please help! hardly any milk during the night

[nello]

hello,

My little girl is now 3 weeks old and I have been trying hard to breast feed her. I am really enjoying it when it is going well and I have lots of milk, but it is awful when I try and feed her and nothing seems to come out of my breasts. last night at 8pm I had so much milk she was having a little party as she was feeding and fed for over an hour in total, emptying one breast and then spending about 15 minutes on the next. At her next feeds though (about 10.30pm and 1.30am) there was hardly any milk and she ended up crying through the whole night, with neither of us getting any sleep.

In the end my partner gave her a bottle of formula as she was so distressed.

I really don't know what what to do. I want to breastfeed so much but when I am not satisfying her it feels awful and I am tempted to just move onto bottle feeding ( i don't want to do this though).

Does anyone have any experience of this and offer me advice as to make sure I have enough milk at each feed?

Thanks very much in advance.

With going out - just feed the baby when they want. You can find a cafe to sit in and feed, and lots of shopping malls and department stores have feeding rooms, but I have fed everywhere. Buses, trains, pubs, parks, swimming pools, libraries, beaches, sitting on floors or walls

You'll get to know a bit of a pattern to your baby's feeding too, so after a while you might know that once she's had a big feed in the morning she won't want another for a couple of hours, but maybe in the evening she wants to feed every hour or more.

I'm still not clear on the night time - after you've fed her, does she cry but won't go back on the breast? Do you offer the other side? Or does she cry when you put her down but calm down if you hold her?

This page is also useful on cluster feeding and fussiness.

Hi Nello
Firstly, congratulations on your lovely baby, and secondly, you sound like you are doing well! The first few months are so hard, especially with a baby who cries in the night time.

It might help you to think of your breast as a stream or a river, rather than like a bottle that gets "empty". The more your baby feeds, the more the breast produces. Even though it might feel "empty" it never really is!

During the first few weeks, your breasts will be trying to get in tune with your baby's requirements, it's a "supply and demand" system.

To directly answer the questions from your last post,

1. Following her cues for feeding during the day.

The answer is yes, feed her whenever she "asks" for it. As a new mum, you might feel that you are nervous about feeding out and about, but don't worry, you will soon gain confidence. There are many places you can pop in to feed in peace and quiet, while you get the hang of it, and before you know it, you will be feeding anywhere and everywhere without thinking about it. Are you in the UK? I just had a feeling from your posts that you might not be? If you are, see if you can go along to a local breastfeeding support group, where there will be other mums to talk to with experience, as well as probably a breastfeeding counsellor to help with any technical questions.

So the answer to your first question is don't wait, just take her, and feed her while you are out. I'm sure MNers can give you a whole list of places you can feed when you are out and about.

1. Squeezing the breast and not much coming out.

The baby is far and away the most effective way of getting the milk out! By giving her the breast, whether you think there is milk or not, you will find that after a few days, the milk will balance out the demand, and things should get a bit easier. She might be fussy for many reasons, but the more you feed her, really and truly, the more milk you will make (it's amazing!)

Your doctor seems to be advising "topping up" with formula, but although that seems to help, as others have said above, it is actually counter productive and will slow down your own milk production.

Keep at it, and things will come right.

The other thing I wanted to say (phew this is a long post, sorry!) is in response to your worries about dealing with the sleep deprivation (I can empathise with that!) as well as with going out. Think to yourself, do you actually NEED to go out?

If it's for shopping, could you do it online, or get your DH to pick it up?
If it's to see friends, could they come to you?
If you could spend a few days at home, in bed, with your baby, getting used to each other and feeding on every squeak she makes, eating lots of cake and drinking lots of smoothies and fresh water, you may well find that things are a lot easier to handle! (and don't worry about the housework, either!)

Do let us know how you get on!

Good advice there. You can youtube feeding lying down too. I found with a tiny headed newborn and a large breast it helped to have her raised up on a pillow or folded towels to get her towards the nipple. As my daughter got bigger this wasn't so necessary.

Also, can I ask if you are in the UK (you mention doctor is all, instead of HV)? I had my baby in Singapore and I found the advice of HCPs there really hit and miss and old fashioned (two hour feeding, dive-bomb latch technique, topping up I had to hire an ex-UK breastfeeding counsellor to tell me things were fine.

If you mean going out as in going out for the evening, well, 3 weeks is very early days but I did manage to get the odd hour or two off after about 20 weeks (expressed like crazy for days beforehand, had a live-out maid who my baby was used to and used to go for dinner in the street where I lived so I could rush back) But after about 6 months she refused a bottle but luckily I did my socialising in my building so could always go next door and resettle. If you mean just leaving the house, just feed away. I've done it practically everywhere, tube was the most intimidating, but once I did it, it was fine.

Good luck. All as you've written here seems normal.

Really sorry, in a bit of a hurry, but, wanted to cheer lead a bit - well done you, it is SO hard!

I had a really hard time at the beginning, I had no idea that newborns could feed ALL the time, and was sure something was wrong.

