Breastfeeding challenges

[anon7683]

Hi,
my baby was born via C-section at 39 weeks. He was born at 2.7kg and I thought he was breastfeeding well as he dropped 6.7% weight. We were admitted into hospital at day five with jaundice and he had light Therapy while we were there. We were told he was dehydrated and we needed to flush out the jaundice so we introduced formula . We have also been giving top ups after each feed as he has been very sleepy. He has now four weeks old. He has gained about 50 g a day which is great but he is not really sucking at the breast I have to do compressions into his mouth and then give him a formula top up. I’m also trying to express three or four times a day, but that is making my nipples quite sore as I wanted to maybe try and exclusively pump. Is there any advice anybody can give as I’m really wanting this breastfeeding journey to work? It seems he also has a tongue tie so we are going to the Clinic on Friday to get that resolved but it seems it’s on the mild end so I don’t think that’s the root cause. He’s just generally sleepy

Sorry to hear that you're having these problems, you must be very concerned.

I also had a CS. Both me & DS were very poorly afterwards as I lost a lot of blood, DS got too much of the general anaesthetic & had to go into the SCBU for a while.

I was brought up on a farm &, when I had my DS, I rather expected that he would be like other baby mammals & somehow have an instinct as to what to do. However, he just laid in my arms, turning his head around with his mouth open expecting me to know what to do, which, of course, I didn't. I got into a right pickle & ended up very upset with swollen painful breasts & a baby who was obviously hungry & screaming his head off.

A specialist nurse stepped in. Put me onto a human milking machine to ease my breasts (as they were so swollen by then there was no nipple for him to latch onto) and showed me various positions that were more comfortable for someone with a CS scar, drips etc to contend with.

This was nearly 30 years ago, but I'm sure that hospitals still have midwives who have been trained to help with breast feeding problems. Keep going because, as you know, if you can manage it, it's best for baby & best for you - not only that but far more convenient than preparing bottles, sterilising them etc.

If you decide that it's not for you, that's ok too. I hate the guilt that so many mums feel when for whatever reason they don't breast feed.

Have you got a local breastfeeding support group? Mine were a god-send and meant I exclusively BF my DS after two failed attempts with my DDs. They should be able to offer advice on latches and positions to help.

Congrats on new baby !
my first was via emergency c section and also had light treatment for jaundice and a difficult start to breastfeeding. After a lot of hard work I ended up breastfeeding him well into toddlerhood.
Are you in a supportive breastfeeding group in real life or online eg la Leche league (which is international) definitely join.
you can phone national Breastfeeding helpline UK for free support 24/7 0300 100 0212
https://www.nationalbreastfeedinghelpline.org.uk
there should be lactation consultant support at the tongue tie clinic? If there is not then in the UK would be covered by your maternity hospitals NHS infant feeding team. They run breastfeeding clinics locally and in some areas do home visits.
New babies can be generally sleepy and need to be woken up every 2-3 hours daytime and night-time to be breastfed (until they’re back up at birthweight) Be careful with formula top-ups as this decreases your own supply (unless you pump when baby has the bottle of formula)
I would phone the national breastfeeding helpline for sure, Your local infant feeding team, a private lactation consultant if possible ( or you may already have this in the tongue tie clinic) and ensure your local health visitor or midwife is coming out to visit and support you. Sending hugs it’s such a tough time!

laleche.org.uk/telephone-helpline/

One thing that helped with my first is is he latching well enough on the nipple. They take a lot of the nipple in - it's not like sucking from a straw as I had imagined.
See if you can find a local breastfeeding support group and they're normally really helpful. It's worth persevering as it's so much easier than bottles, especially in the middle of the night or going out for the day!

I also had a c section and challenging breastfeeding.
I wholeheartedly endorse the recommendation to get a properly trained person to help with latch and positioning and tongue tie. In person is much better

Also if you want to breastfeed put baby ti the breast often and do loads of skin to skin time. You still have time to stimulate your supply (til 6 weeks i think)

Exclusively pumping sounds like really hard work (i did triple feeding for about 6 weeks).

When I had my first I lost a lot of blood and so I started by mixed feeding, and gradually reduced the formula and increased BF over 4 months, until she was basically ebf after 4mo. I then breastfed her for over 2 more years.

That's how I'd do it - do not mess about with expressing. Every single mum I know who expressed-fed gave it up altogether after just a few months or even weeks. It's the worst of both worlds: you don't get all the benefits of breastfeeding and you get all the chore of bottles and more.

I'd start with 50-50 formula and direct breastfeeding, which will give your baby all they need to kick the jaundice, and then gradually reduce the formula. Play the long game!

Also if you want to breastfeed put baby ti the breast often and do loads of skin to skin time

I agree, 100%. Take baths with your baby, do contact-napping, carry them in a sling while you do housework etc.

Be careful with formula top-ups as this decreases your own supply

I really disagree with this. It may do short term, but supply is very fluid. As long as you keep up the breastfeeding everyday, you can easily reduce the formula and increase the breastfeeding at a later date.

This all-or-nothing approach is why so so many women drop breastfeeding altogether very early in this country, in my opinion.

Mixed-feeding is much more sustainable and I think most mums would agree that it's more beneficial to mix-feed for years, than EBF miserably for just a couple of months before giving up in despair.

