Breastfeeding: is this a problem?

[Thejoyfulstar]

I live abroad but am from the UK. I has a babyb4 weeks ago who was born with respiratory distress. After 24 hours in NICU she was fine but my milk didn't come in until Day 5 and I suffered from dreadful nipple pain which hindered feeding even more.

My baby was 3460g at birth. She dropped to 3165g at 6 days old. They gave me a plan to breastfeed on demand and supplement with expressed milk or formula but this was though as she didn't want anything extra than my breasts. I was syringing in every bit of expressed milk I could get into her and giving her formula in a bottle, which she often vomited. By Day 9 she was 3220g.

Regrettably I decided that I would then focus on just feeding her from the breast. As far as I could tell, I had milk. I've breastfed 2 other children successfully so thought I knew what I was doing.

I leak milk when I haven't fed in a while. My breasts feel hard and full and after she feeds, the feel soft and empty. I can see by the movement between her ear and jaw that she is drinking, and I can hear it too. Afterwards she is contented and is a very settled, happy and alert baby. I change her nappy every 2 or 3 hours and there is always wee or poo. She sleeps a lot but I wake her if 3 hours go by to feed and she is feeding almost the entire time she is awake. My husband and I have been joking that we feel how heavy and chubby she is getting.

I took her to the paediatrician for her 4 week check today and she is 3550g. He says that is not enough weight gain and I have to give formula. I said could I still breastfeed. He basically said what's the point as I clearly don't have milk.

I am so upset and confused. I was certain that my baby was transferring a good deal of milk. The initial latch is still painful but that was the same in the early days of breastfeeding my other 2. I fed my middle child until she was 1 and never had an issue like this.

I feel like where I am, doctors overreact about things that drs in the UK would not. At the same time I don't want to be so arrogant to think I don't need to take their advice. I feel like I have put my heart and soul into establishing our breastfeeding journey and feel totally floored that is has all been for nothing. Am trying to find an English speaking lactation consultant but am really struggling to do so.

Does anyone ahve any experience of this? I have received such little support despite asking for it and looking for it. I dont know where to go from here.

My baby lost a lot of weight to start with as my milk took 5 days to come in after a pph. I was told to supplement with formula top ups after each feed and I'll be really honest I wish I hadn't. It caused so much stress and DS was clearly feeding well at the breast anyway.
Provided the baby is gaining weight and has plenty of wet and dirty nappies then you just crack on. Believe in yourself, you're doing a great job.

Go with your instincts, alright I'm old and there was no such thing as 'lactation experts' in my day but I've exclusively breast fed three 👶s. Your baby is feeding, sleeping, wetting nappies, putting on weight and content. That is enough, throw away the scales and relax. There are far too many experts these days..... Your baby is the expert and she seems to think everything is fine😉

Thanks for the most recent messages!
It's 9.17pm here and I woke baby from her nap at 6. I breastfed her on each side, twice over the period of an hour. At around 7.30 my husband gave her 30 ml breastmilk mixed with 30ml formula. She drank that too but spewed a little up then just generally chilled out with my hubby, just looking around her quietly while I got my other kids to bed. At around 8.30 I offered her the boob which she willingly accepted and again fed on me and is still feeding on me, having swapped sides a few times. The past 3.5 hours have been spent feeding and during the only non feeding time in this period, she was super calm and contented. Its just so confusing! She has bobbed off the boob now and is dozing off peacefully like a satisfied and happy baby 😏

I'd just like to add that in my situation DD was showing all the signs of not getting enough milk including irritability and not enough wet/dirty nappies. So your situation sounds a lot more favourable and you might not even have to supplement at all, depending on a revised weight and what the consultant says. The fact that you have also successfully breastfed previous DC should also give you confidence.

They told me this with my DS when he was born too. Luckily he was my fourth child so I knew he was fine and ignored their request to give formula. Breastfed him until 20 months, he’s 3.5 now and great. Honestly, the exact same thing happened. He just took a while to gain weight but he was fine and is fine.

@Nightwithhertrainofstars thank you. My baby hardly ever cries and is just such a calm, chilled out little girl. Surely if she was hungry she would be a lot more unsettled. And at the slightest hint that she is getting irate, I latch her on. I'm second guessing myself terribly. I rarely go against medical advice even if I think it's wrong as I've no confidence in my instincts at all!

@SartresSoul very reassuring thank you!!

How many dirty nappies do you get a day?

While you are feeling worried just remember:

The more feeds then the more milk per day.
The more sides per feed then the more weight gain (Two sides in a feed is great but three or four just equals more milk transfer).
Start the next feed on the fullest breast - if you can’t tell it doesn’t matter.
If you have gone over three hours between feeds then wake for one but expect some to be much much closer together.

Let your instincts breathe but find good support - the starting point is to be sure of a weight and to check say 3 days later.

