Increasing milk supply for newborn

[Doublegloucester]

Ds is 6 days old, and breastfeeding has been tough, as it was also with dd. He has lost almost 9 percent of his body weight but has managed to avoid jaundice.

So far, in hospital (day 0 and 1) we needed donor milk twice as he wasn't latching and I couldn't express enough colostrum.

He is really hard to wake and generally has about 6 feeds a day as opposed to the 8 or more he should have.

When he does latch, he has good long 45 min plus feeds and he does all the right things - good strong swallow etc. His feeds are always perfect when we show a professional!

He'll often finish a feed and still show signs of rooting. However he doesn't relatch and just gets angry. He has had two feeds with formula on day 2 and day 5 as I had spent over an hour trying to get him to relatch with no success and panicked.

He then slept for about 6 hours straight each time, which is not wonderful as I'm supposed to be feeding 3 hourly. Bit concerned now I am messing up my milk supply, and have also bought some probiotics as I 've read something about formula damaging the gut flora balance? He also hasn' t pooed since his meconium, though he is getting a reasonable number of wet nappies.

It hasn't helped that things have been quite manic at hone and it hasn't been a very relaxing environment. Not much time for skin to skin.

I have begged the hospital for an electric pump tomorrow, although it won't be easy to fit pumping in with my other child needing attention too. I am also booking a tongue tie appointment at the earliest opportunity. If I have any problems before tomorrow, or if the pump doesn't materialise, it will be the odd formula feed again (60ml) at a time). With my dd, I managed to avoid giving her formula completely, but I do worry now that she was left hungry at the time.

Is there anything else I haven't thought of that could increase my supply? Any suggestions for a pumping schedule? How long should it take for me to get up to maximum supply considering 2 out of his 6 nights he hasn't been breastfed?

Thanks very much for any advice :-) .

Honestly- I wouldn’t pump-particularly so early. Use the time to put him to the breast- a baby is much more stimulating to milk production than a pump. And don’t worry about having given him formula-it won’t have done him any harm at all.

Is there anyone-friend? Mil? Mum? who can come and help you with the manic ness?

How’s his weight now?

i found that expressing w/ medelin swing pump made my nipples protrude more which with persistence meant i regained lost confidence in my ability to breastfeed = less panic = greater latch sucess. scoop babys mouth up and over! bring babies head to you! we're at 4 weeks now and i'm still getting there / expressing for some feeds to make sure shes getting enough. i used to express 30 mins before each feed and squeeze them dry! reality is she prefers to snack rather than a big meal so thats the toug adjustmentat this point. good luck hope you have access to a good support network. dnt think twice about breast feeding support groups/ call the helpline who can give evidence based and specific advise xx

Thanks both. He has lost 10 percent of his birth weight now

How about talking things over with one the the breastfeeding helplines? NCT for one is still open right now (until 10) tel:0300 330 0700. They should have some good suggestions. With weight loss and not that many dirty nappies it would be a good idea to go over things in detail - but lots of people have these kinds of challenges in the early days, get some good support, and go on to feed for as long as they wanted to.

In the meantime, can you focus on lots of skin to skin this evening? Do you know how to hand express? Sometimes babies get very sleepy when they aren’t feeding often enough and this compounds the problem. Even hand expressing a little onto your nipple to tempt him onto the breast may help.

I think pumping will help, I borrowed a double pump from the doctors and used it for just under two weeks pumping in between each feed and by the end I could fill up a 250 ml bottle from each side each time! I was told that a warm drink whilst feeding encouraged more let down.

I also went to the local NCT breastfeeding lady to improve my latch ( I squeezed each side of my breast so that ithe areola was more ‘0’ shaped than ‘o’ shaped if you get my drift, and get some advice on positions so I wasnt always sat bolt upright.

If the feeds always go well when you show a professional is there anything different that you do? Are you more careful with the latch or change anything?

10 percent is still a relatively normal amount of weight to lose, so I wouldn’t panic about that. Honestly, the best thing you can do is just sit and feed. I wouldn’t bother with the expressing personally. My first lost 12% of her birth weight and didn’t regain it til 26 days. The midwives had me expressing and doing formula top ups and it was exhausting (never mind all the washing and sterilising!). My 2nd is 3 weeks old now and I was determined to not go through all of that again. What I did instead was just to sit and feed him pretty much any time he moved. I didn’t do anything else really the first week or two. My dh did the school runs, did everything around the house, put films on for our dd, did the food shopping, etc. I truly just sat and feed him every second of the day he wasn’t sleeping. It worked and he was back to birth weight by 10 days. No problems with my supply this time and without all the expressing and bottles and sterilising, it was much less stressful. Assuming your latch is okay (obviously get that sorted as soon as possible), even if you can devote a day or two to nothing else, it will make a huge difference to your supply.

