No milk in left boob/combo feeding advice

[Spuddybean]

Hi All

I am a new mum and I really wanted to BF. But i just am not producing enough milk. My left breast just doesn't make anywhere near enough and my baby is hungry and also lazy (he falls asleep on the boob after 10 mins and his suction just comes and goes).

We bought a breast pump so i could see what i was making. 20 mins of full/strong suction on the right (not comparable to lazy baby sporadic sucks) gives 1.5oz and 1 hour on the left gives .5oz. Both have been given the same stimulation, but the left has an inverted nipple so i'm not sure if that is why.

The baby wants 2oz every 2 hours and is unwilling to suck for longer than 20 mins so i don't think exclusive bf is going to work.

Anyway, after another horrendous day and night of just constant feeding and crying baby. We gave him some formula as a top up. He loved it :( He guzzled it down like we'd been starving him and took a solid 2oz every 2 hours on the dot for 4 feeds.

I expressed while he was having this too so we had a store of my milk.

So now i think we are planning to combination feed.

I suppose therefore my questions are; is it normal to not produce enough milk in one breast? Is combo feeding a good idea? What formula is best and compliments this style of feeding?

I am really disappointed as this was the part of motherhood i was looking forward to the most. I really want the connection and comfort of him on my breast, so are there any 'methods' or tips to combo feeding? should I alternate feeds or do each feed with some expressed milk/formula then finish of with boob?

Thanks

I ended up having to do this as I got mastitus twice (absolute agony!!!) then after the second time my right breast didn't produce enough, I combined aptamel and my milk until my milk had completely gone about a month after, so then had to feed full formula... it made me feel like a useless mother and I didn't bond as well with dd after this until I realised actually it wasn't really my fault :) try for as long as you can but honestly do not worry if your milk completely goes as a result of introducing formula your baby still loves you :)

oh to actually answer your question I expressed and mixed both milks, keeping my milk in the fridge or freezer :) my dd became dependant on the bottle and wouldn't attach to my breast, despite numerous mw's and hv's telling me introducing a bottle wouldn't break my dd's attachment to the breast!!!

Spuddy, you don't say how old your baby is but I'm gonna assume he is still v. young, up to a few weeks. I hope you have good help on the spot with breastfeeding and you can ask your questions in real life, too. I am a breastfeeding counsellor with NCT and I hope I can throw some light onto what is happening and the way forward. There is nothing in your post that indicates to me you cannot breastfeed as happily and satisfyingly as you plannned : )

I am going to cut and paste a bit 'cos your post is long, and it should help me cover it all :)

"My left breast just doesn't make anywhere near enough"

Most mothers have differences in milk production between one side and the other - it doesn't matter. With frequent, effective feeding, even just one one breast can produce sufficient for a baby (think of twins!) and although it's highly unlikely you will need to feed one side only all the time, if you had to, you could.

" and my baby is hungry and also lazy (he falls asleep on the boob after 10 mins and his suction just comes and goes)."

Normal for babies to need bf very frequently day and night; falling asleep after 10 mins can be normal; normal for sucking to come and go in intensity. You need someone to observe a feed and see if anything can be changed, but your description is not worrying.

"We bought a breast pump so i could see what i was making. 20 mins of full/strong suction on the right (not comparable to lazy baby sporadic sucks) gives 1.5oz and 1 hour on the left gives .5oz. Both have been given the same stimulation, but the left has an inverted nipple so i'm not sure if that is why."

The pump does not remove milk in the same way as the baby and it is absolutely misleading to assess breastmilk production on the basis of a pump - it gives you no information at all except wrong information. Pumps can 'perform' worse than a baby, or sometimes better than a baby - 100 per cent useless as a form of assessment, believe me.

"The baby wants 2oz every 2 hours and is unwilling to suck for longer than 20 mins so i don't think exclusive bf is going to work.

Anyway, after another horrendous day and night of just constant feeding and crying baby. We gave him some formula as a top up. He loved it sad He guzzled it down like we'd been starving him and took a solid 2oz every 2 hours on the dot for 4 feeds."

It may be your baby is needing more breastmilk at the moment - you don't say what his weight gain is, what his poos have been like - but that can be fixed, honestly :)

Is the midwife still around?

If you combination feed you risk not being able to bf at all.

I expressed while he was having this too so we had a store of my milk.

So now i think we are planning to combination feed.

Please post again with more info and you can also call any of the bf helplines.

Hope this helps.

Tiktok - I understand what you are saying about the pump being misleading, but it isn't the only indication that milk wasn't coming out of the left boob - DS can't latch onto it either and is constantly grizzling if we try on that side. In fact he works himself up into such a frenzy that by the time i put him on the right boob he wont latch onto that one either and punches my boob with his fists and keeps pulling back from the nipple and ramming his fist in his mouth. It becomes really distressing for both of us.

