to think I can't breastfeed?

[ElsieMay123]

I had DS a month ago by emergency C-section due to severe pre-eclampsia. He's been in special care since then, feeding on expressed breast milk. Generally expressed 50ml - 120ml in 30 mins pumping using hospital pump every few hours.

Two days ago we moved to feeding on demand after BF to feeding schedule during the day, which was working well.

One day ago LO started getting angry when latching, and not latching well. Nappies dried up, with urates present. Lost 60g weight in 2 days. I tried pumping after trying BF and got only 10-20ml. Breasts suddenly soft and no leaking.

What happened? Is that it? BF consultant at hospital said everything looked fine, but it's clearly not. Once the stored milk is gone he will be on formula, which is fine for now but I wanted to BF. Can I not? Any suggestions/resources/support appreciated!

I don’t but for you. I uaven’t Any experience of this. Are you eating and drinking enough yourself? There are some good helplines in breastfeeding or the ncp?

Thanks Screaming, waiting for national breast feeding help line to open at 9:30 so thought I'd cast the (mum's)net wider til then. I'm beyond frustrated!
I feel like I've been eating and drinking, 3 meals a day and +2l water. I've definitely been stressed but hard to see how anyone wouldn't be...

There are ways to get your milk supply back up, if you feel you have the time and energy for it. So if you're really determined it can be done, but if actually having a baby in special care is time and energy consuming enough no one would ever think badly of that. Be kind to yourself, you're there for your baby and that's all he needs from you. Honestly once he's a couple of years old you won't give another thought to how he got his milk.

Try giving him a small amount of stored milk the finish off on the breast,that way he won't be so desperate.As you know the more he feeds the more you produce and if you can bare it express in-between.I expect your problem may be that your body is adjusting as you were expressing a large amount and now there is a decrease in demand as your baby is taking smaller amounts each feed.

Yep, change of volume seems possible.
He was getting 'top ups' to begin with through a NG tube, based on how I felt feeding had gone, but we were trying to move to just BF so he could get out of care. He went back to tops ups yesterday once it was clear he wasn't getting full feeds. Since then I've tried pumping but I'm empty. It actually feels really weird after last few weeks.

I had similar with my DD at that age, it just got better by itself (I was a first time mum and just went with what The people in hospital said). Saying that, formula is not poison and if you think baby would be happier on formula then you could maybe try mix feeding? Although mix feeding may lower your supply even more

If you’re going between ebf and bf would nipple protectors help in the short term with latching? I’m thinking that there might be some nipple confusion? Check with your lactation consultant first though!!!
Babies have to work a bit harder on the breast than on the bottle so he might be frustrated a bit by this. A bit more practice might help. You can also pop him on for a comfort suck after he finishes a bottle
It took me a long time to get the latch right, despite everyone telling me it was fine. But when I got it, the difference was subtle but profound.

Thatsnot - do you have any links to good guides. I'm prepared to try! But accept that if it doesn't work then the world won't stop turning.

Not help sorry but and It is bloody hard but keep going as long as you can and then be fair to yourself and stop. You gave him the best start with colostrum and then milk you have produced already

Your breasts work on supply and demand, so the more you drain them, the more milk they will produce. There are ways to increase the supply - one way is your baby himself. They want to feed more frequently, get frustrated and pull on your breasts. You can also express after every feed. Even if you don't get much off, it'll stimulate your breasts to produce that little bit more each time. Eat plenty of oats as they're good for milk production and if you can get hold of it, fenugreek capsules are excellent for increasing supply. From personal experience, it made me stink but it really worked. Keep persevering - you've come so far and done such a great job already. Xx

Ann - no confusion as he's been tube fed, but a LOT more effort for a tiny baby. I think he's exhausted. Maybe just wasn't taking as much and my boobs decided to quite hastily turn off the tap.

I forgot to say he was born at 33 weeks, so is just coming up to 38. Is that a drip feed? No, this whole flipping saga is!

Baby may not be very efficient at feeding yet, has he been checked for tongue tie? I would pump after feeding him to up your supply. Pump/feed as often as possible. The more often you do it the more milk your body will make. But it's time consuming and endless pumping when all you want to do is snuggle baby can be pretty soul destroying!

I had low supply and pumped for a long time. I had wonderful support from La Leche League, they may have a local group to you, or a breast feeding supporter. They also have a helpline.
Good luck!

I had this happen with my preemie. Things I tried:

Big bowl of porridge for breakfast and supper.

Lactation cookies

Nettle tea

Fenugreek, blessed thistle and goats rue herbal supplements.

Pumping every three hours. I tried to feed baby then topped her up by bottle then expressed. At first she was topped up by tube but topping up by bottle meant we could come home.

When all else failed as she was too poorly to feed at all, I got a prescription for domperidone. Some drs won’t prescribe it.

It was hard work. You have to pump every three hours around the clock. Especially at night. It took until twelve weeks actual age to be able to transition to fully breastfeeding. In our case it was worth it as one of my baby’s conditions was much worse when she had formula. If it hadn’t been for that I’m not sure I’d have made the same choices but I’m glad I did now.

It did take over all her early weeks and they are all a bit of a blur. You could express and offer some breast milk and some formula. It doesn’t have to be an either or.

