How long do I 'have to' feed for?

[babybouncer]

DD is 1 wk old today, has lost nearly 10% of birthweight and has been weighed 3 times now by 3 different midwives who have all given different advice. Today's mw has really upset me by saying I'm not letting DD feed for long enough or from both sides at each feed. I'd assumed that because she was content to sleep and was feeding regularly (every 1-2 hrs during the day, 2-3 hrs during the night), I didn't have to force her to 'empty' both sides. DD is less than 7lbs, so I'd also thought she might have a tiny tummy and smaller more frequent feeds, but this mw insisted i get a 40 min feed in, rather than the 15 mins she currently has, so she can get the hind milk.

The thing is, my DS was a big baby who wanted to feed constantly, was always crying, didn't sleep and I never had much milk, didn't get engorgement, couldn't express anything - this time feels so different on every point, but I'm still being told I'm not doing it right.

And on top of everything else, MWs keep telling me to eat and drink lots and rest - but that's basically all I've been doing for a month now as I was on bedrest before the birth - and they don't seem to believe that I'm already doing that!

Sorry, that's turned into a little bit of a rant, but I just feel so told off!

I expect you're doing really well. It sounds as though you are feeding often enougbh. I think the first bit of a feed on one side is high in protein and at the end of the feed they get their pudding on that side as it were which is more carbs - it's incredible how the constituents change in breastfeeding so if you swap to the other breast too quickly they may miss the higher calories end of the feed. May be just increase the time a bit more. 15 mins doesn't sound too bad once a baby has the hang of it. It's only a week so just stick at it.

Hopefully someone qualified will be along to advise you in a bit but at that age, my DD was feeding for about 45mins on each side. After a couple of weeks, it was taking about 25 minutes and now at 14wks it's about 15 minutes per side. Every baby is different though.
My MW weighed DD on day 5 and then she was weighed again on day 10, when she'd all but regained what she'd lost (save half an ounce!). On which days have they weighed her? Has she started to regain any of her loss or is she weighing less each time she gets weighed? Also, are they all weighing her naked on digital scales? I'm not an expert, just another Mum but trying to think of all the things that could be. I think 10% loss is the max they can lose before they're flagged as a worry as such. I'm just wondering if she'd lost and then regained some back or is it less each time? If she's consistently losing weight then it does sound like she's not getting enough milk, it's all the same milk but as the feed goes on, the milk becomes fattier because the fat sticks to the duct walls and is released as the milk is letdown (or that's my understanding of it).
To a certain extent, I believe that a mother should follow her intuition. Is she coming off the boob herself or are you removing her? If she falls asleep whilst feeding, are you waking her up or just letting her sleep?
Sorry my post is all over the place, just typing as I'm thinking really.

I thought all babies loose weight initially, not an expert but try not to put pressure on yourself, I felt pressured into feeding dd1 and it was a nightmare, constantly being boob grabbed to "show me how to do it" and being told "its the most natural thing in the world", just take it at your own pace and she will let you know if anything is wrong, hope it goes well and congrats

You "have to" feed for as long as the baby wants - there's no magic time that gets you to the hindmilk. When she has finished on one side (come off or fallen asleep) swap to the other side. When she has finished on the other side swap back to the first side, and keep swapping back and forth until she doesn't want any more.

Oh you poor thing. That sounds so frustrating.

Are you sure she's lost nearly 10%? Meaning, was she weighed on the same or different scales? What's her nappy output like? How many poos and wees a day? Has she passed all her meconium?

It would be pretty tough to "force" her to feed for 40 minutes. There are no rules on "how long you must" feed for. But assuming that she's not starting to gain weight then she does need more milk. I think you are doing things right, you just maybe need to do a little more of what you're doing. Will she accept being offered longer feeds? Can you put her back to the breast after she comes off? Probably the first breast again if she's on for 15 minutes which isn't that long really.

Expressing is no indication of supply so if you do try to express now and it doesn't work, please don't think that you don't have enough milk. I think you're saying that you are getting engorgement now? Well that might be because she needs to take more milk from you so encouraging that would be a good thing.

It's a shame that this MW has upset you. Was it what she said or how she said it? I don't feel the "40 minute" rule is helpful but perhaps encouraging your bub to feed for longer would mean that you can start to get her gaining weight. That does just need keeping an eye on.

Thanks everyone. I think this MW upset me because I thought it was all going so well compared to last time, but I still ended up getting told off. (BTW DH, who is incredibly supportive and looking after us very well, has been unfairly told off by all the midwives for not doing enough!).

I've been expressing and trying to get DD to feed for longer all afternoon, and now feel thoroughly empty and drained in every sense. Selfishly, I was quite glad I wasn't having to feed the whole time...

Hi Op, congratulations!

I would echo what the others have said in the sense that you cannot force your baby to feed for 40 minutes and "drain" both breasts. A baby who does not want to feed, will not feed. Every baby has a different feeding pattern/time and it is not a great idea to clock watch.

