HV says to introduce a top up of formula but am hesitant..

[loveroflife]

I have ds three weeks old and he is ebf. It has been very, very hard for me as he feeds all the time for hours and hours, no pattern and he also refuses to sleep so I sit on the sofa all day feeding him and in the chair throughout the night feeding.

He honestly sleeps for about 4 hours in 24 hours but has to fall asleep on me first.

HV arrived today and says when DH gets home get him to start giving him 90ml of formula at 9.30ish which would see ds through to 1/2am and allow me to rest.

My mum says to stick with the breast as the formula will become a bit of temptation to use in the day and my supply will adjust accordingly and slow down. I also have very full breast after about 2 hours so if I do let DH do the feed and ds does sleep for 5 hours I will surely need to express in that period as I will be very sore?

Does anyone have any advice, I have come so far feeding as failed to stick with it with ds1 but am utterly exhausted and can't go on with the cluster feeding literally every hour of the day. To give a clearer idea, ds2 feeds for up to 2 hours then has 30mins break and then wants to go back on again. had him weighed today and he is 1lb under his birth weight and his nappies are wet and dirty. Checked for tongue tie and HV says that is all fine. HELP!!

Gosh. Well I'm totally out of my depth, but hate to see a post like this. My first dd did nothing but feed. Turned out to be colic. Awful but suddenly stopped at 4.5mths. If he's not feeding, what's he doing exactly? Screaming? Grumbling? Lethargic?

I'm as worried about you as babes. It's a tremendous toll. There are some on here extremely knowledgeable. You will find excellent support here. Their posts got me through in 2010 so I know they can help support you too. Thinking of you x

Hmm I misread three as thirteen.(how daft am I?!) Our colic started at 10wks so I'm not much help at all. :( sorry.

With my first dd the first month was a massive shock. It did change though week to week from week four as I suppose all her new body functions got used to working and doing their stuff. I also found things improving for me too week to week. It's a slow burn though. I kept a diary. Helped me see the good parts as well as harder ones and find patterns in hindsight even if I couldn't see them at the time. That did help me see how far we had come further down the line.

Walking also helped. Dd slept when on the move. I got the fittest I've ever been. Recommend that!

I think there's supposed to be a growth spurt at three weeks so that might not be helping.

Is he feeding continuously for two hours? Is that all from one breast or does he keep changing sides?
What would happen if you we're to unlatch him after say 30 minutes?

One suggestion would be to try perfect feeding lying down, then at least you could get some rest at night.

My DD did this at the same age, it turned out it was a growth spurt and she was starving. My HV suggested the same thing and although I was very reluctant at first, after 11 hours non stop feeding I just couldn't do it anymore. I have her a top up of about 3oz and she stopped crying for the first time all day. It was a revelation and she was like a completely different baby afterwards. It doesn't mean you have to stop breast feeding but maybe try a couple of ready made cartons for a few days to see how you go?

I also found that pumping when she was asleep helped to increase my supply so that could get around both problems

I feel for you, loveroflife, as I was in a similar position not that long ago. I know it doesn't help right now, but it will get better.

Is it possible to speak to the HV again (maybe a different one?) and explain your worry about topping up with formula affecting your supply? Also it might be worth getting second opinions on tongue tie as it can be missed.

I agree with you that you may well need to express anyway if you skip a feed, and you might want to in order to keep your supply up. So that wouldn't help you rest!

When my ds was 3 weeks old my mum very kindly came to stay for a week - it meant I had another pair of hands so I could get at least some rest here and there. She could also help out with making food etc. Is there someone who could come and do the same for you?

loveroflife, would it help to speak to someone? There are several bf helplines - a proper dialogue with someone can help you see the wood for the trees.

A pound under birthweight at 3 weeks is worth exploring. This is concerning. It can be normal but it is very unusual.

Can you share interim weights to get an idea of overall pattern?

There may be a good reason for the HV to suggest formula, but of course it's not something anyone should do lightly, and it does have drawbacks.

Dd was same. Now she's 4 months and feeds every 3-4 hours ish. I wouldn't have even considered topping up as I know through experience that bf is enough. These times are hard when you feel welded to the sofa with a baby welded to your breast but very short, I promise you! try to stick with the BFing if you are sure you don't want to introduce formula. More bf means more supply.

Well, to start, I'm not sure what crystal ball your HV has got that means she knows your baby will sleep for hours after a formula feed... often they don't. I also wonder why she isn't more supportive in your choice to BF, before suggesting formula top ups. On top of that, I agree with your Mum that giving formula tops ups can interfere with breastfeeding.

Breastfed babies do feed very frequently, especially early on, but if your baby really is actively feeding for 2 hours at a time with only a 30 minute break in between, all the time, then that isn't right and along with still being under birthweight indicates there is a problem that can most likely be fixed.

Is your baby actively feeding and swallowing during the 2 hourly feeds? With one swallow every 1-3 sucks? Do they stop swallowing after a while of being on the breast? What then happens if you swap breasts?

Is there a breastfeeding clinic in your area? (you can ask your HV about this) Or can you see a lactation consultant? (an IBC one!) Does your hospital have a BF advisor you can chat to? I think it would be a good idea to get checked for TT by a specialist too.

It is, of course, up to you whether you want to top up with formula, but if you're reluctant to and your baby seems well, it seems a good idea to get specialist BF advice first.

Hi been there, about 3 weeks ago!
I cracked & DH gave a ff at midnight & I slept tru. A life saver.

