second time around... coming to terms with how it went the first time

[hairtwiddler]

I'm due with DC2 in November, and just started maternity leave. I'm beginning to think about some of the problems we encountered with DD1(now a healthy happy 3yr old about to start nursery) and posting really in the hope some wise people who know more about breastfeeding will offer some wisdom. I know the second baby may well be very different but feel that I'll somehow be more equipped if I have a better idea of why things went the way they did the first time! After a few years I'm now proud of my achievement in feeding DD, but there are a few things I wonder if we could have resolved at the time.

In summary - she was exclusively breastfed for 6 weeks then mixed fed but continued with some feeds until 10m when she 'self weaned' (although with hindsight I suspect the feeds were not worth the effort for her by then, as I wasn't feeding enough to keep up supply).

Born 4 weeks early, so very sleepy and often went for long stretches during the day without feeds. Didn't poo much in early days and when she did feed it would take over an hour before she came off on her own. She never seemed satisfied, particularly at night, and would cry and cry until on the breast again.

I was exhausted, suffering from pnd, and felt like I was on my knees.
I had no pain, no mastitis. But also no feeling of full or empty breasts.

My gut feeling is that she had a problem getting the milk from me to her, which resulted in poor supply.

So, with the benefit of hindsight, what could we have done instead of adding that formula feed? Should I have been expressing to build up supply? Waking her up during day for feeds?

If anyone has any insight I'd be so grateful. It would help me put some demons to rest before this baby arrives.

[deaconblue]

I am no expert, just posting from experience bf ds for 6 months and dd for 13 months. I think babies need to be woken for feeds at least every 2 1/2 to 3 hrs when tiny, don't let them sleep on. You need to ensure plenty of demand if you want plenty of supply.
Was she properly feeding for an hour or dozing off? I used to unlatch and relatch both babies if they weren't feeding properly to wake them up.
The crying and crying at night is normal ime.
Everyone I know who tried mixed feeding early ended up struggling to bf for any length of time. Imo bottle and breast is confusing for a tiny baby, the milk is so much easier to get from the bottle and so they start to favour that, leading to your supply going down. I didn't introduce bottle at all with either baby (until I stopped bf)
hope that helps

[hairtwiddler]

Thanks for reply!
I think she was feeding all that time, although I may have been in a sleep deprived haze, and had also never seen a baby feeding before, so probably didn't know!
I was lucky that she continued on several feeds a day for six months, but I had a lot of issues at the time about mixed feeding.
Have made my peace with it now (some time ago) but am keen to be more informed this time. I knew nothing about breastfeeding so am proud we did so well with no real support!

[midnightexpress]

There are others on here who will be able to give you better advice about establishing feeding, but I just wanted to say, try not to worry too much about it all in advance. I had an absolute nightmare with ds1 (hadn't discovered MN at that stage!) mixed feeding after about 6 weeks, and he was fully FF from 10 weeks, after we just couldn't get it sorted. Anyway, I decided to try again with ds2, but not beat myself up qite so much if it didn't work out. Well, out he came, latched on, and I bf him for nearly 2 years, when he self-weaned. It was completely different right from the word go. No idea why. So, just to say, do give it a go.

Best of luck, and enjoy your new baby.

[deaconblue]

absolutely. There is so little help out there. Next time listen out for swallowing, baby should swallow every few sucks (dd used to swallow every suck as my milk went mental and used to squirt!).
My advice is to try to find a few mins to get help on mumsnet every day when the baby comes, there are breast feeding counsellors on here who are sooooo supportive

[hairtwiddler]

Midnight, that is exactly the kind of tale I need to hear!
I'm having a boy this time, so that will be different for a start.
You've reminded me I did listen out for swallowing (something I know a bit about from work, but not re: babies). I am very generously breasted though, so probably couldn't see under her head very well!
I will come on here, but have asked dh to block me on my pc, for fear I get too obsessed. I think the worry wore me out more than the feeding! I have to come upstairs and attempt to get into very messy study to mumsnet, which is probably a good thing.

