Advice please - desperate on the verge of giving up

[highlove]

DD (dc1) is 9 days. She was a good weight (8lbs), dropped 7% by day 3, had gone up an oz by day five but as of yesterday had not gained any further. She has so far been EBF but rather than getting easier, BF is getting harder and harder and I'm now pretty scared she will actually have lost again at her next weigh-in on day ten. She is very sleepy (presumably not helped by not enough calories?) and would often go 4+ hours unless I wake her. When she's in the breast her latch is (I'm told) a bit shallow so she's not very efficient and we have in occasion spent 45 minutes on just one boob and she gives up before its fully empty. But it's getting worse - she constantly fusses and when/if I do eventually get her latched she'll nod off and now seems to be struggling to do more than 10-15 mins even with lots of waking up. It's just taken me 40 mins to get her to latch followed by ten minutes of half-hearted sucking. The midwife has given us a two hourly feeding programme complete with expressed top ups but we're struggling with that too - for one thing she just doesn't want to feed that often. And I'm so far not able to express the additional 20-30mls she's supposed to have with each feed.

I'm getting desperate. Things seemed to be going fairly well at the start and not sure why it's all gone wrong. DH and I are rowing as he wants to move to formula. I'm desperate not to but now at my wit's end. I so wanted to EBF for a few months at least but I'm now feeling like a total failure that I probably won't even make tro weeks. Have spent half the night in frustrated tears. Been to a BF cafe and counsellor where they told me how to sort the latch but I/wejust can't seem to make it work. She might latch and suck once or twice then will pull away. I've got big saggy boobs do feeling like I'm physically just not right.

Please - any advice at all?

highlove I'm not a bf expert but I didn't want to leave you without a reply because I was you 11 weeks ago.
I could have written this about struggling with my Ds. The thing that helped me was a friend who told me to see a breast feeding specialist at the children's centre or visit a breast feeding group. I did the first one and a wonderful woman sat with us in private for an hour and made sure we were happy with our latch, I've got massive boobs and felt I was not good enough or failing Ds because of it. Chuck in the added pressure of knowing he was getting weighed the following week and the sleepless nights and the constant feeding ( which by the way I found out is normal for a new baby!) and I was a wreck. That woman really helped, if it weren't for her I wouldn't be feeding right at this second.
So there is hope, you're doing an amazing job and well done for persevering! If you can get to a la leche groups or google them or find a bf specialist then I recommend them highly.
Good luck, you're not alone.

Perhaps also have her checked for tongue tie, we asked about it and were fobbed off so we asked again with a different dr and found Ds was tongue tie but by then he was feeding well and now it doesn't affect his feed. But it used to take him half an hour to latch on, it was frustrating and exhausting.

You could express and feed her ebm for a couple of feeds a day, so that you can feel more confident about her intake? That way you can go back to offering from the breast once you are happy she is getting enough, and feel more confident?

It does take a while to settle in - and can be desperately hard to start with.

Basic stuff, has she been checked for tongue tie, thrush? Some women with v large breasts have to express a little before the feed, to enable a better latch? (Is this what they mean by 'shallow latch?)

If you are on the verge of giving up, why not offer an evening formula feed (get dh to do it) and you can express (or get an early night, and then express when you might have more milk). Do keep pumping to try and build your supply if you are going to do this. That way your options are open.

Tinies often fall asleep at the breast. It's common to have to wake them up several times during a feed - there are all sorts of methods - stripping off, flannels, blowing - it's a very common thing.

Most of all congratulations on the birth of your dd! It's so normal to be overwhelmed at this point - do try and carry on, but most of all, as long as you keep pumping, even a few bottles whilst you get your confidence together is fine. It's better if you don't, but ultimately, there is no 'failure'. There really isn't.

Dd1 fed like a dream. Ds1 was a slow starter, and then fed every two hours for ten months. Dd2 couldn't bf. (I expressed for 6 weeks then went onto formula)

In two years, no one will know or care how you fed her when she was a newborn. Don't put additional pressure on yourself xxxx

I think you are doing brilliantly. The first few weeks feel like you sit and feed All The Time. Just relax. It's supposed to be like that - you are both learning. X

I'm not an expert but just wanted to add some middle of the night encouragement. Hopefully you will get others with advices about latching etc. I wanted to second advice to get tongue tie checked, see if there is a recommended 'expert' in your area, I had to travel 30 mins to see someone really good who diagnosed DS2 who also had a ' bubble palate' after we found that out it made a huge difference to latching him on. I also waned to say that I think establishing breastfeeding is harder when you are stressed and your DP needs to support you not row with you, are you getting some rest, eating enough, drinking enough, sitting comfortably etc before you start trying to latch the baby on? Good luck. Xx

Personally I wouldn't let the stress of unsuccessful breastfeeding ruin the first few weeks with your lovely baby. Easy to say, as mine bf well, but I would switch to formula. She'll put on weight and I bet you'll be more relaxed.

