When is it ok to say enough is enough? (long post)

[MissCKitty]

My baby girl was born on the 2nd Jan, 4 weeks prem and by emergency section due to complications arising from my pre eclampsia and foetal distress. I decided from the beginning of my pregnancy that I wanted to breastfeed because of all the benefits it gives to baby. However baby is a reluctant feeder and is struggling to latch effectively on the breast. She suckles from the nipple which means she doesn't get much milk and it's agony for me.
Whilst in hospital I saw several BF counsellors who advised latching techniques etc and still no joy. So to make sure she was still getting my breast milk I began expressing every feed. I have also been trying skin to skin and gently encouraging her on to the breast at feed time before offering expressed milk.
However 9 days in and this really isn't happening for us and we are having to top up with formula and feeding time is getting very stressful for baby and me resulting in lower milk production when I express and a v unhappy baby.
I have spent the last 3 days beating myself up about not being able to BF and for having to use formula to top up. At what point is it ok to say enough? At what point do I accept that baby may never feed from breast and that its ok to stop trying?
Am actually quite unhappy at the moment and need some reassurance that I am not failing as a mother if I give up trying to force BF on my baby and just start enjoying being a mom without the stress

Have you tried nipple shields - sometimes they give the extra stimulation needed to a baby's palate that will stimulate them to feed. You also need to get yourself down to the local bf group and get some more support.

Poor you it sounds tough.

Obviously only you can decide when enough is enough though.

It sounds like you're doing everything right- skin to skin and expressing your milk. Have you tried biological nurturing?(google it).

Only yesterday I read an article about a Mum whose baby wouldn't latch and she fed it expressed milk for months and months and then suddenly he just latched on.

She's very young remember and will just need some time to learn the skill of feeding. Have you thought about a supplemental nursing system (medela do them)?

Sorry if it seems like I'm just randomly throwing questions at you but these are just my ideas.

You'd probably benefit from talking all this through with one of the specialists on the bf helplines.

Good luck.

:( :(

Having a pre-term baby and the sort of feedig difficulties you describe are very, very stressful.

No one can tell you when enough is enough - some people would have stopped the very first time the baby showed reluctance, and others would persist for many months, expressing in the meantime. No one has any right to judge their efforts!

Perhaps you can speak to whoever you have related to best to discuss this - someone who understands about bf and how it works, and who you are confident will support you whatever you decide.

Main thing is that you don't have to make up your mind today, tomorrow or at any time. You can 'see how things go' for as long as you want. Your options are best kept open with your baby close to you at all times ( see www.kangaroomothercare.com and just enjoying the closeness without feeling NOW is THE time at each feed time. Keep up your milk supply with frequent expressing (at least 8-10 times in 24 hours) which is the only way to ensure a milk supply, and which is far, far more important than being stress free. If you feel you are not making much for the pump, then it is far more likely to be a result of infrequent expressing and even a dodgy pump than stress.

It is ok to use formula - of course it is. Your baby has to be well-fed and energised in order to even try to feed from you, and none of this is your fault, still less any sign you are 'failing' in any way.

I hope you find someone to talk to about all this.

Aaaw hon, you are NOT failing as a mum, it's so sad you'd even think that ( although I felt the same for topping up with formula, now I don't feel guilty, my baby is getting fed and feeding is only one part of being a mother, after all).

On,y you can decide but whatever you decide, try not to feel bad about it, IMO a happier mother will result in a happier baby.

I was feeling like you are with my 1st DD and eventually switched to ff at 7 weeks....she remained just as unsettled and in pain but emotionally, I began to strengthen, so to speak, but I did feel remorse and wonder what more I could have tried. Looking back, as a first time mum in a foreign country with NO support other than poor DH, I don't think I could have done more. DD2 and her issues with feeding then food never sorted themselves fully until 18months and now all is well and she's unaffected by being a predominantly ff babe. I'd have loved her to have been a bf babe for much longer though.

