Breast feeding problems getting me down - please help!

[Jules125]

Hi,

I had my baby on 17th dec by c section at 38+2 gest due to transverse lie [and previous fulminating pre-eclampsia and stillbirth in May 2009] she was 6lb 5oz, dropped to 5lb 13oz after about 5 days and has not been able to put on any weight for about a week now. We've had feeding problems since day 2 (when my milk came in). I've been terribly engorged and cracked / bleeding at times. I exclusively pumped for a day or two (my nipples were just too sore) then went back to breast; I guess partially successfully. I've had difficulty getting her latched on (although the midwives observed today and said I was doing it ok)and she tends to come off and start sucking her hands or something else after a few minutes, looking frustrated. It takes up to 2 hours per feed and I feel the milk is being produced too slowly or something (or there is not much of it) and she's not really getting it. I had post-partum haemorrhage, uterine infection, and my haemoglobin went down to 7 so I know I've taken quite a hit physically which might not be helping either. However, I am now recovering and feeling better, and my haemoglobin is rising again.

I've been trying to follow the midwives advice to pump off whats is left after breast feeding for 30 minutes and feed this to her by bottle, but have but found I can only pump about 5ml today (whilst last week I could pump up to 80ml); so it feels like production has just dried up for some reason. Or neither baby nor I can get at it any more. The midwives have now advised me to use formula to top up after each feed instead.

To be honest I am also getting very down and frustrated by all this, and so anxious about my daughter being a bit small and not gaining weight (my first daughter died due to pre-eclampsia only 19 months ago, so I have had a difficult time and am anxious anyway). Has anyone been through anything like this or have any other suggestions for me? At the very least I would like to keep pumping to maintain my supply, even if I have to use formula a bit for now, but how can I if nothing is coming out?

Thanks for reading this long and first post ...

Jules

[PrincessScrumpy]

Do what feels right for you. If you want to give her formula - for both of your sakes, go for it.

I BF easily (not boasting, just realise how lucky I was), but many friends weren't so lucky and MW and HV made them feel crap. My mum had to have formula when I was a baby - 2 months prem etc and I've survived without health issues.

I hated expressing and found it took ages for not very much. She's had the initial breast milk so don't stress about it and just enjoy her! You can always pop her on before bottle to try and she might get it.

Good luck xx

[HeroShrew]

I'm not an expert so just bumping until one comes along, but just wanted to say how marvellous you are for your determination to carry on with BF. Have you seen kellymom ? loads of great advice on there. Good luck :)

[EauRouge]

Hi Jules

Congrats on your new DD. Poor you though, you sound knackered :-( I would advise that you speak to a BF expert. Some MWs are great about BF advice, some aren't but most of them rarely have the time to help in detail because they are just so busy all the time.

Here are some contact details that might help. If you can't get along to a local group then there's almost always someone you can speak to on the phone and they might even do home visits.

La Leche League

NCT Breastfeeding Line - 0300 330 0771
8am?10pm, seven days a week.

Breastfeeding Network

Association of Breastfeeding Mothers

Those are the main ones I can think of, there are lots of other smaller, local ones.

[Haggisfish]

i topped up my daughter with a little bit of formula for the first five days, until I went home and could feed in peace! Have you asked for an ultrasound to mae sure there is no placenta left? I hope they would have done this after the PPH. Good luck with it - I kept setting myself really small goals of the next feed, today, etc etc and now I find myself at six months still feeding!

[Haggisfish]

Rather than pumping after a feed, why don't you just take to your bed with your baby and have lots of skin to skin and feeding on and off for hours, to establish supply? I did this for about a week - had me boobs out all the time.

[thaliablogs]

First, my sympathies for your loss. It must be a terribly difficult time,the joy of your new baby clashing with the acute sense of loss for your first daughter.


