this is what ds is feedibg - experts, is it enough,

(50 Posts)
MostlyCake Sun 04-Aug-13 06:56:02

Hi. DS is 2.5 weeks old snd this would be a typical feedibg session, I'm not sure if he's getting enough to eat, does it dound like he is?

Boob 1: feeds for around 12-16mins, has trouble staying awake without constant poking and proding from me.
Falls asleep for 10 or so mins. Woken by a nappy change.
Second feed of around 10 nuns or less. Again, struggles to stay awake.
Possible third try but rarely longer than a minute ir so.

He will do maybe 5 dirty nappies and 5 or so wet nappies over a day and night. Some days there are a lot more but never less. Most poops are yellow but there's sn occasional green one.

I offer the second boob and occasionally he will take it and go a similar pattern but more often than not he just goes to sleep.

I'm worried he's not getting enough - have posted previously about not being able to express (just don't get anything) and am getting pressure to top him up with formula. If supply is the issue then replacing a feed with formula is only going to make things worse.

Generally the latch is fine but the last few feeds have been painful and I'm constantly taking him off and relatching. It seens to me that he's not opening his mouth wide enough.
I can't get a bf support person to come to my house as I'm not in the town... next group is Wednesday but im going to struggle to get to it - dp back at work and only one car...

My firdt question is, does this sound as though he's getting enough to eat? Snd secondly how do I improve the latch - id there a way to get him to open his mouth more?

Thanks for all advice.

MostlyCake Sun 04-Aug-13 06:57:03

Sorry about typos! One handed on phone...

SoupDragon Sun 04-Aug-13 07:01:03

He will do maybe 5 dirty nappies and 5 or so wet nappies over a day and night.

He's fine. IMO - I'm not an expert but plenty of wet/dirty nappies is a good sign. The poo is green because sometimes it just is.

Is he gaining weight? Why do you think he's not getting enough?

None of my three ever opened their mouths wide in that "baby bird" way they're meant to.

jennimoo Sun 04-Aug-13 07:02:19

Is he back to birth weight / gaining? Is your only worry how long he's feeding for (in terms of getting enough)?

I think DD was a little lazy latching at that stage (i remember worrying about it) and if he's gaining weight and the discomforts fixed by relatching I reckon you're doing great.

But I don't claim to be an expert!

Agree with Soup.

Ds never opened his mouth and I had to use my finger then quickly shove him on. He also never fed for more than ten minutes, usually only five apparently he had an efficient suck smile

It sounds like you're both doing well and you're doing the right thing by re latching when it's painful. Hopefully you can get to the group and get some professional advice

WeAll Sun 04-Aug-13 07:38:27

Lots of wet dirty nappies indicates that things are probably Ok. Mine never did that wide open mouth thing either, if it hurt at all I stopped and restarted.

tiktok Sun 04-Aug-13 09:10:49

MostlyCake - why do you think he's not getting enough?

Time at the breast is irrelevant, really - you certainly can't judge by the no. of minutes at the breast.

By this age, weight is a helpful part of any assessment - what have his weights been?

MostlyCake Sun 04-Aug-13 21:15:51

He's not back at birth weight yet, 100g off at the last weigh in.

I don't know if he's a v efficient feeder so 10mins is sufficient to get the hind milk.

Just worrying in general really.....

Meringue33 Sun 04-Aug-13 21:21:36

What's 100g in % terms of his birth weight?

Who is pressuring you to top up?

My LO took 3 weeks to regain his birthweight. I know it is a stressful time.

I also know an ebf baby who took 10 weeks! Bad reflux, but she got there in the end.

MostlyCake Sun 04-Aug-13 21:30:08

That last post didn't make much sense! He feeds for 10mins at a time so I worry he is snacking rather than getting a decent feed and reached the hind milk.

He could be a v efficient feeder who gets tge hind milk quickly but how would you know that?

My concern is that he snacks rather than gets the good stuff - is there a way to get him to stay on for longer or is this just the way he will always feed?

MostlyCake Sun 04-Aug-13 21:35:30

He lost 13% in total. Hes about 3% off birth weight. MW suggested topping him up with formula which we did for two nights s (two bottles of around 50mls). My mumis wworried and is subtlety pushing formula - she fed my brother and I on exclusively in formula fir various reasons and likes that the volume he eats can be measured.

maja00 Sun 04-Aug-13 21:36:00

So long as he is feeding frequently it doesn't matter - frequent, short feeders will get the hindmilk as much as infrequent, long feeders.

