Milk still not coming in 4 weeks on, despite expressing

[Thenightwillalwayswin]

My son is 4 weeks old. He was delivered at 36 weeks by C-section because of my 'poor obsetetric history' (eldest son delivered at 30 weeks because of IUGR, weighing only 550g and died at four days old).

We have really struggled with the BF. He has a poor sucking action because he was born early, so we've been expressing since he was born. We have regularly tried to get him to latch, and we've only successfully really managed it once. Had lots of support from the breastfeeding advisers, and eventually they said I needed to concentrate on getting my milk supply up before focusing on the latching. Been expressing every two hours initially and then moved to three hourly expressing. I only got about 10ml per express (although I almost had a party when I got 20ml). We get enough milk to feed him a pure breastmilk feed once every 24 hours, so rest of feeds are formula.

I've tried everything: expressing regularly, I'm on Domperidone, doing skin to skin, eating pineapple....but we aren't getting anymore. The advisers are now saying 'it's time to be pragmatic' and I feel that everything is about the expressing and not the little one. They think it may be a hormonal thing, and that it's unlikely to get any better. Yet I feel like such a failure, my body has failed my younger son, like it failed my eldest (although in a very different way). My son is putting weight on and asides from being a bit colicky/windy is doing very well. Any advice anyone has, would be much appreciated!

[BF100]

You have given him breast milk through expressing - that will have helped in so many ways but expressing is tiring, hard work and time consuming. Expressing as much as you are must be so difficult.
Have the advisors suggested a supplemntal feeding system (baby is fed expressed milk or formula through a tube that attaches to the nipple. This means baby feeds in a traditional BF hold and stimulates your milk at the same time.
If it is any help I was only expressing 10ml ish during the first month so sometimes what you can express isn't the same as what a baby can suck off the breast.
Your little one has struggled with latch and sucking. This may be through being born early or could have happend anyway.
You have not failed you have a beautiful baby boy you carried him until 36 weeks and this is only the start. Raising your baby into a healthy adult is more than just breast feeding. Formula is a healthy alternative that you should feel no guilt in using.

If you want to ask about Supplemental feeding systems but if this isn't suitable then feel confident that you are caring for your baby and enjoy every second xxxx

Big hugs

[Thenightwillalwayswin]

Thank you so much, makes me feel a bit better! They haven't suggested the supplementary feeding systems, I will have to look at them. Thanks again!

[ExBrightonBell]

I just want to add that you have definitely not "failed" in any way! You've done an amazing job in really trying circumstances. My ds was in SCBU when he was born (not prem, but poorly) and I had to express to get my milk supply going. It's not what you imagine the days after birth will be like!

If you are happy to keep expressing then do so. Also you may find that your baby's latch gets better with age and growth. If you aren't already, use bottles that mimic the breast/breastfeeding as closely as possible.

It took my ds a good while to get the hang of latching on, and he was still pretty rubbish at it for longer still. Got there in the end though.

Good luck, and remember you have done an amazing job so far

[MissRatty]

Bloody hell, I think you have done an awesome job so far. Not many would have persevered as you have done. I don't have any advice, just admiration!

You really have to do what you feel is right for you and your baby. Expressing is very time consuming, you spend much longer making it than they do drinking it!

If you wanted to stay with breastmilk, do they have donor milk you could use?

Regardless of what method you choose, you will need support x

[Thenightwillalwayswin]

Thank you for your support. Going to look at Supplementary system and also attempt getting him to latch again (that has fallen by the wayside while I concentrated on getting more milk). You've all made me feel a bit better though, thank you.

[Ericadm]

Have you tried nipple shields? My lb would not latch, I tried really hard but it was not happening for us. I had to express and supplement. Then at week 2 I decided to try the shields and it made an amazing difference. He is 10 weeks now, ebf and he is growing really well. They say breast shields may affect your milk supply but for us it has not been an issue do far and without them I would have given up long time ago.
Anyway you are doing a great job, expressing is so hard so give yourself some credit! And if you end up bottle feeding you would have not failed in any way. The important thing is that your baby is growing and is healthy.

[Thenightwillalwayswin]

Tried nipple shields once at the breastfeeding clinic, but they then advised to concentrate on the supply...so definitely worth giving another go. Thanks