Any advice please... reluctantly resorted to top ups and problems with expressing milk and

[Jessiecat]

This is my first post and any advice would be really appreciated. My ds is 17 days old and I had really wanted to exclusively breastfeed him. On day 12 he had dropped to nearly 13% below his birthweight, 7lb 7oz, (when we left hospital he was 10% below) and on the advice of a midwife and also out of sheer desperation began to give him a top up of formula after every feed. Apart from being really sad about not having the professional support to continue with the breastfeeding (I saw 4 different midwifes in a week, each giving differnt advice) I would really like to drop the formula feeds when his weight has stabilised, but I dont know if this is going to be possible. I am trying to express milk with a mini electric pump but not having much luck with it. I'm worried that my ds is jst using me as a comforter and getting all the milk from the bottle. Does anyone have any advice or similar experiences?

Firstly it is unlikely he isn't getting anything when he feeds on, as long as he is latched on properly (has that been checked ?). Is he otherwise healthy - wet and dirty nappies , sleeping/wakeful, not unwell. Continue to offer him the b'feeds first and then express(which in itself is no indicator of your supply btw). You really do need some clearer support though - is there a Breastfeeding cafe in your area and / or could you call one of the support lines (NCT, La Leche League etc) ?

Keep up with the breastfeeding. You can make enough milk to feed you baby! :0 Giving topupfeeds will only reduce you supply. every time your son feeds you body gets signals to amek more milk. The best advice I can give is to get to a local breastfeeding group and talk to other mums and health professionals there. Ask you healthvisitor for numbers. I've breastfed my daughter for 19 months but can only get a drop out if i try to express, so don't worry about that!

I always found expressing really hard too so definatly agree that it is no indicator as to how much your lo is getting.

Agree with everone that you need to get more support to carry on BF. You cou;d definatly increase your supply to drop the formula feeds. Not sure if you are into baby advice books but Tracy Hogg 'the baby whisperer' does have some advice about increasing your supply. Might be worth a read if you cant find the support you need in your area. Also I tried NCT help line when I was BF for the first time with DS1 and it was really good to talk to someone about it all.

drop the formula top ups as these will be decreasing your supply. go to bed with DS and feed, feed, feed even if it is every hour or two for a few days as this will stimulate your body to make more milk. its especially good for supply to feed every few hours during the night, hard i know when you need sleep, but the prolactin levels are higher at night. you could continue with the expressing after feeds but it is not the same stimulation to the breast as the baby suckling.

offer both breasts per feed but make sure the first one is emptied i.e feels deflated as this will ensure ds is getting the hindmilk.

ensure you drink plenty of fluids and try to relax as stress can impede the letdown reflex and milk flow.

there are also herbal teas that are designed to increase milk, try googling "mothers milk tea" or breastfeeding teas.

also get intouch with one of the helplines
ABM 0870 401 7711
NCT 0870 444 8708
BFN 0870 900 8787
LLLI 0845 120 2918

hope this all helps
have faith, you can exclusively feed your baby

Jessie, I would defintely phone one of the helplines. I've been having problems with ds2 (4weeks) and phoned the nct in desperation on tuesday. The lady i spoke to gave me the number of a counsellor near me who came on weds morning, sat with me, worked on my latch and since then the feeding has been so much better. The adjustment she made to the latch was really slight but has made so much difference.

I'm sure if you got your latch sorted out and then spent 48 hours in bed with your baby you wouldn't need the formula any more.

I also had a similar problem. I exclusively breastfed from the start but my DD did not recover her birth weight despite it appearing that I was feeding at regular intervals for decent amounts of time (i.e. not too long and not too short). We found out that although my DD could latch on and knew how to suckle properly, she was lazy and was not taking enough milk from me.

Like you, I was then advised by my doctor to feed 20 minutes on the breast at each feed and then top up with formula.

Now, at 10 weeks, she is mainly formula bottle fed but I express throughout the day with an electric pump (and finish off with my hand to ensure each breast is empty) so that my DD has at least one bottle of breast milk a day. In my opinion, no pump is completely effective and if I squeeze my breats myself once the pump is taking no more milk, I always find that there is more milk to come.

I was very sad about the whole thing as I really wanted to exclusively breastfeed but what else can I do other than pump when I have milk but a baby who won't take it? It got very difficult trying to breastfeed a baby who just wanted to play around with my nipple rather than eat. Of course the problem is that the less you breastfeed, the less milk you have as nothing is as effective as a suckling baby for maintaining milk supply. i am pumping a lot now to try and keep my milk for as long as possible.

Now I do put my DD on the breast sometimes but it is more for comfort. i think that ultimately giving formula reduces your milk and you should try to avoid for as long as possible. my midwife did suggest giving one bottle of formula once a day when you feel your milk supply is at it's lowest i.e. prob evening and see how it goes. i wish i had tried this first rather than doing the 20 min thing as my doctor suggested.

would second the go to bed and stay there for a couple of days with the baby and just feed.

Your situation sounds like mine with DS1 and I reluctantly gave up with him much too soon - he was more or less totally on the bottle by about 6 weeks - it still make sme sad now 5 years later.

