HV says to introduce a top up of formula but am hesitant..

(91 Posts)
loveroflife Tue 21-May-13 11:48:46

I have ds three weeks old and he is ebf. It has been very, very hard for me as he feeds all the time for hours and hours, no pattern and he also refuses to sleep so I sit on the sofa all day feeding him and in the chair throughout the night feeding.

He honestly sleeps for about 4 hours in 24 hours but has to fall asleep on me first.

HV arrived today and says when DH gets home get him to start giving him 90ml of formula at 9.30ish which would see ds through to 1/2am and allow me to rest.

My mum says to stick with the breast as the formula will become a bit of temptation to use in the day and my supply will adjust accordingly and slow down. I also have very full breast after about 2 hours so if I do let DH do the feed and ds does sleep for 5 hours I will surely need to express in that period as I will be very sore?

Does anyone have any advice, I have come so far feeding as failed to stick with it with ds1 but am utterly exhausted and can't go on with the cluster feeding literally every hour of the day. To give a clearer idea, ds2 feeds for up to 2 hours then has 30mins break and then wants to go back on again. had him weighed today and he is 1lb under his birth weight and his nappies are wet and dirty. Checked for tongue tie and HV says that is all fine. HELP!!

Wishiwasanheiress Tue 21-May-13 11:56:03

Gosh. Well I'm totally out of my depth, but hate to see a post like this. My first dd did nothing but feed. Turned out to be colic. Awful but suddenly stopped at 4.5mths. If he's not feeding, what's he doing exactly? Screaming? Grumbling? Lethargic?

I'm as worried about you as babes. It's a tremendous toll. There are some on here extremely knowledgeable. You will find excellent support here. Their posts got me through in 2010 so I know they can help support you too. Thinking of you x

Wishiwasanheiress Tue 21-May-13 12:00:47

Hmm I misread three as thirteen.(how daft am I?!) Our colic started at 10wks so I'm not much help at all. sad sorry.

With my first dd the first month was a massive shock. It did change though week to week from week four as I suppose all her new body functions got used to working and doing their stuff. I also found things improving for me too week to week. It's a slow burn though. I kept a diary. Helped me see the good parts as well as harder ones and find patterns in hindsight even if I couldn't see them at the time. That did help me see how far we had come further down the line.

Walking also helped. Dd slept when on the move. I got the fittest I've ever been. Recommend that!

I think there's supposed to be a growth spurt at three weeks so that might not be helping.

Is he feeding continuously for two hours? Is that all from one breast or does he keep changing sides?
What would happen if you we're to unlatch him after say 30 minutes?

One suggestion would be to try perfect feeding lying down, then at least you could get some rest at night.

mummymccar Tue 21-May-13 12:03:23

My DD did this at the same age, it turned out it was a growth spurt and she was starving. My HV suggested the same thing and although I was very reluctant at first, after 11 hours non stop feeding I just couldn't do it anymore. I have her a top up of about 3oz and she stopped crying for the first time all day. It was a revelation and she was like a completely different baby afterwards. It doesn't mean you have to stop breast feeding but maybe try a couple of ready made cartons for a few days to see how you go?

mummymccar Tue 21-May-13 12:04:23

I also found that pumping when she was asleep helped to increase my supply so that could get around both problems

ExBrightonBell Tue 21-May-13 12:06:14

I feel for you, loveroflife, as I was in a similar position not that long ago. I know it doesn't help right now, but it will get better.

Is it possible to speak to the HV again (maybe a different one?) and explain your worry about topping up with formula affecting your supply? Also it might be worth getting second opinions on tongue tie as it can be missed.

I agree with you that you may well need to express anyway if you skip a feed, and you might want to in order to keep your supply up. So that wouldn't help you rest!

When my ds was 3 weeks old my mum very kindly came to stay for a week - it meant I had another pair of hands so I could get at least some rest here and there. She could also help out with making food etc. Is there someone who could come and do the same for you?

tiktok Tue 21-May-13 12:06:55

loveroflife, would it help to speak to someone? There are several bf helplines - a proper dialogue with someone can help you see the wood for the trees.

A pound under birthweight at 3 weeks is worth exploring. This is concerning. It can be normal but it is very unusual.

Can you share interim weights to get an idea of overall pattern?

There may be a good reason for the HV to suggest formula, but of course it's not something anyone should do lightly, and it does have drawbacks.

Eskino Tue 21-May-13 12:09:43

Dd was same. Now she's 4 months and feeds every 3-4 hours ish. I wouldn't have even considered topping up as I know through experience that bf is enough. These times are hard when you feel welded to the sofa with a baby welded to your breast but very short, I promise you! try to stick with the BFing if you are sure you don't want to introduce formula. More bf means more supply.

Midori1999 Tue 21-May-13 12:10:29

Well, to start, I'm not sure what crystal ball your HV has got that means she knows your baby will sleep for hours after a formula feed... often they don't. I also wonder why she isn't more supportive in your choice to BF, before suggesting formula top ups. On top of that, I agree with your Mum that giving formula tops ups can interfere with breastfeeding.

Breastfed babies do feed very frequently, especially early on, but if your baby really is actively feeding for 2 hours at a time with only a 30 minute break in between, all the time, then that isn't right and along with still being under birthweight indicates there is a problem that can most likely be fixed.

Is your baby actively feeding and swallowing during the 2 hourly feeds? With one swallow every 1-3 sucks? Do they stop swallowing after a while of being on the breast? What then happens if you swap breasts?

