Am I flogging a dead horse?

[LauraRose78]

Hi everyone, sorry in advance for the long message.
I am mixed feeding my almost 6 week old DS and I'm wondering if breastfeeding will ever really work for us.

I had a traumatic birth and a post partum haemorrhage of 1L requiring blood transfusion & IV fluids due to low iron. I was told in hospital this may delay my milk coming in.

Day 3 DS had lost +10% & I was told to top up 70-80ml after feeds. I was sleep deprived by this point (10hrs max over 5 days), jittery, crying and had even hallucinated in the night so I accepted this without question (despite knowing beforehand it would affect supply) as the best for DS.

On day 5 I had only some minor sypmtoms of my milk coming in (breasts felt warmer) but no engorgement etc, and was told the 10-20ml top ups were not enough and we had to increase these. The expectation of the midwives was that as soon as my iron levels rose my milk would catch up with demand. I was feeding for an hour before topping up and DS was crying, frustrated and barely sleeping at all.

However, at 2wks I saw an NCT breastfeeding counsellor who diagnosed my son with tongue tie. We persevered through the next 2 weeks to wait for an appointment for the tongue tie op using a supplimentary nursing system (SNS) with the expectation that as soon as DS could latch properly my milk would increase. I was limiting the formula as much as possible, still continuing with the 1 hour feeds before top ups, feeding for hours & hours at a time as DS would go to sleep at the breast due to low flow, then wake after 10-20mins hungry. As soon as he had the op, his latch no longer hurt me (the pain had been dreadful for every feed) but supply still didn't increase so got a breast pump too.

DS was still only gaining tiny amounts of weight - saw GP who said 'hopefully milk will increase soon' - as if wishing was all it took. In desperation I increased the amounts of formula for DS and found I had a baby who could sleep, smile, coo and engage with us - the best feeling in the world.

Then last week we both got a severe D & V bug and ended up in A & E (I had dehydrated so badly I fainted holding DS, dropped him and hit my head on the wall, then passed out again) - thankfully DS was fine but I needed IV fluids (I still haven't got over the guilt of dropping him).
Based on the amount of formula DS now has (after BFs) he must be getting less than 3oz from me - and I doubt I've ever made much more than this.

The breastfeeding counsellor has suggested I try herbs and a drug on prescription that takes 4-6 weeks - neither of which are guaranteed to work. The HV has suggested a babymoon - I have done this, plus skin-to-skin, co-bathing, breast massage & compressions etc.
All these things combined together have given me such a tiny amount of milk that I wonder whether it is worth the heartbreak of keeping going (at the start I cried everyday about feeding, and think at points I have been on the verge of PND - I'm a bit better now but still have my moments). I feel like a failure for not being able to feed DS in the way I had hoped to but DH says the most important thing is that both DS & I are healthy & well, not how DS is fed and that I have done my best in difficult circumstances (DH has been fantastic, so supportive & helpful with feeding). Part of me wants to continue, even if DS is getting just a little benefit (for a lot of effort for both of us), and part just wants to stop and move on emotionally.

Has anyone else expereinced something similar, or have any advice?

Many thanks,

Laura

You have to decide what's best for your family. It is possible to get milk back even if it's dried up completely - this is called relactation. So you could get to far more breastmilk in your LO's diet, even if you don't get to ebf. But it is a lot of work as you have to pump regularly to increase supply.

I got DD from bottle feeds to formula top-ups to ebm only top-ups to ebf, but it was a lot of work and we didn't have the issues of TT so we got started a lot earlier and I had DH at home for all the hard times.

Oh and babymoons, long feeds, etc didn't work for us either.

:( :( LauraRose - so sorry that things are so hard for you. How lovely you have a lovely DH!

If you call any of the bf helplines, you can talk through your options - no one will make you do anything. You are not a failure - as if! - and it's clear you have worked very hard to make breastfeeding a good experience for you and your baby and your love for him is what has been driving you on....nothing wrong or 'failing' about that!

Sometimes PPH does affect milk coming in (you might want to check out Sheehans syndrome to see if this applies, as this is a complication of PPH, though PPH in itself slows everything up).

What went 'wrong' was the probably unnecessary advice to top up at every feed - I am guessing the 70-80 mls per feed is a typo and it was actually less than that, but even so, frequent topping up can truly hammer breastfeeding. As you say, 'wishing' things would get better is not enough. Snipping of the tongue tie relatively late will not have helped, either.

I agree that one of your options is to relactate. This requires a lot of time, motivation and committment, and it's not for everyone. Some mothers decide - perfectly justifiably - that they want to spend that time, motivation and committent, getting over the difficult bf experience and the emotions it has set up in them....and they switch to formula and put the bf behind them.

So, yes, physically, relactation is possible. Whether it is desirable for you
is a different thing....and you need to make the decision.

