Seriously disillusioned with breastfeeding - from big supporter to just about to give up. Please help me decide.

[Tinwe]

Hi. I know there are similar threads on here, but I really hope someone can help me feel comfortable with a decision either way.

My baby is 7 weeks old and from the start we've been keen to breastfeed for the obvious health benefits for DD, convenience for us all and finances! We'd been breast feeding well (including in public) from just after birth until week 5 or so I thought. On a visit during week 5, HV expressed concern regarding some lingering jaundice, poor weight gain and infrequent poos. Things escalated to an unexpected and stressful hospital admission for tests where we were told that DD was ok, but all these problems were due to breastfeeding. Since then DD has continued to have poor weight gain, spends increasing amounts of time on the breast (often only 1/1.5 hours between 0.5 hr feeds) and is almost always very unsettled when not being fed (especially if not being cuddled constantly with a dummy in place).

We've sought advice from breastfeeding counsellors who have been lovely but can find little wrong with our feeding routine, latch etc.Today I expressed for a day and found my supply is low (despite often squirting when feeding in public!) so we gave DD formula... She was settled and content all day, dozing at times, happy to be laying down without cuddles or dummy, looking around and "talking" to herself or us. The only crying was when feeds were due.

I really want the best for her so I'm finding it very hard to justify carrying on breastfeeding when she seems so much happier on formula and we're not seeing great health gains on the breast. So my dilemma is - should we give up and go onto formula?

Not an expert, but didn't want to leave this unanswered.

Expressing is a very poor indicator of supply, so don't use this as an indicator.
Infrequent pooing shouldn't be a concern by itself after the first week as some breastfed babies can go for a long time without pooing (up to a week/10days, I think). Are there plenty of wet nappies?

I think spending most of the time feeding is usual when they're very young. There's a series of growth spurts that will mean your lo will need to keep demanding more to up your supply. I know my ds spent most of the time feeding at this age. As long as you're not in any pain, your latch is probably fine.
Formula is much harder to digest that bm, so that could be why your dd is more settled.

I thought similar things in the early stages of feeding - again ds seemed happier and settled on formula- but could never quite bring myself to stop breastfeeding.
I remember it feeling like we'd been struggling forever and it wasn't worth it, but it really isn't for long! Feeding settled down for us at about 2 1/2 months, now at 7 months and it's been so easy for so long, weaning seems like very hard work. I'm so glad I didn't end up messing around with making up formula, worrying about quantities and temp of water and sterilising.

It is your decision, you will know your baby better than anyone. Try not to feel pressured by HV or the bf mafia!

Thanks hatters, your reply is much appreciated.

DD was going about 8 days between poops but they seemed fine when she went - 8 days seemed a LONG time. I think I could rationalize 1 or 2 "problems" but the issues seem to be increasingly stacked against us. There was a HUGE push during my pregnancy to breastfeed but the midwife and health visitors have expressed surprise that I am still breast feeding now because they weren't with their children by this stage! They're keen that I top up feeds with formula but I'm worried that will affect my supply.

If expressing isn't a good indicator, is there any way to judge my supply other than weight gain which is poor anyway? She has lots of wet nappies and the hospital said she wasn't dehydrated but I think my supply has lessened since then. Both my mum and sister had to give up feeding as "their milk dried up" so I wonder if it's likely to run in the family...

Ok, firstly, it's incredibly rare that one's milk 'dries up' at seven weeks. More likely, their boobs adjusted to the supply and stopped doing that thing they do at first where they feel rockhard sometimes, and/or leak, and it was misinterpreted. If your midwife and HVs had also stopped breastfeeding by seven weeks, you can see how hard it is to get knowledgable advice about what is normal at this age, and your mum and sister were probably misinformed. As hatters said, expressing isn't a good indication, either, so it's easy for people to worry.

I think that because so few women in the UK do breastfeed for long, it's seen as this magical rare thing that only works if the stars are aligned correctly and any little thing can prevent it. Really, the breastfeeding relationship, once established, is very robust. It would have to be, or the human race would have died out by now.

If she is having plenty of wet nappies and seems alert, then she's almost certainly fine, as hatters said. The behaviours you describe - wanting to feed often, wanting to be carried a lot, etc., are all consistent with being seven weeks old. That was the absolute peak of my DD's unsettled-ness; she was a slightly high needs baby, but always a strong breastfeeder, and she hated being put down ever, she just always needed a lot of stimulation but then she'd get overstimulated, and argh, but it was nothing to do with breastfeeding.

I'm worried that because you have family role models who "had to" give up really early, a midwife and an HV who both didn't breastfeed past a few weeks, you're not getting any real knowledge or support that will allow you to make the decision properly. Is there a breastfeeding support group near you? You really need to talk to women who have fed successfully, not just to women who didn't manage it and therefore see it as an almost impossible task, you know?

no, its not a "run in the family" kind of thing!
please, TRUST your body to do its job. You WILL make enough milk for your baby, as long as she can feed when she wants.
She has "poor" gain but she is gaining, right? The poos are fine, as long as she has wet nappies.