Has your baby continued to lose weight this week? It would be helpful to get a better idea of what she has lost/gained etc.

Agree with Organic that, if your baby is not gaining weight you should encourage more milk intake by offering the breast more often. If your DD is falling asleep at the breast, you could wait a while then try and get her to latch on again.

The feeding pattern you describe does sound normal for a newborn - are your breasts/nipples feeling ok? Do you think that your positioning/latch are ok? So many questions sorry, but do you have a bf group locally that you could pop along to?

In your circumstances, you could ask for the same set of scales to be used for the next few weigh ins.

Your doing well, its hard in the early days :)

Hi I was told they are happy for BF babies to up to 15%.

My DD has only ever feed for 15mins total unless a mammoth growth spurt. I do have a fast letdown and a lot of milk

lagoonhaze I've never heard of 15% loss as being acceptable for any newborn baby. Who advised that this was normal?

i would just feed on one side until the baby would pop off herself then burp then offer the other side, if she didnt want it then i didnt force it and i fed on demand

Babybouncer, how are things?

Can you get a Breast Feeding Counsellor - La leche or NCT round?

they'll be able to go into detail and hopefully reassure you it's all within normal bounds - and 10% loss is within 'allowed' bounds.

Midwife. Said they wouldn't recommend
Formula unless 15% lost.

Oh cripes sweetheart, you are being put through the mill, aren't you? Its kind of funny because when I had DD, I was in hospital 6 nights afterwards. Around night 4 I started asking if she would be weighed before we left. I was told that they wouldn't weigh her because she was BF'd and all babies lose weight after birth.

They had weighed her at birth and advised me not to have her weighed until 2weeks after that. I was to check her nappies were wet and dirty, but other than that she would do what was best for her and I was to allow her to feed as she needed to. I think it took her three weeks in total to regain her birthweight, but no-one was concerned in the slightest (and she was a very small, but full-term baby, we had to use premmie clothes and nappies for the first six weeks). To me, the advice you are being given is outdated and unreliable. Try to get in touch with a local BF councelloor or LLL, and get some proper advice babe, they won't steer you wrong, I promise xxx

Sorry for two posts, but I thought it might be helpful for you to see some actual figures, I was assured that DDs weight pattern was entirely normal, in fact on Day 12 they have actually written 'no problems!

Birthday: 2110g
Day 5: 1940g
Day 12: 2015g
Day 21: 2480g

So she probably regained her BW at around Day 14-15. She also fed for a max of 15.ins, usually 10mins at a time. Please don't get worried about fore and hind milk, again these are outdated concepts, your milk is your milk, there is still some fat in the first bit and some water in the very last bit! Oh, and you can't 'runout' your boobs will provide!

My DD (now 6 months and nearly 18lbs!!) has never fed for more than 10 mins and usually only for 5-6. She also feeds quite regularly so to make sure she gets the hind milk I just put her back on the same side if she feeds again within 3 hours. The only time she has ever wanted both sides was when she had her 4month growth spurt. Sorry you are not being told this by your midwives but it sounds like you are doing a great job - if its working for you and your baby seems content then keep it up!

Sorry, I have no advice but a little anecdote (might make you feel better? Will certainly out me but I'm hardly discrete with my own info)...

DTD1 was stillborn. DTD2 was prem and in NICU. One neonatal nurse in particular was very rude blunt. The first time she offended me, the first time I was alone holding DTD2, she asked me "do you have any more children?" I cried, she looked embarrassed and dug her hole further with "oh, I don't mean that one, do you have any other live children?"

Anyhow, a day or two later she said to DH and I "Just to let you know that DD has lost some weight, but we don't panic unless its over 10% of their body weight" Me: "what percentage has she lost?" Nurse: "11%" and walked out of the room. We weren't sure whether to panic or not! She didn't seem to be!

So anyhow, 10% was apparently the magic figure then, but even though she ended up losing 13%, we were never advised let alone coerced into feeding formula, and that was with a baby that was 32 weeks prem and under 4lb.

Just carry on feeding as much as she will take. It will all be fine and you'll forget these worries in a week or two. Take care. :)

Thank you everyone. I've been expressing and trying to wake Dd more to feed for a little longer (still only around 15-20 min on one side, but now she'll usually take another 5-10 mins on the other) and the good news is she's gained weight at last.

She was 2985g born, dropped to 2700g for three consecutive weigh-ins, but since the midwife upset me and I've been trying to up her feeds she's up to 2875g in 4 days! Midwife is very happy and suggested I drop the expressing.

I think I was being mega oversensitive and terrified that the despite all my best efforts the same thing that happened with DS would happen again. Have now see the same midwife (and scales!) 3 times and she is actually very positive and supportive.

Incidently - if you had IV fluids during labour, your DD was probably "over hydrated" at birth, so would have weighed more than she "should" have. There is research about this and a lot of places are now only using a 24hrs after birth weight to gauge weight loss..

Brilliant, well done, you must be feeling relieved. Far better to be seeing the same midwife with the same scales too.