Help! I want to breast feed, but I'm prescribed formula... Feeling torn

[MissEJ]

Hi, sorry for the long message but I'm so lost and upset.
My baby is one week old today. She was born at 37+1 weighing 6lb 10.5oz by c section as when I was contracting, her heart rate dropped.
When she was born she latched on straight away, fed for 90 mins and I thought all was well. After that, her blood sugar was a little low so she was topped up with formula by the nurses for 2 days in hospital. After that we were breast only, til her weigh in at day 5 which showed she had dropped 11.5% weight.
I was told by the paediatrician I must feed every 4 hours from feed start time, not finish time. To start on the boob, try to feed for 30 mins, but if she's not feeding, then basically force bottle feed 60ml of formula. But, the formula fills her up, so I'm waking her to take breast first, she's not hungry, so not latching, then she's given more formula and this sends her back to sleep again. I've bought a hand pump so that my boobs keep milking and I'm giving her the pumped milk. But she's getting really used to bottles and I'm worried she's not latching anymore. I feel so torn, I want to bond and properly breastfeed, but I'm so worried she'll lose weight again... She has gained since the force feeding formula began, but it's not the way I wanted it to be....
Does anyone have any advice?

I was told you can't overfeed when breastfeeding. Mine used to easily feed for 90mins - 2hrs at a time so 8-9.10 would have been quite normal for him. They do need sleep too though so I wouldn't feel guilty. I would say the only reason to interrupt her would be to give a top up of expressed milk or formula, if you are advised this is necessary re weight.

That sounds really good progress OP. As long as you are comfortable, let her feed as much as she wants - this will stimulate your milk production. I know it's exhausting but it's especially good if she feeds at night, as the level of the milk producing hormone prolactin are highest then.

have you tried cup feeding for the top ups? you use those tiny medicine cups and let the baby just lap the milk from them.

You sound like you are doing really well.

You can't overfeed! What a clever babba :) She's following the "oi, don't leave me under a bush or in a cave and go off with the other hunter gatherers. You smell nice, and you seem to like me quite a lot, and I like being snuggled with you and it appears that if I have this nice thing in my mouth that fills my tummy, you can't go anywhere. So I'm staying put."

And now I'm considering popping along to my GP and having the coil out. Off to read my Week 1-4 threads and remind myself it's not all about the snuggles but it is really.

Seriously MissEJ, if you can cope, let her at it. I take it she's your first? If you have any more you don't get to do this again in the same way. Get someone to bring you lunch, put your feet up, embrace Real Housewives of Orange County (or whatever other inexorable shite is on ITV2 this morning) and settle in.

As she grows, she WILL regularise a bit, I promise. This bit feels like it's an age with your first but actually it passes quite quickly. DD1 went to three hourly feeds within a couple of weeks. DD2 took longer but we made it work it's amazing what you can do one-handed while breastfeeding. Try and take her off occasionally, if she properly falls asleep, do pop her down into her basket if you can, perhaps with a t-shirt or muslin that smells of you over the side of it, so that you can have a break. If the washing up/laundry piles up, don't stress or worry. You or your DP will get it sorted in the next few days. Your focus now is to feed yourself and your LO.

Midwife just left, bubs weight is down a bit. They want me to express feed 30 ml every 3 hours, plus 30 min breast feeds. I've not to breast feed for longer in case I tire her out. What do you think?

If she's losing weight I would follow the advice given, especially in relation to top ups. Sorry if you've already thought of this but are you certain she's actually feeding i.e. swallowing? Despite the health visitor observing several feeds it took me 6 weeks to realise that most of the time he was attached he wasn't actually swallowing, just sucking. I only realised this when someone suggested breast compressions which made him swallow. Once I worked out what swallowing looked like, every time he stopped I did whatever was necessary to keep him swallowing eg woke him up a bit, relatched, breast compressions. It made a big difference and he fed much more efficiently after that. Hopefully as she gets a bit bigger and stronger it will all get easier.

Hi there

My son was bottle fed my milk for the first ten days of his life with me trying to breastfeed a few times a day (He was in NICU after birth).

My advice would be to get into bed with your baby and stay there feeding on demand, stripping the baby down to a vest if she gets sleepy when feeding, tickling toes and keeping her awake.

I was getting loads when I expressed but I always knew that expressing is no indication of supply as a baby is so much more efficient at getting milk.

Just BF when she wants to feed, don't express, don't top up with formula and don't see any doctors, health visitors or MWs for at least two weeks! Preferably far far longer.

How much weight has she lost? Had she had a big poo just before the MW arrived and had she had one before the last weigh in?

