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Help! Wits end being reached - breast, bottle problems with 9-day-old

(32 Posts)
herbaceous Fri 17-Jul-09 20:37:25

Hello all

Please could you give me some advice? I'm trying to mixed-feed my nine-day-old baby, but find that when he has both breast and bottle he fusses, then won't sleep until he's been sick, then wakes again after only about an hour. If he's fed just bottle, he sleeps for 3-4 hours at a stretch, and is not sick. Naturally, the convenience of the latter option is tempting, but I do want to do what's best for him, so have been to various breast-feeding workshops to improve my latch, etc, so he gets more breastmilk when he is on the boob.

Wednesday's advice was to give him one boob, then 100ml of formula. This made him sick every time. Today I was told to give him two boobs, then 60ml of formula. After this he was still hungry, and didn't go to sleep until he'd been sick. Awake an hour later.

Would it help if I gave him bottle first, then boob?

I'm in the throes of major hormones, and sleep deprivation, which isn't helping, and am losing the determination to keep going with BF. The reason it went wrong in the first place is that after an emergency CS, with no skin-to-skin contact, he wouldn't latch on to the right boob, the left one got so sore it bled, then he lost too much weight and the docs put him on purely formula until we were allowed to leave hospital.

My ultimate goal would be to BF in the day, with formula at night for longer time between feeds. Is this a foolish pipe dream?

whomovedmychocolate Fri 17-Jul-09 20:42:38

Sounds tough. Well I think there's a few things:

(1) the formula is so hard to digest his body is knocking him out to deal with it. He doesn't have the energy to chuck it back up again. Your milk is not the cause of the sickness, but you might have a fast letdown and he's gulping air particularly if you are having latch problems (you didn't mention this but the soreness is sort of a clue). You can try expressing a little bit first (decant it for later use in the fridge!) and see if that solves things but it will resolve itself in a few weeks anyway.

(2) If you give him bottle first he will prob. reject the breast because drinking from a bottle takes less effort and he's not old enough yet to think beyond 'yum' wink

(3) You can within two days establish enough milk to solely feed him that way, but of course it's a personal choice thing.

Congratulations btw.

lexie01 Fri 17-Jul-09 20:56:08

Could you drop the bottle and continue with just breast or have midwives advised against? I agree with 'chocolate' that within a few days of sole breastfeeding you should find that your milk supply will be more than adequate for the job. It is exceptionally hard to BF (no one really tells you this do they?). I BF both my DD's for 12 mths each but with each child I struggled to get the correct position and suffered in agony for a few weeks (bleeding nipples etc). I got very close to giving up with each (buying formula etc) but in the end I didn't and am really glad that I persevered. Once you get the hang of it (and it took a number of midwives and a few weeks) it is very easy and worth it. Good Luck

1stMrsF Fri 17-Jul-09 20:57:00

Well done for getting this far, with so many obstacles in the early days. One of my twins was formula fed in the hospital due to low blood sugar. I kept offering her the breast first and then the bottle so that she got as much breast milk as possible and my breasts got as much stimulation as possible for milk production, then formula to satisfy her hunger. I think this way round is better for the reason whomovedmychocolate cites in (2). Once we got home, with frequent feeding we dropped the formula within a few days.

I also think you should just persevere if you can because it gets easier and easier for you and for the baby to breastfeed the more practise you get, but hang in for at least a couple of weeks if you can. Try to set a goal of 6 weeks and then see how it is - it will be much easier and at 12 weeks, the breastfeeding is easier than bottle feeding and faster too.

As to your final question, it depends on your baby - if you can get past the problems you are having now, you might find that he will sleep just as long on breast milk as formula - research shows that not all babies sleep longer on formula milk and lying in bed breastfeeding is a helluva lot easier than getting up to get bottles and heat formula milk!

Can you get some more help? Breastfeeding counsellor? Call NCT? Is there a Baby Cafe near you?

Good luck! Hope things improve soon.

jimbobsmummy Fri 17-Jul-09 21:19:39

the formula is so hard to digest his body is knocking him out to deal with it.

That is not true. It is probably just that he at the moment is not getting enough to satisfy him from the boob alone and is filled up with the bottle.

I had very similar problems and it took a while to settle down, but now at 10 weeks my little one is only having one bottle at night (deliberately kept that going to give me a break) and he is fully breastfed the rest of the time.

