Please help- newborn milk and latch

[CuddlyOwl]

Posting here as Infant Feeding board very quiet.
We have a newborn (7 days) and we’ve had trouble latching which wasn’t established properly in the first 24 hours- very traumatic experience in hospital unfortunately. Baby had one great feed after birth where the latch was perfect, but subsequently baby has only latched for a few seconds and then wriggles away / gets frustrated. Various midwives observed and looked at my hold and said the hold is fine and to keep trying and he should just “get it”, but he hasn’t. Since then Ive been expressing and trying to latch. On day 5 his weight was too low and we were admitted to postnatal ward. Very scary and upsetting. There we spent 24 hours doing a feeding plan of 70ml every 3 hrs. I asked to try a hospital grade breast pump and at first it was great- managed to get all the milk for a feed from the breast. As the 24 hours wore on the breast milk quantity lowered to about 20ml per express, and so we have topped up with formula.
It has been distressing and worrying that we didn’t spot things were wrong sooner and a horrible start to his life. Husband and I have been blaming ourselves and can’t believe we missed the signs- we simply didn’t realise. We love him so much and feel so gutted, but also lucky it was spotted. We are really keen to breast feed, and I have hospital pump at home. Still only getting around 20ml every 3 hours and constantly playing catch up with feeds.
I have been advised to do lots of skin to skin, so for about 1.5-2hours in every 3 during the day he is on me, followed by expressing then next feed, then repeat.
I was wondering if there is anything else I should be doing or can do to boost my supply? My boobs were full and harder a few days ago but have since gone softer and I’m worried that I won’t ever be able to get enough milk to feed him. Secondly he is still not latching though I try him every time I feed.
Has anyone ever been in this situation at this stage?

Has he been checked for tongue tie OP?

Yes he has- nothing there x

Who checked him OP? What is their qualification? Did they feel under his tongue? Have you spoken to the infant feeding team at your local hospital or your local breastfeeding support service? This info will help too <a class="break-all" href="https://www.google.com/url?sa=t&source=web&rct=j&url=abm.me.uk/breastfeeding-information/relactation/&ved=2ahUKEwjBjP3d0dTqAhXNQhUIHccaAgwQFjAAegQIBRAC&usg=AOvVaw2m4bUNka6DmfmBv6lSqWQc" rel="nofollow" target="_blank">www.google.com/url?sa=t&source=web&rct=j&url=abm.me.uk/breastfeeding-information/relactation/&ved=2ahUKEwjBjP3d0dTqAhXNQhUIHccaAgwQFjAAegQIBRAC&usg=AOvVaw2m4bUNka6DmfmBv6lSqWQc

Okay. You could try a nipple shield to help with latch but it sounds like you're doing everything you can at the moment with the skin to skin and the expressing.

The hormones related to breastfeeding are stronger in the evening/at night so it's a good time to try and express/feed to build up supply then too.

Have a look at the kellymom website too, it's full of tips and advice for feeding.

If you're still worried it's perfectly reasonable to mix feed until your supply is stronger. The formula will perk baby up enough to encourage him to latch and feed for longer.

In hospital the doctor checked him. We specifically asked about tongue tie and she had a look. She was the senior doctor there, not a midwife.

Sorry @Bert2e link not working x

Oh poo try this! abm.me.uk/breastfeeding-information/relactation/

Will my milk quantity increase purely through pumping alone, or will it remain low unless I can get him to latch?

So far breasts are stopping after about 15mins pumping and then "dry" for the next couple of hours. No increase in quantity.

Contact leleche league and speak to someone over the phone - my milk took ages to come in and I never, ever responded to a pump, it’s no indication of how much milk you have. Any local breastfeeding groups open just now? Or try facebook for specific advice. Best of luck

Thank you @Pumperthepumper I have contacted LLL so fingers crossed. That's interesting to know your milk took ages and pumps didn't do the trick x

Hi OP firstly. What you get out in a pump is no indication of quantity the baby can get from the breast.
It took me 2days to pump enough for one feed, where as I exclusively breastfed with no issue.

