dehydration + tongue tie + excl expressing = heartbroken mother

[erikab922]

DD born 19 April, natural childbirth, we had skin to skin for quite a while but she couldn't/wouldn't latch so I had to manually express colostrum for her. Over the next 24hrs she seemed to BF fine and we were discharged. 4 days later she was weighed and had lost 13% body weight and we were sent back to the hospital - they took blood and measured salt levels, etc and found her to be very dehydrated.

We spent a terrible 48hrs in hospital (well, good for baby, terrible for mommy). I was hooked up to a pump and asked to pump every two hours and then cup feed it to DD. She would not feed via the cup for love nor money. This is my first child and I was so disappointed in myself for not being able to provide for her, and when she wouldn't feed from either my breast or the cup I broke down and sobbed until one of the midwives finally said to me, this child has to eat - I wasn't making enough food so we had to do what I dreaded and give her formula from a bottle. I've never seen a little thing drink so much so quickly, I was simultaneously ecstatic and heartbroken. She would only feed from a bottle and I saw this as a slippery slope to nipple confusion and non-stop pumping to provide breastmilk for her. That's exactly what's happened and now I'm not sure what to do.

I am pumping between 8-10 times a day and am just keeping up with her demands, just when I thought I'd gotten maybe one feed ahead of her, she hit a growth spurt and I had to top-up with formula. Again this sends me into sobbing hysterics. I continue to try to latch her and have had numerous breastfeeding midwives/consultants watch and they've all said that my technique is spot-on and DD sometimes latches for maybe 5 minutes but then won't have it. (she was diagnosed with tongue tie at 9 days old and we had that snipped). There's one local midwife who's a bit of a BFing legend and she even conceded that we may wind up with mixed feeding. God I just want to breastfeed!!

She said DD should be having 90-120ml (3-4oz) at each feed assuming 8 feeds a day (she's 12 days old) but when I look at the milk calculators where you put in the baby's weight (currently 3155g) it comes out as more like 70ml per feed. I can keep up with her demands at 70ml per feed but to get 90-120ml I'd have to top of with formula for sure. I'm totally confused about which number I should be using.

I'm only off of work for 7 weeks (5 weeks left) and I feel like a sword is hanging above my head, I'm not sure I can keep up expressing every two-ish hours when I go back to work (I work from home so can technically do it but will have zero brain power). So every day the pressure is greater and greater to get LO to latch and feed properly and every time we fail I feel like I don't even deserve to have this gorgeous, funny baby because I can't feed her. Because I am either pumping, sleeping or cleaning/sterilising I get to spend next to no time with her, my husband gets more contact with her than I do, and I am insanely sad/jealous. I just need to get this out there and ask what a fellow MNer would do.

Thanks SO much for listening.

But you ARE feeding her! She's drinking your milk mostly and not formula. You sound like an amazing mum to me and please stop being so harsh on yourself.
Have you tried biological nurturing yet? Can you stop pumping for a day and get DH or someone else to do all the cleaning sterilising etc and just spend the day in bed with DD cuddlling and feeding?

Sounds like you've had an incredibly hard time of things erika. You sound so down.

So it's only been three days since the tt snip?

Have you tried putting her back on the breast since then?

erika - you are doing an amazing job in exceptionally difficult circumstances.

80-120mls per feed sounds huge for a 12 day old! At 10 days their tummies are around 60-80ml (ping pong ball sized) so I can't see how she could doubled her stomach size in 2 days. DD3 had to have bottles at 6m & 9m due to me being in hospital and she had 90-120mls per feed (but more normally 90mls). Also 8 feeds a day seems on the low side tbh - have you not been advised to feed to her hunger cues and let her control how much milk she wants?

In case you haven't been told you don't have to sterilise the pump each time you use it - you can wash out the breast shields with hot soapy water or put the breast shields in a ziplock type plastic bag in the fridge between uses - then you only have to sterilise once a day.

Have you got a double electric breast pump and a hands free pumping kit/top/altered bra? That would mean you could have baby on your lap or even held between your breasts while you pumped so you get to snuggle with baby too.

If she is latching for 5 mins that's really great -there is no set time for a 'good feed' - some babies are done in 5 mins and some want to spend an hour bfing, neither is wrong or right, it's what makes your baby (and you) happy that counts.

