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Infant feeding

Get advice and support with infant feeding from other users here.

So confused - please help!

19 replies

bsmirched · 17/07/2010 20:34

DS was born 9 days ago via C Section and we were in hospital until he was 6 days old. He fed from the breast within an hour of being born, but after that was very sleepy. I was assured this was normal in the first 24 hrs or so.

By day 3, I was concerned that he wasn't weeing very much at all and he was far too fond of sleeping! I was advised to put him to the breast 3 hourly and to wake him if necessary. Sometimes it wasn't but he'd often drift off after a few sucks. I've also been worried about his latch and asked soooo many staff on the ward for help and advice. It got really frustrating as one MW would say "Next time he feeds, we'll try this" only for the next time to be when another MW had come on duty who then told me something different. All through this time I was worried he wasn't getting enough from me.

On day 4, he suddenly seemed to switch on and fed for extended periods and I was delighted that we seemed to be sorting ourselves out, but on day 5, the day we should have been discharged, he'd lost 11.3% of his birth weight, so we had to stay in and I was told that "We need to be more proactive" and to feed him 3 hourly for up to 30 mins, top him up with expressed breast milk and or formula, then for me to express as much as possible too.I wasn't happy particularly about this, but was at such a low ebb having thought we were getting BF sorted only to find out he'd lost too much weight, I didn't feel confident enough to say no.

Anyway, we implemented this and by the following day, he'd put on 50g so we were allowed home. This was on Wednesday and we've been following the plan ever since. By yesterday, he'd put on a further 100g, which is fab.

I'm concerned/confused for a number of reasons:

  1. I'm still not sure my milk's come in properly. I know that it can be delayed with a CS. I have large breasts but have never felt the 'full to bursting' sensation that people describe when their milk comes in. I was expecting 2 beach balls but they don't feel much firmer than normal and only occasionally has one leaked whilst I've been feeding from the other and that was more because I was putting pressure on it by reaching round to the other one! I am managing to express a good 50-70mls every 3 hours or so - would I be able to do this if my milk hadn't come in?

2)DS is still quite sleepy, although over the last day or so has begun to be a little more alert and has woken himself a few times to be fed. We still have to wake him quite often and he still regularly drops off after only a few sucks at the breast, resulting in lots of feet tickling, stripping off, etc to keep him awake. I've read loads of advice on here about demand feeding and how newborns need to feed loads, but how can I do this if he's not waking up?

He can feed well for a good 40 mins, detach himself and not want to go back on the breast, but still glug down some formula or expressed BM a few minutes later - would he do this if he was getting a decent amount of milk from me? I assume not. He seems to be doing a combination of smaller and slower, longer sucks and seems to concentrate when on the breast on these occasions.

Basically, am I doing more harm than good following the hospital's advice and would I be better just trying to BF him more often? I'm worried that if I did this he wouldn't put the weight on/might lose some as even three hourly it can be a real battle to wake him to feed but equally I'm worried that I'm messing up my supply by all this expressing and topping up at such an early stage.

Somebody talk some sense to me please! I've had so much well meaning but conflicting advice whilst on the ward and all I want to do is breast feed my little boy!

Thank you in anticipation, and for wading through such a long post!

OP posts:
jaffacake2 · 17/07/2010 20:45

congratulations on your baby boy!
I think you are right about topping him up with formula this will affect your breast milk supply.I can see why it was suggested when your little one wasnt gaining weight but if he is now growing then the topups will
limit the breastfeeding over time.

How about feeding him 2hrly and doing alot of skin to skin contact which will stimulate him and encourage the feeding.

jaffacake2 · 17/07/2010 20:46

Forgot to ask Is he jaundiced which will make him sleepy?

thatbuzzingnoise · 17/07/2010 20:53

Firstly, congratulations on your new baby. And secondly, congratulations on surviving the extended hospital stay with your sanity. I almost lost mine with a long stay similar to yours, including the conflicting and sometimes awful 'advice'.

Firstly put your baby to the breast at least every 2 hrs during the day, not 3 hrs as they said in hospital. Taht is too long.

Your breasts don't have to become engorged to have a good milk supply. In fact, engorgement can be a sign that your baby is not feeding often enough. It is better to note how many wet and dirty nappies per day he is having. What goes in... The accepted wisdom is 2 dirty and 5 wet nappies in the first few weeks.

Can you stay in bed with him and do a lot of skin to skin contact? It will encourage him to cue more often for milk.

