Hyperemesis, small boobs = problems breastfeeding?

[PavlovtheForgetfulCat]

As anyone experienced having problems breastfeeding after suffering from HG in pg?

I am still being sick, at 39 wks, not all the time, but daily, I have put on like 7lbs in total, and the baby is around 6lbs atm! I am very skinny, and have put on absolutely no weight whatsoever on my norks. I have tried to convince myself that I have, but it is in fact my ribs that have expanded not my norks.

My areolas have darkened and widened, but nothing else has happened at all, they have not grown, or swollen, or hardened, they are the same as always.

This is my second pg, and I know that they 'know what to do' more this time, but I am worried that I will not be able to feed. I am worried that I have not got enough nutrients for the baby stored.

Is there anything I can do to change this? Or will it all be ok when baby arrives?

[TheOldestCat]

No experience of hyperemesis (you poor thing) but I didn't put a lot of weight on with DD (different story with this pregnancy!) and my norkage remained on the small side. No problem with BF, apart from thrush - which I sorted out after a painful couple of weeks. I went on to BF DD until she was 18 months.

I think sometimes breast size doesn't change much in pregnancy - for me, the expansion came a few days after DD was born. And I'm not sure that size actually matters in this case (it's to do with the mammary glands not the way fat is laid down in your body, no?). Hope someone with the requisite knowledge will come along.

But please don't worry unduly - I think your body will do everything it can to provide the right nutrients for the baby. You just have to make sure you get enough nutrients to take care of you.

[PavlovtheForgetfulCat]

Thank you! They did not grow hugely last time, but they did get a bit bigger, and they changed shape, and i noticed blue veins. I also struggled with expressing, and has some issues with my hv saying my milk was not calorific enough as DD did not put on a lot of weight very quickly. As it happened, it turned out to be nothing to do with my milk, as she was born, and has remained petite, but eats like a horse! We realised that as she was being weaned and continued to gain weight at the same pace despite eating very well indeed.

But i guess, the worry seeds were planted, and now there is no visible sign, i am panicking.

I am most likely not getting enough nutrients for me, but i am sure that will change once i get rid of this placenta from me! Yesterday I held down one slice of toast and third of a pot of Phish Food

[NotQuiteCockney]

Ack, pregnancy is hard enough without continual vomiting. You're doing v well to be not lying down having a tantrum about the whole situation, it sounds dreadful!

How long did you feed your DD for? What sort of local BF support do you have? (I can try to find you some if you tell me what town you're in.) If you can manage it, it might be worthwhile to make it to a drop in group now to a) have a chat about your concerns and b) be more comfortable going to them (rather than HV) after you have the baby.

I think there is a bit of evidence showing that larger breasts = larger storage tank for milk = maybe baby can go longer between feeds, but if so, it's not a massive difference, anyway. Certainly larger breasts can cause their own problems, too, though, with positioning, larger nipples = harder for the baby to get a good latch etc etc. So I wouldn't worry much about breast size.

If you had supply issues last time, they are likely to be less this time, anyway, as you say.

[yawningmonster]

Hi Pavlov, I had severe hyperemisis throughout my pregnancy, hospitilised several times for dehydration. I had a 9pound 5 daughter 6 months ago and despite the hyperemisis and small breasts she is fully breastfed (even had a caesar and still going ok) I was worried also as I had leaked during pregnancy with ds and didn't even get a drop out during my pregnancy with dd, like you I thought I was not getting enough in me to provide for the baby but it so didn't work that way...as I said she was a biggun and still feeding like a demon (my problem now is keeping enough calories going into me to maintain her boob obsession and not fade into oblivion myself!!

[PavlovtheForgetfulCat]

Thanks for that post, really appreciate it.

I fed DD until she was 10 months old, she self weaned rather than through any desire for me to stop, I really enjoyed it. Would not have been able to stop earlier even if I wanted to as DD refused a bottle of any kind! I also think the expressing was problematic due to manual pump and so this time I have bought an electric Medela one. See how that goes.

I do not know about support in the local area, I did not seek it out last time. The problem with the HV was she was a bit scaremongering, and the reality was I had a small baby who grew to be a small toddler, and she was being measured on a FF growth chart.

I think I am worried, not so much about the size themselves, but rather the fact that not much has changed might mean they are not working/preparing as they should. But then i have panicked about most things this pg And I have pretty much laid down and had plenty of tantrums this pregnancy . Including last night as it was just too much/too close to the end of the pg.

[NotQuiteCockney]

Good, re: tantrum, that's perfectly understandable. Anyone would be cross/fed up.