[Katie14]

I don't want to give you advice about breast feeding as you've already mentioned the supply demand issue which is important and I don't have experience with a baby who was born early.

What I did want to suggest is that you talk to you GP or health visitor about your previous experience of pnd and try to put some support mechanisms in place in case it happens again. I don't want to make assumptions but it sounds like maybe you're worried about this happening again. It probably won't but you talk to people and are prepared then that could make it easier this time around.

[hairtwiddler]

Thanks Katie.... yes, you're right in guessing I'm worried about pnd. They were dark days, and I don't want to repeat them. My feelings of failure about feeding were very much part of it (should stress I don't feel that way now). We waited quite some time before we felt ready for another baby and now here I am at 29 weeks - eek!
I have a rubbish health visitor unfortunately, but do have links with a peri-natal team who helped me first time around. Also two really great female GPs at my practice who helped then too.
Thanks so much for your concern. Fingers crossed all will be fine this time. If not, I know from experience it does get better.

[Katie14]

I really wish you well. At least this time around you're prepared for how you might feel and you'll know the signs if things start getting bad so hopefully will be able to get help straight away. It's great that you have a couple of good G.P's - perhaps talk to them about your concerns. Best of luck.

[dorisbonkers]

My baby was 5-6 weeks early, had a section, baby was very sleepy and jaundiced and had a tiny gob and I had what the Singaporean nurses said were inverted nipples, so probably would find it tough.

I'm still breastfeeding her exclusively (apart from BLW) 10 months in. I still do worry about her weight but that's just me being a worry wort. She's followed her line just below the 9th centile so I think we're doing something right.

I must have fed her 18 hours out of 24 in the first few weeks. But then I freaked that I needed to so perhaps I fed her when she wasn't hungry. Didn't harm her, but now she still feeds frequently -- say 4-6 times in the day and erm, loads at night.

You said this "I had no pain, no mastitis. But also no feeling of full or empty breasts.

My gut feeling is that she had a problem getting the milk from me to her, which resulted in poor supply."

I had no pain really, no leaking and only fullness if I went more than 2 hours without feeding, which I so rarely did. I also couldn't express diddly squat and thought (wrongly) that

I had to rely on wet nappies and general demeanor of my daughter, rather than what I thought she was sucking. I once tried her with a bottle and she would only take 4 oz. I was always fussing that my latch wasn't right (I have big areolas) and in the end hired a private lactation nurse who checked and said I was doing fine. But that did reassure me.

In the very early days I took my baby to the hospital to see the lactation nurse about 4 times!

I'd go to La Leche League perhaps before you have your baby to talk it through? Get the numbers for NCT and perhaps that book "The Womanly Art of BFeeding"?

Oh, and a little tip I found, Pampers nappies (even if you want to use cloth) seem to be the best brand to use in newborn days after hospital to really tell if your baby has weed. For some reason other brands don't give you that feedback as well. Just my opinion.

[dorisbonkers]

..."I also couldn't express diddly squat and thought (wrongly) that this meant I didn't have a decent supply".

Also wanted to wish you luck, and add that I found letting my baby self-latch, rather than the dive bomb style they taught me in hospital, really helped.

[hairtwiddler]

Thank for taking the time to compose detailed replies. Very kind of you all to help me.
doris - I fed for a similar amount of time at one stage, and also couldn't express.
This time I have already briefed DH that I plan to do nothing else but try to feed for the first few weeks. He's fine with that, I'm the one who needs telling not to do everthing.
Thankfully, this pregnancy has been so tough I'm already well down that route!

