help with feeding newborn

[Susiemj]

Sorry this is a long story -

My dd1 was born on the 1st of January by emergency c-s. Because milk took a long time to come in I allowed her to have formula along with bf in the hospital as she became very dehydrated [due to fear!] which we carried on for a few days when we got home.

She weighed 6lb 6oz [288og] at birth. In hospital she lost 240g. In the first few days at home [on bf and formual] she put on 60g. I then started expressing and giving her top ups using that. I was feeding on demand and she was usually feeding every 3-4 hours, sometimes longer. I am giving top ups because she seemed to be a very slow feeder, often too tired before she was full. In the next week, she lost 20g.

The HV then told me to feed every 2 hours which I am happy to do [except that I think she gets really tired - perhaps too tired to suck?] and to top her up with 2-3 oz of formula 4 times per day. She also told me to stop expressing. I was unhappy with this but went along with it due to pressure form DH and my own fear. We spent a horrible night with her puking the formula and any bm she had taken with it.

I then put my foot down and insisted on phoning the HV to discuss formula. We came up with a compromise that I could express after feeding [which is what I had been planning anyway] and to give her an extra oz 6 times a day. I have agreed to use formula if I don't have enough milk to express.

Any comments on this would be welcome. I know it's not ideal to top up and I do plan to exclusively bf when have gained in confidence and she has gained weight.

My major problem that I really need help with is with BF technique. I went to the local bf support group this morning and they gave me some tips on latching. However, they could not get her to feed effectively. This is probably at the root of our problems.

She will only suck with little fluttering motions. She will not give big long suck [or she has a couple but no more than that]. Has anyone got any tips for helping her to make these long sucks?

I have the numbers of the BFN etc..and intend to call them tomorrow. But I'd like to know what you all make of the story.

[tulip27]

I'm not an expert but I know when I weaned my daughter from breast to bottle she forgot how to suckle from the breast quickly as its a different sort of sucking. Perhaps the bottle is confusing her?

[quirkychick]

I think you need to see a bfc. It took us quite a while to get the latch right, we were using bottles of em early on too (exclusively bf, not topped up). Also had em c-s and dd lost a lot of weight, was slow to gain. Actually only really gained loads at 4 months and went up several centiles.

Bumping for a bf expert to help you.

[constancereader]

Have you looked at the Kellymom site
www.kellymom.com/

I'm sure someone will be along with some expert advice soon.

[sophierosie]

It can be so difficult to get the balance right especially as your supply is just establishing itself at the moment.

I think if I was in your position I would try feeding every 2-3 hours and not worry about expressing or topping up. It will take a couple of days for your supply to adjust but then you shouldn't need to top up as your supply will be enough. As long as your DD is putting some weight on and has lots of wet nappies she should be getting enough.

I agree that the bottle may be confusing her as they have to work harder to get bm. When she latches on does have the whole nipple in her mouth? Do you feel the let down sensation? Are you feeding from both breasts at each feed?

[morocco]

def speak to bfc from nct, lll, bfn or abm rather than just local bf support group, altho local groups can be really good they aren't always.
is she a sleepy feeder? do you do stuff like tickle her toes, stroke the side of her neck while she's feeding? change nappy once she's stopped and then try again? have you tried breast compressions during feeds,www.womenshealth.gov/breastfeeding/index.cfm?page=228
don't know why your hv would tell you to stop expressing and it would make me v suspicious of her advice on other bf matters. expressing is only going to increase your supply - surely not bad?

[Susiemj]

Hi all thanks for replies

morocco - She is a sleepy feeder and we do all sorts of tickling / changing to help her.
I am doing breast compressions which also seems to help a bit.

That's what Ithought about expressing - the HV's opinion is that if I'm taking bm by expressing it will make the baby's sucking job harder.

sophierosie - I'm not always sure the whole areola is in her mouth but the nipple is. I don't get the let down sensation. I do give both breasts.

constance - thanks for link.

quirkychick - it's nice to hear a success story of someone with a similar beginning experience.

tulip - i was worried about this but she doesn't seem to be fazed by it.

