Will bf work out? Any help appreciated (long)

[berolina]

Hi everyone. As some of you know I had my first baby (a ds) last Weds . We were on the maternity ward until Monday and then he was transferred to the neonatal ward because of his jaundice (needed phototherapy), but we were allowed home today. I was and am determined to bf and put him on the breast from the beginning - latching on and sucking didn't seem a problem. My milk started coming in on the Sat. We started weighing him before and after feeding on that day - he wasn't getting much from me at all and the nurses said I needed to give him pre-formula to stop him losing weight (he weighed 2820g at birth). On the Sun I started expressing to try and get the milk flowing. Things were looking up, but after he was transferred because of the jaundice and was also losing some weight he began to get very sleepy when feeding and would also often refuse to latch on - he'd suck briefly, find no milk immediately forthcoming and scream . Often it would work, but he was taking an hour to get 30-45g out of me. Anyway, the doctors/midwives/nurses said he wasn't getting enough to help with the jaundice and the weight loss, so I've been (reluctantly) giving formula - I always put him on the breast first, and I've been expressing like mad, although it takes me an hour to get to 60-100ml and I then can't express after the next feeding because my breasts are too empty. In other words, he's getting a mixture of (very small amounts of) direct breast milk, EBM and formula, and seems to be doing OK on it, but I'm worried he might give up on the breast because if he refuses it, he gets the bottle (of course). I've started expressing briefly before putting him on the breast and sometimes that seems to work, because he doesn't have to make the effort to get the milk flowing, but it doesn't always. Other times he just goes on the breast with no fuss, other times he refuses it completely. There doesn't seem to be a pattern. This evening he refused the breast (with frustrated screaming and a brief perod asleep) for quite a while, but then suddenly went onto the one I hadn't expressed from! I think I don't yet have a huge amount of milk and that's not helping, and everyone at the hospital said it was medically necessary to feed him up a bit (it's not that they aren't supportive of bf either), but I'm absolutely paranoid now that he won't bf and I'll be stuck expressing for months (or even having to continue to mix EBM with formula). I can't help feeling a bit of a failure and worried/guilty about giving him any formula at all, although I know that the stress I have been and am under won't be helping my milk supply either. Any hints, ideas, similar experiences? TIA!

[aloha]

Gosh I hope tiktok reads this. My first thoughts were have you tried Motilium (Domperidone) which is given to mums of premature babies to boost their milk supply which in your case will have been dented by your baby's illness and giving formula. Also just to feed and feed and feed all day if necessary and lots of skin to skin (having the baby naked except for a nappy, in bed being able to feel your skin) as much as possible to encourage him to feed from you.

[starlover]

hi berolina, i had the same prob when i had ds,

he refused the boob point blank, screaming blue murder if i put him anywhere near it.
I ended up giving him formula and expressing for him.
we were in hospital for 4 days because he wouldn't feed.

i would express milk and give it to him, and then top him up with formula, after a few days at home I was making enough to give him EBM completely,

But i made sure to try him at boob before EVERY feed.
One day, about a week after we got home, he took the boob! and we never looked back! (well, we did due to thrush and other probs but that's another story!)

anyway, when you express try just stimulating boobs before you start, and lean forward and shake them! then start off with pump on lowest setting (if you don't have one then hire a medela hospital grade pump) and gradually build suction up.
I found I got hardly anything out with it on full setting.... you just need a light sucking mostly.

most of all, and the hardest part, RELAX!
I was in floods of tears many a time over it, hormones everywhere too! but once I got into the routine and relaxed it all seemed to fall into place.

So, yes, b/f certainly CAN work out for you. Just keep persevering!

[starlover]

ahh aloha... we seem to meet all too often on these B/F threads these days!

[aloha]

Oh, stuff going in post tomorrow - forgot it today. Sorry

[starlover]

that's ok!

[berolina]

Thanks aloha and starlover!
I've got a medela, which I tend to use on quite a high setting as otherwise I don't feel like the nipples are being 'worked' (I seem to have quite tough ones somehow). I've had (am having) the floods of tears too, the guilt, the worry...