And congratulations on your lovely baby - she sounds fabulous

@Flipflopssndsocks thank you! I don't have an exact number but I don't let mor ethan 3 hours pass before changing her nappy except for at night time and there is always wee and/or poo.

One thing I did notice is that her poo is sometimes every so slightly more solid than my other daughters was at that age. It's mostly wet and seedy poo but sometimes it's more like a paste. Don't know if that has anything to do with anything. Breastfeeding does tend to be quite the mystery!

Sounds pootastic - variable as you would expect. Mostly seedy is good - you don’t sound like you have any major probs at all. Other than the awful paediatrician that is. Am sure your ibclc will help you feel better too.

@CatherinedeBourgh

I'm sorry you are going through this. Hopefully the lactation consultant will be able to support you.

If you feel it would help you fight your corner, it might be worth buying some baby scales. I used to weigh ds before and after a feed so I could 'prove' to the medics that he was in fact getting milk from my breasts.

Was just going to say this.

My little rascal fed on me for hours last night, until after midnight. She must know what's going on! She slept until 3.30 and I took that as my chance to feed her. She guzzled some milk on one side for a few minutes and went back to sleep. I couldn't wake her so just left it. I debated whether to pump but felt too tired and was worried about pumping then her waking up soon after to feed on me. Did some googling and have ordered sunflower lecithin (sp) to increase fat in my milk. Now I can't get back to sleep but also feel like I have a head cold starting so feel awake yet wiped out from that.

I got up and did a quick 10 minute blast on the double pump. I got 80 ml which I don't think is too bad considering I already fed a little shortly beforehand and I supposedly don't have milk (and caught about 10ml in a breast shell too)? Anyway, sorry for all the updates. I'm going to throw everything I have at getting my baby to gain weight without having to end breastfeeding.

Does anyone know what the window is between emptying your breasts and them substantially filling again? I drank 2 pints of water, one before and one after the pumping session so hope that helps. Right, I'm going to try to get a little sleep.
Thanks again for listening and supporting me, everyone.

You don't know what it has meant to me!

I struggled bfing my first, mostly emotionally (thanks mil) but also because of one harsh HV's comment at a weigh-in.

Another hv suggested I weigh all the nappies I changed in a 24 hour period, altogether unless you have a super accurate scale, and finally deduct the weight of the same number of dry nappies.

I discovered that ds was 'outputting' more than the tin of formula that I'd hidden in the back of the cupboard suggested he should be fed!

Breast milk is really efficiently consumed by babies - that's why they sometimes feel attached at the boob. Also, growth charts were produced including formula fed babies, bf'd babies do grow more slowly.

Your updates sound so positive joyful! She's feeding lots to get what she needs. And the amount you pumped is great! Absolutely ridiculous what the doctor said, try to put it from your mind. I hadn't heard of the sunflower extract but that also sounds good. You're a superstar!

I come from a country with similar mindset and had a friend being told the same. It was a very anxious time for them being badgered to stop breastfeeding when clearly baby was thriving. So just because a doctor says it, doesn't mean it's true. There are amazing doctors & not so good doctors. You know your baby best.
It feels like the opposite of when doctors don't believe a mother that baby is poorly.
I would at least seek a second opinion, so great news lactation consultant is coming.
My friend's baby is 12 now, perfectly healthy kid🙂

Also in that country there will likely be lactation tea (mostly fennel based herbal) available to buy & drink.

Your breasts always make milk - they make more the quicker you take it. It’s the ultimate in stock control. The emptier you get them the fattier they milk. Gaps where they really fill up reduce overall milk supply.

Oh and water and herby teas or biscuits will do nothing g to your supply compared to just taking milk from the breast by baby or pump. Milk removal drives supply and yours will already be robust as you have fed before snd are feeding successfully now

Aw what heart warming replies! Thank you so much! She woke up 30 mins after I pumped yet still herself on my 'empty' boobs for 30 mins. She then baby guzzled the expressed milk and promptly vomited it (I was too tired (lazy) to pace feed: my fault). Then I gave her a little formula to try to replace what she had vomited as at this stage my breasts had nothing much to offer. She spat that out as fast as it went in her mouth! Then she did the most enormous, explosive, up-the back and down-the-trouser-leg poo. So think she is less hydrated than ever before. She is sleeping now and I'm feeling a let down so will wake her soon to feed again. @Flipflopssndsocks guzzling the water at least makes me think I can make the milk machine go faster 😅

I have no idea what autocorrect was doing in that message!

@Nightwithhertrainofstars thank you!!

Sounds like she's doing great!

One word of warning though. When I was told I didn't have enough milk with ds1 I went crazy on the fennel supplements, pumping, constant feeding, etc. to the point where I gave myself mastitis (more than once!).

Turned out my milk supply was not an issue, and the overstimulation was not ideal. It really sounds like you have enough milk, so do keep an eye on your breasts if you are going to keep pumping.