Please help me to get my confidence back with b/feeding

[Backgammon]

DD is 10 days old and we were re-admitted to hospital at 6 days as she had lost a kilo from her birth weight (she was a big baby to start with). We were told we had to top her up with formula from a bottle or we wouldn't be allowed home. She put weight on and we let her out and now we are topping up with formula at home. I am also expressing and topping her up with that rather than formula when I can.

I expressed 70 mls yesterday so I don't think there is a huge problem with supply - however my confidence has really been knocked. Especially as she can feed for 45 mins and then still take 60 mls from a bottle afterwards. I feel as though I'm not capable of feeding her on my own

[tiktok]

Backgammon, I remember your story from the other day. It's great you are now back home with her.

It will help, I think, to call one of the bf helplines and talk to someone about this. A good breastfeeding counsellor will listen to your story, and will understand your feelings and the way your confidence has been knocked. In addition, she will help you work out a plan to get back to full bf. You are doing the right thing at present - using your own milk when you can as a top up - so that's a good start.

However, feeding for 45 mins and still accepting 60 mls can be part of normal newborn behaviour. Babies love to suck, and need to do so - many newborns just want to be close to mum, on and off the breast a lot of the time, with the option of sucking for much of that time, too

What happens at 45 mins? Would your dd remain on the breast, perhaps if you swapped sides? Would she go back on after a little break? Is there a reason you stop bf her and give her the top up then? If she is feeding effectively, and has the energy and will to feed (that is, doesn't drop off to sleep all the time after a short burst of sucking because she's too tired to do much more), then keeping her on the breast is ok - there is no magic about 45 mins

If there is still an issue about weight and feeding effectiveness, then topping up may still be necessary for the moment.

Do call one of the lines, and keep posting here, too. I hope we can help you gain your confidence again

[Backgammon]

Thanks Tiktok - the main issue is that b/feeding seems to send her to sleep. I've tried waking her and putting her on the other side but she falls asleep at the breast then comes off. She is awake long enough to get a bottle down her, but if I put her back to the breast she is back to sleep again.

Glad to hear this can be normal newborn behaviour though - the midwife is coming to weigh her today and hopefully she will have gained some more weight.

I will try one of the helplines you suggested.

Thanks again.

[lizzytee]

Backgammon, sounds like you have had a horrid experience and am not surprised that your confidence has been knocked. Hope it was good news on the weighing front.

Like Tiktok says, well worth calling the helplines.

[tiktok]

Backgammon, good to know your baby is going to be weighed as this is useful info.

Falling asleep on the breast is fine - it's only not fine if the baby is not gaining weight as she should and falls asleep as a way of conserving energy/calories.

What are the details about her weight, weight gain, amount of supplement?

[Backgammon]

She was 4410 grams in hospital, weighed on day 6 and was 3640, went down to 3530 grams by day 7 and they admitted us to hospital. We supplemented with formula after every feed in hospital and her weight went back up to 3580 on day 8 and they let us home.

M/w did not turn up today so don't know how much she weighs now. Have been promised a visit at 11 tomorrow.

Hospital supps were about 65 mls for the first feed then she has generally been taking an extra 30 mls thereafter.

Since yesterday I have been using EBM for the top-ups as much as possible.

[Backgammon]

I meant to say, the hospital and m/w have both questioned whether the scales were wrong at the initial birth weigh-in. We have checked and they confirmed the scales were calibrated and they've had no complaints. The paediatrician did think this was a possible explanation as she is perfectly alert (when awake), not floppy, SBR result fine, not dehydrated and no probs with the bloods they took.

[Backgammon]

(thanks lizzy and tiktok)

[tiktok]

If she appeared to be actively losing weight after day 6, and she was, then some intervention was justified, Backgammon, whether or not the initial birthweight was accurate.

I think it was letting you down not to visit as promised for weighing

30 mls after each feed for baby of this weight is a good chunk, but good that it is mainly ebm now...you'll get a much better picture of what to do next when you have a new weight tomorrow.

[Backgammon]

Thanks tiktok - she is now back up to 3640 and the m/w is happy she's gaining weight well. They've advised to top her up only if she still seems hungry so I'm going to try to just use EBM for top-ups.

Feel a bit happier now that things are going in the right direction. She was a bit jaundiced and had a forceps birth which the m/w also thinks may have affected her feeding.

Fingers crossed things will improve now, thanks for all your advice.

[Pidge]

Backgammon - no expert advice from me, but just wanted to say that it sounds like you are doing absolutely brilliantly after a really difficult start. Well done.

[LackaDAISYcal]

also echo the thought that you sound like you are doing a fantastic job and doing all the right things in getting back to full BF

re the forceps birth, have you considered cranial osteopathy for the baby? I know of a lot of women who have had problems with baby feeding and the osteo has helped with any issues like a stiff neck that can result from a difficult birth.

Good Luck

[EffiePerine]

Backgammon, sounds like you are doing really well. Well done for persevering and succeeding after a tricky start

btw are YOU doing OK? Repeated hosp visits and checks must be so stresful. Do you have someone who can look after DD while you nap or have a nice bath? Remember you are still recovering physically as well.