DD2 now 7 weeks and BF is going really well. The latch and ease of BF really didn't begin to come about until I would say 4plus weeks and she is a full term baby with no real concerns. It just seemed to take a good while for her to 'get' it and learn it. I really did start to worry but it did come right.

No real help but just to say it did click for us and I wasn't sure when it would and after first experience, I so needed it to. Kept being rational each day knowing from support I do have this time that it would happen. It's very much easier to be rational though when your only issues are attachment difficulties and wind.

Wishing you the best whatever does happen.

Lizzie

You have my sympathies, it sounds like you are having a really tough time. Just wanted to share my experience with DS who was born at term 4 weeks ago but never really latched properly for feeds. He was admitted to hospital at 4 days and we left with him on bottles of EBM and formula top ups. Spent two weeks trying to get him to latch, expressing and bottle feeding. Started to feel he would never get it.

We went to see a lactation consultant who got him latched on which gave me some confidence and over a few days we transitioned onto the breast. However, it was very painful as he was nipple feeding and chomping. It turned out to be a posterior tongue tie which was divided today and feeding is already improving. I had loads of help with positioning and attachment - he nipple fed/chomped because he couldn't physically get his tongue out to feed properly. My DD also had this and had hers done at 8 weeks.

I found this article quite helpful - it says pretty much all babies will eventually latch and the main thing in meantime is to keep supply up.
www.nbci.ca/index.php?option=com_content&view=article&id=54:when-baby-does-not-yet-latch&catid=5:information&Itemid=17

Not saying this is what you should do but I just thought my story might give you some encouragement if you decide you want to carry on. I know how stressful it is and that is without having your issues with prem birth. Of course you are not failing as a mother if you decide you have had enough. Good luck whatever you decide.

Ooh yes. Both mine had Tongue tie too. Dd1 was not picked up for a few weeks & wasn't snipped because by time I got to see the specialist, I'd given up BF and that was the reason I wanted her seen. DD2 snipped at 3days old and it helped with her attachment massively. Not overnight but she did seem to get a much better grip and that made learning the skill something manageable for us both. Always worth a look into as although it may not be the only problem, it might just be the surmountable one that makes the difference, overall.

I would say whenever you feel you just can't take anymore and you and your daughter are suffering as a result. BF may be best but not at the cost of your stress and not enjoying her.

I have two experiences - my first child Ihad a long hard labour and she was born with a nerve injury to her arm. I was exhausted, she was in pain and we had constant visits to the hospital to try sort her arm. BF was a nightmare. She never latched, I got mastitis, nipples like craters (despite help from midwives, BF councillors and HVs) and she just kept losing weight. After 2 weeks I was a woman on the edge dangerously close to PND - all I did was cry. I decided enough was enough after a weigh in with my daughter but giving her a bottle I sobbed wracked with guilt at having failed as I saw it. I never really let go of that guilt.

Two and a half years on I have a 5 week old. From the first feed he latched on well and we are still BF. It hasn't been easy with mastitis again, sore nipples, thrush and an infection but we have turned a corner and it is so much easier. The difference with my daughter is he is really willing to BF and latches with no problem and is gaining weight.

I still feel guilty for FF my daughter but she has certaninly not ailed from it and it was the best for me, her (and my husband who was so worried about us both)at the time. Each baby is different and whilst people come up with potential solutions to your problems i know you get to a point where you just can't take anymore.

Only you know if you are at that point. BF can be really hard at first but whilst I had problems with both babies my daughters failure to gain weight and latch pushed me over the edge. Once I started formula she was a different baby and I started to feel like me again.

~I know there are lots of diehard BFers out there which may disagree, and whilst I believe so strongly in it, I don't think it should be to the detriment of you or your baby.

Sorry - rather a long post but hope it helps a bit!

"BFing to the detriment of your baby" is counter productive in the extreme and no reasonable "diehard BFers" would disagree with that, to be fair. What "diehard BFers" actually would want is to give every woman the support she needs to get through any problems that she encounters in order to breastfeed her baby provided that this is what she continues to wish to do.

misskitty how are things today? Did you manage to speak to someone IRL?