My advice would be to feed him as much as you can bear yourself and then only top up after he has had a really good go (or if you need to replace a feed, do it and express what you would have fed). Give him as much as he will take for now.

I know a lot of people on here say you must only give the boob but that is not always possible. I was so much in pain and having problems initially that if I hadn't topped up I would have stopped breast feeding completely. You do need to do it properly to keep your supply up, but it is certainly possible and ignore anyone that teels you otherwise.

whomovedmychocolate Fri 17-Jul-09 21:23:48

jimsbobmummy - cows milk (and formula is made from cows milk) is much harder to digest. It will indeed be filling him up and yes being stuffed does make you fall asleep - have you never fallen asleep after a big meal?

I'm sorry you have had problems too - breastfeeding is bloody difficult and not enough help is provided IMHO. And of course you can have one bottle a day and still feed. It's not ideal but hey we do what we have to do to get through the days (and nights) and keep our little ones safe.

whomovedmychocolate Fri 17-Jul-09 21:25:23

Another thought - if I was having a nice warm breastfeed and was switched to a cold teat with something that frankly doesn't taste very good (try it) I'd be quite cross too. I don't have a solution to that but just a thought.

madameDefarge Fri 17-Jul-09 21:35:51

it would be worth changing the bottle that you use to one that mimics breastfeeding, so its just as hard for baby to feed. Playtex got me and ds back to breastfeeding after hideous two weeks of using avent which just messed up all bf attempts. (he and me had terrible thrush so bf was agony for him, once it had cleared up, back to boob, cutting back on formula with the right bottle).

jimbobsmummy Fri 17-Jul-09 21:57:08

Filling him up, yes because he at present is not getting filled up on the boob, but not harder to digest. In fact, I thought the latest thoughts were that if anything, breastmilk is probably slower to digest.

idontbelieveit Fri 17-Jul-09 22:10:33

jimbobsmummy, you're totally wrong about breastmilk being slower to digest. It's much easier and quicker for babies to digest breastmilk, one of the reasons breastfed babies tend to feed a lot in the first few weeks whereas formula fed babies will go much longer between feeds. If you can show me some research that backs up your statement then I'd be very interested to read it. Here's some evidence to back up my claim:

"The cows' milk protein used in most formulas is a foreign protein. When babies are exposed to non-human milk, they actually develop antibodies to the foreign protein. Research has shown that without exception the important food allergens found in milk and soybean formulas are stable to digestion in the stomach for as long as 60 minutes (as compared to human milk protein which is digested in the stomach within 15 minutes). The foreign proteins pass through the stomach and reach the intestines intact, where they gain access and can produce sensitization. While research in this area is still relatively new, this early exposure to foreign proteins may be the predisposing factor in such illnesses as eczema and asthma. The effects of early exposure to foreign protein are explored in three abstracts in the Journal of Allergy and Clinical Immunology, from January of 1996."

Have a look [[http://www.drgreene.com/21_552.html here] for more info.

This website will also be very useful for the OP kellymom evidence based information about breastfeeding and some very useful help and advice about newborn feeding.

idontbelieveit Fri 17-Jul-09 22:11:47

sorry about the link

idontbelieveit Fri 17-Jul-09 22:16:38

Herbacious - how are your boobs now? Is he able to latch on to the right one now? If you can take him to bed with you for the weekend and do nothing but feed your milk should catch up with the demand in 2/3 days. Have you seen a lactation consultant, NCT and La Leche League may be able to send someone out to observe your feeding and help you get the breastfeeding back on track if that's what you want to do.
you're doing amazingly well to have kept going this long with the difficulties you've faced.

whomovedmychocolate Fri 17-Jul-09 22:43:18

thanks idontbelieveit - I wandered off again and you saved me a google

herbaceous Fri 17-Jul-09 23:01:03

Thanks all.

I tried the 'boob after bottle' approach, and it worked, in that he took it and wasn't sick. I think he was just gorging on the bottle, post boob, before as it's easier. However, he is just not satisfied by it. He's now been awake since 2pm (it's now 11pm), either crying or feeding. DP has cracked and given him a bottle.

I know the problem is that I haven't got enough milk at the moment - the evidence being that when I express (to try and stimulate supply) I only get about 10ml from both boobs after half an hour. So, he can be on both boobs for an hour, come off, and still cry with hunger. I know it's a vicious circle, in that I have to keep feeding to get my supply up, but at the moment I don't get time to eat or sleep, and he's STILL hungry. I spend a lot of the time crying. The only way to get any sleep - and thus relax, and thus make more milk - is to give him a big old bottle.