If he's done it 10 minutes, then there's no point trying to get him to stay on to get the good stuff - he knows better than you if he's finished with that side!

Could you offer feeds more often if you are worried? At least every two hours, and some in the night too?

maja00 Sun 04-Aug-13 21:37:51

3% off birthweight at 2.5 weeks doesn't sound like a concern, especially as he lost more than expected at the start. Presumably whatever issues caused the initial weight loss have been rectified and he is gaining weight now?

Someone once described the fore milk/hind milk thing to me in terms of a McDonald's milkshake. If you stuck gently you get the watery thin milky stuff if you give a really good strong slurpyou get the fatty thick creamy stuff. And with babies and boobs.

He's pooing. He's peeing. Is he alert and happy when he's awake? Does he seem content and not gnaw his hands overly much? If yes then he's probably getting what he needs. Please try and relax. If he was hungry he'd make it very very clear to you x

jennimoo Sun 04-Aug-13 21:49:29

I worried about my DD 'snacking' as everyone seemed to act like feeding every 2h was wrong, but it was what she needed. If I overfed she'd just not settle well and bring it back up anyway.

It sounds to me like you're doing great and shouldnt worry, although having been there I know how hard it is to believe that!

MostlyCake Sun 04-Aug-13 22:53:58

Thanks very much for the advice and reassurance everyone I feel much better about everything.

tiktok Sun 04-Aug-13 23:26:31

Cake, it sounds as if he is on his way out of the difficulty, whatever it was...he prob needs to feed very frequently and it's this that is the key, rather than the no. minutes each time.

"Snacking' ie short, frequent feeds is normal for young babies.

JiltedJohnsJulie Sun 04-Aug-13 23:38:55

Totally agree with tiktok my dd would only ever feed for 10 minutes but for her tht was normal. She liked short feeds and often.

MostlyCake Mon 05-Aug-13 00:09:56

It was a poor latch in the early stages which meant my milk was slow to come in. We didn't realise so continued to feed in the same way leading to him losing so much weight.

He seems to be putting the weight on now though, will be weighed again tmro I think so we can be sure

Tiktok you're nt wrong when you say frequent feeds! Make that round the clock feeds and you're nearer the mark! Exhausting though....

MostlyCake Tue 06-Aug-13 01:25:02

Had a HV today. He still isn't putting on weight - 10g increase since Friday which isn't good enough.

New advice is to feed every 2 hourly to cut down on the snacking and to encourage a proper feed with a nightly top up of 60ml or so. Is going to be hard to get ds into the new routine but am very hopeful that it will work and he'll soon be a plump little thing.

jennimoo Tue 06-Aug-13 04:43:06

How often was he feeding? Are you going to have to make him go longer between feeds to do 2h?

JiltedJohnsJulie Tue 06-Aug-13 21:48:58

Poor you, it sounds like you are having a really rough start. Has he been checked for tongue tie? It could explain the slow weight gain. If its 10g, was he weighed on the same scales by the same person? Were the scales calibrated and are you confident in the person who weighed him?

There is some info here on increasing weight gain.

If Lo wants to feed before the 2 hours is up, did the HV suggest you let him cry? Feeding every 2 hours is good but if a baby wants to feed, they should be allowed to, especially if they have slow weight gain.

What did she suggest you top up with? Ideally the best way to increase weight gain is to feed more often. If you do top up the first choice should really be ebm. Have you tried expressing? Can appreciate this might be difficult though. If you do top up has she discussed alternatives to bottles?

Are you getting any other help than that you are receiving from your HV? Is there a Bfing Support Group near to you? Ideally they should be able to observe a complete feed and check for tongue tie and adjust your latch, if needed.

Have you tried one of the Bfing Helplines too?. I think the NCT one is open until 10pm.

Oh and have a look on youtube at the Dr Jack Newman videos. They are good for seeing what a good latch looks like and how to do breast compressions smile

MostlyCake Wed 07-Aug-13 02:56:18

I asked them to check in hospital before we were discharged for tt and they said he was fine.

He does want to feed before the 2 hour window but we're trying to hold out as he feeds do much better if we wait - he ststs awake for longer and sucks harder. If he is really upset tho I do feed - was about 1.5hrs between feeds today for example. I pick him up and carry him about to try and take his mind off feeding, we don't just leave him crying until the 2hrs are up.

