Getting newborn from bottle back to breast?

[Wholelottalove]

Hello. I posted when my son was a couple of days old as he wasn't latching well. Despite one or two good feeds, on day 4 he had lost just over 10% of his birth weight and was a bit jaundiced so we were advised to go into hospital. We were kept in for two days in the end, mainly due to no-one being available to repeat blood tests, although he was slightly dehydrated. Whilst there he was fed my EBM through a tube and then a bottle. I had an argument with them about cup feeding which is apparently not hospital policy so we ended up using incredibly fast flow bottles which were throwing milk down his throat.

He is now home, has put on 160g in 2 days (8 days old now) and taking EBM well from bottle, but will not latch on. Sometimes if I offer him breast after bottle he will latch and suck a couple of times, but doesn't seem to get much milk even with breast compressions (can't hear/see him swallow). If I offer breast when he is hungry he gets very upset and frantic. Have switched to slow flow teat now we are home so he has to work harder at getting milk. He is much more alert and less sleepy now.

Tried biological nurturing, which makes him very frustrated - not the aim I know! Currently got him asleep in sling, lots of skin to skin hard as have toddler.

I'm pumping round the clock with an electric pump and expressing up to 90ml a go but he is hoovering up everything I get out, so we are using a tiny bit of formula too.

Feel like I can't keep up this forever - especially when DH goes back to work as not fair on our toddler. Just looking for any encourgaement/advice/stories really as not sure where to go from here.

Sorry so long, I'm trying to keep positive but not getting much rl support and now Christmas is nearly here too so lots of relatives expecting us to see them so I'm worried about missing feeds/expressing.

Any advice or help much appreciated.

Can you see a Lactation Consultant or call one of the BFing helplines (LLL/BfN/ABM/NCT) and talk through your options?

I wonder if one of options might be to use a SNS/Nursing Supplementer/Lactation Aid (different people call it different things) which is a bag filled with milk (EBM/Formula) attached to a tube which you tape to your breast so that as baby suckles they get milk from the tube as well as the breast. This means they are happy to bf (getting milk) and
you get nipple stim. which helps make more milk.

It would require specialist help to get going as you would need latch to be good or else when you phased out the supplementer you would still have problems.

There is a some advice here at Kellymom about SNS/supplementers.

Good luck and congratulations on the birth of new baby.

Crikey, how awful :( I'm shocked at the hospital - I would complain (when you're sorted).

Such a tough time of year, too. Have you got time to try to cup feed him to try get him off the bottle to start with?

You're clearly committed to BFing and that's wonderful. Wishing you all the very best until someone more qualified can give any additional info than truthsweet.

I'd second calling one of the helplines. The NHS National Helpline is 0300 100 0212.

Truth I'm not sure an SNS will help right now, as the baby won't latch on.They are useful in some circs, but baby does need to be attached and feeding.

You are doing absolutely the right thing in pumping and keeping offering gently. Could you try offering gradually smaller amounts by bottle and breastfeeding afterwards? What about watching for very early hunger cues (any sign of wriggling or twitching in sleep) and picking your baby up and feeding them then before they get distressed? Sleepy lying down feeds can sometimes work well too.

Jack Newman sometimes tries finger feeding and then straight onto breast. Try watching the finger feed to latch video here about half way down the page. Some mums find expressing before a feed to stimulate their letdown can help, as it migh be that the baby has got used to a v fast and immediate flow and is not patient enough to wait at the breast while the milk begins to flow. Alternatively short-term use of a nipple shield sometimes helps in cases like this to transition baby back to breastfeeding. All of these suggestions are best used with the support of someone who really knows about breastfeeding.

Time, patience, and no pressure to feed may all help. Is there anyone you can call on to help with your toddler and look after you so that you can just focus on snuggling up with you babe?

Good luck .

Oh, SNS might be useful after all, as I see I misread your post and your baby will latch on after a bottle. That's the time to try it then . You don't need to buy anything expensive, just use NG tube from your midwife and a bottle of milk. Jack Newman's site has info on that too.

my dd had a 'lazy' latch at first and did not like having to work so hard for milk so would fall asleep shortly after latching. she lost weight too.
I got her the medela calma bottle which works like breastfeeding, they really have to suck.to get it out. she didn't like it at first but she got used to it and it greatly improved her latch.

Thanks for the replies. I've had a quick look at the Jack Newman resource and it looks useful so I'll have another look tomorrow.

DS hasn't really latched at all today and in fact seems to have an aversion to my breasts. He'll go to sleep on them, but fusses and cries as soon as I offer the breast. Trying not to force him although have tried to help him position himself. Feeling a bit discouraged tonight - seems like we've gone backwards again.

