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Too much weight lost; might need to top up

(27 Posts)
bunnybunyip Mon 12-Sep-11 17:09:27

hi all
DD was born on Thursday and we are in hospital as she needs antibiotics for a group b strep septicaemia (but is amazingly well as started treatment within 2 hours of birth).
However she has had her day 5 weight check and has lost 12% of her newborn weight. My milk has only really arrived in the past 12-24hours. She is feeding and latching well, is having some damp rather than than sopping nappies, and only having poos every 36 hours or so, greeny colour today.
I have been advised to express before next feed from one breast and if I can't manage 34ml, which can then cup feed to her, then will need to top up with formula.
Feeling very worried as I was so hoping to avoid formula this time. Also just wanted to get on with establishing feeding with frequent feeds etc rather than now faffing about with timing, pumping, measuring etc. Fed up. Hormonal.

crikeybadger Mon 12-Sep-11 18:04:50

Poor you, all sounds a bit stressful. sad

I would suggest you give one of the bf helplines a call for some advice. I really can't see how they arrive at 34 ml either, but I'm no mw!

In the meantime, I would suggest the following-
-lots of skin to skin and feeding at the slightest squeak, even if she doesn't appear 'hungry'.
- switch nursing,- feeding on one side, then offering the other side when she seems to be losing interest. You can swap multiple times.
- breast compressions. If you google Dr Jack Newman, you'll see videos and an explananation of this.

Are you in hospital still?

thisisyesterday Mon 12-Sep-11 18:08:41

hmmm i would def get in touch with a local breastfeeding counsellor and see if they can visit?

meanwhile i would feed, feed, feed, feed, feed... as much as you can! formula is not any more calorific than breastmilk, so there is no reason why you shouldn't just feed more breastmilk rather than top up with formula if you don't want to.

you can refuse formula btw, if you want to? you can ask to give her a couple more days to see how she goes now your milk is in. they cannot force you to give formula if you really don't want to... i realise the main concern however is getting her well and out of hospital and if that means formula then that's fine... this is what it is there for!

thisisyesterday Mon 12-Sep-11 18:09:11

bunny, where are you? roughly?

crikeybadger Mon 12-Sep-11 18:11:33

Here's the link for the helplines on the rh side

and the clip about breast compression

bunnybunyip Mon 12-Sep-11 18:46:42

Thanks all
So far we have been doing lots of skin to skin, she feeds on and off for a 2 hour (4-5 hours at night) session with multiple side switches and then has a couple of hours rest before wanting to feed again. I have been frantically googling and looking at kellymom and came across the breast compressions which I have been trying today. Difficulty is articles all say if baby well, weeing and pooing etc then ok to persevere but we don't fit this picture so I am nervous about going against advice. Also aware that dd needs to be hydrated for kidneys to cope with antibiotics. 34 ml is based on her 24 hour requirements.
I just hope expressing (which I have to do at 7pm) goes ok so I don't have to worry. Scared there will be no milk. Worried dd will wake up and want feed before then. I will check out the helplines, thanks crikeybadger. I am in midlands thisisyesterday, sorry to be vague I am always paranoid someone will recognise me. You haven't recognised me have you?

bunnybunyip Mon 12-Sep-11 18:50:41

Which helpline do you think will be most helpful? As I am in hosp and dd not well will they not just tell me to check with staff here? Am feeling very fragile, don't think could cope with that. Oh no, dd is stirring. Can I feed one side and express the other? Will this help with amounts?

thisisyesterday Mon 12-Sep-11 18:56:53

haven't recognised you, but I know quite a few LLL leaders around the country so thought I might be able to point someone in your direction!

thisisyesterday Mon 12-Sep-11 18:59:47

there is a list here of LLL groups.. they're my bf group of choice, always willing to help... if you can call the one nearest you they may be able to come and visit, but if not they can at least advise over the phone

that isn't to say other BF organisations are not as good, but in my dealings with local braches LLL outshines all the others

bunnybunyip Mon 12-Sep-11 19:18:48

Oh bugger, not even 10 ml. I guess milk hasn't come in after all. I have been starving her. Am going to try again with dd feeding in case this encourages let down.
Looks like formula time though. sad

bunnybunyip Mon 12-Sep-11 19:20:39

I feel bad contacting someone else for help when I should be able to ask the midwives. Won't they be pissed off?