Is there a breastfeeding clinic in your area? (you can ask your HV about this) Or can you see a lactation consultant? (an IBC one!) Does your hospital have a BF advisor you can chat to? I think it would be a good idea to get checked for TT by a specialist too.

It is, of course, up to you whether you want to top up with formula, but if you're reluctant to and your baby seems well, it seems a good idea to get specialist BF advice first.

milktraylady Tue 21-May-13 12:11:23

Hi been there, about 3 weeks ago!
I cracked & DH gave a ff at midnight & I slept tru. A life saver.

Yes when I did wake up I had v engorged boobs.
But just got up & fed right away & it took the pressure off.

Yes it is tempting to ff in the day, but if you are v keen on bf then, just don't!
And keep the ff for the midnight feed so you get a 'double sleep'.

Your baby needs you, so you getting sleep is very important, if doing a few ff gets that, then go right ahead grin

milktraylady Tue 21-May-13 12:13:51

Mind you, midori's questions are v relevant. Definitely get advice from a proper bf counsellor first.

Just want to encourage you to do whatever feels right for you, be a bit flexible.

betterthanthat Tue 21-May-13 12:14:00

I think the important thing is thinking about what you want rather than what the HV advises. It's so hard in those early days when you're sleep deprived and just want someone else to tell you how to solve the problem, but it might be worth asking elsewhere for advice as well. I think it's important to be clear with yourself that topping up with formula doesn't mean the end of breastfeeding and may well be a temporary solution as mummymccar found, or it might be better to focus on increasing supply if that's the actual problem. Equally there could be other issues (eg tongue tie) that can make babies slow to feed, so worth talking to other experts. You do not have to make a decision now or even today if you don't want to - you might like to call someone like your local NCT BF counsellor or the la leche league, or see if there is a local BF support group near you you could go to for a chat today or tomorrow. They should be supportive of your choices, not judgemental. Be as kind to yourself as you can - lots and lots of fluids, rest and good food (cake always helps!). I remember with my second just going to bed for 48 hours with her, and lots to eat and drink and just dozing on and off when she went through a similar phase and it did help. But what works for one person isn't always right for another - try and find a solution that works for you. Good luck!

Willdoitinaminute Tue 21-May-13 12:14:26

Are you swapping sides each time he feeds? If so he may not be getting the rich fatty hind milk that satisfies appetite. Try offering the same side each feed changing side severn 4 hours.
Remember at 3 weeks he only has a very tiny stomach so needs to feed little and often.
Does he fall asleep after 10mins? Then wake him up strip him down to his nappy to cool him down so he will stay awake and feed longer. As he grows a little he will take more milk and go longer between feeds. At 3 weeks he is still building up your supply. Every few weeks you will find he does these mammoth cluster feeds. These will match a growth spurt and your supply will have to match these. Nature is incredibly organised when it comes to bf.
have you tried a dummy? Bf babies love comfort suckling he may not be taking any milk just using the breast for comfort. I managed to fool my DS for a while with this method.
just remember it is only a very short period of your life and in a few weeks time you will look back, actually you won't even remember. You will both get the hang of it. Don't rush to establish a routine, go with flow and very quickly you will start to see a pattern emerging. Bf babies will never refuse the breast early on because it is so much more than food.

Willdoitinaminute Tue 21-May-13 12:18:04

Severn? I meant every.

41notTrendy Tue 21-May-13 12:19:31

A while ago now for me, but ds was just the same, although a little older; 6 weeks. HV advised same. We gave it a lot of thought and decided to give ds a bottle at about 11am. I expressed, which kept my supply going for him for the rest of the time. Tbh, it didn't do anything to his appetite, he just enjoyed his milk grin. However, it got me off the sofa, gave me more freedom and choice with my day.
It's very hard, in so many ways. Lots of conflict and lots of places to go for advice. In the end, all you can do is make a decision that is good for you and for your baby. smile

Me23 Tue 21-May-13 12:20:25

Agree with midori and tiktok you need to speak to a bf expert. Baby should be back to birthweight now. Also is feeding a lot! Are you sure your positioning And attachment is right? Is it painful when you feed?

Weegiemum Tue 21-May-13 12:20:54

At 3 weeks my HV said "give that baby a bottle, you'll never feed her yourself" (she was 11'6 by then).

I fed her tll about 13 months. And never saw he HV again!

KatAndKit Tue 21-May-13 12:21:02

sounds like it would be worth getting him checked for tongue tie by someone more experienced (lactation consultant or pediatrician perhaps) as some are not easy to spot and HVs are not experts. It sounds like he is not transferring milk efficiently for whatever reason (I would suspect TT) and that is why he needs to spend so long on the breast and is still not gaining enough. I wouldn't try a dummy yet if you have concern for his weight gain. A bottle of formula is not the end of the world if you are desperate to sleep - you need to look after your own health too. Try expressing milk, although that is hard if you have a baby attached to you all the time. Phone the La Leche League helpline and try to get real life BF help from a leader in your area.

TarkaTheOtter Tue 21-May-13 12:21:40

I'd get a second opinion on tongue tie and have your latched checked by a breastfeeding specialist.

50shadesofvomit Tue 21-May-13 12:32:04

I formula fed my kids and if I have a bottle at 9:30 it did not guarantee that they'd sleep more.

ksrwr Tue 21-May-13 12:40:07

i agree with the checking for tongue tie, that's what happened with our constantly feeding baby

tiktok Tue 21-May-13 13:14:42

Willdoit - sorry, what you are suggesting is entirely wrong and might make the OP's situation much, much worse.