[hermykne]

berolina
as aloha says just feed constantly , if thats all u do for the next 5 wks , ybaby will thrive and you 'll be brillant.
my breast feed totally, was 11lb2 at birth and now at 10mths is just over 19lb so he has consistently put on weight with a dip around 7/8mths, do not be under pressusre re weights,
if there was no formula your baby would be doing very well on your milk alone.

i often thought i couldnt possibly have enough milk for my baby, but from the onset mears and tiktok were here on mumsnet to tell me i had and not to fret. you mgiht think or fell u havent but it there and a baby can down a couple of oz's very quickly.

also u may be feeding constantly initially , that is normal, and u will be wrecked , but it does settle into a pattern.

good luck, will watch out for u

[hermykne]

that should read
u might think or feel u havent enough there
sorry
typing too quickly -badly!

[sharry]

Well, here are my tips i BF all of my children. My mum bf twins until they were 2 so i thought i could easily feed mine. Firstly have a nice soak in a warm bath with 2 drops of Tea tree oil, 3 drops lavender oil mixed into a little ordinary (cows milk) add this to your bath water relax and inhale. You must eat and drink plenty-small snacks often-sleep whenever baby does, get as much help in the house as you can-so you can rest and enjoy your baby!

[berolina]

I'm leaking! (from both breasts)
is that a good sign re. milk supply???

[starlover]

beroline.. i felt like that about the niples being "worked"... but seriously, do try it on a lower setting for a while.
it might take a little longer for the milk to start flowing but you'll probably find you get more! a baby's suck is nowhere near as strong as the highest setting on one of those pumps... so it'll be fine!

also, try swapping sides every 5 minutes rather than doing long periods on each side!

trust me... it works!

[LIZS]

ds had jaundice although not seriosuly enoguh to need phototherapy. He was a ventouse delivery, didn't take well to breastfeeding becasue he was sleepy, which coupled with variable "techniques" of midwives to attempt to get him to latch on, made me pretty miserable and agree to formula supplements in first 48 hours. I also used the machines to express so we could use ebm instead of formula. Gradually he became more wakeful and in the end I left hospital when he was 5 days old, breastfeeding using nipple shields as that was the most effective way of having him latch on and feed although not ideal a sit doesn't stimulate the supply as much but seemed to require less effort on his part. He needed waking for feeds until he was a couple of weeks old as he was so drowsy and we returned to hospital once to get his levels checked as the midwife thought it had got worse but were discharged again the same day. Gradually he needed the nipple shields less and less, at start of feed or alternate feeds when things got a bit sore. In the end I fed him until he was 17 months old.

Please try to have more confidence in yourself and your supply even with such a difficult start. (60 - 100 ml sounds pretty good to me!) You may find that getting home helps as it will be less stressful in your own environment than having the medical staff around all the time, and once relaxed and at your own pace it seems less of a struggle. However make sure you have numbers for b'feeding counsellors etc to hand just in case you need more support and drink plenty whilst you are feeding.

Good luck.

[berolina]

Liz, ds was ventouse too, could that (also) have something to do with it?

[starlover]

yes it can, ds was ventouse as well. i don't remember all the ins and outs, but it can put them off feeding for a while (possibly due to having a headache)

[LIZS]

Believe it can cause bruising which increases the risk of jaundice. I think it has to do with having increased levels of something to break down - sorry my recall is a rather deficinet as it was 7 years ago . Perhaps Mears could elaborate.

[tiktok]

Berolina - are you in the UK? I ask this because what you are saying doesn't seem to be UK practice. I honestly don't think you needed to give formula, and the test weighing thing you did is not considered to be good practice here...instead, someone who knows what they are looking for needs to observe a whole feed (and should have done as soon as there were thought to be problems) and make suggestions for amending the positioning and attachment.

The expressing will improve with a better pump, or get someone to show you how to hand express.

You are right to be concerned about the way things are going, but it is early days and you can turn it round!

You need to offer plenty of skin to skin contact - 24/7 if poss - to encourage your baby to feed and to allow you to respond quickky to feeding cues. Co-bathing is great if you have someone around to help. Call one of the breastfeeding helplines. If you aren't in the UK, you won't have a community midwife around, but if there is any postnatal home support which is helpful to breastfeeding where you are, call it in today!

He needs to feed lots and lots but while things are still in a bit of a crisis, you may need to give ebm/formula temporarily. The stress you are under will have no effect on your milk quantity or quality, but it may possibly affect let down.....the worst thing about stress is that it affects your confidence, and when you are not confident, it can be hard to persist with bf.

Good luck!