mercibucket Mon 12-Sep-11 19:28:29

if you are still in the hosp, you can ask for donated milk instead of formula, if you would rather she was given that
doesn't the hospital have a breastfeeding consultant on site who could pop in to visit? are you on the neonatal ward or the main children's ward. I'm really surprised they're not offering more help with the bf (specialist, not just random mw). Deffo just get someone in from outside, or advice on the phone, if you're not getting much help from the hospital itself
don't despair if you do have to give a few top ups for a few days - I had to do this with ds1, it's not ideal, but it didn't make any long term difference to his bf and I bf him for 8 months

squiggleywiggler Mon 12-Sep-11 19:34:37

Hi bunnybunyip

it's totally normal not to get much at all when you start expressing - it's no indication of your milk supply. Babies are good at removing milk, pumps not so much. I know a woman who breastfed 9 children (!) and never managed to pump a drop. Normally as your breasts get accustomed to the pump they produce more milk, but hand expressing can be much more effective at this early stage.

MWs shouldn't be annoyed - particularly as many of them have had as little as half a day's breastfeeding training. And my view is a bit 'so what if they are?'. This is an important time for you and your baby and not about them - getting help from all angles is sensible and I'm sure any sensible midwife will see that.

You could also ask the hospital's infant feeding coordinator to come and see you asap - she should be able to show you how to hand express if you need to and will have proper breastfeeding training.

You haven't been starving her if she is weeing and pooing but it sounds like you urgently need some help from someone who knows what they are talking about.

I'd urge you to call one of those friendly helplines and talk to someone asap before topping up with formula. That way even if you do need to you have an understanding of exactly why and a plan for how to maximise the breastfeeding if that's what you are keen to do.

Deep breath, keep snuggling your baby, skin to skin and draw the curtains around you. You can do this and there are loads of people keen to support you.

cloudofpink Mon 12-Sep-11 20:06:05

Hi, I just wanted to offer some support and light at the end of the tunnel. I has similar issues 14 weeks ago when my Dd2 was born. She also lost more than 10% of her birth weight and had not stated regaining by day 4 and I was advised to express so that I could top up after the midwife's next visit if she still wasn't gaining by day 6. I persevered and fed at least every 3 hours day and night and ended up not having to top up as she began steadily gaining. I think it just took longer for my milk to come in. I was lucky that my midwife team were very supportive. It took 2 weeks for her to regain her birth weight but she is now still ebf, thriving and tracking the 50th centile. Sounds like you are taking all the positive action that you can. Now that your milk is coming in I am sure she will start making up for lost time.

thisisyesterday Mon 12-Sep-11 20:11:22

oh bunny.

expressing is NO sign of supply! when i was in hospitl they said it was good that i'd managed 5ml!
it does NOT mean you have been starving her... a baby is far more efficient at milking the breast than a pump is, especially when you are feeling stressed.

please do not feel bad about ringing anyone.
you can ring them now if you like. I know that within the LLL leaders take it in turns to field night calls... at ANY hour.
it doesn't annoy them, they want to do it otherwise they wouldn't do it at all would they? people are out there and able to help you

unfortunately midwives don't get very much training on breaastfeeding. maybe a day?
they don't always know the best thing to do for encouraging breastfeeding, so unless you are very sure that you have knowledgeable midwives then I think it would be prudent to ring someone qualified

catslikefelix Mon 12-Sep-11 20:46:57

Hi Bunny
Congratulations and sorry you re having a rough time! If your milk has just come in in the past 12-24 hours then its not that surprising that her poo is still green..it should be yellow soon! Also try to remember that she has been poorly so your milk is absolutely the best thing for her as formula wont provide all the antibodies and healing properties that breast milk provides...it will just make her gain weight quicker(maybe) but will affect your supply! Be proud...she's probably doing so well cos she's had your colostrum for 5 days! Try to trust yourself but do get attachment checked if poss!
Good luck x

TitaniaP Mon 12-Sep-11 22:20:40

Bunny - just wanted to add my support. As others have said call one of the helplines and ask to see the infant feeding co-ordinator at the hospital. You say you're in the midlands? If you're anywhere near North Brum let me know and I'll give you the details of some local support.