Hope you have a better time soon, whatever you decide to do.

Hi laura OMG I really know how your feeling my ds is now 3 yrs old and i breast fed him till he was 4 months old. I didnt go through even i quarter of the problems that you have encountered but the only reason i continued so long is because to have given up would have left me feeling like i'd failed. I look back now though and if someone says that breast is best i'd have to ask them the question "for who??" even though I loved being a new mum i can definately say that breast feeding left me feeling a little pnd, I didnt even want to get out of bed in the morning because he'd spend every hr on me. Then theres the fact that out of all my 12 nephews and neices he's the only one that was breast fed and he's spent more time in hospital than all of them put together. When i finally decided to give him formula it was the best decision i could have made. I'm sure that you are a fantastic mother and will be regardless of whether he's formula or breast fed your dh is definately right when he says that the most important thing is that you are both healthy. What makes me laugh is when you talk to health professionals and they wont tell you to stop breast feeding because the think its "best" yet they've probably never done it themselves. I hope all goes well with whatever you decide to do take care Rachael x

laurarose it sounds like you have had a truly difficult time during the last 6 weeks. You have done so well to keep going.

I had a similar experience with my first DD, milk delayed coming in, baby with latch/ suck problems etc. With her, I went through the relactation experience at about 8 weeks, using a rental hospital pump every 2 hours. It was very very hard but I am very very glad I did it and I think it was largely possible because I had a supportive partner as you do, and she was my first baby.

With DS now 6 months, I had similar problems, plushe had an undiagnosed tongue tie. I stopped BF him at 5 weeks, and have not attempted relactation this time - it's just not been possible in our current circumstances.

What I am trying to say is that whatever you decide, your DS will be fine, and you have done fantastically well so far. Most people would have chucked in the towel way earlier.

Hi Laura,

I am new to MN, don't have anything specific advice but just wanted to offer my support. I went through this to varying degrees with both my DS's. I too had low iron which until this pregnancy (39+3 weeks) was undiagnosed. Looking back DS1 was probably getting enough milk but I had no confidence at all I used to get so upset when he wouldn't feed or fall asleep at the breast but annoyingly always used to feed well before MW visit. I had no milk whatsoever with DS2, a tongue tie, had the SNS, was on domperidone, fenugreek, the lot, none of it worked. In the end a lactation consultant came from the hospital felt my breast and said "you have no milk" I was heartbroken, but was angry with her as she abandoned me and would never have said top him up with formula. Looking back now at the time it is all consuming but in retrospect such a short time. DH said to me, he is getting all the milk you have and that is better than none at all. So I guess what I am trying to say is be proud of the fact that he is getting some milk from you full stop, enjoy this time with your beautiful DS and if you want to continue, as I did for both of mine as long as I had some milk, then you should do so as long as you are happy to.

Thank you everyone for your replies - I'm so touched by the support (I had a little boohoo but that's par for the course with me at the mo!). I'm sorry that you've had similar experiences to me, but it is nice not to feel alone.

Rachael and rococopops thanks for sharing your experiences and emotions - I never expected to feel so much about feeding - it is such a rollercoaster and the different advice from each healthcare pofessional is so confusing. Pre-birth I never realised what an emotional issue feeding my baby would be - I assumed it would be entirely practical / rational. "Heartbreaking" is the only word to describe it - like you say.

narmada and japhrimel it is good to know that relactation might be possible should I decide to keep going. Can I ask how long it took you?

tiktok thank you so much for your advice - I've just googled Sheehan's syndrome and I will mention this to my GP at my 6wk checkup in a few days - emotionally though it makes such a difference to think that this might be a medical problem, rather than just a lack of persevering. Unfortunately 70-80ml topup wasn't a typo - the community midwife (new to the job) called the paediatrician at the hospital and rang back with that message - it was only when I saw my usual midwife a week later that anyone told me this is a feed, not a topup (I had no idea or frame of reference). And the hospital has just got a breastfeeding friendly policy!

Thanks again for the support, there's still a tough decision for me to make but it feels better to know others have been here too. xx

laurarose I went from zero BF - absolutely none - to exclusive BF in 4 weeks. 6 weeks in I was overproducing by quite a lot, you should have seen my freezer stash! I did pump like a crazy lady and also had a very willing baby whose latch had miraculously improved in the 6 weeks she'd been exclusively bottle-fed so I am not sure my experience is typical, but relactation doesn't necessarily need to be a months-long slog. Plus, you could always go for mixed feeding as an aim.

The only reason I've not attempted relactation with DS is that he has a pretty severe feeding aversion on account of having reflux - so the 'willing baby' part of the equasion is missing! All other things being equal I would have done.

The kellymom website has excellent information about relactation/ increasing milk supply. Also, if this is something you're going to consider I would really recommend seeing a qualified lactation consultant who can provide personalised guidance and work out a plan with you.