We have medela nipple things but ds finds them really hard work and difficult too.

Also i now have one boob much bigger than the other :(

DS is 5 days old. MW's just watch him latch to right boob and say it's fine. I suppose sitting up from 3-8am just constantly feeding seems okay to them but i can't continue. He wont sleep in his cot so we co sleep and he drinks for 10 mins then dozes for 20 then eats then dozes. This is the routine and i can't eat or sleep. I had a traumatic birth and have lots of stitches and double incontinence. I am finding not being able to wash or go to the toilet really limiting.

After the formula last night he has had a really awful nappy and seems to be in discomfort today. I just dont know what to do.

Spuddy, it may well be that your left breast is not producing much - but the pump is not a reliable guide to this. Some women get very little out with a pump, and at 5 days old, this is especially the case. It sounds as if you have some justified concerns, but the pump is really no good at throwing any light on what's happening.

When you say 'nipple things' is it shields you mean? These are awkward and fiddly, and while they can be helpful for some, for others they make bf more difficult.

Can you explain to the midwife/wives how distressed you are and how tired? None of what you say is unusual for the first days -which can be a really challenging time for bf or ff babies - but that doesn't mean there is nothing that can be improved. It is normal for babies to be want to be next to mum post-birth and this is especially the case after a difficult birth. He was inside you less than a week ago and being close to you is reassuring and builds his trust and confidence and love.....it does not last forever.

Has he been weighed? What is his poo like? You need to know he has stopped losing weight, and his poo should be soft and yellow and lots of it :)

It sounds to me that you need someone who knows about early days challenges to really observe a feed start to finish and who can make some suggestions on different ways to attach and position your baby....have you tried biological nurturing (google it) for example?

The eat for 10 mins, doze for 20 mins, eat again, doze again.....is 100 per cent normal in a baby as young as this....but you do need to know if he is transferring milk effectively, too.

When i bf i am bare on the top and tummy, ds lies across me. I have been shown bio nurturing at my nct class. All the mw's say our positioning is great.

Yes, i mean nipple shields. In the hospital ds seemed to get on with them okay but since we have come home he just gives up and tantrums. He cannot latch or persevere with the left nipple and while i am happy with the flow from the right (i can see milk pouring out of the side of his mouth when he feeds/he is sick after/when he cries the right boob leaks etc) I get no such indications from the left boob.

I am not willing to only feed from the right and have one breast substantially bigger then the other.

He is being weighed today but he was 9lb at birth on Weds. He doesn't seem to have lost much weight (he was 2wks late and is quite developed for a newborn - every MW/pediatrician comments on how strong he is). His poos are yellow, but not lots.

oh, and because he cant latch on the left and i don't want to stop demand to it i am expressing on the left after every feed on the right. This also takes up time. So the hour he may sleep i am immobile due to being on the pump. I have been expressing now for the past hour solid and have got 10mls. It is soul destroying.

Realistically how long does this type of feeding last?

Here's a suggestion: feed from the right only, and express from the left to keep you comfortable, as a temporary fix so your baby gets 'into' bf without the fuss and frustration. Ditch the shields - I can't see they are helping at all. Your breasts will not stay unequal - even if you continued long term feeding one sided, you would only have a temporary and minor difference in size, and it would not be visible with clothes on. You could ask on mumsnet for experiences about this - you would get replies that indicated a range of experiences but honestly, nothing that would suggest major, obvious, contrast in size lasting more than a few days.

Yellow poo is good - he should be having 2-3 or more of these today, soft and smeary and about the size of his fist (not a skid mark).

If the midwife is coming to weigh him, then open up to her about how difficult it is for you, and check out what I have said about feeding from the right only and expressing from the left for the moment, so you can see if this is right for you.

Spuddy, just seen your latest message.

No need to pump for an hour - WASTE OF TIME! Yes, and soul destroying!

Instead, try i) gentle hand expressing (midwife will show you) and/or ii) short expressing session....10-15 mins max while you do something else...watch for spurts and when the spurts slow, take a break, and try again in a few moments.

Speak to the midwife....I really hope she helps.

Thanks Tiktok. I will speak to her (she is utter shite and i don't really like her so i will find that quite hard! I have found her vague and unhelpful at best throughout my whole pregnancy).

The boob thing is very obvious and has been commented on already. I am really embarrassed to go out - what with that and the double incontinence i just feel destroyed.

Tiktok is absolutely right. This is all so normal for a 5 day old baby. I have had two traumatic deliveries and on day 5 my milk was only just in. Up to this point both babies fed very often and for short periods (and for a while afterwards tbh). It was what established my supply in the end.

You need good, consistent support with bfing which I will leave to people like tiktok (I'm but a peer supporter in training) and rl bf counsellors.