You are not "trying to force breastfeeding on your baby", you are trying to encourage her to learn a skill which she is finding difficult, but with the right support and assuming that there is no physical difficulty (which is why you need someone to see you in person if possible) you will get there, but of course in the meantime you're having an awful time and I'm so sorry to hear that :(

You mention seeing BFing counsellors in the hospital. To be honest, it's rare to have qualified BFing counsellors (especially more than one!) in a hospital. Are you sure that they were actual qualified BFC? Were they perhaps peer supporters or midwives? Meaning, you may need to speak to someone who definately has the level of training to cover more difficult problems. The NCT counsellors are excellent and you may have one in your area that you can speak to or may be able to come to you (no cost). They also hire out hospital grade pumps which are quiet, comfortable and effective to use to keep your milk supply up. The breastfeeding line is 0300 330 0771.

I'm deliberately not answering your question as noone can do that for you. If you've made your decision already then please disregard this post :). If not, hopefully this gives you somewhere to turn.

Hope you are feeling ok and congratulations on your little girl :)

Congratulations on your baby, but sorry to hear you are having such a rough time.

I had a very similar situation and struggled through with the help of BF counsellor and HVs; ended up bf'ing dd for nearly a year.
(Our maternity hospital was very pro-BF with fully qualified BF counsellor who also did home visits, a milk bank and nurses trained to support bf- so such hospitals do exist, or at least they did)

Looking back, if I had my time over I would do things differently: I would give up when dd's failure to gain weight became a concern. I didn't give up even when her ribs were showing and she started falling asleep from weakness after less than a minute at the breast. Looking back, I think that was OTT. Yes, we got through it, but it was a big risk to take letting dd get that thin and weak- if she had caught some infection, she might have struggled.

So if clarabella sometimes feels guilty for her dd, so do I...

With hindsight, I would probably take my cue from the baby (difficult with a firstborn, though). If she seems to be coping weight wise and alert, then I would try to get the support to persevere. If I got support and baby was still not thriving, I would give up.

Firstly, congratulations on your dd :) I had a similar experience to the one that crikeybadger mentioned. I had some problems with my dd2's latch (she had a tiny little mouth which she wouldn't open wide enough), I had bouts of thrush and mastitis and after 4 weeks of trying to improve the situation, I rented a medela hospital grade pump and started pumping each feed.

I had sucessfully bf my first 2 dc's and I was detirmined to do it for dd2, but it was difficult. We managed to keep it up for 12 weeks, until I had to return the pump. Before I returned the pump I tried to get her to latch on again, and it finally worked!

DD is 8 months old now, and still bf twice a day, even with some shiney new teeth that sometimes make it a bit of a pain for me!

Obviously, the pumping route is not a solution for everybody, but I just wanted to let you know that it is possible, and your dd may be able to latch on when she is a bit older.

Yeh, Congratulations on your beautiful new baby !

I hope you are able to find some time to just enjoy her in spite of challenges about feeding.

I was a committed breast-feeder ( and my children committed nurslings ! I fed DD til she was 4.5 yrs, and DS to six years ! )

But even I can see that feeding/ nursing your baby is only one part of being a mother !

I can tell from your post that you are and will be a great mom - whatever decisions you make about feeding !

I'd echo the idea of getting support and advice from BF helpline, such as the NCT.
And lots of general support from all those around you, as well as from us !

Good luck with it all ! Enjoy her whenever you can !

I had a preterm baby. It's hard, it's not what you expected, and it wasn't the birth you had hoped for. Its very stressful and often traumatic. Personally I believe that unless someone else has been in that position they never quite understand that. Your baby is not even supposed to be with you yet, and so at the moment life is a shock to her and to you. That's normal, and its definitely allowed.

