Help!!!! How do I know she is getting milk?

[CarmenH]

I would be really grateful for anyone's help even if my questions seem really stupid!

I am trying to establish breastfeeding for my dd who is 4weeks old but was born at 32+6 weeks and just came home from SCBU on Sunday. When she was in hospital I expressed milk which she was given via a nasogastric feeding tube as well as formula as I couldn't express as much as she needed. Now that we are home we are on a home tube feeding programme where she has attempts at breastfeeing then I top her up according to how long between feeds and how long she has breast fed for. The community nurse saw her feed on Monday and said that it looked fine. I feel that most of the time she has a good latch (looks like descriptions I have read and pics I've seen) and she can suck really vigourously causing the shape of my nipples to change as if she has managed to draw it up to the roof of her mouth.

My worry is that despite everything that I have said I'm unconvinced that she is actualy managing to get any milk out. I had thought that if she was feeding successfully then her mouth would look milky and milk would clearly be coming from my nipples once she has stopped feeding or I break her suck but this isn't happening. She also looks hungry despite sucking for 20 min this evening.

Sorry if post a bit long but wanted to get all the info in.
Any ideas or advice would be welcomed! Thankyou.

Agree with Moondog that you are doing great. Have you seen anything on MN about spending the night and day in bed with babe just feeding? I know it has a name but my brain is failing! may be worth doing but you need to look after your nipples too - are you using anything on them? Again loads of tips on other threads...

Absolutely. Not having lost any is fab :)

Caremen, my nipples are white in the middle and dark at the edges when DD comes off. If yours are getting sore, make sure you get your DD latched on properly each time no matter how long it takes. I know there is a temptation to think "she's on and feeding, I'll leave her to it" - I know I've done it and ended up sore. It takes much longer for them to heal than it does to wreck them in the first place so take care :)

Hi there. Not an expert but two-tone nips sound like thrush to me. If your nipples are particularly sore, especially when in the shower and drying off, could definitely be thrush. Ask your HV to sort you out with some flucanazole (or summat like that - check Breastfeeding Network website) and some cream for your baby's mouth. If it is thrush the baby may not display any symptoms, but you both need to be treated so that you don't go on passing it from mother to babe & vice versa.

Carmen. Breastfeeding is possibly the hardest thing a woman can do with her body (on a par with the actual birth, IMHO). As an earlier poster has said, trust in your body. If your baby produces 5-6 wet nappies a day, and is lively, s/he is doing fine. I hated it for the first 10 weeks, but am still doing it 4 months later and rather enjoying the closeness and ease of it. Stick it out if you can; if you have a supportive helper, try to get your feet up and chill with your baby as much as possible.

All the best :)

Thanks for all the positive comments. Will let you know how it goes at the big weigh in on Monday.

Don't focus on Monday and weigh in.
Focus on now and enjoying your baby,resting with her,lots of skin to skin,cuddles and feeding.
The babymoon.

Hi Carmen

Does your nipple look like the tip of a brand new lipstick when your DD has been feeding? Mine were like that in the early days and I too got really sore and cracked nipples. I went to a Le Leche BF councellor who sorted out my latch and told me that my nipples should be the samew shape b4 and after a feed.

The centres of my nipples are sometimes white as wellbut if u squeeze it it's just milk and then goes back to normal (I don't squeeze them now but did out of curiousity once!)

My DD used to do the same thing in the evenings, feed then fall asleep with nipple in her mouth, if I moved her or put her down she'd start rooting againg and sucking her fists. I started to try lots of this to keep her awake so she'd get a good feed but then she got bigger and better at bf and sorted itself out on its own

HTH

Lucy

Hi Carmen

Does your nipple look like the tip of a brand new lipstick when your DD has been feeding? Mine were like that in the early days and I too got really sore and cracked nipples. I went to a Le Leche BF councellor who sorted out my latch and told me that my nipples should be the samew shape b4 and after a feed.

The centres of my nipples are sometimes white as wellbut if u squeeze it it's just milk and then goes back to normal (I don't squeeze them now but did out of curiousity once!)

My DD used to do the same thing in the evenings, feed then fall asleep with nipple in her mouth, if I moved her or put her down she'd start rooting againg and sucking her fists. I started to try lots of this to keep her awake so she'd get a good feed but then she got bigger and better at bf and sorted itself out on its own

HTH

Lucy

Yes Lucy, that's a good description for my nipple shape after feeding. Didn't realise that they weren't meant to be like that!