I had a similar problem with my DD. She list too much weight and was taking a long time to feed. We ended up needing to do top ups (I ended up doing formulas top ups as I couldn't express enough). Ultimately what helped me were nipple shields -suggested by my midwife. She found it easier to latch on and for us there was no looking back. We stopped using them at three months when she finally got the hang of latching on directly to my breast. It may not work for you, but could be worth a try. Good luck! You have my sympathy - I remember the worry all too vividly and it's over five months ago now.

Congratulations on your little one!

I could have written this 6 months ago. I too have massive boobs and found BF horrendously difficult to start with.

I was lucky to have great support locally. What got us through was expressing every 2-3 hours and using a feeding tube strapped to a finger (largest finger to get baby used to having a full mouth). Once DD was getting the hang of that, I'd offer the breast halfway through a bottle, but not get stressed if she wouldn't take it.

A lot of the time i was ready to give up. Do persevere if you can bear it, I am so so glad we did. One day at around 3 weeks she just "got it" and we have not looked back. Yes. It was hard work and nobody tells you that. I think her mouth had got bigger and it was easier for her to take in what she needed.

I went to a number of BF support groups which were great.

I do second what pp have said and get checked out for tongue tie to eliminate that first.

I know this is hard, but you are doing a great thing. Hang on in there, it gets better. And truly, if you hit a wall, give yourself a break. Top up with formula if you need to. Baby needs you. You need to retain your sanity levels. Make sure your needs are met by your OH then all you have to do is concentrate on baby.

Also if you don't have an electric pump, for the love of all that is holy, GET ONE!

For you.

Seconding an electric breast pump if you haven't got one.
The Medela Swing ones are going for £5-20 on eBay and you can get replacement tubes and seals.

Thanks all. Have only managed to get her feeding for about ten mins since I posted as she's so sleepy. The more we're struggling the more sleepy she's getting so I'm really worried.

I'm off to another BF drop-in this morning so will see how that goes. Haven't really made much progress at those I've been to so far but will keep at it. I will ask about nipple shields too - my nipples are big so I wonder if she's just struggling to take in all she needs to. By 'shallow latch' they were saying she's basically only taking in nipple and nothing else.

On the plus side I've managed to express 50mls off this morning. Am a bit wary of putting it in a bottle and causing further confusion for her, but we've tried pipettes and cup feeding and neither have been a massive success. Any thoughts?

Thanks so much for all your advice.

I have been where you are. Ds2 now 7wo & feeding improving but patchy. After staying at birth weight with minuscule weight gain for 6 weeks dropping from 91st to 25th centile, he gained 17oz in 10 days!

There is a tendency to lose faith and get too hung up on average growth charts. HCPs round here very supportive of bf and said that providing ds not losing weight we would watch & wait. I'd only supplement if losing weight.

He has mild posterior tongue tie & upper lip tie.

It's important to remember that rapid weight gain is not the be all and end all. It can take done time to adjust to the right centile, which can take a few weeks. The other benefits of bf far out weigh the weight gain you can get from ff.

If I weren't so bloody minded I'd have given up by now. I bf ds1 for 20months when he self weaned so I know that bf is worth it. I would feel so sad not to bf. It's amazing that you can sustain a tiny human life by yourself for 9 months in utero and 6 months of life.

If you want to keep going keep having confidence. Look up breast compressions on Kelly mom & dr jack Newman site. Very good for getting sleepy baby to feed.

Wet cotton wool brushed on the ear or temple, tickle feet, strip off and nappy change, switch sides, all help with sleepy baby. It's hard having to focus so much on getting food into dc. The more you get out the more milk you make. It will get easier.

I ended up giving a bottle rather than cup or syringe. It's good to get a baby used to bottle anyway as otherwise they might turn into bottle refuser. Just keep offering breast as well. I refuse to give bottle, dh or my mum do that. I'm the boob lady! I know there's fancy bf systems sns or suchlike. Could be worth looking at?

