What more could I be doing to boost BF baby intake? Sorry - very long!

(28 Posts)
Accentuatethepositive Fri 08-Feb-13 14:24:56

A bit of background: DD is 8 weeks old. We had a tricky start to BF ? had problems latching to start with, and she was also very sleepy. Plus I was discharged the morning after she was born then had no home visit for 4 days which didn't help!

Day 3, worried she was ill we took her to A&E where they told us her blood sugar was low and made me give her formula top ups for 1 night ? much to my sleep-deprived, hormone fuelled distress. Anyway, got help from a Lactation Consultant and things improved though for several weeks had to wake her for feeds (stripping her off etc ? was hard work!). Was also topping up with EBM when I felt BF hadn?t gone well but was able to gradually phase this out, and now I?m not expressing any more. She gradually woke up and I mostly try and let her let me know when she?s hungry.

But I still don?t feel I trust the feeding process very much! She doesn?t seem as hungry or demanding as any of the other babies I know, and her feeds tend to be very short. I think they are fairly efficient but of course it?s impossible to know how much she?s getting. This wouldn?t worry me too much but her weight gain, while OK, isn?t great ? so the combination of things means I feel I should somehow be trying to get more into her, the question is, how?!

I?ve read loads and know the theory ? offer often, offer at least both sides, etc etc. But what about when the ?offer? is refused? When she doesn?t want any more, the just purses her little lips and there?s not much I can do! I lack confidence in reading her cues, and sometimes feel like we?d be better on a schedule ? when circumstances mean she goes longer between feeds (if I?m out and about for example) I sometimes feel like she feeds better ? but this seems to go against all the advice! Also she has periods of being v fussy on the breast, pulling off and seeming discontented. I?m reluctant to go back to expressing and bottle feeding though I know this would mean I?d know how much she was having. Also the last time I tried to give her a bottle she refused so that option might be off the table. I could be more determined about trying to keep offering, stripping her off etc, but not sure how effective this would be.

I have been to quite a few local BF cafes where the response tends to be, your latch is fine, she?s drinking fine, it all seems fine ? but I can?t shake the feeling it?s not, and really want to preempt having health professionals jump in like they did in week 1 - it really kicked my confidence and I felt I lost all control.

Anyway, I thought I would post a sample days feeding on here and see what people think ? does it sound like she?s getting enough? Sometimes the timings are pretty vague especially for the middle of the night, but you get the idea.

(A note on her weight: she was born on 50th, by week 2 was on 25th and by week 7 had dropped to 9th. At 8 week check she seemed to be holding the 9th, but I?m worried she?s going to drop down again. Lately she seems to be gaining roughly 140g a week, give or take. To my eyes she looks lovely, not fat but well covered with folds in all the right places! She has good periods of being alert and smiley, and seems generally well)

Yesterday

0303 L 7mins, R 2 mins
0535 R 6 mins
0700 L about 5 mins, R a little bit
0830 Little bit each side
0930 3xR, all short attempts, kept coming off coughing
1100 L 5 mins, R 5 mins
1200 R about 6 mins
1310 L, R, R
1530 L about 5-10 mins
1640 R about 5 mins
1744 R ? not v effective
1940 L ? about 15 mins not much active sucking, R a bit more
2040 R about 5 mins, bit frantic
2120 Both sides comfort sucking ? latched on in bath with me but not much drinking
2230 fed to sleep, not much drinking
2300 L 7 mins off and on

Over the course of this period had 3x big yellow squitty poos, one slightly greener one,3 wet nappies (I'm assuming there was also pee in the pooey ones ? also a couple of times she weed while I changed her)

Today
0100 Can?t remember which side but think was about 5 mins? Forgot to write down
0350 L 4-5 mins, R about 4 mins
0720 R about 7 mins, L about 2 mins but nor really interested
0920 tiny bit L but fell asleep again
1010 L about 2 mins, R about 7 mins ? good sucking but had to help with compressions
1225 L 7 mins quite good sucking, R about 5 mins

So far today have only had wet nappies. This is really unusual but have had one day with a very long gap between poos before and eventually one came. Am currently trying not to go into a panic that there's been no poo so far....

