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Infant feeding

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

Reducing cupfeeds for a newborn

11 replies

pescatore · 04/10/2010 17:46

Apologies in advance for the length of this post.

DS1 is now ten days old and my first baby. I'm currently breastfeeding + cupfeeding and would really appreciate some gentle advice on how to wind down the cupfeeding.

In the hospital, DS wouldn't latch on properly. Dr Spock has the perfect description for him - the "irritable nurser" ("Other babies, hungrier, more wide awake or more assertive, react with irritation when they find they can't get enough milk. They jerk their heads away from the breast and yell, try again, become mad again."). When he finally latched on properly, he would promptly fall asleep and no amount of stimulation would wake him up. The lactation consultant said she'd rarely seen a baby so nervous / anxious about latching on.

After two and a half days, he'd lost too much weight so the midwives started feeding him formula through a syringe. By day three, a nightshift midwife put me on an expressing machine every three hours and DS on formula (although after talking to the hospital consultant we fed this using a cup rather than a bottle). This worked for us - my poor sore nipples got a rest period, and DS became much calmer as he gradually put on weight (though the smells he produced from the formula were spectacular).

The milk came in around day 4 to 5 and I was still in hospital. On our last day, day 6, after lots of skin to skin, we finally got him to latch properly, though the lactation consultant told me the milk needed to flow a little stronger for him to have the patience to stay at the breast.

Since we came home (equipped with a hospital grade expressing machine), my milk supply has gradually increased until I now have more milk than DS will drink at the breast - we only had to make formula once or twice. DS has also noticeably calmed down and can now be put to the breast without a giant panic.

My problem is that the hospital gave me a feeding schedule which assumes I'm feeding him expressed milk or formula Hmm and I was so focussed on getting him to feed from the breast / producing enough milk that now that this has all happened, I'm not sure what to do Blush

When being fed only from the cup, DS will drink around 80mls at the moment and then sleep like a log for 4 hours (5 at night), occasionally waking for the odd bit of indigestion. There is no regular pattern to the breastfeed (since he's really only consistently managed since yesterday), but he will feed on one breast for at least an hour (including one or two burpings to keep him awake), and seems to be still getting milk at the end of it - I use a nipple shield and can see the milk in it, plus can hear him still sucking and swallowing and the latch does not usually hurt. This afternoon, he fed for two hours Confused and was still hungry at the end and wouldn't sleep. I hadn't eaten properly all day so I gave up and gave him 40mls on the cup so I could grab lunch and he's again sleeping like a log. On the one or two occasions I've managed to only BF him, he still sleeps for 3-4 hours, ie he is not really waking of his own accord to feed.

It feels to me that DS needs to acclimatise from getting his feeds in one huge slug from a cup over a ten minute period to the longer BFing, and also to get used to not being super-full.

I'd really appreciate any advice on whether / how often I should be waking him up to feed, and how long I should expect a feed to take in this transition period (long-term, I'd be scared of two hour feeds...). Also, if hubby could give the occasional cup feed or bottle feed to give me a break without doing any permanent damage.

Please be gentle with me, I am a giant bag of hormones at present.... and apologies again for the humongous post.

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purplemyrtle · 05/10/2010 09:08

Hi Pescatore. Congratulations! Hope things are going OK. I had to cup feed my son in the early days too, it sounds to me like you might be on to something re getting him used to taking longer breastfeeding rather than quicker cup feeds. I'm not sure if when you say he's not waking of his own accord to feed you mean that you're worried that he sleeps for 3-4 hours, as I'd think that's fine, I think the midwife told me not to let my son go for more than 4 hours or so without a feed in the early days.

How often are you expressing? That could be affecting your supply and making his feeds longer. Maybe try and reduce that and replace it with a bit more BF gradually?

DS had a bottle of expressed milk most days in the early days with no ill effects.

I also wonder if a chat with someone might help, I found this lot useful and they have a helpline:

www.breastfeedingnetwork.org.uk/

Bear in mind the hospital schedule is probably geared towards the first few days, so don't beat yourself up with it - another reason maybe some expert advice might be good?

Also if you have spare EBM are you freezing it? Might come in handy.

Sounds like you're doing really well!

MumNWLondon · 05/10/2010 09:54

I'm sure others who know more will come along but wanted to offer support...advice but how about offering the breast every three hours (ie don't let him go longer than that, although longer ok at night) and if you don't think it was not a great feed stop after an hour (he'll be getting tired by then) and then express and offer him 40ml in a cup?

pescatore · 05/10/2010 15:37

Hi purplemyrtle and MumNWLondon and thanks for your messages - made me feel so much better this morning !

I have tried waking him up to feed every three hours today and to my delight it's going well so far (TOUCH WOOD Grin). Am also not feeding him for longer than 30 mins on the first side - he is coming off much faster and still going to sleep.

