Do I need to just give up BF now?

[IJustWoreMyTrenchcoat]

I am sorry this will come out in a jumble, I am an emotional wreck and starting to think it will be easier to just admit defeat and give in the breastfeeding now .

My baby boy is coming up four weeks and is still an ounce and a half below his birthweight. I am arguing non stop with my partner who thinks there is no problem: baby is gaining - albeit slowly, wet and dirty nappies etc. I think I am not producing enough, I feel wracked with guilt every time I look at my baby and think I am not feeding him.

I just know there is a problem. I am using nipple shields and sometimes there is evidence of milk after a feed, but a lot of the time there isn't. The past two nights baby has suckled and suckled with not much evidence he is actually swallowing or feeding effectively. He doesn't seem frustrated or distressed and is quite happy to stay attached and I realise babies suckle to demand more milk as well as feed but I am worried he rarely seems satisfied after a feed.

He has just had two periods tonight for example of just staying on the breast for over an hour (both sides) but not sleeping after. I had to pick him up and start all over again. Before this he had shorter feeds and 30ml of EBM which also didn't satisfy him. I can't keep up with this, the lack of sleep is killing me. He never settles after night feeds and it is so horrible to think he is hungry.

Very rarely do I get that lovely sleepy 'milk drunk' look off him. The last time was when I had an appointment with the feeding Midwife (he seems to feed well in front of professionals!). For example, the last two nights he has not slept. He has fed and fed, but never settled afterwards. The feeding Midwife said it sounded like it was a growth spurt, but it can't be that as more than 48 hours later and he hasn't settled.

I have contacted and seen an NCT breastfeeding councillor, two breastfeeding peer supporters, the specialist feeding Midwife for my NHS Trust as well as regular contact from Health Visitors. I feel I am being a nuisance, they keep telling me I am doing a good job and to keep going but how can this be true when he is so unsettled and gaining weight so slowly?

He is actually asleep now for the first time all night! I feel this isn't fair on the baby, my partner or me. Should I just give up now?

I'm sure lots of people with proper advice will be along in a bit, but i would say that if you want to continue with BF now isn't the time to give up. Your baby is still very little and likely to want to cluster feed, even if you are producing lots and lots of milk. And a growth spurt can last more than 48 hours (DS used to have 5 day growth spurts - feed constantly for three days, sleep lots for two days, visible growth by day 6).

A few ideas before 'giving up' :- Buy a pump. Try to express. Try feeding DS with the expressed milk in a cup / bottle. Mix feed by trying one feed of a couple of ounces of formula once a day. Look at your diet / hydration. Feel your boobs (gently) before and after a feed to see the difference. There is also the option of getting very exact baby scales - weighing baby before a feed then weighing them straight after, I've heard of that with tinier ones, to reassure you 'something is going in'. Try to rest as much as you can (!) too.

Sorry, my post sounded quite hard, it wasn't meant to be!

I know the lack of sleep at this stage is a real killer. My own personal theory is that babies start to smile at six weeks old because (way back when) they needed to do something to endear themselves to their sleep ravaged mothers at this stage so that they didn't get abandoned in the jungle as more trouble than they are worth...

Sorry that you are having a hard time and are so worried by it all. No-one can tell you what you should do, you really have to listen to your own gut instinct but the fact that you have seen so many breastfeeding support people and they are happy with his progress would suggest that you could keep going with the bf as he is continuing to gain weight and producing wet and dirty nappies.
It might be helpful to separate out a few things as it sounds like the lack of sleep/unsettled factor is a big part of the problem for you, not just worry about whether he is gaining quickly enough. Again, I would say that if all the health professionals you have consulted are reassuring you, then you should be able to relax a little on that score and wait a bit longer and see if you become more confident that he is growing well. (My nephew was the same, started out slow but took off like a rocket after c. 8 weeks!)
My 1st daughter was as you describe in your 3rd paragraph. In general she just LOVED breastfeeding and needed to suckle a lot for the 1st 4-6 weeks. And she would get more needy from 5pm-1am and want to be on the boob a lot even though I felt there might not have been much milk left at this time of the day. A few things helped for me, although it took time for me to work it out ; ) : going with the flow and not over-analysing it all the time: realising that this constant feeding/unsettled style in the evenings was quite common, and would pass with some time and maturity. Also mastering the art of feeding lying down was a great help. I would swaddle baby and then scoot them in to the breast on their sides with one of my arms raised around my head and down towards their back and the other coming across my hip to nestle their bottom half in to me. She would feed on and off on her side and at least I could rest and snooze at the same time.

