Tiktok or anyone - need to increase milk supply urgently - any advice

[tortoiseshell]

Ds2 was born Monday, is feeding well - good positioning etc I think, but as with my 2 previous babies has lost a fair bit of weight (just over 11% birth weight I think) - I always seem to take a while to get milk going, and mw is coming again tomorrow to weigh him, talked about admitting him but given that he was a homebirth, I really really don't want that - any tips? Am feeling a bit discouraged, and am trying to feed as often as possible. Mw said to try expressing and topping up with expressed milk, or to top up with formula to perk him up a bit.

TIA!

if you can just take to your bed for the day... feed him as much as possible.

trust nature and trust your body... it'll work out!

i can't see any point in expressing rather than feeding. expressing is less efficient than a baby feeding, so you're better off just feeding more rather than expressing and giving him a bottle

curling up together in bed for maximum skin to skin contact and feeding whenever he so much as squeaks is recommended I think

the only point in expressing would be if the baby is not feeding and is falling asleep quickly - in which case it might be the best way to get food into him.

But normally the best way would probably be just to feed as much as you can.

If he is very sleepy he may be a bit jaundiced so put him in bright sunlight as much as possible.

congrats by the way.

Oh bad luck tortoiseshell, how discouraging. I bet they are only talking of admitting him because he was such a big boy at birth though.
I had this with both of mine (approx 9lb) and my mw did say the bigger they are when born, the more likely they are to have a dip afterwards.
I think Mears and Tiktok recommend domperidone to increase milk supply, so you could stall your mw by asking for a prescription for that first I suppose. Fennel tea also supposed to help?
Dd especially was a sleepy, slow feeder at birth and nearly got hauled back in because her jaundice didn't seem to be clearing fast enough, but I dug my feet in and she came good in the end.
Where do you feel the "problem" lies? Is ds a sleepy feeder, or is it more that he seems hungry after feeds? Is he jaundiced at all?
Sending you lots of love and a reminder to start your birth announcement thread PDQ so lots of congrats can cheer you up a little :)

I think expressing and feeding ebm as well as all regular breastfeeds is thought to have two advantages 1)more breast stimulation so encouraging increase in production and 2)extra calories on top of regular feeds to help balance weight loss. Where I work we have a 10% weight loss in first week rule, but the whole feeding and behaviour of the baby needs to be looked at. If the baby is waking regularly, feeding well, and is having nicely wet nappies and 4+ yellow bowel movements per day then that is less worrying than sleepy, dry babies.

congrats on the birth of your son tortoiseshell!
i had same problem with ds1 (he lost more than 10% of his birth weight). as previous posters wrote: cuddling up in bed and feeding constantly is a good plan. make sure the baby doesn't get too warm though, as that will make him extra sleepy. if he keeps falling asleep try tickling under his feet, or gently blow in his face, that will wake him up. try to keep off admitting him to hospital (as long as he's drinking regularly, alert when awake, having wet nappies etc), there's a big chance that you milk hasn't come in properly yet (are you engorged at all?), but that it will in the next couple of days. i think expressing at this point will just give you the wrong idea about your milk supply (it's so difficult to get anything out at first, babies are much more efficient than pumps!)
oats are supposed to boost milk supply, if you can stomach porridge in this hot weather (?).
hth

Cuddle, cuddle, cuddle. It really does help a lot. Skin-to-skin contact improves weight gain in very young babies. Your midwife really isn't giving you a chance - your milk may not have come in properly yet and IME it's true, babies who are larger at birth tend to loose a greater proportion of their birthweight. You don't necessarily get engorged when the milk came in - I never did, just got hugely emotional. Plus (to really wind me up) both of my babies got very restless and distressed on that day, and neither would feed well on the day the milk came in. But it settles down afterwards. Give yourself a chance and plenty of resting and cuddling time together.

And Congratulations!

Thanks for the advice so far - I've got the expressing stuff out of the loft and will give that a go along with lots of cuddly feeding in bed - like the sound of that a whole lot more! Ds2 isn't a 'sleepy' feeder as such, but he's not a 'voracious' feeder - somewhere in the middle I guess.