Get support and keep talking to other bf mums. What's happening to you now is so common. Few more weeks of doubt and tears, do what you can but if you have confidence in yourself you can do this.

highlove, sorry you are feeling so down about this :(

I am not sure what the issue is. She lost 7 pr cent (well within normal range) and had gained 2 oz between day 3 and day 5....why was she weighed again? Why is she being weighed again tomorrow? There's nothing especially 'wrong' with weighing this often, but making clinical decisions on the basis of it is questionable.

I am not sure why it's thought there is something wrong. 10-15 min long feeds are within normal for a baby of this age. Her sleepiness is worth exploring, I agree, and going too long between feeds need addressing, but maybe keeping her skin to skin and close to you as much as possible would increase her willingness to feed - and of course it's easier for you to respond quickly.

A two-hourly programme plus expressed breastmilk top ups of 20-30 mls each time is an impossible regime for mothers to follow....really it is. You can't have time to express in that window, and you're being asked to do this 12 times. That means getting a total of between 240mls and 360 mls by expressing. You can't do it! I don't know what the midwife is thinking, I really don't!

Breasts don't need to be emptied - keeping on and on and on until you think the breast is empty is not a help. Taking 40 mins to latch on indicates to me the baby did not want a feed at that time.

Can you seek a second opinion? What are your baby's poos like? Do they indicate she is getting enough? If not, then explore ways of ensuring she feeds more often that are responsive to her, rather than the clock.

It doesn't sound to me that you are getting the right sort of sensitive, informed help with this.

It should be fine to give her top ups in a bottle,BTW.

Pipettes and syringes ans cups are a nuisance, and a baby who's getting plenty of direct practice at the breast is not likely to become unable to bf.

But as I say.....get a second opinion about whether you need to do anything at all, except feed responsively and often.

Also confused, if only weighed on day 5 as is common protocol, she would have been recorded as losing a little over 6% on day 5, a cause for celebration rather than concern in the breastfed baby in my experience! See how the weight goes today but be aware of the limitations of weighing this frequently with different scales, surfaces etc.

I could have written your post when DD was 4 days old. 6 weeks later and I am now expressing and giving all feeds in a bottle. I know I made the right decision for me, but I still have days when I feel really sad about giving up on breastfeeding. My advice to you is don't give up until you have tried all of the support options available to you as I wish I had tried a little bit harder. Saying that I don't find expressing a choice, and DD is still getting breast milk and thriving so it's not all bad. My DH really wanted to move to formula in the early days too. Whatever you decide do not think you have failed, you need to be happy.

The weighing is a mystery - normally, protocol would be to weigh on day five and if all is well (and it was), not to weigh again for at least 5-7 days or whenever is opportune. The reason is that frequent weighing is not always accurate and not clinically informative anyway. Of course babies need to be showing they are fine and thriving - and if not, then you might have them weighed more often. That's why I asked if there is a reason why this baby was weighed again....maybe there are some concerns not outlined in the OP's post.

Try not to worry about a weight loss that hasn't happened yet. Take one feed at a time- it sounds like you're doing really well. When my DS was born he lost 5% by day 5 but then continued to lose ie he didn't "turn the corner" and start gaining by day 10. How are your babies nappies? DS was feeding constantly but started getting orange crystals in his nappy and greeny poos (back from yellowy). These were definate signs that he wasn't getting enough milk and we had to top him up- it turned out it was probably his Tt as feeding got much better after it was snipped. DS is now mix fed and, although I never intended for him to have any formula, it isn't the end of the world-he needed to gain weight- but you aren't there yet.
Try LLL maybe and wait until Dd is weighed. You're doing a great job -the first couple of weeks are really hard.

Thanks again all. No there aren't any other concerns as far as I know - she was a good weight, born vaginally at 40+1, I'm healthy etc. I just assumed this weighing protocol was normal. In fact, because she was born just before midnight, she was only really 2.5 days at first weigh-in, then 4.5 at second, etc. the additional weigh-in tomorrow is because she'd not gained yesterday.

Nappies etc seem fine - plenty of wet and dirty nappies and poo is nice and yellow and seedy. So although I'm in pain and slightly dreading feeds ATM, I guess she's getting something.

Feeling reassured now so a huge thank you. Got a bit scared and stressed by m/w yesterday which probably contributed to awful feeds yesterday and last night. Not exactly helpful if they frighten you!

