An update to my breastfeeding woes - opinions on the 'plan' please

[mangofizz]

I posted a couple of weeks ago about the struggles I am having with my hardly weight gaining, non pooing newborn. Since then we have been bumbling along, another small gain of 80g last week, still 75g to get back to birth weight. As we are so close now it seems like everyone has taken the pressure off and the fact he isn't back to birth weight duffel doesn't seem to be an issue anymore. It's still an issue for me though as it means something is wrong somewhere, and being told 'just keep doing what you are doing' isn't cutting it for me.

I asked the infant feeding coordinator to refer me back to the lactation team. I spoke to someone yesterday and she thinks I may have a supply problem. (I'm surprised by this as I thought it was very rare) I think she is going down this road on the basis of:
Breasts never ever feel full, even first thing in the morning
No increase in cup size from pre pregnancy to now
Constant feeding that turns into frustrated chewing
Slow weight gain

She has recommended that until tues we do an alternate feeding plan where I do every other feed as formula in order to get baby gaining properly and I assume to give my boobs a chance to actually produce some milk in between feeds. I'm also going to be using a double pump from the hospital to see if that helps. I'm speaking to them again on tues with a view to increasing to 2 breastfeeds then one formula etc until we get back to exclusive feeding.

Has anyone heard of this approach before? Have I got the right end of the stick about what it's trying to achieve? It goes against everything I have learned about feeding before although if I'm right about the logic behind it it sounds sensible. Am interested to know what people think!

My logic has been as long as I know she is still taking the formula having more from me is only going to help. However if by having extra feeds she was too tired to take top up I probably wouldn't do it or limit the amount of time for it. Can't really see how an extra feed would hurt though.

mango, yes, I am going to agree with you - it makes no sense to withhold the breast for comfort!

Am losing the will to live with it all now, had absolute nightmare night, only slept for 2 hours 5-7, the rest of the time he was on and off the boob, crying,not taking the formula either. He's been much the same today. I was coming to terms with giving up and just FF as its really not working but I just cant because breast is really what he wants but he's either not getting what he needs as it isnt there or transfer is ineffective

Why cant we just get it right?!! I dont want to stop, neither does he but it isnt working for either of us. I just dont know what to do! What else can I try? The latch looks good to me, doesnt hurt (unless he's been on continuously for 18 hours which is where we are at now) but its just not enough, I cant see whats wrong!

Mangofizz, have you read about cluster feeding? What you describe from last night sounds almost exactly like a phase my DD went through, I think at about 4-6 weeks old. It was hideous, she literally fed every 45 minutes, for 20 minutes at a time, over and over and over. I read about cluster feeding (I think on kellymom) and it described it perfectly. She wasn't feeding to feed, she was feeding to prepare me for more feeding, IYSWIM. It's a natural way of a baby stimulating your supply, it doesn't mean that they are not getting what they need, it means they are ordering in more for when they need it. Once I accepted that, I could deal with it better and it didn't last long.
I'm bemused by the advice you've been given by the lactation consultant I have to say. The best way to increase supply is to spend as much time skin to skin as you can, and to feed as much as you can. Have you been able to spend any days in bed with your baby?

Lizzie my baby is 5 weeks old now, I've been living through cluster feeding etc. Its a problem, not cluster feeding or anything else normal unfortunately.

The lactation consultant has advised this course of action because at 4 weeks he still wasnt back to birthweight, having lost 10%, it isnt a knee jerk 'Ihavent got enough milk must top up with formula'

My Dh has only been back at work for a week, I spend all of my time feeding, worrying about feeding and entertaining a steady stream of healthcare professionals, all of whom have a different opinion and a set of scales in tow!

Just want to make it clear that it isnt day 5 issues we are having, we are far down the line with whatever is wrong and me asking for help from various avenues from what is available in our area (which seems pretty spot on to be fair, I dont feel neglected, I just havent managed to sort it out yet!)

I know you've been through it thoroughly, I read your last thread as well, but the advice still seems completely counter-intuitive to me if the plan is to increase your supply. I hope you manage a better night tonight, it seems endless at the time but it does get better, I promise.

I didnt mean to be short sorry, im just at the end of my tether and I dont even feel like its a decision between giving up or not now, seems I've done a good job of 'establishing' feeding even if its totally ineffective as he wont do without it! Waaah!

Mango I feel your pain - I am the world's most defensive breastfeeder because I have actual low supply and I know that most women who claim low supply don't have it.

I feel for you so much with attempting to top up and still struggling - we are currently contemplating top ups and I'm terrified of ending up in a similar situation. No real advice, just pom-poms from the sidelines

Aww please don't stress! Have you got the time and opportunity to spend all day in bed with baby tomorrow, naked (apart from a nappy for baby of course!) and just lay together feeding and cuddling? Get those hormones working for you! Get someone to bring you anything you need and only break for the loo. If you give yourself permission to do this, you might worry less, and things might just... happen? Right now may possibly be a growth spurt which would explain your baby's current appetite?