I've spoken to the local bf support group but they won't come out to see me and I just can't get to them at the moment. HV thinks latch is fine and it generally feels ok, I think I can tell if he isn't latched on properly now snd unlatch him. It is worse at night when we're both tired.

We've had do much conflicting advice - have hsd 4 different midwifes in the 10 days after birth plus about 10 different ones while we were in hospital all with slightly different advice and opinions so we're keen to stick with the hv advice and not see anyone else or change tack unless it isn't working!

I've tried expressing and just don't get anything worth keeping - a teaspoon full after 10 mins only. It was just getting too much to express as well as the original on demand feeding so was told to stop as it wasn't doing much. Because of this we're giving around 60-100mls formula at night after a bf session rather than replacing one to keep my milk coming.

He is so keen to feed but struggles to stay awake - it's a vicious circle whereby he falls asleep on the boob so doesn't eat enough so doesn't have the energy to stay awake at the next feed so doesn't eat enough....


BusyCee Wed 07-Aug-13 03:19:04

Hi Mostly. Don't forget also that babies may want different amounts at different times of day, so may want to snack more in the afternoons but have good hearty feeds at night (when your producing most prolactin and therefore your milk is at its most tasty and delicious!). And he's still very little and getting used to feeding - his needs and routines will be changing quite quickly still at this age.

If its any consolation my DS2 is 3 wks, and although he's #2 I'm still watchful of how his milk needs are changing. Just this weekend we had a 12hr period of regular snacking, then about 12hrs when he only fed twice and now he's back to about 4hrs between feeds. As others have said, regular nappies, general contentment are good signs whole he works out for himself what he needs/wants. Try to relax and trust both your and your baby's judgement.

BusyCee Wed 07-Aug-13 03:21:31

Ooh, also, applying a little pressure in a circular motion, to the palms or soles of feet can help keep them awake during feeds. Also feeding them undressed except for nappy (him, not you...). Good luck!

jennimoo Wed 07-Aug-13 07:11:25

I was told that I need to 'stretch' the gap between feeds as DD was snacking, although not the weight issues, and I wish I'd ignored the 'advice' as for DD it just meant both of us upset as she was having to wait when actually her little tummy just needed frequent feeds. I still resent what I believe to be totally made up 'advice' from the HV.

I hope it works for you but if you don't feel right about it just do what you feel is right.

LadyDowagerHatt Wed 07-Aug-13 07:20:41

Hi there, we have been in a similar situation with the vicious circle of DD wanting to feed but falling asleep and so not taking enough. What worked for me was carrying her in a sling - she would have a good sleep in there on me and then feed well when she woke up. I think previously she wouldn't sleep much in her Moses basket or anywhere else and I was mistaking her crying and being unsettled for hunger cues. Also because she wasn't sleeping well she was more likely to fall asleep when feeding.

JiltedJohnsJulie Wed 07-Aug-13 08:40:28

I know that it is difficult to get out and its clear that you obviously trust your HV but I really would try to make the effort to get to your Bfing Support Group. Your HV is unlikely to have received much training in bfing and her advice regarding top up quantities and spacing feeds isn't very bfing friendly. Its fine not to seek out additional support but please be aware that bfing may not last as long as you might have hoped.

Also tongur tie is very easily missed. It really is a good idea to get this checked by a BFC. Is there a lll group near to you? The leader may be able to help smile

JiltedJohnsJulie Wed 07-Aug-13 08:41:07

Oh and carrying in a sling is a very good idea ^^.

midori1999 Wed 07-Aug-13 08:51:40

Sorry to hear you're having these problems OP.

I agree that seeing someone who is a specialist in breastfeeding may be helpful to you. Either at a breastfeeding clinic (NHS run) or the hospital's infant feeding advisor or maybe just speaking to someone at one of the BF helplines if you feel you can't easily get out?

I was repeatedly told by health professionals that my latch with DD was good and luckily she did gain weight well, but the latch was dreadful and I only really realised that once she was about 5-6 weeks old and it improved and I could finally stop taking painkillers. I'd had mastitis twice by then too. sad

JiltedJohnsJulie Wed 07-Aug-13 14:15:05

How are you getting on now mostly? Its almost 24 hours since your last post...