You sound like you are already noting the different feeding rhythms with the sucking. When a baby feeds with rapid, shallow suck, suck, suck, he is stimulating the breast for milk. It happens at the beginning of feeds for example. Once they get a let down, it changes to a slower, deeper suck, pause (drink) suck. At the pause you should see the baby swallow. A feed can have several letdowns so don't take the baby off the breast, just let him come off on his own.

It sounds like the expressing (and formula feeds)) are not necessary from what you are saying but you may want to try breast compressions if there is still reason to worry about weight gain at this time. Google Dr Jack Newman. His site has a lot of videos on latch, drinking, latch and breast compressions.

Also you may want to speak to a breast feeding support line. www.abm.me.uk / 08444 122 949 is open till 10.00 tonight.

bsmirched · 17/07/2010 20:54

Thanks Jaffacake - I don't think so. He's a healthy colour and nothing was picked up at the hospital!

We have tried skin to skin but he just seems to enjoy the snuggle!

It's so hard having the confidence to go against medical professionals when it's all so new and I feel so uncertain!!

OP posts:
jaffacake2 · 17/07/2010 21:03

Are you still seeing your community midwife or health visitor to check his weight? If he is gaining weight then the breastfeeding is fine.
I think you need to see that for you to have confidence in your ability to feed him.

angfirsttimer · 17/07/2010 21:04

It sounds like you are able to express a good amount so doesn't seem like you have an issue with supply, I agree that bf more often is probably the answer, mw's and hv's seen very keen to encourage topping up IME but everyone else says it's not necessary. I say go with your instincts.

Babies will suckle in their sleep if hungry AFAIK I dream fed my ds for a couple of months and he didn't wake at all but took a fair amount of milk.

Good luck have faith! This breastfeeding lark is a rocky but very rewarding road!

tiktok · 17/07/2010 22:15

bsmirched - horrible to be confused

I agree with thatbuzzingnoise - 3 hrly feeds are not enough. Most babies of this age feed more often than this at this stage. But the waking-up thing is not a good idea....instead, he needs to be skin to skin with you as often and as long as possible. This will ensure more feeding. Don't worry that he likes the snuggle! That's ok. He will sleep, for sure, but he will also wake too - he may need a little help by not being too hot, and by being offered the breast at every twitch

Feeding for 40 mins and then not wanting to go back to the breast? That's ok....give him a few mins rest and instead of offering ebm or formula, he needs to be offered the breast again.

At the moment you are feeding the very hardest way - bf direct, expressing, using formula. I blame the hospital for getting you into this pickle, sorry - too many staff changes, not enough expertise.

His weight is no longer an issue. From what you say, the way forward is to breastfeed a lot - both sides at least each time. Maybe you can see a midwife tomorrow to check this out with her?

bsmirched · 17/07/2010 22:37

Thanks so much everyone - you're all pretty much saying what my instinct was telling me so it's great to have some back up.

OP posts:
moajab · 18/07/2010 02:06

Try not to worry about weight gain - my first baby took nearly 6 weeks to get his birthweight back (he's now a healthy, active intelligent 8 year old!) I'd suggest offering a breatfeed every three to four hours. Make sure he's wide awake, perhaps by changing his nappy, before each feed. Feed for as long as possible on one side, so he gets lots of the hind milk, which is higher in calories. With my second and third children, who both gained weight very well in the early days, they fed for about twenty to twentyfive mintues on one side before swapping over. Congratulations and Good luck and try to enjoy eveyr moment of these precious early days with your new son.

moajab · 18/07/2010 02:07

Try not to worry about weight gain - my first baby took nearly 6 weeks to get his birthweight back (he's now a healthy, active intelligent 8 year old!) I'd suggest offering a breatfeed every three to four hours. Make sure he's wide awake, perhaps by changing his nappy, before each feed. Feed for as long as possible on one side, so he gets lots of the hind milk, which is higher in calories. With my second and third children, who both gained weight very well in the early days, they fed for about twenty to twentyfive mintues on one side before swapping over. Congratulations and Good luck and try to enjoy eveyr moment of these precious early days with your new son.

piprabbit · 18/07/2010 02:17

I've BF my 2 DC and really struggled with the fact that there was never any milk to be seen. No leakage (I have packs of unused breast pads tucked away somewhere), no dribbling during feeding, the babies weren't even very sicky so I didn't see much coming back up again. And I never managed to express more than a few ml at a time.

But something was going OK, because they are both big and thriving now and I'm glad I stuck to the BFing.

You've had some excellent advice already - I just wanted to wish you lots of luck and determination.