Sorry for the detail but wanted to give a snapshot of what feeding is like.

Thanks in advance for your thoughts!

nickelbabe Thu 14-Feb-13 22:26:18

ah yes, I used to stroke dd's wrist to mske sure she was still awake and sucking

minipie Thu 14-Feb-13 21:01:28

have you had her checked for tongue tie? including the harder to spot posterior tongue tie?

I ask because I think a lot of my DD's feeding problems (which sound much like yours, ie short feeds, keeps coming off etc) are caused by posterior tongue tie. she gets quite a lot during her short feeds, because she is sucking so hard to compensate for her crappy latch, so weight gain isn't a problem - but she can't keep it up for long so has to have lots of short feeds. and it causes sore nipples in me (not always, but any time she has a bit of a growth spurt).

mobellydance Thu 14-Feb-13 19:55:22

Glad I found this thread, I'm in a similar position. My DD started on the 75th centile at birth, at 8lb 6. At 12 weeks she is now on the 20th centile, having just gone over the 11lb mark. I went to a breast feeding club for the first time yesterday, and found it a massive help. It might be worth considering looking for one in your area if you haven't already. Got help with my latch..... Think I must have nipples made of old shoe leather, cos I thought no pain meant good latch, but I needed to get more boob into her mouth, which I was shown how to do. I was also advised to feed for longer on one side before switching her over. Apparently when she does the little nibbly sucks towards the end of the feed, that's when she's getting the fattiest milk. Having to blow on her face and tickle her feet to stop her nodding off though. So the lactation expert said to try that, then she'll weigh her next week and see if it's helped. I read on the iterpipes somewhere that drinking nettle tea can help your milk supply too. Giving it a go, as it won't hurt, and I quite like nettle tea anyway. Fingers crossed for a better weight gain next week....

Both of mine were ebf and slept from 11pm-7am at 8 weeks, so don't worry about that. DD2 used to only feed 5 mins each side at that age and I could never believe she was getting enough, but it would keep get going for 2.5-3 hours, whereas DD1 would need 25-30 mins each side! Hopefully your little one is an efficient feeder and you can relax a bit about keeping offering her more food. She may take a better feed if she's had a little more time between feeds but of course feed her if she seems hungry! Good luck, you're doing brilliantly.

nickelbabe Wed 13-Feb-13 20:03:37

smile
see, you're doing great smile

Accentuatethepositive Wed 13-Feb-13 19:29:20

Hey just wanted to say thanks again to those who replied... Had her weighed again today (I know, need to wean myself off the habit but not ready yet!) and she seems to be holding the 9th percentile curve now, so I think she's found her groove. It's given me a bit more faith in the process and I'm now going to try and be grateful for the relatively short feeds and the current run of restful nights!

nickelbabe Sun 10-Feb-13 13:28:19

no, weighing in is not the only way to tell.

it's the best way to make you worry too much...

getting bigger. developing well, being alert, smiling etc, are all ways to tell.

and it sounds like you're both doing fine. smile

Accentuatethepositive Sat 09-Feb-13 23:26:36

Thank you all again. I've had a lovely day with family just trying to enjoy her and am feeling much more relaxed. Your reassurance has also really helped. An going to just try and enjoy the extra sleep and attempt to trust the process at least until the next weigh in- it seems that's the only way to truly see if it's going well or not. Thanks again for reassuring me.

nickelbabe Sat 09-Feb-13 14:12:09

you sound like you're doing great. smile

don't worry about "how much" she's taking, and just concentrate on making sure that you're offering the milk whenever you think she needs it.

don't worry about "snacks" - all her food is the same, so she can't "ruin her appetite" grin

if she's really hungry she'll scream, if she's not, she'll probably just grissle. and if she really doesn't want it, she'll refuse (not likely at this age wink )

You now need to concentrate on you - are you eating and drinking enough? and resting?
that's nothing to do with the baby's nutrition, but your own state of mind.
If you look after yourself, you'll feel happier that your baby is being looked after too smile

sleepyhead Sat 09-Feb-13 13:53:45

At 8 weeks going for a 6 hour stretch through the night is normal (and good! Enjoy your sleep).

