1 week old, help please

[tmc14]

Hi,
My gorgeous boy was born last Thursday. It was a very long labour with last minute complications so we were both exhausted. Friday feeding was a struggle. Saturday morning my midwife came and helped us feed. Saturday/Sunday went much better and he took to feeding really well. However, he started to get sluggish and was sleeping a lot. By Tuesday he’d lost 13% of his body weight. So, on MW advice (who is really pro breast feeding) we started some mixed feeding to get his weight stabilised.
Unfortunately now of course he’s preferring the bottle. I’m still feeding at each feed, both breasts, and expressing after each feed, and just mixing in some formula, but I’m worried this is the beginning of the end, at only one week old.

Any advice on how to move forward please? My milk is coming in but my breasts don’t get the engorged feeling I was expecting. I’m expressing around 10ml each time. I just feel so sad that I’m not feeding my baby :-(

I'm sorry I've no advice but wanted to bump this for you. Is there a breastfeeding clinic or cafe near you?

How's his weight now?

Thanks for the replies. His weight is increasing now. Next weigh in tomorrow. There is a breast feeding clinic tomorrow morning I am going to try and get to. It involves a bus though and I haven’t left the house with him yet!

I guess I just really need help & reassurance that I will be able to get back on track.

If his weight is increasing then you're doing brilliantly I suggest just feeding him whenever he squeaks. Try not to give the top ups- it's still early days and your supply won't be properly established yet. Him feeding loads will sort that out.:)

It probably is worth going to the clinic if you can face the bus trip. Or ask them at weigh in for some more advice.

I had this with mŷ DS and ended up doing both for 6 months. I am not sure at all how much he was getting from me but he was thriving and 8 felt I was doing the best I could.

He’s now 14 and 6ft tall 😀😀

Almost the same happened with my youngest ds, except he wasn’t poohing either. We mix fed until he was 19 weeks old then he refused to bf (I was on anti-b’s so could have changed milk?) so he is now eff at 6 months.

I have just been through something very similar and I was utterly heartbroken for a while.
My little boy was induced at 37 weeks and really struggled to feed. He lost 16.9% of his weight in the first 3 days and was hospitalised. We formula fed him every three hours including the 10-15 mls of expressed breastmilk I managed.the weight started to go back on and, following a visit to the local breastfeeding cafe he suddenly started breast feeding. I was expecting it to be a really long hard slog but DS is only 3 and a half weeks old and we're almost there: breastfeeding and almost at birth weight. There were some dark moment when I thought it wouldn't be possible.
I definitely recommend going to a breast feeding cafe. You could also ask about cup feeding formula rather than bottle feeding. It's quite messy but the baby has to use the Same suckling motion as for breastfeeding so they don't lose the instinct for it.
Good luck and don't lose hope.

You can absolutely return to exclusive breastfeeding, if that's what you want, with some perseverance. Until the health professionals are happy with his weight keep putting him to the breast/expressing and topping up. Once his weight is on track start decreasing the amount in his top ups slowly. You just need to male sure you're stimulating your supply to help it increase. Have lots of skin to skin cuddles, baths together etc to encourage oxytocin release! Night breastfeeds are really important for supply too as that is when prolactin is highest.
Are you doing paced bottle feeding? It probably isnt that he prefers formula/the bottle it is jusd a lot easier for babies to feed in this way as they don't have to work to get the milk. Paced feeding mimics the way a baby breastfeeds. I can't do a clicky link but kellymom and la leche league have useful info. I think a breastfeeding clinic would be really useful for you.
It might be reassuring to know that women can reestablish breastfeeding after stopping completely, and you are still breastfeeding so don't feel disheartened x

Thanks so much for the replies. It means a lot to hear other people’s experiemces. I had read about removing the formula completely and ‘making’ him breastfeed as his only option, but also don’t want him to be hungry.

@bertrandrussell one of our problems is that he doesn’t seem to get hungry that often, we currently have to wake him to feed him. I’m breastfeeding him as much as possible, so hopefully it’s enough.

I will definitely get to the clinic tomorrow. My husband can do the journey with me so hopefully won’t be too scary.

@hopeandjoy16 thank you, that sounds really positive. I’m not currently doing paced bottle feeding, so will do that too. We’re doing lots of skin to skin and having our first bath today. Thanks for the advice & encouragement x

It'd be good to confirm that he isn't a bit jaundiced too-sometimes reluctance to feed and sleepiness can be a symptom. Maybe keep a bit of a tally of how long between feeds and not let him go longer than a couple of hours.

Yes definitely keep topping him up, it's really important that his weight increases and any jaundice or dehydration is avoided or treated as this can have long term consequences.
1 week is still very early days and you absolutely can BF if that's what you want.
It is actually very difficult for most women to exclusively breastfeed especially at the start (just look down some of the threads in this forum!) So don't get disheartened, but also a lot of women fun combi feeding to be the best of both worlds.

When your baby is stronger you can look at things such as "finger feeding" or using a supplementary feeding system. Get specialist breatfeeding support for this either privately (you can pay a lactation consultant to visit you) or via the many helplines. Right now weight and calories are very important.