If you have money to throw at the problem, I’d recommend finding an IBCLC. I saw one with my baby last year and it cost just under £100 to visit in clinic, tongue tie check, watch a feed, gave me a plan and was available for WhatsApp support afterwards. And obviously I can’t speak for all lactation consultants but she was so warm and kind and caring. And so fast! She called me within 2 hours of me filling in the online form even though it was a Sunday

My daughter used to latch but not suck. The thing that made her actually suck was a nipple shield. Some people don't like them but it might be worth a try and seeing if you like it or not. Also breastfeeding position mattered, I did laid back feeding. It did work out in the end!

@anon7683
The latching and not really drinking, very sleepy, was how my first child was. It caused me a lot of anxiety as I had hoped to ebf. I ended up pumping and combo feeding, but the regular pumping with little output (happens with some), baby at breast and bottle (breast milk and formula) was time consuming, exhausting and very stressful. I really felt like I was a failure despite a fed baby. My 2nd baby was completely different. Mostly breast fed. Still bf'ing a few times a day at 2. 🤷‍♀️. My advice is to go with what you can manage and don't stress about changing things as needed.

As someone said above, expressing is very hard to maintain and will never give you as much milk as your baby can get by feeding directly from the breast, so it can feel very unsatisfactory all round, and mothers often get into a cycle then of topping up with more and more formula which then decreases supply even more. Tiny babies are sleepy, they don’t manage more than a few minutes awake at this stage. I think seeing a lactation consultant is a great idea; in the meantime, can you take to the bed with your baby for the next 48 hours and just do nothing else but rest and feed her on demand? Every time she’s awake, basically, feed her; this should ramp up your supply quickly.

The 48 hour thing is what I did with my 2nd. It's called The Cure (🙄 re the name)
I did skin to skin in bed a lot. It might've helped, or it could be luck of the dice. 🤷‍♀️

I wish I'd had the thinking capacity to shell out for a lactation consultant. If you can, do that.

I had pemature twins via c section, jaundice etc... the support to breastfeed in hospital wasn't there. It was shocking. It was the opposite to what I'd expected. As soon as there's something wrong with baby, breastfeeding support goes out the window.

You're home, do plenty of skin to skin, all the stuff you're already doing I expect.

Midwives, awful. Health visitors, worse. All claimed to have helped me, on paper. None helped at all. What i was doing already was parrotted back to me as though it was new advice. Nobody is as gaslighted as a new mother. I found a group at 5 weeks. I finally cried with relief, not frustration. A simple nipple shield for a few days to teach them and make it easier, then on and off when they got too tired to suck saved us in the end! So simple. Drop of milk on the end, gave them something to aim for, and work at, as my nipples just weren't cutting it!

(They are three-years-old now, and still breastfeeding, so my nipples figured out how to compete with teats!)

I never used them, but you might find silver cups useful for your sore nipples. I've heard good things.

I agree with skin to skin. My second baby was very sleepy and thought was barely taking in any milk burned putting on weight okay, then about 8 weeks they woke up and weren’t so sleeping. Mine also had a very shallow latch

they may be taking in more than you think

I ended up exclusively pumping because my baby just couldn't transfer milk from the breast effectively even after having her tongue tie cut twice and seeing a cranial osteopath. I spent a fortune on lactation consultants and private tongue tie nurses and all that but it made no difference. She would latch and suck for 10 minutes then just cry with hunger and frustration and my breast would still be full, she just couldn't do it, she would suck all day and get barely anything. The stress nearly killed me in the first month so I just gave up and pumped and bottle fed expressed milk instead. It was really hard but it was really important to me she had breast milk for the first six months. I made it to six months bang on and binned the pump and never looked back! I'm so proud I made it though, I gave her what I set out to give her.

You can follow all the advice in this thread and see all the specialists and it still might not work, some babies just can't do it it's nothing to do with you. Don't kill yourself for it and if you're determined to give breast milk but your baby can't feed properly just get a good pump, set yourself a goal, get there then ditch it guilt free. Expressed milk is still far superior to formula don't listen to people telling you it's not.

Well done @YourBreezyBiscuit that is a labour of love

Hi,

Congratulations on your lovely baby.

Breastfeeding journeys are rarely linear, and you need to give yourself some grace. It sounds like you've both been through a lot. The priority is having a well, nourished baby, whatever that means, and not tearing yourself apart in the process.

Whilst their are some moderate health benefits of breastfeeding to babies and mums (these are often overstated, see Emily Oster's book Crib sheet), maternal mental health is a much stronger influence of outcome for kids.

My baby was born prematurely and was on a ventilator, in hospital for weeks, and then fed via an NG tube after we came home. We're still breastfeeding 8 months later, but it took lots and lots of time to establish (at least 4 months!). In the moment it feels so frustrating but it won't last forever and it's still possible you have an entirely successful breastfeeding journey.

I used to feel SO INSANELY JEALOUS of women who just threw their baby to the breast but now, in retrospect, 8 months on, I am so proud of my persistence and what I have been able to do for my baby despite many challenges.

Excellent advice from others on the thread re feeding baby at the breast.

Advice re pumping - I exclusively pumped whilst we needed and still pump now.

Check your flange size multiple times - the size I was given in NICU was generic and the totally wrong size for my nipples so check yourself. Ensure you've got a decent wall pump (spectra is the most commonly available). Stay away from any "wearable" pump at the moment, even if it claims to be "hospital grade". You need to pump every 2-3 hours, including overnight. You can start to drop pumps once your supply regulates at 12 weeks.