Advice needed re feeding frenzy

[owensmama12]

Breast feeding ds1 was a nightmare-everything that could go wrong, did so. Bf ds2 (7 weeks old) was going well only I have to wear nipple shields (over sensitive nipples) and now have been told to ff to top up as he is underweight. I don't want to get caught in the trap if breast and bottle feeding everytime. Takes too long, non of advantages and all of disadvantages. Plus my toddler is not a happy person whilst I'm feeding so the more efficient the better. Any advice? I'm frustrated body seemed to be working but actually isn't and I'm reluctant to stop bb but I'm even more reluctant to be keeping a foot in both camps so to speak. Is it possible to feed only at night for example? Or will milk wave goodby with a song and dance regardless? I need to make a decision re what I'm doing as faffing around not knowing if I'm coming or going isn't helping.

There are many ways to improve a baby's intake if that's what he needs, without using formula. What other options have you discussed with the hcps?

I've been feeding to demand, which is roughly between every 2-3 hours with a little longer between at night. Ds empties both breasts and seems satisfied/asleep as is alert when awake so they can't explain why it's not enough, only that he is underweight still

Maybe try feeding more often? In what way is he underweight?

I'm (ds) having weekly weigh-ins at moment and he should have put on 120-200 g since the last one, but had only put on 20g, hence being strongly advised to supplement with formula. Can't feed more regularly as already too little time between plus toddler son struggles with it and tantrums prevail during feeding already. Feel like Im on a slippery slope to exclusive ff...just would like to make sure I don't overlook other options first.

Have you tried putting him back on the same boob he just drank from rather than swapping to the other side? You may think he has emptied your boob when in fact he has only had the high volume but very thin foremilk - babies need to get past that before they get to the thick fatty hind milk which contains all the calories. So might be worth just latching him back on to the same side for the duration of a whole feed to make sure he gets the good stuff?

What do you mean by too little time between?

2-3 hourly isn't all that frequent for a breastfed 7 week old. Are the feeds taking a very long time? Maybe the baby's latch isn't great if he isn't feeding efficiently and you are sore?

Is your baby following a centile or dropping down?

I don't think that's really true wishing - babies don't have to get past the fore milk and of course it contains calories too! It's all milk and is all good stuff, and it is the quantity of milk they consume which drives weight gain. Swapping sides (switch nursing) is a good way to increase volume and weight gain.

kellymom.com/bf/got-milk/basics/foremilk-hindmilk/

Feeds are taking a long time now as doing breast and bottle-around an hour. Which by the time he sleep leaves no time inbetween to interact with ds1. I do re attach to the breast to ensure he has hind milk (as much as you can be certain). Left nipple sore, right not but afraid to take off nipple shields in case ruin both nipples. Has lots of advice at beginning re latch and looks like I'm just sensitive.

I think you might have misread that wishing - the fat content changes depending on how full the breast is but that doesn't mean babies have to "get through" the fore milk or that only hind milk has calories or is any good. As that page says, you just let the baby finish one side and then switch rather than trying to keep putting back on one side to "get to the hind milk"

Restricting feeds to one side is a way of reducing milk supply.

kellymom.com/nutrition/milk/change-milkfat/

"The research tells us that baby’s milk intake (the volume of milk – not the amount of fat in that milk) is the only thing that has been correlated with infant growth in exclusively breastfed babies. As noted earlier, average fat content of human milk is highly variable, but has not proven to be significant when calculating baby’s total energy intake or weight gain. (Aksit 2002, Butte 1984, Cregan 1999, Mitoulas 2003, Mitoulas 2002.)"

How long does a breastfeed take?

20 minutes each side on average, but longer first side and shorter second. He wasn't left hungry but since introducing the bottle I get the feeling feeding time is shortening and he is asking for the bottle afterwards (this could be imagined or over analysed, but it's a gut impression)

If you want to avoid bottle feeding, the best things to try are ensuring your latch is good, feeding more frequently, breast compressions while feeding, and switch feeding where once he stops feeding effectively/swallowing on one side your switch to the other, then once he slows on the second side switch back to the first and so on offering as many sides as possible until he doesn't want any more.

Oh ok, you sound like you know what you're talking about Hollie and that makes sense! Had just always thought the most calorific milk came at the end of a feed. Good luck OP!

The milk from an empty breast has a higher fat content, but the milk from a full breast is still good milk, still has calories and still helps a baby gain weight.

Thanks for the advice. It's my first time positing and I'm impressed with the speed of response and support. I will reduce the formula supplement for the next couple of days to try to increase breast feeding again and see what they say at next weigh in. Advice much appreciated

What has his weight gain been like? Has he dropped centiles?

Owensmama, I agree with hollie - this is not very frequent feeding, especially with nipple shields. But if the only reason you are being advised to give formula is on the basis of a single week's weighing, then it's worth thinking whether your baby is actually underweight.

Why is he being weighed weekly? That's not normally necessary and it can be misleading.

Over 4 weeks he has gained very little so they are just monitoring him whilst we get his weight up. Would it be possible to stop ff when weight is back on track?

It depends on what the situation is really - some babies are born big but destined not to be (my DS1 was born on the 75th centile but went to below the 25th by 8 weeks and has stayed there, so his weight was never going to "get back on track" to the 75th!). If it's just that his weight gain is a bit slow because he's not feeding enough you might be able to fix it just by feeding more.