When she was very unsettled in the evenings I used a fabric jersey 'wrap' sling and swaddled her up tight in it (tighter than you think you need to ; )) and sent her out with her dad to pound the streets for a 40-45 minute break while I took some time out for a shower or a bath or a snooze. The sling was great for all my babies as I could carry them around the house if they were unsettled and they would be much happier for being on me and they would invariably nod off with the movement. I would really recommend using one.

My daughter rarely settled before 1am but after about 8 weeks this began to improve and again at 12 weeks. There are all these little stages where their feeding and sleeping patterns shift and change but it usually gets easier (except for those who have very sleepy babies for the early weeks who become more wakeful as they mature - that can be a shock!).

And whenever he sleeps, you sleep too! leave the laundry, the internet and all the other little chores and just sleep. When you sleep and eat as well as you can, then everything else seems more manageable. You have to look after yourself. And your husbands job is to feed you and encourage you and take the baby for walks/fresh air/sling time around the house while you rest.

Good luck.

Oh yes, and growth spurts can last longer than 48hrs - 3 days was the average for all my 3 . And they go through them all the time as well. Cluster feeding is exactly what your little one is doing, and he is doing his job well. (For my 3rd I had to wake her a lot to feed her as she was a really sleepy baby.)

Hi IJust,
I noticed you said you were using nipple shields. Is there a possibility you can try BFing without them? You don't mention why you're using them so not sure if it is an option. Nipple shields can affect milk transfer and also your supply.

I tried using them when my nipples were ravaged due to DS's tongue tie and found that DS had to suck 6 times before he swallowed with the shields, whereas without them it was 2 or 3 sucks to a swallow so he was getting much more milk.
Could this be an option?

What Robba said.
Unfortunately some babies feed more efficiently than others. My DDs both took ages to feed and very frequently. Remember it's a partnership and not 'all your fault' if he takes ages to feed.
If the MWs are all happy with his progress then believe them. Good luck

My gut instict is telling me he is hungry, it feels awful .

I do have a pump but am struggling to find the time and inclination to use it. I have been advised to 'drain' the breast he has fed off after every feed, or if he is cluster feeding to pump every 3 hours at least. I am only managing to pump once a day, or twice max and am only getting enough for one 30ml top up. After I have fed baby I try to pump but have to to because he is unhappy and wants to feed again. (have managed on a couple of occasions to do both at once).

I do have a sling - a close caboo, I think he would love it as he is needy and loves being held, but I have ignored it so far until I feel a bit more energetic.

I would love to feed lying down and have attempted this, but it feels a bit dangerous to me with a shield. I wouldn't want to risk falling asleep in case it came off and covered his nose and mouth.

Well if you are still unhappy about it but do want to continue bfing 'in theory' then do you think you should maybe consider trying to change a few things? Try without the shields, as AuntieJu said and perhaps try out the sling? It doesn't take much energy really, it's the same as carrying him around except it's hands free. Unless you are recovering from a cs or a difficult labour would it be worth giving this a go now, even just around the house? That is how I used it, and left my husband to do the longer walks out and about with dd in the sling. Also re the lying down feeding, if you try a few times without the shields, you may find it more restful for you at times that you really need to just close your eyes.