Chilli - thanks for the suggestion of the medela bottle, I'll have a look into that.

Thinking of trying with nipple shield again tomorrow, only problem is DS treats it just like a bottle teat and wants to chomp on end of it which is v painful and doesn't give him much milk.

This was me 8 weeks or so ago! I took several trips to my local baby cafe, and to the hospital LC clinic before we got thelatch issue sorted out. We were off bottles by 4 weeks, and at 9 weeks, things are going great!

Highly recommend getting your latch issues sorted out with a LC.

thanks Invader, that really helps keep me going. :) How do I find a LC?

DS sort of latched just now with shield when I did a quick switch during bottle, but sucked on nipple only and has now fallen asleep.

You can contact a lactation consultant here or try one of the usual suspects (NCT/La Leche League/Assoc. of BFing Mothers/Breastfeeding Network) for a breastfeeding counselor.

I bottle fed DD1 for 8 weeks (mainly formula too) and she then was ex.bf to 25ish weeks and continued nursing until 3.6y/o (not saying you have to too but that an rough start to bfing doesn't mean you have to finish early too)

I now have mastitis in both breasts :( :( V v painful night, on antibiotics now and expressing two hourly, but nipples extremely sore. DS still showing few signs of latching although have been too tired to try.

DH wants me to give up and switch to formula. Feel so sad and tired. Maybe I am crazy to try and carry on BF him. He's now 11 days old.

Dear wholelottalove
Now mastitis! What a rubbish situation for you...
Your post brought back so many memories for me. My DD was born three years ago at exactly the same time of year, and we had almost exactly the same difficulties including being sent back into hospital with a jaundiced baby. I felt like such a massive failure, that I hadn't been able to do the one thing in life which was most important for a mother to accomplish. Then of course while she was under the special lamp in hospital I wasn't holding her, so bf tailed off even more, until it culminated in the rubbishest Christmas of all time, with me deranged for lack of sleep and crying constantly as I didn't know whether to give up bf altogether.
Let me offer first some words of congratulations, first for the safe arrival of your DS, and second for your monumental efforts so far. I won't offer advice, as I am not an expert, but I can reflect on my own experiences and what I what do if I were in the same position.

1. jack in absolutely every household task possible. I spent hours entertaining relatives at exactly the time when I needed to be...
2. lying in bed with DD taking it easy and giving her 'free access' to the boob. And relaxing to recover from the birth of course!
3. keeping up with the pumping BUT not at the expense of my sanity. Expressing every two hours is very laudable and I am sure some on here will tell you it is the only thing to do. On the other hand, if you are going barmy for lack of sleep, then consider giving yourself a bit of a longer break between some of the pumpings because...
4. using formula is not the all or nothing which it will feel like at the moment. For several days my DD was entirely bottle fed, and then we managed to transition so that she was eventually (almost) entirely bf (one bottle a day). I wouldn't necessarily recommend that to anyone, as the more your baby feeds from you the more milk you will make, and it took a long time to get my supply up. BUT the sky will not fall in if you give some formula, and it need not be about 'giving up' and entirely moving to formula. I used to give some ebm then some formula from a bottle when she was frantic with hunger, then switch to the boob once she had calmed down a bit but before she was full, and then gradually there was less and less need for the bottle.That's my personal experience, based on my going slightly loopy through anxiety and lack of sleep. I had to balance my child's feeding and my own mental health, frankly. I was also lucky because my DD didn't get too confused as we moved between (slow valve) teats and the boob.
5. You need some professional advice. In my experience the bf helplines were open over Christmas- being staffed by volunteers, the women were clearly also trying to make Xmas dinner at the same time as giving advice (!), but they were very helpful. Are you still under your MW care, or moved to a HV? Have they mentioned groups or bf counsellors locally? They will be able to help more than us mumsnetters, not least as they will be able to actually see your latch and your hold. They will also point out that not being able to see or hear him swallow doesn't necessarily mean he is not getting any milk.

But we will be able to hold your hand virtually, and wave encouraging pompoms from the sidelines.

Domestic - thanks so much for your encouragement. Feeling slightly better physically now as antibiotics have kicked in and my fever is gone although one breast still v sore. I also think I was being a bit rough on my nipples when expressing and trying to be gentler. Am only expressing so frequently to get rid of the mastitis, but may go longer when it is all gone. We are giving some formula top ups although they haven't been needed last couple of days.