I went from expressing 50 mls to barely getting 10 mls and managed to build it back up to 100 mls by the end.

Try giving the la leche league helpline a call (it's 24/7) learning to bf is hard work for them so if it's what you want to do don't be too put off yet. Theres lots of options and tricks that can be tried. Your hospital should have an infant feeding coordinator too who you can request to see

The only thing that actually matters is that your baby gets a sufficient quantity of milk. Exhausting yourself with round the clock pumping, beating yourself up with guilt over “failing” to breast feed, making the whole experience of new motherhood thoroughly miserable - why put you and your baby through that? I also had an inadequate milk supply, and when I finally gave up and bottle fed, the relief was enormous. My daughters slept through the night from 8 weeks, and gained weight at a healthy rate.
They’re both now grown up, fit and well, with degrees from good universities. Neither of them appear to have suffered from being “deprived” of breast milk!
As a doctor myself, I’d always advise patients to try breast feeding, but it’s absolutely NOT essential for your baby’s survival or well being.

I found fenugreek tablets had a quick effect.

My first was fed through an ng tube and I expressed. He had a very strong suck but couldn't go on the breast as he was on oxygen. As he wasn't fed through his mouth except for the occasional syringe of ebf he lost his ability to suck by 8 weeks.

Have they recommended any oral stimulation? I was given excersises to get him used to things being in his mouth with the aim of eventually bf. He might be getting frustrated if he isn't used to a nipple maybe? Also I would express after you have bf so your body thinks you need to produce more and drink loads of water!

I just wanted to add my own experience in case it was of any help. My LO was in neonatal for a week after birth and was NG fed. We struggled to get her to latch on despite being told by nurses and BF consultant that positioning was good and no tongue tie. She would take expressed milk from a bottle but would still retch and gag, which was a concern so they would top her up through the NG tube. It didn’t improve until I accidentally snagged her NG tube and they agreed to leave it out for a short while to see how she went. She latched in no problem and then later discussions with the dr, he agreed the tube can irratate when feeding and make latching on difficult (no one mentioned this while it was in).
The circumstances are abit different as my LO was full term and wasn’t losing weight but wanted to share in case it was of any help.
I hope you get the support you need and it all works out one way or another.

Thanks all, lots to think about and try. Going to try some nipple shields to see if they help him attach and keep pumping to see if I can get the supply up. The more I think about it the more I think he wasn't feeding so well when we started, and the tube 'top ups' were actually the main event. The uncertainty is killer though, I wish there was a better way of knowing how much they get on the boob. I'm really shocked that milk can reduce so drastically in two days so will talk to hospital and make all is ok with me.

Please make sure you talk to a qualified lactation consultant (IBCLC) and get your baby checked for tongue tie. It is fab that he has been tube fed and not had bottles so there should be no nipple confusion. I wouldn’t use a nipple shield if you are not in pain and baby is not used to bottles. You could try finger feeding if you need to give top ups (using a tube from the milk to your finger and baby sucks your finger and the tube. Your milk won’t have dried up overnight. After a few weeks all breasts feel soft and not full/engorged that is normal. You probably couldn’t pump because you were worried.

update: I have a period! From what i've read although it's unusual it's not unheard of, and it can cause a dramatic reduction in supply. I'm pumping on schedule as recommended but it seems like it might take a couple of days to come good.

Annoyingly some articles online say it's not possible to have a period so soon, making me wonder what on earth all the bleeding was 4 weeks after major surgery and scaring me senseless. Thankfully other more detailed explanations say that the prolactin that promotes milk production and holds off periods can be seriously reduced by night time separation and pumping (i.e. not directly BF), which makes sense.

So I'm not dying, my milk hasn't totally dried up and side point - my tiny mouthed preemie loves the nipple shields; we might have him home soon! What a relief. Thanks again for the replies, most helpful. x

I think it can be really hard to establish bfing with a baby in nicu/scbu. I easily bf my first two full term babies but really struggled when dc3 was prem and needed transitioning from ng feeding. There was so much pressure on recording volumes/timings etc. Also pressure because I knew he couldn’t come home until he was feeding “properly” - every failed bf meant longer on the ng tube - longer in hospital. In the end I decided to carry on pumping and bottle feeding until he was home and then switched back to bf at my own pace.

Well done with the nipple shields! I never could get on with them. It's worth getting him checked for tongue tie before you go home, just to rule it out. It's much harder to get it snipped once you're home because of referrals and waiting times, better to have it done at the hospital. I pushed and pushed to get it sorted before we came home from SCBU and I'm so glad it did, it made all the difference for him.

I have no experience of supply dropping I'm afraid but fingers crossed it will stabilise again, I've heard that the stress of having a baby in SCBU and having to pump there can cause supply to drop, it's very different from being comfortably curled up at home!!

Fingers crossed for you. I hope you do get to go home soon, it's the best feeling walking out of SCBU with him.

Fingers crossed for you OP!
I also had a tiny baby in SCBU and he bf until he was just over 5 months old, then gave up himself for some reason?! The hospital and HV were all really pleased with him as it's such a battle to get them to bf when they are that small, it's so much effort as you said.
Hope you get home soon.