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Quick change to expressing due to complications, struggling to get enough milk. Advice really appreciated

(21 Posts)
hufflepuffle Sun 18-Nov-12 21:30:45

Hello ladies. I hav 4.5 wk old v hungry boy, over 11lb weight already. Had v bad delivery resulting in lots blood loss and subsequent transfusions and recovery slow but hav managed to exclusively BF til now. Had thrush last week, cleared up but hav been unable to recover cracks on right side. Pain too intense and continuous, was exhausted. Quite run down and not feeling great! Went to GP on Friday who decided that my body has had enough, too many medications (3 antibiotics post birth plus anti fungal plus so many painkillers) and BF just taking till on me. Advice was to seriously consider stopping. I do not resent this as he has my welfare at heart but really prefer to keep trying. Agreed to express on sore side over wknd and glad to say feeling so much better and nipple looks lots better tho still cracked.

Sorry, bit long winded but wanted to give background.

As thrown quickly in to this am struggling to express enough for little man. He is only 4.5 wks but in bottle will take anything from 5-7 oz per feed! Current plan is to use 6 am ish feed to feed on left and express right, thus having an advance feed. Did this sat am and today am but as day goes on not always able to express over 5 oz and end up topping up from other boob. However he can feed every 1.5 hrs and this is starting to make good boob sore!!

I really want to keep BF but am concerned I cannot keep up with this boy! Considered plan for tmrw is to add in 2 formula feeds and still express on sore side to give us a stock of milk for fridge so we can make up lower volume when needed. Don't wish to incorporate formula permanently, just need a head start.

If I do this, will the physical act of expressing keep production up or can there be some detriment caused by psychological guilt???!

And is 7oz a shocking amount for a 4.5 wk old? He did have one bottle formula last night as I could not pump any more and even with it he had 7 oz. I am using Avent bottles with newborn teat which only has 1 hole thus I am assuming slowest flow they have.

Advice on the temporary addition of formula much appreciated if anyone can help

Thank you

SamSmalaidh Sun 18-Nov-12 21:34:58

Babies tend to take more from a bottle than they do from a breast just due to the way a bottle is designed - they can't control the flow. I would say 7oz is far too much for a baby that age, and overfeeding is a real risk.

Breastfed babies take on average 25oz of milk a day - if you divide that by the number of feeds a day you will get a typical feed. For example, if your baby feeds 8 times a day, try offering 3-4oz in each bottle.

Bear in mind that babies have a strong need to suck for comfort as well, so allowing comfort sucking on a bottle may result in overfeeding. After/between feeds give your baby a dummy to suck on.

hufflepuffle Sun 18-Nov-12 21:46:36

Thank you for quick response Samsal. He really screeches if we take bottle away and will not settle until gets it back. He will suck on a dummy if happy and settled (as we hav tried to get him used to it in last week) but he simply will not take it instead of more feed. How can I get him to take less of a feed??

SamSmalaidh Sun 18-Nov-12 21:54:27

How often are you feeding him? Maybe offer smaller feeds before he is really hungry. Try pacing the feed so there are lots of breaks, switch him from one side to the other, and have him quite upright so he isn't just gulping down a huge feed in a few minutes before realising he is full.

hufflepuffle Sun 18-Nov-12 22:05:44

Those tips all make sense. We hav only been doing this since Friday eve and at first he resisted so I hav had him in more of a lying down position to make it feel more like breast feeding for him. To be fair it had been more often 5 oz, actually only 2 7oz sessions when I check. He really does gulp it fast. I will try your advice on next few and see if I can slow him down. I am less concerned about when he takes the expressed milk as I know he digests well, it's the potential large ff that unsettling me, tho it will hopefully only be temporary. And I am struggling to get him bottle totally there before v hungry and screeching as the transition from asleep to that happens v quickly! Can only get better organised as days go on.

hufflepuffle Sun 18-Nov-12 22:11:36

Have just done a bit of googling and seems a general consensus that Avent is very fast flow. Trip to Boots tmrw perhaps. Also, he cannot hav a tiny 4oz stomach as he does not regurgitate so much as 1 drop! He was 9lb 3 at birth and gained rapidly. Has 6-7 feeds per day. Is the 5oz reasonable, sort of? Will aim to keep below that and resist any more

SamSmalaidh Sun 18-Nov-12 22:39:45

5oz is maybe a bit high if 6 feeds, but not outrageous - maybe offer 4oz though and see if he will take it slowly? If you think about a breastfeed, it probably takes 20 minutes or more for them to drink 4oz - it takes a while for the brain to register than the stomach is full, so if he is drinking quickly he could easily take an oz more than he needs before realising he is full (I do this quite often with a Sunday roast hmm).

