Another Weight Related Update

Our appointment with the lactation consultant went really well. I left feeling reassured and encouraged that there was hope and that I was doing the best I could.

Adelaide's latch was great, she said I was doing all the right things to get my supply up (dom, fenugreek, power pumping, etc.) and Adelaide was taking in enough in a nursing session (weighed 5 minute feeding indicated 2.5oz taken in). She suggested I add blessed thistle to the regime, which I need to remember to do tomorrow and she instructed me to cut out the midnight pump. Apparently I need the sleep more than the milk. She also suggested switch nursing so that my lazy, sleepy eater got multiple let downs and a little wake-up call mid-feeding. In the end, she told me that she wasn't concerned and sent that information to my doc. She basically said she wasn't concerned and that the lack of weight gain wasn't anything breastfeeding related that she could see.  It was nice to have someone telling me that I was doing OK. She was confident that we'd be able to cut out the constant pumping and eventually the supplements with a little work and the right cocktail of supply increasers.

Adelaide then went for a weight check on Wednesday and was up over  9lbs 9.5oz!! Granted, she had eaten not long before, but that was the case the two weeks previous, so this was promising news! The doctor finally gave us a reprieve and said she wasn't really concerned anymore. She still wanted to see us in two weeks (better than a week) and said since she had already sent a referral to a pediatrician, she wouldn't revoke it... but she was just acting on the side of caution.  She really feels , because she checks out so well otherwise, that the babe is just small.

The switch nursing has made a huge difference in both my supply and keeping the babe actively interested in eating, and I actually notice Adelaide is not nearly as interested in the bottle supplements. We went from 2oz down to 1.5 because she was spitting some of it up, but now I'm starting to think that even that is too much. We're going to go down to 1oz and see what happens.

I've been able to pump enough to avoid formula so far, and I'm crossing my fingers and toes that, that continues. I even took a break from pumping at every feeding today. I was able to pump enough this morning (at 5am), combined with yesterdays leftovers, to have enough for the day and a little 3oz freezer stash. I'll still get up at 5am to pump for as long as she needs supplements, and will probably pump after every other feed tomorrow just to make sure my supply stays up, but it was a nice little break today. Nursing the baby is wonderful, but the power pumping is hard work.

In all, I'm happy with the way things are starting to go. Hopefully it continues and we will be able to successfully cut out the power pumping, and eventually the supplementing, and I'll be able to go back to EBF. I long for the days of being able to just sit and cuddle with my girl after she finishes eating. We're working our way back there.

My New Full-Time Job

After my last post, Adelaide had another weight check and had only gained 1oz in the 8 days between appointments. To add to my anxiety, my supply tanked again, and the doc told me it was time to start supplementing. Fortunately she encouraged supplementing with expressed breast milk as much as possible, only adding formula to fill in the gaps if necessary.  She also doubled my dose of domperidone in hopes of getting my supply back up to an acceptable level for the amount of feeding and pumping I was about to start doing.

Immediately after the appointment I went home and started the work towards packing on some pounds and getting my supply back up. I was, and still am, determined to make this work.  Feeding our wee girl has become my new full time job. Here's what our day looks like now (obviously, times vary based on her sleep/wake schedule for the day, and she may drop one of the mid-day feedings if she decides to nap):

5am - alarm goes off and I pump from 1 side
7am - Adelaide wakes- nurse from opposite side, pump (she doesn't need a bottle with this feed because I have a decent morning supply)
9am, 11am, 1pm, 3pm, 5pm, 7pm, 9pm- nurse, 2oz bottle, pump
Midnight- alarm goes off (if I've made it to bed yet) and I pump from both sides

In total, a nurse/bottle/pump feeding session takes about 45 minutes (plus the time it takes to clean and prepare my pump for the next time around) so I really only get just over an hour between the end of one feed and the beginning of another. It makes outings difficult, and it has obviously messed with our sleep schedules, but we're doing what's necessary to give her what she needs. It's not permanent.