DD is now 15 months and still feeding. She has never had any formula (I had none to hand at the times I felt I needed it) and is absolutely fine. I never had any great success expressing, never had anything come out when I squeezed my nipples and DD cluster fed every evening for 11 weeks, BUT there must have been milk there as she grew, wee'd and poo'ed etc.

If the HCPs are happy with her weight gain, anbd she seems generally healthy then try really hard to trust in your baby and your body. Throw away the clocks, the books and ignore unhelpful comments. Feed, feed, feed, whenever, wherever. You are doing brilliantly and it DOES get better!

Also, I found that sometimes DD would need to swap sides every few minutes when clustering - again, normal and seemed to work!

Is there a medical reason the doctor advised feeding every 2 hours? if not, waking a sleeping baby is pure madness, so leave her to sleep!

as everyone else has said, feed her when she shows the cues, and throw away the clock, and all will be fine :)

Aaargh! Stupid doctor! Unless there is a specific medical reason, you don't need to feed to a schedule and if your baby is hungry (e.g. if going through a growth spurt) the only way to up milk production is to breastfeed more not offer formula!

How much you can express - even with a pump! - is no indication of supply. If your LO doesn't want the breast, that would suggest to me that they are not hungry. They may be overtired, they may have had too much stimulation, they may have tummy ache, they may be scared of this big wide world. Try holding them in a sling - partners can do this too - and walking around.

It really doesn't sound like you have a supply issue.

With cluster feeding, I would swap sides if DD came off for whatever reason or fell to sleep temporarily.

I would get as much help as possible with latch and positioning though so you can be confident your LO is feeding as efficiently as possible so as to reduce the amount of cluster feeding needed (some will always be normal!).

Otcha - no i'm not in the uk at the moment, living in Mexico and will be returning to the UK when she is about 4 months. So yes, it is the doctor who gives the information about breast feeding. he told me 2 hours between each feed and if she wants sooner try and distract her by dancing,playing singing etc to get her to the 2 hours to make sure that she is properly hungry and gets a full feed each time i feed. There is no other medical reason for waiting the 2 hours that he has said.

RitaMorgan - In the evening she feeds and goes down most nights but when she wakes for more feeding or starts crying my breast doesn't seem to satisfy her...to be honest i can't remember exactly what happens due to tiredness but i think i give her my breast and she sucks but pulls off and cries as if she is not getting anything from it and when I check my breast can't see anything coming out (at other times I can see the milk).

ok, so let me check, when ever she shows she is hungry I just feed her for as along as she wants and if nothing seems to be coming out i just let her keep sucking anyway? and if she sleeps I wake her how often if she doesn't wake 9daytime/nightime)? sorry!! i am so confused

If she's asleep, leave her! If she is gaining weight and not ill etc, then never wake a sleeping baby, use the time to get some rest yourself.

Yes, feed when she is showing the cues, let her feed as long as she wants, it's really important for milk prodcution, so even if nothing is coming out now, it is sending the order in that she needs more milk so make it please body :)

Oh Nello, you sound in a pickle, but you are doing so well. And what's more important, you don't sound like you're about to give up yet and you can get your head around this (I mean this in the sense that you can alter your expectations and let the baby lead you and ignore unhelpful advice -- hard to do when it's a doctor). I remember that hazy, knackered time so well. Your doctor's advice is outdated and incorrect (although it might by sheer dint of luck be correct for some babies who happen to feed every two hours)

Evenings are a fussy time for many, many babies.

In the evenings keep her near in a wrap as you have dinner and do a few things or sit down and watch a film. If she cries feed her. If she has bother latching on, try the other side. If still not latching on, perhaps just go for a short walk (partner can do this if you want to take the chance to have a bath.

If still crying try feeding again. Sometimes just keeping her in the wrap and singing, rocking may help. If still yelling, try feeding again. Keep at it, trying each side (sometimes they get a preference)

Don't time all this, don't time her feeds and don't clock watch.

When you are knackered get into bed. Read a book or watch a film while feeding/not feeding.

Remember that this intense phase won't last long and you are doing the best thing for establishing a longer term, easier, more routine breastfeeding pattern.

If the crying gets too much at any time, she won't shrivel away if husband takes the baby out of the room for a few minutes. Collect your thoughts, have a cry, eat something, then try again.

If you think she really is struggling with the latch (although this isn't a problem in the day, you say?)

Milk does NOT dry up in the evening. I thought this, but it doesn't. Your baby just gets a bit fussier and more tired and more determined to suckle on and off.

Do not express, do not pinch yr nipples to see what comes out. Just rely on wet nappies to guide you.

I'd try to get to a breastfeeding counsellor (must be some you could hire privately?) to check position and latch and just simply to reassure you that you are doign great (which you are)

Silly advice from the doctor! Why jiggle and distract a hungry baby?

Feed whenever she wants for as long as she wants

If she comes off one breast offer the other, and you can switch back to the first if she wants more

Let her sleep (though during the day you might want to offer her a feed if she hasn't fed for three hours)

Your breasts are always producing milk, they never empty. Sometimes the flow might be slower and a bit frustrating for the baby though.

