Top ups and nipple confusion

[birdofthenorth]

DS is 12 days old. Lost 13% birthweight by day 3 within severe jaundice. Had phototherapy treatment and 2 hourly breastfeeds and is putting it back on although very slowly (still 6% below birthweight today). I am giving top ups after most feeds on instruction from the midwives. Top ups are EBM as want to avoid formula. DS refused them in a cup so have been syringe feeding but midwives now want me to give more than is recommended via a syringe. If I introduce bottles now will it screw up feeding forever? His latch is still not great sometimes and I wouldn't describe bf as established yet.

My DS is 6 weeks old today and last week I tried him on a bottle of expressed milk and so far so good with him swapping between breast and bottle.
I know he is older than your LO but didn't want to leave your thread unanswered.

I guess worst case scenario is he prefers the bottles and you end up expressing and feeding him that way but you don't have to go down the formula route.

Good luck with what you decide to do

My personal choice is to offer the boobs even more frequently during the day. You'd be surprised how often they will take more. That may take some pressure off for top ups if it is working well by next weigh in. Hope that helps. Congratulations on your little one and you are doing great!

We had to give ds top ups (we did f) at 10 days old. Carried on mix feeding until 6 months and he just went from boob to bottle without any bother. It only became an issue at around 5 months when he had a growth spurt and we'd been reducing bf anyway when he really preferred bottles. Bottles don't have to mean the end of bf in every case but if I had the choice again I would probably have waited until later.

It doesn't mean the end of bfeeding necessarily. I would suggest using bottles that mimic the breastfeeding action (we used the Medela Calma ones but there are obviously others). The idea is that they have to suck like they do when breastfeeding, as nothing comes out of the teat unless they do. They can also stop the flow of milk themselves, like they can on the breast, unlike ordinary teats. It's obviously not a guarantee but I do feel it helped me and DS to get back to 100% breastfeeding after a rocky start to breastfeeding in the SCBU.

I'm not sure of the logic behind increasing the top ups if he's now gaining well.

DD had prolonged jaundice including re admission to hospital at 8 days so I have an idea what you're going through. In my experience HCPs are very keen to see volume going in, but this isn't really how bf works.

I wouldn't worry too much about giving a bottle, especially if you offer the breast first and continue to express to stimulate you supply

However, at this point I wonder if you can just feed on demand. Have you spoken to anyone from the breastfeeding helplines or La Leche League?

I'm not an expert so don't go against your mw advice on my account, just maybe worth querying.

Like culture we used the Medela calma ones to mimic the bf action. And have had no problem. We had to top up after a week as ds had severe tongue tie and lost 11% of body weight. It's brilliant that you are able to top up using ebm - must be exhausting though! formula top ups really messed up my supply and I had to work really hard to build it back up when we ditched the top ups finally.

If latch still doesn't feel right it might be worth getting dc checked for tongue tie? It seems to affect a lot more children than you'd expect !

I have friends who are struggling to get their babies at 4 months to take a bottle after exclusively breastfeeding so there are definitely advantages of starting early - I love not having to do the evening feed so I can put my feet up and chill/ have a bath etc

How are you getting on?