I take 80mg domperidone and 6 tablets of fenugreek each day, along with milkmaid tea when necessary.  When the fenugreek tabs are gone, I'll be switching to Mother's Milk which is a combination of herbs in drop form. I've also increased my food and liquid intake to help keep my body fueled for milk production. I'll focus on weight loss later.

I'm also meeting with a lactation consultant tomorrow to see if they can help at all.  I have a feeling my low supply (and therefore low weight gain) is a lazy latch issue. I think Adelaide simply eats until she no longer feels hungry, and then drops off.  It's often a fight to keep her awake and focused on what she's doing after about 5 minutes.

The last of my freezer stash



So far, we haven't need any formula (I have some as a back-up just in case), but I used the last of my little freezer stash last night so that may change today. My supply is coming back up, but I'm still not sure I'll be able to express enough to meet 100% of her supplement needs (approx 12-14oz per day). I sure am going to try though, and, if it comes down to it, I am just going to have to be at peace with the fact that the formula is what we need to do to make sure she's growing properly.

Through all of this, Adelaide is as happy and amazing as ever. She may be little, but she's developing so quickly I can hardly stand it. I'm so lucky to have been given such a sweet girl. 

Breast is Best... Our adventures in breastfeeding

Adelaide and I were really lucky when it came to breastfeeding.  My girl latched immediately after she was born during skin to skin... they hadn't even cleaned her off yet and there she was, happily latched and eating at my breast.  In fact, the nurse had to break her latch to get me cleaned up to go to our hospital room.  The only struggles we had after that were her overall sleepiness on day 1 (making her completely uninterested in eating) and my engorgement on day 4ish, which led to having to soak in hot water right before feeding her.

Adelaide latched, my supply came in great, and we were off to the races. No pain, no cracked nipples, no struggle.  If anything, I had too much milk, which often led to my poor girl getting sprayed in the face.  I remember waking up one morning to find dried milk all over her face from a 3am feeding, during which I had been too tired to get out of the bed, never mind turn on the light.

I thought we were in the clear.  For 2.5 months, everything was going great and I was loving being Adelaide's sole source of nutrition. Then, just as we find out that she's not gaining enough weight, my supply starts to dip.  Honestly there was a couple of days, just before her three month birthday, that I thought our nursing days were coming to an end.  I immediately started drinking Milk Maid Tea (Earth Mama, Angel Baby), and when I didn't notice a huge difference, I added Fenugreek to the regime as well.  I also started feeding her every two hours (which was both to pack on the pounds, and hopefully increase my supply) and I added an evening pumping session. 

My supply definitely increased, but I was still feeling... empty.  I know that I'm not supposed to feel full like I did in the beginning, but everything was different.  Adelaide's swallows were very shallow and short. I wasn't hearing any of those satisfying, deep swallows, even at her morning feedings, which should have the best store of milk to work with.  Feeding started to become painful.  I felt this strong pulling pain, and my nipples were tender from Adelaide having to work so hard. I was getting frustrated, and really worried. I was supposed to be putting weight on Adelaide, and yet I wasn't producing enough milk.

When we went back to the doctor last week for her weight check (she was exactly 3 months old) I talked with the doc about it.  She gave me a prescription for domperidone which apparently helps increase milk supply.  While I'm not thrilled that I'm on any kind of drug while breastfeeding, the doctor wanted to make sure I have the supply that she needs to continue to grow. I started taking it right away.  Originally I went off fenugreek, which was a mistake.  My supply dipped dangerously low again, and after some frustrated tweets, I learned that it takes longer for the dom to kick in then I thought, so I went back on the fenugreek. 

I'm happy to report that my supply is way up.  My girl is giving me those satisfying, wet, swallows... and the pain and pulling sensations are gone.  The only thing I'm concerned about is some headaches that I've been getting since I started the pills. I'll talk with the doctor on Wednesday (Adelaide's next weight check) and see what she says. For now though, we're back in business.  I plan to invest in a better pump to see if I can improve my pumping efficiency. I'd like to avoid formula for as long as possible, including when I go back to work.  The bigger my stash, the longer I can do that.

I'm hoping not to have to take the Dom for long. A friend of ours in an acupuncturist, and I've seen some good success with treatment of lactation issues in my research, so I may enlist his help and drop the dom... but we'll see how it goes. 