Feed lying down at night

One other thought, if she comes off crying and won't go back on either side, could she need a burp? I found this with ds sometimes.

The wrap sling was a lifesaver for me when DS was tiny. Early evenings he would not settle at all sometimes and just walking round the house with him in the wrap while I put washing away and stuff was often the only thing that would calm him. I do think tiredness has a lot to do with it, when he is tired he is more impatient in waiting for the letdown so would seem a lot fussier that at other times.

thank you! so in the day time, on demand or else 3 hours between feeds...do i calculate this from beginning or end of the feed?

looking into a breast feeding counsellor - just hope they don't give me different advice!

sorry....another question! i hava just been feeding her, she's taken about 25 mins on one breast and now fallen asleep. should i change her nappy to wake her and give her a bit more or when she falls asleep when feeding do i just leave her? sooo difficult, i still have the clock in my head that the doctor set of telling me about 25 mins each breast every 2-3 hours!

I'd count 3 hours from the beginning of the feed. My ds very rarely managed 3 hours between feeds until he was 6 months and on solid food, but in the early weeks if he was sleeping for a particularly long time during the day I'd wake him for a feed if it had been three hours - mostly because I wanted him to get plenty of feeds in during the day so he didn't want so many at night!

I know other people who would never wake a sleeping baby and it worked fine for them, so that one is more of a personal preference than a hard and fast rule.

Leave her to sleep, when she wakes offer the other breast.

At 3 weeks ds was feeding an hour out of every two, to sometimes 10 minutes in every 30 minutes - I think there are very few babies who do 25 minutes every 2-3 hours, or whatever arbitrary number your doctor has come up with. There's huge variation between babies and between feeds.

Oh Nello, sorry you've had such rubbish advice in real life.

I'm not an expert, but just to reiterate what others have said, feed her when she seems to want it, there is really no point trying to 'distract' a tiny baby. If they are hungry, they are hungry. I have never understood the mentality that says a baby should eat at exact intervals. Sometimes I want my lunch at midday, sometimes 2:30. Sometimes I'm snacking all day, others I suddenly realise it's dinner time. Why should a baby be expected to be any different, especially when they don't even have the habits we do that lead us to eat at the same times.

Unless there are particular reasons (jaundice, weight issues, etc) there is no reason to wake a sleeping baby every 2 hours, particuarly at night. You want her to start loading her feeds into the day and sleep longer at night eventually, so why encourage the opposite!

The thing that makes me sure your doctor knows bugger all about breastfeeding is the suggestion that you routinely top up with formula at the end of a feed. Your body is mighty clever, but how is it meanat to know to make more milk if what it's currently making isn't being used. It's all that sucking and (exhausting) cluster feeding that tells it 'this baby would like some more'.

If your baby falls asleep after 25 minutes of feeding, I would say that that was a full and happy baby. Take advantage of it. Sit with her on your lap, or ease her off if you reaaallly need to (i.e. you want a sleep or you need a shower, drink, food or a wee. Housework does not count at this point). There is really no need to force her to take both sides if she seems content. As an example, mine both did 10 minutes or less at each feed, only ever wanted one side and settled into a roughly 2 hour routine pretty much straight away. Other babies feed for longer (or even less), more or less frequently, more or less evenly spaced, they're all little people working out how they like to do things.

And finally. Well done!!!

Thanks so much for support and advice!! let me give this all a go and see how we do....i'll let you know in a day or two!! :)

one last ask...last night i fed her at 8.30pm and she was sleeping well and then i woke her at 10.30 to giver her a last feed beofre bedtime. should I always wake her more or less at this time? I guess what i mean is, when does night time start in terms of letting your baby sleep for longer and forgetting about the 3 hour waking?

Well, a lot of people like to wake the baby for a feed just before they go to bed - the theory being that you should then get a decent stretch of sleep before they wake up hungry again. This is often known as a 'dream feed' as people don't wake the baby fully, just sort of pick it up and offer the nipple, with some gentle rousing if necessary.

Works for some people, but made bugger all difference for mine! They both slept about 8pm-2am (or,if I was lucky, 3am) from an early age, then work frequently for the rest of the night. Waking them in the middle made no difference at all, still woke up at 2/3am. I had to start going to bed very early myself, so I got 4-5 hours befor the first waking

Mine was the same as RibenaBerry's - always had his longest/deepest sleep from his bedtime around 8ish, so trying to wake him for a feed when I went to bed at 10.30pm just disturbed his sleep and didn't make him sleep any longer. I wish now I'd just let him sleep! He used to sleep 8pm-1am, and by 8 weeks was going 7pm-3am.

mine has always had his longest patch of sleep from first going to bed, so I take advantage and often go to sleep at the same time!

I had to wake my baby up as she was born at 8 months and jaundiced. The third night she slept 7 hours, which is obviously not good! I set an alarm although not needed as she was a 2-4 hour waker for a feed for 18 more months.

But this was when she was just just born, by three weeks she was letting me know alright that she wanted to feed/suck/whatever.

Dream feed never worked for me. I don't think it works brilliantly for many ebfers on demand. Apparently works better for bottle fed, but that's just my anecdota.