If you want to go to FF give yourself a break, the vast vast majority of mothers with premature babies do, there are a variety of reasons for this, and in my view nearly all of those reasons are good ones, and no-one should feel they failed becuase that is the choice you make. IMO It is always ok to say enough is enough when you are suffering and you are stressed. You need to give yourself a break and get some strength back for you, if BF is making you more stressed at a difficult time FF may be the right decision.

If you do want to carry on BF and that might make you less stressed it is possible, even if you don't feel you are getting enough milk and currently using formula top ups. There are lots of ways to increase milk production, and if you do want to express medala hospital grade pumps are great. But it doesn't work for everyone. With a lot of determination, difficulty and a number of regrets for a period of months I did BF my DS. It was bloody hard work on top of everything else, and although now I feel I did the right thing perserveing, I almost gave up every day for about 6 months. I also teetered on the brink of PND for a while and still wonder if giving up might have been better for me at some points.

If you want to know more about what we did and how we made it work I will post further, but I don't want to push you into feeling more guilty if the right decision for you is FF. Only you can make the decision and if you do decide to FF it is also possible to enjoy that.

take care of yourself and congratulations on the birth of your dd

I can only echo the above post.

Please don't feel guilty or beat yourself up about it. No way are you a failure!!!

MissCKitty, I suppose I would regard myself as a "Die hard Bf'er" , but I just want to give you a hug. Your efforts have been awesome and you are doing the very best you can.

Having a baby is a marathon event so do not underestimate how this can effect you emotionally. Having a prem baby brings a lot more emotion to the situation - you have a lot on your plate.

Please remember that it's not uncommon for prem babies to have difficulty breastfeeding in the beginning. She is still not fully-developed and her oral muscles won't be as prepared as a full-term baby. You cannot do anything more than what you are already doing. That is a guarantee.

You need also to get her checked for tongue tie - just to rule out other possible factors, but you have two choices here: 1. You stop expressing, and focus on the formula feeding. 2. You carry on expressing and see how things go. BOTH options are perfectly right for you and your baby. My heart tells me that you should carry on, if only because you seem to really want to bf, but I'm loathe to tell you to do something that would exhaust you more. Only you can decide what's best.

If you do decide to carry on, then remember that it takes 6 weeks for your milk supply to settle and your still very much in the early stages, so this coupled with your distress will affect how much you yield. Give yourself regular time slots to express (you shouldn't be doing anything else at the moment, focus needs to be on your baby and YOU, so eat and drink and rest well!) and get an electric pump to make it easier for you. I've used the medela in the passed with success. The hospial should have one to lend you, but am certain large tesco's sell them. Don't get distressed about giving her formula (that's what it's there for) and remember that time IS on your side here - she's getting stronger by the day. I'm certain that the day will come when she will just suddenly latch on, so offer her plenty of boob in the meantime. You're doing the very best you can, but you need to stop being so hard on yourself.

Whatever decision you make will be the right one. You sound like a lovely mum - thoughtful and caring. I wish you all the best. x

Ladies, thanks for all your words of support. Its great to hear that I am not the only one who has experienced these issues. After a conversation with my midwife, she sent out a member of the breast feeding team for me this morning. We had a good chat and came up with a plan for me and baby to make feeding time less stressful but to also keep gently encouraging her to try to latch.
I feel much better today ( to the extent that I managed to express 2 bottles after she left. And baby is happier cos she doesn't have a mommy who sobs at the prospect of feeding her.

Once again thanks for your help and advice

that's good MissCKitty- so glad you're feeling happier and you have found a way forward.

Remember- slowly,slowly - catchy monkey (I think that means take one day at a time. )

Thanks for the update.

My DS was not prem but I feel that I was in a similar situation to you in that, although DS latched on, my milk never came in and I really struggled to BF (DS is now 7 weeks) after C-Sec and time spent in hospital after.

