Does this sound OK for day 4?

[AntoinetteCosway]

Sorry to post again for reassurance-this is all new to me!

Am engorged as milk came in yesterday and DS finds it difficult to latch on to monster boobs and was getting frustrated and frantic really quickly and then spending ages trying to latch and not managing it. Last night out of desperation I gave him about 30ml of formula to calm him down and then he managed to latch on, so that led to today's 'plan' (only formulated after several more extremely frustrating feeds) which went as follows...

1. Managed to express about 6oz with a pump which took out the engorgement and some of the lumpiness. Took about an hour with a Medela swing.
   
2. Fed DS 30ml expressed milk and he then latched on but only on one side for about 15 mins before falling asleep. Couldn't interest him in the other side. Argh.
   
3. Expressed more from the side he hadn't fed from as didn't want that boob to end up engorged again. Got another 4oz (including a little bit from the boob he did feed from too) in about 45 mins.
   
4. Next feed-gave DS 10ml expressed milk and then convinced him into staying awake for 15 mins on one boob, switched to the other and managed about 6 mins before he fell asleep. Gave him another 10ml expressed milk and put him back on second breast until he fell asleep again, about another 10 mins.
   
5. Give or take some of the timings, repeat.
   

I'm happy that giving him little laps of expressed milk from a cup both wakes him up and keeps him calm enough to then deal with actually latching on but I'm worried that he doesn't stay awake long enough on the breasts and that he'll get reliant on the expressed milk and lose interest in actually feeding from me. Is that likely? Should I try giving him smaller amounts of expressed milk in the hopes that it has the same effect but he doesn't get so sleepy?

Yesterday I experimented with letting him just stay on one boob for as long as he wanted and he managed a max of about 25 mins, but then I think that partly led to the agony of engorgement I had overnight as they weren't both being drained at the same rate.

So what's better-let him drain one as much as poss at the expense of the other (or alternate feeds from one and expressing on the other which is very time consuming and noisy especially at night), or aim for as long as possible on both, which is hard to gauge in advance of course (and goes against my instincts to switch if he's actually feeding) but seems to be about 15 mins on both?

Sorry that's so long.

[hollie84]

The engorgement bit is unpleasant put won't last long - expressing large amounts though is going to make it worse. Try just hand expressing a little bit to make it easier to latch.

Try to ride this out, let him feed as much as he wants before offering the other side. Avoid expressing more than a small bit as it will make your breasts more engorged and it will take longer for your supply to settle down.

Feeding him expressed milk is an extra complication you don't need at the moment.

[AntoinetteCosway]

The trouble is that I can't seem to hand express anything-it just doesn't work for me. I've been shown how by a BF counsellor but I can't make it work. Which is a pain.

I don't intend to express anymore unless I get all lumpy again-it was really awful.

[AntoinetteCosway]

Is it a bad idea giving him expressed milk to calm him down then? I just can't find another way to calm him down long enough to deal with the engorgement. If he's already had a bit of milk then he seems better able to calmly try and latch where if he hasn't he's just crazily rooting and not managing to get on, which makes him really upset. Is there a better way to deal with it?

[springbabydays]

Try hand expressing in a warm shower, should loosen it up a bit!

[hollie84]

Could you try offering a feed before he gets to the frantic stage?

If you need to express a little bit with a pump, try to stick to just a tiny bit rather than 4-6oz. The milk you remove is just going to be replaced so it will increase the problem.

[Paloma12]

Have you been given proper advice and support on how to help him to latch? I found it woeful lacking with my first. These things helped me

Tummy to tummy - so the baby's tummy against my upper tummy, obviously across my body
Nose to nipple
And don't be afraid to be firm! I used to lift up my boob and shove DD's little head to the nipple when she opened her mouth wide to scream - make sure whole aerola goes in, not just nipple.

[hollie84]

Try to move the baby with your hand on his back/shoulders though, avoid holding or pushing his head.

[Paloma12]

Yy, I probably shouldn't have said I shoved her head!! I just remember somehow making her swoop down like a hungry little bird

[TheOriginalWinkly]

Can you make a 'sandwich' with the end of your breast, by cupping underneath with your fingers away from the areolae and your thumb on top? That flattens an engorged breast and makes it easier for little mouths to latch.

How often are you feeding?

[CelticPromise]

Hello. I am a peer supporter. Congratulations Try latching him on when he's just waking, before he gets really stressed. Try biological nurturing position.