The idea that it is better to deliberately not switch sides and to stay on one side for a period of whatever-hours is only every appropriate when the mother has a clear case of over-supply - it reduces volume of milk available and in a mother whose supply might be marginal, reducing feeding on both sides like this could be very risky. To couple that with offering a dummy to make the baby go longer between feeds and you have a recipe for milk dwindling....sad sad

You are not the only person to have misunderstood fore/hindmilk - this blogpost explains thefunnyshapedwoman.blogspot.co.uk/2011/05/foremilk-and-hindmilk-in-quest-of.html

OP - please call a helpline and talk this whole thing through. Not all the posts on this thread are going to help, although all are well-meaning, and you need to be sure you are able to make a decision based on good info.

tiktok Tue 21-May-13 13:17:09

Heavens, willdoit, I explained all that in a thread we were both on in November last year....sad sad

Get the baby checked for tongue tie by a professional. Find a lactation consultant who is expert on this. They can also assist with feeding positions and talk through feeding patterns.

Quite frankly I wouldn't trust a HV to recognise a tongue tie if it slapped her in the face been there

WouldBeHarrietVane Tue 21-May-13 14:20:41

Willdo, if you read this LLL link, you will see that as tiktok says, offering as many sides as baby needs is best, as is dropping dummies (pacifiers):

https://www.llli.org/faq/increase.html

flanbase Tue 21-May-13 20:16:58

not back to birthweight needs to be medically investigated and this is by a medical doctor not a hv.

dozily Tue 21-May-13 20:23:45

Is he definitely 1 pound under his birthweight or did you mean 1 oz?

Either way, the constant feeding sounds really hard work, but just wanted to double check the weight with you.

loveroflife Tue 21-May-13 20:56:59

hi everyone,

thanks for the responses - they are all so helpful.

dozily - yes, I DO mean an oz - the sleep deprivation is a killer! he was 8lb9 at birth now 8lb8.

I've called a couple of lactation consultants and left mesages - I can't get to a breastfeeding support group as I had a c section and can't drive.

re: tongue tie, hv says as I don't really have any pain from feeding (apart from an initial wince when he latches on) and nipples are OK, she doesn't think he has it but will get it checked from another source.

I need to see how I get on over the next couple of days and then I think I will express and see how I get on with that and if things don't change, try one bottle of formula and see if it makes any difference to him sleeping longer than 1hr30mins at best!

I've also been sick the last three nights after feeding about 3am (not food, just fluid) DH thinks it is from exhaustion - has anyone else had this? I don't feel sick in the morning but a huge wave of nausea washes over me after long feeds during the night...

dozily Tue 21-May-13 21:05:43

Glad it was 1oz smile that is much more positive. It's also a good sign that feeding isn't painful. Hopefully once he puts on a bit more weight the feeds might start to space out a bit.

While waiting for the lactation consultants to call back, it might be worth phoning the nct or la leche league helplines.

WouldBeHarrietVane Tue 21-May-13 21:06:19

The LLL breastfeeding support line will still be open now. Why not give them a call?

They are all qualified bf counsellors and will be very happy to discuss what you could do to try to increase weight gain alongside the advice your hcp are giving.

dozily Tue 21-May-13 21:13:45

Another thought: can anyone take him out in the pram for an hour or two during the day so you catch up on a (little) bit of sleep?

Xiaoxiong Tue 21-May-13 21:21:42

OP I used to get that wave of gnawing nausea in the night when DS was breastfeeding for hours when he was tiny. It sometimes felt like the bottom dropping out of my stomach like you get on a rollercoaster and I did feel like I was about to be sick a couple of times.

I always thought it was hunger and thirst, and always had a stash of something by the bed to settle my stomach. I do wonder in retrospect if it was actually hormone surge from feeding/let-down on an empty stomach that made me feel that way.

DH used to put water and snacks on the bedside table for me when he came to bed at midnight (I would go to bed at 8pm and leave DS with him so I could get some sleep, he would then bring DS to bed when he cried, or at any rate by midnight and I would then BF DS the rest of the night in bed).

The best ones were Ritz biscuit sandwiches with peanut butter and nutella. I did get crumbs all over sometimes but it was a small price to pay wink I hear granola bars or power bars can be good too and probably less messy.

loveroflife Tue 21-May-13 21:26:10

Thanks dozily - I have some help from mum who takes toddler out as it is tough on him stuck inside with me sat on the couch feeding all day. I am planning a walk with DH and ds2 this bank holiday to see how we all get on - funny how you can become such a hermit so quickly...I also stupidly pulled my c section scar from bending with toddler last week and now have a small hole in it which is infected so feeling pretty bad overall...

Wouldbe - I will give LLL a call in a bit, just waiting for DH to walk in so he can take ds off me, he has fed since 5.30pm, I have not moved from the sofa (mum put ds1 to bed) apart from attempt to put him down in cot twice - he went mad!

Oh well, this too shall pass! I keep reading the first 6 weeks are the hardest, so only 3 more to go!

loveroflife Tue 21-May-13 21:31:31

xiaoxiong - yes, that's the feeling plus severe stomach cramps.

