What next? Breast refuser. .

[SellyMevs]

I posted a few days ago in Chat about the difficulties I was having with my then 2 week old DS. We are now almost 3 weeks and things aren't improving.

We had a difficult start with BF, it took 4 days for him to latch, due to gestational diabetes, he was started on formula straight away to keep his sugars up and because he wouldn't tolerate a cup, this was given with a bottle.

Once we managed to latch, on day 5 I needed an emergency scan and due to the radiation, we had to stop BF for over 14 hours. I wasn't even allowed to cuddle him in that time. Since then he latched, but it was always painful and he was still having formula top ups.

I had managed to reduce the number of top ups but his latching was hit and miss and has become more and more painful. I was getting toe curling let down pain, my nipple would come out misshapen and it felt like he was clamping down. He was finding it just as stressful as I was.

For the last 36 hours I haven't managed to get him to latch at all. He has developed a huge aversion to my boobs, and will howl hysterically even if I pick him up and try and position him. On the rare occasion he has tried opening his mouth for my breast, he doesn't attempt to suck and spits it straight back out again.

I've been expressing as often as I can, but I'm worried my supply is starting to dwindle. Each pump is producing less and less. We managed to latch overnight using a nipple shield, but I find that it doesn't matter how long he sucks for, and he will carry on until he falls asleep and let's go, 10 mins later he is starving again and will take a full 120 ml top up. I'm still having to top up with formula because I am not expressing enough.

I looked into support groups and was going to attend today - except it turns out they are not running this week due to the school holidays so I can't make it to a drop in until next week. I'm going to ring the support line later and hopefully get some more advice.

I'm just worried it's now too late.. I don't enjoy feeding him and I can't sustain expressing this often as it's taking all the joy out. My DH is worried because I'm not enjoying my baby, I will feed him and then hand him over straight after so I can express. I'm not resting enough because I'm stuck in a cycle of BF, topping up and expressing. This cycle is going to break down the moment I need to actually leave the house.

I really wanted to BF, and I was trying my hardest to make it work. But I'm miserable, the baby is frustrated and now that he is refusing the breast altogether and I think my milk is showing down I feel that we have hit a brick wall. What do I do next?! Is there any way of recovering from this or is it healthier for us both to move onto formula and accept it hasn't worked for us? The thought of formula feeding is daunting.. its hard enough making up top ups and sterilising, how do I cope with it 24/7?! I just desperately want a happy baby and to enjoy feeding him again.

Wow, you've had a really tough time :-(

I had a similar(ish) start with my DD1 in that she couldn't latch for days (think it was a week before she managed it, but 3 before any regularity), had to have formula from day 0 because of low birthweight, we ended up in cycle of try, cry, too up and express. I could never express more than a few mls so formula was necessary. She ended up having a tongue tie diagnosed but it was almost 8 weeks before it was fixed, and by then my supply was buggered and I had PND. EBFing seemed an impossible dream for me so we stopped the expressing, had a BF twice a day and just formula the rest of the time. I know how exhausting, demoralising and miserable that cycle can be, so I'm thinking of you.

If you want to continue to BF you'll need real life help, and it sucks that the clinic is closed for the holidays. Expressing is important to keep up supply but as I understand it, it's not what comes out that's important or indicative of supply, it's stimulating the breast that's important.

Mixed feeding could be an option. It will affect supply, but perhaps view it as every drop counts, and look forward to the cuddles instead, rather than viewing it as completely replacing a formula feed.

Or, switch to formula full time. It may be daunting, but there are ways to make it easier. Sterilise your bottles in the morning (add the lids etc once the machine is done and they'll stay sterile for hours), use cartons when you're out and about, and it's even possible to make some in advance when required as long as you follow proper guidelines - see here for WHO advice www.who.int/foodsafety/publications/micro/PIF_Bottle_en.pdf

Only you can decide whether you want to continue or not, and there's help and support for either route you go down

Good luck x

Have you tried a bf helpline? I found the LLL one excellent when I was relactating. Have you tried latching him on while taking a bath (low lighting) together? Has he been checked for tongue tie? Are there any board certified lactation consultants near you? An SNS (Supplemental Nursing System) would enable you to offer formula whilst stimulating the breast.

