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Archive for March, 2012

I recently wrote a post about my over supply of breast milk, which is causing a foremilk and hindmilk imbalance. I am happy to say that I think I am on my way to correcting this issue. My supply seems to be calming down and my baby is doing much better with nursing and is having less tummy and pooping issues. But, my let down is still very strong. Once my milk lets down, it gushes out, and my baby is chocking down my milk. Poor guy! You can hear him gulping it down and spilling into his belly. He’ll pull off and my milk will just spray and soak his face and clothes. He would cry at let down due to the amount of milk that just filled his belly. The over active let down was also causing some spit up issues. Along with the strong let down, Haydon was getting too much of the foremilk, which is high in lactose and harder to break down in the gut, causing Haydon major gas and tummy cramps.

Here is how I have dealt with my overactive let down and its worked!

1. Latch my baby on until let down is achieved. Next, I would unlatch and allow my milk to flow into a cloth diaper or burp rag until my let down slowed down and was not longer gushing. Finally, I would re-latch my baby to resume nursing. I have several let downs while nursing so I repeat this step at every let down.

2. Hold baby upright position (almost a sitting position) at my breast so that the milk flow is not flowing to fast down ward. This helped Haydon not choke on the milk as much. A cradle position or football hold are not great position to be in during let down because they have your baby laying more flat as the milk spews into their mouths, causing them to choke.

3. Burp several times through the feed. The reason for this is with my over active let down, Haydon is gulping so fast that he is most likely gulping more air. This air needs to be released for the feeding to be easier and prevent tummy issue or gas. Seems to have helped so far.

For more information, please read this article:
http://www.llli.org/llleaderweb/lv/lvsepoct95p71.html

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Nursing:
During week 2, I was nursing one side per feeding, ever 3 hours. However, this week, I moved to nursing one side per feeding every 2.5 hours. He was not sleeping through to the 3 hour mark for some of naps so I thought it was best to move back to a 2.5 hour feeding schedule. Haydon was also having a cluster feeding frenzy and was fussy in the late afternoon/ early evenings and refusing to fall asleep until very late in the evening (AKA Witching Hour). I thought about ways to try of eliminating the late bedtime and the cluster feeding, and it occurred to me that he was most likely cluster feeding to get in additional feedings before bedtime. Moving from a 3 to a 2.5 hour feeding schedule allowed me to fit in an additional feeding during the day. Ever since I moved back to a 2.5 hour feeding schedule, 6 our of 7 nights resulted in no cluster feeding and earlier bedtime. Another wonderful side effect of moving back to a 2.5 hour feeding schedule was that Haydon started to sleep a longer stretch at night 4-5 hours.

I am still experiencing an over supply issued with my breastmilk. I am still blockfeeding, feeding from breast per feeding session, which seems to be cutting back on the spit up and evening fussiness, but he still continues to have tummy issues, green poops, and a diaper rash. I wrote more about my over supply in this post- Breastfeeding Issues: Foremilk Hindmilk Imbalance.

Wake Time:
Haydon’s wake time length, which includes feeding and activity, is about 40ish minutes long. The first wake time of the day is the shortest. I notice that I can put him down around 35 minutes of being awake and he returns back to sleep rather easy. The rest of the wake time lengths continue to be about 40ish minutes in length. I know it is time to get ready for a nap when he yawns, gets fidgety, or starts to blankly stair with a glazed look on his face. Sometimes, when I am holding Haydon, he will try to hide his face in my shoulder or chest when he gets tired. I guess he is trying to block out the stimulation all around him.

Nap Routine:
His nap routine is the same as when he was 2 weeks old:
The nap and sleep prep routine that I have fallen into using with Haydon is the following:
1. Turn on Sound Machine
2. Change Diaper
3. Swaddle
4. Turn off Lights
5. Hold up right over shoulder and gently pat his back or bottom
6. Lay him in his crib
*** If he has trouble settling, I shush/ pat his belly until his breathing slows down and his eyes grow heavy and begin to shut. Or I will gently rub his head. If I am lucky, he’ll take his paci to calm down every once in a while.

Naps
most of his naps are about 1.5 hours in length, but he does wake for about 50% of them at the 45 minutes mark or sometime mid nap. I started to let him fuss and cry midnap for 5-10 minutes to see if he’ll put himself back to sleep. More on cry-it-out written below.