Everyone says 'persevere', but does that mean just having him cry the entire time he's not plugged on to the boob?

By the way, for those asking about soreness, it's much improved, thanks to a lovely lady at an NCT breastfeeding session I went to today who helped me with the latch. He is also feeding from both boobs I thought it would also improve my let-down, but it would seem not.

jimbobsmummy Fri 17-Jul-09 23:04:10

Maybe 'digest' was the wrong word. I didn't mean the actual process of breaking the milk down, but more the amount of energy that a feed supplies.

I might be wrong, but I understood that once the supply is properly established, which it isn't for the first few weeks, it is now thought that a breast feed is probably more calorific than a bottle feed, volume for volume.

earplugs Fri 17-Jul-09 23:05:16

No its not a foolish pipe dream, please go with what you feel is right for you and your baby and don't feel guilty. I went thro total hell to BF DS for 5 months with good advice coming from everywhere (NCT/La leche). It totally destroyed my experience of motherhood for those early months and I desperately regret it. My DS (whom already suffered with terrible eczema) has subsequently gone on to develop a severe peanut allergy so if your DC is going to get these things, they will regardless of BF.

I guess what I'm saying is give BF everything you've got, but if it really isn't working for you, please don't let it destroy those precious first few months!

whomovedmychocolate Fri 17-Jul-09 23:05:35

No it doesn't mean that but remember he's not got a lot of options with communication here. It may not be hunger that is causing him to cry, sometimes it's probably 'ah feck off with your monster mammeries mum, I want a nap' or something

When DD was that age she fed for up to four hours at a time (drove me demented) till six weeks when it all suddenly came together (good job too I was going insane with the sleep deprivation while trying to recover from an caesarian, liver damage etc.).

Is he particularly bad in the evenings? You might find a tummy tub helps you if he is. Actually I used to dunk DD all the time when she was unhappy and she used to calm down quite a bit.

What makes you think your letdown is a problem? Also what's his weight like?

herbaceous Fri 17-Jul-09 23:14:27

chocolate He is worse in the evenings, it's true. I know it's hunger that's making him cry, as he sucks his hands, roots about with his mouth, and bobs his head. His 'nappy' cry is different. And anyway, I check his nappy before going down the food route.

His weight is still not great. Even after a week on basically formula he's only put on ten grammes or so. And I don't actually know that my letdown is a problem, it was just one of the things to eliminate.

What's a tummy tab?

Earplugs: thank you. Spoiling our first weeks together is something I'm now afraid of. It's a balancing act between that and the guilt of not BF...

All is now quiet downstairs. The magic of the bottle has worked.

tiktok Fri 17-Jul-09 23:16:17

herbacious, sorry you have had these early-days difficulties.

If you want to maintain breastfeeding, even if you combine it with formula, then what you are doing now is undermining your choice massively.

Whoever told you to give 100 ml of formula at each feed can certainly be ignored, IMO, as this is a massive amount to give and is totally imcompatible with building up a milk supply. 60 mls is a bit better, but not much!

If you are keen to maintain breastfeeding, and it sounds as if you are, then the best way is to keep formula to the minimum needed to keep him well-nourished while you build up your milk supply. You'll need real-life help to make the calculations for this. You will also support your milk supply if you can find the time to express often, as well.

With regard to 'which is easier to digest?' of course human milk is easier (and quicker) to digest. It is slightly more calorific than formula. All that is irrelevant at the moment, though, as your milk supply needs protecting - hope you find good help to do this.

All this can be explained in more detail if you call any of the helplines or speak to a breastfeeding counsellor.

idontbelieveit Fri 17-Jul-09 23:23:37

tummy tub
Hope things get easier soon. My dd1 used to feed from 4pm til midnight nonstop for the first 6 weeks. It's like psychological warefare! It does get easier if you get that far though I promisesmile

herbaceous Sat 18-Jul-09 10:43:25

Six weeks?!!? I'll be entirely insane by then, which I can't believe would make a good mother.

After a good night's sleep - thanks to bottle given by DP in the middle of the night - I've resolved to do loads of BF today, to up the supply. So far he's fed non-stop from 8.30-10.30, and is crying downstairs while I'm up here having a shower.