You say she is "unsettled" when you don't cuddle her - her default mode is to BE cuddled and close to you, so she may well cry when she is not in your arms. It is tiring and maybe not the image we have of a peacefully, sleeping baby but it is utterly normal. And as she gets older, she will be able to be left to play for a few minutes etc. She is still so very very tiny!

you are doing GREAT - as I said, your body knows that it has to make milk, and your baby being fed and being close to you is the signal for milk-production.

get a sling and hold her close! she will grow up so fast, you won't believe it!

x-posts, tortoise!

Just wanted to add support and totally agree with other 2 posters, My dc is 14 weeks and also went through this period of feeding constantly and wanting to be close, i used the sling which he loves and am lucky his sisters are in school so let everything else go and just concentrated on him. At 14 weeks he is much more settled, feeds are spaced out more and are shorter. I would say hang in there, its early days despite what your HV and MW say!
I also agree with finding some local breast feeding suppport, i found meeting other mums who were successfully BFeeding very reassuring and good company. Best Wishes

Lots of good advice already, just wanted to give you a pat on the back!

Its hard, but its your decision. Do find a local support group/ playgroup and sit and chat with the breastfeeding mums. You will find you are not alone in this and that everyone finds it an uphill walk.
It really does get easier past 12 weeks, as a little routine kicks in. You are in the toughest spot where supply demand is being established if i remember correctly (over 2 years ago for my youngest).

Good luck and be gentle with yourself. Rest, walk baby outside, sleep.

Are you exhausted? (I imagine so, 7 weeks after giving birth and feeding around the clock.) Try having a day or 2 completely in bed, lots of drinks, , good sustaining food and just keep resting and feeding. No racing around in the car doing errands, hanging washing etc- just have a time of complete rest and being looked after yourself if you have a friend, sister, Mum or DH available.
In my experience, this is about the time when the euphoria wears off and the deep exhaustion sets into your bones, and this might affect supply. If you can hang in there it will get better.

What constitutes poor weight gain?

It sounds like you are doing fine. As long as she is gaining and has lots of wet nappies I think the HV is talking a bit of rot. With regard to the pumps I could get loads from one pump (an Avent one) and virtually nothing from a Medela so it really, really isn't an indicator. Is there a support group near you, some advice from people that understand breastfeeding would probably really help. I understand you aren't sure whether to carry on, but it sounds like all your advice about BF is from people who don't know much about it.

Your DD might be very hungry if she is having a 6 week growth spurt. I second the advice to spend 36 hours in bed doing nothing but eating (buttered toast, chocolate, whatever is fattening), drinking lots of water & feeding baby. That kind of babymoon is the best way to build your supply and get your body in tune with what your baby needs.

If you do want to top up with formula, try one bottle a day ( eg lunchtime) rather than a little formula at each feed. But try not to be tempted to do more than one bottle per day.

What do you mean by poor weight gain? That is the only possible problem as I see it.

Jaundice is common, I assume she has had all the tests to rule out any more serious causes, she is waking for feeds. Even tho it is more common in bf babies, the paediatrician told me it isn't a reason to stop bf.

1 to 1.5 hrs between feeds is fine.

Infrequent poo on it's own is fine too. The issue is weight gain, can you clarify what you mean?

This sounds so similar to what happened with me and ds2.
I agree that it depends on what you mean by poor weight gain. I will describe what happened with us and when I decided I needed to change tack in the hope it helps.

Ds2 also had jaundice, weight on 50th centile when born. He always gained but by really small amounts and dived down the lines. When he hit 9th centile I started topping up with expressed milk. When he dropped just below 0.4 centile (under care of a paed by now), I dropped direct breastfeeding and bottle fed, expressing frequently but also with some formula - this was by 12 weeks. It was the bottle feeding that turned the corner for us.

I still don't know what went wrong, I had no nipple pain, latched checked by more than one counsellor. I was constantly trying to balance the importance of bm with decent weight gain. We did ok in the end, 5 months of bm, but he had to go on hical formula. And I can't really look at photos of him at 2-3 months because he looks gaunt. But he was happy and chilled throughout.

I understand the dilemma, I hope things turn around for you.

Breast fed babies often don't poo because the food is perfect for them so there is no waste to poo out.
You sound like you are doing brilliantly but need a bit of support from people who have been there ,I would try and find a support group ,try La leche or the NCT

Also, check that your HV is using the new growth charts based on BF babies, not the old standard ones based on FF babies

This is a really, really good point and I'm glad someone thought of it.

