Little confused - breastfeeding

[TeacupTempest]

I have a 3 week old DD who is right at the lower end of 'normal' for weight and although has gained in the last week it was below what was expected.

I have been bf on demand and DD has been appearing to feed well. Cluster feeding in the evening. Lots of wet and dirty nappies. But still a tiny weight gain.

The HV yesterday told me that DD might be using me as a dummy and if she was not fully feeding to take her away from the breast for a couple of hours. But that doesn't really seem to be demand feeding anymore as she cries when taken away...

She also suggested that I should wake DD in the night so she doesn't go more than 3hours without a feed.

Any thoughts or advice? I would rather not have to top up with formula.

DH and I are not exactly giants so maybe DD is just a bit weeny?

Thanks Reality, that's what I thought and why I was confused. No she isn't losing weight, she is just a tiddler. Just hope I am doing right by her.

I agree total madness even using you as a dummy is helping stimulate your supply. Waking through the night I am a bit on the fence about how long does she sleep between feeds? I did occasionally wake ds2 when he went more than 4 hours during the night but he was slightly jaundiced which made him quite sleepy so I would wake to feed in the early weeks.

Are you and her father small/short?

It doesn't matter if she is small and stays small - it just means she is likely to be small as she gets older - as lots of us are! It only matters if she started at a bigger centile and is dropping down significantly.

So also going with sounds like madness, as long as they are feeding regularly, having lots of wet and dirty nappies and aren't loosing lots of weight I'd leave her be!

"Using you as a dummy" is probably more an indicator that she is coming from a standard position of bottlefeeding and comparing breastfeeding to that. Comfort feeding is normal and totally fine, it's beneficial to the baby and it stimulates your supply.

Waking after 3 hours tends to be if the baby is too sleepy to feed much - if she's alert and happy when she is awake, then this is probably unnecessary.

I would take this particular HV's advice with a pinch of salt - do you have any local breastfeeding groups you could go to? They are often good and very supportive and depending on the group, the people running it tend to be well informed.

Thank you everyone.

She has just spoken to DH on phone. Again advising waking for feeds but also expressing after each feed and then giving this by cup or bottle.

DH and I are not tall and quite slim build so...

Yes I am reluctant to take her off even if she is suckling for comfort as if that's the case then she clearly needs a bit of comforting!

DD did very long slow feeds with big breaks inbetween right from the start. She was average size and stayed average size so it never occured to me to do anything but leave her to it.

Expressing after every feed?! Why not just stick her back on the other breast if she wants more milk!

I really would ask at your local bfing group, they will be a lot better informed than your hv who doesn't seem to know what he's on about.

Let baby suckle any time she wants, it will stimulate milk supply, it's the best thing you can do to keep putting her to the breast. If she feeds then falls asleep for a while, offer the other breast when she wakes, if she's not interested then fair enough.

As you say, you and your dh are on the small side so she is probably just made that way

Re waking in the night, it's a tough one. If it were me I'd probably wake her if she had slept for more than 3-4 hrs at this age for no other reason than your hormones are at their peak for ensuring milk supply in the night so any feeds in the night will stimulate your supply even more.

You can get some great advice on here, from tiktok in particular.

As I say though the best thing to do is to speak to people in real life who are knowledgable (Breastfeeding group)

Thank you I will contact my local group ( still a bit housebound after tricky birth). She is not going longer than 4hours in the night and tbh rarly more than 3 which is why I felt so confused having to wake her on the odd occasion she slept longer than 3hours. We are cosleeping so she we can feed as and when she needs.

"Yes I am reluctant to take her off even if she is suckling for comfort as if that's the case then she clearly needs a bit of comforting!" I wish more parents and HCPs would understand this!! Lovely.

The idea of taking the breast away is totally counter-productive.

However, I wouldn't dismiss completely the idea of waking her to feed overnight. It really depends on how the weight gain is going. Being on the lower end of the spectrum is totally fine and not always tracking the centile is fine provided there's not a sustained drop through the centiles.

How long is she sleeping overnight for? At 3 weeks few babies sleep for more than 3 hours so there may well be a good opportunity here to a) get milk into her and b) encourage your milk supply to continue to develop well. There is a high level of the milk making hormone being produced overnight so it's really, really good to get in those feeds both for your supply and for getting lovely, rich milk into her.

I would certainly consider this before topping up with either EBM or F.

Just a checklist for you to look at to see if there are any points where she's asking but you might not spot it:

www.kellymom.com/bf/start/basics/hunger-cues.html

Sorry, Xpost there with Dalrymps and OP.

OK, I interpreted it as that she was regularly going longer than 3 hours overnight.