Tbh, I'm not really surprised, as both ds and dd lost a lot of weight and were slow to put back on - my milk does seem to take longer to get going than average. I just don't want to fall 'into they system' iyswim, for the sake of numbers, when I'm sure a few more days would mean his weight was going in the right direction. Obviously if there was a problem then I would want it seeing to.

marina -thanks, will do a birth annoucement thread now!

tortoiseshell, there's some good info on here. I don't recommend domperidone - got nothing against it but I am not a medic or a midwife so I leave the medicaments to others! There is no point in using medication if the basics are not right - so here are my Qs:

• how accurate is the weight? If it's been done on spring balance scales, forget it. Not accurate enough. If the baby wasn't naked, ditto

• what about poos? if they are soft, yellow and copious today, then that's a good sign

• hospital admission? Way too much of an overeaction IMHO - but maybe the midwife is seeing something you haven't mentioned

• ditto formula

• lots of skin to skin is right, lots of feeding, express and give to the baby if the baby is just not feeding well

• keep an eye on him, even so....we don't want him to be conserving calories by sleeping a lot

Hi tiktok - no yellow poos as yet, nappies are wet though. Scales were digital ones, baby was naked. Has pooed out a LOT of meconium though, since being weighed at birth. He was a very big baby - 4.58 kg, so has lost a fair bit of weight.

The mw said he looked 'clinically well' and had good colour/tone etc, it was only when she looked at the numbers that she started talking hospital.

Thanks for replying everyone!

just keep on feeding him tortoiseshell. Bea was tiny at birth so didnt ever lose much weight, my midwife told me catagorically that the bigger the baby, teh bigger the initial weight loss.

Are you sure your latch is good - if you have no sore nipples then I'm sure it is

as others have said I really don't see the point in expressing, just feed him as much as you can

tortoisehell, I had real problems with DS3, who was the biggest of my three boys. And although I thought he was latching on okay, in fact he was not, and that was part of the reason for his continued weight loss. He was also very very sleepy, and it just became a vicious circle.

As well as getting the latch sorted out, I did the expressing and topping up with ebm thing, and it worked fine. No need to resort to formula!

TS: watch out for those yellow poos, then. We'd be looking for them tomorrow.

My middle boy was admitted back into hospital at 10 days as he lost about 2 lb (he was 10lb 14 to start with tho so still a big baby). He was 10 days old when he was admitted.

In our case though, it wasn't just the loss of weight - he was a very sleepy baby and dry. We found expressing useful to increase my milk supply because he was so sleepy and not feeding much. If he's feeding well, then better to feed him yourself as much as possible I guess.

Hope you manage to avoid being hospitalised and that everything works out for you.

mrsbang - that's interesting - what did they do in the hospital? I'd have thought it was easier to feed at home than in a hospital.

When expressing, when are you supposed to do it? He's feeding every 2-3hourly, with each feed lasting half an hour to an hour - the chance of expressing ANYTHING then is really small, as he uses both sides in a feed (obviously not together!), but I don't think I could co-ordinate expressing off one side with feeding off the other.

tortoiseshell - sorry you are having problems. My only advice is with expressing (I do it mainly when at work but also when feeding to top up the freezer but never when babies were tiny)

It sounds tricky to express when feeding but i really really found that I get much more. I am going to post a link which looks a bit bizarre but helped me get the knack of expressing when feeding...
its popsy btw

\link{http://www.kellymom.com/bf/pumping/hands-free-pumping.html\hands free pumping}

Even if you are using a hand pump, this can realy help!

I have a medela mini electric that I dont use - which I could hunt out. prefer hand pump. would you like to borrow it?

I know some people are funy about second hand breast pumps but if you want to borrow it, it's yours

I would not express at such an early stage...
How are you feeling now ?
If you really want to take something then fennel tea.

11% of loss isn't THAT bad for a big baby... He shouldn't have been weighed... best practice is to leave it for 10 days !

Basically they observed (both of us) and tried to get the feeding sorted

They were very supportive of the fact that I wanted to continue breastfeeding and also looked after my post-natal needs (we were on the paed ward, in a side-room where I had a proper bed, and they sent a midwife across from mat to check me over each day). They supplied a pump, helped me to use it and I got into a routine of feeding him and then expressing, (a) to try to get him to take more bm and (b) to up my supply. Was in from Tuesday to Friday.

