help with my 5 day old

[happypotamus]

DD was born on Sunday and appeared to latch on and feed soon after birth. By Sunday evening I realised that she might appear to, and all the midwives etc on the post-natal ward said she was in a good postion and had a good latch, but she wasn't actually sucking and swallowing any milk. On Sunday night I was putting her to the breast regularly but she was just falling asleep so I was advised to hand express colostrum and give it to her in a syringe. By Monday it was like she had forgotten how to latch on entirely and wasn't feeding but was still having expressed colostrum. On Monday evening she suddenly realised she was hungry but couldn't get the milk out and was very angry about it, screaming and lifting her head up and down at the breast. That night the midwife said the problem was that her nose was blocked so she couldn't feed. She told me she would get a doctor to check her and see about prescribing saline nose drops but it never happened. On Tuesday we saw the ward paediatrician, who suggested regular blood sugar testing, not trying to breastfeed for 12hrs and giving 30-40mls formula 3hrly instead!! Fortunately, the midwife disagreed with his plan and told him so, as DD's blood sugar was fine and she looked well despite her poor feeding. I did lots of skin-to-skin and she seemed to have a good feed at one point and I was much happier, but that night she wouldn't feed at all. I sat up all night skin-to-skin trying to do anything I could think off to help her know what to do, still expressing but a few 1ml syringes did not satisfy her anymore. By about 4am we were both so upset. I had expressed about 10mls into a container and I asked about how best to give her that. A member of staff cupfed it to her, then some formula too as she still appeared hungry. On Wednesday I couldn't take being in hospital any longer. There was no support available, staff didn't really have time to help with breastfeeding, no one tried to work out why she wouldn't latch or suck or swallow, so DH and I persuaded them she was feeding better and that we could top- up with EBM or formula at home if necessary just as well as in hospital.
So, we have had her home since Wednesday evening, and it isn't getting better. She has lost all interest in trying to breastfeed, probably because we have had to try syringes, nipple shields, bottles of EBM, bottles of formula just to get something into her. I put her to the breast 3hrly (or other times if she makes feeding cues), spend ages trying to wake her enough so she doesn't fall back to sleep, spend ages trying to latch her on, attempt to bottle feed her, express more milk for next time, wash and sterilise everything, sometimes all that takes over a hour so no time to do anything or sleep before the next feed. Bottle feeding isn't even working, as she isn't swallowing well enough (although she does have a strong suck if you put a finger in her mouth) or spits half the milk out, so she isn't getting enough from that either.
Today I took her to the breastfeeding support group, which I credit with sorting out the problems feeding DD1 3yrs ago, but even there they couldn't get her to latch on at all and could only advise to carry on bottle feeding EBM so she gets some milk until she is bigger and stronger and can breastfeed. I am not sure that she will be able to learn to latch on after bottle feeding so long, but that is something to worry about later.
The midwives keep saying she is not feeding enough and has almost lost 10% of her body weight and they are coming back on Monday to weigh again, but they have no advice how to get her to feed better either. What will they do if DD does lose more than 10%?. We are already bottle feeding and giving formula top-ups.
I don't know what else we can do now. I am very upset that this has gone so badly. I didn't expect it to be easy as DD was also difficult to establish breastfeeding. Honestly, it would be a miracle if DD2 hasn't lost more than 10% by Monday, and I'm sure she doesn't wee or poo as much as she should. She hasn't pooed at all today, and has never had a big wee. What else can I try?
Sorry this is so very long. I hope it makes some sense given that I have had about 10hrs sleep in total since Saturday.

happy, so sorry this is happening to you....but there is nothing in your post that even hints at you not being able to bf, or a risk your dd will not want to bf.

It is early days, and sometimes, the intensity of the situation can make you forget just how early it is.

Here's something to consider: stop struggling and fighting with her. Just feed, whether it's formula or expressed breastmilk. Keep her skin to skin as much as you can and let her find her own way to the breast by 'baby led attachment' and biological nurturing, without you trying to do anything more than enable her to do this. Try having a bath with her - no pressure to feed, just enjoy the closeness.

Trying to 'get' her to latch makes both of you stressed and you both need a break :) Yes, your dd needs to feed - choose the least stressful way for the moment.

I think you need to see someone before Monday - call the midwives and ask for another visit. Explain how difficult things are.