What do you feel about her. Do you feel she's awake enough, alert, looking as though she's getting enough to eat? Nappy output is a good indicator of course but looking at your baby does she look well? Are your nipples comfortable? Any pain?

She seems happy and healthy to me. More alert each day. Suckling often, especially into the evening. Filling many nappies! Sleeping and waking naturally. Perfect skin! A bit of wind every now and then but doesn't seem to be a problem.

I am not in pain (although I raised my arm in bed last night and it felt a bit like something in my breast snapped! Feels fine now). Not sore. No cracked nipples.

DH thinks maybe I could eat more, thinking perhaps the quality of my milk isn't up to scratch, but I am eating the same, perhaps a fraction more than when pregnant.

Need to stress this.. You don't need to eat more or drink more than usual. Your body will make the perfect milk for your baby and your diet won't affect this unless you ate literally starving and malnourished. So don't worry yourself about that

Well, actually, I rephrase that. You may feel hungrier than usual because Breastfeeding burns 500 calls a day so basically just eat to appetite. What I mean is, you don't need to eat loads and loads to make good quality milk, your body will do that regardless

Hi Teacup you've got some really useful thoughts on here and it sounds like you are a very instinctive and tuned in mother - well done!

You can reassure your DH that what you eat and drink has no effect on the 'quality' of your milk. As long as DD is feeding regularly (whether for comfort, nutrition or both) you'll produce the amount of milk she needs. Nature's a clever old thing and wants the species to continue so will produce enough milk for the baby at your detriment to the point of starvation.

Obviously it's a good idea to eat and drink enough that you feel well fed and hydrated - but that's for your benefit not the baby's.

Your milk will be wonderfully responsive to what she needs -more watery when it's hot, fattier at the end of the day when she wants to feed little and often, full of antibodies to whatever bugs you and she are exposed to - top quality no matter what you nourish yourself with!

I second going to a breastfeeding group - and maybe see if DH is welcome? This book is also ace www.thefoodoflove.org/

Thank you all for the advice and help. I am so glad I posted as I feel much reassured and more confident already.

Everyone is absolutely right about your diet not being a factor to consider, but it's lovely that your DH is trying to help. There feels like there's a logic to the suggestion, even though the science shows it's not the case, and therefore it was a good suggestion from him. Get him to keep them coming, be involved, understand what's going on as the more he thinks and suggests the more he'll learn and better be able to support you.

All sounds well but of course it is really important that you follow your own feelings as well as considering the suggestions that the HCPs who can see your baby give you rather than just relying on a talk board where we can't see your baby. It would undermine my confidence in a HCP who came up with what yours said, though, so maybe worth trying to see a different HV next time?

I definately feel that getting someone experienced in BFing support to see your baby just to ensure that they also feel all is well would be a good plan. Ideally a trained breastfeeding counsellor if possible. However, from what you've described I feel happy with things - but with the reservation that just in case there is an underlying reason why she's not gaining weight as fast as expected isn't just her normal, personal pattern (which it probably is) that you just watch carefully while continuing what you're doing.

Does that sound like a reasonable suggestion?

Absolutely, thank you organiccarrotcake.

I just have to comment on the bizarre advise to wait 2 hours between feeds to stop her using you as a dummy, but to then express and feed her with a cup instead - did the HV really listen to what was coming out of her mouth? What on earth could that be meant to achieve?

Your little one sounds like she feeds just like mine did (who's a 50th centile boy all the way) - totally normal.

Teacup - my DD is the same age as yours, and she's a proper chubber right now. The weight gain she's had isn't as much as the Bounty pack advice says, but the MW was very happy with her.

Seems your HV is being a bit paranoid - if she's gaining weight and not losing it, then I'm sure she's fine.
My DD also does the cluster-feed thing (3 hours straight ), and sleeps about 4 hours in the night afterwards (in with us), but then she feeds while she's in with us (it's quite easy to lie down with her sucking), so it seems like she's eating non-stop.
The worst thing you can do is express rather than feed her - it sounds completely barmy to me!! BFing is mor than just food, it's also comfort and being close to mummy, especially at this age.

I think you're doing really well, based on whaty you've said, and I wouldn't change it - feed "on cue", feed when she wants it, and yes, let her use you as a comforter ("using you as a dummy" is a total lie - a dummy is a fake nipple, not vice versa.).

One thing I've learned in the past couple of days, is that when DD pulls off, she's not necessarily finished - she just screams 10 minutes later! What i'm doing now is letting her stay in feeding position, then look for feeding cues again after a couple of minutes. Then I'm putting her on the other side and see if she latches again. If she's not interested, she either latches then pulls off again, or she keeps her mouth firmly closed. :)

She hasn't actually got back up to birth weight yet...does that change things?