I don't actually know about hyperememesis and breastfeeding, but this page suggests you will probably be ok.

Having fed for 10 months, presumably that was exclusively for many of those months, will make a huge difference to your supply. Also, this time around, you know it's possible the baby will just be small. (How big are you and your husband?)

Are you happy to say what town you're in? There's always the option of BFN/NCT/ABM/LLL if you're struggling, but I think a drop-in group is a better option, if you need someone to check out your latch or attachment. (If supply is bad, better latch or attachment can improve the baby's effectiveness at sucking, which can improve supply. Improving latch or attachment can be a simple question of changing how you hold the baby.)

[NotQuiteCockney]

Arse. Sorry for assumption you are married to father of your kid, if that's not the case.

[PavlovtheForgetfulCat]

yawningmonster oh thank you for that, that is so reassuring to hear. This little one is predicted at around 7lb or so, hard to say as they said DD would be around 6lb and she was born at 5lb, he will not be a huge baby, but certainly will be bigger than DD. But neither DH or I are tall people so i am not expecting a 6fter when he is an adult! Well done on your milk monster! I am looking forward to having to stuff my face. I cannot physically do that right now! I can sometimes, but its not constant and the food i eat is mostly very bland. I so want to eat a huge plate of curry with extra chillis, with a side helping of aloo gobi and chana massala, some chapatti, rice, poppadum, pickles....right now I could do the poppadum and chutney!

notquitecockey forgot to say, am in plymouth/plymstock area so any suggestions for support groups would be very helpful. I would be happy to go there before baby is born for advice and to establish some contact.

I really really do want to bf. I enjoyed it so much last time, so I am prepared to put a lot of effort in to make it work. If it does not work out, I shan't beat myself up about it, and will be fine bottle feeding, but would like to not just be like 'oh not working, let use a bottle'. I want to know I have given it my best shot.

[PavlovtheForgetfulCat]

On this occasion a correct assumption

[NotQuiteCockney]

Oh, and should have noticed, you said you were thin, too - another reason to be unsurprised if your baby isn't a fat one.

Here is a good list of Plymouth breastfeeding groups. The organisation whose webpage that is, looks good. There are bazillions of groups! And at least one is Plymstock. (I'm afraid I'm frightfully ignorant of non-London geography, so I hope that's the right Plymouth etc.) And they say explicitly that pregnant mums and partners are welcome, too.

[Lastyearsmodel]

Hi, Sorry to hear you're feeling so awful. I'm just doing a La Leche League breastfeeding peer supporters course and was amazed to find out the latest information is that breast size is irrelevant in breastfeeding success. It's now thought that breasts don't act as storage tanks in the way previously thought, but that breast milk is 'made to order' as the baby begins to suckle and the letdown reflex occurs.

My DD was slow to regain her birthweight, and I was also under pressure from HVs to supplement (along with lots of poor information from them). She too was just small and like your DD has gone on to eat with her appetite. Then DS fed brilliantly from the start and has been a completely different sort of baby, and of course I was much more relaxed and experienced about the whole thing.

Your nutrition has to be very, very poor to affect your breastmilk, and if you're eating anything at all that's good. Your body will prioritise the baby, and you can't tell anything about your supply until after the pregnancy when bf starts. Once your sickness disappears, your appetite should return in line with what your body needs to do its next job of feeding your lovely baby. I think you are right when you say it will be OK when your baby arrives. Hopefully not long to go now...

[PavlovtheForgetfulCat]

Thanks notquitecockney, there is one v close to me! I shall pop along.

I am skinny enough normally, DH is quite portly, but atm I am just skin, bone and a neat bump!

[PavlovtheForgetfulCat]

lastyearsmodel yes, anytime now! I am waiting . My eating has improved significantly over the last couple of months and I am able to hold down at least one good meal a day, not a huge meal, but nutritious enough, some days more, some days less. Only in the last week/10 days has it taken a down turn to less than that (before around 26 wks, I ate nothing, or very little). I try to make the food i eat highly calorific, and find tortilla chips and soured cream good to keep down .

I feel reassured that baby will take what he needs now. I shall just ignore my friends humungous norks when she next whips them out to feed her little one!

[crokky]

In bit of rush, but had 2 bad HG pgs, after baby born, was lighter than pre conception!! vomited to end of 2nd pg

have NO boobs at all virtually, pg didn't change this

complicated by fact delivered both at 37wks (induced)

anyway, excl bf both for 6m, then contined bf with solids until 12/13m for both

[crokky]

...so don't worry!

[MintyCane]

I had very bad HG and have v small boobs and had tons of milk. You will feel so much better as soon as the baby arrives.