Purplemyrtle - I got the times in my first post wrong - before, he was sleeping up to five hours even with just a breast feed. I will try the link you suggested and freezing the EBM is a good idea (DH is picking up freezer bags tonight). I'm also encouraged by the idea of the bottle - it would be nice for DH to take one of the evening feeds if possible. Might try it later this week.

I am also cutting down on the expressing a bit to see what happens.....

Many thanks again to you both !!

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MumNWLondon · 05/10/2010 22:51

I'd glad it seems better. Although I am not sure if the bottle is a great idea until you are sure he's got the hang of the breast, maybe wait a week or so?

I have always pulled off one side after 30 mins and then offered second side for 30 mins - on basis that newborns get tired pretty quickly and if wait too long before offering 2nd side they are too tired to drink it.

I always feed at least three hourly in the day at the start, usually means can manage a longer gap at night.

If you express before a feed he'll have to work much harder to get the milk, so best not to do that. If you feel you are very full can feed him the fuller side and express from the other side?

purplemyrtle · 06/10/2010 07:59

Sounds like things are going well! Yes fair point about waiting a little with the bottle, we started with cups (in fact I now remember we got a soft cup feeder which was a bit easier, don't know if you can still get them). I think I fed on one side for the first morning feed than expressed the other while DS went back to sleep. I think I found one side sometimes enough earlier in the day but 2 or more (ie back to the original side again, I'm not blessed with a 3rd!) later on when I was tired.

With my daughter I didn't express at all, but didn't try a bottle (ebm) til about 11 weeks at which point she looked at me as if I was bonkers and was having none of it! I've since read that if you so want to use a bottle it's an idea to get it in before about 10 weeks.

pescatore · 06/10/2010 21:17

Well we managed yesterday without any cup feeds and today with two, one in the morning and one this evening. The trouble is that I suspect the latch is wrong - I don't think DS is opening his mouth wide enough so it is occasionally really painful and today he kept on wanting to feed every two hours and never really settled down. All in all the first really bad day since we got home, so thank you for keeping up the posts - really cheered me up tonight. I have started to express only every other feed (after the feed, not before).

I am not in the UK so getting a BF counselor slightly trickier but not impossible. I have finally sent off a mail to see if I can see someone before the weekend.

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purplemyrtle · 07/10/2010 09:10

Couldn't get either of mine to quite open wide enough in the beginning (not like the nct pics anyway), if it helps to know I think it improved fairly quickly as they grew a bit. Both mine were hungry every few hours in the beginning too, it gets better! Think you're doing the right thing cutting back the expressing gradually too as I'm sure that could make feeds slower/more frequent.

Another thought, did you have your iron levels checked after the birth? Mine were pretty low after my son was born and I'm sure that made a difference.

Not sure where you are but I think la leche league are pretty international and have counsellors.

pescatore · 07/10/2010 21:25

Purplemyrtle, thanks again for the really good advice. I have a counsellor coming tomorrow and it hand't occurred to me to check iron levels.

Today he fed nearly 1.5 hourly from 2pm onwards so I'm really glad the BF counsellor's coming tomorrow !! Also, tomorrow hubby is home all day which makes life much easier.

Nearly through the first week home so I'm encouraged to hear things got better for you, hope that they will for me too.... at least he sleeps better and night and is grizzling through the day (so far).

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pescatore · 08/10/2010 16:42

Well today the BF counsellor was here with a set of scales and we discovered that our little boy has lost 70g from his going home weight of 3010 gr Sad . The BF counsellor has told us we need to cup feed him after every breastfeed and I also need to pump milk after every feed if possible Sad Sad

I feel awful, like I have been starving him....I had thought he was drinking too little but hadn't realised he'd lost weight

We are due to see a pediatrician next week and unfortunately she thinks there's a chance that he will insist on the baby being formula fed to regain weight. So we have to spend the next four days stuffing him full of milk to see if we can get his weight up.

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purplemyrtle · 08/10/2010 19:54

Don't feel awful, of course you haven't been starving him. As far as I know although weight loss should be investigated it's normal for breastfed to lose some of their birthweight before regaining it. And it's also possible that the weight loss happened earlier when he was struggling to feed more and that he's been gaining recently. Other things I think you're meant to look for are wet nappies, poos etc that show he's taking something in.

I found the kellymom website helpful, maybe these pages?:

www.kellymom.com/bf/normal/newborn-nursing.html

www.kellymom.com/bf/supply/enough-milk.html

Again, not to say things shouldn't be kept an eye on but both my children lost weight before they gained it. Also I don't know where you are but there has been some politics in the UK about weight charts because until recently they were using charts based mainly on formula fed babies, who I believe tend to gain weight more rapidly.

Again, please don't feel bad, it really does sound like you're doing a fab job. It's not the easiest time either!

Hope you have a lovely weekend.

pescatore · 09/10/2010 12:38

Thanks again purplemyrtle....will keep trying !

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