Ps it is a real shame that you were given such poor advice by the community midwife. I also had similar poor advice and it nearly completely scuppered things for me and my first baby too.

LauraRose - Sheehans is very rare indeed. But low milk supply after a PPH is not so rare.

I am shocked that a midwife thought 70-80 mls was a suitable top up or even a suitable amound for a whole feed for a newborn.

Very, very, poor care :(

tiktok do you know if low milk supply after PPH is usually temporary or is it a permanent problem? I'm worried that if i decided to put in the time & effort to try & relactate and it didn't work because of the PPH etc how that would affect me mentally & emotionally. Part of me doesn't want to look back in a few weeks or months & think I should have tried everything I could though.

narmarda - WOW! I am so impressed. thanks so much for your advice/experiences - I will check out the kellymom site. I want to make an informed decision. Can I ask what a typical day was like during relactation - and how the process affected you emotionally?

Laura xx

Laura, I don't know the answer to that, sorry, but I would guess temporary - even Sheehans (which you prob have not got, as it is so rare) is treatable. I have come across a number of women who had PPH and most of them did manage to overcome their problems but none of them had quite your history.

The real challenge is the way milk supply is thought to be calibrated in the early days. Frequent feeding gets the prolactin receptors in the breast working - this is a biochemical process which you can google if you want to know more (prolactin receptor theory) and if frequent feeding is interrupted or messed about with (like telling a mother to give top ups of 70 mls from day 3 ) then it might mean difficulties later on....it's one of the reasons why scheduled feeding in the early days and weeks is associated with early curtailment of bf.

However, I have known many cases where even really dire situations have been rescued - there are examples on mumsnet - and the human body does overcome difficulties with effort. Not everyone feels they want to exert the effort needed to relactate, and that has to be their choice - there are other aspects of parenting to put effort into and other aspects of life that need attention and care. So it is something to think about seriously before you do it. For what it's worth, my informed guess is that you could do it - but it would take several weeks and you would need to have your cheer leaders around you!

My situation was quite dire in a way as DD was fully formula-fed from 5 days old to 8 weeks old. I had therefore never had an established milk supply to revert 'back' to and I still didn't really have any problems establishing a full supply. I know I may have been a little unusal but it can certainly be done.

Well, I've decided to give it one last go to increase supply (and hopefully eBF but I'm aiming for increase and see where it goes). I feel I owe it to both of us as I don't want to look back in a few months and wish I'd done more. The HV saw me today and is really supportive - I've scored as mild PND on a questionnaire she had, but we discussed how this is tied in with my feelings about feeding. I've got Fenugreek tablets and I've been feeding every 1 1/2 -2 hrs in the day, and at least every 3 hrs at night, for as long as possible before giving him a little formula; I've also got a pump for any gaps in time! I've never had an established full supply but we have always breastfed a huge amount - I've just looked back over my notes of the first few weeks and (despite his painful tongue tie latch) we were feeding all the time, 20mins - hour or more round the clock so hopefully the receptors are there, they've just been unable to work properly due to low iron, tongue tie etc and will now kick in! Fingers crossed there wil be an improvement - I think even a little bit will spur me on.

Thanks eveyone for your support xx

Good luck to you, Laura!!

Yes, good luck Laura. What a terrible start you've had.

You may find this book helpful. It's the breastfeeding mothers guide to making more milk and is very simply and clearly written. It explains the process behind milk production and has lots of suggestions for increasing supply. There's also a good section on herbal galactalogues too.

Good luck and let us know how you get on.

Good luck laura. I also had mild PND when I was going through the relactation process - I was on antidepressants but I firmly believe getting feeding established with DD was a major part of me recovering.

Really, the best of luck with everything. Sounds like you're doing everything right. Let us know how you get on.

Thank you so much everyone for your support. I've managed to get back to the level of supply (or slightly more) from before we were both poorly with the stomach bug. I've found some great resources on the Kellymom website for weaning from supplements too which has been helpful. I'm aiming to reduce by an oz (over the day, not per feed) every 2-3 days as the Kellymom helpsheet suggests - I was worried about weight gain as DS has been slowly dropping from 50th to 25th percentile but in the last week he has put on 1 lb 8oz!! feeling a bit tired & sleep deprived but this (plus other positive signs like the length of feeds etc) is spurring me on.
Laura x
Can anyone suggest the best method for topping up when you are looking to reduce supplements - at the moment I offer it whenever he is not satisfied by a feed (and has softened both breasts - normally swapping at least twice). Is this the best way or should I give set amounts at set times of the day? Thanks!

1lb 8oz in a week! Blimey Laura Rose that's an amazing weight gain. Well done.

