BF and Top Ups.. arrgh..

[anonMum2]

Sorry.. a lengthy one.. but I feel like I'm losing this battle.

Basically, had a good start and doing well with BF until midwife took DS2 from me in the hospital when I needed rest and gave him a bottle when he was less than a day old. I kept going round to ask for him so I can put him on breast but they said he's fast asleep, this went on for around 7 hours. I later found out they gave him 30ml and that's why he slept for so long! Isn't that a bit much for a 1 day old baby??

Got home, EMCS, tiredness, pain.. lack of sleep, I struggled to latch him on properly since that bottlefeed at hospital. He started getting hungry and we were told to give top-ups so we did it with cups. Midwife told us to start him on bottles so he wouldn't be so hungry and I could get some rest as I wasn't sleeping at all. Made a bottle, very stupidly made 120ml even though I intended to give him around 30ml. MIL offered to help as I was sorting out DS1 and I gave clear instructions to just give him only 30 ml. Came back in 5 minutes and to my horror found MIL had given DS1 ALL the milk. Since then DS2 started demanding for top-ups after every feed rather than just the evening.

When milk came in, I had engorgement as baby wasn't latching on properly and I developed mastitis. Things got worse, sore nipples meant I couldn't just feed him non-stop as I intended to and I was once again advised by midwife to just feed every 3 hours and to give top up after he's been on the breast for a while as I get too sore.

He is now 10 days old and his top-up has gone up to around 90ml after each BF, a lot more in the evenings. I try very hard to put him on every 2.5hours (except night time when it's ever 4 hours), but it doesn't satisfy him and his top-ups are increasing. It definitely doesn't help when all well-meaning relatives who are staying with me keep saying things like "he needs more milk..." and keep offering to feed him when I'm bottle feeding him, hence stuffing more formula inside him than necessary. He then sleeps for far too long and has missed a few breastfeeds. DH has also started doing that now and I'm wondering if I'm the only cruel one trying to starve my DS2!

Why isn't my milk supply increasing?! His top-ups are increasing at an alarming rate and there is no way I can catch up. But if he doesn't get his top-ups he screams the house down and with so many visitors around and a toddler trying to sleep I cannot just let him scream. Have been talking about giving up BF for quite a few days now but would really love to continue BF if possible.. any advise appreciated.

Ahhh.. thanks. :)

Been feeding non-stop since 9am and DS is still not satisfied so will definitely need tonight.

For every suckle, he's telling your body to produce more milk. It won't last forever. x

There's a common growth spurt at 3 weeks (and 6 weeks and 3 & 6 months) so that could be it. It'll pass.

Are you still feeling sore after feeds? If not, you could try using a pump to increase supply more quickly (wld recommend that you hire a hospital grade one - IMO they're far more comfortable on the nipple than either the hand pumps or the electric pumps that you buy on the high street). Just go on the pump after each feed. Even 5-10 mins each side would help. Even if you don't get much milk, the pump's action will stimulate your breasts to produce more. Extra bonus is that you can use the milk that you do get for top up feeds in place of formula.

It's not as sore now but after 2-4 hours of non-stop feeding per session, it does get a bit tingly and slightly sore.

Only gave DS one bottle during the day yesterday and today so he can bf more, but his nappy has been less than half his normal volumn. Feeling so guilty, especially since he appeared hungry all the time and cried a lot. :(

Do you mean a wet nappy or a dirty one Anon?

Hi Anonmum,

Ive been reading this thread as I also had problems like yours early on. DD would be on me for HOURS, I remember just sat in bed watching it gradually get light outside and crying with tiredness yet every time I thought she MUST be full and took her off she would scream. Fortunatley I had a fantastic breastfeeding counceller who visited and sorted my latch and position out and also showed me how to feed lying down in bed so that I could doze while feeding, or at least be horizontal.

She also explained that it wasnt unusual for them to be on the breast so much when theyre tiny, if they want more milk they will just latch on for hours to increase your supply. Just by being attached to you and snuggled up close they increase your supply, even if they dont suck much. She gradually got better over the first month or so and by about 8 weeks feeds were lasting 30 mins or so.

Agree with the others, you need to hole up in bed with baby. Can you say that your midwife told you to do this? I know with my MIL that I could explain something till I was blue in the face and be ignored but as soon as she heard it from a health professional it was gospel!

I ask because if you mean a dirty nappy then that is quite normal and to be expected since breastmilk generates much less waste than formula. So not necessarily a bad sign, but do keep an eye on the wet nappies in particular.