Both fortunately and unfortunately you're going to get a lot of slightly conflicting advice on here. The main things to hold on to

• only you and the health professionals involved have actually seen you and your daughter. So none of us can tell you for sure what the problem is and how to fix it
  

• your baby is small and has not gained weight for a week. She is therefore not getting enough to eat, and it's important to address this as soon as you can. She is not going to die because you are keeping a careful eye on this,but she needs to grow, and she's not able to do that right now
  

I would strongly suggest getting an IBCLC qualified lactation consultant to come and see you. They are usually very good, and will spend a couple of hours seeing what's going on. It may be several things. If your nipples were very sore, there is probably a latch issue. She may have tongue tie. If your boobs were very full, she may have found it hard to latch. If milk wasn't being effectively removed, your supply may have dropped (unlikely after such a short space of time, but possible given all else you've been through).

In the short term if you can't pump enough breastmilk to give her, I would keep pumping (to stimulate the boobs so they know they aren't making enough) but give her a formula top up to make sure she's getting the calories. A lot of ppl will say that's the beginning of the end, but (as someone with low supply) I don't see it that way if you continue to put her to the breast and to pump to stimulate at the end of each feed.

You can use an SNS to give the top up to avoid 'nipple confusion' - these are fiddly to start off with but mean that she gets all her nutrition at the breast which avoids some of the 'beginning of the end' scenarios.

If you do turn out to have low supply (not yet clear to me that you do) then there are other ways to raise it. The low key ways are various galactagogues like fennel tea, fenugreek (not the same thing) and various other herbs. Then the one that worked for me, domperidone which increases your prolactin - it's a drug often given to babies for reflux and is safe for both of you. You can buy it over the counter as motilium but it's hard to get enough that way. Your GP may prescribe it for you,if not you can buy it on line, let me know if this turns out to be something you need and I can give you the info.

Hang in there. You will find the right way to give your baby what she needs.

[Jules125]

Hi,

I've realised from pumping more that it can take ages (20-30 minutes of vigorous pumping) for me to get a let down, and wonder if its taking me that long and that much effort if it might be the same for DD and that is why she is taking up to 2 hours to feed and not gaining weight? Sometimes she does seem to get impatient and roll off.

Does this seem plausible and does anyone have any suggestions as to how to get the let down to happen faster?

Thanks again

[organiccarrotcake]

Stress can interfere in a big way with let down so if you can, trying to get as much lovely, cuddly time with your baby, skin to skin, putting her to the breast as often as you can but with no actual pressure to feed, this could all help.

click here to see a Kellymom article which will be useful. Not all of it is relevant to you but have a read through and see what you think.

Remember that HV have virtually no mandatory BFing training so you may need to find a qualified BFing counsellor near you. Your local NCT branch may well have one - that will be free.

[VeronicaCake]

This sounds really hard. I agree with the people above who've said you need to see a breastfeeding counsellor or lactation consultant. I saw an NCT breastfeeding counsellor when DD was tiny and it made a huge difference. Her advice on latch and positioning was much more practical than the advice I'd had from the MWs and she was also very sensitive to my anxiety and offered me lots of reassurance.

In the meantime try not to get sidetracked by how much you can express, it isn't a good indicator of supply. I've never been able to express much (never more than 25ml) and DD is a healthy 8 month old now (EBF to 6 months). Similarly the fact your daughter wants to feed for long periods doesn't mean you are doing anything wrong. Tiny babies like snuggling their mummies, it makes them feel safe.

You can maintain your supply by continuing to give your DD the opportunity to breastfeed as often as possible, even if you also offer formula top-ups.

And I really sympathise with the anxiety. I was horribly anxious when DD was slow to regain her birthweight and it spoilt what should have been such a lovely time. To some extent the anxiety may have been an inevitable component of the baby blues for me, but fixating on DD's weight definitely didn't help. It would be pointless saying 'don't worry' to you (!) but maybe try and give yourself and DD some time together snuggling and offering her the breast, or just letting her doze on you and enjoy being together, rather than trying to fix anything.

Oh and it is possible that even once weight gain is resumed and breastfeeding is well established that your daughter will continue to be on the titchy side. Some babies just are and this in itself is nothing to worry about.