Any experienced BF ladies out there or any BF consultants? Really need some advice

[MrsGiraffe12]

I've posted before about this but I was hoping someone experienced could advise me.

My DD is 7 weeks old. I EBF her until day 5 and then stopped as she mashed my nipples. At day 10 I felt guilty about this so put her back to the breast at she latched and fed. She's not made me sore anymore though we did check for tongue tie and she hasn't got it.

She's needed formula top ups after each breast feed or she screams and cries.

When speaking to a trained breastfeeding peer support worker at my local breastfeeding workshop we narrowed her fussing, crying and boob refusing (even though she still seems hungry) down to either over active supply, under active supply or slow let down.

Based on that I tried expressing and don't get anything with a double ameda lactiline pump so it's either slow let down or under active supply.

Further to yet more research I've been taking 3x 610 fenugreek tablets 3 times a day, having 3 cups of fennel tea a day and oats as much as possible and of course as much water as I can. DD is having a breastfeed as her "first" meal each time, I let her feed till she latches off, then offer the second boob till she latches off. Then I will offer a top up of formula if, and only if, she's fussing and crying for more food but wont take more breast. Then I'll manually express if I can to make my body think I need more milk than she's taking if that makes sense. The trouble is, her top ups have been increasing and she's having 5 bottles of 5 ounces a day now on top of breastmilk.

Any ideas on reducing the formula based on what I've put? She's gained 4lb 5oz since birth and has, and always has been, on the 50th centile.

I am not an expert but until someone else responds...what happens at night? I think that feeding through the night is crucial for supply at this stage (albeit very tiring!). Have you tried doing nothing but relaxing and breast feeding for 2-3 days.

She sleeps through at night now, 10pm - 5pm ish.

I'm guessing I should be getting up to pump / feed around 2am?!

Agree with the above poster. If it's possible have a BF holiday- box set on Tele, skin to skin and just let DD feed on demand all day! I had overactive let down and I found this was the best way for DS and I to get into a rhythm and I felt more confident in our technique afterwards!

I'm sure some one with better all round advice will be along soon!

You've done bloody brilliantly, OP! Is hard work, isn't it?

I was still feeding every three hrs at your stage and I think my supply would really have suffered if I hadn't been. Having said that, I would have walked over hot coals for more than 3hrs straight sleep at that point so it's six and two threes, really.

Are you feeding to a schedule? Is she cluster-feeding at all? I'd advise offering the breast as often as possible and not worrying too much about disrupting any kind of routine at this stage.

Also, have you tried contacting La Leche League for advice? You don't have to be a member.

Yes, night feeds are important.

When I was reestablishing bf I would feed until baby would take no more, then express for half an hour after each feed. Offer breast every 2 hours, so that meant that I was feeding or pumping pretty much continuously through the day for a bit! I would also feed twice at least at night.

Apparently milk thistle along with the fenugreek can help too, I took the combination and it was very, very effective.

It's bloody hard work but it really is worth it! It's just a few short weeks and once your milk supply catches up you will be able to gradually move to a slightly less crazy schedule.

You are doing great MrsGiraffe.

As mentioned above, I would recommend a breastfeeding honeymoon to re-establish supply. Plan for 2 or 3 days of not moving from the bed/sofa and just feeding constantly. Deal with the crying/frustration with lots of cuddled and skin-to-skin contact.

Frustrated hunger crying is part-and-parcel of breastfeeding at times when baby is trying to increase supply. So you just need to grit your teeth and get through it with cuddles rather than formula.

It is hard work, but you and baby will get through it. Well worth it in the long run.

The 2 or 3 days I mentioned include nights as well and days. I should have been more clear.

You are unlikely to find a breastfeeding baby going more than 3-4 hours at 7 weeks old. Certainly not if you are trying to increase supply.

My DS is also 7wks old and I'd give my right arm for a night's sleep. He feeds every two hours overnight and perverse as it sounds when you have a miracle baby that lets you sleep I think this may be part of the problem. Can you try offering her the breast every 3 hours and if she refuses express for a few nights to see what happens? (I almost want to cry offering this advice - who the heck advises waking up a sleeping baby!!!)

