weight - again, am I just destined to failure at bf

[Anaiasmum]

apologies for the typos, I'm one handed typing whilst attempting to feed.
DD2 is now nearly 12wks and I've been watching/reading the other weight posts so know I'm not alone and wondering if someone can help.

DD2 was born at 41+5 by elective cs, i was told induction would fail and as DD1 was breech and also elective cs at 38wks cs was the only remaining option suitable for me.

DD2's birthweight was 3.72kg which fell over the following 9 days to 3.29kg triggering phone referral to paeds and a saga of topping up with ebm (for 6 days) and formula (2/3oz in 3 days) and domperidone for the following 10 days. (inc 48hrly weight checks. From about 2wks DD2 continued to follow the 25th centile. However at wk 6 DD2's weight gain began to fall and has culminated today in being told I need to see GP (she now weighs 4.3kg and is on the 9th centile).

I was at the bf support grp this pm which is where she was weighed after voluntarily contacting them as I had started to become concerned at her lack of weight gain, though all other signs are that she is a healthy baby. (urine and poo output are fine imho). All those that see her (inc the feeding co-ordinator who has dished out this advice today) comment on how long she is, but also how alert etc. (I took her to see my colleagues yest (all nurses with DCs) and they also agreed that she was healthy.

I don't know what I'm asking really. I'm falling apart at the seams. We got to this point (only sooner) with DD1 and she eventually was referred to paeds and we were admitted until her weight was back on track (i.e. formula fed) from 12 wks.

I don't know whether to bother fighting my corner with bf. I know I'll really struggle to express and top up (I'm rubbish at expressing) and I have DD1 to consider. I'm already a wreck after this meeting this pm. I expressed some milk a couple of weeks ago as we've a family wedding tomorrow and I didn't want to be feeding during ceremony. (3oz in total after feeds - took me 3 days, as I couldn't do it after each feed!) I don't think supply is a problem, I'm not a leaker (xcpt sometimes from one side at night) but DD2 does seem to feed well, we get sickly burps, I can hear swallowing, so I know the milk is going in.

DH has said he'll take time off work but thinks she needs to be topped up if that's what "they" all say. I fell out with DM who, at 3wks, insisted that my baby was "starving" so I don't have any family support locally who coul take DD1 off my hands.

Sorry for the length, any thoughts?
TIA

Just seen that you've had the tt snipped. That's great news anaias.

You may notice an immediate improvement or it may take some time for DD to relearn how to breastfeed properly.

Thanks. I've called the nct.

Nice but dim hv has weighed dd today and her weight is as it was last week. Much arm waving and panic. No apology just an 'oh I was going to check for that today'. (TT)

I've now been passed back to the infant feeding co-ordinator for support!! (Shame I didn't get it from that very person when I asked weeks ago).

dd's latch does seem to have improved but I still need to top her up until my supply improves and I'm struggling with that - she's no sucking reflex yet. Any tips?

Not sure at this late stage whether I'll catch up with her need. The LC told me that she'll b able to maintain a supply but not increase it til her tongue strengthens and that could b some time. At the mo I'm not sure when to stop bf and give formula to make way for pumping to increase supply. Feel like I'm running out of hands (and hours). Naps are all v short.

I had exactly the same problem except for one important point. My dh has been nothing but encouraging and you need to set yours the task of finding out about breastfeeding (not making appropriate milk for your own baby, it's a oxymoron!)
As long as your baby is otherwise healthy, alert, good colour etc they only need to be gaining 2 oz a week to be within the world health org version of "normal"
She only has a little belly, don't be bullied into bullying her into eating more than she wants. (one hv said i should ram her full!)

After 3 months of constant worry and self-recrimination, convincing my self i didn't make enough milk after seeking much advice and support...
... I stopped letting them weigh her!

she is clearly thriving, I trust her to tell me if she is hungry and i will feed her.
If she is hungry, you WILL know about it she will see to that.

Trust yourself and your instincts, you are doing a great job .

Take your partner to your breastfeeding support group ( afreind of mine did this for the opposite problem "your making her fat")
he is your most valuable support, his attitude can make or break the whole shebang, he sounds very uninformed and urgently in need of breastfeeding support.

