Second time mum trying to be better at bf

[Amyloubell]

Hi there, hope someone can give me some advice.

Been to bf workshop today at the hospital. I was advised to get a routine in place from early on last time and to use a dummy for soothing and express for the late evening feed, so I could get sleep. I was warned against not introducing a bottle for longer than 3 weeks because it would then be difficult to introduce. I've seen here that a lot of bf babies resist the bottle. Although dd took to the bottle, she (I think) became lazy on the breast so I stopped after 6 weeks amidst concerns she wasn't getting enough milk. Also my milk seemed to reduce significantly over that time instead of increasing. Whilst am sceptical about on demand feeding, it makes sense to get your milk to come in, but if you need to do that, when would you introduce a routine? and when should I start expressing?

Thanks in advance

Ok well for the first 4-6 weeks you should feed on demand as a minimum as your supply is established. Maybe think about a routine after that if you really want to but again I'd carry on feeding on demand past then because baby's demands change with growth spurts (they know when they're hungry better than we do!). However as you get to 12 weeks you'll likely see a pattern anyway.

Dont use a dummy - babies will want to feed a lot in the early days because they need to tell your boobs to make milk. It's normal for newborns to feed every hour at some times during a growth spurt. If you give a dummy when they're tiny you could miss feeding cues until they're starving, screaming their head off. They'll then feed quickly, fall asleep and fall off boob when they should be feeding a little bit longer to stimulate milk production.

I was told to introduce a bottle at 6 weeks and had no problems.
I also started expressing then too.

So to summarise, put aside time to feed a lot in the early weeks. Learn the early hunger signs (sticking Tongue out, rooting for boob, sucking hands) and feed then. Get more sleep by having early bedtimes and keep your baby close at night. Introduce a bottle 4-6 weeks in (we used just a teat at first with some milk). Avoid using a dummy especially to try and settle a baby because it'll probably be more tiring and stressful than sticking on the boob. Also nights will be hard but I suspect that it would be the case FF a newborn regardless!

The advice you received last time sounds very odd to me.

Why are you sceptical about on demand feeding? IME its the best way to do it, your baby demands when hungry so that's when you feed.

Dummy's and bottles are ok from 6 weeks when bf, but not recommended before.

If you can get your baby into a routine and it works for your family then fair enough, and I suppose with an older child on demand feeding is difficult.

How old is your new baby?

In awnser to your question, I never really introduced a routine, except at night.

Congratulations!

Amy, pretty poor advice last time, and it is no great surprise you were disappointed that bf did not last longer. Hope you have a better time this time round :)

The truth is biological and physiological. Early introduction of bottles is undermining to breastfeeding because it interferes with the (at first) highly delicate, and sensitive, supply and production of the first weeks. A routine is inimical to breastfeeding - as is the use of dummies and expressing in order to extend the gaps between feeds in the evening. Just as you found, milk decreases when bottles, dummies and expressing are called into play :(

Clearly, some people manage to bf despite these challenges, but a lot of women don't . I think 'demand' feeding is a horrible phrase but it looks like we're stuck with it. All it means is ensuring you feed in response to your baby's needs, and that you accept that these needs may be unpredictable at first, and that these needs may encompass the baby's need to be close, and social, and soothed, and reassured....all of which happens at the same time as being well-nourishd and well-hydrated.

Many babies just get into a routine by themselves.

You can express when you want to, but it's never a good idea (when you baby is very young) to give expressed breastmilk as a means of not breastfeeding, because the body reacts to the 'gap' between feeds by not producing.

Why are you sceptical about 'demand feeding'?

Hope this helps a bit.

Thanks for your advice.

Baby not here yet, due in 6 weeks

The advice last time was basically babies do not need to feed on demand, but they do need to suck on something to soothe themselves, and feeding on demand encourages babies to use the breast for comfort rather than feeding, hence use a dummy and have a routine which should meet nutritional needs. The advice I think only makes sense if you accept that premise that babies aren't in fact hungry more often that every 2 hours.

However, if that isn't right, feeding on demand makes perfect sense...... I'm not opposed to it if it's what the baby needs, and have no particular pressing need for a routine - i.e. not rushing back to work and my daughter is at school now.

I think all I know is that last time we weren't particularly successful at bf - latching on, my anxiety about how much milk I was producing etc so I struggled on for 6 weeks and then went for ff instead. I really would like to do longer this time.

