Baby won't feed from me: on the point of giving up

[lotsofcheese]

DD was born at 35+6 & spent a week in scbu due to low blood sugars, jaundice & was tube fed initially then moved to bottle feeding. I started expressing colostrum after my EMCS & started building up a supply.

I really wanted her to come home established on BF, however she was sleepy & a poor feeder - she'd almost lost. 10% of her body weight. I roomed in the night before to really concentrate on getting it established, but she wasn't BF much & I was constantly topping up with EBM. I panicked at the thought of her being re admitted & concentrated mostly on bottle-feeding EBM to keep her weight up.

Since we've been home, she's not really interested in BF. The unit supplied nipple shields & I've also tried without, but she doesn't latch on & either gets irate or falls asleep. There is no milk in the shield, so she's not drawing milk off the breast.I've tried giving a bit of EBF 1st, or feeding 1/2 way through. Also tried at every feed & stepping back by having a bit of time not trying.

The unit have been very supportive of BF & I've had lots of good, consistent advice, including from their feeding clinic advisor & home visits from the outreach nurses.

But I'm now at the point where I am so fed up expressing, not making progress & neglecting my 4 year old as I'm spending all day feeding, expressing etc.

I need to make a decision about whether I continue. Or just switch to formula. Any advice?

How old is she now, and how is her weight?

She's now 39 weeks & was weighed last week at 2560g -thankfully she had a big growth spurt & gained 300g in less than a week.

She is taking around 600mls daily & I'm making only about 500mls. So we're topping up with formula. My right side is only giving me 20-40mls per express. Have tried expressing more but really struggling as have 4 year-old & DP back at work plus no family support.

Well the weight gain shows what you're doing now is working. I guess your ideal situation would be that she starts latching on. Has she fed from you at all? If she falls asleep are you waking her with nappy changes, stripping her off and doing skin to skin? Have you tried biological nurturing where you do skin to skin, put baby on you and just let her find the breast herself?

It's possible that she is just struggling because she is so small still. My babies certainly found it easier to latch on when their mouths got bigger at about 2 weeks old.

Hand hold here OP. DD turned up at 27 weeks and getting her breastfeeding established in the early weeks home was far from easy esp with a 2 yo to amuse too. I also had no family nearby. Have you tried a supplemental nursing system? They are fiddly but good. Also try feeding 2 hourly during the day esp after baby has been recently stripped and changed. It wont always be like this. Prems tend to click and suddenly get the hang of bfing around their due date. Good luck.

Thanks for your replies.

Noble giraffe: I'm not sure if she's ever fed properly from me. There has only been 1 feed where she's fed a reasonable time, then slept a few hours. Sometimes there is milk in the nipple shield, at other times not.

I tried feeding her again earlier & it's the same pattern every time: trying to latch on but my nipple is too large, then using nipple shield, which she grabs with her hands & pulls off or knocks off with her head. A few sucks & falling asleep - tried tickling her feet, behind ears, stripped a layer off etc.

After 1/2 hour I gave up. She then took 120ml by bottle.

Switch to bottles , you have tried and it hasn't worked. I was in same position with my babies, after four weeks the stress of trying and failing was too much. I switched to bottles of express milk and then formula and we were all happier.

Do not feel guilty about this. It just doesn't work for everyone

Poppet - thanks for sharing your experience & good to hear you got there despite an even earlier baby & toddler.

I didn't think it would be so difficult for a 36 weeker. It's her term date next week & several people have said the same about things clicking around term.

I'm not sure what a supplemental nursing system is? Will consult Dr Google when DS in bed.

I'll reassess things at her term date & see how I feel. I don't mind investing in this if I see progress, but it just seems "same-old" at the moment.

Mine never suddenly clicked at term

Givemeaclue: I suspect that is what will happen: that she prefers the bottle & won't establish BF. I have set the target of her term date next Friday for making a decision.

It's the expressing I hate - being day on the sofa tied to a sodding breastpump. Not being out & about with DS. Been stuck in house for 2.5 weeks pumping/feeding & fed up with it.

Ideally I would like to BF but I won't continue to express if it doesn't work out. Will wind down supplies & use formula.

Google biological nurturing - it's harder to explain in a few short sentences but could be worth a shot.

Has she been checked for tongue tie at all? And can she latch if you sort of squash your boob by holding it between your fingers and thumb and squashing so it's wort of flatter and wider, like a hamburger?

cheese - my DD (born at 34 weeks) was also sleepy and a poor feeder. it took until she was nearly 41 weeks for her to "wake up" and really start latching properly. it didn't happen at term, which really worried me at the time, but it did a few days later - so perhaps give it till term plus a few days? if you feel you can.

also, DD was tongue tied (we found out much later) which I think was part of why she was so slow to latch properly - has your DD been checked by someone who knows what to look for? I see Yoni also suggests this.

I tried biological nurturing but found it near impossible with a baby too young to support their own head. I may have been doing it wrong though...

I don't know how it works in that respect, but there are videos of babies doing it from a few minutes old so it must be possible.

lotsofcheese, babies doing biological nurturing don't support their own heads - do look again and see what's happening. A call to any of the bf helplines would help you with more ideas.