And congratulations on your new arrival.

confuddledDOTcom · 18/07/2010 02:33

My first baby (CS) it took more than 10 days for my breasts to get to that "house bricks" stage. I had day three five blues where my milk started to flow but nothing much then for a few more days.

You might find rebirthing helps. You get in a warm bath and get a helper to hold baby on his back in the water, just floating around for a minute or so with just his face out the water. Then you bring him up onto your chest and allow him to self latch. It's supposed to be good for getting things going if you've had a difficult start, and if you've had a section it can help to reclaim the birth.

I used to find cobathing always got my baby wanting to feed.

Lots of good advice already given so I'll leave it to them.

mjinhiding · 18/07/2010 03:31

This reply has been deleted

Message withdrawn

tiktok · 18/07/2010 09:04

moajab - sorry, some of your advice/info is misleading. I'm certain you're well-meaning so please don't be offended!

Three to four hourly feeds are nowhere near enough for a baby who has had weight issues in these very early days - such infrequent feeds will reduce his intake and the OP's supply.

There is no need to artificially prolong feeds on the 'first side' either - the concern about 'getting the hindmilk' is largely over-stated because of misunderstandings. It is usually fine to allow the baby to take what he 'asks' for on the first side and then swap over, without keeping on the first side longer than he seems to want. Intake of milk is increased by offering both sides at least once at every feeding session - foremilk/hindmilk intake don't normally need to be 'engineered'.

Ayamama · 18/07/2010 13:36

This is my first time to post. I just read your post and really identified with it.
My DD was born by C section, weighing under 5lb. When we got her home we were prepared for screaming and constant feeding but it never came, instead she slept for hours and was nearly impossible to wake. We tried everything changing her nappy, getting naked, even bathing her (can you believe, even in the bath she stayed asleep apart from the lazy opening of 1 eye). She also slept all night. Anyway, after a week her weight had dropped dramatically and the midwives prescribed top-ups with formula or expressed milk. The consensus was that DD had gone into 'power-saving-mode' (the midwife's words) and was actually burning more calories sucking (when she did feed it lasted ages!) than she was consuming. I was really against bottles because of nipple confusion and I didn't want to introduce anything other than breast milk to my babies gut (I'm a bit more relaxed now). However, I tried topping up with just 25ml of expressed milk after some feeds. I found that the bottle teat forced her to suck in a way I could not with my breast. I also made sure to feed her at least every 2 hours and within a week she had become strong enough to cry, suck normally and demand feeds all the time. I then chucked all the bottles and we have never looked back. She is now 8m and 21lb! So there is hope for you. Some babies just take a while to get the idea.

Sorry about the long post!!

Ayamama · 18/07/2010 13:37

Oops! Should have put more gaps in my post...

bsmirched · 18/07/2010 14:14

Thanks so much everyone.

MW been today and he's gained another 80g in two days, I think that's about 3 oz in old money, so am really pleased.

Have only topped him up once today and he seems to be demanding food off his own bat every couple of hours, and feeding better. We're still practising positions though! lol.

Tiktok - interesting what you say about fore and hind milk. We had it drummed into us at antenatal class the importance of sticking with one breast due to the quality of different milks at different stages of the feed. I feel a bit better about the fact that he never seems to 'empty' one boob now before fancying a change now!

Anyway, thanks all for your experiences and advice.

OP posts:
tiktok · 18/07/2010 18:05

Glad things look better today, bsmirched

It is quite quite wrong to tell mothers to stick to one breast - yet it is a common misunderstanding. There are no rules! Babies can have one or both, sometimes or all the time, as long as their needs are met. In the early days it is useful to always offer at least 2 sides, and in cases where the milk supply looks low, offering both sides at least is essential....all this is explained at www.kellymom.com if you go to 'how breastfeeding works'.

No one needs worry about fore/hindmilk as the baby sorts it all out, usually.

waaaarthur · 19/07/2010 13:10

I may be way off the mark here but this may be worth thinking about -

I had a c-section and my baby was also quiet and undemanding at first, then settled into BFing quite well. Then about 3 - 4 weeks in he became insatiable and I was feeding so often it was excruciating.

Ask to have your baby checked for tongue tie, this affects their latch and often means they fall asleep on the breast having given up trying to get what they need.

I think once the baby's stomach is no longer the size of a marble and he needs more, you may find your breasts get sore from the constant demand.

Your baby may be absolutely fine, but it is something worth checking (and get checked by more than one professional - it took 5 weeks and many, many midwives / health visitors to spot my DS's tongue tie).

Midwives in my area are militant about BFing, yet a fairly common problem is not routinely checked for.

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