With DS2 I was much more adamant I was going to stick at it and a few days in bed (not planned - I was ill but obviously was the best thing!) and just feeding as much as possible did the trick. His nappies were really soaked so I knew he was geetting enough - with DS1 they weren't at all and the MW or HV didn't really comment on it.

Please hang in there and phone an advice line for extra supposrt. Our materbnity hospital has a BF counsellor as well who is great.

You can get off the top-ups. I did with ds after 4 weeks of struggles and breast refusal, he then exclusively bf to 6.5 months and he is now 20 months and still bf. I was cr*p at expressing too.
If you can spend a weekend in bed with your ds just feeding, it is an excellent idea. Night feeds are (sorry) important at this stage. How often are you bf him? Don't limit in time or frequency. I agree with the others that some more concrete bf advice (e.g. wrt checking latch) would be invaluable. Good luck!

btw, don't give formula and EBM at the same feed if you can avoid it.

I found that expessing and feeding at the same time helped, but as evertone says topups dont help.
During growth spurts i would take to the sofa with lots to drink and lots of snacks, i always found this helped. (left housework of dh when he got home from work on these days

ladies! not very responsible advice to drop bottles. Depending on circs, may well take time and dedication (cold turkey is quite extreme) - possibly best solution may be to mixed feed.

Jessie speak to one of the advice lines; get someone to talk through your entire situation; get your latch checked etc. And take good care of yourself (physically and emotionally) because small babies are exhausting, even without feeding complications.

Babymoon is lovely idea - but it may take more than that to fix the problem. Get proper help.

foundintraslation - i don't give formula and expressed milk at the same feed but why do u say it shouldn't be done? i thought i read somewhere that expressed breast milk can be topped up with formula if not enough for a whole bottle. thks

It's supposed to reduce the beneficial action of bm on the gut - this cropped up in a conversation I was having with a bfc on (I think) the ABM helpline when I was having my bf troubles.

that's interesting (and i mean that in a genuine and not sarcastic way ). I think what I read said the opposite: i.e. that the enzymes in the breastmilk assist with the digestion of the formula milk.

It's all v confusing...especially for first-time mums like me.

Thank you all for your advice - really helpful and nice to know I'm not alone (was beginning to feel like a real failure). I will definitely be getting some further advice on this from a bfc. Not sure if it makes any difference that he was born by ceasarean at 38 weeks due to breech presentation (and delivered early as our first baby was stillborn). I agree that he is probably lazy and just not sucking enough, but not sure how to change this. Also, although there does seem to be milk there (I leak all over the place sometimes) I'm never sure when he is finished on one breast - sure it's different for everyone but ds tends to suck for anywhere between 10-20 mins before falling asleep - does this sound average? I'm sure the fat that the ceasarean recovery isn't helping things much either - desparate to get out but just not ready for it yet. Can't wait to be pushing ds proudly all over the place!

Jessiecat, I had similar advice when dd (11 days) and I were having problems getting bf established. We couldn't get the latch right and every feed was turning into a fight, with advice coming at me from all angles. She is now on bottles, some expressed and some formula and seems well, feeding at 4 hour intervals. Tips for expressing if you still need to: take 3 or 4 deep breaths to relax you, try having a hot bath (I've even managed to express in the bath using the battery pack for my pump, but prob not really the best idea), try distracting yourself by doing it whilst watching telly and finally try sniffing either your baby or the clothes he has been wearing (yes, looks weird but seems to work for me anyway). The worry with bottles is overfeeding, for me, anyway. Go with whatever works for you as this is an anxious and difficult enough time anyway. Good luck!

don't forget breast compression - this really helps with getting that little bit extra out when expressing.

Good luck!

bumping, as just seen Tiktok posting

I had exactly the same situation when DS1 was 10 days old. I had to start topping up and went to see a lactation consultant. She gave me a lactation aid, which allowed me to top him up with formula at the breast, so it helped me increase my milk supply. I also took Motherlove's More milk plus pills, which made a dramatic difference. In the end I was able to cut out the top-ups after about two weeks. Going cold turkey on the formula didn't work for me - DS would get dehydrated very quickly. He's now been on breast milk only for just over a week . His latch is still awful though.

Jessiecat, can only echo what people have said already, and to suggest you speak to someone who knows what's what and who can give you some trained and skilled help.

You were already let down by the 'system' - a baby on day 12 still 13 per cent below birthweight is a baby who has not really got feeding together at all, and that is not your fault but the fault of the people whose job it is to avoid that happening

Yes, you can work towards dropping the formula, but not without good help to get the bf fixed, and not suddenly (please don't drop the formula - your baby needs it at the moment, and the bf has to be worked on before you can cut down on the formula).

I hope it works out for you. Milk supply, and babies' growth, happen with frequent, effective removal of milk from the breast. I think your baby needs to be weighed again, on accurate digital scales, to get a full picture of what's happening, too.

Hope you get the right help.

i understand that c/s can make your milk come in later - may well be a factor.