Google Marmet technique for hand expressing, or try again with BFC. You can also try pressing your fingers and thumb in a circle around your nipple for about 30 secs before a feed. Just softening that area around the nipple can help latch.

Don't worry about clock watching. Offer one breast until he comes off/sleeps then offer the other, he may not need it. If you are engorged and need to express, just do so for comfort not too get a feed. Your baby is learning, and EBM is a faff so I would try to feed direct ad much as you can. Lots of skin to skin, and if he is distressed calm him before trying again. Latching can be really hard work early on, but it will get easier.

[AntoinetteCosway]

Great tips, thank you-will especially bear in mind not to express too much. Was just desperate to get rid of the lumps and the agony!

His stress seems to come from not being able to latch onto the engorged breast rather than being v hungry, though obviously the longer it takes to latch on the hungrier he gets. Vicious circle.

[hollie84]

If he starts getting stressed maybe take him off, swaddle him, rock him, give him something to suck until he's calm (maybe your partner can do this?) and try again.

[Toadsrevisited]

Def try expressing in warm bath or shower. Will just take the worst off as PPs have said- expressing too much at this stage could be counterproductive.

Or, Have you tried hand expressing a little on one side as baby feeds on the other? Feeding may help the let down in the side you're expressing. A bit complicated but possible perhaps.

[mrscog]

I would try expressing less, if you're very engorged then you might need to express a small amount to slightly soften the nipple area to help him latch. I understand why you gave him some expressed milk to calm him down and this isn't a bad idea, but 30ml was probably a bit too much - that would be almost a full feed. I second the advice you've been given above to try getting him to latch before he gets hungry and frantic. My DS had a 40 min feed every 1.5 hours (yes really) for the first 2-3 weeks. He too was very sleepy, he'd basically do about 3-4 sucks then drift off. I found I had to constantly switch sides, but it really did improve over time.

And lastly, congratulations, it sounds like you're doing great, try not to over think. Just expect a lot of feeding - up to 12 hours a day, and look for lots of wet and dirty nappies. Faster feeds, and more alertness will come before you know it.

[springbabydays]

In answer to another couple of points you made in your OP, don't switch him too soon or he won't have time to get the hindmilk (which is what fills him up). If he only gets the foremilk you will find green poo in his nappies and he will be constantly hungry (and therefore grumpy).

You can try keeping a sleepy baby awake on the breast by tickling him on the cheek as he dozes off!

[hollie84]

I really wouldn't worry about fore milk and hind milk, just offer both sides frequently and let him feed as long as he wants and it takes care of itself.

[CelticPromise]

Agree with hollie.

[CustardFromATin]

Agree with Hollie too, at these early days. And wouldn't worry about waiting until he's hungry either, it always worked best for me when I spent the first couple of weeks as a human milk dispenser, carrying in the sling and popping a boob in their mouth at the tiniest peep! Biological position is great for latching and for lying down and resting a bit. Congratulations and good luck!

[AntoinetteCosway]

If he feeds for as long as he wants he falls asleep with only having fed from one side. Is that ok? It really makes the other one engorged. And if I move him while he's still feeding I don't know what point to do it at because I don't know how long he's going to feed for. Argh. All of this is complicated by the fact that I've got giant boobs and can only really manage the rugby ball hold. We managed some lying down feeds on day 2 but not since and every other position we've tried has been too difficult (including laid back)-that's with a BF counsellor and various midwives all helping too.

[hollie84]

If he feeds and falls asleep that's fine - you could switch him over and see if he'll feed on the other side while asleep, or just offer him the other side when he wakes. Your boobs will settle down soon.

[HSMMaCM]

My lovely midwife showed me how to squash the end between two fingers in a scissor to make it easier to latch. She also suggested that when dd started to doze off, I should change her nappy and then try the other breast. Worked for me.

Sounds like you're doing a great job. Well done.

[AntoinetteCosway]

Thanks all. My nipples are so horrifically sore. Have an appt in the morning to get him checked for tongue tie. Am at the stage now where it hurts for them to even touch a breast pad so I hope there is a tie that can be fixed as at least that would solve that problem!

[buttercupyellow]

When my milk came in and my baby couldn't latch on because of big boobs the only thing that seemed to work was to stand up. Don't know why but anything's worth a try..

[AntoinetteCosway]

Oh God, one of my nipples is so badly cracked and in the other boob the lumps and engorgement are back

[springbabydays]

Lansinoh will help your sore nipples, apply after every feed.