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.

Just be careful with any supplements to check if they are OK to be taken together :)

Quite quickly! I can't remember exactly (was 15 years ago!) but I remember being surprised at how fast it was.

It's really tough and seems to last forever when you're going through it, but when you look at them all grown up it all fades away...

You are doing great. Every day when she gains is a triumph, and something you have given her that no one else can. for you

@BertieBotts oh that's a good point! I'll cut the sunflower for now.
I'm not seeing any difference despite pumping and feeding what feels like forever. I think my baby is forgetting how to latch. I weighed her before and after a feed and she took about 40 ml over 45 minutes. She just kept nodding off and bobbing off the breast. I've been using more formula than I would like and would say that's where the weight gain is coming from. This is the second day that I'm just so exhausted and I'm starting to doubt if it will even work. I will see what tomorrow brings but I'm not feeling very optimistic.
Poor latch, low supply, slow weight gain...I'm struggling to imagine this ever getting better.

Thanks @CatherinedeBourgh but I think the formula is doing all the heavy lifting!

Are you on FB? I would recommend joining one or both of these groups, they are run by IBCLCs and very good.

www.facebook.com/groups/992032454537530

www.facebook.com/groups/1490285441069342/

It's OK, if she needs some formula she needs some formula, it's not poison! So long as you keep your supply going you can increase the bm as she becomes stronger and more able to feed.

Be kind to yourself too, your wellbeing also matters.

@BertieBotts I'm not on fb but might consider rejoining.
@CatherinedeBourgh I know, I have no problem with formula in and of itself but I'm scared I'll never get my supply up. If it doesn't work then we will try power pumping and see if that does the trick

The LLL have three golden rules for increasing supply and establishing feeding when you've had a rocky start.

Keep baby close - skin to skin when you have the chance. To the breast as often as you can. Co-sleep if that feels safe to you.

Keep baby fed - formula, expressed milk, direct feeding, it doesn't essentially matter, don't worry about what she is drinking in terms of your supply. Baby fed is a priority :)

Keep the milk flowing - feed directly as often as you can, pump as often as you can.

All of this understanding that life happens and you will have other needs and priorities as well. But seeing these three as separate goals can all help you not catastrophise that one thing (feeding formula for example) is undoing all the rest of the work. It's definitely not.

@BernieBotts

That's very helpful. Am absolutely catastrophising.
I've decided to keep the faith and just it go. If it works it works.

I found bf so traumatic in the early days that I just cannot do skin to skin. Can my husband do it?

@Thejoyfulstar your whole breastfeeding story is sounding just like mine with my baby who had tongue tie. I know you said it’s been checked, but I would recommend getting a second opinion if you’re able to. In the meantime, feed and pump as much as possible to keep up your supply, but your story really is almost identical to mine.

@honeybeesknees what happened to you?

Hi op just want to add, are you aware you do not have to wash your Breast pump every single time you use it. It only needs washed once very 24 hours and stored in the fridge in between this. Just incase it helps although you may know this.

@HPmagic oh my gosh: I did know this but forgot!
Thanks for the reminder!

I'd recommend getting a tongue tie professional to have a look. When DS was born, I had multiple hospital staff members, including the infant feeding team, all tell me that the latch was fine and no obvious tongue tie. I pushed and got referred to a specialist, based on the symptoms (pain, lipstick shaped nipples after feeding, him being slow to put on weight). The specialist confirmed a posterior tongue tie and snipped it there and then, and everything got much easier from there onwards!

@Arthien yup I have a lipstick nipple. How was it getting the tongue tie cut? To be honest, I don't know much about it bit the thought seems grim 🤔 Is it a really simple and relatively painless procedure? I feel woozy and weak when I think about it!

[quote Thejoyfulstar]@Arthien yup I have a lipstick nipple. How was it getting the tongue tie cut? To be honest, I don't know much about it bit the thought seems grim 🤔 Is it a really simple and relatively painless procedure? I feel woozy and weak when I think about it![/quote]
They swaddle baby to keep them from moving, one person holds them and another has a pair of scissors. One snip later and done, hardly any blood and straight to you for a feed. Literally over in seconds. Honestly, if they confirm a tie and you get it snipped asap, it'll make such a difference to the pain and the milk transfer!

Oh and he only cried for about 30 seconds,
mainly because he hated being swaddled . It took a few days to get the hang of latching and feeding effectively though, so be prepared for that.

@Thejoyfulstar my DS lost over 10% in the first few days so I was told to start him on formula. It did help slightly, but not enough, so I was told to up it and up it, to the point I was barely breastfeeding. His weight gain was still poor, and so we were referred to the GP. He checked my DS over but no mention of checking his mouth. After advice from a friend, we booked a feeding specialist, and tongue tie was diagnosed and cut there and then.
Things got a little bit better but gradually slipped back again, and we were eventually admitted to hospital for poor weight gain. Baby was checked really thoroughly, and they had a quick glance in his mouth as I had mentioned tongue tie. Again, nothing found so I was then advised to do what you’re doing, feed, pump then bottle feed. It almost killed me over the few weeks we did it. In desperation I asked the feeding specialist to help us again, and she said the tie had reattached. Again, snipped there and then, and things have been amazing since! My son is now climbing the centiles, and is happy and settled, and breastfeeding is easy and painless!
The procedure itself isn’t too bad. My baby was wrapped in a blanket, and I held his head still while the snip was made. He cried instantly, but seconds later I was feeding him and he was fine. It’s definitely worth it for the gains you get in my experience.

Sorry, that was long….

OP your baby sounds absolutely fine and you sound like you are doing an amazing job.

@honeybeesknees wow what a difficult journey you have been on!I am so happy that everything worked out so well. You actually deserve a medal! Thanks for sharing. I just asked my LC and she said that she didn't see a TT. She was checked at the hospital too. I'm going to keep going for 2 weeks and if I can't resume breastfeeding after that I will gradually let it go, sadly. I feel like my other kids are suffering a bit as I'm not really present even when I am with them and I have been so short tempered with them which isn't fair.

@iPaddy thank you!

Update: my baby has gained 130g since Monday on the plan!

Power pumped this morning and will do it again this evening and will keep putting her to the breast. The plan is that once my supply increases, I don't need to give the expressed milk or formula.

Have you heard about an SNS? That can help with low supply as it gets the supplement in while maximising time at the breast. It also cuts down time for you with triple feeding. Medela make one, we used it for 7 months as I have insufficient glandular tissue and can never make enough milk.

I would still get a tongue tie specialist to have a look, especially if you've got a lipstick nipple after feeds. Posterior ties can be harder to spot and I'm not certain that a lactation consultant is qualified to say for certain if there is one or not. Good luck!