being pestered to give up breastfeeding

[supporter]

Need advice for a niece who is being pestered by everyone around to give her first child formula. She's keen to continue but everyone (like MIL, health visitor, friends) except me, is pushing her to top-up with bottles and telling her she has insufficient milk. Naturally this is making her a bit nervous herself although the baby is gaining weight.

Baby was premature and jaundiced so lost weight initially. She is now gaining weight but the consultant has just looked at difference between birth-weight and now and is talking failure to thrive. The baby also has a inguinal hernia for which she will be having surgery soon. She had been having few dirty nappies (also the cause of nagging by my sister and nephew) and can be a very windy baby. She cries quite a bit and is happier when held up. She's now about 10 weeks.

I've told her to trust her instincts about the baby's growth - and to show the consultant her own weight gain charts. I've also e-mailed an old mumsnet thread about fenugreek and maybe doperamide as things that should be suggested before top-ups. My sister has been told she shouldn't be pressurising her DIL, especially with a family history of allergy and with no experience of breastfeeding herself - but being older she probably won't listen.

Anyone with any useful stories/ advice for niece on how to resist the pressure?

forgot to say mum is already expressing milk afetr feeding but with a hand pump - would electric be better? She's had good advice about latching on.

Doperamide - domperidone, yes?

Shame your neice has such little support.....hard to tell from what you say if there is a problem with supply or not, but if there is, then it can be addressed by breastfeeding more often. After all, if the baby needs more milk, why should it not come from the breasts? They're telling her the baby needs 'more' - well, she can have 'more', just more breastmilk

No point in fenugreek or domperidone if this very basic thing has not been tried - feeding more often and feeding at night, if this isn't being done. Also, check she is offering both breasts at each feed. This can be important too.

Let us know how she gets on!

How often is she nursing? Can she take to bed for a day or two with lots of skin-to-skin and have a real feedathon to help build up supply if she's concerned? What rate is her DD gaining at at the moment?

Sounds like you're telling her the right things. I really can't understand why health professionals will in one breath suggest low supply and in the next suggest a course of action that will make it even lower, rather than exploring any of the tactics for building up supply.

If the baby is going to having surgery soon, then that is a really important reason to keep going with the breastfeeding, particularly as it will be surgery relating to the gut. The best thing you can give an ill or stressed baby is breastmilk - both the milk and the body contact have healing properties that must not be discounted.

Birthweight is not relevant to the child's weight in the long term. Birthweight relates to the mnother's health during the pregnancy. My ds was born over the 75th centile, IIRC, and found his place on the 50th centile. I, too, was pressurised to formula feed because of his weight relative to his birthweight. Yes, he went back up to 75th, but eventually settled on 50th. So what did he gain?

Has your niece had any contact with NCT, LLL, ABM? All organisations who will listen to her and give her excellent advice on feeding.

Get your niece to drink fennel tea (use a make called Dr Stuart Botanical from health food shops) frequently every day, even give the baby a cooled teaspoonful a couple of times a day. It will help with the wind.

I myself have used fenugreek with great success.

nagging because of dirty nappies??? what planet are these people on? it's good for a baby to have lots of dirty nappies - shows the digestive system is working properly. giving her formula will almost certainly make her constipated - is that what the sister and nephew want?!

you are right about telling her to trust her instincts - and the advice to just feed more if the baby needs more is totally right too.

it makes me so that so many people think formula is the answer to everything when it so definitely isn't.

i really hope she carries on bf and tell her to try and find a bf support group in her area (find a HV that is pro breastfeeding and they should be able to tell you).

I am totally that HV are still telling people to turn to formula - it should be an absolute last resort IMO.

Breast is Best!

pianomuumy it was the lack of dirty nappies that was worrying them - because they feared constipation. MIL has no experience of breastfeeding herself and doesn't realise its not unusual for breast fed babies to miss days.

tiktok I copied the drug name from an old thread on mumsnet. I don't have any experience of it myself. I don't think she could feed any more often most of the time although the baby did sleep for 5 hours once and her mum didn't know whether to wake her. She'd been given conflicting advice.