Thanks again
Amy

Yes, feeding in response to the baby's cues does encourage the baby to find comfort at the breast, more than 'just' food and drink.

This is a Very Good Thing, because babies' comfort sucking stimulates milk production, and it also ensures they come to learn how lovely it is to be loved, and to show love, and to be in loving relationships, to feel protected and to start being a social, responsive and emotionally-reciprocal person.....all good :) :) :)

Boob = comfort is a wonderful thing.

I BF DS for 2 years and it's amazing to be able to make him feel better if he was ill (he had raging fevers, very weak and pale and would only BF), if he hurt himself or needed comforting. That's to say I didn't whip the boob out at every whimper but I think that BF being more than food is not a bad thing.

I went against advice and bf every three hours. The first day was tough as I felt like I was torturing him by not feeding on demand, but with support I stuck with it. Colic disappeared within 24 hours and feeding was much more effective, less of the sleepy falling on and off, and the comfort sucking was not needed (and no more projectile vomiting!). If you are worried about producing enough, you can always express off what is left after each feed and then you have another three hours to make more. I used to do this and it built up a nice little stock for the late feed if you want to do it by bottle. Advantage in this is that the milk you express will be the rich creamy stuff and will give you a better start to the night as baby stays fuller for longer. You will still increase production as you are effectively emptying your breasts at each feed so the body gets the message that you need to make more.

If a baby is regularly projectile vomiting, this needs checking out - presume you did this, bigpigeon. What you did worked well for you and your baby if you had this sort of vomiting - it's not a plan for most babies, though.

bigpigeon to be honest, while it's obviously brilliant that this worked for you, BFing probably worked despite what you did, rather than because of it. I mean that in a positive way because you seem to have had a good experience, which is great :) but there's extremely well understood scientific reasons why your suggestions can be totally counter-productive to a strong milk production and successful breastfeeding relationship :)

tiktok, yes we did get him checked and it was just a byproduct of overfeeding from pain from colic. Health Visitor told me it was child abuse to routine feed which was emotive blackmail based on ignorance and not at all productive, so please excuse my forthcoming soapbox indulgence...
organiccarrotcake: I believe that demand feeding (in UK) is a relatively recent development as is child centric rearing. By that I mean that if you go back a few decades, people breastfed by the clock and didn't let the baby run the show. The problem is that the bf experts convey too rigid a protocol and if you don't follow it then you do seem to get negative comments thrown at you with little scientific basis. With regards to the "scientific reasons" why my methods are counter productive to milk production I am at a loss. By breastfeeding or expressing you induce the body to produce prolactin, which stimulates breast tissue to produce milk. If you feed regularly and empty the breasts you stimulate further milk production because your body continues to react to the elevated levels of prolactin that feeding induced. When your child matures and takes larger feeds, less often, by your reasoning everyone's milk would dry up. Yet this does not happen, children continue to thrive and grow.

bigpigeon if your health visitor used those words then she was totally out of order.

"Demand feeding" (also with Tiktok on not liking the term) is not a new invention. Quite the contrary, routine feeding is a modern recommendation (last - what - 60 years or so maybe) and what we know as demand feeding is how babies, and primates, were always fed (and are in non-western societies).

You clearly have a clear understanding of the science of breastfeeding. But, "feeding regularly" doesn't mean every 3 hours. You used the phrase "then you have another three hours to make more" but this implies that the breast needs to re-fill between feeds whereas this can be counter-productive by actually slowing milk production because the breast makes milk faster when the breast is emptier, and slows production when it's fuller. So, the mother who is feeding more frequently will have a faster draining breast and therefore a faster filling breast.

There is a huge amount of scientific basis behind the recommendations behind breastfeeding :). There was no scientific basis (although lots of theory) behind scheduled feeding, mother-baby separation, etc etc :)

Of course, it CAN work for some and that's absolutely brilliant. But as a general rule, and assuming there are no other specific things going on where some scheduling may be indicated, scheduled feeding as you describe is far more likely to cause breastfeeding problems.

No, demand feeding is not a recent development - for 99.9999999 per cent of human existence (approx :) ) babies were fed responsively and that is how milk production evolved.

Since recorded history, there have been some cultures that restricted or limited feeding, in some social groups, but the mass of humanity has never raised infants like that,

A young baby is not 'running the show' in the sense you mean. He comes out into the world expecting to be a social being and to make emotional and physical contact with his mother, which is not timed or restricted. That's just being a baby human, depending on his parents for everything.