Once things have had a chance to become less fraught, both of you can start afresh and take it gently and slowly :)

Gosh, I hadn't realised my post was so long and such a ramble through DD's life history. Thanks for taking the time to read and reply.
We are just bottle-feeding Ebm at the moment now, because we need her to put on weight and be ok. Sometimes DH gives her a bottle of formula, which she takes much better than Ebm. I am doing skin-to-skin when I can fit in time, often in the early hours of the morning, but with no expectation that she will actually feed or anything, just trying to enjoy her. Have also tried cup-feeding as suggested at the support group, with varied success.
It is mostly the midwives that have stressed me out so much about this with their talk of more than 10% weight loss and implication that I am doing something wrong to not even be able yo bottle feed properly.
I am trying to resign myself to the fact that this is the way it is for now although the frequent expressing is not compatible with going out or having visitors so can't be a long -term solution either.
Thanks again for reading and replying.

She's less than a week old - it is fine to take each day as it comes. Don't think about what is sustainable long term. Review on Monday and enjoy her in the meantime.

BTW it's far to early to make judgements about her taking formula better than ebm....any change in feeding behaviour is likely to be chance and things can change hourly at this stage :)

Has she been checked for jaundice and infection? They can affect willingness to feed.

Good idea to ask about these issues when you see the midwife on Monday, OP.

I don't know if it's the same at all hospitals but I was on a ward called the transitional care unit with both of my babies when they were able to come out of SCBU, one had neonatal jaundice and the other group B Strep. Other women on the ward had been readmitted as their babies had lost more than 10% of birth weight. Those who wanted to bf were given loads of help and support with a midwife or care assistant available to help with feeds. I credit them with helping to ensure I could bf both my children, yes it was crap staying in hospital for 10 and 7 days respectively but I had so much 1:1 support compared to my friends.

Hi happy just to reassure you on bottle feeding your baby right now. I found latching DD2 and DD3 hard at the beginning. With DD2, I expressed and bottle fed for at least two weeks before we sorted it out, and with DD3, due to ductal thrush, which was really painful, I expressed and bottle fed for the first 4 weeks. Hopefully this will help to reassure you that all is not lost, and you have not somehow missed your chance.

I am no expert regarding why your baby is not latched on, and have recently had very good advice regarding sleep and breastfeeding, so I am sure you will get the information you need from here.

Congratulations on the the birth of your baby girl

My sympathies, I recently had a similar ordeal getting DS to latch on and it was awful. I exclusively cup fed expressed milk for about two weeks and it was a huge PITA by the end, it was going everywhere, but eventually he got it. I also ended up giving him a FF in the hospital just to get out, the postnatal ward in my hospital was understaffed and horrible and I was never going to get bf established there. If I was ever in that situation again I would discharge myself.

What is she actually doing with her mouth now when you try and get her on, or is she not attaching at all?

From memory I think I struggled to get mine to latch on for a good couple of weeks and then until 10 weeks for it to really all fall into place. We did cup and bottle feeding of EBM on and off over the first couple of weeks. He lost just over 10% of his weight and I was really close to being re-admitted but avoided it in the end.

He's 8 months now, still feeding and he loves the boob!

My 11 week DS lost 17% at 5 days but they didn't talk of re admitting. We were told to pump and feed 2oz every 2 hours to get his weight up and responded beautifully. He had been latching and sucking but was very sleepy baby so when the milk came in he couldn't suck it out although we had thought he was feeding ok. The 3 days of feeing up meant he was back to birth weight in 2 weeks. He didn't go back to the boob BUT I know I could have tried harder, I just didn't have the spine for it as I would cave when he refused the nipple and got upset and give him a bottle. I think if it's very important to you, you could succeed. I ended up supplementing with formula too, he was fine taking both. It's scary when they drop the weight but they can bounce back so quickly, and no one is judging you for the weight loss, it happens a lot. DS is now 75th centile for weight and a bouncing boy!