Lastly, bfing is wonderful, but very often it is hard work at the beginning and this comes as a bit of a shock to new mums. I don't know whether this is your 1st child or not, or whether you had any previous experience of others bfing but although it is so great in so many ways, it is tiring for the mother. This settles down with time but it can be a bit overwhelming at the beginning I remember as I had sore nipples for the 1st few weeks and very engorged boobs for the 1st 4 months . I would have found bottle feeding a pita and so even though I had some struggles bfing my 1st (but all fine with my 2nd and 3rd), yes I was tired and drained because at this small age you feel they are always 'on' you.

I can't really comment on the pumping thing. I tried and never seemed to get very much out so I would put myself through doing it for very little milk and it just made my sore boobs ever sorer so I never bothered with it much except for when I wanted my husband to start introducing a bottle after 8 weeks. She took to it easily enough but I hated pumping. I wasn't worried about her growth as she was gaining fine, but yes, she did seem to want to feed all the time .

Try some small changes/some of the tips above and see how you go?

Hi AuntieJu the shields were for a combination of reasons - trouble latching and sore nipples (cracked and bleeding). I am worried about them because over time my milk supply may decrease, but more immediately because of poor milk transfer.

This morning he has fed and fed but there is evidence of milk so feel a little better. Sure it must be comfort thing partly as he wants right back on and can hardly be bothered swallowing the milk in his mouth. He is just sleeping.

This is a Problem with him as he is often sleeping at the breast, and I panic as I have read this can be a sign there is not enough milk to keep him interested/the flow is too slow. All the usual stripping/changing etc. have little effect.

I know I must sound pathetic! I mean just figuring out how to use the sling is beyond me at the minute.

I was periodically trying without the shields with a bit of success and a bit of frustration from him. Had stopped for the time being as had been told just to carry on with them ad long as he was feeding.

It's not pathetic at all! BF is indeed wonderful, as Robba said, but it's bloody hard work for both of you figure out what works best for you. And I'm not sure that anyone says just how tough it can be.

Meanwhile, slather on the Lansinoh (and it's not a popular view, but maybe consider a dummy if he really is "feeding" for comfort, to help stop you getting so sore)

Rather than giving up completely, would you feel happier giving a bottle of formula every day? Lots of people do manage to mixfeed, though it can hasten the end of breastfeeding. If you are feeling like stopping anyway, it might be worth a go.

Go back to the nct/bf counsellors etc... and get help with the latch so you don't need the shields anymore as these will be having an impact on supply and your ds's ability to suck. I went EVERY day to a bf group for weeks on end, and when they groups weren't open I called out MCA's to my house. You are not pestering them, its their job!

Just read that back and it sounds a bit bossy!

Agree with the above posters about the use of the sling, it has completely saved my sanity. You could find, as I did that the unsettled behaviour you describe isn't actually due to hunger but is a tired cry - my DD doesn't nap in the day except for in the sling. Similarly at night - if I put her in the Moses basket after a feed she cries and can't get to sleep, however in the bed next to me (often with a further feed lying down) she goes off to sleep.

Has anyone who knows what they are doing checked for tongue tie?

A lot of this rings bells with me. DS1 was tongue tied, but nobody picked up on it.

You need to know that most HCPs are clueless about ties unless they have taken a specialist interest.

does any of this sound familiar?

No mawbroon they haven't! I just keep getting the same old spiel that he can lift his tongue, stick his tongue out so is fine. No mention of posterior tongue tie which is what I have thought having looked at the site you linked to. I live in an out of the way area, no specialist Drs/dentists etc. Nearest lactation consultant is about 70 miles away.

My wifi is playing up but a lot from that site about trouble latching etc. fits so well. I have just tried without the shield and it is the same problem where he opens his mouth but doesn't take a big mouthful of breast, he draws back and chomps on my nipple - painful, and it ends up misshapen. He gets distressed even when I 'shape' the breast for him.

I have just had a blazing row with my partner, he wants to move to formula and thinks we are doing more harm than good persisting with breastfeeding. I feel crap. Baby is being weighed on Tuesday and I see the feedin midwife again that day. That means I will miss the local breastfeeding group that day but I might try to get to another. It is hard to leave the house with him as he is but I think the help would be good.