Different areas have different protocols though I have not heard of anywhere that repeats weighing so soon, after a normal gain on day 5.

Do discuss the impossibility of the midwife's advice to feed according to the clock and also fit in an expressing session with a yield of 20-30 mls in that time...plus the time needed to feed your baby the expressed breastmilk.

Yes, maybe your baby needs/needed more opportunities to feed, but really and truly....sounds like an over-reaction to me, and not an especially effective one :(

highlove it can be so hard at first when both you and LO are learning to bf. I had DD who couldn't bf effectively til six weeks, no sleep and constant crying, then DS who was too sleepy to feed just like your DD. I foung tickling his feet and playing with his ear most effective for waking him up, but he often conked out again before he could latch. My issue was complicated by flat nipples, so I was advised to use nipple shields which helped us get started. Althoug DS was still extremely sleepy, I could tell he was getting something when he did wake up. I was able to wean him off them around three weeks.

The only thing I wondered, and it is a long shot, but is your DD's skin becoming more yellow? It turned out one of the reasons DS was so sleepy is that he had late onset jaundice. He was fine when he came home from hospital at five days old but by three weeks his bilirubin levels were up to 280. I knew he was still a bit yellow but thought it would resolve itself til my Dad visited and wanted to take him to A&E. An over reaction, but the paediatrician did want to start him on phototherapy. Luckily with persistence on the two hourly feeds and what seemed like constant feeding all night, it had gone by around 6 weeks.

I also had saggy boobs all the time, haven't even started feeling engorged until now at 11 weeks though DS weight gain has been good. I got a bit obsessed about feeling like my breasts were empty but your breasts not feeling full doesn't necessarily mean there isn't milk in there, especially if LO is feeding very often, even in small amounts.

Oh I just wrote a very long post and deleted it now DS has finished feeding...

Gist:

Re: how to give top ups - Don't faff about with cup and syringe. Get a bottle. Or if you really don't want to swaddle arms to stop flailing and minimise spillage. I can't believe I messed about with syringes for so long. We didn't have any nipple confusion with a bottle. Sometimes if failing to latch and both getting worked up 1ml calmed him down and we could try again.

Check for jaundice re sleepiness. Do wake up if longer than 4 hours.

Re: latch - Check for tt (and again. And again. Ours was undiagnosed until 8 weeks) go to breasfeeding drop ins, keep trying different ones, someone's advice might just click.

Every two hours + expressing + giving that top up is not sustainable. I did it and I was beyond tired, utterly miserable with about 20 minutes not feeding every 2 hours day and night. You can't be expected to live like that for more than a few days. Why is it necessary if putting on weight and didn't lose much?? Get another opinion. I found 3-4 hourly moving to on demand feeding and 6 top ups a day more manageable and once tt sorted no top ups at all.

Good luck!

I could have written your post word for word last week except LO lost 13% rather than 7%.

To be honest it sounds like your baby is feeding perfectly normally so I wouldn't stress about it.

FWIW expressing using a medela swing and topping up with a bottle had worked really well for us. We feed every three hours with one four hour gap in the night. Baby doesn't have nipple confusion and her latch is getting better each day.

Id say try and relax and keep going, you're doing really well :)

Highlove, just saw your thread and it reminded me so much of my baby's first 2 weeks I have to reply, hope you are still checking in. My Baby lost more than normal weight and was jaundiced and very sleepy. Pediatrician in hospital told me to top her up with formula after each breastfeeding. I did so for 2 days and she regained some weight and was less sleepy so we were sent home. After 48 hours trying exclusive bf again, she became yellow again,very very sleepy and had bright orange flecks in her nappy (apparently sign of dehydration). I didn't hesitate and went straight to buy some formula, I kept up the breastfeeding too and followed the same advice from the dr in hospital. Bf for 15 mins (1 side) then 60ml bottle. Every feed no more than 3 hours apart. Baby was thriving In days. I carried on combi feeding (bf first, then bottle), every single feed , for 4 months, giving me the satisfaction of knowing she was getting breastmilk but also that she was getting enough with her topups. With tommee tippee closer to nature bottles she had no problem switching between the 2. I would highly recommend this method for anyone struggling with exclusive bf. I had 2 prior babies and gave up bf at 4 weeks because of sore nipples and mastitis, this way I was able to carry on for 20 weeks. The way I see it Some breast milk is better than none. Congratulations, enjoy your baby xx