low milk supply. Any thoughts?

[chimichanga1976]

Hiya, my daughter's 12 days old and she lost nearly 15% of her birth weight so I'm currently feeding her up with breast and formula in a bottle. It turns out that she wasn't getting enough exclusively breastfeeding and I'm just wondering why this might be.

I know the birth was the polar opposite of what I planned, a forceps delivery, shoulder dystocia with cord round her neck so they had to cut it before she was delivered and she was whisked straight to SCBU for antibiotics as my waters went more than 3 days previous to birth ( failed to labour, long induction, long story!! )

So there was no skin to skin and breastfeeding from the outset like I'd envisioned. Also, SCBU gave her formula from a cup as her 1st feed. Given her start in the world it's no wonder we struggled with breastfeeding to begin with.

I could not express colostrum and when the mw did it was much too painful so in hospital I just topped up with formula in a cup. When the milk came 3 days later I thought all was well. My boobs were swollen and had hard lumpy patches and when I used my breast pump some came out but now it's just a few drops appear on the nipples, certainly not enough to go in the container and be used to feed her.

Also my boobs are now just back to pre baby condition, they're just normal soft boobs! I thought when you were breastfeeding you suffered swollen, uncomfortable boobs that were prone to leaking and you had to use breast pads etc. I don't have any of this so I can only assume, along with the evidence of her weight loss, that my milk yield is low for some reason.

Once I started formula feeding in a bottle she became a new baby, during the day anyway! Much more settled and sleeping for long periods. I just was upset knowing she must've been sucking on fresh air, or for comfort all this time. Only thing is I don't wanna give up breastfeeding and moving to formula only. The mw said it may be because I'm not eating enough calories, but I'm not exactly starving and don't think I eat less than any other new mother that's permanently sleep deprived and grazes as a result!

Just wondered if anyone had any similar experiences or suggestions on how to increase my milk yield? Thanks in advance.

p.s currently I breastfeed every 3hrs max, or if she wants fed more regularly, then I follow with a bottle of no more than 60mls, though she never has this volume in 1 sitting, usually averages 40mls. It's cos I've no idea how much she's actually getting from me but I know it isn't sufficient. Also, she always falls asleep and I have to keep prodding her! ; )

The FF won't be helping your milk supply - the more your baby is on the breast, the more milk your body (should) make for her.

I started giving FF at 11pm and the HV warned me this wasn't ideal as night time is the peak time for your prolactin levels which is what boosts your milk supply (and I think she was right, I gave up BF at 7 weeks because DD was never off the breast, probably because my body wasn't getting the signal at night to make more milk!)

Is there any reason why you've scheduled breastfeeds to every three hours with top ups of formula if she wants feeding more often (which is how I read your last paragraph) - if she's hungry your best bet is to latch her on no matter how frequently to let your body know to make more milk (apologies if I have misunderstood!)

chimi - sorry you have had such a difficult start :(

The first days were absolutely not the greatest way to get bf going, that's for sure, but it does not have to mean bf is not going to work for you.

The things that will help are:

• lots of skin to skin, day and night, inc in the bath (co-bathing is great though obv you will need someone else to help)
• no fighting or struggling (has there been some manhandling in the past of breast and/or baby, trying to get them together? This can 'switch' some babies off)
• unlimited feeds, at least both breasts if you can
• frequent feeds - 3 hrly is nowhere near enough, and you can aim to double that

Things that won't help are:

• formula top ups - these may be necessary in the short term of course as it is important your dd gains weight and strength in order to bf well
• big/frequent formula top ups - 40 mls several times a day for a 12 day old is a huge amount - again, you may need some of this, some of the time, in the short term, though

You also need to find a midwife who knows what she is talking about. Feeding yourself more calories makes no difference. In addition, any of the HCPs looking after you should have spotted things were not going well, long before the 15 per cent weight loss :(

Call any of the helplines (on mumsnet bf pages) and perhaps find a support group for cheerleading :)

Hope this helps.

Thanks girls. Yeah I actually meant I've been advised to not leave it more than 3hrs between feeds as sometimes she can exceed this during the day when she sleeps, though she def makes up for it at night when she will not settle in her basket!

I'm thinking we may have some latching on issues. She doesn't tend to open her mouth very wide, as in how we're advised to give them a big mouthful of breast, and I dunno if maybe she isn't on properly as it can be quite painful. Had to give boobs a rest the other night as nipples were so sore with evidence of blood on the ends and some skin coming off. Not nice! Started using that Lansinoh stuff after a feed now.

I almost rang a breastfeeding counsellor ( I'm an NCT member ) to ask if they'd come out to the house, but when the mw suggested upping my calorie intake I just went along with that idea. Think I'll speak to a counsellor in that case. I think my technique is OK, plenty mws in hospital and community have helped me with that, but it's worth getting checked out again.

I def don't wanna overdo the formula but she's only just started to gain weight back and is now within 10% of her birth weight. I was in hospital for 6 days so I've no idea why they didn't weigh her before I left so things could be dealt with sooner. Expecting another visit today so as long as she continues to gain I can prob start cutting back on the top ups.

Is it normal for her to just have a few sucks then fall asleep? Have to keep on rousing her! Don't want her to favour the easy option of the bottle. Thanks for the tips and I wasn't aware of the night time prolactin thing either.

Please make the phone call (BTW you don't have to be an NCT member).

It's absolutely not normal for your baby to have a few sucks and then fall asleep - you are right to be concerned.

Things are not good, chimi, but they can be fixed.

But a midwife whose response in the face of a clear serious problem with bf is to tell you to raise your calorie intake is not helpful. However, you will need guidance from her on how to reduce the top ups.