I hope the weigh in goes well today happy

thanks everyone for the reassurance and advice. Yesterday she had put on 60g, which is great, apparently she is not gaining weight as fast as she should but the MW admitted that the recommendations for how fast weight should be gained are based on fully formula-fed babies. MW is coming back on Thursday, hopefully for the last time.
My problem now is that I don't have the ability to express as much milk as DD wants. I am mostly just hand expressing. We have a hand pump, but I only occasionally manage to get it to work. Yesterday she probably ended up having more formula than EBM, which upsets me, as I suspect my supply will not catch up with her demands. What do you think? I know that the more formula she has, the more my milk will decrease but I cannot let her go hungry when there is no EBM left either. Yesterday I felt like I spent the whole day and most of the night sitting either expressing or feeding her. Fortunately, my mum was here to do things with DD1, but it is hard to express while holding DD2 so DH gets all the snugly baby cuddles and I feel like I just get the difficult bits and he doesn't understand why I am so upset about the whole thing.
In good news, she seems to have started to work out breastfeeding. We are using nipple shields, which I also had to use with DD1, and she is sometimes appearing to latch on, and get milk out. The MW observed her feeding yesterday and agreed that she looked like she was feeding well. However, she is just as ravenous when given a bottle afterwards, no matter how long she is at the breast for. Is that to be expected or a sign that she isn't really feeding at all?
Today DH is at work, DD1 is at pre-school, no one is visiting, maybe I will take DD2 back to bed, practise her breastfeeding, and try to enjoy my beautiful girl rather than just stress about expressing and feeding her.

Wjat did the midwives say you should do from now, happy? What happens if you continue to breastfeed her, instead of giving her a bottle of formula? What you are doing now is the most awkward and time consumiing way to feed - direct bf, expressing, ebm and formula, plus the faff of shields :( :( .

They expect me to carry on as we are because it is working I.e. DD is gaining weight. Well, I guess they wouldn't mind if I gave up with expressing etc and just formula feed her, but I don't want that. I am stubbornly persevering even though this is probably unsustainable and incompatible with going out or seeing anyone (lack of time that isn't already taken up with expressing and feeding, and you can't express milk while out or in front of visitors) in the almost certainly deluded belief that I will be able to properly breastfeed her at some point. For the moment at least we have to carry on giving her at least one formula feed, because she always takes lots of it, suggesting she isn't getting enough from breast milk.

You sound very down and disilusioned, happy.....why think you will never be able to fully bf, when your baby is still only 9 days old?I think it would help to find real life support to enable you to have more confidence and a better, easier-to-manage way of getting back to full bf.

This might be a bf counsellor, a lactation specialist, or a midwife.

I'm on phone so can't link, but look up breast compressions. That can help get more milk into them.

Can you borrow or hire a better breast pump? With an electric one you could express from one side whilst feeding off the other.

Kellymom website can be helpful for breast feeding advice, although the forums might be best avoided.

Has she been checked for tongue tie? It's not always easy to spot, particularly if it's a posterior tie.

Also, try the nct or la leche league helpline. They are often more knowledgable than midwives.

The MW came again today, DD had put on weight but not enough apparently. She is coming again on Monday. I wish she would just leave us alone. I was just starting to feel happier with DD. She is breastfeeding more and seems to be actually consuming milk now. I was beginning to trust that she had fed well enough if she fed for say 30mins then fell asleep and didn't make any Feeding cues, so i felt ok about not fighting to wake her for a bottle too. Now I don't know if I am right to trust her and my instincts or not. Tomorrow my local breastfeeding group is on again. They are lovely there, and hopefully this week DD will wake up and I will be able to get some advice on what to do for the best with her. Except the group is at the same time as the open day for DD1's potential school for reception, I feel like I am having to choose which is my most important child :(
I really wanted to be able to write a more positive post about how much she seems to have improved.

Today DD had somehow put on 140g since Thursday despite only having gained 20g in the 3 days prior to last Thursday. Now we only have 75g to go to regain her birth weight. Midwife is coming back in a week for what I assume will be the final time. She made me promise I would carry on topping DD up with bottles after every breastfeed, but I haven't actually been doing that over the last couple of days. I have started to try and follow her cues and my instincts, and only topped her up if I felt she hadn't breastfed well and actually needed it. Fortunately, that seems to have worked out ok, and I am finally starting to feel happy and hopeful about her feeding. Thanks for your support and advice over the past 10days.

All that sounds good, happy.....the weight shows you and babyhappy were doing fine and getting into your stride, just taking a wee while to do it :) She's now actually making up for some of the lost time...brilliant.