Cry-It-Out
I have started letting Haydon cry this week. I still do my nap time routine and help sooth him to sleep, but sometimes even with holding, patting, and calming he still needs to cry. I started letting him cry for about 5-10 minutes. The first few days he would cry up to 10 minutes, then I would go in a sooth him and he would go to sleep, but by the end of the week, he was down to only 5 minutes of crying and falling asleep on his own for most naps (if he even cried at all). I also started to let him fuss and cry if he wakes early or mid nap to see if he’ll go to sleep on his own. If he cries longer than 5-10 minutes, I go in and rub his head, pat belly, or offer a paci to help calm him and help him return to sleep. He started putting himself back to sleep for some naps if he woke early, but I still find myself having to help sooth him back to sleep most most naps. That’s okay, I am just happy he’s making any progress on self-soothing at all. I figured it is better to teach him these self-soothing strategies now rather than have to break a lot of bad habits later.

Schedule:
6:30 Eat, Wake, Sleep (35-40 minutes of wake time)
9:00 EWS (40ish minutes of wake time)
11:30 EWS (40ish minutes of wake time)
2:00 EWS (40ish minutes of wake time)
4:30 Eat, Bath, Nap (45-50 minutes of wake time)
6:30 Eat, put right to bed for the night
10:00 Dreamfeed
Middle Of the Night Feeding around 2am

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What is Foremilk & Hindmilk Imbalance?
One of the problems with having too much breastmilk is something called a Foremilk Hindmilk Imbalance. Foremilk is the milk that comes out of your breast during the first part of the feeding. This milk is high in lactose. Lactose can cause a baby to be gassy and it is harder to break down in the gut. Hindmilk is the milk that comes out during the last part of the feeding from the breast. Hindmilk is high in fat and contains less lactose, which is the part of the feeding you want to make sure you baby is getting. With foremilk hindmilk imbalance, a mother is either producing too much milk so the baby is drinking too much foremilk and not enough hindmilk during a feeding, or a mother is not allowing a baby to feed long enough at one breast, allowing the baby to drain that breast, before switching the baby to the other breast.

Personal Experience:
I never thought I would ever had to say this, but I am making way too much breastmilk. With my first child, I barely made enough. I was able to breastfeed him until he was 10 months old, but at that point, I was not making enough to satisfy him so we switch to formula. Then with my twins, I was able to breastfeed them until they were 15 months-old, but it took a lot of hard work to keep up my supply and I often was crying over how little milk I was making to sustain my twin daughters. I just thought my body had a hard time making an adequate amount of breastmilk, until I had my fourth child Haydon. I seem to be producing way too much milk. My son is only 2.5 weeks old, so I am hoping that my milk supply will decrease to meet the current nursing needs my son has without having too much excess.

In my case, I am just making too much milk. At this point, I am making so much milk that I am only able to feed from one side a feeding. I allow Haydon to nurse at one breast until he will no longer latch. This takes a lot of work to keep him awake long enough to finish a full feeding, but my goal is for him to drink as much as possible from my breast to try and correct my foremilk hindmilk imbalance. Even with all the effort to correct the imbalance, Haydon is probably still getting too much foremilk. He has been very gassy, explosive water poops (happening over +12 times a day, sometimes 3-4 times during a feeding), poop has a foul smell, very irritable after feeds, terrible diaper rash around his anus.

Symptoms (Found from this website)

– Green frothy explosive stools

– Baby spits up a lot

– Colic symptoms (fussiness)

– Baby wanting to breastfeed all the time…not becoming satisfied.

– Gassiness

– Blood in stools

– Slow weight gain

– Diaper rash due to acidic stools

– Baby has a bowel movement immediately after feedings

Coping Strategies:
Here are some of the strategies that I have been using to deal with the imbalance until it corrects itself.

  • Feed from one side a feeding. Making many efforts to keep re latching him until the breast feels drained. That way he is not only drinking the foremilk but also the hindmilk.
  • Burp him several times through out a feeding
  • Offer gripe water after a feeding
  • Pump his legs back and forth to get the gas out after a feeding
  • Hold him up right after a feed and gently rub his back before laying him down
  • Do not pump- that could be causing you to produce more milk than necessary
  • Try using cabbage leaves on your breasts to reduce amount of milk made
  • Only nurse when your baby shows signs of hunger, not sooner, too frequent feedings could be a culprit.

