Failing at breast-feeding - is there a way back?

[Coops79]

My LO is 8 days old. I was determined that he would be EBF for at least the first 4 months. After 4 days of BFing, he was still not latching properly and tended to scream at my breasts rather than sucking on them. My milk did not appear to have come in. The midwives referred him back to hospital as he had lost almost 13% of his birth weight. Because of this I was advised to feed him on a 3 hourly schedule with a mix of whatever I could express, topped up with formula. I feel desperately guilty for having got to a point where I had no choice but to give him formula and I wish more than anything that I could take it back.

However, we are where we are. I am still on this schedule but start every feed with an attempt at BFing. This is followed by mostly expressed BM and finally a little formula to make up the required amounts. I really want to get BFing going but the problems I am having are as follows:

LO is hugely reluctant to latch on. He will scream blue murder when placed near my breast but will occasionally latch and take 3 or 4 good sucks. He will then either pull away and scream, raising his head as far from my breast as possible or he will stop sucking and go to sleep with his mouth puckered over my nipple. Incidentally, he drinks my EBM quite happily so I don't think it's that. He has just had a very small tongue tie snipped which doesn't appear to have made much difference.

I am expressing as much as possible while we're trying to get BFing going but I am concerned that this will affect my supply when he comes to my breast, creating a vicious circle.

I am now terrified of underfeeding my LO. If I start EBFing successfully, how can I know how much is going in?

Finally, and I guess really the thing that is causing me most anxiety: have I damaged my child by allowing him formula, particularly at such a young age? Would it matter if I failed to breast feed but was able to express enough to feed him in a bottle?

Apologies for such a long post; I am broken-hearted and any reassurance would be gratefully received.

Hi, not much help really but did not want you to be unanswered.

I am sorry you are having a hard time. Have you asked gp or hv for more help? Or your local nct? I think they offer breast feeding help.

As long as you keep expressing then baby is still ebf isn't he? Just getting it from different means.
Maybe ask gp to check tongue tie.

Someone else with far more experience and knowledge will be along soon to help.

Firstly congrats on your DS

Secondly, you need to find some RL support as I'm concerned at the "3 hour" routine that has been advised. Have they said feed 'every 3 hours' or feed 'on demand but no less than every 3 hours'?

It would be advisable to feed him on demand (I hate the phrase, prefer 'on cue') watch his cues for feeding and off a boob. If this is every 30 min, then so be it. These early days they can feed every 3 hours or every hour- each baby is different.

Look for signs of hunger: My dd would move her mouth sideways if I stroked her cheek. She'd also do something funny with her hand too, like twist it. So I fed at those cues - normally before she cried for milk.

It is hard to check if your latch and positioning is right just from a post so I urge you to find a bf cafe in your are and speak to a bf counsellor or facilitator.

Others will be along with more advice I'm sure (tiktok and truthsweet are fab).

I know you are worried about formula but you need to think that it is helping him weight gain; for now, it is a temporary fix and with some real life support and sheer determination you will breastfeed exclusively.

www.kellymom.com has lots of info on bf'ing.

And the la leche league are a good source of help too.

Keep smiling, it will get better

Thank you Kahlua. Sadly he's no longer exclusively BF as I have had to top up expressed milk with formula in order to get his weight back up. He's had his tongue-tie snipped which doesn't seem to have made much difference but then it was only done today so perhaps there will be more impact later on.

I have had about 10 different midwives advising, supporting, watching and helping with BFing. A few have managed to get him to latch but none has found a way to get him to feed in a meaningful way. :(

I really appreciate you responding and being supportive. Thank you.

The other thing coops is that if he's had his tongue tie done today he will be 're learning' to latch. Keep persevering with latching him on. Think that his mouth need to cover all of your nipple/areola and his face needs to be comfortable (imagine trying to swallow with your chin on your chest- it hard, so his chin needs to be up at an angle)

Get yourself off to bed with him, both strip off with a light sheet over you and lots of skin to skin so he's near your boobs. He'll sleep and wake with you nearby and smell your milk.

GodisaDJ - thank you. I think the 3hr thing is mainly just as long as we are getting his weight back up. I should be able to feed on demand once he's back where he should be. The difficulty is, I can see when he is hungry; he's not subtle at all! It's just that he gets himself really worked up and angry when I try to get him onto my breast. I've tried putting him on at various different points (when he's hungry, when he's been fed already, halfway through a bottle feed).

I will have a look at the links you suggested - thanks so much for your suggestions and support.

Right stop all the negative talk about guilt and failing. If it helps think of the formula as medicine to get you through a difficult time. Yes its not as good as breastmilk but it feeds babies who aren`t being breastfed. The bm he is having helps counter-act some of the risks associated with ff anyway.

