Newborn feeding questions - bear with me!

[CaringForPod]

Hello,

I have a four day old, and while I am so proud to be his mum, we're finding bf-ing really hard.

I'm still confused as to how I know he's latched on properly and taking it in. I;m actually expressing my milk (took over from colustrum last night!) so that we have a back up. But how do I know he needs it? I don't want to overfeed him, but I'm worried that if I just bf, he won't get enough. I've been mainly giving him the expressed stuff the last few days as he just wouldn't latch on, but today he's mainly had stuff from the breast. But how do I know he's actually got any? I know that they're sleepy drunk when they've had enough, but doesn't a baby not getting enough milk get really sleepy too? How do I tell the difference?

Also, how do I tell if he's hungry or just plain agitated? Again, I don't want to overfeed him and assume he's starving, but I don't want to underfeed him either.

I'm getting regular visits, but keep getting told different things. I'm so new to all of this and scared of messing it up.

Thanks in advance for any advice.

there is no reason to think he isn't getting enough. ,if he is latching on, drinking, coming off satisfied those are all good signs!
at 4 days i wouldn't worry about whether he's hungry or agitated... boob cures all newborn ailments, so just feed whenever he looks hungry and you can't really go wrong.
the more you feed the better your supply will be, so it can be dangerous to start expressing instead of feeding direct in the early days, although it works for some people.

if he wasn't getting any milk you would expect him to be asking more and more frequently, being quite unsettled, and of course after a little while signs of dehydration- sunken fontanelle, no/very few wet nappies
they can become VERY lethargic if not taking enough milk, but that would normally manifest itself in baby not waking for feeds, or sleeping for very long stretches

so tbh if he is feeding well, you're not in any pain/discomfort, he's having wet/dirty nappies and otherwise seems well in himself then I think you have nothing to worry about

Good advice from thisisyesterday. Can I just add that you don't need to worry about overfeeding him, he will stop feeding when he's full. If he does take in too much for his wee tummy he'll spit it back up. If he's latching on better now I would just carry on with the breast if I were you - sooooo much easier than pumping, it's ridiculously time-consuming. Due to latch probs I tried to feed DS1 with expressed milk and within about 3 weeks I was going dememented and had to stop. I felt like I was either pumping, sterilising or bottle feeding 24 hrs a day, it was a never-ending process.

you can't overfeed him if you're bf. if he's not hungry, he just won't feed.

a couple of things: if they're latched on well, their jaws are quite wide open and have more than just the pointy nipple bit in, they also have a sizeable chunk of areola too. bottom lip should be pushed out rather than tucked into mouth iyswim.

i know it's hard when you can't SEE what they're getting, but trust your boobs and trust him and feed when he's asking.

you can't over feed - i'll say it again. just keep feeding when he's asking for it.

nappies should be wet etc. as thisisyesterday mentioned.

i just fed my newborns whenever they cried or bobbed around or looked like they were trying to latch on to anything: finger / shoulder / muslin.

keep going and trust in your boobs. they're doing a great job.

Trust that your body can do it - you don't need to express at this stage, just let him feed. And as the others say, get to a bf support group and I am sure you will find some reassurance there, but as he's only 4 days old and you say he wouldn't latch on, then a MW will come out and see you, so give them a call. You may as well anyway, even if he did latch on today, just to check his latch. You can never get too much support when starting out with bfing, IMO!! I am sure you are doing a great job.

Hiya, all great posts above. Just trust your body, eat well keep your fluids up (water is best) and get rest when you can and your boobs will be giving him everything he needs and no more than he needs thats why it's just so perfect. I always offered my boobs whenever my babies have cried or started to bob or root around. Call your community midwifes if hes not latching on, although you say hes latched on OK today. If feeds are comfortable and not painful then chances are his latch is spot on. I would ditch the expressing you need the stimulation from him to produce the milk a pump is not the same when trying to establish your supply.

While hes establishing the first few sucks can be sore and painful however this doesn't last the whole feeds and also dissappears as feeding establishes I think your nipples need time to adjust and the skin needs to toughen up a bit

I'm going to repeat an earlier poster. You can't overfeed a bf baby. YOu can underfeed one, though, and it really is best practice to offer the boob for every squeak: before if possible, look for rooting, fist sucking type behaviour. And don't even think of trying to guage how often he should/shouldn't be feeding. Newborns feed a LOT, around 12-14 times in a 24 hour period, and these are not regularly spaced, so yes, he might be hungry 20 minutes after you've just fed him. Greater spacings come with time.