Do what feels right to you and it will be.

Don't forget there are helplines that will give you on the spot support and reassurance that yuor doing great so just get on with it!!!!!

National Breastfeeding Helpline
0300 100 0212

I just hope the paeds feel the same pignut. I've to see them tomorrow to 'check there's nothing else wrong'. Horse and bolted spring to mind. :(

If my experiences with dd1 are anything to go by I'll be told 'you've done your best, she's had all the benefits she's going to get, time to give up now, here's a bottle' :(

Feeding co-ord came round this am and is swiftly trying to cover backs. Her response was to provide me with an array of teats so I can 'get extra calories in'.

Think it's too late for us now sadly. :(

Anaiasmum sorry to hear you're still having a difficult time. Is there anyone knowledgeable who you trust, who you could go back to for more support? Could you speak to the LC again on the phone?

Anais hope her latch can improve quickly. Try some different positions?

Don't have time to write much now but try not to worry too much about it all.

The most important thing is to nourish your baby, and if that means ebm or formula top ups so be it. You may well achieve full BF again.

And you have done your best BTW.

Can you pump one side while feeding from the other?

Thanks everyone and I'm sorry that this post is so negative. I'm v low today and feeling unable to cope. Prob is think I'm heading for pnd which doesn't help.

Paed gave me 3 options
Formula
fortifying ebm top ups
Baby rice dd is 13wks.

I've just about had enough now. I was told the tt probably didn't impact on feeding and as per my post header I would have failed anyway.

Top ups are hell. dd is an ardent bottle refuser and so are either painstakingly given by syringe and/or accompanied by screaming. Ebm quantities are drips (literally) so fortifying, whilst the preferred option, is impractical as sachets require 50ml, then we still have the problem of getting the stuff in.

Got until monday. :(

Hang in there - you are doing a fantastic job, following up every possibility and working so hard to be an advocate for yourself and your DD.
Whatever the outcome over the next few days, be very proud of yourself for all your hard work. Nobody could do more than you have to crack the problems you've been dealing with.

Anais if possible can you leave the room or even the house and take a walk and let your DH try with the bottle? If she would take one good bottle feed I think you could still persevere?

I would not be offering baby rice but this is only my opinion.

Oh people thank you for your support.

I've tried again for 20mins with bottle this morning, we succeeded in feeding ml. :( dh is trying too but no joy so we're resorting to the syringe again. One feed has now taken hour and a half!

I really don't care now what dd has, (bm or formula) I just need her to put on weight. On the bf front she seems to be sucking better but I think her latch is still poor. Not sure we'll have done enough by monday.

Have you tried a different bottle/teat to see it that might improve matters? Another option is to feed as just waking up before they have twigged that it is bottle rather than boob.

I think you are right to focus now on nourishment rather than is it BF or formula.

When I got to this stage I continued pumping as well to supplement the formula with the last of the dwindling BM. Made me feel a bit better about the transition which was not my preference but a necessity in the end.

On a practical note how many mls did you manage to syringe in? Are you feeding her frequently eg every three to four hours or earlier if she is hungry? It might be a case of little and often to begin with.

Another thing I tried was to offer a dummy while in her most relaxed position which was along my arm, (monkey in a tree) while patting bottom. Dummy was pretty much wedged in as my arm was against her mouth. She was happy like this, then I quickly removed dummy and popped bottle in. Sounds brutal but honestly it was OK.

anaiasmum, I'm a complete novice myself, but I was just reminded by a friend about another feeding method: have you heard of a "lactation aid" or "supplementary nursing system"? You put a little tube from a bottle on the breast and the baby sucks up supplement on the breast. If she sucks at the breast, this might be something to try, and maybe it would get her more practise there. Hopefully someone with experience will come by and comment on whether this is a good idea or not!

I read about it in Jack Newman's book, and here is a link a quick search just found: www.breastfeedinginc.ca/content.php?pagename=doc-LA

I'm thinking I may want to try this if we end up having to supplement...