How do I know he's getting enough to eat? God. I can so see why people give up. If I keep going I feel guilty he's hungry; if I don't I feel guilty I'm not giving him 'the best'. If only the half-way house were easier to achieve...

idontbelieveit Sat 18-Jul-09 11:02:36

Babies cry for all sorts of things, he just wants to be close to you and he's still coming to terms with the fact he's no longer inside you.
Have you tried putting him in a sling and getting out of the house. I carried my dd2 around a lot for the first few weeks and it seemed to calm her down. The other thing I would recommend would be cosleeping, that way even if he feeds all night at least you're lying down and can get some sleep. There's some information on safe cosleeping here and here
Hope you have a good day today. It is quite crazy getting used to how demanding they can be in the first few weeks. Keep posting and you'll get lots of support from mumsnet.smile

NorkilyChallenged Sat 18-Jul-09 11:21:22

He's only 9 days old, he doesn't need a huge amount of food.

I'll just tell you my experience with DD1, it's not directly comparable to yours but shows that it can take a while to establish feeding and not necessarily harm a tiny baby (as long as you're sure he's not getting dehydrated, which doesn't seem likely given the amount of formula he's getting anyway plus you can check the fontenelle etc).

DD1 latched for her first feed in hospital after birth so we got a big tick on "feeding well" and were discharged. Never mind that she cried every other time after that when I tried to feed her. I thought it would get better.

It didn't. She cried, arched her back, screamed every time I tried to feed her. The midwives were coming every day to check on her. They didn't weigh her at all (they didn't say why but assume it's because it would have worried me unnecessarily). Just checked for her hydration and general appearance (she was pink and fine looking).

They tried and tried to help me but we were not getting anywhere. So I was putting her on the breast trying (lying down skin-to-skin) but she wasn't really feeding, getting extremely upset so we would abandon that and try cup feeding (I was expressing to deal with my supply because she would stimulate letdown but not feed so I was super full - unlike you).

She was sleeping a huge amount. It took 4 days for her to have a first meconium poo. I was beside myself with fear but the health professionals were all very laid back about it (only realise now how lucky I was).

On day 9, I took her to a bf'ing clinic and while there we woke her enough to feed and... she fed properly! First time ever, did all the same things as usual but this time she fed. From then on it was about 50/50 whether or not she woudl feed so I kept cup feeding fora while.

All that guff to say that it can take a while. A little baby doesn't need much. By day 9 she was taking about 60ml in a cup feed but basically the vast majority of that was pouring down her front (every tried cup feeding a small child? hilarious if it wasn't so stressful). So I think your ds is getting plenty of food.

I think there are lots of reasons at his age for crying. He might be a baby who likes to be held a lot, or whose tummy is causing problems, or anything.

I think you can definitely keep trying as you have been and don't feel worried if he's not taking HUGE amounts. The being sick does make me wonder if he's taking more than he needs then thinking "oops, bit full, will get rid of some of that".

The main thing to remember is that this feels like an eternity now. Esp when you are awake most of the time. But it will change so quickly at this age and you will be out of this (and into some new worry) before you know it. Hard to think that when you're in the midst of it and full of hormones, as I remember so well.

Good luck. Sorry I wittered on so much.

logrrl Sat 18-Jul-09 11:37:57

The thing that made breastfeeding easier for me was my mid wife telling me on yet another tearful morning that my "job" was to feed my baby and that all that other stuff; showering, tidying up, going out, even getting dressed etc would just have to wait. If I'd "got" or even been told that beforehand, I think I would have despaired less. I had been feeling like I was losing my mind with all the feeding and crying and lack of sleep and v slow weight gain...but after she said that (and many puddles of tears), I did it. I sat there and fed him and fed him and fed him for hours and hours and hours (I got a sore bottom!) day and night and eventually we got there. It's bloody hard work. No book had prepared me for it. You will be tired and demented. You may not (perhaps scarily) have any semblance of what life was like before, but then...but then.. it will get easier and your confidence will grow and you'll eventually realise you seem to have cracked it...a hard hard job for some of us, but really really worth it in the end...

idontbelieveit Sat 18-Jul-09 12:06:48

When I was pregnant my mum said "All you'll do for days and days is feed." I didn't really understand what she meant, I thought I did but until the baby arrived I had no idea. I think the responsibility and the fact you can't do anything else at all comes as a real shock, it certainly did to me.

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