One day at a time. I will say that the #bfcafe ladies on Twitter are a lifesaver for advice and just encouragment.  I don't know what I'd do with out them. 

Three Months Old

Adelaide's Third Month in Pictures

 

Watching the Summer Olympics with Daddy

 



 

 Finally big enough to pose in the outfit that Mommy wore home from the hospital

 

 

Warming up her teeny feet to draw blood

 

We finally made the switch to cloth diapers! Hooray!!!!

 

First bottle!! While she still EBF, I'm building a little freezer stash so Daddy can feed her every once in a while.

 

 

Dinner out as a family... Montana's in Collingwood (our first family getaway)

 

 

Tiny baby... big bed.  (Cranberry Resort- Collingwood)

 

Having fun at Blue Mountain

 

 

Gave-up the soo soo for her fingers

 

 

My teeny girl

 

Firsts and Milestones

First real laugh: August 16, 2012 while playing with Mama

Rolled Over (front to back): Friday August 31, 2012 with Mommy and Poppa there to see!

 

Month three has had some ups and downs.  Adelaide is still the happiest baby I've known!  She's still happy in the morning, loves to splash in the tub (and we're getting better with the after-bath tears), and LOVE LOVE LOVES to be outside. Even during evening cranky time (which is getting better too) I can take that girl outside, and she immediately settles and looks around in awe. It's about the sweetest thing.

 

She "talks" up a storm now and always has a story for anyone who will listen.  She's becoming so expressive and gets very excited when someone gives her their full attention.  She talks with her hands... a lot. Just like her Daddy.

 

She's able to entertain herself better now. She's much more of a little person, with a personality all her own, and less a newborn now. She loves her play mat and spends a lot of time hanging out there and lounging on her boppy pillow with Daddy. Car seat meltdowns are few and far between.  He favorite toy right now are her colored links, which are a lot of fun to hold and chew on.

 

She's rolling from front to back (we were so happy that Poppa was here to see that for the first time) and she's sleeping most of the way through the night.  She still wakes up for the odd 5am feeding, but it's not unusual for her to sleep right through until about 7:30.

 

We finally made the switch to cloth diapers.  I'll have to do a separate post on that, but we gave up waiting for her to fit into her AIOs and spent a little more money to get prefolds and covers (Bummis, we love you!) and we're LOVING them. It took some adjusting to see her with a bubble butt, but it's just adorable.

 

Breastfeeding and weight issues really got us down. I posted about her weight issues and will post separately about our breastfeeding issues, but it's getting better now and I think we're back on track. We have another weight check on Wednesday, but I think she's gaining and I think we'll be able to avoid formula supplementation.



 

I didn't think it was possible, but I really do love her more every day. My heart tightens every time she grins when she sees me.... she's just incredible. I can't believe how fast time is flying.  While it's sad, I'm also excited to watch her little personality develop even more.

 

I love you to the moon and back my sweet wee girl.  Happy 3 month birthday!!!

 

 

August 27, 2012 - 8lbs, 13.5oz

September 4, 2012 - 9lbs 3oz

 



My tiny girl has me worried

Below is a copy of the email I sent to some friends today about my worries around Adelaide's growth... or lack thereof. It pretty much sums everything up.

 

Adelaide went for her 2 month well-baby visit 2 weeks ago and hadn't gained enough weight. The doctor wasn't concerned at the time since she's happy and seems healthy. She said to come back in two weeks for a quick follow-up. I worked hard to feed her for longer, and more often when we could, but we went back this morning and she had only gained 3oz (she's 8lbs 13.5oz now- at 12 weeks old), which isn't even half of what she should have gained at a minimum in the two weeks since our last visit. So now our next steps are to get blood work done to check for several things, including diabetes.

The thing is, she seems fine. She's really content and alert most of the time, eats really regularly, sleeps really well at night, and has the proper amount of diapers. The doctor said she still checks out great, and doesn't show any signs of dehydration or anything. So, it's not like she's starving. I'm so concerned that it's something more than just not getting enough calories.