SamSmalaidh Sat 09-Feb-13 12:55:21

At 8 weeks my DS started doing an 8 hour stretch at night - didn't last for long though.

Accentuatethepositive Sat 09-Feb-13 12:53:04

Yes I'm sure you're right! It was the big gap between 230 and 830 I was more worried about... I felt she should have woken up starving but that doesn't seem to be the case. Perhaps she's just not that hungry today and will ear more tomorrow. I'm off to try and force myself to chill out!

SamSmalaidh Sat 09-Feb-13 12:36:03

8.30am-11am is only 2.5 hours, so not a ridiculously long time to go between feeds? Some babies are just quick feeders, so long as she is content, alert and gaining weight I would really try to relax.

Accentuatethepositive Sat 09-Feb-13 11:11:41

Hi thanks all again. I do hope you're all right and DD is just doing what's right for her. Feeling a bit wobbly this morning as she fed off and on lots of short feeds last night (a few mins every 40 mins or so- is that cluster feeding?) then slept midnight to 230, fed. Woke at 4 but only sucked for 2 mins, was impossible to get her to take more. Then even though I'm sure I set an alarm for about 6ish the next thing I knew it was 830! Shd had 5 mins then and I tried again just now but she still doesn't seem hungry! She's very happy and content but it just seems odd!

sleepyhead Fri 08-Feb-13 22:09:25

God yes Sam! I remember those 7 days between poos - bloody hell, it was a shocker when it finally arrived!

sleepyhead Fri 08-Feb-13 22:06:33

5oz is about 140g, so pretty much what Accentuate's dd is gaining smile

SamSmalaidh Fri 08-Feb-13 22:06:26

By 8 weeks, number of dirty nappies isn't an indication of how well a baby is feeding - some ebf babies only poo once every 1-2 weeks!

Writerwannabe83 Fri 08-Feb-13 22:01:14

Hello there - sorry to hear you are having an anxious time. The hardest thing about breast feeding is not knowing exactly how much milk the baby is getting - but, obviously breast feeding is encouraged as much as possible.

Has your Health Visitor spoke to you about the mechanisms of breast feeding i.e the fore milk and the hind milk and the different forms of swallowing that can be observed to identify how a breast feed is progressing?

Breast milk production works on a supply and demand process - so the worry is that if a baby isn't having enough breast milk then production slows down and so the baby gets less milk - a catch 22 situation really. One way to counteract this can be to express some milk after the baby has fed, not necessarily to feed the baby but just to make the body think that more milk is needed and so milk production is naturally increased.

Professionals ideally like a baby to put on 5 ounces of weight a week.
(not too sure what that is in grams?) However, as has been said, babies put on weight at different rates so don't worry yourself too much. It isn't abnormal for babies to drop a few centiles in the early stages but it seems things have plateaud now and she is staying on the 9th pecentile so that is another really positive aspect for you to focus on.

With relation to dirty nappies - breast milk has a natural laxative in it which is why breast fed babies typically have more dirty nappies than formula fed babies. I was always told that what goes in, must come out so compare how many dirty nappies she is having to how many feeds she is having.

Breast feeding is so individual - I have known babies to feed for only 5-10 minutes at quite spacious intervals and other babies to be on the breast for 45-60 minutes every couple of hours. That can be because every woman's breast milk is different in terms of fat content and the baby will feed accordingly.

It sounds like you are doing a grand job and stay focused on the positives and congratulate yourself on how much you have already done to give your daughter the best start and the efforts you are going to in order to persevere as opposed to going for the easy option and switching to formula.

You are definitely doing the right thing in offering your baby to breast more frequently - even if she doesn't feed a lot it is better than nothing and just one feed will stimulate further milk production.

Stay positive - babies are very good at picking up on anxiety and even anxiety and stress can affect breast milk production in some circumstances.

You are obviously a brilliant mom and doing the best for your baby x x

sleepyhead Fri 08-Feb-13 18:54:23

Ds had to be taken off the breast - he never came off of his own accord. However, I reckon that about 80% of that time he wasn't actually taking in milk - just comfort sucking. It's something that bf babies often do and one of the differences between bf and bottle feeding.