Yes some women do just feed expressed bm, called exclusive pumping. It is hard work though.

We can't say for sure what is happening over the internet. But newborns usually need feeding more often than 3 hours so he may just be very hungry and getting flustered at the breast - it takes a bit of sucking to get the nipple in the right position and milk to start flowing whereas milk from a bottle comes out easy. Have you tried giving him a bit from a bottle and then switching to the breast once his initial hunger is quenched.

Also to avoid nipple confusion you could try feeding from a cup, spoon or syringe - let him lap at it rather than pouring too much into his mouth.

Please ring a breastfeeding helpline or go to a local group. They can reassure you about what is normal and get a more detailed view of what is happening with the two of you (search here).

Otherwise try lots of skin to skin and biological nursing.

Hi ya as GodisaDJ has said think of this as a temporary fix and keep persevering, it's still early days and baby is still learning too, they can be fiddly/fussy little things, I felt like i had my boobs out constantly at the beginning as worried every little sign was them wanting feeding! I also think look in to some RL support, they offered breastfeeding workshops here and there was a helpline number given out, which I was lucky to never need but reassured to know was there. My sister struggled with both her boys early on (sore nipples/latching on her biggest problems) but went on to happily feed them for longer than she planned. I loved loved feeding my 2 girls (did 10months 1st one then nearly 2 years with 2nd!) you are in the right mindset of wanting this to work and I'm sure you will get there, I know of friends who have up and regretted it so stick with it and keep asking for help/advice

Coops you should give yourself a little more credit, it sounds to me like you're doing an incredible job.

You say that you feel guilty! Whatever for? You really must try not to think of yourself as failing, you are producing milk and you are feeding your DS with it and in the end thats what its all about.

Good luck and congrats

Hi coops,

I just wanted to post to say that I've been in your shoes... Nearly 3 years ago now. My ds would not latch on at all, I expressed and used a cup initially then a bottle when he started to suffer really bad wind and couldn't get enough via a cup. I tried for 4 weeks and over time I had to top him up more and more with formula as my milk was diminishing. I was determined to make it work but after 4 weeks and more visits to midwives, health visitors, nct, breastfeeding clinics that I care to remember I accepted that my ds would be formula fed. No amount of trying and advice could get my ds to bf.

Don't be so tough on yourself... We can only do so much and despite our best intentions sometimes that's not enough. The important thing is that your baby is fed, content and settled - however you can manage to do it.

My ds is now 2.8 and I'm 21 weeks with dc2... And I know I'll be putting myself under less pressure this time around if I can't get bf established.

Xx

Hi there Coops, sounds like you're doing brilliantly... I had a tongue tied baby, so I know what it's like!

Firstly, as Godisadj says, 3 hour feeding schedule is mad... any kind of schedule is mad. Babies that young need to feed when ever they want and with your problems, I would be offering the boob more often - this will help with your supply too.

Have they suggested any alternative ways of supplementing? Bottle feeding can be an arse if you really want to bf because babies can become accustomed to the fast flow and teat. Basically they don't have to work so hard at getting bottle milk, so may lose interest in the boob. Also, babies use a different part of their mouth to suck a bottle teat (hard palate), where as they should be encouraged to use the soft palate which is what they use for breastfeeding. Alternative feeding methods are finger feeding: baby sucks on your finger while you supplement with a syringe or tube into the corner of his mouth. Or supplemental nursing system, this is brilliant as you actually supplement at the boob - Amazon used to sell the Medela one for £20 but it's gone up in price. You can make one yourself or there are a few on ebay I think. Basically it's a bottle you hang from your neck or somewhere reasonably high up, with tubes that attach to your boob. So baby latches onto your boob and takes the tube in his mouth. Here's more info:
kellymom.com/bf/pumpingmoms/feeding-tools/alternative-feeding/

When you got his TT revised, did they give you post procedure wound massage to do? This helps ensure the TT doesn't re-attach, which is what happened in my baby's case. I can't find any info right now but will keep looking.

Have you been advised to take him to a cranial osteopath? This made a huge difference with us, the TT revision wasn't enough to get him efficiently breastfeeding again. I really recommend seeing one. Where abouts are you? If you are anywhere near south London, Wandsworth have a free clinic - Let me know and I'll find the details.

With regards to latching, have you tried the exaggerated latch technique? It's where you sandwich your breast, around the areola area, between your thumb and forefinger and use the nipple to nose, then when he gapes bring him on quickly so that he gets as much boob in his mouth as possible.

Get naked with him, lots of skin to skin will encourage him to bf and help your supply. I used to take afternoons out and just let him feed (or comfort suck) for hours, it was a great bonding time too.