Yes when I did wake up I had v engorged boobs.
But just got up & fed right away & it took the pressure off.

Yes it is tempting to ff in the day, but if you are v keen on bf then, just don't!
And keep the ff for the midnight feed so you get a 'double sleep'.

Your baby needs you, so you getting sleep is very important, if doing a few ff gets that, then go right ahead

Mind you, midori's questions are v relevant. Definitely get advice from a proper bf counsellor first.

Just want to encourage you to do whatever feels right for you, be a bit flexible.

I think the important thing is thinking about what you want rather than what the HV advises. It's so hard in those early days when you're sleep deprived and just want someone else to tell you how to solve the problem, but it might be worth asking elsewhere for advice as well. I think it's important to be clear with yourself that topping up with formula doesn't mean the end of breastfeeding and may well be a temporary solution as mummymccar found, or it might be better to focus on increasing supply if that's the actual problem. Equally there could be other issues (eg tongue tie) that can make babies slow to feed, so worth talking to other experts. You do not have to make a decision now or even today if you don't want to - you might like to call someone like your local NCT BF counsellor or the la leche league, or see if there is a local BF support group near you you could go to for a chat today or tomorrow. They should be supportive of your choices, not judgemental. Be as kind to yourself as you can - lots and lots of fluids, rest and good food (cake always helps!). I remember with my second just going to bed for 48 hours with her, and lots to eat and drink and just dozing on and off when she went through a similar phase and it did help. But what works for one person isn't always right for another - try and find a solution that works for you. Good luck!

Are you swapping sides each time he feeds? If so he may not be getting the rich fatty hind milk that satisfies appetite. Try offering the same side each feed changing side severn 4 hours.
Remember at 3 weeks he only has a very tiny stomach so needs to feed little and often.
Does he fall asleep after 10mins? Then wake him up strip him down to his nappy to cool him down so he will stay awake and feed longer. As he grows a little he will take more milk and go longer between feeds. At 3 weeks he is still building up your supply. Every few weeks you will find he does these mammoth cluster feeds. These will match a growth spurt and your supply will have to match these. Nature is incredibly organised when it comes to bf.
have you tried a dummy? Bf babies love comfort suckling he may not be taking any milk just using the breast for comfort. I managed to fool my DS for a while with this method.
just remember it is only a very short period of your life and in a few weeks time you will look back, actually you won't even remember. You will both get the hang of it. Don't rush to establish a routine, go with flow and very quickly you will start to see a pattern emerging. Bf babies will never refuse the breast early on because it is so much more than food.

Severn? I meant every.

A while ago now for me, but ds was just the same, although a little older; 6 weeks. HV advised same. We gave it a lot of thought and decided to give ds a bottle at about 11am. I expressed, which kept my supply going for him for the rest of the time. Tbh, it didn't do anything to his appetite, he just enjoyed his milk . However, it got me off the sofa, gave me more freedom and choice with my day.
It's very hard, in so many ways. Lots of conflict and lots of places to go for advice. In the end, all you can do is make a decision that is good for you and for your baby.

Agree with midori and tiktok you need to speak to a bf expert. Baby should be back to birthweight now. Also is feeding a lot! Are you sure your positioning And attachment is right? Is it painful when you feed?

At 3 weeks my HV said "give that baby a bottle, you'll never feed her yourself" (she was 11'6 by then).

I fed her tll about 13 months. And never saw he HV again!

sounds like it would be worth getting him checked for tongue tie by someone more experienced (lactation consultant or pediatrician perhaps) as some are not easy to spot and HVs are not experts. It sounds like he is not transferring milk efficiently for whatever reason (I would suspect TT) and that is why he needs to spend so long on the breast and is still not gaining enough. I wouldn't try a dummy yet if you have concern for his weight gain. A bottle of formula is not the end of the world if you are desperate to sleep - you need to look after your own health too. Try expressing milk, although that is hard if you have a baby attached to you all the time. Phone the La Leche League helpline and try to get real life BF help from a leader in your area.

I'd get a second opinion on tongue tie and have your latched checked by a breastfeeding specialist.

I formula fed my kids and if I have a bottle at 9:30 it did not guarantee that they'd sleep more.

i agree with the checking for tongue tie, that's what happened with our constantly feeding baby

Willdoit - sorry, what you are suggesting is entirely wrong and might make the OP's situation much, much worse.

The idea that it is better to deliberately not switch sides and to stay on one side for a period of whatever-hours is only every appropriate when the mother has a clear case of over-supply - it reduces volume of milk available and in a mother whose supply might be marginal, reducing feeding on both sides like this could be very risky. To couple that with offering a dummy to make the baby go longer between feeds and you have a recipe for milk dwindling....:( :(

You are not the only person to have misunderstood fore/hindmilk - this blogpost explains thefunnyshapedwoman.blogspot.co.uk/2011/05/foremilk-and-hindmilk-in-quest-of.html

OP - please call a helpline and talk this whole thing through. Not all the posts on this thread are going to help, although all are well-meaning, and you need to be sure you are able to make a decision based on good info.

Heavens, willdoit, I explained all that in a thread we were both on in November last year....:( :(

Get the baby checked for tongue tie by a professional. Find a lactation consultant who is expert on this. They can also assist with feeding positions and talk through feeding patterns.

Quite frankly I wouldn't trust a HV to recognise a tongue tie if it slapped her in the face been there