Breastfeeding to formula dilema...

[RubyRuby007]

Quick background:

DS is 4 weeks old, born at 41+4, 10lbs, back-to-back, forceps delivery.

DS was exclusively BF until yesterday because:

He hadn't had a poop for over 4 days, when he did poop last night, it was quite sticky, smelly and not the korma consistency it had been! DS has been very niggly during this time, but I just put it down to needing a poop.

DS was weighed by the HV yesterday and had put no weight on at all since last week, when he had continued to put on, and was up to 10lbs11oz. I had very sore boobs on saturday/sunday and saw the dr on monday who assured me blocked ducts, hot flannels, massage etc. HV advised to "feed like mad" over the next couple of days.

I had bought a pump to start expressing, so gave it a go last night...only a few drops, but thought the pump wasn't working / I didn't have the hang of it. Tried a breastfeed, cue screaming niggly baby. Tried to hand express to check milk supply...only a few drops DH popped to the shop for some formula, we fumbled around in the kitchen trying to figure out what to do with the steriliser while DS cried but he took a feed from the bottle and was content and slept well

Today, I have managed to express a measly 50mls all day while DS has fed from a bottle, but has been content, alert but has slept well too.

So, my questions to you ladies are:

1. Has anyone experienced anything like this? Milk supply just stopping?
2. Any chance the milk suppy will return?
3. If I do have to formula feed, how do I make sure I don't end up with painful boobs?
4. How do I stop feeling guilty? Up until last week, I was really proud that I was breasfeeding, and DS was gaining weight well.

Sorry for the ramble, and thanks in advance for any replies

What you can express isn't related to milk supply, so it's unlikely it has stopped. Some people can bf fine but never get a drop out expressing.

I'm not expert enough to help, but hope that will reassure you. If you can, I'd keep trying to feed.

In the meantime, call a bf helpline, details are on the mumsnet bf advice page I think. They can give advice about the formula too.

Oops, hit post too soon.

Also check
www.Kellymom.com, a really good page for info and advice.

Hopefully someone expert will see your post on here too.

It's quite normal around 4-6 weeks for your supply to settle down- you produce only what your baby needs rather than just loads like in the beginning. Plus I think there's a growth spurt at the same time :)

I doubt your milk supply has just stopped. Many people can't express, or have to practice every day to be able to do it.

The more you feed from a bottle the more you will affect your supply- expressing does not have the same effect a baby does.

Feed as much as you can. warm flannels, breast massage etc can all help, but best thing is to go to bed with your baby and rest and feed. Get your DH to bring you snacks and drinks.

Get the numbers for your local la leche or find breastfeeding cafes.

Weight gain frequently slows down in breast fed babies too. Keep an eye on his general health- wet/dirty nappies, good sleep, alertness etc.

Hi I bf exclusively for six months and still couldn't express more then 100mls a day max and I had to build up to that, previously when I have had painful breasts my supply seems to decrease especially if I have become engorged. It seemed to take ages to get to a point where the supply seemed to meet demand.

If it might be worth keeping one bottle of ff at night if you think this helps and gives you reassurance and continue to feed feed feed during the day till it all settles down.

We have added occasional bottles in and then stopped for a bit where she became a complete bottle refuser but have managed to restart it and she is now mixed fed for reassurance and ease for us both.

Don't worry about the odd poop mine's sometimes seemed to change colour and consistency daily, when they happened.

It's well worth finding a breast support group if local to you as they can be helpful

Have you ruled out tongue tie?

Also the amount you express doesn't correlate to how much milk you are producing. I doubt your supply just stopped. I think weekly weigh ins aren't recommended any more so would be wary of one week of a blip.

One thing I noticed and I'm sure someone will claim it not to be true, is that if I didn't drink enough water my dd wouldn't poo as much. I had to drink a lot when feeding.

I would see a BF counsellor for advice tbh. Your ds may have fallen asleep as he was tired from the crying.

You say you had blocked ducts - I've never had a problem with expressing, but when I had a blocked duct I couldn't get a drop out of that side.

Ruby, milk supply never just stops - sometimes there can be a crisis of let-down (not what I think has happened to you).

Clearly your HV was not concerned about your baby's health and growth, and suggested increased frequency of feeding.....just to ensure you were giving your baby sufficient opportunity to build up your supply.

4 days with no poo is within normal range. The consistency you note is within normal range. Your baby's weight and growth is within normal range, especially for a baby as heavy as 10 lbs at birth (it is normal for there to be catch down growth after the first few weeks).

Also normal to find difficulty getting much out with a pump.

Not enough info in your post to understand the painful breasts - you are right to get more support and help with this, though.

You do need an overview from someone who understands about bf - your HV maybe?

If you are keen to breastfeed - and you sound keen :) - and proud to do so, as you say, then it would be mad to assume it's all over.

Get good help, call a breastfeeding helpline, and keep on putting your baby to the breast - in any case, sudden stopping like this. on top of suspected blocked ducts, is very risky to your health (mastitis, abscess, huge discomfort....not good).

Hope things go well for you.

(iggly, mother's fiuid intake has no bearing on the baby's pooing frequency, and there is no physiological mechanism for this, believe me :) What you noticed was coincidence :) )

Phew, tiktok has arrived.

