Help! Help! Help!

[misspollysdolly]

Gorgeous DD is four DAYS old. We have been readmitted tohospital because she has lost 13% of her birthweight (she was c-section born and fat with fluid if that makes difference to anything). She is my third DC and I am passionately committed to exclusively breastfeeding. My milk us only just coming in today. DD is feeding well. Latch is fine. Very content and sleeping between feeds. Poo and wee are both appearing at intervals. However here we are in hospital. She isnow subject to a delightful 'feeding programme' and I have just declined topping her up with formula against advice and am now feeling thoroughly confused about what to do for the best for my baby. She is now to be fed three-hourly (not 'on demand') I can only keep her on the breast for 30 mins each time 'so that she doesn't use up too much energy feeding' (apparently the amount used fretting and yelling for Mummy isn't the same thing at all) and I need to express using a pump so that she can be topped up with my milk on too of her reduced feed from me. Allof this goes against the grain and yet I'm adamant not to add formula in at all. I think that will muckabout with her system ament supply. Can someone help me make sense of all this and tell me what to do. DD is yelling. DH is holding her. I want to feed her. Help!

Thank you martha that is exactly the one i used....it really was a blessing.

Having a much more positive time now, two days on and hoping it will continue. Spent the first night home from hospital religiously following what is now referred to here as 'the blessed feeding plan' and by the time I last posted DH and I were completely exhausted. I had convinced myself that I'd never manage to bf again and that all hope was lost. I feel a lot less like this now and a lot more hopeful. The plan continues, but frankly is playing second fiddle to my instincts now. If DD is hungry I feed her - but if need be am waking her three hourly. I feed her with one or both boobs until I guess they feel empty (I don't get a feeling of fullness of emptiness - which was freaking me out but then I remembered I had the same with DS2 as well) or she comes off herself. If she still seems hungry, she gets whatever expressed milk we have. If she's still hungry/rooting/crying she gets a tiny bit of formula. Midwife I saw yesterday happy with this plan and not keen to weigh her now until Monday as weighing daily is far too frequent, in her opinion.

The only time that everything goes really to pot and I doubt my instincts again is during the night when I am so tired and sleepy that I lose all track of time and DD is first inclined to cluster feed or repeatedly feed to settle (or both?) from about 11-1 and then absolutely zonked out til the morning and even up to mid-morning. I am then struggling to wake her to Feds but the old anxiety kicks in that if I leave her my milk will go and she'll lose weight and we'll end up having everything scrutinised by health care professionals again. (just for the record, I am a HCP myself, so this is not a statement is not a prejudice it's more about not wanting everything to get totally over-medicalised). Should I be concerned by DD's heavy sleep-time? Or should o trust my instincts fully again?!

The main thing I wanted to say is that my hope has been restored in managing to fully breastfeed again. We are all hoping the formula will soon be a thing of the past and I suddenly feel confident in my own body - I do have milk, DD is wanting it, taking it and almost exclusively satisfied by it. Fingers crossed for the weigh-on on Monday as we might then be allowed to just play by our own rules again.

I notice how many people are facing this exact or similar issue on MN at the moment. I am bowled over by how many of us had our babies by c-section and wish the implications of fluid and overinflated birth weight could be researched fully. This sense of not being alone at this time has given me hope and comfort. Hope things improve for everyone soon. MPD

MPD I hope you will soon have the confidence to ditch what I said on Thursday was the hardest way to feed - feeding, expressing and topping up with ebm and formula.

One thing you might ask the midwives about: what is the justification for giving expressed and then formula if your baby seems hungry after bf? If she seems hungry, what is the justification for not putting her back to the breast? I think you are yet to accept that a young baby (and she's only 9-10 days old which is very young :) ) may well root and feed and doze and then root and feed again and then doze for long periods of time - literally hours and hours and hours. This is normal. At the same time you are worried when she does sleep that she is sleeping too long - exhausting for you :(

You are right to be concerned enough to wake her after long sleeps but it's easier to feed more often if she is skin to skin/close to you so you can respond quickly to slight feeding cues. This is better than trying to go through all the fuss of waking her from a deep sleep. Some babies come out of a deep sleep, and then if this is not responded to, they simply go back to sleep again. Not an issue, of course, unless there has been a bit of a background with weight loss.

Hope this helps.

Thanks tiktok - you are always so encouraging .