Also when DS wants to increase my supply he does these short, frustrated feeds from one breast to the other, never fully satisfied, for a couple of days and then spends a couple of days on very long feeds. dD was the same and there was a very perceptible difference from normal weeks to growth spurt weeks.

Agree that you are doing really well. You are amazing!

Also agree about the night feeds. The small hours are when your breasts kind of put in their orders for next day (hormone levels etc.) so feeding through the night is important at this age. Don't worry about building bad habits - your baby is very young, and not on the same body clock as adults or older children. They all sleep through the night eventually... but at just 7 weeks it's not to be expected really.

Have you thought about co-sleeping? It's not for everyone, I know, but is an easy way of letting your baby snack throught the night while you have a comfortable doze. Obviously you would need to follow safe - sleeping guidelines, but they are not hard to follow (and the lovely, snuggly tiny baby cuddles are great and very precious).

When you express after your baby has finished feeding, how much milk do you get? Generally speaking, babies are much more efficient than hand-expressing and/or pumps, so if you are getting a decent amount of milk fairly easily, it might be worth having the positioning / attachment checked again.

Don't feel bad about the top-ups. You do what you have to do in order to keep your baby safe and healthy. Every drop of breastmilk counts, so again I say that you are amazing!

I have a close friend (also a trained breastfeeding supporter) who was in exactly your position, and tried everything she possibly could to keep breastfeeding. Her baby is nearly two now, and still breastfed but with no top-ups any more. As the baby got older, the amount of breastmilk stayed the same, and the top-ups decreased (rather than the other way round). That baby/toddler doesn't have any top-ups now, and breastfed three times when we were all playing together this afternoon.

You are doing so well...

Something I found helped us both when baby was getting frustrated and breast refusing was to feed in a warm bath - got both of us relaxed and produced some of our best feeds.

You need real life support for this I think. Your baby is having a large amount of formula and your supply hasn't been stimulated over night or effectively in the day. If you haven't bf before (this helps our supply) then it is possible that you will really struggle to increase your supply.

No amount of oats and fenugreek will be more helpful than more feeding expressing. Google switch nursing and breast compressions. To up supply aim for more feeds per 24 hours and more sides per feed.you aim to express more frequently too. Have a look at domperidone if your gp will prescribe it for you outside its license it can boost your supply by about 20%.

It may well be possible for you to boost your supply but it also may not so it might not be appropriate for you to go cold turkey on formula for instance- good luck with it all. Can you get face to face support

Like others have said you are doing great MrsG

Great to ask for advice both here and in RL, but if she's going to be a mixed fed baby to some extent then all that BFing will be doing her lots of good.

Congrats on your lovely dd and enjoy her early weeks as much as you can x

It's hard isn't it op? I was in a similar situation giving f top ups after Ds's Tt led to painful feeding and no weight gain. Ds would latch on, feed, un-latch and then cry and cry in frustration until he got a bottle. I never got rid of the f completely but got down to around 6oz a day and the rest was bm.
I didn't go cold turkey- probably should have but I just couldn't stomach the crying, cuddling doesn't really help a baby who isn't getting the milk they need. I fed on both boobs then offered the f- but only maybe 2 oz then back to first boob. Ds also fed every 2 hours during the day and 3 hours at night at 7 weeks. From giving 3 oz after every feed at 4/5 weeks it was about a month before we were down to a bottle a day so it was really very gradual. TBH it was when I "gave up" on ebf and just tried to feed him as much as I could but not beat myself up about it that things got better- I think I stopped seeing it as problem that needed to be fixed and that helped me relax and see bf as less of a chore.