Don't worry about the formula, it's helping him at the moment and any breastmilk you can give him is a bonus.

Here is a facebook tongue tie group that is very good - there are lots of lactation consultants and mum's who have been there before:
www.facebook.com/groups/tonguetiebabies/

Have you contacted your local La Leche Leaugue leader? They are brilliant and might be able to come to your house to see you, seriously worth a call: www.laleche.org.uk/pages/about/helpline.htm

Hi beksparkel
Could you give details of this clinic in Wandsworth? Think DS needs to see a cranial osteopath..

Hi all - thanks so much for the kind words and advice. We are persisting and I'm in the process of trying to find a BF group or breastfeeding specialist in my area. Today LO is still raging at my nipples; it occurred to me, could he dislike my shower gel? I am feeding every 3 hours as per the doctors instructions but if he shows the slightest hint of hunger I'm putting him straight on my breast That doesn't happen often though (he's always asleep) and when it does he'll latch for about 3 sucks then pull away and scream like nothing on earth. I wonder as well whether, because I'm expressing, there isn't enough in there now to satisfy him?

Thanks again. xx

Do whatever you need to do to 1) help the baby gain weight and 2) keep you sane.
Breast milk is best but formula is not poison. I was in a similar position as you, my baby lost 12% of his birth weight and I couldn't produce enough and I couldn't get much out when I tried to express. If it's easier and keeps you saner to express and then bottle feed the do that. Don't worry if you need to top up with formula on top, you might not have planned to do this but it's not going to hurt your baby.
Get him weighed weekly if you need to know how much is going in.

In a years time none of this will matter because you will have a lovely fat cuddly baby. Good luck! x

Tongue tied babies often object to the breast because the suck/swallow/breathe pattern is disorganised and because breathing is top priority they don't want to feed as it compromises it. Plenty skin to skin and try feeding in the bath might help.

It will take time for the tt release to make a difference as he learns to feed with his "new" tongue. Are you stretching the site of the snip to avoid reattachment?

There is a tt support group on FB where you can chat to other mums in the same boat.

Thanks guys - mawbroon I haven't been stretching the tongue-tie. How would I go about doing that? Ecgwynn - thank you; it's nice to know it's not just me.

Becsparkle I have heard about cranial osteopaths but I'm in Wiltshire - not sure how many of them are around but I'll take a look

Incidentally, have been trying skin to skin but that seems to upset him too.

I'm going to give myself and my LO a break for night. He is getting so distressed every time a nipple appears in his line of vision that it's becoming unbearable. It's horrible that I'm causing him so much upset. Tomorrow I will try bathing with him and get in contact with some BF groups/consultants.

Having just typed that, LO finished his 7pm feed and was still hungry and this time actually latched on for a minute or two without screaming. I count this as progress. Slightly more upsetting is the fact that he merrily latched on to my husband straight afterwards!!!

Hang in there.
Your baby was dangerously underweight and needed food, don't feel bad about giving formula.

Eat, drink and rest yourself as much as you possibly can to improve your milk supply.

Tomorrow morning pull out all the stops to find a bf advisor to help you feed. Can someone
help tonight by making a list of telephone numbers - la leche, local bf group etc. be pushy, say you need help that day. Once you find someone, do not let them go! Try and get them to help you with as many feeds as possible, even if feeding starts going better.

Thats my advice anyway - you can get over this, with some one giving consistently giving you a bit of help.

Congratulations on your DS! Don't view that as upsetting - view it as progress that he's realised latching on is something good to do!

I found this list of support groups in Wiltshire - I hope there's something nearby to you there.

PS How's the expressing going? Have you been given advice on how to maximise your supply when pumping?

Here you go Cosmo: occ.uk.com/

Hi! I was exactly where you are, your story sounds a lot like mine! FWIW, I was able (through lots of perseverance at the breast feeding clinic - I would really recommend seeing/hiring an expert to help you with your DS's latch) to drop formula by 4 weeks and expressing by 6 or 7 weeks. Once you get them latching and transferring milk, it's a bit of a leap to trust that it's all working. There is some advice on dropping top-ups on Kellymom, it involves tapering off formula.

Are you pumping enough to keep your supply up? At least 8x in 24 hours with at least one of those being between 1-5am.

Best of luck and congrats on LO!

Re the shower gel, if it has any sort of lasting scent then it may have an impact. Baby wants and expects you to smell like you :)

Hi - sounds like you are doing amazingly well in really hard circumstNces - don't feel guilty ....

2 thoughts - could you have a delayed let down hence crying with frustration ? Try hand pumping first perhaps ?

Second - dont worry too much about mixing at this stage - I got down to one partial feed a day with mine at 14 weeks then worked back up to nearly ebf for a year - you can do it !