Less poo is fine - breastfed babies can go days without pooing (babies use breastmilk really efficiently), if you mean wet monitor it carefully and speak to your breatfeeding midwife again.

Feeding lying down really helps - I sometimes read over ds's shoulder. You are building up milk - with my ds if he cried I put him to the breast every time - when young he accepted it every time, now only when hungry.

I don't know how bottle feeding works, but if you get worried, you could give irregular formula maybe as and when??? The midwife might be able to help again.

Your ds has such a kind, determined mum.

anonmum just wanted to say you are doing brilliantly :-) second previous posters advice- my dd2 only poos every 2-3 days now on only bm, dd1 was formula fed and pooed every day. To get down to one bottle has took lots of perserverance, you should be very proud! If you keep at it, soon your baby will feed more efficiently, my dd fed 24/7 at first now sheonly feeds for 20 mins, she is bloody massive at 4 months .

I have to say anonMum2 that I am totally in awe of your determination here against all the odds. Your thread had me on the verge of tears a few days ago through sheer frustration for you. Now I'm verging on tears again because of how you've turned this around. You will be an inspiration to many other mums who find this thread in the future.

It's not like that, really! He's still on 2 (enormous) bottles at night. Also, each time watching him scream with hunger after bf or drinking all that formula before he's satisfied, always gets me thinking about stopping BF. At dinner time today, DH and I have been discussing stopping again, that's how bad it still is. Only thing that keeps me going is reminding myself the benefits of BF and MN of course!

It's wet nappies unfortunately. He's had 2 full ones during the day rather than 3-4. They are pale though, not sure if that matters. I think I might have cut down his daytime formula a little too quickly.

Really appreciate all who are still sharing experiences and advice. Sincerely hope mine will be a success story too. :)

You're doing so well to persevere like this, real determination there.

If you think the wet nappies are less wet than they have been previously, have you tried weighing them? Sounds gross I know, but I know that my perception of things gets skewed if I'm stressing about it and having actual figures reassures me - you can make 'absolute' comparisons rather than just going by your feelings.

If you think you've cut the formula down too quickly, just offer more tomorrow. If you pump milk then you can mimic the demand from the baby to keep your supply up. It's all about supply and demand (or rather, demand and supply).

As you say you keep on talking about giving up, can I just put a third option on the table - you could exclusively express milk and give that by bottle. People talk about the choice between "breast or bottle", but there is a third option available if bfing doesn't work out but you don't want to ff. Quite a few women do this but it doesn;t seem to be discussed much (although I know that some women do experience problems maintaining supply - you'd need to consider this). Not saying you should do this, just think you should be aware of it.

You need to get the bf mw you saw out asap to help. She needs to help you sort out a plan for cutting down the formula but being more successful with the bf so your LO is more satisfied. What advice re:top ups did she give you last time?

Ring her today! Or try the bf helplines again. Honestly, you really need some good RL help with this. We on here can give you loads of ideas and of course encouragement, but someone needs to actually see you feed and help you sort out a plan of action.

You are doing so well to keep going with this and in a few weeks this struggle will be a dim and distant memory if you get help to get this sorted now.

What I did was transition first from formula top-ups to ebm top-ups, which meant I upped my supply before I was relying on it 100% for DD. She then naturally took less and less in top-ups and more and more often seemed satisfied after breastfeeds and so we gradually dropped the top-ups.

TBJ Hmm... I'll have to ring her again. Not really discussed a plan apart from saying that I should let him feed more regularly during the day as the milk is more fatty so that's what I've been doing.

Once again struggled to feed DS today because with each passing day, he is getting wiser to the fact that a bottle contains a much faster flow and bigger amount of milk. He doesn't open his mouth to latch, and when I do get him latched on he cries and pulls and unlatches because it's not as 'good' as a bottle. This evening I had to abandon a feed because he could not latch on for 20 minutes so we had to give him a bottle in the end as he was getting hysterical. I really envy all those whose baby switch between breast and bottle with no issues.

Zombieplan/japhrimel, I managed to squeeze in an express today as DS had a long nap after a bottle, but gosh it hurt so much compared to BF now I've got used to BF. Also the usual disappointment as I only managed to get 1oz after 1 hour. Unless I wake at 1am, I do not have any time left in the day to express. japhrimel Do you mind letting me know what sort of BF/expressing schedule you had and I'll try and see if I can 'follow' bits of it?

I can see that things are still very difficult for you AnonMum2, but I don't take back what I said. I am in awe of you for persevering so hard with this.

