12 day old + BF problems - advice please?

[mummyjah]

I am seeking some advice on why my 12 day old (4th DC) DS is having difficulty BF. He was born at 38 weeks, 7lbs. 15oz, easy labour, apgars 10 and 10. He lost 11% of his body weight in first five days as we did not establish BF while still in hospital - no idea why. He had jaundice although no treatment required. I feel that we have two problems: his latch is not good - sometimes he latches on beautifully; other times, he fusses, latches on badly so that we have to do it repeatedly. However, given that he can do it sometimes, I don't really know where I can go for help. The second problems is that I feel that I may not have enough milk for him - with my other DCs, I felt my milk come in, my breasts felt full and leaky, and I could express a large Avent bottle in about 10 mins.. This time, none of this is happening - I can express about 60 mls, per feed but it's a struggle and my milk does come to an end (it never ended with the other DCs). His jaundice has gone but he is still quite sleepy and will rarely rouse himself. I have to wake him to feed although he does stir sometimes on his own. He was not back to his birthweight at 10 days - he was 170 g. short. He is gaining but slowly. He looks thin and small (all my DCs were all thin but long (even the 8 and a half pound ones) at birth so not necessarily an indicator of anything). I am starting to get anxious as I can't see much improvement in his feeding patterns. Nappies seem to be fine although he's currently doing many small poos (but he does do at least two large ones) and it's mainly sludgy green (which may be a foremilk issue?). I would be grateful for any advice. These boards have kept my anxiety at manageable levels during the past few days - thank you to all.

[Solo]

No real advice here, but Congratulations to you :) and just to say that I had bucket loads of milk with my first and yes, I felt my milk whooosh in and was able to express gallons, but with my second, I didn't get the milk coming in feeling or loads of milk and I could not express more than a tiny drop so gave in on that.
I do wonder if expressing so early is the thing to do before getting actual bfing established though...

[Solo]

Btw, my youngest is now coming up for 4.8yo and still breastfeeds when she feels like it, so it's not necessarily that you don't have enough milk for your lo, I'm sure you probably do, but need to establish it first and it is very early days.

[mummyjah]

Thanks so much Solo. I've read several times here that milk does not necessarily gush with subsequent babies but I'm a bit thrown by the fact that it has gushed with three of them but not with this one. I actually agree with you that it's perhaps too early to express and I need to focus on establishing BF - we went back to hospital overnight when it became apparent that DS had jaundice and was not feeding properly. I think I got crap advice - same old story - top up with formula or expressed milk, etc..I was in panic mode at that stage so ready to do anything. I think everyone was expecting me to know what to do (I BF my other three for two years each and never had any problems) so was pretty much left alone to sort this out. Still feel that I am very much struggling but am heartened by your suggestion that it's still early days (and that I can break this negative cycle of topping up, expressing, low supply).

[Solo]

:) I'm sure everything will be fine, but it's natural to feel a bit panicky and inadequate even, when all we want to do is feed our baby and watch them gain weight steadily and happily...It will happen I'm sure, but do consider just concentrating your efforts directly and not through a pump just yet; there's plenty of time for that if you want to do it later and don't forget to look after yourself! plenty of food, drinks and rest when you can ~ which cannot be easy with 3 others! but none the less it's so important that you try to find the time.

[MaMattoo]

It is early days yet. My DS never latched on. My milk really appeared in 14 days..and oh boy did it appear! It was a little late for latching as DS was bottle fed formula and could not figure the breast. So I am pumped and ebf him for 6 months. Early anxiety disappeared as he piled on the weight to reach 97th centile in 3 months!
It is early days. I would say don't be fixed on things going only a certain way based in previous experience! Go with the flow (excuse unintended pun). Stress less, rest more and in my opinion drinking a lot of full fat milk and loads of water helps milk production..(I made 1.8lts a day with that idea).
And ofcourse...congrats!!! 3 is the best number :)

[MaMattoo]

Sorry meant 4 on crappy iPhone with fancy keyboardless typing! 3 not good..can play few games as kids ( I am no 2 out of 3 siblings and I know how to be referee in basketball, tennis and badminton :(( !)