But you must also tackle the birth trauma too because it saps everything: strength, confidence, joy. You will be finding it all immeasurably more difficult because if you're anything like me, you'll be feeling like your body can't do what it's supposed to do in terms of birthing babies and now it can't nourish them either. This is the birth trauma speaking. The birth trauma association is good, Sheila Kitzinger knows her stuff and your midwife should be able to access good care and perhaps a debrief for you. Talk talk talk about it too. On here if you like. There's always an ear.

The only other thing I will add is that first time round, my dd had some significant muscle damage from her delivery. It took me a few weeks to realise that her inability to latch on the left side was actually an inability to turn her head that way. She needed to see somebody who sorted out her range of movements and sorted the problem with her neck and shoulder. In the meantime I found that she could latch on that side using the rugby/clutch hold so that she was turning her head the other way iyswim.

Congratulations on the birth. It's all so new atm. You're going to be fine.

Thanks ISee. Physically he is fine. We tried the rugby ball technique too, but as it's the nipple that is the problem it wasn't effective.

I know what you mean about feeling rubbish at having babies. I had a great pregnancy and i am quite natural and physical person so was looking forward to the birth. I went way overdue and everyday just became more stressful. I had 7 nights of early labour getting to contractions for 1 min every 4 mins then stopping at 8am every morning. My mw was useless and went awol. In the end i was induced and had a 3 day labour. There was no room on the labour ward so the 1st 2 days of increasing pain and contractions were on a different ward with no pain relief. Eventually at 5cm i was given some gas and air. After what seemed like ages and pethidine and a drip the pushing part started and 4 hours later the head was visible but not progressing. Ds's heart rate dropped and they had to do forceps, no more pethadine or time for an epidural they got the head out. But the shoulders were stuck in my pelvis. 4 more pushes later and the baby was dangerously grey. They pushed my legs up and got ds out but i tore into my rectum. Ds was resuscitated and i was taken to surgery.

So now i can't get my stupid left boob to work i feel like this just confirms my absolute failure as a mother already.

I have no one to support me or help out either. I am an only child and have no friends. Dp is back at work and his parents aren't involved. My mum is looking after my dad who has just had surgery and even so she is very forthright with her opinions and is very old school about how to look after babies. She doesn't think I should feed on demand or feed thru the night with him close to me. She thinks put ds in the cot and leave him.

:( spuddy, no wonder you feel so low.

You can contact the Birth Trauma people - they are highly thought of .

www.birthtraumaassociation.org.uk/

There's no telephone helpline but they can offer email support.

You can also call the NCT helpline who are also able to talk through birth and afterwards.

www.nct.org.uk/ scroll to bottom for number.

Can your DP take time off work? Your mum's attitude is not helpful and it sounds badly informed, too.

Ohh Spuddy your post made me cry. You poor thing

I had a traumatic labour with forceps, a distressed baby, stitches etc & it took a while to get over it. I felt very much like a piece of meat & was terrified for most of it. Completely the opposite to the water birth what I planned.

Breastfeeding didn't go to plan for me either. It was a total nightmare, I had no idea what I was doing & the whole thing was majorly stressful.

I spent the first four weeks naked either feeding, showering my stitches or expressing. I got mastitis two weeks in, as if I didn't feel crappy enough already.

It does get better. Hang on in there if you can. Breastfeeding is really worth it and has helped me bond with my baby which I found hard after a difficult labour.

Ignore your mum. Mine is similar & I only saw he twice in the first six weeks. Post on here as much as you need too.

Sorry to come to this thread a bit late.

I have a left inverted nipple. I fed DC1 from the left as well as the right, but the left side never produced as much milk, feeding really hurt, and I ended up with mastitis and blocked ducts on that side. Awful. Tried shields, made it better but not great.

I pretty much gave up feeding from the left when she was 9mo and went to 14mo from the right only, along with formula.

With DC2 I tried feeding from the left and gave up after about a week. The pain wasn't as bad, but I decided to give myself a break and use my right boob and formula (one or two bottles a day) to supplement. The formula is best used at the end of the day, when your supplies are low.

I am still going with this at 13mo. Yes, I get a bit lopsided at times, but I throw a scarf around my neck and it hides things. After a big feed they look the same size.

I tried the left side recently and there is still milk there, believe it or not! So I could resume from the left if desired, I guess. I don't want to, though!

PM me if you want to ask me anything. This is not your failure! It honestly hasn't affected my bonding with either of my DCs one jot.

P.S. once you settle into feeding, being able to bf at night is so much easier than formula!

Just to add, you can feed from just one side without needing to use formula is you want to. This is what I have done with DD after getting repeated mastitis. The side I feed from is my 'worst' side, the one that produced less milk, but have had no problems with supply at all and plan to tandem feed from just one side if DD is still feeding when I have another baby.

You've had some really good advice on this thread and I agree that good, RL support, from a person you can trust and like will be a good idea.