[berolina]

Tiktok, you're right, I'm in Germany. I also wasn't entirely happy with the midwives/nurses on the maternity ward (a couple of them tried to shove ds onto the breast without asking me ). The one's in the neonatal ward, though, were brilliant and there were/are good reasons for checking ds's weight. This morning I took him into our bed and we had a long cuddle - he wouldn't latch on, but I managed to express 90ml afterwards. (Does it confuse him if he cuddles with dad too during these skin-to-akin sessions?) Have just had a visit from my excellent midwife, who's certain that I will be able to bf once ds has settled down and maybe got to the 3kg mark. I'm feeling a bit betrter about te prospect of expressing after every feed - just feeling generally a bit more motivated.

[tiktok]

Not saying your baby shouldn't have been weighed, berolina - important that he was, in fact. It's the test weighing (before and after feeds) which is misleading. The shoving of the baby on the breast is not helpful at all....it can turn some babies off.

I'm glad you've got a midwife on hand, and that things are going a bit better. Skin to skin with mum is best when you are aiming to get breastfeeding going, but skin to skin with dad is very nice, too, as an extra ...no, it won't confuse him (the baby I mean, not dad!).

[throckenholt]

I haven't time to post now - but I will this evening. CAT me - I have been through this twice - once I succeeded in establishing breastfeeding (continued until 12 months), once I expressed for 9 months (for twins).

[chipmonkey]

Berolina, can I recommend the Avent Isis pump. Its a hand-pump but it worked far better for me than the Medela pump in hospital. Tho I think starlover would disagree with me on that! A lower setting is better on the Medela though.

[Mirage]

Beroline,congratulations on your little boy.I am having to express,bottle feed ebm,& formula feed at the moment due to wrecked nipples.I'm using the avent isis pump & can reccomend it.I haven't been able to actually bf since Wednesday night,due to huge blood blisters on my nipples,but put dd2 to the breast again today & she seemed fine.

DD1 refused the breast almost totally & I expressed for her for 6wks-the amount you are getting sounds great-it is hard work & time consuming,so well done!

Good luck & I really hope things work out for you.

[popsycal]

me again....
if you really want to breast feed berolina get all the help you can. ring a breastfeeding counsellor in the uk (are you oringinally from here?).
you know the story of my ds1....i mixed fed as i was racked with worry about his jaundice and dehydration and as a result, breast feeding ended for me way earlier than i wanted to

i am banishing my demons now with ds2 though - 12 week and not a bottle in sight

if you really do want breast feeding to wok for you then get all the advce possible and trust your body
xxxx

[Eulalia]

berolina - had almost exactly the same situation as you. Had to feed ds a mixture as he had a very poor suck and probs latching on. It seemed to get worse before it got better. But don't give up. I just gradually phased out the bottles. ds was quite small at birth and didn't really get better till he was a month old and weighed 8 1/2 lbs. I always tried breast first then top up and finally breast last (sometimes he would fall asleep like this). Basically just so he had as much breast contact as possible. Even when things got better he would want to feed constantly, like every hour. It seemed that he only wanted or was able to take a little at a time. He was really about 3 months before he went down to short breastfeeds. I ditched the very last bottle at 8 weeks when he had gone down to a couple of ounces in a few days. That was a great feeling.

I also kept a diary, noting how much formula/EBM milk he was having and guessing how much he was getting from me.

Also try expressing from one breast while baby is feeding from the other. It makes the let down much easier.

Good luck.

[berolina]

Thank you all! B - thanks so much, will CAT you - and you throckenholt.
The saga continues - today was the first day without any successful bf attempt at all . I've observed Samuel during the attempts and he does seem to want to bf - he searches and tries to latch on -, there's just something stopping and frustrating him, which leads to him screaming until his bottle of EBM arrives and makes me feel awful - I hope he knows his mummy is there for him and wants to give him his milk . I've noticed he almost always gives the actual nipple a couple of sucks and my MW also reckons his mouth isn't big/strong enough to get the areola in properly at the moment, so I've bought some nipple shields and, as my MW is coming again tomorrow (she's a gem ), will try them out with her. It would be great if that was the answer to the problem and I could then gradually wean him off them. Am busy expressing after every feed - managed to express 90 and 80ml this morning and again a similar amount in the afternoon but only 50 early eve and (just now) 40ish, so that's a bit disheartening. Anyway, off to snatch a couple of hours sleep