Is she actively suckling and swallowing milk while she is latched or is she 'hanging out' with your nipple in her mouth? While she is still happy to be latched, can you keep it up with lots of skin to skin? If she is 'hanging out' have the MW talked about breast compressions with you - they are a way of helping baby get more milk by a kind of hand expressing while they are bfing - or using a Supplemental Nursing System (SNS) which is a tube that delivers extra milk to a baby while they bf (the tube is taped to the nipple).

Videos of breast compressions during bfing and bfing while using an SNS here as well as lots of other useful bfing videos.

Hope that's of some help.

'I've never seen a little thing drink so much so quickly'

That is exactly how I felt with my DS - after 24 hours he was floppy, dehydrated and passing urates in his nappy, so we were advised he needed to eat right away as, just like you, I didn't have enough milk. He recovered so rapidly, it was incredible.

You've done amazingly well expressing so much, we never managed to do as much as you have and my DS was on formula with breastmilk top-ups from day 2 of his life. However, I am still glad we managed that much because even a tiny bit of breastmilk has got loads of immune goodness in it and YOU are providing that for your baby - it will be doing her good.

Please don't beat yourself up over this; there is so much more to being a mum than being able to breastfeed. You should be proud of what you've managed so far but you still need to look after yourself too.

Un-mumsnetty hugs

Ahh Erika, you have all my sympathy - I went through similar although not as bad with my DS and it was absolutely awful, I remember literally feeling my heart break.

We expressed for a week and used formula when I hadn't expressed quite enough.

They're not always recommended, but have you tried to latch your DD using a nipple shield - that's what worked for us in the end. You do have to be careful as they can reduce your supply (I carried on with some expressing at the same time), but I used nipple shields for 3 weeks, and then once DS was bigger with a wider gape etc around 5 weeks, we weaned him off them, and we're now bfding as planned.

You've done a great job so far, and you've given such a tiny baby such a lot of your antibodies etc. that she's still had the best start - well done as lots of people don't even make it this far.

This is why the breast is best campaign can be so damaging to those mothers who struggle. It is also so important not to see formula as a bad thing. Okay, it is not breastmilk, but it is a nutritious, safe alternative.

The difficulties you are experiencing to breast-feed are nobodies fault and, as you say, pumping and sterilising is dominating the precious time you could be having with your DD. Coupled with the shock of having a newborn and the recovery of pregnancy and labour, your hormones are dominating your desire to breastfeed. But you have been a wonderful mother to have got this far. I failed miserably with my first two children and the guilt was enormous. But making the decision to stop was brilliant - I started to enjoy my babies and enjoy being a mummy.

Be kind on yourself - motherhood is full of decisions and deciding to stop breasfeeding is one of the hardest. I look back at that time and wish I hadn't beaten myself up so much and made the decision sooner.

For what it is worth, DC3 had a TT. He wasn't very keen on feeding after. You read that it made instant changes - for us, it took 4 or 5 days for him to start increasing his feeding time. So if you decide to keep BF'ing, then give her some time to let the tongue heal.

Send DH to do some washing of bottles and sit on the sofa and let your newborn nuzzle into your neck and fall asleep...those memories are more powerful for me then my abilty to breastfeed. These days are very precious.

Big hugs

Gosh, you are doing amazingly well! An odd top up with formula when required is really not a problem. You are doing your absolute best under very difficult circumstances. I think you are doing an awesome job!
My DD had a night of formula when I was hospitalised due to blood loss from retained placenta. They would not allow her to stay with me on the gynae ward. I was devastated at the time, but she needed to be fed!
Afterwards she was topped up with formula a few times as my supply was awful. I justified it as preferable to her crying with hunger. Now the problem is resolved but I have no regrets at all.

I feel for you so much. Please give yourself a break.

Thank you all so much for your kind and reassuring words - I'm not a crier but I just look at my little one and the waterworks begin!

I am using a double electric pump and am awaiting a hands-free bra which should arrive soon. I've been keeping a log of every feed since we've been home from the hospital - just taking yesterday as an example, she fed 11 times and we did all of them as cue feedings, LO is the best judge of when she wants to eat IMO.

Some feeds are big and some are small - I just work myself into such a tizzy because when we were in hospital they were like 'she must have 55l at every feeding' so I was in a race with myself with pump that amount before the next interval was up.