Last night and this morning she wanted to feed almost continuously. Would suck vigourously for 10-15 min then go sleepy and just lie there but if I tried to get her to lie in her moses basket or be removed from my breast would wake up and look ravenous again. Has just been very sleepy this afternoon and evening. Do worry about her sooo much. She just looks so thin and scrappy. Really don't think that she has put on any weight but will find out for def tomorrow.

I know it's hard Carmen but do try to stop worrying so much. I can relate to this though as dd1 was only 5 and a half pounds even at full term and as you say was really thin and scrappy - she looked like a spatchcock chicken!! She did fine though she was never podgy like many babies you see so try not to compare.

Hi Carmen

What time is weigh in?

The BF councellor said that my nipple was shaped this way because my DD wasn't taking it far enough back into her mouth - it was getting squeezed on her hard palate and it should be going back passed that onto her soft palate. To resolve this I had to really make sure she had a good wide open mouth before swiftly latching her on, thank goodness it seemed to work.

Regarding her feeding/sleeping then trying to move her, my DD still sometimes does this at night. Have you tried waking her up more on the breast by moving her arms/blowing on her face/coughing etc? I found this helped a bit to wake her up then she would feed for a bit more. However mostly what happened is that I'd take her off then lay her in her bed and sing to her with my hand on her chest and then she would go to sleep.

Hope the weigh in goes well

Lucy
DD 17 + 2 wks old

p.s meant to add that when my DD really used to stay on my boob practically from 7-10pm she was feeding/napping/feeding/napping etc and a lot of people told me this was cluster feeding. Very common in young babies apparently.

Thanks Lucy, dd did another run of that feeding/napping at the breast this morning sounds just like your baby cluster feeding.

Has still not gained any weight, only 1.98kg so have agreed to try to give her low-birth weight formula twice a day for a week and see what her weight is like after that. Hope this will only need to be very short term and then can get back to breastmilk alone. Will express whilst dp gives formula top try to keep up my supply. Just want her to grow!

That sounds to me like pretty good advice from your carers, Carmen. It can be a difficult tightrope to walk - she is, after all, not yet of a weight and age which allows the usual advice of 'just feed on cue and the baby will get what she needs' to apply without compromise.

Getting her weight up might well mean she can breastfeed more effectively.

Hang on in there :)

Hi Carmen

You're doing a great job with the BF, soon it'll all fall into place and these early weeks of worry will be a distant memory.

I don't feel qualified to give advice really, I just try to offer my own experiences and if it helps someone else then great! Tiktot would probable know more about this, at my local BF support group today there was a girl who is a midwife and she has a DD who is 5 wks old and is BF, only she has lost weight for the past 2 wks and is now back down to the weight she dropped to after birth so she is now doing "piggy back" feeding where she puts her DD on her boob but there's a small tube going from a bottle of formula into the corner of her mouth at the same time. Apparently this is to keep her supply going but letting her DD get a good feed at the same time? It's supposed to be a temporary measure.

Best of luck Carmen, you're doing a great job.

Lucy

Not heard of piggy back feeding before. It sounds as if i would need another pair of hands to manage to coordinate it although maybe that is just clumsy me!

Thanks again for everyone's help and support. Will keep you posted on how it goes. xx

Carmen, Lucy's talking about a system called a 'nursing supplementer' and there is a brand name, Lact-Aid...probably searchable on the web.

It's more widely used in the US than here, and while fiddly and complicated, it can be helpful in some circumstances.

Just wanted to let you all know that dd has gained 8oz in the past week! She is now 4ibs 12oz and I'm so pleased . We are going to continue giving her a little lowbirthweight formula each day as well as her breastfeeds.

Thankyou for all of your advice and support. xx

Brilliant news. Well done you and keep up the good work.

Fabulous news :)

I was/am CarmenH but name changed as thought oldname a little bit dull compared with the exciting names you ladies have .

Sorry to be a complete pain/pest but for the past week or so dd has been constantly wanting to feed.

Don't think that it is cluster feeding as I mean CONSTANT feeding where if I take my breast away from her for any more than 5min she cries and looks very hungry and agitated. I don't think tat she is just seeking comfort.

Will sleep at night in bed next to me as then I presume she is managing to latch on herself in the night?

Getting totally fed up this evening as simply feel like I can't do it any more, niples are getting to look like prunes just because they are in her mouth constantly, not sore because of latch.

Was really happy yesterday re weight gain but now that excitement has worn off slightly now feel miserable about it again . What can I do?

How you doing today? Has she slowed down a bit? They do have guzzley days every now and again so hope you feel better today.