Questions to ask LC

[muscari]

Hi all! Ahh I once checked in back in September or early Oktober I believe then sort of disappeared /lurked.. oops 😊 Hope you don't mind me posting and asking for a little help.
I probably should have posted earlier but I haven't managed to get on before so last minute posting it is! Apologies in advance for the lenght of this!!

I am meeting with an LC tomorrow and I was wondering whether there were specific questions I havent thought of yet that I should/could ask. I am seeing her for supply and latching issues. Also looking for stories of those who had supply or other BFing issues real bad and how you dealt with it. And does any of you combine BF and formula and how do you put that on practice? Any other anecdotes and advice welcome as well.

Some background: After an initially rough start with BFing (baby started on formula in NICU, took a week for my milk to come in, latching issues requiring nipple shields) all seemed to go well. I EBF from week 4 till our 2 mo appointment at 10wks, pumping some extra to supplement on occasion (we switched from finger feeding to a bottle at 3wks orso) and/ or freeze. LO id a happy and content little girl and meets all development milestones. Except for the weight issue. She was right at the 50 percentile at her 1mo but had hardly gained weight those 5wks in between her 1 and 2mo appointment and dropped down to -2 (they dont use percentiles at our pedi office for some reason but 0 and +1 +2 and -1 -2).

We started supplementing as per advice of the nurse, one 3oz bottle after every nursing session. I also tried to pump after every session to boost my supply meanwhile but this was too much (i struggle with ppd/ppa and the whole situation made things so so much harder) so I been pumping just once or twice a day max the past week. I feel as if supplementing formula (and the stress of things) made my boobs dry up even more and I think the advice we got t help D gain weight didnt at all take my wish to continue BFing into account. So I contacted the LC for help but she didnt have room till now so we plodded on for over a week..

Good news: D. gained 325gr in one week. Less good news: even tho we use a medela calma slowflow nipple and try to do paced bottle feeding she seems to prefer the bottle over my boobs when it comes to eating. She loves hanging out at the boob still but hasnt been drinking as well as before. She even refused my right boob several times, or screams at it, mostly later in the day. Mornings she drinks best- I guess cause my supply is highest then? I started weaning her of the nipple shield which has gone well and she now drinks without. But I think we need to learn how to do it better as it hurts esp at the beginning and she doesnt always drinks as well as she can.

I hate the thought of having to quit BFing due to supply issues and would love to EBF again. If I can. I would be okay with formula supplementing as well if need be. Fed baby is best after all. With how stressed out and anxious I have been and the pressure that pumping multiple times a day puts on me and worsens my ppa I wonder though whether a combination of BF and formula wouldnt be a better goal? Especially since once I return to work I won't be able to pump as often as necessary to keep up EBF.

Questions I plan on asking the LC include teaching us how to latch baby properly (no one ever taught us), how to boost my supply without going insane with all the pumping, how to get back to EBF/ build down the supplementing without starving my baby, how/ when to pump once supply is back up to par so I can continue to build some freezer stash (I pumped extra up until mid october then stopped, which i suspect may have been the reason behind why my supply tanked.. i quit pumping to abrupt??), help set up a pumping schedule for when I go back to work, whether it is possible to combine BF and formula bottles and how to make this work without killing my supply.

I feel like there are other things I should ask but can't think of them.. help? Thanks in advance! (I may not reply right away as I am 6-9h ahead of most of you and am heading to bed now zzz)

[vvvvvfee]

i think your questions sound great! if you can manage it mentally and physically, i think EBF would ultimately be easier than combo-feeding, and it is easier to keep your supply up when you're not supplementing. if LO is starting to show some preference for the bottle, you can use warm compresses on your breasts and try pumping or hand expressing for just a few minutes before you start nursing her- probably she is getting frustrated if your flow is slower than the bottle. good latch is definitely key- you need that stimulation to your breasts to let down milk, and LO needs to see that she is getting a good flow of milk so that she doesn't give up. the LC will show you how to get a good latch, but you can experiment with different positions for BFing too- LO may be able to get a better latch depending on position. depending on how much you need to supplement/store, i would definitely pump regularly sometime in the morning bc supply is highest then. when you pump at a regular time each day, your body grows accustomed to it and produces extra milk at that time. then you can use for supplementing and/or freezing. most women have to pump 3x a day when they go back to work (assuming LO is approximately 3 mo old at that time). when LO is well-established on solids (probably 7-8 months), you can cut back to 2x a day, and then approaching a year you can cut back to 1x per day, with the goal of stopping pumping at around a year. you can of course continue to BF your LO when at home. best of luck and i hope the LC gets all your questioned answered!

[Deleted]

I didn’t see this earlier. Hope your meeting went well!

[piratecat]

muscari, I hope that your meeting with the LC was helpful.

We supplemented from the beginning and the nursing-supplementing-pumping at every feeding was really stressful to me as well. We were able to gradually wean off the formula at around 3 months. During my 12 week maternity leave, I attended a breastfeeding support group and was able to get the baby weighed weekly and that was really helpful to make sure that he was gaining properly as we were tapering off the formula.

I still have relatively low supply but I am now able to EBF when I'm home with him. I pump 3x at work and try to fit in extra pumping sessions either on the weekends or after bedtime in order to keep up with the amount he takes at daycare. Every now and then, maybe when he's going through growth spurts, he still needs a bottle of formula at daycare, but I can't fathom pumping more than I already do in order to build a freezer stash. So do the best you can but at the end of the day your baby will get fed.

[muscari]

Thanks for the responses ladies! This week has been a beast and flown by.. hopefully can get back to comment properly tomorrow