Just wanted to say congrats on the successful BF. We had a really tough time here and gave up at 11 weeks. Slight regret but now have a very happy baby. Still feel like a bit of a failure and wonder if I should have stuck with it so I would say keep going for a bit longer and see if things settle down!

Poor weight gain needs to be addressed BUT it depends on what the definition of poor weight gain is.

If it is dropping less than 2 centile lines (e.g. from 50th to 25th%ile line), not gaining 8oz a week* or not gaining centile lines then it's not poor weight gain just normal bf behaviour.

If it is static weight (e.g. 8lb 2oz at 4 weeks, 8lb 2.5oz at 8 weeks with no illness during the interim or identifiable cause like heart condition or similar), dropping more than 2 centile lines (e.g. from 50th to 2nd%ile line again with the above caveats), or if baby isn't gaining much & no change in length but their head measurements are going up and up then it needs to be looked into.

However none of those are indications for stopping breastfeeding, they are indications that breastfeeding needs to be evaluated by a breastfeeding professional (e.g. BFC/Infant feeding coordinator/IBCLC not a GP/HV/Nursery nurse) to see where improvements can be made to maximise the amount of milk baby can access. If the maximum baby can access is less than they need to grow then yes formula or donor bm needs to be given but not before a proper thorough examination of mum and baby's feeding relationship.

Sometimes mums find changing how the position baby at the breast or using techniques like breast compression or feeding more frequently or switch nursing can help increase baby's weight with out stopping feeding. Even if you do need to give additional feeds it can still be done alongside as much bfing as possible/desirable as every feed counts. It's not exclusively bf or excusively formula feed. There is a middle ground.

*Normal weight gain for bf babies here

even following that link truthsweet can be mis-leading. DD was a 3oz or less gainer, but nothing wrong with her, but it is all in context. A 2nd centile baby (or less at times but started at 25th) will gain lower than average. The lower number isn't a minumum

Just wanted to offer support, my DS was similar at 7 weeks, he would feed every 2hrs during the day, for up to half an hour each time, and then after about 5pm he would just want to feed constantly for several hours before he finally fell asleep (for all of 3hrs). Lots of crying from him and me, I was sure I must not be making enough milk for him. But after a while his constant feeding obviously told my body to make more milk, and then it all settled down. He is 23 weeks now and goes 3-4hrs between feeds during the day.

I can never express more than about 80ml tops either, DS was obviously much better at getting it out than I was.

If you decide to carry on, it might be another few weeks before things settle down - you are doing really really well to have breastfed this far!! Hope you can get lots of support in RL, and just want to reiterate that what you've said sounds really normal. My mate told me "when in doubt, feed" in the early weeks, and that really helped, I just sat on the sofa and fed and watched telly for hours and hours. Good luck.

if you're baby really isn't getting enough milk from you (AFAIK only around 2% of women can't make enough) you could mixed feed, either with an SNS or a bottle (hopefully just temporarily) rather than give up completely. You could also try galactogogues (fenugreek or medication like domperidone) to up your supply. Have you read kellymom? lots of very good sensible advice there.

obviously the most important thing is your baby thriving, feeding that often, as the others have said is normal at that age. I think jaundiced babies do need that bit extra to clear the jaundice.

congratulations and good luck, loads of women on this forum have to temporarily or permanently supplement with formula so you're not alone.

Definitely agree PenguinArmy - some children gain less the average and are completely and utterly healthy.

However, as a lower than average weight gain can indicate less than adequate nutrition, a child who is gaining less needs to be checked to see if that is normal for them or if there is a problem that needs to be addressed.

The trouble is when a HCP sees a baby gaining 5oz (for example) a week and thinks that is too low and there is a problem with the mother's milk so recommends formula rather than looking into the bfing relationship to see if there is any obvious changes that could be made (e.g. moving from scheduled feeds to cue feeding or allowing baby to feed until they finish rather than timed feedings).

Have you considered combination feeding? Best of both worlds and worked for us! No nipple confusion either. I chose to stop b/f ing at 8 weeks due to a seperate health issue which required steroids but was glad I gave her what I could. I also had low supply and DD was a very big baby who needed a lot if satisfying. Just my exp but hope it helps.

Just to echo what other posters have said, you are doing well to still be breastfeeding, and from what you have said it looks as though your DD is exhibiting completely normal bf behaviour.

I'm not an expert, but I'm slightly concerned that the hospital told you jaundice, "poor" weight gain and infrequent poos are "problems" caused by bf. I am bfing my baby (nearly 7 months now) and he was a very "poor" weight gainer - 2 or 3oz per week, born on 91st centile, dropped to 25th. In the first few months it was not unusual for him to go 10 days without pooing. He is healthy, happy and now i am starting to wean him he is bounding up the centiles!

So in my experience, slow weight gain and infrequent poos are not necessarily problems. I think you need some RL advice and support -try calling nct breastfeeding helpline, and they should be able to put you in touch with a local support group.

Good luck!