[kiskidee]

co-bathing is a good way of getting babies to be more interested in feeding. This video is essentially what is called breast crawl, allowing your baby to use its own innate instincts to find and latch onto the breast. I have heard that when a mum latches on a baby, about 5 natural instincts are in play. With breast crawl, 17 of the baby's instincts are active.

lots of skin to skin contact also allows your baby to ask more often for feeds. take your baby to bed with you. consider a babymoon. you can do also allow your baby to self latch in bed with you by placing her a little above or below your breasts, with skin to skin and she should find her way to the nipple.

also try breast compression before swapping sides when she stops actively drinking.

also please of course call a help line.

[morocco]

i don't understand that reasoning at all what is she on about?? i can't advise on whether giving the ebm is good or bad but just expressing isn't going to cause mayhem (looks anxiously over shoulder for tiktok in case i am talking nonsense )

[tiktok]

It's late and i will post tomorrow, but the HV is talking nonsense....removing breastmilk with expressing does not make it 'harder' for the baby at all. Where does she think the milk is??? Up by your neck??

[Susiemj]

will look forward to your post tiktok.

[Susiemj]

just to say, she's put on 80g in a day and a half on this schedule. mw just weighed her.

[tiktok]

Morning, Susie.

I am not sure why your baby needed formula in hsopital - this does sometimes happen for good reason, but too often parents are scared into giving it. If your baby needed milk more quickly than yours was 'arriving' or than she was able to get it out 'direct', she could have had expressed colostrum. The risk with formula (apart from the health impact) is that it undermines breastfeeding, and I think this is what has happened with you

3-4 hours is usually nowhere near often enough for a newborn, and it's not enough to build up a breastmilk supply. So the weight loss was not surprising. The HV had the right idea in suggesting more frequent feeds, but she is mistaken in stopping you from expressing, and topping up with formula 4 times a day (up to 12 oz formula in a day) is a lot of formula and will not help breastfeeding at all.....it may have been your baby needed more than she could get direct, but you were prepared to express, which is a far better option (it does not undermine continued bf).

The formula she is having now is less, which is good, but you need help to get her to bf effectively - I can see you know this. I don't think it sounds as if your HV will be any good at all at this, and you can call the helplines and see if there is anyone who could come and see you.

Skin to skin, holding baby as much of 24/7 as you can, not timing feeds, breast compression, super switching, (see archives for more info), expressing and giving this as the top up.....all these things will help.

Good luck!

[tiktok]

BTW - your baby can show she is feeding well by the poos she produces She should have been producing several soft yellow poos a day from day 5-6...always a good sign

[Susiemj]

thanks tiktok
she is producing this poo.
she's not having formula at the moment - she's having top ups of ebm

do you think she can bf effectively without these long sucks? MW today seemed to think so when she observed her.

[Susiemj]

p.s. yes - mws can strike fear into my heart!

[Ledodgy]

My ds gives those little fluttery sucks sometimes and this is often when you can hear him take big swallows the most so I think they are fine look out for her swallowing as this is always a good indicator.

[tiktok]

Susie, if you trust the midwife's knowledge and observations, then they are gonna be better than how I can assess her sucking

Babies certainly do not have to give 'long' sucks...not sure what they are, to be honest with you, but if you mean 'sucking for a long time' that is totally optional, and babies will always differ in the time they need to take.

[Susiemj]

I think what the woman at the breastfeeding group meant was that she doesn't fall into a rhythm of long glugs. What she does is 'flutter' and rest, flutter and rest. She seems to me to be swallowing and the flutters do move the breast. I do hear swallowing.

Sounds like you both [and the mw] think that's ok. That's ok for me too! The woman at the bf group did say I should ring the bfn as well to check. I haven't today becasue I'm so happy she gained weight!