For more information:
http://www.breastfeeding-problems.com/foremilk-hindmilk-imbalance.html
http://www.kellymom.com/bf/supply/foremilk-hindmilk.html

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Nursing:
We are strictly nursing from one side a feeding right now, otherwise known as block feeding. Haydon was not tolerating feeding from both breasts. If he did feed from both breasts, he would spit up a ton, have tummy issues, and be restless. Now feeding from just one side has helped to reduce all the issues Haydon was having. It usually takes Haydon about 15-30 minutes to nurse, but on average 20 minutes. He is not as sleepy so it is much easier to get through a feeding without having to play the stay awake Olympics to keep him awake. I do find that I might have to stop and burp, change positions, or do a diaper change to wake him up to finish a feeding. But, nursing has become much easier for Haydon and I. He nurses about every 3 hours during the day and then starts to cluster feed, every 1-2 hours, in the late afternoon/ early evening until he finally goes to sleep.

Waketime:
I have discovered Haydon’s wake time to be very short. Most newborns can only handle about 30-45 minutes of wake time. Well, Haydon is no different. He can handle about 40-50 minutes of wake time. It is best if I start the nap routine at about 35-40 minutes so that he is in his crib soundly before he gets overstimulated. Haydon only has bout 5-10 minutes of activity in between feedings and sleep. He has mostly spent that time in a bouncer seat, laying on a blanket, or in someone’s arms. I plan on adding in some tummy time to one of his waketimes next week.

Nap/ Sleep Routine:
The nap and sleep prep routine that I have fallen into using with Haydon is the following:
1. Turn on Sound Machine
2. Change Diaper
3. Swaddle
4. Turn off Lights
5. Hold up right over shoulder and gently pat his back or bottom
6. Lay him in his crib
*** If he has trouble settling, I shush/ pat his belly until his breathing slows down and his eyes grow heavy and begin to shut.

Witching Hour
Starting in the late afternoon/ early evening, Haydon has a very restless time of day. He fights sleep and if he does sleep it is usually for 30-45 minutes at most. He also wants to cluster feed, eating every 1-2 hours until he finally goes to sleep at night. My desired bedtime for Haydon is 8pm, but many of the nights during this week, Haydon did not go to bed until 9 or 10pm. I am not really sure why he is resisting sleep during this time, as he takes very solid naps during the day and feeds every 2.5-3 hours during the day too. I have read that it is very normal for young infants and newborns to have a “fussy” time of day that usually comes at the end of the day. It is strange to me that Haydon is experiencing this because my other 3 children never fought sleep this hard when they were newborns. The way I have been coping with this time of day is to feed Haydon as often as he wants because it seems to calm him. To put him in the bouncer or swing swaddled because that also seems to calm him.

Night Time Feedings:
Haydon does fairly well in the middle of the night for feedings. He nurses, I diaper change him, then nurse him again, and then lay him back down. I do not turn the lights on and do not talk to him in the middle of the night. He did two 5 hour stretches, but most of his stretches of sleep are about 3-4 hours in length in between feedings. I feel like his length between feedings are pretty good given he is only two weeks old.

Personal Notes:
I am just head over heals in love with Haydon. It is so different caring for a newborn when you are not a first time mom and you sort of know what you are doing. It just makes it so much easier, even on hard days and nights. Caring for Haydon just seems so much more simple too because, well it’s not twins. My last newborn phase was with my twin daughters. Caring for twin newborns presents a whole other host of issues to trouble shoot. So caring for just Haydon seems like a walk in the park. He is so snuggly and I just love being his mom. I am excited to watch him grow and explore the world. Thanks for reading along with me as Haydon grows up.

Schedule:
7:30 Nurse, Wake Time 40ish minutes, then nap

10:30 Nurse, Wake Time 40ish minutes, then nap

1:30 Nurse, Wake Time 40ish minutes, then nap

4:30 Nurse, Wake Time 40ish minutes, then nap

6:30-8:30/9:30 Witching Hour.  He refuses to sleep during this time and also cluster feeds until he finally crashed and goes to sleep between 8:30-9:30, and sometime as late as 10pm.

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