We know milk production is best stimulated with unrestricted access to the breast. Your understanding of the role of prolactin is not quite right, and production of milk beyond the newborn period is much less dependent on elevated levels of prolactin - that's why people can breastfeed an older baby/toddler without the milk drying up. But in the newborn period, three-hourly feeding only is not usually sufficient to establish and maintain a supply. It can be for some, of course, and you found it was ok for your production.

Sorry, just re-reading your post and want to just clarify some things.

"If you feed regularly and empty the breasts you stimulate further milk production because your body continues to react to the elevated levels of prolactin that feeding induced."

There is an implication here in what you say that feeding more frequently (demand feeding) means that the body becomes less receptive to prolactin which isn't true. Not sure if this what you meant, though. But you are right, the more the nipple is stimulated, the more prolactin made, and the more milk is made (basically).

"When your child matures and takes larger feeds, less often, by your reasoning everyone's milk would dry up."

No, the body settles into a pattern of production which becomes very resilient to variabilities in demand with the older baby. Breastfeeding can be very delicate in the first weeks, yet becomes surprisingly resilient after a few months. Prolactin levels actually start to drop significantly over the first few months and it becomes less important for the continuation of milk production. BUT it's the first few weeks and months that are critical.

Tiktok and Carrotcake:
I successfully bf two babies that were in the 90th percentile, needed 8 breastpads a night and frequently woke with sodden bedsheets. I have to disagree with your put down that it worked despite what I did and just did ok for my milk production.
You are obviously singing from the same hymnbook, as is most of the breastfeeding expert population. Shame that really, as that is probably the reason most women don't even try it because it smacks of superiority. The result is that women are made to feel that they are doing it wrong and often don't get the support they need when they need it most.

My post was to encourage Amyloubell to try something different if the usual wasn't working for her. Guess I shouldn't be surprised that my opinion be stamped on.
You can infer all you like from my post, I never once rubbished the current "wisdom" or said it didn't work. I did however explain why my method did work. Why does it always have to be done your way or you are branded cruel or a freak that it happened to work out for. Open your minds and allow people to be different.
Amyloubell, I am sorry that this has hijacked your thread, it was never my intention. I wish you well and I hope you find your own way, one that suits you and your baby, whether it be their way, my way, or some other way altogether. And, if it doesn't work, never let anyone tell you you failed or did it wrong. x

"Why does it always have to be done your way or you are branded cruel or a freak that it happened to work out for. Open your minds and allow people to be different."

That's completely out of order, bigpigeon. Neither TT nor I have said, or implied in any way that you are cruel or a freak. Clearly you are taking issue with the fact that TT and I have wanted to ensure that your suggestions are taken within the context of general breastfeeding knowledge. Do not make accusations about us which are (clearly) not true and totally outrageous.

Most of the "breastfeeding expert population" are singing from the same songsheet for the simple reason that they are experts. I'm sorry that you feel that makes them superior but that is your interpretation, not a reflection on the way things are.

Your opinion wasn't stamped on. It was genuinely respected and supported as something that worked for you. But, it's unlikely to be a method that works in the majority of cases. It may work for amyloubell and she is free to try anything she likes but she needs to understand the whole picture to make an informed choice.

OP I am very worried about the advice you were given at the hospital. What was the organisation running the BF course? Not Nestle I hope...

OP, was the advice you were given from your visit today, or from when you had your last child?

No need to be defensive or unpleasant, bigpigeon. No one was rude to you, or stamped on you, or called you a freak or cruel.

The reason why breastfeeding understanding is pretty consistent is that there has been a considerable amount of observation, research,and general increase in understanding all round of how breastfeeding works, in the past 30 years or so.

You seem to think it is a personal conspiracy against people who want to do something different and that it all sounds 'superior' - where you get that from, I don't know.

You also leap into blaming the fact that breastfeeding support is based on evidence for how bf works for 'most women' not trying to bf - eh? almost 80 per cent of women begin breastfeeding in the UK. Then you say it's also responsible for women not getting the help they need - preposterous.

Breastfeeding stats plummetted 40-50 years ago, partly because women were told to breastfeed to a schedule. It didn't work for most of them, and like the OP, they had a very short and largely unrewarding bf experience.