My memory is a bit hazy (wasn't the easiest of births and I was on medication) but generally I fed him and then expressed whilst someone else tried to give him a cupfeed/bottle of ebm (in hospital). Once home often had to do all three things myself. Don't quite know how I managed it tbh with a toddler running around too, but like anything you get through. DH was fantastic too.

I continued expressing and topping up for about six months (after a while not after every feed) - by now I didn't need to express so much, but carried on to ensure I had enough iykwim. By this point he was on solids and then I continued b/f until he was about 13/14 months.

In theory being at home would have been better, but at least being in hospital meant I could concentrate on the baby (much as I missed my toddler I knew he was being well cared for by my parents). It was also quite restrictive but I had BF my eldest, and was determined to do the same again (aided somewhat by my HV who was great generally, but who insisted on mentioning formula in passing "just in case" on her way out the door)

I must stress though that DS was very sleepy and had dry nappies, therefore imo hospitalisation was correct for us. It would have been foolhardy not to get a 2 lb weightloss checked out (even though he was such a big baby).

This doesn't sound like your experience with your ds2 at all. Hope it all works out ok.

i would also recommend doing what everyone else has said.
i also won't be in too much of a hurry to go for domperidone - no real reason, but if you've done it twice before i'm sure you can do it again.
as long as your babe is active, alert and feeding well then hospital can be avoided. the worry comes when babe is sleepy and not waking for feeds,and then not feeding well. quite often this is due to being jaundice, or becoming dehydrated. if they don't drink enough, this then doesn't bring up their blood sugar level giving them the energy to gain weight and then wake for the next feed.
if he was to be admitted they may well pop a feeding tube down his nose into his tummy and fill him up that way.(very harmless).
(i work in a baby unit as a nurse)

pupuce - theere's nothing wrong at all with weighing babies before 10 days, as long as it's done properly and with knowledge and understanding; in situations where no one can be sure that ineffective breastfeeding is noticed (ie almost every maternity unit and everywhere else in the UK) by the mum or her carers, then it can be one way of building up a picture to check all is well.

I hear from far too many mothers where poor feeding isn't discovered until the baby is weighed again at 10 days or so and then it's panic stations....

It's what you do with the weight that counts (and it's vital it's done accurately, too).

11 per cent weight loss is actually not good.....but it's only one part of the picture, and it may not mean anything at all if everything else is fine (baby feeding frequently and well; nappies normal; mother not sore; baby not sleeping too much).

I've never heard that weighing before 10 days is not best practice, and I don't agree with leaving babies this long without a weight check. Most will be fine, of course, but some will not.

mrsbang, you sound as if you had good treatment once the crisis was discovered. It should have been spotted a lot sooner by the people caring for you, even so, and if it had been, you and your baby would have been spared the hospital.

Maybe tiktok.

We were monitored by my community mw between leaving hospital (2 days old) and being admitted when he was 10 days old.

Feeding didn't appear to be a problem in the first few days, either in hospital or at home, and he had wet nappies at first.

Thanks everyone - mrsteacher, that's amazingly kind of you - I've actually got a Medela one, so am trying that, but THANK YOU so much.

Mrsbang - sounds like you got really good attention in hospital - my dread is that he 'falls' into the system and then they impose a regime a that makes b/feeding impossible.

Pupuce - I think they have changed the system here a bit - it used to be weighing at 10days, but they seem to have got a bit more fussy about it.

I'm coming to the conclusion that it is me not producing the milk that is the problem - don't know why, but I never have that 'milk coming in' experience - things just get going slowly. I'm wondering if there's some physical reason for this, so will talk to mw today. Spent an hour expressing yesterday afternoon, to get about 1/2 an ounce (if that). Have been doing lots of skin-to-skin feeding, and he does seem to feed better like that. He is a bit sleepier in his feeds than he has been, but more awake the rest of the time iyswim - in himself he is alert, but is falling asleep a bit when feeding. Last night I woke him for a feed at 2.30, he fed till about 3.30 (with encouragement) then I woke him again at 6.30, so I'm a bit concerned that he didn't wake for those feeds himself.

On the plus side, he managed to do 2 ENORMOUS wees all over dh yesterday evening!

Sorry this is so long - thanks everyone for advice!