I knew someone would say I was wrong! I didn't drink enough and was thirsty a lot. I convinced myself that my milk wasn't watery enough I may have been sleep deprived so baby didn't poo enough. It happened a few times so made it true in my head.

:) what can I say, iggly? Your body must be unique?? water in breastmilk is related to the amount of milk in the Breast, not the amount of water in the mother 's diet.

I've had blocked ducts that stopped my supply. Dd was increasingly fussy on the affected side and I had to top up each feed for a few days.

I spent a few days trying to pump in the bath but not much luck. The main thing was to take ibuprofen and I put a heated wheat pack on that side and an electic massager which sorted it. Had her feed from that side every time, including doing the rugby hold to fool her into feeding off that side.

Even now I'm slightly uneven with more supply in the other side as a result, but I've only had issues twice in 6 months so worth persevering.

Blocked ducts, when very severe, can indeed affect let down. Longer term, this can affect supply.

What I ate definitely affected poo. Red Thai curry had an interesting effect. And cabbage and broccoli made dc extra windy. I don't know if that's supposed to happen, but it certainly did!

Definitely seek out some breast feeding support. The local children's centre/sure start centre might be a good place to start, or ask your health visitor.

I think being dehydrated does affect supply or at least it is unproven.

I've had discussions with you before on whether foods we eat affect supply. I know you say not but I think they do. which is why I get annoyed with bf counsellors who've dismissed my concerns

I give up. You cannot prove drinking insufficient fluids impacts on milk supply or milk consistency because you cannot deliberately dehydrate women in order to see if their bf suffers. What you can do is look at the physiology of lactation and how milk is made and what drives the water content of milk, and work it out that way.

We do have a study that shows deliberately giving mothers more fluids has no effect on quantity of milk, and in fact may reduce the quantity.

Clearly it is good and healthy for mothers to drink to thirst, but if they don't their milk will not change.

This is not to dismiss the individual perceptions of individual mothers and babies. Things can seem very real, but until they are replicated in many mothers by objective assessment, they cannot be held up as general principles.

Food is slightly different. We know flavours can reach the milk, for instance, and some babies can react to dairy and other proteins which reach the milk. So I would never say food does not affect milk.

Quantity of food does not, quality of food does not. Individual experiences may appear to contradict those assertions, but the same thing about replication applies. They remain individual until they are replicated and until it makes sense physiologically. I would not dismiss them, but I would dismiss them as general principles.

Hi,

I have a five week old ebf DS too and can confirm he has been fussy, snouty and niggly for at least the last week! I think it is just normal at this stage and important just to keep feeding.

Also, I ebf twins for 10 months and never managed to express more than about 20 mls, even when they had missed a feed. What you can express isn't the same as what is available to the baby.

The Wonder Weeks app has helped me understand what is going on for DS this time round ( with my twins I was completely in the dark!)

And everything tiktok said!

Snouty! I meant shouty!

So you cannot say for sure that not drinking enough affects milk - I think it did in my case. I got the impression that you thought it definitely didn't.

I am pretty certain of it, iggly - it does not make any physiological sense whatsoever. I mean, does your blood dilute if you drink more water? I hope not! So why would your milk dilute, or increase in volume, or whatever?

I don't doubt that it may feel that drinking more fluid improves breastfeeding. This is a 'logical fallacy' (confirmation bias, if you're interested :) ) whereby something happens and we strive to work out why it happens. As humans, our evolution provokes us to see links between events and predictability. If someone feels or suspects their breastfeeding goes better (in whatever way this might be) when they drink more fluids, they will be very likely to see the opposite as well (that breastfeeding goes less well when they don't).

Find me a biological explanation of why breastmilk would be affected by increased fluids, and of course I will think again.

www.ncbi.nlm.nih.gov/pubmed/24916640

It's so unlikely, according to this paper, no one is inclined to test it.

It would be like thinking that (for example) wearing red shoes makes you make more milk.

No one sensible is going to test that hypothesis :)

But of course I can't prove it doesn't......

Increasing from maintenance to increased fluid levels may not make a difference but I suspect restricted fluid intake would reduce supply, though as you say it would be unethical to test, and the reduction may not be significant to the sorts of volumes needed for one baby. It is well recognised in dairy cattle that adequate water intake is important for optimum milk yield, and milk yield falls if anything stops the cows drinking enough. There are some important differences (eg that modern dairy cows are producing vast quantities relative to the volume a calf would need) so I'd be cautious about directly extrapolating, but it suggests to me that there is some connection.

PS apologies to the OP for the tangent. :)

Ha :) Imeg, you have forced me to become an instant veterinary surgeon, speciality cattle, via google :) :)

Seems dehydrated cows can become so very quickly - the lactation of the dairy cow is turned up to the max, and they produce far more milk than they would 'in the wild' for a calf. This makes them thirsty. The dehydrated cow is sick, underweight and scraggy - she is starving. To prevent this, farmers make sure to increase fluids at the first sign of dehydration and to keep fluid levels high generally. Starving cows go into 'life saving' mode and do not have extra resources for lactation, so milk production slows down. It is not that the water boosts milk production directly.

The human mother who is literally starving experiences the same.

The human mother who doesn't drink enough fluids over a few days is not starving.