Not sure about the topping up tbh, but I do know that soft breasts have more fattier milk in them so it's good that you are swapping at least twice. Personally I would carry on doing what you are doing- he's obviously doing well on it.

I would keep going as it sounds important to you. I also had traumatic birth, poorly baby and emergency surgery when dd was 2 wks old but being very stubborn I wanted to keep trying!!!

It took a while and I topped dd up with formula if I felt she was still hungry, esp found by the evening my suppply would be waning!!! However by 3 months she was ebf so it can be done!!!

Don't panic too much at having to top up with formula it doesn't mean you are a failure but there is no point stressing with a hungry baby as long as you always offer boob first, you will start to find that eventually baby won't want the top ups.

Also I found it helpful to really increase my calorie intake and drink loads!!! Someone reccomended a pint of water with every feed and I noticed an improvement with my supply with a couple of days!!

Hi again everyone, thanks so much for your support.

Had a tough day yesterday (lack of sleep plus thrush treatment for us both hasn't worked :( got a new prescription now thankfully) but DS had a normal weight gain this week & stayed on his percentile line which was encouraging. I'm wondering if my supply has plateaued - but I have been tired so will rest tomorrow & have another burst at it. girliefriend that is so encouraging to know it can be done - thanks for the tips about food & drink - DH has made it his mission to make sure I have water & a snack.
I'm finding the lack of routine really hard as sometimes he seems to need formula (then sleeps for a while) sometimes doesn't & then feeds every hour so his sleep patterns are all over the place - just have to weather it out for a while I think.

Thanks :)
Laura xx

Hi again, I wasn't sure whether to ask here or to start a new thread but does anyone know if the following might be possible (just trying to explore all my options as I'm starting to think I've plateaued at the max milk I can produce) ...
At the moment I breast feed before topping up with formula. There is zero pattern to feeds other than when I do top up DS will sleep. If I don't he tends to go to sleep on the breast (low flow) 30-60 mins later he wants more. Is there some way I can perhaps give him 2 full breast feeds (eg morning & evening) & the rest formula feeds or is it impossible to sort of scrape together all the small amounts I produce? I really think I need to do one or the other for the middle of the night feed as often I'm up for 2 hrs+ (breadtfeed, formula, winding & then trying to get him back to sleep because he's been up so long he's proper awake now!)

thanks for your help, just trying to explore all my options as my current method of mixed feeding is so exhausting (averaging about 12-14 feeds a day)

laura

LauraRose - I could almost have written your original post (in fact you replied to one of mine about tongue tie). I have an 8 week old (9 tomorrow) and like you had PPH, tongue tie, baby losing birthweight, latch problems etc. even the hallucinations!.

My milk also never seemed to come in (think due to PPH in part) so my baby was formula fed to start with and he has also had reflux (the crying was really the worse thing of all) but that has been managed with a change of formula mostly. I also couldn't get my baby to even take the breast even after his TT snip until week three so was giving him expressed (tiny amount) and formula until then.

I have been pumping (hospital grade pump) from the first week after getting in a lactation consultant and been taking domperidone, fenugreek and blessed thistle for 6 weeks now to try and get my supply up (I have more milk but not that much). Also skin-to-skin, compressions etc... and it has been incredibly difficult and my feelings of failure have been overwhelming at times (a supportive DH too). I tried the SNS but with the latch issues it was so difficult and fiddly so this is the only thing I gave up on.

After finally getting him on the breast his weight stopped increasing so I have ended up breastfeeding, then giving an expressed milk top-up, then a formula top-up and then pumping for the next feed (I've got this down to an hour in total) which is finally making a happy and content baby who is putting on weight again.

It is a bit of a nightmare but like you, I also think my milk has maxed and won't go up now so I am stuck with this regime for as long as I can manage it.

My baby also fell asleep on the breast (low flow perhaps or maybe a hangover from the TT and being formula fed or maybe a palate issue and not being able to efficiently feed - who knows at this point)

If it is any consolation at 6 weeks he was still having a lot of feeds but this has slowed down now to around 6-7 (with a cluster in the evening which I kind of count as one and my DH does while I sleep) so I have gaps of around 4 hours between most of the feeds and my sanity is coming back.. however he is also starting to go off sucking the breast a little (he never truly got the hang of it even though he liked it) which means I am preparing myself for him being fully formula fed at some point (but hopefully not soon) which is a shame when my nipples had finally stopped being sore and cracked.

I wonder if your baby is just still so tiny or just not getting enough which is why he is feeding so often? I would also worry that if you just do 2 breastfeeds it might affect your supply even more. If you could get longer gaps then you might be able to breastfeed at every feed. Are you pumping at all? I think that is the only thing that is keeping my supply going, would pumping and supplementing with that help do you think?

Not sure how helpful that all is except to say that perhaps it is good to hear about other people in similar situations and their solutions.