I'd definitely recommend finding a bf'ing group, they are great for confidence building, which is the most important thing at this stage.

Congratulations on your new arrival :)

The best way to tell from day to day if your baby is getting enough milk is whether he has wet and dirty nappies. Weighing will help reassure you periodically.

You can't overfeed a bf infant (I simply don't know about formula). They won't suck if they don't want it. Having said that, bf is more than just nutrition. Babies do suck for comfort and may do so if they are 'agitated'. Many women find this a nice thing.

You have to have confidence that your body can feed your baby. It can. It's hard to feel confident when you are getting conflicting advice. HCPs will have been trained at different times and have different ideas. Some have good knowledge of bf, others have very little. It may help to find a local bf support group as they will have kept up with latest thinking.

Some videos of good latching are here. I found them useful when starting out.

Oh, and to reinforce what some others have said: new babies do suck a lot. They need to to establich your milk supply. The best way to mae sure you have enough milk is to let your baby suckle whenever he wants to. That's how demand feeding works in the early weeks and helps establish your supply for later when they may suckle less.

Just to add I won't bother with expressing either. Your baby is much more efficient than the pump. If your little one looks unsettled, check his nappy and offer the breast. The breast is food, pacifier and cuddles all roll into one.

Also you can hear your baby swallowing if you are feeding in a quiet room.

You'll get to know when he's feeding properly because they make a very distinctive sound, which I can't discribe well, but something like a regular rhythm of clck, gush. SOunds weird, but sure other mums know what I mean!

Some people can't hear that sound. I never could. Baby was doing fine though (Just thought I'd say)

You might find this useful. It gives you the breakdown of exactly how many wet and pooey nappies you should roughly be getting.

Agree with lilham- try to think of the milk as more than just a hunger satisfier - it will satisfy thirst, a need for soothing, a need for calming down, and a need for sleep.

Two other suggestions- feed from one breast until your baby comes off by himself, and then offer him the other breast. He may fancy a bit more, or he may not.

Chuck out your clock . By that I mean - just keep your baby close, watch his cues for feeding and don't worry if he feeds every hour, two hours or three hours. Just follow his lead.

You often find that mws have different ways of doing things so you might be better off speaking to one of the breastfeeding helplines for reassurance. The bfcs really are experts in this field.

Good luck and ask away if you have any more queries or doubts.

All good advice above. Just to add remember a Bf can be a cuppa tea, a snack or a three course meal for your baby. Trust yourself and feed. You are doing brilliantly.

Oh and if feeding isn't stopping squawks don't forget to check the nappy! Sounds obvious but dd2 was born on 2nd may and with tiredness I've forgotten to check a couple if times!

Oh re pooey nappies do check out the recent poonami thread here. For a laugh and indication of what can be 'normal' re bf baby poo.

Everyone's given you great advice. I really wouldn't express at the moment, it will only confuse your body. If you can, sit down, make yourself comfy, get some great films and cuddle and feed your baby. These first weeks will fly by!
You're doing great!

Thanks everyone for the advice - only just had a chance to log back in and read over it all.

The midwife visited this morning and freaked me out by saying he's lost weight (I know this is normal) but implied that he wasn't getting enough food and would need to go to hospital if it wasn't upped.

As I said, he's latching on better now, but he doesn't seem to be getting enough from the breast. So I'm expressing and bottle feeding him that as well. It's really getting to me - as SarahScot says, I feel I don't get any rest. The whole process takes about 1.5 hours - bf, then bottle feed, then a session of expressing. Once that's done, I have around 30 mins before it starts again.

I suffer from depression, anxiety and am generally a bit of a nutcase, so I'm considering just going for formula. But this makes me feel like a bad mother. But my mental health is fragile enough as it is, I just think this would be one more thing off my mind. I'm exhausted, barely resting and can't really sleep when he sleeps, because he only seems to want to sleep on me. Husband is currently pacifying him as I type.

