So today Bram had his 2 week follow up appointment - he's only gained 4 oz in the past week. Dr isn't happy and wants him back on Friday for another weight check and wants to see him up at least 3-4 oz. Um.. in 2 days?? Is that possible??
I did get a chance to work with one of the office lactation specialists for over an hour and I think she gave me some really good tips on getting my milk to come down more. Basically right now Mr. B is exerting too many calories getting the milk to come down and by the time "let down" occurs, he's too tired to eat. She sent me home with a starter "nutrition kit" from Enfamil but she said we could use the BM I have stored in the freezer if we wanted to.
It's killing me to not do 100% breast but he just isn't strong enough right now. She said once he's back up to birth weight, she thinks he may be able to go 100% breast without syringe supplement. Poor little dude.
His billy count was down to 9.something - VERY happy with that!
The crap part of my day was when I had to go into the work office to have some insurance papers sent off and my boss said "Let's see the little rat. "
My son is NOT a rat. I hate that man.. I really, really don't like him.
I normally expect 20-30 grams/day of weight gain in a young infant. 30 grams = 1 oz. so, 3-4 oz in 2 days would be A LOT to me. 4 oz in a week is an average of 17 grams/day over 7 days so, I wouldn't say it was terrible weight gain. And he IS gaining so he is taking in more than he's expending. I would try not to stress too much and breastfeed as much as you're comfortable with. One idea would be to pump until you let down and then put him to nurse. Also, the bili dropping is a good sign too! It sounds like you are doing good to me; I know it's so hard...trust me, I KNOW. I struggled A LOT last time...
Also, here is a link the lactation consultant I hired and met with a few weeks ago gave me to browse. She said if production or let down are a problem hand expression helps with that. There is a link to "hand expressing milk" on the left...she said to do that to get milk going then, pump or feed. Preventative Management Guidelines - Newborn Nursery at LPCH - Stanford University School of Medicine
Keep up the good work, Momma
And screw your boss.
I agree about maybe hand expressing or pumping until you let down. When I was having issues with #3 BF, I was advised to hand express until I let down, and then even continue expressing for a few minutes. Then by the time baby latches on, milk is flowing well, and they also skip some of the fore milk and get more of the fatty hind milk. It makes for pretty sopping receiving blankets (or you could catch it in a storage container if you really wanted) but it makes it easier for baby to gain weight and not get so stressed out waiting for let down.
I say he is gaining weight, so it can't be all bad. I hate when doctors get all up in it like your kid (or adult) is a statistic and not an individual. I like the idea of giving the pumping to let down then offering him the breast or using hand manipulation to help it better than supplementing if he is gaining. Plus he was born (albeit only slightly) early and they put on weight a little slower than full termers. That is a great bili number as well.
Boss-man would have likely gotten yelled at for calling my kid (or any other in my hearing) a rat. I know I make lame jokes sometimes, but leave the babies alone.