[ejbab]

I had a similar experience to you hairtwidder. DD was breastfed for 2 1/2 then fully on formula by 3 1/2 months. Had PND and have felt horribly guilty about early weaning and what I considered to be failing at breastfeeding ever since. Nevertheless, uring my pregnancy with DD2 I told myself I would do my best to BF again but not beat myself up if it didn't work out.
It's been a long journey with the same difficulties I had last time but DD is now 4 months and we're still BF, with one formula bottle in the evening that DH gives her while I sleep. The difference this time was that I got loads of help - saw the (free) lactation consultant at hospital (don't know they are available in UK?), spent loads of time on MN (like you nearly had DH step in to stop me as I get a bit obsessive too), and searching for information on good latches etc. I think good old bloody mindedness got me through - that and the fact that second time around time seem to go much quicker. Before you know it the baby is 3 weeks, 6, then 12 weeks old etc.
Also, and this is perhaps more relevant for you, I had a huge milk supply this time around, unlike the first. I read somewhere that second time around breastfeeding mums often have 30% more milk than they had for their first baby. Not sure if that's a scientific fact but it's certainly been my experience. Of course the fact that DD2 was permanently attached to my boob from the beginning certainly helped boost my supply.
Good luck - I'm sure you'll find things much easier this time around.

[hairtwiddler]

Thanks for sharing your experience ejbab, that's good to know.
I'm going to make it a point to find out from midwife exactly where I can get good qualified breastfeeding help. I don't think my hv last time ever looked at me feeding... in fact I can only remember being briefly looked at once in the hospital, ie. before milk came in. Because I wasn't in any pain, no one thought there was a problem.
My midwife is fab, I'll be sure to pick her brains when I see her in two weeks.

[tiktok]

There's some great stuff already on this thread, hairtwiddler...would just add that when you say ".. when she did feed it would take over an hour before she came off on her own. She never seemed satisfied, particularly at night, and would cry and cry until on the breast again" you are describing normal newborn behaviour which is best responded to by keeping the baby close for as much of 24/7 as you can, even in SCBU.

The 'never seeming satisfied' needs unpicking - if you mean 'always objected when put down in the crib and seemed to want to resist' then that is normal. If you mean she literally never seemed to show signs of having a contented feed, then that would be addressed by improving the bf. The temptation in our culture is to judge breastfeeding effectiveness by the wrong things...so women tend to only think they are bf well if i) they can express a lot (irrelevant) ii) the baby feeds at spaced out, predictable times (irrelevant and misleading) iii)the baby is happy to settle and sleep away from mum (again, irrelevant and misleading)

There are other, better ways to keep an eye on bf effectiveness.

Introducing formula is sometimes necessary, but far, far more often than not it messes up breastfeeding, in the medium and longer term

[weasle]

i also 'failed' (in my eyes) at bf ds1, mix fed then fully ff by 4 months due to slow weight gain.

with ds2 i was like a previous poster above and hoped to bf but tried not too worry too much if i had to give ff. i have had lots of problems but am still bf at 20 months. MN, RL help and bf groups have all been great and just knowing abit more about how bf works. Also i found short term goals important eg i tried to bf for 2 weeks and then 4 weeks then 2 months etc. and now here i am at 20 months! time flies!

good luck

[hairtwiddler]

Some great replies, and helping loads.
Tiktok, was hoping you'd come along too
I know know that the extended feed times was normal behaviour, wish I had then! It was such a massive change to my lifestyle, one I found very difficult to adjust to. This time the change won't be as marked.

The 'never satisfied' thing was more that she wouldn't be put down after a feed. I would try to settle her, but the only solution seemed to be to put her back on the breast. Was terrified of falling asleep, so was exhausted. Is this what I've heard called 'non nutritive sucking'?

I suspect she was doing quite well, although wan't producing many dirty nappies.. she was never in scbu, as was born at 36/2 and thankfully did well without support.

She's downstairs as I type, asking for more food - has been eating all morning! Some things never change!

I'm so glad mumsnet will be here to help address any questions I have in a few months. This is very educational though, now I can look back objectively.