I felt that I was letting him down, really wanted to BF and used to sit crying and apologising for being a bad mummy while he struggled to feed from me. Ended up with him being re-admitted to hospital due to weight loss and the paed doctor telling me to FF in order to get his weight up. Although I felt so guilty (couldn't shake the feeling that I wasn't doing my job properly), I knew at this point that it was best for him so started FF. I also, I must confess, felt relieved that someone told me to stop. Have continued to try to BF and express so you can do both but he does get majority of food from formula.

Congratulations on the birth of your baby and try not to beat yourself up too much. As WelshSara says, whatever decision you make will be the right one for you and your LO.

Oh and I think tiktok said it already but 'your distress won't affect how much you yield.*

Stress can sometimes affect let down but it won't affect the quality or quantity of your milk. (either for that matter will what you eat or drink or how much you rest - although of course it's important to look after yourself since you've just had a baby.)

Also to say, You've already done a lot of good with the BF'ing you've already given her. Each day is good.

All babies move on to other sources of nutrition at some point ( whether that includes FF, follow on milk, or solids ), it's just a matter of day by day deciding what's best for her and you !

Power to you, MissCKitty. Sounds like you have a plan. Thanks for coming back to let us know - you don't sound so distressed now. I'm new to this whole site, but am more than willing to lend a 'hand' as are the others no doubt, so will keep an eye on this thread for any calls for help! x
PS Flapjacks are delicious and happen to also be great for boosting milk supply (along with regular pumping of course.

Glad you are feeling better, and given you have decided to carry on with BF for the moment I will post more, if only to tell you what happened with me and how we managed to carry on.

1. I only ever gave us short term goals, intially to express until we got out of nicu/scbu etc, later I was always going to carry on until tomorrow. On one of those tomorrows I got prescribed nutriprem, on another one I went and collected the prescription from my docs, on another I handed in to the pharmacy on another I picked it up. It meant for me there was always another way if I really couldn't help. My last goal was to get to xmas, my new goal is to get to march when ds will be 1. (I now use the prescription nutriprem in DS porridge or other food occasionally as when I finally passed 6 months, thought i can't do this anymore and tried to give it DS he wasn't having any of it)

1. Spend as much time as you can in bed with your dd. Get a TV,computer,books anything you may need within easy reach. I have never watched so much crap on telly and felt less guilty about it.

1. Get or hire or borrow a good pump. The hospital may have one. Ask. Personally I use a medela freestyle, but pumping was always going to be a longterm option for me. Work out a way to pump handsfree if you can. Its so much easier to pump if you are doing something else, and IMO yields more when you are not watching every drop.

1. Offer your dd the breast, then expressed milk, then pump. I found that was the best order. having had my DS bf from me, helped the let down. It also meant he always had to work for the first bit. It also meant he nursed often enough.

1. Try to pump at least 6 times a day. Some people say 8-10 as Tiktok did and that is I am sure better advice, but I never needed to do that many times myself. Also some insist on pumping overnight. I didn't do overnight when DS was in hospital as I found I needed sleep more. Work out what works for you, and the balance between rest and sleep and pumping, but bear in mind that you are better off pumping more frequently for less time. So you can always pump every 2 hours in the waking hours if its easier.

1. If you are giving formula and/or expressed milk, make at least one of those feeds one that someone else gives your DD if she is feeding frequently, and get some rest. I know people say that you need to offer the breast whenever you Lo is hungry but if you are feeding and/or pumping 6-8 times a day then missing one to get a break of 3 hours between feeds and a 3-4 hour block of sleep makes everything seem better and makes it easier to face the next day, or hour

1. personally I found the yield higher in the mornings, and concentrated the pumping and feeding then.

1. Don't compare yourself and your DD to a term baby. At least not until she is in the positive from when she was due.

1. Get help with anything and everything else.

10. Go to as many drop in sessions BF sessions, coffee mornings as you want to. If i was anything to go by you get so much support, and so much back up as well as awe that you are managing to BF at all. That kept me going a few days when i wouldn't have otherwise done so, if only by thinking I have come this far why stop now.

11. feel proud of yourself you have got this far and give yourself a huge pat on the back. And if tomorrow you FF accept that you did your best