Breastfeeding

[MyPatronusIsAnOrca]

Hi,

I’m hoping someone can help. My DD is 4 days old and I’ve been trying to breastfeed. I had a decent amount of colostrum and all the midwives said she’s latching well.

However, she had her day 3 weighing and she has lost 8.5% of her birth weight. The cut off point for “intervention” is 8%.

The midwife assistant that came out to weigh her said I need to top up with formula and they’ll review the weight again on day 5 (which is tomorrow).

The thing is although I can see she is getting milk (spat out a little, wet nappies, and from me leaking) I don’t think my milk has come in properly yet.

I tried expressing earlier for the first time and I only got about 5-10ml from both breasts combined.

I have a beaker from the hospital which I put the expressed milk into but she can’t quite get the hang of swallowing it. This will be the same with formula. I really don’t want to introduce a bottle so early on.

I am desperate to breastfeed, I’m still carrying so much guilt and sadness with me from having similar issues with my DS from 4 years ago and regret giving up and stopped with breastfeeding. This was due to him losing weight and me getting scared he will get ill and pressure from the in laws to give formula (who we were staying with at the time) saying I was starving him.

I’m so worried that tomorrow she will have lost more weight and that the pressure to stop BF will be there again.

I’m doing skin to skin contact and she’s constantly on my breasts. Is there anything else I can do to bring my milk in?

Anyone experienced a similar situation and went on to BF successfully?

I feel like I’m spiralling into my feelings of guilt and sadness at potentially failing both my children.

I would welcome any tips/advice.

Thank you for reading.

I was in a similar situation to you when DD was born last year. I declined to top up. I didn't feel confident in the advice that was given as I think the midwife has just been on a course and no personal experience so just box ticking.
Some other mothers suggested that if I wasn't worried about her before I learnt her weight, then perhaps knowing her weight didn't change anything.
I think when they are so tiny and half an ounce will make a difference to the course of action, it can be hard to remember that either side of a dirty nappy can produce a reasonable change in weight!
Other posters have suggested some great resources and the breastfeeding helpline is open in the morning. I found them very helpful and reassuring.
Good luck xx

The advice to give formula top-ups in the absence of any actual concern about your baby and how well she’s feeding is little half-hearted. There are many things to consider first, so try not to lose heart. Keep feeding as much as she wants, and don’t worry about the results of the weigh-in until it happens. Everything sounds very normal so far, take it one day at a time.

Hi I am a midwife and HV and I would not be advising formula top ups at this stage. The cut off for our weight loss pathway is 12%
As others have said you don’t have to top up but I understand it can be hard to challenge her. Successful feeding isn’t just about weight gain this early; it’s a complete assessment including the things you have outlined (number of feeds, length of feed, wet and dirty nappies, nipple comfort/shape at the end of the feed, absence of clicking noise etc). I would challenge on what evidence their practice is based.

Thank you for all the responses, it’s given me some hope.

I think I will hold off the top ups, at the very least to see if my milk coming in makes a difference.

I’m so desperate to succeed this time around.

It sounds like you're doing a great job op. The LLL helpline is open and manned today so there's always someone about who's had breastfeeding specific training if you want to have a chat about what your mw is saying

Hi OP,

I had DS 2 weeks ago and was told the threshold was still 10%, so I wouldn’t be too worried. I agree with PP that formula will confuse your supply, so I wouldn’t go there yet.

Yes, it’s normal for baby to live on the boob (day or night, they can’t tell the difference yet). It’s to stimulate your milk coming in so that baby can get more food.

You’re doing a fantastic job - your baby would tell you if they were starving. I’m here for you if you want to chat as we seem to have similar aged babies.

Merry Christmas xx

Keep pumping to build the supply maybe. Ultimately, don't lose heart, I'm sure it will get better. Has anyone been round to check positioning? That was the issue for me! Sound like trying to relax could help too! Can you take baby to bed for a couple of days and just feed when needed? I do top up but they call it the top up trap so only do it if you want to! X

Thank you for the messages of support and advice.

The midwife assistant is due again today to do the weighing again; trying not to stress about it based on what everyone has said above.

I’ll also be calling the helpline after midwife has gone.

