Baby refusing breast

[Slumberparty]

Any advice please?
My DD is 11 weeks old and has always had quite short feeds from birth - very rarely went more than 15 minutes total. She seemed happy and healthy with the short feeds. I have been expressing milk for her bedtime feed at 7pm and dream feed at 11pm.
Over the last couple of weeks DD has been getting worse and worse at the breast - feeding for 6-7 minutes then pulling off crying etc. Same when I switch breast.
I had her weighed on Monday and she is not gaining weight at the rate she should. Midwife suggested she is probably getting frustrated with milk flow slowing after initial let-down? She told me about the importance of fore milk / hind milk etc and her advice was 'try and get her to feed more' (helpful) and to express 3 times a day after a feed to increase milk supply.
It has got to a point where she gets really worked up when trying to feed. She refuses breast after 5 min (sometimes even 2 min!) but is obviously hungry so I end up giving her a bottle of expressed milk or now sometimes formula if I don't have any milk to give her. After that she is happy and content.
I have tried starting on a bottle and finishing on the breast but she still gets just as frustrated. I don't know what to do as I really want BF to work and don't want to end up FF all the time. But at the same time don't particularly want to spend half my life pumping milk.
Any advice?

Can you try breast compressions during a feed to increase the flow of milk? If as your midwife suggests she's getting frustrated when the milk flow slows, then compressing your breast while she's latched on can give her an extra gush of milk that might encourage her to stay on the breast. This is a good video of how to do it: www.breastfeedinginc.ca/content.php?pagename=vid-4dayold and this is a good general article on low milk supply with some other things you can try: kellymom.com/hot-topics/low-supply/

Also if you're supplementing with a bottle, then using 'paced bottle feeding' can help minimise confusion between the two for the baby. Essentially you hold the bottle horizontally, tip a little milk into the nipple area and wait for the baby to get it all out, then tip a little more in, mimicking the way breastfeeding works.

Not heard of he paced bottle feeding so will try that.
Yes I've been trying breast compressions which helps keep DD interested for another minute but I will watch he video again to refresh my memory as I last watched it about 6 weeks ago so may not be doing it right perhaps.

I really feel for you, I had a similar phase when my baby refused to feed (but that was reflux related) so I know it's really hard and upsetting. I was told to have a few days in bed with her so you're both relaxed and get some skin to skin - possibly worth a try! Also oats are super for milk production (chocolate oatly milk is lush!) but I doubt it's your supply, it's probably her frustration at having to work a bit harder for breast milk so the previous post sounds like a great idea.
At the end of the day though, as long as you're both happy and baby is fed you just need to do whatever works for you, be it breastfeeding, mixed feeding or bottle feeding xx

I'm having porridge every morning for breakfast!
Yes it's getting upsetting and when talking to others about BF have always said that what's most important is that baby is fed and mum is happy so if you need to FF then so be it...but can't seem to apply that to myself! So hard not to feel like a failure.

I know what you mean, you'd never expect anyone else to feel so pressured but it's easy to do it to yourself! I think it's easy to assume that bf is fine once it's started but we've had a few hiccups at various points - we are still going at 20 months. Take each day as it comes, she's still very little and will soon get back on track I'm sure. I went to a bf group once a week while I was on mat leave and it was great, lots of advice and support available. You should be able to find someone through your surestart centre who's a bf supporter - if not your local la leche league will also have a network of people who can give you advice. Try and be kind to yourself, you're doing a great job and you obviously love your baby very much xx

Thanks Norbert. I'm not in the UK so not as easy to find breast feeding support but I'm sure it's out there. Will ask some of my mum friends.
I will try and persevere and hope this is a passing phase.

It sounds like this has started recently. Around 12 weeks your milk supply switches from being driven by your postnatal hormones to being driven by the baby's sucking. That means that if you were overproducing milk before (and if your baby was a quick, fussy feeder but gained weight well you might have had an oversupply of milk to start with) and now you have a 'just enough' supply, that can be frustrating for the baby, who was used to having massive gushes of milk and now has to work for it. Switching back and forth between your breasts can help with this too, so feed on one side till she gets fed up, then the other side till she gets fed up, then back to the first side, and you can keep on swapping back and forth as long as she'll take the breast.

Are there any breastfeeding support groups in your area? Your midwife might know, or facebook often has local breastfeeding groups listed. It sounds like you're feeling really down about this, and having face to face support can make a huge difference.

I hope this phase passes too, try to not let it spoil enjoying your little baby for now and just see what happens. La leche league has places set up all over so there might be one near to you, if not their website is really useful too. I think there's also a LLL book called "the womanly art of breastfeeding" which I know sounds a bit serious but I often wish I'd bought it as it's meant to be really useful.

Thanks both of you. I will definitely look up LLL and have a look at the book you recommend.
Philosophical mum thanks for reminding me about that website. I've just been watching a lot of the videos on there and feeling more renewed and determined!

Slumberparty, I am not sure I agree with what your midwife is saying or suggesting - there are deffo other possibilities.

What is her weight? It may be ok. It is normal for the rate of weight gain to slow at this age. Do you use the centile charts where you are? Where is she on those?

It is normal for feeds to be shorter.

Babies get frustrated when they are continually 'asked' to get back on/stay on the breast.

Expressing 3 x day is a real nuisance. It would be easier and more effective to breastfeed more often (if supply is a problem - not sure it is). You are missing at least two breastfeeds (by giving ebm at 7 pm and 11 pm). This is not good for milk production....some mothers can get away with skipping breastfeeds and you may well be one of them. But leaving long gaps between bfs is not helpful. Could you just breastfeed at those times instead?