Aw don't apologise, sleepless nightmare such a killer. You honestly sound like you are doing fine though, I know you don't believe it. He's putting weight on (albeit slowly), he's wetting nappies, he's going a while between feeds. I think you are almost at the point of it getting easier, get through this current phase and I'd be surprised if things don't improve.
Would highly recommend a day or two in bed snuggled up though. Also for you to try and regain the enjoyment of breastfeeding.

Hey that's rubbish he won't take the top ups. I was in similar situation with baby literally taking no break from feeding not even ten mins and there is literally nothing else you can do. And have to say was the same in that didn't seem to just last a few days to increase supply was a permanent state. As well as adding in top ups though my baby has silent reflux and we have added in the medicine for this and although she still struggles a bit lying down isn't constantly demanding food. Could something else be causing him to want to feed constantly? Have you tried different bottles for the top ups? I was lucky in as she isn't very fussy but am using the basic tommee tippee ones. Have you given any top ups before? Initially I started with just a couple a day and if he is gaining weight already you may just need a few? My daughter was only at birth weight at 6 weeks hence why she is on so much now.

Another update, had a really good chat with the LC this morning. Baby has been weighed and has gained just short of a pound in a week so now weighs 10lb 2oz. We talked about how he is feedingin detail , what he's taking formula wise and how often Im needing to top up. We also discussed how the pumping is going.

The upshot is that she thinks its a supply issue and is going to refer me to the GP for a prescription of Domperidone. In the meantime she said I could be exacerbating the problem by being so anxious about it and trying too hard to make it work. She said I need to try and relax about it and try not to spend 24/7 worrying about feeding, feeding or pumping.

So we have changed the plan to: Stop alternate feeding now he has gained a good amount of weight so we have some room to maneuver. Im now going to offer the breast every time, make a real effort to switch feed as soon as he stops swallowing (from explaining the feed in detail we realised that I was only switching him when he started fluttering rather than when he stopped swallowing, inadvertently allowing him to use me as a dummy when I thought he was actively feeding) and offer a top up of formula after every feed, as much as 120mls if needed (I was offering this as a full feed on the formula one)

I feel much better about this course of action, I still feel like im breast feeding him, he is getting the benefit of the breast milk and I dont have to panic about whether the feed is going well as will always offer a top up regardless. She also said to just pump when I can and not to worry too much about what im getting off rather than killing myself to get 6 in a day, she said these plans arent meant to result in you staying at home pumping and feeding 24/7 so relaxing may have more benefit than all of the other things combined.

So but more hopeful today and as sods law would have it the first feed I have done since speaking to her was really good and he's gone out like a light straight away! Interested in your thoughts as always!

All that sounds good, mango.

Glad things sound improved mango, and well done for perservering. Hoping this is the start of things settling down for you and bfing in the long term.

I had a rocky start with feeding my first, he ended up on an NG tube for a bit due to weight loss and dehydration, loads of pumping etc. However, in the long term we got back on track with ebf and I fed him for 18 months. So just wanted to to say that hopefully there is light at the end of the tunnel when this is sorted out for you (if, of course, you decide you want to continue). Wishing you all the best.

Sounds good Mango. This plan sounds much more like the sort of thing DS and I were advised-both boobs every time then top up as needed. I was sent away from the LC and MW thinking that DS would ff with a bit of breast milk- I sort of reconciled myself to this, relaxed and just stopped stressing about feeding my baby ALL of the time. We did so much better after that. Once the sheer pain and grief of it was over and it was just me and him having a cuddle, feeding and watching silly amounts of telly it got much better. He has never been ebf but in the end I am happy with him being mix fed, it was just feeling like the choice was taken away from me, the guilt and, frankly, the disappointment of it all that got to me.
Well Done. Wishing you well- the new plan sounds great

Hiya,

I had a big baby (11lbs6), and was advised to offer formula as a top up after each feed. I fed both breasts each time, then offered a bottle. My mum was staying with me, so she was keeping records of times and amounts. It was obvious that the amount of formula he took increased over the course of the day, and by the 7pm feed he would take 7oz.

So, I stopped breast feeding the 7pm one, and would just give him the bottle.

I did both sides for all the other feeds, and offered a bottle if he still seemed hungry. But we ended up not needing to top up, as he was obviously full. (Other than 7pm).

I still consider that I breast fed my child. And I did this til about 9 months. Breast feeding is wonderful for so many reasons, but there is no shame in formula - and dual feeding like this can be the best of both worlds.

Plus was lovely for other family members to be able to help with the 7pm feed.

And he flourished and continues to do so. Most important that they are full and content.

Enjoy your lovely baby xx

I am mixed feeding too. I doubt I will ever be ebf but my DH said yesterday that he tells people I am bfing because I am. I hadn't thought of it like that. I do both boobs until she starts chewing (ouchy) so about ten mins each side then a top up.