I think the research that found babies take 25oz breastmilk a day on average saw a range of 19oz to 30oz in individual babies. Interestingly, the amount per day stays pretty stable between 1 month and 6 months, are the content of breastmilk changes through time - unlike formula which stays the same, so babies have to drink ever increasing amounts.

hufflepuffle Sun 18-Nov-12 22:44:31

Even on BF he is finished in 10-15 mins...!
Hav just donea slower feed of 3 oz being more upright and is now asleep!

Thanks so much, will let u kno how we get on over next few days, really appreciate your time

SamSmalaidh Sun 18-Nov-12 22:57:02

Good luck smile

stargirl1701 Sun 18-Nov-12 23:37:24

Maybe try the Medela Calma bottles. They are designed to mimic bf - there is no flow unless the baby sucks. The bottles are expensive though and a bugger to construct initially.

hufflepuffle Sun 18-Nov-12 23:48:07

Thanks Stargirl. Just had a look at them, they sure look different! I need to get a handle on this ASAP so as hungry boy does not get used to Avent teat by sounds of it and don't think those are available in Boots. Will go shopping tmrw morning and take it from there. Didn't expect to hav to make change so quickly, I normally research the life out of everything!!


stargirl1701 Sun 18-Nov-12 23:53:40

I got our Calma bottles in Boots. The instructions are a pictorial nightmare. It took myself, my DH and my Dad all working together to figure it out. grin

hufflepuffle Sun 18-Nov-12 23:59:00

Oh grand. I've never noticed them in mine but worth looking for! Thank you, hopefully we can work out the construction......!

Thanks again

Kickarsequeen Mon 19-Nov-12 00:09:14

Hufflepuffle, I know well the pain of cracked nipples and thrush, but I seriously recommend you get yourself to a really good breastfeeding advisor tomorrow.

The nipple damage could be positional and while you are clearly doing brilliantly to keep this going, a little help from the right person really could make all the difference.

They will also be able to advise you on increasing your supply. Sometimes changing the latch position just slightly can make a bit difference to your supply too!

Look online for the BFN near you, they helped me hugely!

hufflepuffle Mon 19-Nov-12 05:20:07

Thank you kickarsequeen. I had poor experience with a local group but it is on my Monday agenda to try to find some better help! I am in NI, def not as much available, but I will be trying. Thanks again x

hufflepuffle Mon 19-Nov-12 20:15:41

Just an update if any of you reading back. Had visit from a BF support lady today. So incredibly helpful I could cry. Turns out although my latch good, position of baby poor so he slipping and damaging nipple. Still need to give time to recover but hopefully normality will resume soon Nd urgency for high volume expressing gone. Such a relief. Lesson learned- ask for help Huffle!

stargirl1701 Mon 19-Nov-12 20:21:21

Glad to hear things are better. I was thinking about you today!

hufflepuffle Tue 20-Nov-12 08:49:58

Stargirl thank you so much for advising the medela calma bottle!! And I deconstructed it carefully to see how goes together!!! Weird!!

He initially refused to take- cant blame him!! V different!! But we used we syringe to put some milk in teat, got there eventually! 4oz tool him half an hour, after which he was exhausted and fell asleep!! Did not wake looking more!! So despite having about 15 bleeding Avent bottles, will be using these with expressed milk. Fantastic!! Thanks so much x

stargirl1701 Tue 20-Nov-12 09:24:26

You're welcome.

Kickarsequeen Tue 20-Nov-12 19:01:56

ahhh!!! So glad you got some help, things will get better now, good luck and just keep asking for help if you get stuck or things don't seem right. It's a journey and you are doing fab! smile

hufflepuffle Tue 20-Nov-12 20:56:22


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