Difficulty establishing feeding (day 5) looking for advice to keep my nerve.

[Lyra75]

I'd be really grateful for any advice that anyone has on those early days of breastfeeding, especially those who have done so with larger breasts! Sorry for the long post.

I've just been discharged from hospital with a gorgeous 5 day old baby boy, but the breast feeding isn't going so well. I don't think I was very well helped in hospital. On day 3 his weight had gone down by 10.7% and so they advised top up with EBM and formula. I feel guilty now that I agreed so readily, but I was still a bit shell shocked from a 48 hour labour followed by an emergency section that when they suggested he might be losing too much weight I just agreed. They also kept mentioning the size of my breasts like it was a big problem, not to mention fairly demoralising when you're not feeling so great about your shape anyway!

We're now home and I realise that I don't really know what I'm doing at all and am worried that we might not crack this. At the moment I'm feeding 3 hourly (often having to wake him up), I'm not sure how well he's feeding (if any). Then he has top up EBM (this has just really been the past 24 hours, I think getting home relaxed me enough) and then some formula.

I'd be really grateful if you have any advice. Thanks.

sorry, just read it back and meant to say that I am a size 40L in my nursing bra, so not exaggerating when I say I am on the larger side.

lyra - congatulations.

Do you have a local breastfeeding councillor who could visit you to help?

I too am fairly large breasted and find that i have to gently squeeze my breasts just above the areola to help dd latch on. sometimes it does take several attempts and i do sometimes have to open her mouth wider with my finger on her chin.

hth & good luck. you are doing really well and don't worry about your lo losing weight initially.

Congratulations on the birth of ds lyra
I agree with Melissa, I think you need to ask your midwives quickly for the names of the local b/f counsellors - with any luck, you might even be near some kind of extra support initiative like a drop-in session, or a b/f cafe.
I too had larger breasts, especially just after dd was born, and you do have to take a bit more care with establishing the latch on a newborn (this gets easier as your baby gets bigger even if your norks don't get smaller).
When you say "not going well", what do you specifically mean? Has he been checked for neonate jaundice, which can cause drowsiness and slow feeding? Both of mine had this at first, and, coupled with the effect of the c-section, I struggled to get b/f established each time.
Is he doing wet nappies?
Ds and dd lost nearly 20% of their birthweight but did put it back on.
Please don't feel bad about the formula, it is very possible with good support to get back to a position where you are exclusively breastfeeding. Ds was mixed fed for a few weeks at birth too, and I did feel guilty about it, but shouldn't have.

I should have said, sounds like you are doing very well to me Well done on getting started even with less-than brilliant support at the hospital, and a c-section scar too. Are you using a pillow to feed him from, or trying the underarm hold?

Lyra,at this stage the best way to get the milk flowing is lots of skin to skin contact and lots and lots of feeding.
By giving EBM and formula you are reducing demand on the breasts and breastfeedin g is demand driven so less direct sucking = less stimulation =less milk. Do you see where this could end up?

Boobs are not a problem.Hunker often says she has huge norks and it never stopped her.

A phone call to one of the helplines could strengthen your resolve.

Assoc. of Breastfeeding Mothers

08444 122 949

Remember

unrestricted access to breast is what is needed and for you to concentrate on that alone.EBM and formula are interfering with your supple.Kick back,have faith in your body and concentrate on this.

XX

Lyra - congrats on your lovely boy!!

I'll echo everyone else and say, do try and get professional help. There's no substitute for having someone there who can see what's going on.

The NCT and the La Leche League both have helplines you can call, and they will advise you where to go from here. If you google those names, you'll find the number no problem.

Don't feel guilty about topping up with EBM or formula - I did too, to get my boy going, as like yours, he was very sleepy too. EBM is probably better, as pumping will stimulate your supply if your lo is not feeding well.

However, ideally you don't want to carry on with this long term as it will affect your supply, so do try and get some advice.

There's some real experts on this site - I'm sure they'll be along soon.

Jojay,I know you are trying to help but you are giving inaccurate information which may well scupper Lyra's chances of breastfeeding longterm.The formula and EBM issue is NOTHING to do with guilt,it is to do with basic biology.