Everything I see in DD looks and feels - to my instincts and based on my previous babies - entirely normal. The doubts that have been sownin this

GAH!

The doubts that have been sown in this first week have done some damage to this natural confidence and I guess I'm struggling to shake this off.

I think the reason for continuing with some form of regime rather than to just put her back on is now a mish-mash of differing midwives opinions, as follows: Don't let her feed for longer than 30 mins at a time, lest the feeding in itself becomes too tiring fir her; only feed from one side (for up to an hour) to allow the other to fill up adequately (I personally thought this was not how boobs worked... I'd love confirmation of this); and only allow the feeding/expressing/topping up bit of the three hours to take about an hour so that there is time to rest (for me) in between feed times. These points are three instructions from three different midwives. I'd love to know if there's any pearl of truth or wisdom in any of them...! (but also a bit )

As for me, so far today I have not yet expressed any milk and DD has had no formula. We've done two hours skin to skin in bed while she was very sleepy but between two short feeds and she's also fed well from one boob (whilst apparently asleep!) and slept. If she stirs or roots again I intend to put her back on the other boob. She is content, not agitated or uncomfortable and suckles well at the breast even when apparently fast asleep! Last night we had the ridiculous situation that I was desperately trying to express 25mls of milk (my current record), while DH was feeding her previously expressed milk and considering formula... The frustration at pumping milk instead of putting her on the other boob was huge .

Am not an expert but can tell you about what happended with me if that helps. this happened to me - by day 2 DD had lost 12.5%. DD by this point was dropping in weight every time feeding as uses energy so we used an intensive feeding method to get the weight back up and it was a temp measure. I continued to try to do feeds every three hours but on top of that I expressed as much as I could every 30 mins. We used syringes to pump as much milk into her as pos - 2.5ml syringes squirt very small amounts to the side of the mouth, blow on their face to encourage to swallow - they will spit some out but keep going. When they've had enough they will simply chuck back out what they dont want. Give them a break and then go again. I stayed up 24hrs straight doing this. By 6am the following morning DD did massive poo was more alert etc and I dropped it down a bit - and gradually kept decreasing until back down to 3 hourly feeds. the syringes do not confuse/hinder BF so feeding fine after that. It is true that they waste energy when dropped so much in weight when they suck - you need to get their weight up quickly.

She was back on track at the end of the week - it may go against instinct - I cried lots - but its what you have to do to save your baby - when they've lost that much weight you just need to get it back up as fast as possible. Good luck OP

I am not an expert but I don't get the expressing. Surely the baby can extract milk better than you can. Just feed her with your breasts until she is not hungry any more. At this stage she will probably be permanently attached to your breast suckling or sleeping or both! Your breasts are never empty and don't need to fill up, you are right it doesn't work like that. I think it is unlikely she can expend too much energy feeding as well, but as I said I am no expert.

Just read your last post - normally you would use both sides for feeding but when they've dropped in weight you need to only feed from one side to maximise the amount of the fat rich hind milk they are getting as you need them to gain weight. You wouldn't feed in this way normally. It also allows other boob to increase in amounts that you can then express - if you've fed from both sides you will have less left to express to do top ups with. Also forgot to mention my advice was given by independent private BF specialist and not midwife and I trusted her and it worked.

you should feed a lot more than every three hours btw, should be whenever she asks which will prob be every 10min, this is normal and does not mean there is something wrong with your milk!

ITSALL - when they've lost that much weight the act of sucking (which is hardwork anyway) uses more energy than they can make up from the feed so they will continue to lose weight - you need to express and top up otherwise your baby will continue to lose and will be hospitalised and stuck on a drip etc - I know it seems to go against instinct but OP I am begging you to trust me and the midwives and do the top ups - sucking will use up their energy and their weight will drop if you do nothing and continue to feed without supplementing with topups. It will be tough and exhausting but so worth it.

Also sleepy can be a bad sign - when they've lost weight like that they become drowsy - and only stir when absolutely starving - you've got to give more often than that. i remember well the expressing while DP was feeding - its only temp. We did that for 24 hours solid - I know it seems insane but it worked much more quickly than midwives had said etc. Also the 3 hour rule is to give baby a rest from the sucking and allow you time to express maximum quantities - every 30 mins gets best results.

:( :( so much myth, so much misunderstanding, so much contradictory stuff :( :(

MPD - you said this is what you have been told.

