Combined feeding, please be gentle!

[forgetmenots]

I have a week-old DS who has been pretty poorly since he was born, after quite a traumatic birth (for him).

He had trouble latching on at first and then we thought we had hit the jackpot after seeing a lactation expert. I was so determined to bf especially as he was unwell, and the midwives were keen too. However, he then literally would not come off the breast - I was switch feeding at an almost constant level (nine hours straight at one point, with empty sore breasts and he was still showing hunger cues). He himself was only getting an hour's sleep a day, screaming himself hoarse for the minutes or seconds between switching breasts.

And after all of that, after his hard effort and mine, his weight plummeted. The consultant recommended I hand-express which I found very painful, and to be honest given how little time DS actually spent not feeding, I needed to sleep in that time.

So... With all that in mind, the solution we are looking at is expressing milk using a pump for feeds and in an attempt to galvanise my supply. We will carry on skin-to-skin (both me and dh, with ds). Possible formula top-ups if supply is meagre (he had 20ml of aptamil today and seemed better for it. It feels to me at the moment like a good balance for my boy but I'm missing something, aren't I? Looking for advice/reassurance on next steps please, you deserve a medal for reading to the end!

I should add to this that I feel like a total failure not being able to ebf

When did your milk come in? I had emcs and milk didn't come in until d5. Baby lost 15% of birth weight but community midwife just advised me to plug on. Dd fed constantly but became more settled when milk started being produced. By d10 she'd put all the weight back on (500g!).

If your nipples aren't sore or cracked can you just carry on feeding rather than expressing?

Hi plummyjam

My nipples are sore, cracked and I'm sore and cracked :-) we can't figure out why he doesn't seem to get the milk when I feed him. The switch feeding was good to a point.

Milk came in day3. That's great about your dd.

Hi forget. Can you get to a breast feeding clinic? They shoukd be able to give you advice. I went to one today. Baby three weeks old. Have been trying breast feeding with some top ups but still no weight gain. Said she has tongue tie. But they really looked at get feeding and also gave me formula advice. I've felt so guilty too. But what matters is happy babies and mums! Get help, you will feel better. Sorry to not be able to give you more advice but you're not alone!

That's a good thought massagegirl. I have the number of a 'feeding advisor' in our area so might ring it... Bit scared that they're going to say breast or nowt (the impression I've had from some MWs).

Baby put on 225g in ONE DAY after I changed to combined feeding. So, as much as I'm aware about relative increases with different kinds of feeding, I was so relieved.

Would be incredibly bad if someone refused to consider an option to use formula, forgetmenots....do give the no. a try.

What was the weight loss for your baby?

Are you confident in the scales? Your memory of a 225g weight gain in one day is bound to be a powerful one, but it would be a very unusual gain in that short time, and is far more likely to be the result of one set of scales (or both!) or human weighers under-weighing/over-weighing/reading results wrong :)

Thanks tiktok - only going by the figures the midwives are giving me (we are still in hospital) - I agree it sounds unusual and is part of my general bewilderment.

Weight loss was 13.6%, but combined with the fact he has been really unwell, they were very concerned.

I will give them a ring. Think I may have encountered a couple of hard liners on one of my weepy baby blues days and it's made me reticent...

Forget, where are you based? I had an amazing lactation consultant after a nightmare first week or so (couldn't latch, screaming between and during attempted feeds, lost 12% of birth weight by day 5). He'd had a semi-traumatic time of it (true knot in cord, bruising to his head thanks to his 99th centile head) and it took a lot of creative positioning to get him to a point where he was actually taking in milk. I was in absolute agony.

The lactation consultant was amazing. Non-judgemental, supportive of alternatives (we cup-fed both ebm and a small amount of formula to calm him to the point where it was possible to get him latched on and she helped us figure out the position that worked for him for the first weeks - me sitting up fairly straight and him latching on facing me bolt upright, as if he were sitting on my lap. It was weird but it worked.

I won't say it was plain sailing, but that's because his gas and reflux kicked in after that. But it was easier and I then ebf to six months and bfed until 17 months.

Just dropping to say mix feeding is not destined to end in ff (if that's what you decide). I had a tough start to bf, needing a hospitalisation for weight loss, no milk, hospital insisting on formula and no breast, loss of latch. By the time my baby was two weeks old I thought my hopes of bf were gone forever but with some hard work he is ebf at 14 weeks. I have no probs now and can see me going for ages!

The things which helped were seeing the hospital breast feeding advisor, getting a decent pump (have only been able to pump 2oz max),lots of skin to skin and domperidone to boost my supply.

Once your nipples have healed, you can work on the latch. It does get easier as their mouths get bigger. Just take everyday as it comes, don't think I have to bf for six months as it seems impossible, just keep going day by day. You have options, my ds doesn't care whether he gets breast or bottle - he just likes food!

Others have already given fab advice, but just wanted to say you are NOT a failure, you are doing everything you possibly can and sounds like you have worked really hard. I hope things get easier for you. Congratulations on your DS!

Just to say I gave my baby a bottle of formula daily from about day 3 as milk was late in and the midwives were freaking out about his weight loss. Breast feeding gradually became easier and I was still breast feeding (with one bottle of formula) at 10 months.

I always found it very hard to see what was wrong with that as it worked so well for us. And I just couldn't express anything for some reason.

Try not to worry and just plug away at doing what you can. It's all incredibly hard but in a couple of months you won't even remember the trauma!

You are so not a failure. You have done fantastically well.
Ok here's what I think.
Weight loss is normal for newborns, as is wanting to constantly feed - their stomachs are the size of a marble which is why they need to feed often to begin with. It may be different for your baby as not only every baby is different but your baby has been ill.
When my DD was born she fed every hour for half an hour - her latch wasn't good even though midwives said it was and I was in tears with bleeding nipples and an unsettled baby.
I used FF to begin with on occasion to ease the stress and pain.
Things will get easier. Those first couple of weeks are so tough. In fact I couldn't bond with my baby at first (maybe partly because my dad was in another hospital in intensive care and I wanted to be with him) I felt like this baby was intruding upon me!
Now at 7 weeks BF is much easier, I've bonded with my little girl and I've managed more than 5 hours sleep at a time! That's something I could not imagine 7 weeks ago.
My baby is now EBF but I still have FF as a back up just in case. Don't feel guilty for using combined feeding as you have to weigh up what is best for both of you. But IT WILL get better, just try and persevere. Xxx

must must must get him checked for tongue-tie!

Some fan-bloody-tastic advice here. And you've made me cry. Thank you, all.

He's been checked and doesn't have tongue tie. The doctors currently think that there was a delay because of his illness and that he was feeding to soothe rather than eat. Doesn't really solve anything. But my supply does seen to have gone up and I breastfed today without real pain which is a huge step.

Thanks too for being gentle. I never knew I would get quite so emotive about this.