Advice needed - should I start expressing/bottles exclusively and stop breastfeeding?

[ppandj]

This is my first baby and I have been getting conflicting advice from professionals so have turned to MN for support!

DS is 9 days old and has been ebf from birth. He does not open his mouth very wide at all for feeds and appears to sometimes have trouble latching on though not always (he has been checked for TT and they said that isn't it). He also appears to be quite windy and often takes himself off the breast mid-feed or fusses at the breast, shaking his head and hitting my boobs with his hands. This is not every single feed, but it is quite frequent.

Last week DS wasn't latching well and to ensure he definitely got a good feed I expressed and bottle-fed him every now and again with the midwife's advice. He only lost about 3% birth weight, has lots of wet and dirty nappies and seems quite content between feeds as long as he is properly winded. We have also started using infacol which I think is helping. We had been bottle feeding maybe once every two days for the past week so not very often at all and DS feeds relatively frequently at 2-3 hours but not for long feeds.

My dilemma is this; DP is anxious about the amount DS is getting and obviously this is immeasurable at the breast. Last night he gave DS a 60ml bottle of EBM while I had a sleep so that I could have a rest, and then DS slept for around 4 hours peacefully. Now my DP wants me to only feed DS from a bottle so that he gets "bigger feeds" and doesn't do all the crying/fussing/coming off the breast. He also is concerned because DS only ever feeds for a max of 10-15 minutes at the breast and he thinks this is not long enough to get a good feed.

I am really torn because I do find the breastfeeding really, really hard at times, but other times it seems to be ok. I am enjoying the bonding aspect of it and feel that I'm trying my best for DS. I'm worried that stopping breastfeeding will eventually lead to having to switch to formula due to milk drying up/time consuming nature of expressing. While I am not opposed to FF if BF doesn't work, I don't yet feel ready to make a decision because it's only been 9 days.

How long should DS be feeding for and how often at this stage to ensure he is getting enough? Does expressing and bottle feeding exclusively mean the end for BF?

Please help, I'm getting so upset caught between different advice and trying to alleviate DP's worries and just want to do the best thing for my DS. X

I really think expressing exclusively is the worst of both worlds. In the beginning breastfeeding seems all consuming, spend time worrying about how much, how often etc. It sounds as though you are really well. If your baby is coming off himself after 15mins he has probably had enough. At this age they have tiny tummies and will need to feed again very soon, this is normal. You can expect some long cluster feeding sessions to start soon and continue for a few weeks. The best markers of input are nappy output and baby's weight gain. What I want to add is that this doesn't last forever. it gradually gets easier and in a few weeks (about 4 weeks in my case, but most say 6-8weeks) it becomes really easy. Is there a breastfeeding group nearby?

Just to answer your other question, at this age expect at least 10-12 feeds in 24 hours, maybe more. Try not to worry about the length- some babies will feed actively for 15 mins and pop off, others can feed actively for 5 and snooze on the breast for an hour. The first type will have had more milk.

With respect to your DP, it's not him who will be sitting for hours expressing milk to bottle feed, so it's easy for him to say this is what he wants to happen! I've exclusively expressed and it's bloody hard work.

If the only reason you're considering it is just to reassure your DP that your DS is getting enough milk, then maybe giving him some good information on the reliable signs of a baby getting enough milk from the breast instead might reassure him - ie. gaining weight, wet and dirty nappies etc. There's a good list of these signs on the Kellymom website , which is a reliable, evidence-based source of info. There's also a good list of things which AREN'T reliable signs of a baby not getting enough, one of them being length of feeds. I would personally try other ways of reassuring your DP to give things time to settle down.

Hi ppandj. What makes you think he wasn't latching well? It sounds as though he is doing really well. Some babies never have a textbook latch, but if they are weeing, pooing and gaining weight and it's not uncomfortable for you, well... if it ain't broke don't fix it! Kellymom is a good source of info as suggested above.

Have you got a bf group nearby? It might be reassuring to have some bf supporters take a look at a feed. If there are issues with latch they can suggest things eg exaggerated latch. Some babies just latch better as they get bigger too.

I had to exclusively express for a while as my son was premature. It was flipping hard work and without some of the rewards of direct bf.

What course did your DP do to make him such an expert?
Fussing and hitting the breast are all ways to increase supply.
Sleeping 4 hours at 9 days is a fluke.
What will your dp do on the growth spurts and wonder weeks?

I think you seem to be doing great. I have a 5 week old and the 4 h stints are rare... And she lost 8% of birth weight at the start so you did really well

I went through the fussing stage too and nearly quit. It does get better! At 9 days he will be trying to increase your supply. I've realised over the last few weeks (dd 7 weeks now) that I needed to relax more and trust my body to feed my baby rather than worrying about amounts. And you need support from your DP so as suggested above reassure him about all the positive signs.

My DD is 7 weeks old and to start with she couldn't latch, I got in a horrible mess of trying to latch, then giving expressed milk, then expressing for the next feed, it was demoralising and exhausting! She lost 10% of birthweight too. Now she breast feeds really well, I'm pleased to say. At the start my DP would keep saying "shall I get a bottle?" while I was trying to get her to latch, rather than being more supportive of my efforts. But now he can see that she is gaining weight, is happy, sucks well etc, he is very supportive. We still need to use an exaggerated latch though.

I would reassure your DP about the signs that a baby is getting enough milk, and keep going with the BF if that's what you want to do. It is hard work though, much worse than labour for me, and I've still not quite cracked it I don't think!

Some mums do exclusively pump, I think it's more common in the states, so it is possible if you prefer.

Good luck!

I think often partners can feel a bit helpless in the early days of breastfeeding, especially when you're having a tough time. Mine certainly did, and also kept suggesting bottles. I wonder if it's sometimes a bit of a male approach of "right, how can I fix this" - expressing and bottles, with measurements and certainties, are an attractive solution. Pumps can be fixed and monitored, boobs just do their own thing!

As PP say expressing is a right hassle and far more work/worry than breast feeding.
Also both breast abd bottle babies get fussy and have wind. It won't solve that! Though they tend to grow out of it.
What you describe about having to 're latch' happened to me ... its quite normal. Babies don't know how to do much, they're babies lol It takes a few weeks or months for some to reliably get the hang every time (anecdotal experience) but gently re latching teaches them.
In terms of amounts, wee and poo are what to look for I was told.

Fussing and wind are just what babies do!! the magazines and adverts lie, lie I tell you!! They do whack your boob when they feed, so don't worry.

There are lots of wind tips around - baby massage, sit up or lie in fore arm after feeding, warm baths, infacol ...
I found my DD just grew out of it.

Oh my goodness.... it's such a shame you are upset and confused :( :(

Your DP is complicating things. He is not helping.

Why would expressing and giving by bottle even help? There is no advantage in knowing how much milk a baby takes at a feed - babies take different amounts and there is no way of even guessing how much an individual baby 'should' have at any particular feed.

10-15 mins is within normal....why does your DP think he knows about infant feeding needs? He clearly knows nothing, and worse, he doesn't know he knows nothing!

It might help if you both went to a bf support group and just chatted to others about the way bf works.

Expressing and giving by bottle is a pain in the arse, and not something you would want to do unless you actually had to.