"Don't let her feed for longer than 30 mins at a time, lest the feeding in itself becomes too tiring"

A healthy, term baby - which yours is - does not need to have feed times limited in this way - this might be appropriate for a sick, weak, vulnerable pre-term and even then they can be cared for with 'kangaroo care' - you just would not be struggling to feed them for lonf.

"only feed from one side (for up to an hour) to allow the other to fill up adequately ("

NO!!!!!! Anyone who says this does not understand how breasts work - anything they say can be ignored. For an explanation of why this is totally wrong, see www.kellymom.com (BullyBeefBadgers you were misled - great you got things sorted, but it was everything else you did that helped, not that :( ) This idea that babies need to drill down to the fattier milk is responsible for a lot of confusion; it is volume of milk that drives weight gain, and the foremilk/hindmilk sorts itself out with no engineering...in the majority of cases.

"and only allow the feeding/expressing/topping up bit of the three hours to take about an hour so that there is time to rest (for me) in between feed times."

That has a grain of common sense - not to make a great long performance of feeding/expressing/topping up, to give you a break, but it's really prescriptive to say an hour. The main thing would be to avoid that treadmill of feeding/expressing/topping up, if possible, in favour of direct breastfeeding.

Hope today goes better, MPD.

Thanks tiktok - you have confirmed quite a lot of the things I did already know and it's good to hear that I've not been naive or dim or whatever.

Thus far today I have just fed her on demand, roughly 2 1/2 hourly, at least going to the first breast twice (brief snooze/attempt at rousing mid-feed) before - if she's still rooting or grumbling - putting her on the other side. She's slept pretty much between feeds and is now wakeful but happy/placid. She's had no EBM or formula today and we all seem happier for this... She has not peed massively but has done a lot of yellow poo nappies so I'm almost happy with that...

I just need to stop worrying about the weigh in on Monday and what might happen if her weight isn't up ...just need to feed, feed, feed her and keep a lot of things crossed...!

Don't imagine anyone is around now, but we're having a nightmare night now. DD been feeding beautifully all day. Looked this evening like she was cluster-feeding so I just fed her, but now she's in a terrible stat, crying, rooting but fussing at the breast - not wanting feed just wanting to suck. She's not been to sleep since mid-afternoon and must be utterly exhausted and overtired. I'm stressed, DH is stressed and DD is stressed and we are running out of things to try. I'm terrified that after all the other crap that's happened this week, she is burning off precious calories and will not have gained weight tomorrow or will cry herself to a point of dehydration and the whole nightmare will return. Can anyone advise. Please tell me this is a blip night and not colic starting as I'm not sure I could cope as it stands. MPD

You poor thing..how distressing for all of you. I haven't read all the posts which I'm sure have all given good adivce. Could you not just give her a couple of drops of Infacol, in case it's colic and just put her to your breast as and when she wants it ?
FWIT my DD used to feed and then go all whingey and fretful a few minutes later as if she wanted another feed. i persevered with getting her to latch on again and she did after a while and then she'd settle.
Hope you sort things out xx

Ps If she just wants to suck for comfort I'd let her... exhausting for you but she might settle xx

I know this is a bit late, and the night is hopefully over, but don't worry- and I'm sure it was just a blip - Just let her comfort suck, let her go to sleep on you. Whatever she needs, she is only tiny.

One thing I didn't know was that babies cry when they are sleepy - they don't necessarily go to sleep. I found walking her up and down in the tiger in a tree hold worked well if she got worked up and wouldn't sleep on the boob.

tiger in a tree hold

Oh, and you are doing fantastically with the feeding by the way!

Hope you got through last night MPD- like pp says, don't worry about comfort sucking.

Fingers crossed for a good day today and that the weigh in goes well.

Just read your thread. How are you doing today MPD?

Well we made it through our nightmare night - DD conked out at 2am in the end and pretty much slept til the morning then. She was also sleepy all the next morning - apparently she was a bit tired, having been up all night . Monday morning we went to see the Midwives and she had gained another 50g, which brings her to just about the level of 10% off her birth weight, so although they said feed and top-up with whatever we want still, so I am now just demand feeding her and have not given her any top-ups at all in almost 48 hours. The midwife even had the audacity to suggest that they might have recorded her birth weight incorrectly - meaning that all the fuss, panic and stress may have been totally unnecessary - can't think about that one too much, as it would make me too cross, but still...

