Breastfeeding advice/reassurance after poor start

[Woody16]

Hi all, would appreciate advice if anyone has been through something similar.

My son is 3 and a half weeks old and we've really struggled with feeding. He was born at 37 1/2 weeks and was low birth weight, 5lb 7. We were in hospital for 3 nights as he was struggling to latch and had to have most of his colostrum given by syringe and also had a couple of formula top ups when he had low blood sugars. He was able to latch by the time we went home and as far as I could tell breastfeeding was going well, however it was agonisingly painful and causing bleeding. Fast forward to day 8 and we were readmitted to hospital as he was losing weight and needed treatment for jaundice secondary to poor feeding. He had a tongue tie which was cut, and I started expressing and giving bottles of expressed milk and formula in hospital (as I wasn't pumping enough milk). For a week at home I expressed 3 hourly and gave him my milk + formula, after trying to breastfeed first, but following the tongue tie division he wasn't able to latch at all. Saw a breastfeeding councillor at 2 weeks who advised a nipple shield, and using it finally managed to get him back onto the breast. She advised to continue top ups until breastfeeding was better established. We had an exhausting week of breastfeeding (he feeds for a minimum of 40 mins), followed by expressed then formula from a bottle, followed by 30mins of pumping to provide for his next feed. It really pushed me to the edge as left almost no time for sleep at all. He reached birth weight at 3 weeks.

Saw breastfeeding councillor again a few days ago and she was really pleased with his progress. He is apparently latching and suckling well. I expressed concerns at the length and frequency of his feeds, which she said was probably cluster feeding due to a growth spurt. She advised cutting top ups to 3 per day and eventually weaning them down completely, and has discharged us.

Obviously that was reassuring but I still feel desperately worried that it will go wrong again and I won't realise. Since cutting back on the bottles he has breastfed almost constantly for the last few days, particularly in the afternoon and evening through til about 4 am. He is feeding hourly most of the day, with one or two longer stretches of 2.5/3 hours. Today I was literally stuck on the sofa all day. He will feed 45 mins- an hour (though is sleepy a lot of this time) and still be desperately hungry and at night will scream if he is taken off the breast, unless he is given a bottle. His face just lights up when he gets the bottle and he instantly calms down and guzzles masses. It breaks my heart and makes me feel like he can't possibly be getting enough from breastfeeding. I've read a lot about cluster feeds and scoured these forums and it does seem like 3 weeks is a common time to feed round the clock due to a growth spurt. So I suppose my question is, does this seem like normal behaviour for cluster feeding or is it possible he's still not breastfeeding properly and is just desperately hungry now the bottles have been cut back? I'm so worried he will lose weight again. I feel like such a failure that he had to go back into hospital before. Also concerned that my supply will dry up if he's not feeding well. I'm only expressing 3 times a day now, to provide some breast milk for the 3 top ups, and I can't possibly fit anymore pumping in when he feeds constantly (today I pumped one side whilst he fed from the other!)

Sorry for such a long post. I'm just desperate to get breastfeeding to work. I never imagined it would be so hard!

[Woody16]

Honestly it's so reassuring to read you managed to build up supply with 4-5 pumps a day. I've been reading online and watching YouTube videos and stuff about pumping and a lot of it says to pump 10-12 times a day if you really want to get the milk flowing! There is just no way I could ever manage that (at best I managed 8 times a day, but only on a couple of occasions as it leaves time for so little else when you're also doing a breastfeed first.) So I've been kicking myself for not doing it enough, but sounds like I shouldn't be so hard on myself!

Have found a medela on gumtree which is about half the price so will buy that. Supposedly only used for a couple of days and if I sterilise it first I'm not really bothered that someone else has also used it.

Thanks so much for sharing, it's really helpful to hear about others who've been through similar and what different things have worked for different people. Am making sure we are never at risk of running out of chocolate! :)

[Woody16]

Thank you kennington :)

[RedToothBrush]

If you are pumping 4 or 5 pumps a day PLUS breastfeeding, I'm pretty sure you are doing the equivalent of 10 - 12 pumps! The 10 - 12 will be pumping only I suspect. As I say, there isn't much out there for anyone doing anything out of the ordinary.

[Woody16]

That's a good point red, hadn't really thought of it like that! Well I now have 2 pumps, started using the medela yesterday. Not convinced any more milk is coming than with the avent, but the shield was the wrong size for me so have ordered a different one and hopefully will see some improvement. What is good is having the two pumps- I have tried double pumping a few times now and while it is a faff, it's definitely worth it for me to spend half the time pumping. Getting about 30ml/session now and trying to pump after most feeds, but not managing all (doing it 5-6 times/day). How long did it take for your milk to start increasing?

I am still breastfeeding for up to an hour for each feed before topping up. But he then has such a huge top up after each feed (20-30ml breastmilk, plus 50-60ml formula, sometimes more) that I wonder if he is really getting anything at all from breastfeeding? I suppose there is no way to tell, but I'm so worried that he will start taking more and more via the bottle and end up just breastfeeding for comfort rather than actually taking any milk. I'm not really sure there is anything I can do to prevent this and I know the important thing is he gains weight and gets stronger, hopefully when he is he will be better able to latch and suck.