With regards to expressing yes you can pump off one side and feed off the other - it's tricky to master but some people get more that way.
Hope you get the support you need soon and that your LO picks up.

bunnybunyip Tue 13-Sep-11 05:14:53

Hello all and thanks so much for your replies.
I have been a while as dd was admitted to neonatal as her blood tests showed she was dehydrated. So she has had to have some formula, but I was glad not to have to make the decision; she was too poorly not to. She has has 2 formula feeds via cup but I have continued expressing and trying to breastfeed her (although she has been a bit too drowsy) And managed to express enough for her to have ebm for her feed just now.
They hope they will only need to top up for 24 hours or so so I'm sure if I keep expressing, skin to skin, encouraging her to feed supply should be ok.
It has been a long night. I am sad she has had to have top ups but it is not the end of the world i suppose.
I will contact support lines in the morning. I think maybe it just takes a while for my milk to come in; with ds it took over a week (although he was prem) and he had to have formula but then bf took over and managed to keep going for 15 months so I know it is worth it in the long run.

crikeybadger Tue 13-Sep-11 09:26:46

Well done bunny, sounds like she really needed the formula top ups in this case.

It's good in a way that this has happened with your ds as you know that this is just a short term measure to get dd back on track. You're protecting your supply and keeping up the skin to skin which is brilliant.

Hang on in there, hope you can get some rest today. smile

btw- are you using an electric pump?- the hospital should be able to give you one.

squiggleywiggler Tue 13-Sep-11 11:25:15

As crikeybadger said - sounds like everyone made a good decision and you know from experience that a few top ups don't mean upsetting breastfeeding.

I hope the little one gets back on top form quickly and you get some sleep.

well done.

thehairybabysmum Tue 13-Sep-11 11:38:29

i had this situation with my eldest, was incredibly stressful and upsetting at the time. I did end up giving top up formula, however i still successfully established breastfeeding and carried on doing so for the next 3 months (gave up when i wanted to). With hindsight the little bit of formula he had in that firt week really wasnt worth all the tears and stress that i felt at the time.

I also gave up with he cup feeding after 1 week as it was just such a faff, again the teat didnt seem to affect bf. I did bf first at each feed though before giving the formual and also fed 2 hourly in the day. He was also v. sleepy so was waking him up, stripping him off etc...all v horrible!

You sound like you are coping well anyway....good luck and it will pass!

thisisyesterday Wed 14-Sep-11 17:49:14

hi bunny, hope things are going well and dd is a bit better now?

like I said before, formula milk is available for a reason, and situations like yours are exactly the right use for it. she needed it, she's had it, and hopefully you're back on track for breastfeeding now.

you have to do what you have to do, her health is the most important thing.

by the by, if you're worried re the virgin gut and the effects of formula on that then I think it's generally considered the case that when exclusive breastfeeding re-commences then it takes just a week or 2 for the gut flora to return to "normal". so a few tops ups when little isn't going to stop her being excusively fed or from gaining all the benefits of it smile

bunnybunyip Wed 14-Sep-11 21:42:06

Hello
Just to let you know dd is doing fantastically, back to full breastfeeding with no top ups or expressing, feeding every 2-3 hours on demand and is weeing, pooing and gaining weight. So we are back on track and hopefully home tomorrow, hurray! Thanks so much for all your support which made a stressful situation easier.

crikeybadger Wed 14-Sep-11 21:52:14

Ah, that's such fanastic news bunny, well done to both of you and hope you get back home tomorrow. smile

crikeybadger Wed 14-Sep-11 21:52:56

or fantastic even, oops.

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