I did have some dry toast last night about 4am after vomiting and took some nurofen and downed 500ml of water which helped hugely - I wake up (well jolt upright with ds on my chest) STARVING in the morning so will pop some cereal bars on my bedside table tonight.

thanks for the advice everyone

morningsarepants Tue 21-May-13 21:32:01

Sounds difficult, I hope it gets better soon.
I found it really hard too especially for the first one. Pushed through with ebf for 6 weeks with both then added a bottle at late evening feed only and it didn't affect my supply one bit. But I guess it was well established by then. It was a relief to do it though as I could go to bed early and let DH do the late feed.
I was glued to the sofa for weeks. But I did watch a lot of crap telly as a result - the whole back catalogue of Tenko last time grin

Willdoitinaminute Tue 21-May-13 21:36:51

tiktok - there is also a disclaimer at the top of this blog. As the disclaimer says at the top of every MN page ours are opinions based on personal experience not on scientific data.
I successfully bf my DS. He started life in SCBU being tubefed and I expressed until he was 4 days old when he eventually latched and never looked back. I too observed the differences in the milk while I expressed.
I had a massive amount of midwife led support during his first 10 days since I had one to one care in a transition unit. Sleepy babies don't feed well they often look like they are feeding but actually they are just comfort suckling. This can be difficult to spot if you are inexperienced. The midwife spotted this and I was encouraged to stimulate him to wake him up. In fact even now aged 8 you can still hear him making suckling noise when he is in deep sleep.
I bf until he was 2. My sister bf both of hers well into their first year. She was great for advice and support. We may not have done everything by the book but hey most breast feeding mothers have to rely on instinct since they don't live in the the nice clean organised scientifically proven world we do.
Why is it so many women on this sight are so obsessed by tongue tigh?

WouldBeHarrietVane Tue 21-May-13 21:41:48

Willdoit, unfortunately while your advice may have worked for you it is not evidence based and is potentially a bit dangerous to repeat to mothers. Your advice is contrary to the position taken on this by:

- the NHS (advise switch nursing unless there are specific contraindications)
- LLL
- one of the leading bf textbooks used by hcp, Breasffeeding Answers Made Simple

You may have had oversupply or breasts with a better than average storage capacity. If your advice was followed by a mother with average supply or lower than average storage capacity it could actually harm her baby's weight gain.

Xiaoxiong Tue 21-May-13 21:42:43

Are you feeding lying down at all? Just that you mentioned sitting upright in a chair for hours. That would have killed me.

We took the side of the crib off and lashed it to our bed with bungees to make a DIY sidecar. Then we just lay down together, DS in the crook of my arm, and drowsed our way through most of the night with DS latched on 90% of the time. He generally would only sleep on us, but he would sleep in his sidecar with my arm loosely crooked around him and then I could stealthily withdraw.

FamiliesShareGerms Tue 21-May-13 21:53:09

My advice (based my experience of feeding a prem baby) would have been similar to Willdoit's...

OP, you've done brilliantly getting this far, do persist with trying to speak to specialist BF support (local NCT might have someone who could visit you?). It really annoys me how many HV dish out the (IMO) lazy advice to "just give them a top up" without supporting new mothers to BF when they clearly want to.

Do take good care of yourself (make sure your DH is helping on this front!). Always have a pint of water to hand when you are feeding, make sure you are eating enough calories - little and often (like a newborn!) worked best for me.

flanbase Tue 21-May-13 21:57:17

The sucking which is described here as 'comfort' sucking is to maintain and increase milk supply. The suckling stimulates the breast to produce hormones that reduce ovulation, increase milk and provide stress relief for the mother. A dummy used instead of the breast will mean the mother misses out on the suckling. The baby has the advantage of an ensured milk supply and also facial muscle development from the sucking.

flanbase Tue 21-May-13 22:00:08

I don't see the disclaimer. There has to be one though -where is it?

Willdoitinaminute Tue 21-May-13 22:03:31

Whatever Wouldbe I'm not in the mood for an argument. As I said I winged it when I started bf. Had no antinatal lessons and no LLL classes. I asked advise from individuals who had successfully bf not those who had read a book.
Loveroflife I too was wondering if you had tried lying down on the bed to make feeding more comfortable. CS is bad enough but with infection added it must be getting very uncomfortable. I wouldn't advise doing it when no one is around because it is difficult getting into position after CS. If you get comfortable on your side then get DH or you mum to position baby and stay with you until you are comfortable.
Also have you had some antibiotics for the infection. Make sure you are having it dressed and treated.

WouldBeHarrietVane Tue 21-May-13 22:20:25

Willdoit, definitely don't want to argue with you - you obviously want very much to help other women to bf or you wouldn't be spending your time posting on here.This board is a great resource of bf support because people like you post.

All of us need to try to make sure our advice is evidence-based, though, because that is going to help mothers and babies most. I was ticked off (no pun intended) by tiktok when I was a new bf mum for saying something completely wrong in response to a query on here blush and I have never forgotten it - was a good lesson - so thanks tiktok smile

tiktok Tue 21-May-13 22:48:29

Willdoit, don't denigrate things 'found in a book'. If the book(s) is/are based on good evidence, and the evidence comes from decent research and understanding, it can be a lot more helpful and applicable to more situations than someone's personal experience.

It's great to share personal experience, and of course there is no one 'recipe' for happy bf; some women have perfectly happy bf experiences doing the opposite from what other women do.

But what you have done - more than once - is to be pretty clear with suggestions that almost certainly would make this mother's situation worse, not better. I am not sure what you expect others to say in response to this - nothing? And let this mother and others in similar situations try something that is not based on good knowledge or evidence, but one person's own experience?

I tried to be polite about it, then remembered the same conversation and realised you were still convinced what was right for you would be right for other people, and got a bit tetchy.

Sorry about that.

Wahla Tue 21-May-13 22:53:13

If you go onto YouTube and search Breast compression, there are some good video's about breast compression (obviously) which can help to get more milk out of the breast during a feed. There are also related vids that show good/bad latch and the difference between babies drinking well at the breast and those that aren't.