You say the bottle has a much faster flow. Are you using a size 1 teat or a faster one? It doesn't necessarily have a faster flow per se, as once your milk is letting down that can come pretty quickly as well. I guess it has a more regular flow and a more instant reward for less work.

I am wondering about what ZombiePlan said about giving expressed milk by bottle. That isn't so different from what japhrimel suggests about trying to replace formula top ups with EBM. It does strike me that you are spending so much time breastfeeding your DS that you really do have very little time/energy left to express (and I feel your pain, because my DD seemed to be permanently at the breast too). I wonder whether you could look at spending a bit more time on expressing and ease up on the direct breastfeeding a bit, especially if your DS isn't finding it too easy just now. As japhrimel says, at least that way you are stimulating your supply while providing milk for "top ups".

But I'm no expert, and I've never had a problem switching between breast and bottle - I guess that's because breastfeeding was pretty well established. Definitely discuss this with someone.

But you know at the end of the day, any breastmilk your DS gets is a great thing for him. If that comes directly from you that's best of all. If it comes out of a bottle that is definitely not the end of the world and you are helping to maintain (hopefully increase) your supply while you work on getting him back to the breast.

You really are doing a great job you know!

For a start, I took a day and a half "off" breastfeeding to concentrate on upping my supply (and resting as I was on my knees) as DD wasn't taking enough to maintain my supply and there weren't enough hours in the day to bf more without it meaning neither of us got any rest. During that time I expressed every 2-3 hours during the day and every 3-4 at night, double pumping.

We were then feeding every 3 hours at first (had to have a schedule as DD wouldn't wake for feeds at that stage). Each feed would start with a breastfeed, but if DD got upset, I'd give her a tiny amount (10ml?) from a bottle to take the edge off her hunger. I'd also hand express a few drops onto the nipple to start.

We'd stop if DD or I got really upset, or when she came off herself. She'd then have a top-up (usually from DH though I tried to do it sometimes) and I'd go express. With ebm we tried to keep one top-up ahead (sometimes she'd have some formula if we had no ebm) so she'd have the ebm from the previous session while I pumped for the next one iyswim?

HTH.

FWIW expressing shouldn't really be painful.

Milk isn't more fatty in the day afaik, anonmum2.

I know you've had loads of tips and advice on here already so I don't want to bombard you with more....

That said...you could try a supplementer (google supplemental nursing system ). It's a bit of a faff, but basically you can put ebm or formula in to a bottle which hangs around your neck. This feeds the baby through tubes which you attach to your nipples.

Yes, it does look rather bizarre, but it does mean that the baby is getting some milk and stimulating the breast at the same time. It stops the preference for the bottle.

Good luck with it all and hang in there.

Anyway, it is the one thing that got me back to ebf, after my supply had dropped drastically and DS's weight had plummeted.

Ooo, we tried one of those (homemade! didn't know then that medela made one) but by the time I'd got the hang of it we were already dropping top-ups anyway.

Also, it is really really common to get very little at first when expressing. It doesn't mean that you don't have much milk (although obviously we know your supply isn't great just now). The stimulation will be helping to build your supply, even if you don't get anything out. If you express at fairly regular times then your body will adjust and produce milk accordingly.

Oh and we didn't keep up the 3 hourly schedule for long as DD started wanting to feed for longer and it got more random. But while we did top-ups, the rule was that if she got a top-up, I expressed.

Crikey - do you think maybe the MW meant that more frequent feeding meant her DS would be getting more fatty milk?

I'm really reluctant to express and feed from a bottle and take a break from BF as I'm afriad DS will completely forget how to latch on altogether. He is already having a preference for the bottle and appears to be forgetting how to latch on. The supplemental idea is great, but looks a bit fiddly.. having said that I'd try anything now so might invest in one to replace those bottle feeds. Have to say, I was thinking of trying the Breastflow bottle first, but remember DS1(who was already solely FF at the time) hated it and I gave it away.

japhrimel, I am still astonished how you did it! It sounds so simple but I'm wondering how I can slot them in. Will think when my brain is working(slightly) in the morning. Normally between feeds I only have enough time to dash to the bathroom and grab a drink/food. Today is the first time I managed to express. The last 2 night top-ups I am far too tired to even sit up let alone express.

MW definitely said milk is more fatty during the day.

Right, if that's the case AnonMum2 (the more fatty milk thing), then I think you might need to get yourself some different advice to get you through this. I'd give one of the helplines a call and try to meet with a qualified breastfeeding counsellor.