[MintyCane]

sorry meant "bad hyperemesis" in hurry also

[PavlovtheForgetfulCat]

Thank you! Feeling much happier now!

[Longtalljosie]

Another one with virtually no change in boob size in pregnancy, and then tons of milk. I worried about it too but there wasn't a problem. Many sympathies re. the hyperemesis - it sounds horrific

[coffeeaddict]

Pavlov I sympathise, I have similar worries. I don't have HG but have tiny boobs with no change in pregnancy and milk supply has never seemed plentiful.

DS2 was nearly 10 lbs (I am quite slight but husband big and beefy). After I fed him in hospital they did a heel prick test, said his blood sugar was too low and my choice was either to give him a glucose injection or a formula top up. Was horrible choice, who wants to see their newborn injected? I went for formula and of course immediately felt guilty, then got paranoid about not being able to feed him properly. Topped up as and when - and only lasted two month bf. Bf the others (also big) exclusively for a few weeks, but never seemed to get a good supply. Could never express more than a drop even with industrial machine. Was never leaking very much either. Fed pretty much all day solidly but I never seemed able to catch up. They would feed, then come off and yell angrily, making me feel like a total failure. At last I cracked and topped up. They fell on bottle like ravenous hungry things.

Now pregnant with number 4 and would like to make a better go of it this time. What can I do? I have heard oats. Was already resting and having baby in bed, drinking lots...

[coffeeaddict]

PS sorry to hijack the thread. But in case any bf experts come on and read this.... what should I have done when they did the heel prick test? Should I have said no to both glucose injection AND formula??

The trouble is, you have just gone through labour, you are feeling vulnerable, it is v difficult to say 'I don't mind my baby having low blood sugar, I want to exclusively bf'. And isn't low blood sugar a problem for a tiny baby? I genuinely do not know what I should have done - or should do if put in a similar position again.

[Lastyearsmodel]

Coffeeaddict Am not an expert but have a few books and contacts so will research your query. Gotta dash now but will just say ability to express can have nothing to do with supply - some boobs are happy to express, others prefer the real suckinling baby. And I never leaked, or felt full with DD - everyone's experience is different.

The things to go on are wet/dirty nappies, weight gain, baby settling (although other things can affect this) and your own instincts.
Will get to the research asap but might be this evening.

[coffeeaddict]

Thanks lastyearsmodel

[Lastyearsmodel]

Hello again,

Right, the best info I've found is on the La Leche League website as it will be more up to date.

The basics seem to be that low blood sugar is possible with babies larger or smaller than average but it should be tested for and not just assumed or suspected. The best thing for low blood sugar in an otherwise healthy newborn is colustrum and breastmilk, so feed early and often. Initiate feeding as soon as possible after birth, particularly if after a caesarian or drugs in labour (skin-to-skin, etc).

This article goes into detail about low blood sugar in newborns:

Hypoglycemia (low blood sugar) and the Breastfed Newborn

A useful quote: "If a baby does have relatively low blood sugar, the mother may be advised to give glucose water and/or formula. A mother can ask her health care provider what test results indicate that her baby might have a need for supplementation, and work with him/her to develop a plan of action that maintains and values
breastfeeding." Childbirth and Breastfeeding article

And this Dr Sears article contains a lot of the same info but with links to further info if you need it.
Dr Sears article

Broadly speaking, your strategy for successful feeding for baby number 4 could be to arm yourself with as much information as possible about good positioning and latching on, get as many midwives and bf counsellors to check your latch, and if the tests indicate low blood sugar again, keep stressing that you would like to exclusively bf your baby and could they keep monitoring the baby while you feed and feed, rather than supplementing.

And above all, trust your instincts and have confidence that your body knows what to do to feed your baby. If you managed to feed your other DC for a few weeks, you can get there and beyond with this one - be determined.

Oh, and yes, oats are good for milk production (aka galactogogues) and so is fennel (in tea or tablets).

Good luck and keep us posted.

[coffeeaddict]

Thank you so much. Will do all this and start stockpiling the oats and fennel now...

I think what freaked me out at the time was when they said low blood sugar could, worst case scenario, cause organ damage. Although presumably the medical staff would let you know if they thought there was a serious danger of this, it's such a horrible risk, it's hard to persevere confidently. You've spent nine months growing these precious organs, the last thing you want to do is risk them in any shape or form, even if the risk is minute.

But you are right, info is confidence. I will print out your post and keep it as moral support, thanks...

PS They should maybe mention this low blood sugar thing as a possibility in breastfeeding classes - it had never even crossed my mind as a possibility but clearly from those articles it does happen in certain situations...