When I was pumping yesterday or when I hand express the milk doesn’t squirt out, does that mean my milk still hasn’t come in? Even though it’s now day 5.

I’m leaking when I’m feeding from the opposite boob, enough to get a decent sized wet patch on DDs babygro. I can also see that DD is getting milk into her mouth as she came off suddenly and milk dribbled out.

She’s producing wet nappies still (no crystals) but her last dirty nappy was yesterday morning and that was changing to a browny/yellow colour. No more dirty nappies so far.

Just worried that milk may not have come in as it’s not squirting.

Sorry for all the bombardment of questions.

Thank you for replying.

Congratulations on your baby x

That’s interesting you were told it’s still 10%. I hadn’t heard anything different either until this assistant told me the threshold was 8%.

Ask the midwife or health visitor if there is an "infant feeding specialist" or preferably a lactation consultant that they can refer you to for expert support.

There are often breastfeeding clinics and drop-ins run by the NHS and/or voluntary groups, so you should look those up, although they probably won't be running over the Christmas holidays, it's worth checking.

If you have no luck with any of the above I suggest that you look up lactation consultants near you and see if any are available to see you ASAP, presumably 27th would be the earliest now.
www.lcgb.org/find-an-ibclc/

When you do see a lactation consultant or other specialist, please ask them to do a tongue tie assessment. It's a common problem and often missed by midwives, HVs and other HCPs who aren't trained to do a proper TT assessment.
www.tongue-tie.org.uk/Mobile/m-tongue-tie-information.html

If it's not tongue tie the specialist will obviously be able to give advice on the other issues.

Wet nappies are a good sign. Milk probably hasn't totally came in. That's why she's feeding at night. The cluster feeding is to help your milk come in.

Don't tip up with formula as missing feeds will make you produce less milk.

Read Kelly mom. And the milk meg on Facebook. Join some support groups on Facebook too. Loads of advice on MN.

Feed every 2 hours. More if she wants. Drink plenty of water. And relax. You're doing everything right.

Let us know how it goes with the midwife.

Btw it's 10% here too xx

@MyPatronusIsAnOrca how did you get on with the midwife and weigh in?

@blueskiespls she was weighed on day 5 again and had put on just over 30g which brought her weight loss to just over 7% so under this 8% so the midwife was happy with that.

Our next appointment is at day 14 when DD needs to have returned back to her birth weight.

My milk has fully come in now, so feeding as often as DD wants and more.

Challenge is to keep her awake as she falls asleep at the boob

Glad it went well. 7-10 is seen as 'normal' and ok for breastfed babies where I am.

Just to say she doesn’t have to have returned to birthweight by day 14. As long as she’s increasing that’s fine. Breast compressions have been mentioned before if you think she’s falling asleep before she’s had enough.

@isittimeforbed yes I’ve heard from friends where their babies have taken longer than 14 days to get back to their birth weight. So will try not to be too disheartened if DD hasn’t gone back to her birth weight.

I’m trying to just focus on my DD and establishing breastfeeding and trying to enjoy this time; but at the moment it all feels so target driven for want of a better word which is making me so anxious.

Thank you to everyone for all the supportive messages. I’ve been going back to them when I’m feeding in the middle of the night.

Breastfed babies lose more weight in the first few days than formula fed babies. The weight charts etc are based on formula fed babies so people tend to freak out unnecessarily. My bf baby lost over 10% in the first 3 days.

It’s wise to top up because your baby is having to expend effort to get milk from the breast - it’s easier to drink from a bottle. But there’s nothing to say that the top ups have to be formula. I pumped and gave that as a top up.

As for not squirting milk when you hand express - I’ve breastfed for nearly a year now and I still can’t hand express.

@MyPatronusIsAnOrca well that's excellent you're doing a great job :)

When she stops feeding gently stroke along her jawline. It will encourage her to feed again.

Sounds like your doing well lots of fluid, snacks and resting/feeding - expressing v hard in early days hope your midwife more reassured tomorrow’s x

I just wanted to thank everyone for their messages of support and advice.

We finally seem to have turned a corner with the breastfeeding and DD is now putting weight on. Turned out to be a shallow latch.

So thank you to all those that took the time to give their advice and encouragement. It really means/ meant lot in those early days.

Fantastic!