Pumping tips:

12x per day inc. 3 overnight
Look at a photo of baby while pumping
Smell an item if baby clothes
Try bf hypnotherapy (Maggie Howell)
Reward yourself with choc for every pumping session
You don't need to sterilise after every session. Put all the pieces in a freezer bag and into the fridge. Sterilise once a day.

You do need RL help though OP. Did the Infant Feeding Specialist at your hospital get in touch? Is there a local support worker? A local bf cafe? A local LLL meeting/leader?

I can't express 12 times a day... I can barely manage 8. In the hospital it was easy, he always slept after a feed so I could put him down. Now I can't rely on that. I feel like I'm neglecting him as it is, willing him to go back to sleep so I can fit in another pumping session. I admire those who can do it long term, but I can't do that. I was willing to keep doing it until I was able to get some help, but I won't be able to get past the weekend.

The LLL drop in was last week, there isn't another for 2 weeks. I've searched for other groups but they are term time only. I asked to see the lactation consultant when I was in hospital, but the midwives kept assuring me that his latch looked "fine". I did feel like I was that annoying mum who couldn't cope with a new baby, buzzing them every time he wouldn't latch. They kept brushing off any issues.

I've left a voice mail for the hospital feeding consultant so I'm hoping I'll hear soon.

Is there any contact number for the LLL leader? I'm sure she would be happy to talk to you over the phone.

If you have had enough, you can stop. I did. I ebf for 10 days, mix fed for 8 more days and then ff for 8 weeks. After that, I relactated and mix fed until 8 months. It's not all or nothing.

Hi there, it is not too late to get your baby back to the breast, Stargirl had some good suggestions and you might find more here How to Get Baby Back to Breast. However I hear that you are not sure you want to carry on because it is stressful. And I agree that enjoying your little baby is the most important thing. If you want to give it another go how about trying to find a private practice lactation consultant? They would have more time than a hospital based one and their reputation depends on giving a good service. They would support you and help you with a plan to increase your milk and get baby back to breast whether partially or completely, whatever is best for you. Why Hire an IBCLC PS LLL Helpline 0845 120 2918

How are you doing Selly?

You could try PMing tiktok here on MN. She is very knowledgeable.

Hi Star,

We've had a little improvement today in that he doesn't appear totally disgusted with my boobs and has been rooting and trying to latch. We've latched a couple of times, mostly with a nipple shield.

Let down is still excruciatingly painful, and without the nipple shield his latch is still uncomfortable. I find I'm getting pain long after a feed as well. However, I feel we've made some progress with him no longer refusing the breast (yesterday I couldn't even cradle him without him howling).

Does anyone have any suggestions for painful let down? I'm feeling much more positive about continuing, it's just a matter of the pain :-(

I had painful let down. Paracetamol and ibuprofen helped. A glass of wine at dinner made a difference too

You could ask your GP for Diclofenic as an alternative to ibuprofen.

It took 8 weeks for my let down to be pain free.

Unfortunately I am allergic to ibuprofen, diclofenac and any of that group of meds... so paracetamol it is. I can get him to latch with the shield a bit better now, sometimes it's mildly uncomfortable, but he has a tendency to clamp down. I'm not dreading it so much today though, plus we are having a lazy day around the house so no pressure.

Thinking of you Selly. I had a hell of a time with DD1. I remember the dread of the next feed as I heard her waking. I hope your DH is looking after you!

I saw a different midwife today.. she thinks that DS has in fact got a partial tongue tie. I've got an appointment tomorrow to review this and hopefully get a referral. After weeks of everyone telling me he and his latch were "fine", I might finally be getting somewhere.

In the mean time we are coping much better. We now use nipple shields and the pain is improving. Even the let down pain isn't as bad and I don't get the burning nipple pain between feeds. We are even cutting down the bottle top ups.

Thanks for your support, I feel so glad that I kept persevering. Hopefully there is a light at the end of the tunnel now and we can carry on long term.