I'm a peer supporter with the NHS, do they have a peer support scheme in the area you are in? The midwife can refer you if you want her to. It will 'just' be another Mum who has breastfed/is breastfeeding but has some training and can offer you support either in person, on the phone or by text, or all of those. Peer supporters are limited in what 'technical' help they can offer, but for some Mums it can really help to just have someone to go to with their smaller concerns (such as is frequent feeding normal) or to let off a bit of steam to.

Thanks everyone. I seem to be yo-yo-ing all over the place. After seeing the mw earlier i was positive i could do this but then after the worst night yet i am now feeling dubious again.

Mw came and showed some latching techniques. The baby latched and fed on both sides beautifully while mw was here. I really thought 'oh i'm just fussing over nothing'. I had a plan. I had expressed 3oz throughout the day. I was going to do 2 feeds on right boob (try left first to see if possible) then do one feed formula and one feed of expressed milk.

Mw advised to continue expressing on the left - to even up demand/flow - and persevere with the nipple shields.

Sadly ds had other plans and wouldn't latch on at all to either side, shaking his head furiously, punching, kicking and scratching and screaming. He took the expressed milk then promptly threw it up again. So i had to deploy the formula. He had just fed constantly all night too (4oz of formula and 20 mins on boob and still lip smacking and hungry). He was refusing to lay at all. He has been paced round and offered boob but he is so worked up. He has kicked so violently he has ripped off his umbilical chord :(

My stitches are hurting and he only will feed if i am sitting bolt upright, which is just too painful atm.

Ds has finally settled. Laying next to me now but every time i lay down he screams.

To answer an above question about whether dp can take time off, he can't. He's had 1 wk of pat leave last week while i was in the hospital. So we cam out Sat avo and all we had was Sunday together.

Thank you for all the good advice. I think i will cal the mw today and ask if she can come back to show me the positioning/latching techniques again.

:( :( Spuddy...it's really common for early difficulties to appear to be resolved and then to have a bad spell....just as you have had last night.

It's good the midwife is coming again.

Now would also be a good time to call any of the bf helplines, too.

"4oz of formula and 20 mins on boob and still lip smacking and hungry" - NORMAL. He wants the closeness and reassurance of the breast, but it sounds like he gets himself all wound up and upset and can't calm down enough to organised himself to latch....and this makes him even more upset.

I hope you have a better day today.

How's your day been Spiddy?

Spuddy sorry bloody phone

Seriously - not great, i've had a separate issue with ds's umbilical cord. I posted a thread in health about it smelling of rotting flesh.

Anyway, feeding has been hit and miss. ds responding better today to the rugby ball hold. so we have been persevering with that. I also have been feeding much more frequently so whether he lip smacks or not about every 45 mins i have popped him on the boob just for a few mins if he's not interested and for lobger if he is.

He has also seemed more alert and we have been trying to have fun - rather than me just despairing. So have been singing and dancing 4-6pm to the beatles :)

I am trying to make this not affect my bonding with him, i don't want to associate him with frustration.

MW is coming out tomo to help with feeding. Also my left boob seems to have kicked in a bit more and is now leaking when i feed on the right. I have expressed twice for 15 mins - just to keep up demand.

Umbilical cords creep me out. I couldn't wait for it to fall off which it did on day 7. I was so pleased! The are essentially gangrene so just rotting flesh. What's worrying you?

Sounds like you guys had a nice day. The Beatles antics sound fun I barely got out of bed for the first few weeks, so well fine for dancing! How are you feeling? Hope the stitches aren't too painful.

The rugby hold really worked for us too. DS seemed to latch on well like that. I fed him every hour in the beginning and it meant he didn't get worked up and cry, plus he was usually hungry.

Hope you have a reasonable night

Hello again, we are feeling okay and the nights are getting better, but only because we are supplementing with formula. He is so hungry and only seems to sleep when really full.

The midwife came out to see me Weds and we tried again with the left boob but it just isn't happening. It takes so long for milk to come out DS is in a right state by the time a not very satisfying trickle comes out.

MW told me to keep expressing and massaging which i am (it's very boring and uncomfortable). But she also said if i can't get it working there is no way i can feed DS with just one boob - it wont be able to keep up with the demand, which is constant from a 9lb guzzler.

I have spoken to DP, and while he is supportive there isn't much he can do to help. He also hates to see DS distressed and hungry so he thinks we should go to formula feeding. (DP does not do any house stuff or cooking and works really long hours so i have to do everything)

So the way we are proceeding is every feed give him a few minutes on lame boob (with a shield - just for demand purposes). Then a proper feed for up to an hour on disproportionately massive boob (which now looks ridiculous). Then DS takes about 3-4oz of formula.

I am very sad but resigned to this and i think we will probably have stopped bf altogether by 6 wks :(