THE LESS THE BABY SUCKS THE LESS MILK IS PRODUCED.
THUS ALLOWING THE BABY TO SUCKLE FREQUENTLY IS THE ONLY WAY TO GET A STEADY SUPPLY GOING.

Lyra,have alook at this useful link from Kellymom site

Does expressing really not stimulate milk production then, or just less well than direct suckling? It must do something cos I gave ebm exclusively for 4m with DS1. I still gave the occasional bottle of ebm when establishing direct bf because it was such a comfort to know that he'd eaten well at least once - establishing b/f is such a cliff-hanger, it really seemed to me that he was taking next to nothing, until I had gained confidence.

DS started out on formula while in hospital, since my placenta had ruptured and I was at death's door for a bit. But I was able to establish b/f via ebm, and we went on to direct b/f until ds was 15m. So anything is possible, however rocky the start, and don't give up!

Does expressing really not stimulate milk production then, or just less well than direct suckling? It must do something cos I gave ebm exclusively for 4m with DS1. I still gave the occasional bottle of ebm when establishing direct bf because it was such a comfort to know that he'd eaten well at least once - establishing b/f is such a cliff-hanger, it really seemed to me that he was taking next to nothing, until I had gained confidence.

DS started out on formula while in hospital, since my placenta had ruptured and I was at death's door for a bit. But I was able to establish b/f via ebm, and we went on to direct b/f until ds was 15m. So anything is possible, however rocky the start, and don't give up!

Defo get ringing round the helplines to get some expert help & support Lyra. I was in a similar situation when DS was born...50+ labour without much sleep & a DS who was v sleepy & couldn't latch properly, pressure to feed on a 3 hourly schedule, formula top ups etc...left hospital feeding EBM & formula via bottle & discovered that DS was by then literally scared of my boobs & screamed when he was anywhere near them. My saviour was a local LLL leader who I spoke to on numerous occasions & eventually got DS feeding from me again.

Here are the helplines & their opening times. It can take a while to get through to someone so maybe get a friend or your other half to do the dialling for you while you rest...then hand the phone to you when someone answers.

LLL: 0845 120 2918 (open 24 hours)
NCT: 0870 444 8708 (open 8am to 10pm every day)
BfN: 0870 900 8787 (open 9.30am to 9.30pm every day)
ABM: 08444 122 949 (open 9.30am to 10.30pm every day)

Dazed,if you are a dedicated pumper with good technique then it can work (like for you) but sure you would agree that much easier and less hassle to get baby used to breast first in ideal scenario.

Hats off to yuo for expressing for so long btw.That's dedication.

Just wanted to say congratulations and well done. I had a similar labour and em cs, discharged from hospital with no help whatsoever and a jaundiced baby who was sleepy and slow to feed. My best advice (apart from get in touch with a bf expert asap) is to have lots of skin to skin contact- get in the bath together and try feeding there, lie in bed and try feeding lying down. I found clutch hold was the best, baby under arm like a rugby ball, supported on pillows, try 'feeding' the breast to him using your hands, sort of squashing it a bit like a burger my hv always said (of course she's mad though). Has your milk come in properly yet?

The best indication of whether he's feeding is wet nappies. If you can't 'see' the wee, try weighing a used nappy in your hand, compared to a new nappy in the other. His nappy at this stage may also be stained very slightly orange by urates in his wee.

Let him suckle as much as you possibly can, enjoy the closeness and trust that you can do this.

I am happily breastfeeding still at 13 weeks and have a supply coveted by Dairy Crest.

Keep it up, you're going to be just fine.

Bit harsh Moondog.

My first point - get professional help.

Second point - maybe not made clearly enough - until help arrives, feed EBM as a top up so baby does not starve.

Third point - don't do this long term as it will affect your supply.

don't see what's wrong with that??

I don't mean to be harsh Jo,so sorry if it came across like that.The fact is that giving formula means baby is not stimulating breast as should be happening. Also pumping stimulates in a different way to suckling.

Easier for everyone if baby on the breast as often as poss.

