Help - confused by midwives

[lill72]

I was wondering if anyone can offer their suggestions on my situation - as every midwife tells me something different.

My baby is almost 3 weeks and still a tad under her birth weight. So the midwife said she must not be getting enough milk, so said to top her up with formula after every feed. I am loathe to do this, but we have given it a go over the last day or so. It does seem to fill her up, when no amount of Bf will. For instance, I BF from 2.30pm on and off until 11.30pm last night and could not settle her for any length of time. In the end, I don't think any milk was coming out as I can usually see some. She also kept sucking her hands everytime we put her down.

At the end of our tether, we gave her some formula, which did enable her to stop sucking her hand and go to sleep.

I am trying to get her to suckle as much as possible to stimulate milk flow, but I am just not sure it is enough.

When she does go to sleep, she sleeps through the night. The midwife says wake her up, but I don't agree as she doesn't really sleep at all during the day. what do you think?

any comments or similar situations and how you coped would be most appreciated. I am very very confused!!

Personally if she hasn't regained her birthweight yet I wouldn't let her go more than 3 hours without feeding at night. "Cluster feeding" like that, on and off for hours, is quite usual in breastfed babies too. And I seem to remember there being a growth spurt around 3 weeks?

If I were you I would just keep breastfeeding as often as possible - giving formula will reduce your milk supply.

I would just BF and forget the formula, as it will only cause you supply problems unless you are careful to also express to replace the 'missed' feeds.

That cluster feeding all afternoon and evening is very common, it is your baby increasing your milk supply to meet their requirements.
How long is she sleeping at night? The problem is that if you are going a long time without a feed, especially overnight then it may affect your supply. So you need to either wake her up and feed her, or set an alarm to wake up yourself and express during the night. Much better to wake the baby, especially as she is still just shy of her birthweight.

also the night feeds are in theory helpful at keeping up your milk supply. You don't have to wake her up. Just pick her up and feed her while she still sleeps.

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Giving her formula is bad advice from the midwife. She needs to be advising you of ways to help increase your milk supply, not decrease it. You'd be betetr off pumping/hand expressing after every feed to help increase your supply, don't worry if you don't actually get anything out at this point but it will help to increase the supply by activating your hormones.

Cluster feeding is good and is her way of boosting your milk supply. I would wake her in the night, your hormone levels are higher at night and again it will help your overall milk supply by feeding her in the night.

Set your alarm, go in and change her nappy, etc to wake her up a bit and then try and feed her. If she won't feed then pump/hand express.

Remember all babies grow at different rates so try not to worry too much. I take it she is gaining weight and not losing it? Some will just be slower than others with the gaining but as long as the trend is upwards then its good.

lill72 - horrible to be confused :( :(

Going through the night without breastfeeding is not good - if you are keen to continue breastfeeding, then the only way you will maintain your production is to counter this with (safe) co-sleeping which will certainly lead to more bf in the night, or by waking your baby at least 3 hourly to bf.

Giving formula top ups after every feed will undermine breastfeeding pretty seriously - can you find a midwife to talk to who supports bf, and who can help you work out a plan to ensure your baby is well-fed and which supports your bf? It may be that your dd needs some formula as well at the moment, who knows, but this would need to be limited, and to be given as part of a plan that meant you were also bf frequently and effectively.

Good luck.

Thank you everyone for your helpful suggestions. I was wondering whether not feeding during the night could be affecting my supply. I will try and Bf every few hours during the night and see if it makes a difference. I have been trying to express but I have not been very successful. I am def going to keep BF , so I think perseverance is the key.

DD did lose a tiny amount on the last weigh in, which is why I kind of freaked out and took the advice from the midwife. Thank you Tiktok - agree formula needs to be very limited. Just not sure what to do if I have been feeding all afternoon and evening, should I keep feeding all night if she won't sleep at all? what do you do?

lill72 - best to find an informed and supportive midwife, I think....but speaking generally, feeding in the night is crucial to breastfeeding success and essential if we are talking about a baby whose weight has already given cause for concern. Yes, this means some busy night-time sessions, but (safe) co-sleeping makes it easier for you to do.

Yes just keep going :)

It is knackering, but this phase won't last long and it does sound as though your supply needs to increase so the more time your DD spends at the breast the better.

Is your DH being supportive? Mine used to bring me tea and toast/biscuits at 3am and then go back to sleep.

Echo what the others are saying about letting such a small baby go so long at night esp when there are BF issues. Even though my DC have all been good sleeps I did two night wakings until they were around 6 weeks/5kgs. Sucking hands does not necessarily mean hungry.

Also she really needs to sleep during the day or will get very overtired and not be able to feed effectively - take her for a walk in her pram to encourage her to sleep. During the day short sleeps are ok though.

If you are worried about having enough milk, and you need top ups how about using a breast pump, even if you have to hire a hospital grade one for a few weeks, this would preserve/improve your supply unlike supplementing with formula which would reduce your supply.

I'll tell you what I did in the same situation:

15ml top-ups of formula or EBM after each daytime feed (ended up managing to express so only used formula for about a week)

feeding at least every 3 hours, setting my alarm overnight to feed him, keeping a drink and a snack beside my bed to make those night time feeds easier

expressing after each feed to up my supply and get the milk for the next top-up (this got much easier as I went on)

fenugreek 3 tablets 3 times a day

I think the extra calories and weight gain helped improve his latch and feeding. Once he was feeding better, I reduced the number of top-ups each week, getting him weighed each week to make sure that his weight was going in the right direction (didn't care how much weight he put on, just as long as it was going up). After a few weeks, he was back on EBF with no top-ups and is doing grand.

Thanks again for all your helpful suggestions.

MumNWLondon - I agree with wanting her to sleep during the day. I am finding this very difficult also. DD just wants to be fed ALL day. Even when we walk she cries. I cannot put her down for 5 minutes and the only thing that stops her crying is feeding her. I really don't know what to do.

Mrs Gangly - thanks for your suggestions.I will try and do same.

I know it will get better, but it is just hard at the moment, when it is impossible to do anything!

lili - she's three weeks old, and your closeness and smell and voice and touch and tastes are familiar to her. She does not want to be separate from you. Less than a month ago she was inside you.

Going with the flow and accepting she is like this because she is a young baby helps - and it helps your milk supply and her growth.

It may be you have quite high expectations of what a young baby would do and would need to do - it's easier to change your expectations than to change her needs :)

Well done for getting this far! You are doing brilliantly. It is hard but it will get better. I got so wound up by cluster feeding, but it was better for my sanity to go with it rather than fight it. Make a base on the sofa, have loads of DVDs, snacks, drinks, phone, internet all within reach and accept that for a week or 2, feeding is what you will be mostly doing. Similarly, have snacks, drinks by the bed and set an alarm to feed through the night.

Have you got a sling? I found that I could buy a bit of time in the evenings with DD in a wrap sling. It should also help to encourage naps in the day.

I can't speak on the medical side, and clearly you have to seek advice in the flesh, but my understanding of supply and demand is that if you give formula top-ups, you may be undermining your own attempts to establish supply iyswim?

Good luck and well done!

Going for a co-sleeping nap in the afternoon might help. You can lie down and doze while she cluster feeds.

This will pass. If cluster feeding bothers you, offering more feeds at convenient times can help, but it is tempting to let them be when you have a couple of hours of peace.

I agee with everyone else def dont let her go all night without milk, max 4hrs til feeding better.

If you want just give her some formula before bedtime if it helps settle her, lots of people mix feed and you will be bf rest of day so one bottle wont affect your milk supply.

My 18week old cluster fed loads and still does a bit from 5pm.

Keep going your doing great :-)