It's very hard for us to go against an HCP's advice as we don't want to advise something that would be wrong for your baby but if she's feeding well (can you see the little muscle just below her ear going, is she latched well, can you see her swallowing in her neck) and she's well hydrated I wouldn't worry too much.

The problem with the expressed feeding advice (tiktok please come and say what I'm going to say more articulately and sensibly) is that it assumes that breast milk and formula are more similar than they are! Expressed milk first thing in the morning will be much thicker (IMHE) than in the evening so those two 30 ml feeds will be very different!

Where are you OP? Have you found your local NCT breastfeeding person yet?

I used to go to an excellent (private) bf drop-in when DD was tiny and the (very experienced) bf consultants there railed against this endless weighing-as-a-means-of-assessing-wellbeing. They really believed in trusting your instinct as to how baby is doing, as well as looking at things like skin tone, alertness, and pee and poo output. I'm no expert myself, but if you think your DC is doing well then feed on demand from the boob and you'll soon get into a good rhythm with the baby. DD fed every 90 mins or so at this age.

If you have concerns, can you either get to a good bf drop-in or call your local NCT bf person? Midwives sometimes aren't the best at giving tailored bf advice and don't get me started on GPs...

MissEJ, sorry you have had a disappointment about the weight :(

It's really not right that some posters are suggesting you ignore what the HCPs are saying to you - I'm sure you yourself understand that the HCPs who have seen you and your baby have to be acknowledged over and above what a stranger on a talkboard says :)

However, of course you can discuss and question and get a fuller picture of the options.

The advice you have been given makes some sense - you absolutely need to ensure your milk supply is protected, so expressing frequently is a good idea. It's not clear if someone who knows what to look for has observed you feeding, and assessed milk transfer; if they have assessed your little dd's sucking ability and checked for oral anomalies eg tongue tie; if they have assessed 'output' ie is she pooing yellow poo 2-3 times a day or more? All this is very relevant and goes further than just the weight.

The time limit on direct breastfeeds is discussable - 30 mins might be far too long if your dd cries or is fast asleep, or it might not be long enough if she is happy enough on or near the breast. The concern will be that she does not use up energy not feeding very well - but this can only be really assessed if a feed has been observed.

middlings, not sure what you mean about morning milk being thicker than milk expressed later in the day - not heard of this, and wonder if you have misunderstood? Milk 'thickness' ie the amount of fat in the milk does indeed vary, but it varies mostly with the volume of milk in the breast.

tiktok that's why I said in my humble experience. I found that I got fattier milk earlier in the day. It happened with both my daughters, despite my supply being very different.

I completely agree with not ignoring the advice of the HCP.

Elephants, for a baby that is losing weight at a week old, that is dubious, if not dangerous advice.

MissE, can the mw refer you to a breastfeeding specialist? What sort of nappy output are you getting from dd?

Ok, but I was assuming the OP had the sense to see a medic if she was worried.

IME HP are about as much use with BFing advice as a chocolate tea pot. They simply want to get the baby into formula and off their problem list.

Some babies never get the hang of BFing, DD1 didn't, but the hospitals crack handed BFing 'help' and giving her a cup of formula pretty much without asking didn't help.

The OP knows her baby will take formula if necessary. She needs space to see if she can get the baby to BF or to decide to use formula. Lots of conflicting advice causes stress and stress and BFing don't mix.

Believe me I've been there, twice.

Hi, my LO has one or two poos per day, plus 5 or 6 wet nappies'. She's still a bit jaundice but it's reducing.
She either takes the boob like a champ or fusses, windmilling her arms, coming on and off the boob. She'll latch, then stop, come of the boob, go all stiff in the body, then go routing for a boob again. When this happens I find she'll feed for longer if I use a nipple shield.
Regarding the expressing.... This is a task!! I can't get 30ml out my boobs every 3 hours. I get about 10-20ml so I'm having to make up the difference with formula... Which I hate, but, I'm so lead by stupid scales. I'm using the pump more and more, but when do my boobs get a chance to refill? I feel like I'm either feeding bub or attached to a pump!
My brother in law is a paediatrician. He said to look at the longer weight gain trend. Daily won't reflect how's she's doing. I don't feel I'm being given the time to look at long term. Like I'm being bad if she loses daily.
Waw, this is a stressful time, lots of tears before bedtime, my OH has been great and is very supportive, I may have given up before now if he wasn't so good,
She's getting weighed again today and the dread makes me feel sick.
I have the breast feeding clinic tomorrow. When I asked on Tuesday about clinics, the MW said, 'oh, yeah, that might help, there was one this morning, next one is Friday...' It would have been so much more useful if I had a list of support groups/clinics at the start!!! :@/

Oh, she lost 80g in 2 days, but the previous day to that she gained 110g when overheating formula, the loss days reflect the breast only days.