I will admit to being very confused about when and how often to pump in order to increase/maintain supply, and I'm usually a pretty smart lady. I read and read and none of it is sinking in. LO latches and feeds for a few minutes one probably 1 in every 20 attempts, and the other 19 end in me dissolving into a heap. I don't let her get too hungry before I try because that won't work, I wait until she's just starting to stir before trying to put her on the breast. It doesn't take long before she gets herself worked up by not being able to latch.

The woman who snipped her TT suggested nipple shields for a short time and I will give them another try tomorrow but I spend so much time trying to get them to stay in place that I get myself frustrated.

I haven't tried the whole staying in bed with LO for a day, I'd never heard of biological nuturing before but it sounds wonderful. Very silly question - how long do you do it for, and how long can I realistically let LO go without the bottle if she still refuses to latch?

erika, I'll not add to the very good info you have had here - it is early days and you are picking up the pieces and there is no reason I can see why things shouldn't resolve the way you want them to :)

I'd just point out that

• midwifery care for you was poor, to end up with a dehydrated baby on day 5.....you were probably told everything looked fine, but no one was spotting that milk transfer was not happening
• nipple confusion is over-stated - your baby isn't confused, she's just 'voting' for the productive bottle and teat. Continued opportunities to latch on to a breast that's producing milk let her know milk is available from you, too
• the amounts suggested for your baby at 12 days old are massive - perhaps you can check this in case someone's maths is wrong

Your question about 'how long to let her go without a bottle?' - check with midwife, but if your baby is getting upset, then she needs to be fed. Don't 'fight' her to latch her on - she needs to associate the breast with lovey, snuggly cuddles, and not struggles :)

You can hold her skin to skin when giving the bottle and you can do biological nursing any time and all the time :)

oh bless you, you are me entirely. The same thing as you, ds is 3 months and I am pumping his feeds and suplementing with formula. we had to be hospitalised as he was dehydrated at a few days old, low salts spr levels, jaundice. He had to go under the lights and top ups which caused nipple confusion. i desperately want him to feed off me and i am at women that i see bf with ease. i feel that why does it not happen to me. i still try and put him onto my breast but we are too far gne now, and i find myself pumping 3 months later

tiktok whats biological nursing? can ds do it at 3 months?

i know that the consensus on here tends to be negative surrounding formula, but its a perfectly fine altrenative. yes the baby needs to be fed and if formula is needed than so be it. that is what i am telling myself at the moment.

erika you are doing a brilliant job, just enjoy your baby and if you are not able to bf its not the end of the world. i know its easy said and done, but i am telling myself this at the moment too

piglet, you can do BN at any age :)

It;s just a nice way of holding the baby whatever the feeding style.

www.biologicalnurturing.com

thanks tiktok

I am in exactly the same boat as you, except I have admitted defeat for one feed a day, where I give formula to give myself a break from the 'dairy farm'.

Ds is 1 day older and had TT snip yesterday.

I have a single pump on loan from the hosp and have been managing, sort of, but I just had a terrible stomach bug and I am worrying that my supply has reduced, though the worry might be doing that! He just puts my nipple in his mouth but does nothing with it, he bats away the nipple shields but guzzles the expressed milk from the bottle. I feel like I've already lost the fight.

I had to have a CS instead of the lentil-weaving birth I had planned, so my failure at BFing just compounds the feeling that I'm not a good mother because he and I can't do something that should come naturally.

I desperately want to crack it, so I'll be reading replies with interest. Its nearly time for his formula, which means its nearly time for me to sit on the bed and bawl my eyes out.

I was in exactly the same boat as you with my DS. Tongue-tie, admitted back into hospital as he wouldn't feed. We managed a combo of expressing, formula and bf until he was 5 months. It was a slog and eventually he preferred the bottle and the milk dried up but I comforted myself that he got the benefit of 5 months of my milk in some form or other. Towards the end he wouldn't have a boob and I just expressed, popped it in a bottle - topped up with ff and gave it to him! In hindsight the times he was up for a bit of bf I should have been more confident to take away the ff and perservere but it's difficult as you always feel inadequate and guilty about 'not feeding them enough'.

I too used nipple shields to get him to latch (post tongue tie snip) and think they made loads of difference. I recommend the medela shields in small - you may need to order online. Good luck - it's hard but just say to yourself "one more day". You will get through this, It's just a small part of being a mother and when you look back you'll think 'why did I beat myself up so much?!':)