[mummyjah]

Thanks everyone. It is reassuring to hear other people's experiences and that they've come through them intact. My other DCs are with my mum as they are quite a bit older - all I've done is concentrate on BF (spending days in bed, etc. as per boards - great advice!) and it's still not happening consistently! Tonight is a typical example - yesterday/late last night, he fed like a champ for about four hours (6-10/11pm and again at 1am) - I was so happy as he was latching on and really feeding properly. He has just roused himself for a feed(4am) and we have now been struggling for at least 40 mins. - he will not latch on properly at all. I've checked position, technique, hold, etc.. All ok and like last night. i have swaddled, unswaddled, skin-to-skin, tickled, etc.. He just won't create a vacuum or open his mouth wide enough. He got stressed and anxious so I've just topped him up with expressed breast milk (with a heavy heart but didn't know what else to do). Does anyone know why he would latch on some of the times but not others? I am totally at a loss to work this one out. Has he got a tongue-tie? (never heard of it before but have been reading the boards), is he not hungry? Has anyone else had this happen with them and if so, what did you do? Thanks again for the support. It's been invaluable (had similar issues after jaundice with first Dc but did not know about this website then - struggled for four months to establish BF - ended up feeding for 2 years and 3 months but the early months were traumatic - not sure that I can go through that again so am desperate to nip problems in the bud now. Had no issues at all with the other two DCs - both latched on immediately).

[idlevice]

The best thing to do would be to show a feed to a trained bf counsellor if you can get to one or get one to come to you, or at least talk it through with one. Try La Leche League/Association of Breastfeeding Mothers or a lactation consultant through your nearest maternity dept. Local midwives, doulas or bf support group may know of someone near you.Websites that are good for bf advice are kellymom and Jack Newman (the latter has helpful vids).

[Irishfairy]

Has he been checked for tongue tie? My Dd had it and if caused latch problems although she could sometimes latch on properly.

[Solo]

I wonder if he's just tired...

Your HV should be able to check for tongue tie.

Hope you have a better day today :)

[crikeybadger]

Sorry you're having problems mummyjah

It sounds like you're doing everything right- skin to skin is perfect as you can respond to the feeding cues as soon as you see them. Maybe have a look at biological nurturing too as this may help.

I definitely second the advice to get someone in real life to watch you feed - someone that really knows about breastfeeding such as an infant feeding specialist from your hospital or a breastfeeding counsellor.

Good idea to get them to check for tongue tie too but again it would have to be someone who knows what they are looking for.

The main thing is that you are protecting your milk supply by expressing and getting this milk in to him to get his weight going. No need to feel sad about this, it can just be a short term measure until things calm down.

Oh and finally, don't feel you have to drink loads of full fat milk or water to keep your milk supply up. Just drink to thirst - there is no research to suggest that drinking, eating, resting more will give you more milk. Of course you need to do all those things for your own general well being and to recover from the birth, but not for more milk.

Hope things go well for you today.

[crikeybadger]

How are things now mummyjah?

[mummyjah]

Hi Crikeybadger,

Thanks for asking! Things are moving in the right direction, although we are not up to full speed yet. The BF counsellor came yesterday (she was great) and our latch is better. DS is actually feeding from me now (not for long periods but that's probably related to the jaundice, which has all but gone, thank goodness). I would like to thank everyone who posted in response to my rather frantic post. Without MN, I wouldn't have known that I could ask a BF counsellor to come to my home, to have skin-to-skin 'feed fests' in bed, to try different feeding positions and, the simplest, to feed, feed, feed! The moral support has been fantastic also. I'm still bemused that as a fourth timer, I missed the fact that we hadn't established BF in hospital (and so did everyone else - and I went private!) and my baby lost 11% of his body weight. The BF counsellor mentioned that she had just been to see a woman on her 6th child, who was having problems so I guess you can never assume that it'll come easily. Having spent a lot of time these past few days glued to the boards, it's striking that there seems to be a predictable pattern to a lot of BF problems - BF not established early on, baby develops jaundice, lacks even more feeds, mum panics (who wouldn't?), HCPs state the need for more fluids (correctly, of course), suggest formula top-ups, this leads to less suckling and less milk production, etc.. Given how common this cycle is, I imagine that it would actually be quite easy to intervene...Thanks again everyone.

[Solo]

Glad things are better :)

[crikeybadger]

Great to hear that things are improving for you mummyjah.

Personally, I think it is harder the more children you have because although you may know a bit more about what you are doing, you still have so much other stuff to do that you can't give so much of your attention to the new one.

I was chatting to an infant feeding specialist the other day who said that they are seeing a lot of new babies readmitted with dehydration. New mothers are kicked out so early from hospital that they don't get time to really crack the breastfeeding. (and in general the post natal wards are not the greatest place to be that many want to rush home anyway.)