[lizzytee]

Good news on the weight gain Backgammon and thanks for the update. It's not as if you have lots of time on your hands. Keep us posted.

x

[Backgammon]

Thanks for this everyone.

I met my health visitor today. Not too sure about her. She told me not to top up but instead to replace an entire breastfeed with a bottle. She also told me not to express if I was doing this.

I'm basically going to ignore this advice - I thought breastfeeding was a supply and demand thing and surely if I start replacing breastfeeds with bottles and don't express then my body just won't make enough milk?

[tiktok]

If this is what your HV has told you, Backgammon, she really, really needs to be challenged on this, and asked to justify it. Maybe she has a good reason for saying it (though on the info you give here, I don't know what it could be).

Replacing a breastfeed with a formula feed (or a feed of EBM) can be disastrous to breastmilk production. The effect is to lengthen the gap between breastfeeds, which if done more than just occasionally, actively reduces the amount of milk made - this is, after all, what people do when they want to stop breastfeeding.

To do this with a baby of 2 weeks is asking for problems, it truly is.

If your baby still needs supplements because your milk supply is not nourishing her on its own (and it can take a little while to 'repair' a milk supply, and it's not always possible simply to drop all supplements straight away), then the safest way to preserve for your milk supply is to

• make sure the supps are EBM as far as possible
  
• minimise the supps, consistent with ensuring your baby is well-fed, of course
  ensure breastfeeding happens frequently and effectively*
  
  You would be justified in calling your midwife and telling her you are confused because the HV has told you something very different from what she (the midwife) has told you.
  
  Hope this helps.

[moondog]

Jesus Backgammo,n that is so bloody weird.
Please challeng her and read what Tiktok has said v carefully.
Did she not give you any reason (however weird??)

[tiktok]

Backgammon - even if you decide not to follow what your HV has said, I do think you need to call her on this advice if you feel brave enough to do so. She could be going round harming other mothers and babies, and she needs to be stopped

[Backgammon]

Thanks Tiktok and Moondog, I am so glad I have been on MN for a while because without it I would have accepted her advice without thinking.

She basically said "you will get lots of contradictory advice about breastfeeding but the current advice now is that if you are going to top up with formula then you should be replacing an entire feed with a bottle, rather than topping up at the end of a breastfeed". I didn't ask her whose current advice it was - she presented it to me as though it was the official line from somewhere though. I wish I had asked her who this advice came from, she is coming on Thursday so I will ask her then. As soon as she said it though I chose to disregard it so didn't really have much of a conversation about it.

I did think it was really odd though.

[Backgammon]

Right - just got my notes. She has written:

"home visit from health visitor. Advised to give a bottle instead of breast feed rather than top up - as per guidelines."

Doesn't say whose guidelines.

[moondog]

Yes, ask whose guidelines and what is purpose of them.
If she thinks this will allow you to continue b/feeding, she needs to be horsewhipped.
Please post again when you have seen her. Start a thread with something like 'Idiot HV' in it or summat.

[Marlabarla]

I had virtually identical situation. My dd was readmitted into hosp for 4 days when she was 3 days old with suspected jaundice and low weight. Desperate to get her weight up and confidence in bf shattered, I gave her ff or ebm until we got out home.

Once home I tried to re-establish bf and was advised by mw to top up every feed with either ebm or ff. Just like your dd she would polish off the bottle as if she was starving even after a a 60+ minute bf. It was so disheartening not to mention exhausting to bf and deal with sterilising bottles too.

I started going to a breast feeding clinic at my hosp every week. They weighed her each week and as her weight gained suggested I cut down the amount of top ups until now, at 3months, she is entirely bf. Also in that first month she was pretty much strapped to me as they also told me she might need feeding often and the more she was on the more it would stimulate my milk supply.

They also were at pains to stress to give her a bottle AFTER a bf not to replace it. I agree with tiktok- very strange advice from your hv.

At my lowest point my confidence was so broken and I was very depressed. It was some wise words from my doctor that suddenly made things click. He put things in perspective by telling me I had given her bm in her first week and that Id done everything I could. If I did end up giving her ff then it would not be in the end of the world. Others had said the same to me but he said it in the right way at the right time. Suddenly with the weight off my shoulders it fell into place anyway!

Hope you don't feel I am hijacking your thread- just thought our experiences sounded so similar you would appreciate hearing our story. Hope you manage to crack it. It sounds like you are doing everything you can.

[tiktok]

I am shocked at this - these guidelines need to be challenged, as they do not make sense.

It is perfectly possible the HV has misunderstood them.

It is even possible she has understood the very opposite of what was intended.

(Love the way she puts in the notes 'as per guidelines' without actually saying which guidelines.)

[Backgammon]

Thanks everyone - I will definitely ask her on Thursday and will definitely ignore her advice.

DD was weighed today and has been putting in 1 oz per day which I'm told is about right.

Marlabarla - thanks for your post.
It's great to hear from someone who has been in the same situation and fantastic that your dd is now back to exclusive b/feeding, hopefully we may be able to do the same.

Will post again after Thursday's visit.