Hi TikTok. DD is 5.23kg and was 3.59kg at birth.
If I stay in the house with DD all day (ie no distractions ) DD will often try and feed every 2 to 2.5 hrs so pretty regular already. Also I express between the 7 and 11pm feed so do you still think my supply could be compromised by that? If I need to start BF then I will but at the moment I feel that those are the only decent feeds she gets.

Just a quick hello to say I hope today's a bit better x

All of my DC have been short feeders but they feed really frequently. I don't think you can make your dd take longer feeds so you'll need to offer more short feeds if you want to increase the overall volume of milk she's taking/you're making.
I think it's pretty unusual for a breastfed 11 week old to go four hours between feeds in the evening. I'd try offering at least every 2hrs until 11pm and not worrying about how long each feed is, even if it's just a few minutes. Especially if she sleeps well at night. Just feed, feed, feed during the day - much more effective and less tedious than pumping.

Hi Norbert, much the same today!
Apple the 11pm feed is a dream feed as I put her to bed after her 7pm feed. If I don't wake her at 11pm she'll sleep for about 6 or 7 hours. During the day I will often feed every 2ish hours or as much as she wants but it's not just that the feeds are short it's that after 5 min she pulls off and gets upset. She keep relatching then gets frustrated again and pulls off. She's obviously hungry but refuses to feed from breast and ends up having a complete meltdown. I end up giving her a bottle which she takes happily and is content after. I'm not sure it is supply either as earlier today she fed for approx 5 min each side before refusing to try anymore and crying. I gave her 50ml of expressed milk I had in fridge. After that I pumped exactly 50ml! So not like the milk wasn't there ...

Sorry prob way too much info...just getting frustrated.

Have you thought of trying nipple shields. My little one was having problems and they helped. May be worth trying?

Oh no, poor you. I'm hesitant to suggest yet another thing but when my baby had silent reflux she hated breastfeeding as she was flat, much happier and no fuss from a bottle because she was more upright and it wasn't painful to feed. Long story short she has a milk allergy which set off the reflux so once we cut out all cows milk the reflux stopped anyway and no more fussiness. That's not the case with you but it might be that position helps? Babies are so hard to figure out! X

Yes anything is worth a try! Have tried lots of feeding positions. Amazingly it turns out that a friend of a friend is a lactation consultant and has offered to come over tomorrow to see if she can help. Fingers crossed!

OP, that weight could be fine. Why did they say it was a problem? Of course it might be different if she is losing weight or has not gained at all for some time. But the raw numbers are ok.

It's good you are meeting someone who can help. Your experience with the breast refusal and then the bottle may not mean anything. Babies may take what they want or need at the breast and refuse more and yet may still take a bottle because the super-stimulus of the teat makes them feed more.

It's just not possible to say what's going on. Which is why it's good you are seeing someone. It's not clear what's happening in the evening. Whatever - hours and hours with no bf or expressing is not good for supply. If you are expressing in that time that will overcome some of that.

Good luck.

Midwife just said she's underweight mainly I think because she is not following the trajectory she was on.
I saw a lactation consultant today who has been great. She thinks it is nipple confusion and the type of teat I was using. I had a tommee tippee teat which is quite short and stubby and LC says DD can't latch properly on it and so is not latching properly on my nipple. We tried with a different teat (much longer) and I can really see the difference. So basically have to retrain her to latch properly. I'm feeling quite hopeful and had a couple of better feeds today - still short feeds but much calmer. Fingers crossed this is the answer. Thank you everyone for your advice and concern x

Glad you were able to see a lactation consultant.

Agree with what tiktok has said, especially in terms of by giving the bottles at 7 and 11 you may be missing out on the milk production. Expressing wont be stimulating the same supply as baby is usually far more efficient at getting milk than a pump. Also, babies often cluster feed in the evening so by giving bottles at these times, you may be missing the cluster feeding.

It's also really common for babies to go through a fussy phase at this age-lots of skin to skin and going back to basics with latch and positioning - which sounds like you're doing, can help.

Look up the 'top up trap'.
Some babies do develop a bottle preference too so can make them even more fussy at the breast. Defiantly do paced feeding with any bottles.

Good luck, sounds like you're doing brilliantly.

I had exactly the same experience, with baby preferring the fast flow of a bottle. We ended up in the top up trap too. We were badly advised by our doctor and should have done paced feeding/giving the medicine we were giving in the bottle with a syringe instead. My supply dropped a lot too so do try and express to maintain supply, even if you just freeze it. Breast compressions also helped. So glad your LC was helpful. In hindsight I wish we had used longer teat mam bottles from the start as we also used tommee tippee.

Anna, so many people are badly advised by HCPs, a lot of poor advice is given about weight gain and bottle feeding. It's such a shame. The 'closer to nature' tommee tippee advertising must be quite powerful as I think a lot of people start with these bottles.

Yes I fell in to the 'closer to nature' trap. My LC said a lot of westerners (I'm in Asia) use tommee tippee but they're not mimicking the latch a baby should have on the breast.
I have been expressing between the 7 and 11 feeds but am now going to make sure the dream feed is breast rather than bottle. I wanted to do one bottle so DP can help out and give me a break in the eve. DD does often feed hourly from about 1630 up until 7pm bottle.
Feeding has been much calmer today (evening here at the moment). I'm going to tentatively say that just changing the bottle teat may have reminded her how she is supposed to latch on. LC has warned it can take a while to retrain but so far so good. First day in a while I haven't felt upset and dejected when trying to feed DD

That's lovely to hear xx

So glad you are doing well. That closer to nature advertising has a lot to answer for here definitely!