I found them to be really helpful as a "this is what is supposed to look like" tool because, despite having been to workshops and read loads of books/websites, I needed a practical demonstration to put the theory into context ITKWIM.

Also, my love, as a seasoned c-sectioner (4), you need to spend a 2 or 3 days in bed, with lots to eat and drink. I know you probably feel like you should be up and about by now but trust me, a few days of total bed rest now could save you from a long, slow recovery and a difficult breast feeding journey.

Your body is doing an epic amount of work and you need to give it the best chance you can. I know, I know, your saying "but I'm not doing anything but sitting on my behind and feeding baby", but your in conflict about what you should be doing and that tension does not allow you to properly rest. Give in. Fully meeting your own needs for rest and recuperation will put you in the best place to l

flanbase Tue 21-May-13 22:55:56

It's not a professional forum here and people can suggest whatever they want in accordance with the talk guidelines

Wahla Tue 21-May-13 22:58:01

Stupid iPhone

To fully meet the needs of your DC's in the future. Ask your mum and DH to take over for a few days and hole up in bed with your lap top and loads of good food. I promise you, you will feel so much better able to cope if you give yourself that time to heal.

tiktok Tue 21-May-13 23:05:59

I agree, flanbase - people can suggest what they want, as long as they're not abusive etc etc etc....but if what they are suggesting is plain wrong, or is likely to have drawbacks, then other people can point that out, surely.

If someone suggests something based solely on their own experience, then it's a good idea to say this, and not to give the impression that it is generally applicable - don't you agree?

flanbase Tue 21-May-13 23:15:15

I pointed out the good points to 'comfort' suckling and didn't have a go at the person who wrote use a dummy. It's different peoples opinions and not qualified advice here. Anyone reading something here has to make up their own mind and seek the advice of their real life doctors. If you add a source of the advice then this gives extra information but from what we say it's a personal opinion. You say to a poster that what she says is completely wrong and you don't back up what your reasons. It's your opinion and that's all

flanbase Tue 21-May-13 23:16:33

How are people to know that what works for them wont work for others or everyone? They can write what they want

larlemucker Tue 21-May-13 23:30:06

I was exactly the same. DS fed every 40 mins for the first 2 weeks. I hadn't bern to bed for 3 days when the midwife advised topping up.
He never had more than 3 oz at a time but it meant I could shower, sleep etc.
I expressed once a day to keep my supply up and once the cluster feeding had calmed down we started slowly weaning him off the formula.

That was 3 months ago. He is now 5 months and ebf.

I would suggest trying the top up if it means you get a break so you can carry on bfing otherwise you sound like you're that knackered you'll end up stopping completely.

No one tells you how hard it's going to be!!!

WouldBeHarrietVane Tue 21-May-13 23:40:26

The reason switching sides is better for babies with slow weight gain is because when breasts are full a whey protein called FIL tells the breast to slow milk production down.

So when one breast is not used in a feed that breast remains full and the FIL tells the body to produce less milk. When both breasts are emptied in a feed (switch nursing) there is less FIL and this tells the body to produce more milk. All explained here:

kellymom.com/bf/got-milk/basics/milkproduction/

The BAMS book I mentioned before is a highly respected evidence based bf textbook. There is a specific section about increasing weight gain where mothers have concerns. The advice listed is to make sure baby is well latched, breastfeed more (ie offer more frequently) and keep offering additional sides at every feed until baby is finished ie switch nursing.

Using breast compressions and avoiding dummies are also recommended.

janey223 Wed 22-May-13 00:01:57

Sorry I haven't read all of this but when DS was still under birthweight at 3 weeks we had to go to the a&e paed to have him checked over (by that point it was only an oz or something too as he'd been on topups after every feed of either bm or formula). It's standard here that if they haven't reached their birthweight they need to be seen, was sent that day.

The paed there told me to not let him feed for longer than 30-40 mins at a time as he would be too tired to fees properly and to take him off, burp & change then either back on or topup.

He despised boobie though, screamed on/off full time but that was undiagnosed reflux+allergy.

tiktok Wed 22-May-13 09:22:22

Flan base it is absolutely not my personal opinion. I gave a link that explained what I was saying. If someone has an opinion only and personal experience only then that is fine. Just don't present it as something generally applicable. How do you suggest I and others respond when we read something here that is likely to do harm if followed by others? Do we say nothing because its ok to present personal opinion as fact? And as for suggesting mothers check with their doctors about breast feeding.....this is fine when it comes to health and medical issues but research - and not just opinion - shows clearly this may not be helpful if we want to understand breastfeeding concerns.

dozily Wed 22-May-13 09:32:47

loveroflife it's possible the c-section infection is what's making you feel sick - please tell the midwife as soon as you can if you haven't already as I would imagine it might need treating.

I hope last night was a little better smile

flanbase Wed 22-May-13 09:49:48

Tiktoc - The link you posted says at the top of the blog that it is just opinion. You are using others opinions to back up your opinions smile

Midori1999 Wed 22-May-13 10:03:52

Flanbase, what Tiktok says is evidence based. This link explains the concept of fore and hindmilk well and has further links explaining in more detail. This website is evidence based and run by an IBCLC, which is the most qualified breastfeeding professional there is.

kellymom.com/bf/got-milk/basics/foremilk-hindmilk/

WallaceWindsock Wed 22-May-13 10:19:18

Hi OP that sounds exactly like my experience of feeding DD two years ago. I had a useless HV who said no tongue tie and that she was latched fine and to just keep feeding. The thing was that I wasn't moving from the sofa because she just screamed with hunger all the bloody time. I was exhausted and after a month started to feel that something wasn't right. I ended up expressing all her feeds and bottle feeding them so that I could physically see that she was getting enough milk. Four months down the line my supply dropped and I started to mix feed and by 6 months she was completely on formula.

