The downside is that it can produce some depression, which happened to me a bit.
Earth Sign Mama said…
I agree with the idea that the first six weeks are just random. As time goes on a schedule will develop, but at first, just go with the flow. If she wants to be in bed with you during part of the night, then go with that. You can change that soon enough. But drinking lots of water is essential for making enough milk. #5 was hospitalized at age 2 months for pnuemonia for a couple of days, and I almost lost my milk, but sitting around nursing and drinking all weekend restored everything. The one quote: "You can't spoil a newborn baby" is totally correct.
Cheryl said…
I haven't read any of the comments, so my stuff might be old hat already. But here are my experiences:

1. Getting the schedule changed just takes time. It just does. I still believe strongly (after all five kids) that the first 6 weeks are the adjustment period and are to be seen as the adjustment period. So, you're not allowed to care during the first 6 weeks, yo! ;)

2. Nursing on demand: I only did this with one child and it's my 5th. I'm actually still doing it! What "demand" really means is just that you don't have a set-clock-schedule for feeding. Sometimes I'll nurse him four times in the morning and then only once in the afternoon and than 3 times in the evening. But it also means that I can nurse for 10 minutes before I have to do something, and then 2 hours later come back and do a real 20-25 minute feeding. I have to admit that although I never did this with my other kids, this has been wonderful. My schedule BECAUSE of the other kids is such that everything is random and I cannot set a feeding schedule. It's also weird for me because I did set a feeding schedule with the other kids. Go figure.

3. As far as sleeping in the crib? Super-hard, that one. None of my kids liked being in the bassinett at first, so we would set the car-seat into the bassinett and let him/her sleep in there. I made sure the angle was correct, but they all loved that so much more --because of the sitting-up sensation. It makes sense! The baby hasn't been lying flat inutero, so why would they like to be lying flat outside? It's just something you slowly adjust to. By 2 month, I had all my kids sleeping flat, so look at my first point and aim for after 6 weeks.

4. And just fyi --right this very moment we are sleep-training #5. He has co-slept with me for the last 7 months or so and although it's been convenient, I really don't recommend it at all. Plus, #5 hates solids (although he likes sweet potatoes!) and refuses a bottle. Sigh. It doesn't matter how many kids you have or how "veteraned" you are in the craft of mothering, there will always come a child who throws you for a loop. It keeps things interesting! :)

5. I'm sorry I haven't stopped by. It's been crazy here (not as crazy as there, eh?) but I promise to make some time. I've got something for you, so I need to! :)
Cheryl said…
P.S. If you can supplement formula (or pumped milk) along with nursing --DO IT. You won't regret it because A. Your baby will be able to eat fine without you and B. If your milk does go away sooner or you can't produce enough for her, then she'll already be okay taking a bottle.
Desmama said…
One thing to consider: putting baby in crib right away? I did that with all my kids. They immediately went into their crib and did fine. It's just one fewer transition they have to undergo (i.e., from bassinet to crib) and then they're in their own room so we can both sleep better. It's up to you--whatever you feel works best and you're most comfortable with, but maybe think about it. ;)
Clare said…
My newborns cluster fed in the late evening for several weeks -- it seemed like they were always nursing on and off for a few hours before bed time. That's just the way it is with newborns, I think. If you can get the babe to nurse long enough and fill up on the hind milk, his belly will stay fuller longer. One trick for that is to nurse on the same side for two consecutive feedings. Since he's nursing so often during that time, it shouldn't screw with your supply. And on-demand, for me, was I fed the baby when he cried and would latch on, no matter how long it had been since the last feeding.
FoxyJ said…
Thanks for all the good advice guys! I can tell it's been a while since I had a newborn--I'm recommitting myself to six weeksof adjustment. Thankfully the last few nights have been relatively decent since I've resigned myself to let her sleep in our bed with me and she's been sleeping pretty well.

Nursing is generally going pretty well too since I've been trying to just relax and follow her cues. The main thing I've noticed is that I can't feed her within an hour so sometimes I have to hand her off to Dad if she's very needy. I've also realized that sometimes she's been falling asleep while eating, especially at night, so even if she seems like she's been eating for a long time she hasn't been getting very much food. So I'm trying to make sure she stays relatively awake and gets in a decent feeding each time. Hopefully things will keep going well--she's usually not very fussy so far, so I'm crossing my fingers that she'll stay mellow.

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