I would also get the tongue tie checked again. Senior doctor Doesn’t in anyway mean they are a breastfeeding or tongue Tie expert.
Contact your infant feeding team at the hospital and ask for their support.

I’m not clear on your timelines, are you expressing then offering baby the boob and doing both in 3hr rotations?

With breastfeeding it’s best to offer the boob at every murmur, once they’re noticeably hungry or crying. It’s kind of past the point they’ll happily latch on.
Arm waving especially with clenched fists, doing little Open / closing fish mouthing And turning their head side to side are all signs they’re hungry.
Basically at this age, it’s often time for a feed more often than not.

In terms of getting a good latch, hold their head at the top of the neck loosely so they can move it themselves.
Aim your nipple at the tip of their nose so they have to tip their head back and open their mouth wide like a hungry baby bird.
If you search the flipple technique on YouTube you’ll see what I mean.

And don’t beat yourselves up. You’re doing brilliantly so far, you are all learning this new process and you’ll be fine in the end

If you stick your pinky in his mouth, is he able to suck it? Or can you feel a "slipping off" of his tongue on your finger? Is his palate a bit bubble shaped? If his suck is strong but you can feel him slipping off your finger, I would echo the possibility of a posterior tongue tie which can only really be felt by a tongue tie expert.

Ps I'm so sorry you're going through this. How stressful. X

Other PPs have given lots of great advice about latching.

To help boost your supply, make sure you stay hydrated - drink, drink, drink!

Also, I found that if I was stressed, I couldn't express. I had to get myself relaxed - hot drink, biscuit (oats can help boost supply, so I had a hobnob) - and then I looked at photos of my baby on my phone. It sounds bonkers but it helped to trigger letdown.

I also couldn't get much out in the evening but found mornings good for expressing.

I hope something here may help you 🙏

Congratulations on your little one.

What a worry for you but don't despair. I had a similar problem with my second daughter. A lovely nurse gave me the advice as above about bopping her on the nose with my nipple so she had to really chomp down with an open mouth. Take care of yourself, drink lots, muesli bars, flapjacks etc. Good luck.

I had a little one who didn't have a great latch, mainly due to being tube/bottle fed in NICU and I ended up expressing and using formula. He's 4 months now and I still kept putting him to breast every now and then and he can actually latch on quite well now, maybe as his mouth has got bigger and he's stronger? I would breastfeed now but unfortunately my supply isn't good enough and he would be a very hungry baby while waiting for it to increase.

Maybe try pumping every 2 hours instead of 3, that was what I was advised to do in the beginning. And lots of water and skin to skin. Can you hold baby skin to skin and pump at the same time?

Thank you all. To answer questions above-

• yes he is able to suck - he sucks my finger very hard and doesn't stop bless him. He doesn't give up or let go and it's a strong suck!

• yes - 3 hr feeds

• I have had a wonderful chat with La Leche League tonight and feel so much better. The counsellor said that 7 days in is nothing and there is still more than enough time to get breast feeding started. She said she is 99.9% sure we will be able to do it and to remind myself many women would have given up trying by now, and not to beat myself up. She said many women start far later than this for all sorts of reasons, and go on to successfully exclusively bf. She also said that I am to focus on building milk supply through pumping, hand expressing and the power pump method for the next couple of days without any pressure on breast feeding him- just focussing on getting him fully fed and up to a good weight and getting my milk up. We are then booked for another session in a couple of days time to tackle the breastfeeding / latch, and she was really positive.

I think it's also worth checking him out for tongue tie with a proper lactation expert as well, just in case.

It's so hard I feel so much love for him- he's had such a hard few days and together we've had a horrible first week of his life when it should have been a happy one and wish I could make it better - but I do feel more positive now.

Thank you for the advice and sharing your experiences.

On a broader note I do not feel that the antenatal care makes it clear enough how common breastfeeding challenges are or how long it can take to get started- it's not said enough.

owl you are doing brilliantly! Are there any breastfeeding network groups near you? Our local one has been doing Skype sessions. There's lots of great FB groups too if you search for them and there's always someone active for a chat and advice.

OP - I just wondered how you are getting on?
I hope things have improved for you and your little one and you got the support you needed.