Please help, I'm in a complete feeding muddle

[daisygirlmac]

DS is 8 days old and we only came home yesterday from the neonatal unit after a traumatic labour and delivery. He was born at 40+5 and was 9lb 15 so by no means a small baby!

We've managed to get into a total muddle with feeding. Whilst he was on neonatal I was expressing non stop to get supply established and he was having bottles of my expressed milk topped up with formula as he wouldn't latch on for a breastfeed.

We've come home yesterday and I persevered with offering a breast and he had some ok length (5 to 10 mins) feeds but didn't seem to be sucking or swallowing a lot after the initial 2 mins. He's then been almost constantly on me overnight and this morning. Community midwife has just been and said I need to top him up with formula or express and top up and she doesn't think my milk has come in properly. She also thinks I shouldn't cuddle my 8 day old baby to sleep so I'm inclined to think she can bog off but I do need help sorting this feeding.

Options are: carry on trying to breastfeed, although frankly I'm on my knees with exhaustion and I'm just not sure I can stay awake another night.

Just give him formula, which he's perfectly happy with.

Have some strange hybrid where I express milk but bottle feed it topped up with formula (surely the worst of all worlds?)

I'm so tired and I can't stop crying so please help me decide what to do and tell me what you think

Sounds like you've had a rough start. Congratulations on your baby!

I don't know whether you should top up or not, but I do know you can combine formula top ups with at-the-breast breastfeeding. I seem to remember hearing it's best to give a small amount of formula first, so the baby associates the happy and full feeding at the end of the feed with breastfeeding rather than formula.

Kelly mom is a great resource, here are some good posts- kellymom.com/bf/got-milk/supply-worries/enough-milk/

kellymom.com/bf/pumpingmoms/feeding-tools/bottle-feeding/

My first DS was born at 40+12 weighing 9lbs 13oz and was in SCBU with group b strep infection for 5 days, then a couple more on transitional care before being discharged on day 7. Sounds fairly similar to your experience. We went home doing a mixture of direct breastfeeding, expressing and topping up with that or formula if we needed it. It is hard work doing a mixture of everything!

Doing formula top ups need not be the end of breastfeeding, if you want to continue with it. But you have to be careful that the amounts don't increase to the point where you're basically just formula feeding. I used to breastfeed first and then give a top up. I breastfed every 2 hours in the day and 3 at night, to try to up my supply. I expressed as much as a could as well. It took till about 6 weeks to gradually shift to 100% breastfeeding.

Has anyone checked your DS for tongue tie?

Also, ignore the advice about not cuddling him to sleep, an 8 day old baby needs to be on or near his mum!

daisy, what a difficult start :(

You are now feeding in the most difficult, cumbersome way, and you are 100 per cent right to want to see a way out :)

Your ds is still very young and of course you can get back to full bf.

You need some decent help and informed support:

• find a breastfeeding counsellor or lactation consultant to see you and observe a feed. The hospital or community midwife should tell you how to get hold of one working for the NHS or else do a google search and/or contact one of the bf helplines

it is possible your milk has yet to come in, but this could change at any moment :) . So keep on feeding ad* lib without taking him off unless he shows he is done, swapping over to the next side (and back again and back again....) when he comes off

don't assume that after two mins he has stopped feeding....it is normal* for sucking and swallowing to slow after the first minutes. An observer who knows what to look for will be able to tell if he is still feeding

• what's his weight like? Is he producing several yellow poos each day? These are signs that things are going well

• the constant feeding is fine and is perfectly normal esp for a baby who has spent some time in special care after a difficult birth....the idea that you should not cuddle a baby to sleep of this age and after these experiences is indeed an odd one, as you suggest

Do get real life help :)

Thank you all. Yes he was checked for tongue tie and none found.

Is it right that he seems so hungry even after nearly 4 hours of non stop feeding? He's literally inconsolable and I've had to settle him with a dummy so he can even consider trying to latch on again. He keeps falling asleep at the breast as well so I'm trying to do as suggested and tickle his feet etc.

His weight is absolutely fine and plenty of nappies of both varieties.

I will have a look for someone to come and help me, I don't have a lot of faith in my local community midwives as they've made a complete mess of my antenatal care. The breastfeeding support in hospital was actually great but it's almost an hour away and I'm obviously not driving. I'm sure lots of new parents feel like this but I feel totally out of my depth today!

Call the hospital, mention how good the bf support was and ask them how to contact similar outside...there may well be people who work for the same service in the community.

Or, call one of the bf helplines.

It can be normal for feeds to last hours. In fact what happens is the baby does doze a bit, then perks up and feeds again....then dozes....then feeds. It can seem continuous, but in fact the baby is sleeping a bit, but at or on the breast.

I don't know why you are tickling his feet?

He might want/need to sleep :)

Daisy- just in case you don't know, tiktoc is a proper expert on this subject and you can depend on her absolutely. Good luck.

Just to add: sometimes feet tickling is fine, if a baby really does need help to feed and consistently drops off and is really not feeding well. But the OP's baby is feeding ok, from what she says :)

Thank you so much I have called the hospital and there is a group near me who might be able to send someone out so I've left a message. I was feet tickling to try and keep him awake so he could feed a bit longer than 3 minutes it was on Kelly mom I think, but happy to leave the poor boy alone if that's best. Community midwife suggested I wipe his face with cold wet cotton wool which seemed very harsh!

It's just you said he was feeding loads and loads e.g. For four hours. So I reckoned he was beyond the feet tickling stage :)

If you have been told to tickle him awake then don't let me tell you different. But use your own judgement. Sometimes you might think he does need encouragement to feed more.

Really hope you get someone good to observe and help you in real life.