We now know better - that's not being superior, for goodness sake, that's just saying we now have evidence that is going to help most women, rather than hinder them, in breastfeeding.

You did something different, you had a baby who may have benefitted from a deliberately-decreased milk supply (because it sounds like you were over-producing to the extent it caused a problem - this does occasionally happen). No one's denying that - why go into a huff?

Blimey!

Morning!

The advice I had last time was not from the hospital, whose only advice basically was feed on demand. This time I attended a 3 hour workshop (which was not offered 5 years ago) such was my guilt at "failing" last time. I wonder whether anyone has seen the Cherry Healey documentary about the guilt of not being able to successfully bf?!

The advice last time was not to not bf, in fact the contrary. I fully intend to breastfeed this time. What I am trying to get to the bottom of is if the advice which I followed to introduce a dummy and go to 2 and a half hour feeds after the first few days actually affected my milk production. Tiktok I think you are saying yes and I can see why that makes sense.

To be fair it might have nothing to do with that - but rather the pressure I put myself under to "succeed" and paranoia caused by mw comments about the weight she lost in the first week.

A related query I have about on demand feeding is if my child begins to associate the breast with comfort, and I need to take that away at some point how do I teach him/her to self soothe? (which was my motivation for using the dummy in the first place)

Thanks for all your input, the discussion is very illuminating.

I would just add that I think it is important to remind myself, that despite moving to formula (which was a decision I did not take lightly) and implementing a routine my DD and I did bond successfully and I believe that regardless of the lack of continued and unlimited access to my breast she is a perfectly happy and well adjusted young lady

Amy, it is good the breast is associated with comfort. The research shows that babies whose needs for comfort are responded to by loving attention (doesn't have to be the breast - just the breast is convenient :) ) develop self-soothing skills, and cry and whinge less at 8-9 months when followed up. It's reckoned this is because they grow in confidence and understanding that they are not 'abandoned' and that the world is a friendly, caring place.

If you decide to stop bf, then gradually doing so and replacing it with other forms of comfort and attention will maintain this confidence in your baby.

Reliance on a dummy to self-soothe has its own drawbacks as well - parents usually try to reduce reliance gradually as well, or otherwise make 'the break' easier.

Using a dummy is not wrong or harmful in itself. But using it to extend gaps between feeds is harmful to breastfeeding for many - a baby does sometimes 'make do' with the sucking comfort of the dummy instead of coming to the breast (not all babies are like this - some always reject the dummy if they are really hungry/thirsty). This reduces the stimulation of the breastmilk production process and less milk is made than the baby truly needs. Many babies feed more often than 2-3 hourly, especially at first.

Perfectly understandable that you and your baby bonded just fine, by the way :) Breastfeeding is not the only way of mothering and sharing love :)

Amy - I am by no means a breastfeeding expert, but I just wanted to add something about dummies.

Once breastfeeding is well established (so rarely before a month, but could be longer depending on your breastfeeding relationship), lots of breastfeeding mums do introduce a dummy. As Tiktok has said, it cam be harmful to breastfeeding to use it to extend gaps between feeds. However, it can be a god send in certain situations. Both of mine have had dummies after about six weeks, but only used when I knew they had just eaten and where, for some reason, I didn't want to comfort them using the breast - striding down the street to playgroup, driving down the M4....

I have found that both of my children (2.5 and six months) have, as they got older, developed self soothing skills. The younger one sucks her fingers (sadly not in the night, ggrrr), the older one her thumb. The younger one sometimes still has a dummy. Breastfeeding as comfort does not necessarily mean that it will be the only comfort. I think a portfolio approach works pretty well.

Hi Amy,

I agree with Secondtimelucky. Dummies are not a bad thing, but try and avoid in the first few weeks.

Personally I found the fact that my breast was a comforter was a hugely useful tool. DS is now nearly one and I have always fed on demand (I am far too lazy to try distraction or anything else when I can plonk my bum on the sofa and he can feed away!) It is true that that means he associates boob with comfort as well as food but I don't think that is a bad or limiting thing - after all I'm his mum, I'm around when he needs me! And if he is with DH he is comforted with a cuddle and a dummy.

Now at one year, DS has a bedtime feed and although I have always fed to sleep I have recently found he will pull off, gaze around, then fall asleep in my arms rather than at the breast. So, you don't have to encourage soothing by other means - it seems to just happen naturally over time.

Good luck with your new baby!