Hi again IJust,
As I mentioned, my DS had tongue tie, I would really recommend getting it looked at. The NHS failed us and we ended up going privately and having to travel 80 miles to have a consultation and then again to get it cut. It was worth every penny and mile travelled to carry on BF as it was very important to me.

I'm not a BF expert but I believe that general nipple soreness (ie not from tongue tie) usually sorts itself out between 4 and 6 weeks. Bleeding and cracked nipples at this stage suggests there could be a tongue tie. It was 8 weeks before my DS got his cut - really the sooner the better - for your sanity and also because the baby has to relearn how to move their tongue in a completely new way.

Just a thought, have you tried using the exaggerated latch, where you squeeze breast into a hamburger shape so he can get a bigger mouthful?

Also if he is falling asleep breast compressions can help to increase the flow and wake the baby up. Good video on YouTube by Jack Newman.

Yes, the exaggerated latch and the flipple are good techniques to try.

There's a group on facebook called tongue tie babies support group which is worth joining. there are lots of other mothers on there going through the same thing.

There are a couple of dentists in the UK who have been trained by Dr Kotlow (he's the leading expert) and use laser. If I had ds1's baby time again, that's where I would be heading for.

Hello, had another awful night with baby not settling. Phoned some helplines yesterday and although knowledgeable, it was all things I had read about. I have tried to shape the breast for him, and also breast compressions (found the video a bit unclear though about when to start and stop according to when baby is sucking).

The general impression from GP, MIL, partner and my mum (who said it very reluctantly) is that he is hungry . Think I will try to see the health visitor today instead of tomorrow, but I have to start considering formula as this is just so unfair on my boy.

I feel very down about it, I don't want to 'fail' at this and can't see me ever wanting to make up formula or feed him a bottle as I just feel so sad about it at the moment.

Oh lovely it sounds v tough for you right now. My thoughts are either lo is comfort feeding for silent reflux or has a posterior tt. Do your nipples look lipstick shaped after a feed without shields? If so I'd def suspect a tt... hcps can be woeful at spotting them my dd was given the all clear after almost three months in hospital and she had a tt and lip tie. A good hv got me an appt to have her tt cut that week and it was the start of things all coming good for us and two years later i wonder how i'll ever wean her. It sounds like you've invested such a lot in bfing I'd try getting a tt sorted as a last throw of the dice so you can be at peace with whichever path you take.

Hi I just wanted to share my experience with you. My DS couldn't latch at first and we moved on to nipple shields out of desperation in the first week. It took him a very loooooong time to feed, well over an hour each time. I too thought I must not have enough milk, I can't tell you how many times I read Kelly Mom for reassurance. I was going to BF support groups twice a week. At one when he was about 9 weeks there was a BF specialist who said she thought he was tongue tied. We got it cut a week later and life changed dramatically. He would feed in 20 minutes and was then full. I would definitely get it checked.

Couple of other tips, with the shields I tried getting him on at first and when he was relaxed and the nipple fully out, whip the shield away and put him back on.

With the constant feeding, I got so down as I just felt like he was always on me. I then felt guilty for feeling like that! So we tried giving him a bottle of formula before we went to bed at 11 pm, to try and fill him up. I would then express, gave me a break and Dad some snuggle time. Best thing we ever did. Word of warning though I mentioned this at a BF group an they made me feel guilty ,like formula was the devil, I came home and said to DH that I was going to feed him exclusively.This did not go well. 2 days and many tears later we were back to topping him up and everyone was a lot happier.

I really do know how hard it is now but it does get easier as the weeks go by. My DS is 4 months now, it's only in the last month have thing been "easy" with BF. Give yourself time but trust your instincts too. If you think you would enjoy your baby more if you could be sure of how much he is eating then maybe the bottle might be the answer. But don't give up because other people are telling you what they think. Good luck x

Help Needed!!

I have been breast feeding my 5 week old son and the journey has been far from easy. After much thought I want to move on to bottle feeding.
I am just unsure the best way to do this.
Any help would be great