Keeping up with expressing will help to maintain and build your supply. Eg pit baby to breast first then you can Express whilst someone else gives the formula top ups

10mls is actually quite good to be getting from expressing at this stage, so don't lose faith.

"It is actually very difficult for most women to exclusively breastfeed"

Sorry- please don't say that - it's really not true. Can you substitute "some" for "most", please?

Just wanted to say that things change really quickly and not to lose hope.

My DS was fed using bottles (of expressed milk) at about 1 week old and got used to the bottle teat. We managed to get onto boob by using nipple shields at first before eventually transitioning off them.

Good luck x

@bertrandrussell one of our problems is that he doesn’t seem to get hungry that often, we currently have to wake him to feed him. I’m breastfeeding him as much as possible, so hopefully it’s enough

I found waking to feed absolutely did not work. I ended up with a baby that wasn’t hungry enough to feed properly, but not tired enough to go back to sleep. So i had an hour or so of screaming and latching on and off until she wore herself out and went back to sleep. It set up a cycle where she never fed or slept properly.

If I left her to wake up naturally she’d latch straight on and take an enormous feed. Then awake time and nappy change, and a small top up before going back to sleep. Made a huge difference.

Worth thinking about. I got into the routine by not waking at night, then feeding at every squeak in the day.

Problem with breastfeeding is it’s different for everyone. You just have to try lots of different things and find what works for you.

Stay in touch with the midwife, OP....I am always a bit uncomfortable with mothers of babies so young and still tiny getting advice from the Internet. None of us here are remotely able to tell you what you should and shouldn't do though shared experiences can be heartening and encouraging.

It sounds like the difficulties started on Sunday night and Monday morning. Sluggishness and sleepiness are red flags, and it's not surprising his weight showed a lack of intake by Tuesday. Another thing which they might not have told you to watch for was frequency and colour of poo....by Sunday his poo should have been changing to green and Monday should have been yellow, and copious. It's likely that these changes were not happening. Lack of these changes is another 'early warning' that things are not going well.

However, it is early days. Plenty of babies with a difficult start like this go on to full BF. The midwife should probably be arranging for frequent weight checks to make sure things are going in the right direction. Direct BF plus expressing plus formula is the most awkward and time consuming way to feed so you'll want to move to simple BF ASAP!

thanks again, such good advice. We’ve just had a really good mixed feed with more of mine & less of the formula (including expressed) and I think part of that is perhaps just being more relaxed after hearing everyone’s thoughts. The paced bottle worked really well too, with breast feeding in between so he was still having to work hard. As he’s asleep I will take a look at some other threads now as well, I hadn’t really checked before. x

@tiktok - yes, absolutely. I’m very lucky to be part of a community midwife programme where I’ve had the same midwife from booking in and has been amazing. I have been in constant contact about this, especially when he was sluggish and we were asking whether he needed to go into hospital or not. I came here as I know other women struggle with feeding and like someone said, every baby is different. So wanted some ideas/options/thoughts for things to try to get back to just breastfeeding. He was weighed Sunday, Tuesday, Wednesday and will be tomorrow. My midwife won’t sign me off until she’s happy & the health visitor has her first visit on Tuesday. Internet wisdom & experience is just an addition xx

@tiktok - the poo was actually changing in the right way, which was slightly surprising considering the other signals. I feel much more confident now that we can do ok with this than I did at 3am this morning.

Out of interest, what did he weigh on Sunday?

@tiktok He was 9lb 4 at birth on Thursday. On Sunday he was 10% down, was told it was a bit fast but that was the limit. On Tuesday he dropped to 13% off his birth weight. Wednesday, after starting mixed feeding he’d gained 200g. So hoping for another good gain at tomorrow’s weigh in.

And you're confident in the figures, and the maths? And in the way your baby was weighed (naked, on digital scales, not spring balance)? Flat hard surface?

It's just that while sleepiness and reluctance to feed is indeed indicative, I'm surprised poos were normal.

It's quite common for weights and/or calculations to be incorrect.

As much as I can be. I assume the hospital weight was correct. The home weights were all on flat hard surfaces, in the same place each time and the maths from those were corrrct. I’m not saying they definitely are but seemed ok.

Just adding my experience in case it's helpful... It's just my experience, I'm not in any way qualified.

I've combi fed my daughter since the day she was born. It's absolutely possible for you to ebf still - it's such early days. It doesn't have to be one or the other though, you can do a bit of both.

The secret I have found is to always bf first and don't ever replace a bf with a formula one, only top up as needed. That way you build, establish and protect your supply while still doing formula if you want to. If you want to cut it out, just gradually reduce it over a few days / weeks and your body will make more milk.

Your baby will need to be pretty much permanently on the boob for their next couple of weeks... Don't assume this means he isn't getting what he needs, he's just establishing your supply and building it up. As long as he is gaining weight and you are getting plenty of wet and dirty nappies everything is going well.

Good luck! I hope he is soon feeding better. Arm yourself with biscuits and box sets!

Did you have lots of IV fluids in labour? I'm told they can artificially inflate the birth weight of a baby, making it appear they've lost more weight than they actually have.

Lots of skin to skin, boob constantly in mouth. You can do it.