My other option is to get a double pump to speed up the expressing process. Has anyone got any experience of these? Do they really save time? They're expensive, so it wouldn't be something to buy on a whim.

Has anyone else used formula? I just feel like I'm letting him down, but my mental health is really starting to suffer.

Sorry for the brain dump, and thank you again.

The first weeks are hard, whether you bottle or bf. You have a huge mental adjustment to make. Be kind to yourself.

Is expressing really helping much, either with your mental state or his weight? Pumps are not as good at getting milk out as babies, so he will probably get more milk if you just let him suckle as much as he wants. The cycle of feeding and pumping and sterilising is exhausting and I suspect counter-productive.

Please talk to an expert, which your midwife isn't necessarily. If you are not happy about using formula, you might feel more comfortable if you get as much support as you can before making a decision. Have you any local bf groups? Would you consider calling a helpline? The Breastfeeding Network number is 0300 100 0210. National BF helpline is 0300 100 0212. They'll help you talk through your options and come to decisions you are comfortable with in regard to feeding your child, whatever they are.

caringforpod what area are you in? perhaps we could suggest a nice breastfeeding group to go to?
that way you could have someone qualified check your latch, and talk to other people who have been through the same thing?

like you said it IS normal for a baby to lose some weight, and your baby is so small still!
i really honestly, truly don't think you need to be doing the whole expressing and bottle feeding thing if you don't want to

IF you aren't making enough milk then the best way to remedy that is to feed baby more often! instead of expressing why not put him to the breast more frequently? a lot less time consuming than pumping and bottle feeding IME.

if you want to swap to formula that is your decision to make, and for every person who has used it and loved it you will find someone else who has used it and disliked doing so... so it has to be your choice iyswim?

but honestly, having breastfed 3 babies so far I cannot stress how useful it is to actually get some real life help from a proper breastfeeding counsellor (midwives sadly have very little training in breastfeeding) and to get out and meet other breastfeeding mums. it's saved my sanity more than once!

Thank you latrucha. I've thought about phoning them, but assumed they would just talk about bf, not other options. That's good to know.

I'm getting a fair bit out when I express - between 60/80ml (two breasts combined), but it takes so long and I have to do it when I might otherwise get a chance to rest.

Thank you again, it's really helpful to hear from others.

How stressful CaringforPod

Loads of good suggestions already.

Can I ask, how much your baby has lost?

I hesitate to offer my own personal experience as it isn't necessarily helpful to you but I know the mindset you're in very well. You can do it, believe me, but some support would do you the world of good.

Have a hug!
I agree with seeking some support and advice. Believe me
BF does get much much easier. Little like riding a bike or learning to drive. So much to think of and do at first but it soon becomes second nature for both you and baby.

I don't want to add to your pressure but personally I wld stop expressing and relieve yourself of that pressure immediately, feed on demand, eat well yourself and stay well hydrated. It's normal for weight to be down that first weigh in (ours is tomorrow). Your baby is otherwise well, you are getting wet nappies and poo. Sounds good.

Don't worry if you choose to go with formula - you dong need to add stress to your life like that. But don't assume it will necessarily be easier or less stressful either. Why not give feeding of demand without expressing a go? Sounds to me like you are doing really well - so well done you!! Keep faith in yourself, be kind to yourself, see what happens when you remove the stressful aspects you've created and do it the "old fashioned way".

Caringfor pod your doing so well. These early days are unimaginably hard how ever you choose to feed but it will get easier. Everything you describe sounds normal most babies loose some birth weight, establishing the bf is hard and can feel stressful. I second the suggestion of ditching the expressing it's an extra stress you don't need instead of that offer him another breast feed if hes hungry again he'll go on and feed, I think that would really help your situation. If he continues to have lots of wet and dirty nappies then he is getting all he needs and he will regain and put on weight. It is far better to allow him to suckle than to use the pump. You can then get more rest between feeds which will help you to make more milk.

Do you have family/friends support other than your husband. I had a few friends who'd had babies and breast feed that I got a lot of support from by talking to them when I had my first baby. If you choose to switch to formula that is fine too and you have given your little one a great start already. Being a parent is more than just feeding. Just take each hour at a time and go from there but remember you've done a brilliant job already and all this will get better and easier as the days go on.