Keep posting and let us know how you are doing smile

MostlyCake Thu 08-Aug-13 12:01:14

It's been a difficult few days! Still persevering with the 2hourly feeds but its quite draining as a feed plus nappy changes and burping takes up to 1.5hrs. Add in a half hour of fractious crying before finally dropping off he is asleep for an hour before its time to get up again.

HV was here yesterday and he's put on 4grams only. Because of this We've been advised to add another bottle so thats us up to 2 now :-/

I feel the bottle is contributing to his poor latch and now I have really sore nipples. He still falls asleep at the breast and is really difficult to wake him.

He seems hungry and gulps down the formula. Am feeding him first to try to keep my supply up and so far haven't noticed a difference - however this also means that my supply hasn't increased either.

HV was here yday and hes

MostlyCake Thu 08-Aug-13 12:13:26

Oops! HV coming back on Tuesday for another weigh in.

nextphase Thu 08-Aug-13 12:28:18

Can you read kellymom for advice on bf? In my experince, most HV know nothing about bf, and sometimes just give plain wrong advice.

I'd listen to TiktoK further up, but try and find an expert, rather than listen to all us lot. Not sure who the new experts are, she's just a name I recogonise.

That said, he's my point of view - making him wait 2 hrs is obviously not great for either of you. What happens if you split the difference between what he want (90 mins) and the HV (120 mins), at 1h45? fwiw, I'd feed on demand. With DS1 we loosly followed EASY (eat, activity, sleep, you), except we were EAES, and the mummy used the "you" time as extra sleeping. So he was feeding about once an hour.

Please, don't get him weighed so often. The difference between just being fed, due a feed, just filled a nappy, about to fill a nappy can make the differences your talking about. Think the recomendation is every 2 weeks.

I'd go by looks. He's weeing and poohing. Alert for periods through the day (and possibly night?), generally happy except when he;s asking for milk and you wont give it to him? Sounds like a happy baby to me.

Don't expect to be able to pump sensible amounts- baby is much more efficient than a machine.

One more thing to think about - how often do you eat / drink? Breakfast, early morning coffee, snack, drink, lunch, drink, drink, supper, snack? That more than every 2 hrs (but then you'd liek to sleep through). Is he feeding much more often than you eat or drink something?? eapecially in this heat.

Congrats on your baby.

JiltedJohnsJulie Thu 08-Aug-13 13:18:54

If your nipples are sore, what has the HV said about them? It sounds like you really do need some additional support to what your HV is giving you.

Is there a reason you can't get to the bfing group? I know you must be utterly exhausted but it should be worthwhile.

Did you manage to read the Keelymom info on increasing weight gain? That suggests working with a Lactation Consultant but a BFC should be able to help you too smile

Did you manage to contact the la Leche league as well. Hopefully they may know a BFC who would come out to you or be able to help you on the phone.

Hate to tell you this too but feeding every 2 hours is from the start of one feed to the start of the next. So if baby feeds at 7am you should start the nect feed at 9am.

Has the HV suggested trying breast compressions? This might help to speed things up a little.

Agree tiktok is a BFC so worth listening to. Feel though that with your sore nipples, poor weight gain and the rather unusual advice you seem to be receiving from your HV you need some RL support and quick.

LadyDowagerHatt Thu 08-Aug-13 14:18:22

Agree with pp, you really need to get some RL help as what you are doing at the moment clearly isn't working in terms of the desired weight gain. And if more formula is being added you are in danger of not being able to get back to EBF (assuming that is what you want).

I had my latch checked by 2 midwives (1 at the hospital and my own community midwive) but DD was slow to gain weight. I went to a bf session and the advisor said the latch was poor and helped me correct it. The weight gain is now speeding up now and thanks to a HV who didn't panic we weren't advised to give formula even though it took nearly 5 weeks to get back to birthweight. However if I hadn't gone to the group it would have been very different as I was sure my latch must be ok and would have carried on as I had been with a poor latch and slow weight gain.

RedKites Thu 08-Aug-13 15:42:59

Another one saying try one of the phonelines if you aren't able to get out to a group. If you don't have them the phone numbers are in bold at the end of this page .

Also, when people talk about x hourly feeds, I think they normally mean from the beginning of one feed to the beginning of the next. So if it's 1.5 hours of feeding, then half an hour of settling, then an hour of sleep before feeding again, many people would say that is feeding every three hours rather than every two.