I know I'm probably overreacting, but I'm worried. I feel so bad that she's so tiny, and I feel like I'm somehow failing with BFing, even though it seems to be going perfectly.

Ugh... I feel like crap over this.

 

Here's a quick pic I snapped of my sweet girl, patiently waiting for the doctor to arrive.

Update: We took Adelaide for her blood work and it was AWFUL. It took almost an hour to sqeeze two vials of blood, drop by drop, from a prick in her tiny foot.  She screamed.... I cried.

The good news is that her blood work came back clear. No diabetes, no abnormalities.  SUCH a relief.

The bad news... she's still tiny. We go back on Tuesday for a weight check and I'm pretty sure that they doctor will ask me to start supplementing with formula. This breaks my heart. Breastfeeding is so important to me and I'm torn up that I can't give her what she needs.  And I'm so mixed on adding formula when she's content and has plenty of diapers. How much more can I give her.

I've bumped her feedings up by an hour and am feeding her every 2 instead of 3, and I plan to head out today to get some herbal supplements that will hopefully boost my supply.  I'm not optimistic though. I feel like my supply is WAY down and I haven't seen any improvement.  I'm going to keep trying though.  Even if it means getting up in the middle of the night to pump so I can supplement with breast milk and keep my supply up, that's what I'll do. I desperately want EBF.  Fingers crossed.

2 month check-up

Adelaide had her 2 month well-baby visit yesterday (at exactly 10 weeks old) and it went really well, all things considered.  She was happy and content for most of the visit, smiling at the nurse and giving the doctor the once over.  She's such a good little baby.

She now weighs 8lbs, 10.6oz and is 22.5 inches long and the doctor said she looks great and that we should just keep doing what we're doing.  The only concern is that she hadn't gained quite as much weight as they would have liked, but because she's looks healthy, is eating regularly, is content most of the time, and is having the right amount of both kinds of diapers, she didn't suggest supplementation quite yet.  She may just be small (which is so hard for me to wrap my head around since I was expecting a giant baby, right from birth).  We're going back in two weeks for a weight follow-up and I assume that if they still don't like where she's at at that point, we'll discuss our options. I'm going to get to work and try to put some pounds on her, because I'd really like to avoid supplementing with formula.  We've been so lucky because we've had absolutely 0 problems breastfeeding so far, and I'd like to keep it that way for as long as possible. So, I'm going to encourage longer feedings and shorten the times between some feedings for the next couple of weeks, and see if that makes a difference.

The hardest part of the visit was, of course, her first set of shots.  She was a champ through the first one, giving just the smallest little complaint... but she screamed after the second shot. Like, all out, stopped breathing and making noise screamed. I cried.  It was horrible.  BUT, she calmed right down after only a minute and her eyelids started to droop.  I'm sure the oral vaccine (the first thing she's ever had past her lips other than my milk) helped.... she gulped it right down.  She was a champ for the rest of the day, napping and playing like normal, and really didn't seem any worse of the wear.  No sign of a fever, no crankiness, just her normal, happy, tiny self. We are so lucky!

Growth Stats

June 4, 2012 (Birth)
6lbs, 3oz
21 inches long

June 6, 2012 (released from hospital)
5lbs, 8oz

June 11, 2012
6lbs, 5oz

July 4, 2012
7lbs, 15oz
21.25 inches long

August 13, 2012
8lbs, 10.5oz
22.5 inches long

Total gain since leaving the hospital: 3lbs, 2.5oz
Total growth since birth: 1.5 inches

Two Months Old

Adelaide's second month in pictures

Missy finally took a paci at 5 weeks old (known as soo soo around our house). 

It has made a huge difference and she's been much happier.

We figured out our HotSling and though we don't use it much yet, but she loves it and falls asleep almost immediately.

\

Playtime with Daddy and Jenny

 No better place to nap than Mommy and Daddy's bed.

