Expert: Sally Wendkos Olds - 2/10/2008

Question
My daughter is almost 2 wks. When I was in the hospital, she was severly
jaundiced and getting fluids/nutrition in her was the foremost priority. I did
not want to supplement with formula, so in addition to trying to get her to
feed from breast [which she couldn't maintain b/c of her lethargy] I would
follow up with breast milk from bottle.

I kept trying to put her to breast for 10 -20 mins and then following up with
bottle hoping she would become more aggressive with breastfeeding once
the jaundice passed. Well it has and she is still sluggish at the breast and I
still must follow up with bottle.

She does make an effort to latch, does about 3 sucks, then dozes off. I almost
feel like she is just putting in minimal effort b/c she knows a bottle is
coming. I have had people advise me to totally take away the bottle. My issue
with that is:

1) that the few times my husband feeds her allows me a few hours of sleep
and he wants to feed her also

2) If I take away what she is accustomed to, she will constantly be hungry and
start losing weight in addition to being fussy all day.

Is there some sort of compromise where I can get her back on the breast AND
take bottle and interchange the two?

Also, my breasts have gotten considerably smaller and softer. Do I need to
worry about my supply dimishing b/c of this? They are practically back to the
size they were prior to pregnancy, but I still manage to pump about 50ml per
breast per session.

Thanks in advance!

Answer
Dear Wendy,

First of all, congratulations for giving your daughter the best start in life by giving her your precious breast milk!

I am so sorry to hear about the problems she is having. There are a few things you can try to get her back onto the breast. One involves finger-feeding, which my own daughter did when her baby was having trouble nursing. (She went on to nurse for more than two years!) You may need a lactation consultant to help you with this. (To find a lactation consultant near you, contact www.ilca.org -- International Lactation Consultants Organization.) Briefly, what you do is run a narrow tube from a bottle of breast milk or formula, tape it to your finger with surgical tape (after, of course, washing your hands), and offer your finger to the baby. Your husband could do this too. You might also try giving her milk from an eyedropper or a cup, just a little at a time.

Another technique some women use is to use a nursing supplementer, which is made by Medela, Inc. (800-835-5968). This involves taping the same kind of narrow tube to your breast, close to the nipple. The other end is attached to a small bottle of breast milk or formula, and this is on a strap that hangs around your neck. This has an added adventage. As the baby nurses, she suckles on your nipple, thereby stimulating your production of milk, and meanwhile also gets milk from the tube. I describe this in my book (see below).

With either of these techniques, you need to monitor your baby's weight, to be sure she is getting adequate nutrition. And the best way to stimulate your milk production is to nurse her frequently. It's also good to continue to pump.

As far as the change in your breasts, different women react differently. Lactating breasts do become softer and smaller eventually, although it's unusual for this to happen this soon after delivery. However, since you are getting milk from pumping, this may not mean anything.

Good luck to you!

Sally
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Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters. Now in revision for a fourth edition, with Laura M. Marks, M.D.