Other babies might have really long feeds and poor attachment might mean they're not actually transferring all that much milk.

Other babies might just have really big appetites!

Your short feeds are totally within the range of normal, and the weight gain seems pretty normal to me too.

It's horribly ironic isn't it, that when they're babies we fret about how much they're taking in and want big increases in weight (ds was 50 centile but he was never chubby with wrists like they had elastic bands round them etc like I was led to believe babies would be), and then for the rest of their lives people bang on about obesity hmm.

Weekly weigh-ins are kind of frequent at this age imo, but you know what will give you the most reassurance - just remember than babies don't put on weight at the same rate every week smile

Accentuatethepositive Fri 08-Feb-13 18:14:27

Thank you all for your replies and reassurance! It does make me feel a bit better.

SamSmalaidh - it's a bit of a mix of offering and demanding tbh, sometimes it's clear she's hungry, sometimes I offer because I'm not sure what the issue it, other times I offer because I think it's been a bit long. One of the things that worries me is I feel like I don't really know how to read the cues, and sometimes think she's not really hungry but takes a little snack and somehow 'spoils her appetite' - but no idea if this happens with babies?!

Pinkponiesrock - very glad to hear someone else is in the same position. I feel rather guilty around friends whose babies are permanently stuck to their boobs that I complain mine doesn't eat enough... but we all have our own issues don't we! That's about the weight loss we had in the first 5 days too.

I think I just need to try and relax a bit more, but it's soooo difficult. Especially as this afternoon she's been especially lacklustre with her eating, and still no poo...

SamSmalaidh Fri 08-Feb-13 15:27:15

My DS also lost about 9% and went from 75th to 25th, and that was without norovirus or latch problems grin He is still on the 25th now at 2.5 years and I stopped getting him weighed more than 6 monthly after 6 months.

Pinkponiesrock Fri 08-Feb-13 15:22:50

I could have written your post, my DD follows a very similar schedule and I too worry about weight gain! My DD was born on the 75th centile, wouldn't latch on for a few days and I had Norovirus the morning she was born so my milk took ages to come through, this resulted in DD losing 8.75% and she is now on the 25th centile. She is 11+weeks now and my is gaining between 4.5 to 7 oz a week. The HV told me not too get too obsessed with weight gain but look at the baby too. I'm trying to relax a bit but its hard!!

SamSmalaidh Fri 08-Feb-13 14:43:23

Is she asking for those feeds, or are you offering? Do you offer the first side again after the second.

A drop from 50th to 9th sounds fine to me, and gaining weight every week is a good sign.

I know what it's like to feel anxious in the early days of bf, it is really hard if you've had a tricky start. DS was hospitalised in the early days as he wasn't feeding properly and it took me a long time to relax about it.

If your baby is feeding regularly, having periods of being awake and alert and producing wet and dirty nappies, these are all really good signs! Sometimes as bf babies get older they start to go longer between dirty nappies, so don't take this as a sign that your DD isn't getting enough.

It sounds like you're doing a grand job. Do keep going with the bf groups if you have concerns but from what you've written here things sound good.

Jojay Fri 08-Feb-13 14:38:11

I totally understand your anxiety - the first few days, the A&E trip etc sound really stressful with a tiny baby. Well done you for persevering with bfing.

However, things are looking good now, really they are.

Plenty of wet and dirty nappies is a good thing - it shows that milk is passing through, and the odd longer gap between poos is nothing to worry about, honestly.

She's feeding little and often which is great for stimulating your supply. Some babies, and it sounds like yours is one, are very efficient feeders. You may have a fast letdown so your milk gushes out pretty quickly, but whatever is going on, she's taking what she needs in a few minutes. You'll soon be very grateful for this, no hours and hours glued to the sofa!

Keep an eye on her weight, but if she stabilises on 9th centile, perhaps that's where she was meant to be all along.

But in a nutshell, she's feeding frequently, plenty of wet / dirty nappies and you say she's contented and smiley in between? It sounds like you're both doing great to me smile

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