I dont think a peer supporter can necessarily give you the level of support you need. At the moment your baby is getting the majority of her milk from formula. A five oz feed isn't a top up. So I don't think you can go cold turkey. I think you need expert advice on whether she is transferring milk effectively from your breast and also how to increase your supply. If she isn't transferring milk well then I'd assume your body isn't getting the message to produce more for her. Look on the baby cafe website to see if there is one near you or find a lactation consultant. La leche league might be able to help.

Thanks so much for all the fantastic advice ladies.

As I'm replying on my phone I can't name each individuals questions but:

In regard to pumping after a feed, I get nothing really. I always thought that was a bad sign! Yet if she boob refuses all day I can easily get between 6-8 ounces in about 40 mins (about 3-4 ounces per boob).

In regard to night feeding, could I try and dream feed rather than wake her up?

In regard to co sleeping, we've got her cot against the wall in our room, one side removed and our bed shoved against it, there's no gaps anywhere so its like a co sleeping cot :-)

If I've missed any queiries I'm sorry x

In regard to pumping after a feed, I get nothing really. I always thought that was a bad sign! Yet if she boob refuses all day I can easily get between 6-8 ounces in about 40 mins (about 3-4 ounces per boob).

I got nothing too! I was lucky if I ever got 1 ounce. It was for the stimulation.

In fact when I eventually had to stop pumping because it was overstimulating me and I was getting engorged and mastitis, I still was getting barely any at all! Some breasts just don't respond terribly well to machines, it seems, but it still helps tell them to make some more milk.

We got TT cut at 5 weeks and by then I had a low supply. Low supply and growth spurts was a nightmare.

A few good weeks of constant feeding got my supply back up.

I remember on my birthday feeding for 2 solid hours and still she wasn't satisfied. It got me so down!

Another time having only a 15 min break in between feeds. At the time it was hard.

Looking back now it was her trying to increase my supply.

Try and feed more on the boob and offer less formula if you can x

Hi all.
I went to a breastfeeding support group today and they recommended a supplemental nursing system.

Does any one have experience of these x

wahey. I hesitated to mention supplementers, but the friend I talked about upthread had some success with hers.

Think dr Jack Newman has some good information about these (am on phone so can't Google). Anyway, sounds like you are getting gre a t support.

Good luck!

Just to say I bf baby with no supply probs, but I could rarely get more than a dribble from expressing. Think my boobs just didn't listen to the pump! Do u get the letdown feeling when u pump just like when baby feeds?

Yes, cup of chai, babies are much more efficient than pumps (assuming good latch). manual expressing works by compression, while commercial pumps work by suction. babies do both and have the added bonus of all the "love hormones" (oxytocin etc) that help us feed them.

I have personal experience of this - couldn't express a drop -until ds2 was in hospital, dangerously ill in an incubator, and I wasn't able to feed him directly. All of a sudden the milk just flowed!

I think getting milk by expressing can be a kind of psychological thing , with your body sometimes only responding to your actual baby.

op, if I was your breastfeeding supporter, I would say don't go cold turkey on the formula feeds. Your baby is having a fair amount of formula at the moment, ams toy need to build your supply back up. However, it seems that you have every chance of being able to carry on breastfeeding.

There's no particular scientific evidence that fenugreek etc works. The supplementer might help.

I used a supplementer with ds1, it might help when she is refusing the breast. I don't really know how big a part it played in helping me reestablish my milk supply, but it is unlikely to hurt, so you may as well give it a try.

I found it a bit of a faff, tbh.

I used a supplementer. I also had a similar experience in that it took me 10 days to find support for bf'ing my first baby and in the meantime no milk was coming out. I was never able (even with the lactation aid - I used the one Jack Newman recommends - and a lot of expressing) to build a full supply.

Is this your first baby OP? Sorry if I missed that, but if it is, google 'prolactin receptors' for why you might not get a full supply, and definitely shouldn't drop formula all at once. Kellymom has useful info on weaning off formula.

What worked best for me was domperidone - again, Jack Newman writes a lot about that - though you need a supportive GP to prescribe as it's fiendishly expensive to buy over the counter (where it goes by the name of Motilium).

Best of luck to you!