I've mentioned NCT and will look at some contact details for the others.

She lives too far away for me to see often but apart from being very windy the baby just looked like a dainty little girl to me. If there is any problem with milk at all I suspect intolerance to lactose rather than poor supply. There are relatives on both sides of the family (including the mother's father) with lactose intolerance. The consultant asked if the mother drank much milk (she doesn't) but didn't take that any further.

LLL
ABM
NCT

Personally I am familiar with the NCT's Breastfeeding Counsellor telephone service - having used it extensively myself - and have a friend who is a Breastfeeding Counsellor from the ABM.

HTH

Supporter: "I don't think she could feed any more often most of the time"....so when are they asking her to top up then? She can top up with more breast, surely?

She breastfeeds, and then she breastfeeds again, going back to the first side.

the baby has to sleep sometimes, she can't spend all day and night feeding. So far the mother has resisted any suggestions that she give the baby a bottle, except for a few syringes before her milk came in when the hospital staff were insisting the baby had to have something. In effect she's being told to stop feeding and give the baby a bottle instead because the baby will feed faster.

I've e-mailed the contact details for the NCT breastfeeding line and two local support groups, thanks for the links.

Hi Supporter

I agree with Lemonaid's idea of a feedathon - it's often called a babymoon too...skin-to-skin contact not only encourages frequent feeding, which increases milk supply, but also it increases milk supply itself!

The other thing that your neice might like to try is what is known as switch-feeding - feed on one side until baby has had one let-down (baby has done that long, deep sucking and then slowed down and is having a 'rest' but not coming off the breast), then take her off and put her on the other side for another 'let-down', then switch sides again, and so on until baby has had enough. Very, very frequent feeding is the most important thing, but it will only help if the baby is latched on well. I know you say she's had good advice about latch - who's given that advice? It's very easy for someone to say 'oh, she looks like she's latched on well' but that doesn't necessarily mean she is - there are far more signs to look out for.

Re. nappies. After 6 weeks, it's normal for babies to poo infrequently and there is no chance that she's constipated if she's being exclusively breastfed. It's the consistency of the poo that is so important - is it copious, yellowish, runny and maybe with milk curds in it? If so, it's a good sign she's getting enough, along with plenty of wet nappies. If it's greenish and not much of it everytime, then that indicates baby isn't getting enough of the fattier milk that comes towards the end of the feed and baby may need to be encouraged to feed for longer at each feed, if possible.

Weight isn't the only sign of thriving and breastfed babies often don't put on weight in the same pattern that formula fed babies do. If your niece can call a BFC (I see the links have already been posted), it would help her a huge amount, I imagine.

Thanks. She saw a breast feeding counsellor in hospital. Didn't ask too much about it at the time so I'm not sure exactly who they were. Althought the baby isn't going often when she does it's in large quantities, so she probably isn't constipated. But my sister has been linking straining to the hernia. My sister bottle fed herself and wasn't around when I was feeding mine, she has no experience of breast fed babies. She would, I think, like to be able to give the baby (first grandchild and long awaited) a bottle. However it's the implied criticism from the consultant that is getting to my niece most, I think.

I've had words with sister about her lack of knowledge and told my nephew he should be more supportive of his wife. But I agree it would help if she can speak to a good counsellor. I'm also trying to get her to join mumsnet

Has the baby been going down the centiles? I think birth weight is a red herring, it's dropping down the centiles too fast that's an issue, IIRC. Presumably the hernia isn't helping. Would be good if your niece could speak to a b/f counsellor who can look at the weight gain issue and see if there is genuinely anything to worry about. And if baby needs more milk, as everyone has said, answer is to feed more often/for longer, not add in formula. It would be very, very rare for someone not to produce enough milk to feed their baby.

Can I just add that inguinal hernias are relatively common in prem babies and much likely to be related that than to any "straining" for a poo.