I always believed it was something wrong with my milk or my let down reflex which had been the problem. DD was still taking bottles at 18mo because she didn't seem able to extract fluids from any of the cups we had bought so I took her to GP. She has a complex form of tongue tie, really hard to spot and we now know passed down from her Dad. I have a 9wo DS who also has the same form of tongue tie but luckily he naturally gets feeding and has been a breeze in comparison.

So my advice would be to push and push and push with a GP or someone who knows their stuff to get a yes or no on tongue tie. It certainly sounds like TT and if you could get that sorted I expect that feeding would be so so much easier. You said you had probs feeding DC1? Could that have been TT as well - some forms do seem to be hereditary. Good luck and hope you get it sorted.

flanbase Wed 22-May-13 10:33:45

the link used Midori was a blog that says it's based on opinion. It wasn't Kellymom.

flanbase Wed 22-May-13 10:44:42

The header of the blog TikTok linked to states "Articles published on this blog are my opinion only, and may not necessarily reflect the views of any organisations with which I am associated. Please be aware that articles posted on this blog are not intended as a substitute for professional medical advice. If you have a medical problem relating to breastfeeding, please seek further advice from a Lactation Consultant (IBCLC) or trained Breastfeeding Counsellor."This is clearly not evidence based no matter what is quoted or said as the author removes a responsibility for the words written. Just saying. I understand the mumsnet site to be opinion based and not as a substitute for medical advice. If I have this wrong then happy to be corrected.

mindalina Wed 22-May-13 10:45:04

I don't know much about breastfeeding, tbh, being a bit of newbie at it (DD is 12 weeks), so don't have advice in that respect, and you are getting loads of good advice from lovely people here. However what I have just read about is this dysphoric milk ejection reflex which I think I have a mild case of - I get that lurching sensation and a wave of mild anxiety on letdown. I just thought I'd mention it as a couple of posters have mentioned that awful feeling in the stomach, and this might be reassuring. Best of luck smile

Midori1999 Wed 22-May-13 10:46:57

Yes, the link is a blog, but it does actually explain fore/hind milk quite well and the pictures are especially helpful, IMO. However, that doesn't change the fact that what tiktok (and others) are saying Regarding block feeding being counterproductive in the OP's situation and fore milk/hind milk not being something she needs to worry about etc (regardless of links they have posted) is evidence based.

Midori1999 Wed 22-May-13 10:48:22

Flanbase, mumsnet is opinion based, but Tiktok is a breastfeeding professional/counsellor.

flanbase Wed 22-May-13 10:55:22

That's good but still it's opinion. I think it's good for people to be able to say what worked for them. There is no professional responsibility on here.

Soupa Wed 22-May-13 11:03:17

Nct bfcs use evidence based research and are qualified, their contributions are likely to be accurate.

Whilst the wonderful thing about bf and breasts is that their are many variables and experiences there are also ways if feeding likely to have certain consequences.

The consequence of block feeding is reduced milk and or reduced weight gain. Nct, lll, ibclcs, bfn supporters etc all agree this as all use evidence based materials.

flanbase Wed 22-May-13 11:16:20

soupa - just saying that here we don't know for sure people are nct counsellors or whatever. Just saying and no offence and not suggesting anything wrong with anyone. I mean this in the best way and good intentions.

flanbase Wed 22-May-13 11:34:44

I used to carry my kids when they were small and bf from the left breast a lot I used the left arm mainly as right handed. I didn't always sit down to bf as looking after other children and doing housework. When I was co-sleeping I would bf from both sides. The breasts will do the job if you feed from just the one mainly or both equally - just my opinion. For the op -I still say get medical help as her baby is not back to birthweight

tiktok Wed 22-May-13 11:55:49

I linked to a blog which explained my point in a way which is not opinion. I am getting a tad irritated with this opinion thing . I can link to research papers and text books if you prefer flanbase but often a clear explanation is a better bet. My point is that if you present opinion as something generally applicable to all, you will mislead and in some cases cause damage . Someone follows this opinion and experience and they are worse off than before . A shrug of the shoulders and the 'explanation' that 'it was just my opinion' is not helpful.

Put it this way . Opinion and experience is fine as long as it is highlighted as this and not presented as advice or fact. If I see something here that is factually incorrect and which may harm someone, then why would I not put something to counter it? Something that is not my opinion or experience but which comes from an understanding of how bf works.

If you think the right thing to do is to say nothing then my opinion is that you are wrong: )

minipie Wed 22-May-13 20:02:25

to the OP

if your breasts are getting engorged in 2 hours that suggests you have plenty of supply, so it's not a supply issue

engorgement, plus DS feeding for hours and still losing weight (or at least not gaining) suggests the milk is not getting through to him properly

that suggests a latch problem and or tongue tie

also, if you had problems with ds1, it's possible he had TT too - it often runs in families - so again that is a possible pointer towards TT

it is NOT TRUE that no pain = no tongue tie. especially with posterior tongue tie it can take weeks before the pain starts (was the case with me)
so I wouldn't trust your HV to spot a TT as she doesn't seem to know that much about it.

you need a good BFing counsellor/lactation consultant to look at latch and TT. how are you getting on with finding one?

in the meantime, formula will help your DS not be hungry and give you a bit of a break, but you'll need to express to keep your supply up which is hard work (and you need a decent pump)

good luck!

if your breasts are getting engorged in 2 hours that suggests you have plenty of supply, so it's not a supply issue

Not necessarily. If baby has tongue tie, baby may not always be draining the boob properly. TT can look like over supply hence shouldn't risk block feeding unless sure.