So, a little update.
Dd had tt snip on 7may and bf seemed to improve slowly.
we were giving Top ups of anything from 1/2 to 3oz day until tue this week and her weight increased by 8oz in 2wks til mon.
This wk as I mentioned I cut out the top up as bf seemed to be going well, and on wed and thurs we seemed to have a bit of an over supply-lots of fussing at let down, spitting up and I was quite engorged a cpl times. (I've done no pumping since last week so had to assume that dd has done that herself)
So, fast forward to today and dd has put on 5g since mon! So unhappy.

We've started the top ups again and we're seeing a doc at hosp nxt wk but I don't understand what's happening. Have I just been over confident? (And in need of keeping my sanity-screaming top ups were horrible even though I just kept tellingmyself we were doing her good).

We're seeing an osteopath and she suggested that it could be a gluten intolerance. My dad is coeliac so it's possible. (I cut down on gluten last wk but not this wk). or is it a fore milk hind milk thing? Dd's poo is usually darker yellow/brown though we did have brown/ greeny this am but I wouldn't have said frothy, more slimey (she does have cold).

I got feeding co-ord (who weighed her) to check latch today and she deemed it fine.

Dummy's and bottles are all steadfastly refused so top ups will continue to be syringed, not sure how we deal with it long term.

Maybe I'm clutching at straws but I really don't know what to do. Are top ups going to be long term? Think we'll be encouraged to wean early.

If you start topping up again, your supply will diminish. Much feeding is in order, try skin-to-skin, in bath, in a sling, co-sleeping at night etc to encourage her to feed more often.

If supply is an issue, even if you don't get much milk by pumping (what you do get can be topped up with instead of formula, and you could ask another mother for some donated milk for the rest), pump during and after a feed, and the stimulation will help. You could try a softer insert in the breast shield, to massage the areola to attempt to be more like their tongue action. You could also try fennel or fenugreek.

Is it possible the tongue tie wasn't fully snipped? Sometimes there is a thicker posterior tie behind the anterior one, which gets missed. They aren't always visible, some can only be palpated.

Also, some weeks weight gain will be very low, it's better to weigh them once a month after the first few weeks, as it averages out.

:( :(

Can you see and speak to someone who has a good, clinical understanding of breastfeeding, anaismum? I'd rule out the osteopath on that score, and the HV who from previous posts is not well-informed. What's the feeding co-ord like? They vary, too.

This is beyond a breastfeeding counsellor's knowledge and boundaries, so while a call to a helpline will give you support, they will not be able to unravel the mystery.

Weighing a 15 week old baby on a Monday and then again on a Friday is questionable, IMO. I don't know what conclusion anyone can draw from the reading.

Meantime, back to basics of feeding as often as you can on both sides, and expressing if you can, is the main way of increasing milk supply and intake.

This is probably going to get me flamed but I had so many problems with breastfeeding that I expressed for 13 long weeks and topped up with formula. After crying over the expressing machine, I hated it so much. I decided for my own sanity to formula feed. Once I got over the guilt and sadness I actually felt relieved. He's gaining weight, my DH can feed him too and I've got my life back. The only downside is the cost.

Do what you feel is best, and don't feel like a failure if you can't make enough milk. IT'S NOT YOUR FAULT!

sc I am bothered that supply will b affected and it's the constant argument I have with dh. I've been hand expressing the past cpl am's when I've woken up 'bursting' and dh has added the fortifier before giving it by syringe. I actually am wondering if the couple of days to wed last wk were supply building days (hence the apparent over supply)

we already co sleep, I carry dd in a wrap (much to my mum's disgust) though I've never mastered feeding in it. We feed 2-3hrly.

I'm fairly sure her tt was properly snipped, it was done by an lc.

tiktok, I've struggled for any support here. The lc I used is based 3hrs away, I txt her yesterday and fessed up to my misdemeanor :). the feeding co-ordinator is being 'supportive' but her suggestion was to leave dd with dh or mum til she got so hungry she took a bottle (I'd be breaking my heart as would dd I expect.) She didn't notice tongue tie even though she observed a feed, and this week she virtually washed her hands because I think we've reached the end of her knowledge.