The last two nights have been much better, though the nightmare night has reminded me that even teeny weeny babies need enough sleep in order to get enough sleep, IYKWIM - so I've been trying make sure she has some deep sleeps through the afternoon and evening.

I am completely hoping that we are now firmly on the road to exclusively breastfeeding her. She seems happy enough, is feeding, weeing and pooing and usually sleeps contentedly in between feeds. She seems to cluster feed a fair amount in the evenings and yesterday pretty much fed all day long (I'd forgotten that they had days like this!) I'd love her to sleep a bit more in her cot at night, but hey, she is only 12 days old - this will come, though I'd welcome any tips....!

The only niggling doubts I have now are this: will those few ounces of formula have caused any lasting disruption to her health or immune system...?! And also is it now safe to assume that my milk is 'in' and - now that there is no more topping-up being done - will be adequate for her needs...?! TIA MPD

Hi, I'm so glad things seem to be looking up!

Formula (and anything other than breastmilk) strips off the gut's protective layer which breastmilk creates which can allow bacteria and viruses through into her system (which is one of the reasons why FF babies are more prone to illnesses.

HOWEVER, this is a TEMPORARY effect and as you return to exclusively breastfeeding this protective layer will return in full force - no long term effects at all, so be proud of what you've done and what you're doing :)

It's not possible to say whether your milk supply is sufficient from a forum - but it's unlikely not to be given what you've said, and if you just let her feed on cue, and cluster feed as required, your supply will be absolutely fine.

Can't help much with the cot I'm afraid. My first son slept in his from a few days old and didn't look back. DS2 is still in our bed at 15 months and showing no sign of leaving. Both were fine by us. I love co-sleeping anyway, although would love a full night's sleep but that's just not going to happen with DS2 and having him in our bed means we get the maximum amount of sleep possible. If he was in a cot he'd not sleep at all as he hates being away from us.

So all I can say is, work with what you feel comfortable with, not what is culturally normal, and if you do find that co-sleeping gets you more sleep then here's a wonderful book to make you feel warm and cosy about it: www.amazon.co.uk/Three-Bed-Benefits-Sleeping-Your/dp/0747565759/ref=sr_1_1?ie=UTF8&qid=1319020352&sr=8-1

If the cot is the way forward for you, I would say just keep trying but go with her needs (if she needs you, she needs you) and she will eventually be confident enough for her own space. But don't exhaust yourself just because you feel she "should" be in a cot.

MPD I also had to use formula top ups for a week or so until DD had gained some weight & got over her jaundice. She's now 16mths and I'm trying to wean! So it didn't do her any harm, didn't stop her feeding in any way. We stopped the top ups and she had no more formula until about 8 months when we finally got her to take a bottle so I could have a little downtime.

Do not feel guilty - if you are told by doctors that it is necessary for the health of your tiny new baby, then of course you do it. Do try and get advice from different health professionals if you can to make sure it's not just one persons opinion. Interfering HVs who are insufficiently trained are a different matter and as your DD gets older it'll be easier anyway. Good luck.

Aargh! Another fretful night for DD which is leading me to doubt my ability to feed/soothe her enough. Coupled with the next weigh-in tomorrow, I am now feeling pretty stressed and pretty ... MPD

misspolly, are you still offering one breast at a time? A classic way to increase milk intake and production is 'switch nursing' which involves offering the second breast when active suckling peters out, causing renewed enthusiasm with the faster flow, then switching back to the first, an so on as needed. All in the one feed. Have you tried this?

Restricting to one breast for a period of time is akin to block nursing, which is a method used to decrease supply.

She has pretty much been cluster feeding all night! Have completely lost track of which side she's on now, but no, I'm usually offering both at each feed now. Not bothering with the 'one side per feed' suggestion. Slightly bothered today that her poo has been slightly green but i think - IIRC - that this has something to do with hind and foremilk. Should i be mire worried??!

Until tonight I've enjoyed a week of freely feeding her and reconnecting with my instincts. Then a fretful night happens and with the prospect of weighing in with her again, I am suddenly totally doubting that all is well. Realise how much last week's readmission has knocked my confidence. - and I'm really scared that if she's not gained weight they will force us back into hospital. Frankly I think DH would allow it to happen, but still...