Willdoitinaminute Wed 22-May-13 21:05:40

Loveroflife I hope you managed to get thought to someone today who could help you. Having read the posts tonight I do apologise if my suggestions were misplaced. It does get better and you will eventually get some sleep. Wishing you well.

minipie Wed 22-May-13 21:34:00

completely agree, i wouldn't risk block feeding. i just meant it's not that the OP doesn't have milk.

loveroflife Sat 25-May-13 19:27:06

sorry for the delay in responding - I can't seem to put DS down without him crying...

I don't know if he has silent reflux or if there is a problem but I can't put him down not even in the chair for 10mins to shower..it's very draining and I am trying to hard to stick with everything.

I spoke to a number of lactation consultants and am going to a drop in clinic next week to see if he has tongue tie so at least we will know one way or the other.

Does anyone have any advice on nights - I am literally sleeping for an hour or so at night while DH rocks him to sleep. He screams when in the cot and is better next to me in bed but I'm very much on guard about rolling over him and don't really sleep this way either.

Sorry to sound so negative, I had hopes of warm, snuggly breastfeeding but it is pretty tough and the constant feeding is taking its toll...

flanbase Sat 25-May-13 20:46:59

My eldest couldn't be put in the cot without shouting at full strength so I carried her around with me and did the same with my others. It is more intensive and the only break would be when said child was asleep in my arms. I co-slept and managed to do most things (apart from ironing) with one hand. It was a hard time and also very nice as well. I see the reward in that my children are well behaved and calm. I think this is from having carried them with me so they didn't have stress. I'm not saying that this applies to you as it's just what has happened with me.

loveroflife Sat 25-May-13 20:59:26

thanks flanbase, there's a lot of truth in your post

dozily Sun 26-May-13 07:16:00

Just read your latest update. That sounds really hard :-(

Any idea how the weight gain is going now? Just trying to figure out if this clingyness etc is feeding related or not.

chocolatemartini Sun 26-May-13 09:33:44

Wow this turned into a bunfight. Please think people before putting real experts like tiktok in a position where they are having to defend themselves. Mumsnet is lucky to have such people giving up their time to help.

loveroflife Sun 26-May-13 10:31:17

he is due to be weighed on tues so will see how he has done then..he feels and looks a lot bigger which is wonderful.

last night dh gave him 3oz of formula at 11 and he slept till 5. He was pretty awake after the bottle and we tried to settle him in his cot but he wasn't having any of it so i popped him in bed next to me he had two sucks on the boob and fell into a deep sleep.

my boobs were very sore at 5am though and a real relief for him to drain them. he hasn't done a poo yet and does seem pretty groggy which might because of the formula? i just wondered how my supply will be affected? sorry for all the questions...

tiktok Sun 26-May-13 12:46:35

Hope the weigh in is reassuring, OP smile

Your baby went a long time without a breastfeed (apart from the two sucks which helped him settle, hurrah smile ) - he had a bf at 5 am and that was 6 hours or more after the last bf (not clear when the bf before that was - if the formula at 11 pm was as well as a bf, then that's 7 hours, guessing that he had a bf before the formula).

A seven-hour gap between breastfeeds with a baby aged 3 weeks is just too long, sorry - as a one-off occasional emergency measure, it's not going to have a long-term effect, so no need for concern in that situation. But as a routine, it is simply not going to help build up and maintain a good milk supply.

It even seems that the formula was no great help in settling your baby - he still needed to have those two suck to get him settled. Were you asleep when he had the formula? Or were you awake, waiting to see what effect the formula had? What was the benefit of the formula at that time? It probably did keep him asleep for longer last night, but that's not a benefit to the breastfeeding sad Please don't think this is criticising - it's not. You certainly felt you needed that break. But you need to have the information that it does not help with your goal to bf sad

loveroflife Sun 26-May-13 13:14:24

Hi tiktok,

Thank you for your response and please don't worry at all about criticism - I know you're not at all and this is exactly why I post and am VERY GRATEFUL for the replies and help from those kind posters who are informed and passionate about bf.

He had a breastfeed at 10pm and was sleepy on the breast so we waited an hour and DH gave him the 3oz of formula at 11pm. He wolfed the first 2oz down and took about half an hour to finish the remaining 1oz. He won't settle in his cot anyway, so knew that probably wouldn't happen so he came in with me (I was in bed watching DH feed him)after DH attempted to rock him to sleep and had the two sucks (but didn't seem to take any milk) and fell fast asleep. We then waited a while and gently put him in his cot.

At 5am he woke, was sleepy and groggy, he didn't cry just stirred so I put him next to me and fed him lying down. He didn't take too much actually (about 20mins on left breast) as he normally feeds for an hour just on one and fell asleep. 8.30 he awoke and had a big feed off both lasting until 10. I then fed him at 11am and am just going to wake him now (we went out and he fell asleep in the carseat) to feed again as my breasts get very sore and full after 2 hours. Does this sound OK and most importantly is he getting enough?

He is, without a doubt, less 'alert' today - could this be from the formula? I have to be honest and did feel guilty about giving him the formula but I (selfishly) feel wonderful today after that sleep.