I'm not sure what the doc s are like /how knowledgeable they really are or how willing they'd be to consider anything other than more top ups.

elkie, I'm not going to flame you, crikey I don't think I could have kept my sanity if I'd expressed for 13wks! I came to the conclusion a few weeks ago that to protect my sanity I'd give up and give formula because the stress of those scales is like going to an exam unprepared every few days but dd seems to have other ideas and will not take a bottle and believe me I've tried (as have the 'professionals) who also couldn't manage!

Will just have to hope that some concrete help is provided at the hosp!

:( :( really feel for you, OP :(

2-3 hrly is not enough feeding, sorry.....it's not frequent enough to really address the possible supply/intake issues. Would your dd take more if it was offered more?

tiktok, I've offered her the breast every time she has so much has put fingers near her mouth today and, a couple of times, she's simply got cross. As soon as the milk lets down, she pulls away and we've ended up in a vicious circle. TBH she's got her fingers in or near her mouth most of the time, so I'm stuck as to whether it's feeding cues or just development.

Yesterday DH gave her some ebm which we'd 'fortified' in the morning before he went to work, after the school run and another feed I pumped for a little while but got next to nothing - and the rest of the day I just fed fed fed, particularly in the afternoon/evening when she seemed to cluster feed from about 4pm - 8pm. DH and I rowed over whether to give her formula but as soon as he took her away from me she fell asleep for an hour or so. This am I was leaking milk all over everywhere and we had a frothy poo which I took to be the result of a lot of foremilk from one side this morning. Her nappies are wet wet wet.

I tried her with a sippy cup this morning and she has accepted it in her mouth, which is progress, though she doesn't take a lot. It's a real drip feed. I'm starting to wonder if I'm topping up or replacing though!

She's such a happy little thing, (when I'm not trying to force feed her), is incredibly long, won't be away from me for long and doesn't sleep much but I can cope with that, I just wonder if she's burning all her calories!

I'm still waiting to hear from the hosp for our appointment with the doc, I called to chase it this morning on the instructions of the feeding co-ordinator but by all accounts it will not be until later in the week.

I'm trying to keep from going insane but I'm so sick of this dominating life completely. I was crying over my breakfast this morning. DD is 16 wks old today and in all that time there aren't many days when this hasn't been at the top of my mind. Life's just too short, but drip feeding from a sippy cup isn't going to sort it either. I'm stuck.

:(

Again, real life help is what you need, but I hear you....it's not easy to get.

Fingers near mouth are not a feeding cue, really, not in a 16 week old. As you say, this could be development.

It's best not to force feed -just to offer and if it is not accepted, don't fight it, 'cos fighting doesn't help.

Poo is not significant.

Horrible that this is dominating and upsetting you and leading to rows....at least you can look forward to having the chance to discuss all options later this week. Can your dh agree to back off until then? Clearly your dd is healthy and so there's no emergency here.

Ok, so I've decided just now in a mad moment that I'll probably regret to give up bf, there's too much stress and dd's weight gain is dominating life.

So whilst I'll miss the convenience, perhaps I'll carry on overnight (I'm too lazy for night time bottles), I won't miss the stress.

The infant feeding co-ordinator is coming in the morning to weigh again and I'm going to speak to her about it. I don't know how I'm going to get a bottle into her though as she still steadfastly refuses.

Our paed appt is next wed and I've been told she'll tell m to wean early. There's a history of coeliac disease, asthma, eczema, and type 2 diabetes in mine and dh family so I'm hoping that perhaps a high calorie formula might be the way out of this mess for us. I actually don't believe that weaning will help, dd still has tongue thrust and I can't see how filing her tummy on carrot will increase her weight! Baby rice is just not an option for the above reasons.

I'm really sad and will try and put on a brave face but I can't handle this any more.

anaia I would totally get why you've decided to give up if you knew she was going to drink more of you formula fed but if she refuses the bottle then how is it going to help?
I hope things get better for you whatever you decide

I don't know olimpia but I can't carry on as I can. I told dh my decision when he came home just now and he said it doesn't have to be all or nothing but I just feel like I'm on trial every time the scales come out. I gave up top ups because of the trauma of syringe feeding but she clearly needs that milk aNd I feel really crap now.

I feel really trapped tbh. Perhaps if she has no choice she'll take it?