[tiktok]

hairtwiddler - sounds like you will be in a good starting position for this coming baby

You ask about 'non-nutritive sucking' - you're right, this is sometimes used to describe the baby being on or at the breast nibbling and licking sleepily without doing much actual sucking and swallowing. It is massively normal, and the distinction between this and 'real' feeding is very blurred, I think. Because this sort of snuggly nibbling can become a more obvious 'feed' at any time, and from the baby's point of view, he is satisfying a normal, developmentally-appropriate need anyway...to be close, to be in human contact, to be with his loved person, to not be alone, really. To the baby, there's not a huge gap in 'feelings', between wanting to do all that and wanting milk.

To a mum who's scared of sleeping with the baby, then of course it's really hard to meet those needs, which is why you wanted her to settle and stay settled apart from you. That was the reason why bf seemed so unsatisfying for you - you were either terrified, exhausted, worried about her intake, worried about your supply....and often all of those things

It's easier, and better for bf, if you can adjust your expectations, seek support for your fears and worries, and work out ways you can get a reasonable amount of sleep and rest and keep the baby happy....hope it works out better this time

[hairtwiddler]

You are right there tiktok.
I'm so glad I can now talk about it objectively. So much easier to reflect on 3.5years on.
I found the responsibility of feeding totally overwhelming. My relationship with DH has always been one where we share everything. I found it so difficult that what I deemed success or failure was soley on my shoulders. I was in such a sleep deprived haze too.
Now I've been a parent for a few years I view responsibility differently. When new baby comes I'll be feeding, and he'll be looking after DD and doing the housework!! He is under instruction to ask me what more he can do, and to give me lots of encouragement. My mum has been given subtle hints that I know lots more about feeding now and feel more confident this time around. She's a fab lady and wasn't pushy about bottles, but didn't feed my brother or myself, so she couldn't understand my feelings at the time. At one point she did tell me to give up feeding, although I ignored her!
I've bought one of those snuggle nest things to help with co-sleeping, and plan to have the cot bedside when baby is a bit older. I'll be much keener to feed lying down too.

Will let you all know how it goes....

[hairtwiddler]

tiktok, would you mind also telling me about expressing/pumping to boost supply? Do you think it would have been of benefit in my case? I never managed to hand express but have rubbish grip strength and couldn't manage manual pump.
Worth buying an electic one??
Thanks again for everyone being fab.

[tiktok]

I dunno, hairtwiddler....expressing last time round would have been a great (not) way for you to judge your bf performance, and an added pressure because of that. You'd also need to have found time to express (and sterilise the pump and its bits and store the expressed breastmilk). Why not just feed the baby if you have all that spare time ?

Expressing is useful if if some reason the baby is unable to build up a good supply or unable to suck effectively, or if there are other issues not resolved simply by feeding and holding the baby a lot.

Reading what you went through last time, I think expressing would have been another chore, another thing the baby would have to 'settle' for in order to let you do it.

I really think nothing you;ve said here makes it sound as if an electric pump would be a good buy for you. If it turns out you do need one, for convenience or whatever, you can always get one at the time

[hairtwiddler]

You're right... five mins internet shopping or sending DH to mothercare and we'd have one!

[dorisbonkers]

If only I knew that expressing wasn't something everyone did, or that I felt I should buy a pump in case I'd have saved myself a lot of heartache and a lot of stress and a lot of worry and a lot of time.

Besides, expressing takes time away from your baby sucking, which if everything is on track, is the way to build supply.

So instead of thinking 18 hours out of 24 (ok, perhaps it's not that much for some) breastfeeding was abnormal or an imposition or intolerable, it's actually normal and a good way to ensure a good supply.

If you need a pump the hospital can supply one, or you can order from the internet and it can be with you in hours. Medela Swing is the one that works quite well with a lot for mild home use.

Expressing is just the most miserable f*cking thing I've ever done! Kudos to mothers who crack it and continue to do it when necessary.

[deaconblue]

re dirty nappies - dd only ever did one poo a day from newborn, I think wet nappies are much more relevant to how the bf is going than dirty ones.

[hairtwiddler]

I read on kellymom that 1 dirty nappy on day 1, 2 on day 2, 3 on day 3 was a good indication. Obviously it stops going up from there! Haven't heard this anywhere else though!