Normally he feeds for an hour every 2 hours in the night so I am just dead in the morning. I'm not planning on giving him any formula again tonight as that will be a long time with no night feeds but I am considering expressing regularly so DH can give him a bottle of EBM at 11pm (I would have to pump then to relieve some pressure.)

When you feed lying down I have read that the babies latch on themselves whilst mum is sleeping. How does this work as I always need to position him and think he would not be able to latch on alone.

Also, I presume many wake up and swap baby to the other side surely one breast would be drained in the morning and the other very full and engorged - is my presumption correct? I think co sleeping is the way forward as he is very happy next to me (as I am) and it is proving too much of a distressing battle to attempt to settle him in his cot.

tiktok Sun 26-May-13 13:56:08

loveoflife, have you thought about calling a bf helpline?

You need to discuss all this, I think, with someone who knows about how bf works and who you can bounce ideas off.

I think you have got yourself into a complicated pickle, to be honest - you are juggling expressing, with formula, with direct breastfeeding and every time you feed you are asking yourself 'did I do that right/for long enough?' or 'is he going to settle?' or 'how much sleep will I get?' and 'will I wake uncomfortable?'....and it's all exhausting, and he's still not even four weeks old.

What do you think?

loveroflife Sun 26-May-13 14:13:46

Well, yes, I do have lots of questions as it is a new experience and one that is harder than I anticipated..

I think because there can be so much conflicting ideas and theories from different sources it makes a little more tricky - what works for one baby might not work for another...I just want to ensure ds is as happy and contented as possible.

I hopefully will feel more confident at the end of next week when I have him weighed again and checked for tongue tie.

flanbase Sun 26-May-13 14:32:00

I had no idea just how time intensive bf would be when I had my first. I went with it and it worked out. My experience was different to others who had babies that slept a lot and those formula feeding. I tried to explain how it was a 24hr job with no letup. I made things easy by adapting to suit my child as she liked to be carried and I used a sling instead of a pushchair most of the time. Just went with it. There's pressure to be like other formula fed routines and I had terrible bf advice which I ignored. I hope your little one doesn't have tongue tie. For the slow weight gain it has to be medically investigated. If all ok then it could just be a case of letting him bf as he wants for as long and then seeing on his weight gain.

plummyjam Sun 26-May-13 14:34:26

I'm a fan of feeding lying down. I lie on my side with arm stretched out, baby goes on breast. Having arm outstretched stops me rolling forward (have never slept on my front but I think it's a good precaution). I sleep with light blanket not duvet which only goes to my waist and tuck it between my knees so it doesn't ride up. Baby sleeps in a grobag. We sleep in spare bedroom, husband is in other room so we both get some sleep.

I think older babies are able to latch themselves on. With my 14 week old DD I know she needs a feed when she starts rustling around, I just latch her on then nod off myself. Even though she wakes quite frequently and I sleep very lightly I feel more refreshed than if I have to get up during the night.

I know the recent study has shown that co-sleeping is not as safe as having the baby in a cot, but I'd be interested to see some research on how it compares in terms of quality of life for mums - whether there is a difference in daytime tiredness, rates of PND, effect on relationships etc.

Personally I think without feeding lying down and co-sleeping, I would have gone nuts by now!

plummyjam Sun 26-May-13 14:37:50

Oh and I move baby to other side of bed and lie on other side to alternate boobs during the night. It is possible to lean forward a bit to stay lying on same side but give other boob but I find it gives me a stiff back and not as easy to fall asleep that way.

Still easier than hauling my arse out of bed!

loveroflife Sun 26-May-13 14:41:14

thank you for the reassurance, it's really comforting to read - I am going to try to stop worrying about everything....he's just had 40mins on each breast and is now asleep on my chest snoring away which is lovely.

loveroflife Sun 26-May-13 14:45:43

Thanks plummy, I will try the new positioning out tonight . Also, the constant in and out of bed does nothing to help the healing of c sec scar so am keen to stay lying down for as long as possible!

FrustratedSycamoresRocks Sun 26-May-13 14:50:44

Hi lover I co-sleep and feed lying down, I'm lazy and can't be arsed to get fully up at night, well that and feeding at night sendse to sleep I've found that ds (11days) will whinge if he finds the offered breast empty, so I usually wake up enough then to offer him the other one. Sometimes I move so he's on the other side of me, or sometimes lean over him a bit.

If you are engorged in the morning, I would presume that you have a good supply, if you are wanting to keep the supply up when DH is feeding, then expressing would be good for you.

Do you burp DS?

loveroflife Sun 26-May-13 14:58:55

hi frustrated,

yes, I always give him a good rub but he doesn't really burp, always just falls straight asleep after his feed as long as he is on/lying next to me!

ghosteditor Sun 26-May-13 15:17:25

Hi OP.

Huge sympathy here from a parent of 16 mo DD, still breastfed. Some great advice above, and hope the lactation consultant can help.

Just adding my thoughts re tongue tie. DD has a grade IV lip tie which didn't cause me any pain or apparent BF problems. It was never diagnosed but after help from MNers, I spotted it and it has been confirmed by a specialist. I think perhaps my physiology helped her to feed successfully. However, she fed so frequently, often fell asleep feeding, and would only manage to feed from one breast before sleeping until she was about 7 months. She struggles to eat much food and has a lot of milk even now. I wish it had been picked up earlier. So, don't trust non-expert MWs on this and look for both tongue and lip tie - with the symptoms you describe it's entirely possible.

Only last week we had a thread on here where despite not managing to bf with two children, lip tie had never been spotted by both MW and GP. The skills for diagnosis are sadly being lost.

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