First smile caught on camera

Outside playtime- our favorite way to spend the evenings

First hike (with our $40 like-new Baby Bjorn score)

Hanging out with her cousin Aiden

First boat ride

Catching a nap on the dock

Snuggles with Ma at the cottage

Taking in the sights of Muldrew Lake

First time "swimming"

Month number two has been a whirlwind.  Adelaide has changed so much over the last month, I'm almost in shock about it all.

She's full of smiles and definitely recognizes her Mama and Daddy. My heart melts every time she catches sight of my and smiles... it's the best. She's finding her voice too and loves to "talk" with us.  She babbles away with lots of oohs and wows... it's adorable to watch her try to wrap her mouth around what she wants to say.  It's still hard for her, but she's trying and getting better and better. We spend a lot of time interacting with her now and we love every second of it.

She's in the best mood first thing in the morning and I spend a lot of time laying in bed with her, just talking with her and soaking up her beautiful smiles.

She finally took a pacifier, and we're very glad for it. If I have to deal with meltdowns later when we wean her, so be it.  She's much happier and is now pretty content 99% of the time. She loves to sit in her boppy pillow or lay on her play mat and just hang out.  Naps are getting much better as well, and we're having fewer car seat meltdowns.  She has a cranky period every evening when she fights sleep, but we walk and sing and generally it's fairly short.

This child LOVES to be outside.  We often take her play mat on to the back deck where she coos and plays for an hour or so before she gets bored.  If we can pace the driveway or take a walk in her stroller during her cranky time and that usually keeps her calm and happy.  I'll often think she's fast asleep, but find her wide eyed when I peek in. She loves to watch the world go by.  When she's crying, I can often just step out the front door to calm her down. The fresh air works wonders for her.  She also loves television (just like  her Daddy), and I'll admit to putting her in front of it for a couple minutes to get a few things done.  Right now, she's LOVING the colours of Cat in the Hat on Treehouse.  She just stares... it's cute, for now. 

We took her on her first vacation to the cottage for a week where she celebrated her 2 month birthday. Packing for a child was difficult (I WAY over packed) but she was a rock star. She loved the boat (and fell asleep each time we were in it), she was happy to nap outside in her covered bassinet, and spent hours on the dock in her sun tent, propped up on her boppy pillow, looking at the sky and trees.  She even went "swimming" for the first time and loved it.  She slept through our trip in to town to visit the farmers market, and took in the sights at the Muskoka store. In all, she was a breeze to travel with and I hope that continues for our trip at the end of this month.  She was spoiled with love by her Ma and Pa who loved having unlimited access to her for a week.

She's still in newborn diapers (she's still to tiny for her cloth AIO diapers) and is just starting to outgrow newborn sleepers.  While they fit her well everywhere else, she's getting to long for anything with feet.  The onsies and dresses are still fitting her just fine for now. She's our petite girl and is entering an awkward stage because 0-3 month clothes are too big, but I don't think she has much longer in the newborn clothes.  She's so long and skinny.

Speaking of which, we measured her this week and she's just now 21 inches.  The hospital nurses must  have measured wrong when she was born, because she's definitely much longer now then she was then, when they told me she was 21. She was definitely long for her weight, but I'm thinking more around 19 inches. I'm sad that I won't have that stat for her later.

I'm still breastfeeding exclusively and it's still going great (she's an awesome eater), but I haven't had much success with my pump yet.  I'm thinking of exchanging it for a better model.  We'll see.  I'm not in a rush to get her on a bottle... I still have 5 months until I go back to work.  We have time.

As for sleep, she's down at about 10 every night and sleeps in her bassinet until 5:30 most days, wakes to eat, and then goes back to sleep (usually in bed with me) until 730 or 8.  It's been amazing and I'm crossing my fingers and toes that it sticks.

Her two month check-up isn't until next week, and while I'm anxious to see how much she weighs now, I'm not looking forward to her first set of shots. It's a good thing Daddy is off that day, I wouldn't want to have to do it alone.

I still find myself staring at her, getting totally overwhelmed by just how much I love her.  She's got a sweet personality forming and I'm loving my time with her. She's such a happy baby... we got so lucky.

Happy 2 Month Birthday Wee Girl - I love you to the moon and back!

Adelaide Ruby - August 4, 2012 - 2 months old