Got in the bath with DS this morning and he actually latched nicely for a few moment although not sure he was getting any milk. He also latched once this evening but again seemed to give up after a few sucks. He sits there with my boob in his mouth but not sucking or swallowing. My letdown takes a little while to come through and I don;t think he wants to wait. I also have quite big, flat nipples and wondering if he is finding them too big and soft compared to a bottle teat IYSWIM.

I will try another BF line tomorrow. We have BF groups locally and I know one of the NCT counsellors as I had a lot of issues with DD too although she did actually latch and get milk but made me really sore because of tongue tie.

Feeling pretty guilty about DD who is suffering from lack of attention and is playing up - weeing on floor etc.

No progress. Under pressure now from DH and other family members to stop expressing and FF. Mastitis gone but ds still no atch. Day 13 today. :(

Wholelottalove - you need some real-life support, right now! Did you try the BF counsellor? Please persevere until you can find someone who will come to the house today and sit with you. Do you have all of the phone numbers handy?

Thanks for your responses. I have found a LC who we are going to see tomorrow. She is an hours' drive away, but hopefully it will be worth it.

Haven't really tried to latch DS much today as I'm not sure if I am actually making things worse. He seems to kind of give up and go limp on the breast or go to sleep.

Although I had a rough start with DD, and so wasn't expecting plain sailing this time round, it never occurred to me he wouldn't latch at all. It's really hard not to feel rejected or frustrated, even though I know those negative feelings are not going to help at all.

Well done Wholelottalove, fingers crossed she can help. I think you have been remarkably determined, not at all surprised you are feeling frustrated!!

Had session with LC this morning and DS latched and fed both sides!! :o

Since we've been home, he latched on his preferred side and drank, but after 5 mins or so slid back and chewed on nipple so I took him off but couldn't get him latched again.

MW just been and he has regained to his birth weight too (day 14 today). Feel very proud as that's been on 90% expressed milk with the odd top up of formula. I think now we're finally getting somewhere and I'm very hopeful now we can make the transition back to the breast.

The only problem now is I have very sore nipples from all that pumping but using lasinoh and hoping it will settle as we work on his latch. Fingers crossed the mastitis stays away until we're sorted.

That's great news, well done indeed! Presumably you can keep calling the LC for further ideas and encouragement? Hope your family are being supportive now.

Thanks theboobmeister, feel like we are making slow progress. He latched four times in total yesterday although he seems to slide back a lot and my nipple is coming out of his mouth wedge shaped. He really dislikes the left side. We have bottle fed overnight as I found it too hard sitting up in bed to feed him - seem to remember having problem with night feeds with DD too.

Going to try and keep latching him before the bottle today and see how it goes. BF cafe tomorrow which is again an hours drive but probably worth it if I am up to it.

Good for you!

Might it be worth asking the people at the BF cafe to show you how to feed lying down? Night feeds sitting up can be really tough because you're both so sleepy, it's harder to maintain a good position/latch. Lying down, if you can find a good position then you can just stay like that and it doesn't matter if you doze off.

Had mixed luck today. DS has latched and fed a couple of times and sucks until he falls asleep. The second time he came off the breast on his own but I've also had to take him off as he was chewing the nipple towards the end. Problem is, he doesn't seem satisfied and is awake and looking for more not long afterwards. He wouldn't latch at all this evening as too hungry and took 100ml expressed which makes me worried he isn't getting enough at the breast alone. Also worried he's not draining boobs and mastitis could come back, but it is getting even more ridiculous as now trying to bf him then top up with bottle and then pumping so DD has basically seen nothing of me today.

OK it sounds like latching is getting better, that's encouraging!

You say he is slipping down and nipple-gnawing - I wonder if this is him trying to stimulate another letdown of milk? During a full BF there will often be multiple letdowns, and babies can do the oddest things to get one going!

If his re-latching (nipple-gnawing) is causing pain, would it be an option to try to stimulate another let-down by hand-expressing, then put him back on as soon as the milk has started flowing??

Also, if he is "Awake and looking for more not long afterwards" that's not necessarily a sign that you don't have enough milk! It just means that he hasn't had enough of that feed yet and needs to go back onto the breast until he has. A baby who is still sucking (even light 'butterfly' sucks) will keep stimulating more letdowns, so the breast is never empty.

Also, the key is not to wait so long so that he's really hungry - many babies find it hard to latch when they are ravenous.

Hope this helps !!!

Argh, after great few feeds yesterday afternoon, had to go back to bottle overnight and now he is now almost solely nipple feeding. Am going to start new thread about how to get him to open mouth wide. Thank you for your help on this threas, I really appreciate it :)