LadyDowagerHatt Thu 08-Aug-13 16:06:01

Agree with pp, you really need to get some RL help as what you are doing at the moment clearly isn't working in terms of the desired weight gain. And if more formula is being added you are in danger of not being able to get back to EBF (assuming that is what you want).

I had my latch checked by 2 midwives (1 at the hospital and my own community midwive) but DD was slow to gain weight. I went to a bf session and the advisor said the latch was poor and helped me correct it. The weight gain is now speeding up now and thanks to a HV who didn't panic we weren't advised to give formula even though it took nearly 5 weeks to get back to birthweight. However if I hadn't gone to the group it would have been very different as I was sure my latch must be ok and would have carried on as I had been with a poor latch and slow weight gain.

LadyDowagerHatt Thu 08-Aug-13 16:07:15

Oops, thought I had forgotten to post my first message, clearly not!

JiltedJohnsJulie Thu 08-Aug-13 18:55:36

lady anyone would think you you had a baby and were sleep deprived smile

JiltedJohnsJulie Fri 09-Aug-13 15:59:42

mostly how are you both today?

MostlyCake Sat 10-Aug-13 09:58:22

Managed to get to the bf support group yesterday and DS latched and fed perfectly! 20 mins each side with a little snooze in between then out like a light for 2 hours!

The hv person couldn't see anything wrong - quite an atypical feed but I at least was able to see that we could do it and to recognise what a good latch felt like etc.

We've decided to move back towards more on demand as he seems to be ok with 2 hourly feeds during the day and night but more often in the evening which we were trying to not feed as it was outside the 'schedule'...

Im happy giving him formula top up 2x per day as he is so small.

Think we've cracked it!

JiltedJohnsJulie Sat 10-Aug-13 10:34:11

So glad you feel in a better place. Just out of interest, was it a HV or a BFC? Did she check for tongue tie? We're they able to discuss the slow weight gain with you?

Is the bfing group one that you could go to each week?

I'd go with feeding on demand too. All the current information says to do this and it seems a little odd that you were advised not to.

Wanting to feed more in the evenings is just what babies do. Bathe best thing you can do is to let DH bring you drinks and snacks, watch TV, chat to DH and feed, feed and feed some more. Have a look at this smile

If you feel like you want to reduce the top ups when he's a little older, there's no reason why you can't work with a BFC to do this. There's some good information on it here.

MostlyCake Sat 10-Aug-13 11:01:55

I think she was both? There were a couple of student midwives there too, one of which observed the feeding as well.

I didn't discuss the slow weight gain-want to keep consistency with our own hv and forgot all about the tongue tie! I really don't think this is an issue tho as he is feeding ok.

Keeping more to a schedule has massively increased the time he spends actively feeding before he would snack by going on for a few mins then dozing off wakung up and coming back for more.

This was really draining as I'd have to sit with him in my arms fir hours st a time or if I did get him down he'd wake after half an hour si neither of us were getting any sleep and ny boobs couldn't catch up as they just weren't getting a break. Then if he did suddenly sleep for a linf stretch I'd pass out too do he would then end up going for hours without feeding. So I do think the advice was sound as it is helping break this habit.

MostlyCake Sat 10-Aug-13 11:13:04

Punctuation is over-rated I think..... hope the above post makes sense! You might have to read it over a few times....

JiltedJohnsJulie Sat 10-Aug-13 20:36:23

Think I'll bow out of this thread now but OP please reread tiktok's comments. She is way more qualified to advise you than 99.99 percent of HVs.

Congratulations on your new Lo and I hope things work out the way you want thanks

NothingsLeft Sun 11-Aug-13 19:35:23

I do think people forget that boobs are both food and drinks. Sometimes, especially in this heat, they just want a little drink and a snuggle. Sometimes they just want a bit of comfort. The boobs are a million things rolled into one.

Sunflower1985 Sun 11-Aug-13 20:24:53

Thanks for this , having similar problems with my 1 week old. Going to support group tomorrow for some hopefully sound advice. So tired

NothingsLeft Sun 11-Aug-13 21:22:48

It's exhausting in the beginning sunflower hang in there and utilise all the support you can smile

JiltedJohnsJulie Mon 12-Aug-13 13:31:33

Sunflower how did you get on at the group? What problems are you having? Is it sore boobs and slow weight gain like mostly?

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