I'm sort of going through similar thing. Ds born 41+6 then had an infection and jaundice and was tube fed. I tried and tried to bf with and with out shields every diff position I had loads of help and support but ds just Wundt open his mouth enough to latch if he did he fell asleep or cried, then I cried. I switched to a medela 'sucking' bottle as advised by a bf coach so he wouldn't get confused and so we could go home assuming we would be able to do it at home but no way. The first 2wks was a constant cycle of attempting feeds expressing and crying! I feel gutted and as if I hav failed as a mum and woman. I'm am slowly coming to terms with the fact we aren't going to b able to bf and focusing on my happy healthy baby. I'm expressing less now and doing maybe 2 feeds a day ebm. This came when I was expressing and couldn't comfort ds when he needed it. I don't no how u hav managed with another child! Well done for getting this far. I feel better now bottle feeding that we hav more quality time and a bit of a life. But u hav to choose what's best for u. I decided a less stressed mum with time for ds was better then bf. I think I'll always feel guilty but I thnk mums will find something to feel guilty about!
Moan over!

Don't feel bad or guilty, Catherine!

From the posts on this forum, it seems fairly rare to "convert" a bottle-fed baby to BF. It's certainly not any failure on our part.

I'm beginning to accept that DD is going to require FF - I'm only expressing about 400mls per day & she's consuming about 700mls, so mixed feeding would be the most realistic option, even if she did latch on. There's just not enough hours in the day to express more for increasing supply.

I always wanted the convenience of BF, so I won't continue expressing if she doesn't get the hang of it. It will be a relief to stop on some ways & move on. But I am finding the letting go very hard: I'm a healthcare professional with a nutrition degree & felt so strongly about BF. Interstingly, the HCP's have all been supportive but pragmatic - it's me who puts pressure on myself.

I'm trying to do skin to skin, nipple shields/not at 1 feed per day, when DS is at nursery & I can get peace to do it.

I'll speak to the breast feeding clinic lady at the hospital who liaises with the neonatal unit & see what she says.

But I have an understanding of where this is going to go & just need to know that I've done everything possible before giving myself permission to stop expressing.

It's the same here. My sensible side tells me that I hav tried and it was him that didn't get the hang because he was too sleepy then lazy because of being tube fed, he was a big baby etc but then the emotional side kicks in. I think the main reason I keep expressing is because while there is still milk there is that slight ray of hope. It was a weight off though when I decided to express when convenient rather the every 2 hrs. At 4wks old I fed ds in public today for the first time cos I was too ashamed. Think we need to think about the bigger picture ff is still good and we can help our babies health and development in other ways. Other people enjoy the experience of feeding as well. We are good mums r worrying and trying.
Now if I cud just make myself accept that. . .

OP I really feel for you. I had similar issues with ds1. He simply would not latch on. I was expressing but it was killing me and my supply was dwindling.

I did manage to bf him but only because I got some brilliant support. Have you got access (in person) to a decent bfing counsellor? That was the turning point for me.

Have you heard of exaggerated attachment? Have a look at this link

I am actually a trained bfing peer supporter and could explain this more via pm if you want me to?

While I'm giving you this information I also want to say please don't feel pressured into continuing if you don't want to. You have tried really hard and you also have a 4 yo to consider - you can absolutely give yourself permission to stop.

Hi everyone. It's been really good to read your comments on this subject. I'm in a similar situation to you Catherine and LotsofCheese and I sympathise with you. I've been trying to get mine to bf but he was a small (and lazy) baby when he was born and the hospital insisted on giving him a bottle in order for him to gain weight (as he didn't latch on properly at the breast). Since then, I've tried loads of different things to make him bf (shields, the medela device with the tubes - very fiddly!, different slow flow "nipple shaped teats"(yeah right!) for the bottle but no luck. So he's had a mixture of ebm and formula.

I feel just like you - there is part of me that has had enough of using the pump to express and wants to change just to formula, but as you say Catherine, as long as there is even a little bit of milk, I always see a ray of light.

He will latch on but seems mostly to swallow air which gives him bellyache and he'll just doze off even with stimulation. I don't know how to make him change sucking action. He's sooo lazy that he sometimes even falls asleep at his beloved little bottle!!!

Does anyone have any ideas? I'm fed up with expressing as well!

lotsofcheese, first of all a huge well done on the support you're giving your daughter.

Can I second the suggestions above to get some good, skilled real life help to help you feed your daughter? It's very common for babies who are considered mildly preterm to have early feeding problems - and all too common for their mothers to get minimal support in understanding how to help their babies to feed.

I would suggest having someone knowledgeable assess whether she might have a tongue tie as this can affect a small baby's ability to latch - ideally a lactation consultant or NCT/BfN/La Leche League breastfeeding counsellor who understands tongue tie.

Ditto re someone who can help you work with shields - these are often more effective if you are feeding in a 'laid-back' position - a little baby can feed more securely and is less likely to dislodge the shield. I'd also suggest using the smallest size of shield you find comfortable - eg Medela 20mm as some brands (eg Avent) are just too big for little babies' mouths.

If you'd like to continue expressing, if you're not already using a hospital grade double pump such as the Ameda Elite or Medela Symphony, you could consider hiring one. ExpressYourselfMums, Pumps4Mums and NCT can put you in touch with a local agent.

If you PM me I may be able to make some more specific suggestions about help.

Best wishes