On the refilling point, breasts constantly make milk I was told, so there is no need to wait for them to refill as though they were fleshy bottles.

Having said that, your poor nipples must be fairly sore from all the effort - have you got plenty of lanisoh to keep them feeling alright?

MissE, it sounds hard and worrying :(

Your brother in law is right that long term it is overall weight trend that's important but the problem is that in these very early days there is no long term overall trend....and you can't leave it for six weeks to see it! A newborn should not be losing weight at 8 days - there is no way this should be treated casually, waiting for a trend to emerge. I am assuming the scales were accurate.

Happily you are being proactive and ensuring you are protecting the milk supply and helping your baby to feed often and effectively.

Her poos sound within normal.

Expressing should be getting more than 10 to 20 mls a session now - check your technique. Go from breast to breast and back again, switching when the milk is not coming out.

Breasts don't need a long time to refill. Frequent removal of milk drives supply. Shorter gaps between feeds/expressions = more volume of milk made. Longer gaps = less.

You are doing the right things to turn this round. Keep your baby skin to skin; try co bathing which often helps a lot with spontaneous and effective latching on.

MissEJ I have no practical advice but just wanted to say I'm rooting for you - I really hope this gets easier for you and soon. Getting this established is hard big is worth it in the end. What a lucky little girl to have such a fab Mummy.

So sorry op. You're really not being"bad" at all if your baby doesn't gain weight but it really does need to be addressed in a tiny baby.I'm sorry but I really feel that people saying to ignore hcp and trust your instincts are wrong. I'm sorry as I know you say you hate it but right now if your baby needs a formula top up then you're being a great mum by giving her what she needs. It really doesn't mean the end of bf.

The bf clinic sounds like a fantastic idea. Everyone says it but the latch is so important-I was feeding my baby for an hour at a time every other hour but he just wasn't getting the milk properly-the constant trying to feed was exhausting him. My DS had a tongue tie-have you had dd checked? The hcp and mw are there to help-really use them. I think I allowed myself to be a bit fobbed off, told my latch looked fine and sent away then told to top up when it went wrong. When you go to clinic ask if someone could observe a whole feed for you.

Good Luck-it's really hard but gets easier

MissEJ I've been watching this thread as it sounds very similar to the situation I had with my DS a few months ago.

I just wanted to say I've been where you are in terms of weight loss, formula top ups, endless expressing (Do you have a good breast pump? I found that absolutely essential), frequent baby weigh-ins and the feeling that this was completely taking over my early days/weeks with my baby and that I didn't know what to do for the best. We got through it in the end, with a lot of real life support and DS is now a happy little 6 month-er, bf-ing well and just started on solids. I still remember just how worried and exhausted and overwhelmed I was in the early days though. So just hold tight, you will get through this too!!

Meanwhile, be very very kind to yourself, and remember that this won't last forever. You are doing brilliantly in a very hard situation.

MissEJ I've been watching this thread as it sounds very similar to the situation I had with my DS a few months ago.

I just wanted to say I've been where you are in terms of weight loss, formula top ups, endless expressing (Do you have a good breast pump? I found that absolutely essential), frequent baby weigh-ins and the feeling that this was completely taking over my early days/weeks with my baby and that I didn't know what to do for the best. We got through it in the end, with a lot of real life support and DS is now a happy little 6 month-er, bf-ing well and just started on solids. I still remember just how worried and exhausted and overwhelmed I was in the early days though. So just hold tight, you will get through this too!!

Meanwhile, be very very kind to yourself, and remember that this won't last forever. You are doing brilliantly in a very hard situation.

Hey, I have lots of nipple cream. I'm actually going to return my breast pump today, suction on it has reduced, like the motor is going, just my luck!! So, I'm missing out on pumping this morning as I'm waiting on the MW. Stress!!
I've had to top up with formula alone, but dd won't wake now for her 3 hour feed as she's so full. So, I feel like I'm just force feeding formula... Anyway, I actually can't wait fir the breast clinic tomorrow. :@/

Can you hire a double pump? Some NCT branches hire out breast pumps. I got my industrial one from the hospital as I had a premmie baby.

How much f did she take MissEJ? Did you bf her, then top up, then she slept for 3 hours and now won't take the breast?

Just a thought (apologies if you've already checked this) have you made sure the rubber valve thingies on the pump are fitted in securely? I have a medela swing double pump and once when it lost suction this was the problem -- one of them had popped out. If just one of those fiddly little rubber inserts is not quite in its slot then there's no suction.