Thanks all, appreciate your replies. Once I can get him on, he will feed for a good while but I'm spending so much time waking him and getting him to latch, rather than scream in frustration, it's affecting how many feeds he actually gets!
Will have a go at plenty of skin to skin today - another weigh in tomorrow!

Pumping to improve supply is useful if baby is too weak from hunger to suck. If he can suck then that's better. Sleeping 6 hours is too long - you need to wake him to feed. Strip him, change his nappy, rub with a cold wet wipe should wake him up. If he won't feed, pump. You can get a manual pump for £30 if you can't get an electric one. Remember that lethargy and sleepiness can be a sign of not getting enough food.

My midwife told me 10% weight loss was the cut off for being readmitted to hospital (my DS lost 12% so we were readmitted). Keep an eye on baby and make sure your midwife checks his weight regularly.

Remember it's a learning process for both of you - my DS didn't know how to latch and feed any more than I did, it took over a week for him to figure it out and he would get very frustrated because he was hungry. I used to pump a small amount so he'd had some and was less agitated, then let him suck. Also my supply was slow to come in so he was upset because he was hungry and sucking but not getting what he wanted. I was literally putting him to the breast every 30 minutes until the milk came in, demand is the only way to boost supply, you need to be draining the breast and encouraging it to refill.

Fed is best If he's starving then don't be afraid to give him a formula top up while you keep trying to establish your milk supply. Don't starve him because you're so focused on breast is best.

More difficulties last night as after several hours on the sofa bf, he got angry at around 10pm and wouldn't latch. He is now on 2 x 80ml formula a day. Feeling a bit down that things seem to be getting worse. Am booking a gp appt in case of silent reflux. Really want to get to the position of exclusively bfing but seem to be going in wrong direction

Hi,
I’m mixed feeding my 15 week old son, we had a 13% weight loss in 5 days. I was unable to up my supply enough to ebf. I eat lots of oats and take Goats Rue which has helped.
I’d recommend lots of irl support from local groups/Lactation consultant etc. I could never get much from expressing but concentrated on feeding feeding feeding.
But mostly I just wanted to say try not to feel terrible if you have to continue mixed feeding. I cried for 3 days when I had to give formula, and each time I tried to reduce top ups & my son lost weight I’d getvreally down again. But he is a happy, contented baby who gets some good stuff from me and the rest needed from formula. I still get sad that I couldn’t ebf but am working on not feeling bad about it.

Not sure if my rambling is useful at all, but enjoy your baby, try your best with the feeding and if you stay mixed, then so be it. Be kind to yourself and remember that fed is best. Good luck xx

Also, and not sure about this, but if he’s sleeping lots aftervthe top up, could you try smaller amounts but more of them if needed? I can’t remember but think I was doing 30ml at a time at 2 weeks, and were trying to feed every 2-3 hours. Also night feeds are super important for hormone production, so although exhausting, try and get as much suckling overnight. If you haven’t already, check out the Kelly mom website, which I found really useful. xx

Oh double I'm sorry , that sounds tough. Two 80ml top ups isn't enormous and lots of people do manage to move back to exclusive breastfeeding if that's what they want. But you do need some expert real life support. Midwives and health visitors are sometimes excellent and sometimes not. Do you know where and when your local groups are? Have you tried one of the helplines?

Yes also that's a good question about smaller frequent top ups vs two big ones. I'm not qualified to comment but the big ones may delay your next feed and effect your supply. If you want to protect your supply then generally it's a good idea to express whenever you give formula

How are things OP?

Thanks both. We're seeing someone re tongue tie tomorrow. We're on one bottle a day at the mo at night as I just can't get him to sleep otherwise. The problem then is that he won't wake up in the night to feed :-s

Hope the tongue tie person is helpful. Do check what their training is - some HVs etc will 'check for tongue tie' when they're not experienced enough to do do and can miss it. ATP is the place to look for the experts if you can pay www.tongue-tie.org.uk/Mobile/m-index.html

Re: night feeds, they are important for your supply as your milk hormones are high at night. Can you wake him to feed or will he absolutely not do it? Any chance you could express once at night if he's sleeping a long time?

Thanks :-) ds has an 80 percent tongue tie! We have been referred to someone to cut it for us on Friday (decided to pay privately as the NHS wait is 2-4 weeks and I can't go on like this for that long). I have been told to switch feed and do lots of breast compressions. I have also been prescribed domperidone. I have been told to do 48 hours worth of 8 feeds a day, plus 8 expressing sessions a day an hour after each feed. Needless to say, I am failing at this, as the timings are so tight and he wants to feed again when I've only just pumped so there is not much left for him in the breast. Plus nighttimes are still tough. Still on one bottle of formula a day around 10-11pm as he gets so angry, he won't feed from me. Hoping Friday will sort things out!

Yikes! Don't worry about there not being anything left after expressing as most of the milk in any feed is made during the feed so there is always something. The flow is just likely to be slower (the breast compressions will help with that).

Thanks :-)