Fair enough

hi, no expert here but personally I think with all that topping up, pumping, making bottles, sterilising etc you're giving yourself too much work.

Best trick in the book I know is to rest in bed with baby and feed on demand.

If he is sleepy and going three hours between feeds i doubt he is starving.

hi there - no expert either but congrats on the birth of yr bubba and well done so far with bf. just wantd to say - i agree with other s- prof upport has meant the world to me and despite early diffs and tear filled posts here - i am still goign at 15 weeks. helplines are great for support and motivation but the face to face support of a bf specialist can be great! also - i am 40G at the mo - so big boobs can do it!!! i find reclining and having bubba propped on pillows has helped.

good luck honey xoxoox

Agree with the others, rest in bed with baby, lost of skin to skin contact/cuddles and avoid formula and EBM if you can, and get help from a breastfeeding counsellor if you want feel that would belp.
Also try not to worry too much about his weight if you can, most babies lose weight in the first week before your milk comes in. But the more your DS suckles the more milk you will produce.
Good luck and keep at it, its hard work in the first few weeks...

Hi, I really think you need to get in touch with one of the b/feeding helplines - NCT have one, as do La Leche League - I'll have a look for numbers for you in a second.

I've had 2 very sleepy feeders who lost 10%+ (ds1=15%, ds2=12%), and I did the EBM topping up. But I had a different outcome to the feeding with the boys, largely due to dd, who came in between them, lost only 8% or so, quickly put it back on, and gave me the confidence that I COULD feed a baby.

Ds1 - rubbish support in hospital, was told all sorts of rubbish. Day 8 - lost 15% of birthweight, sleepy etc. Tried topping up with EBM, still lost weight, tried one formula top up, still lost weight. What I should have done is fed him every 3 hours (as you are doing) from the start, but no-one told me that - they told me 6-8 hourly. I ended up b/feeding for 13 months, but always with formula topups - 3 topups a day. Which made me sad.

Dd - born at hom,exclusively b/fed till 6 months, carried on b/feeding till 13/14 months. No problems.

Ds2 - born at home, excellent support from mws, and MN! Day 4 - lost 12% weight. Was already feeding every 3-4 hours, started giving EBM - after every feed (he was very sleepy, and the idea is it is some 'easy' calories for them - they don't need to work to get them - this can then perk them up to encourage better feeding) - still lost a bit of weight, had about 2 formula topups of 1oz each, started putting weight back on, I gained confidence, ditched the formula, exclusively b/fed to 6 months, just weaning him now at 15 months.

So do have confidence in yourself. If he needs feeding more, then lots of skin-skin, try feeding him in the bath, wake him up if he drops off in a feed, try 'switch feeding' (swapping from side to side, as the increased spurt of milk wakes them up a bit). But do get some support, preferably from someone who can observe a feed. Keep an eye on nappies - they should be wet, and poo should be yellow - a few poos a day I think. Feed every 2-3 hours in the day, and don't let him go longer than 4or possibly 5 hours at night. Wake him up if need be!

Good luck - you're doing really well, and giving him such a good start.

one thread from ds2

second thread

I thought I read somewhere (maybe on here?) that you should try to feed newborns at least every 2 hours if you need to get your milk supply going...
My experience with DS1 and DS2 is that both wanted to feed more often than this in the first few weeks so I never had a problem with my supply.
Have you looked at the Kellymom website, has lots of good info on it?

Hi

The first few weeks are hard work when you start breastfeeding - you're both learning how to do it and working towards establishing supply/demand.

In the early days, like most other folks have mentioned, allow unrestricted access to boobs, led baby feed as often as he wants (and preferably no longer than 3 hrs betwen feeds), no dummies/soothers, and no supplementary feeding: you're working towards telling your body to get producing that milk! So long as he is having plenty of wet nappies, that's the key thing to look out for, because breastmilk is so 'perfect' sometimes bf babies poo only occasionally!

Ensure that you are getting some good feeds in at night as that is when your hormone levels are at their highest, and will ensure you have plenty of milk for the next day.

If you want to express milk, do it by hand as that maintains the milk supply better than a pump.

Finally, unfortunately the advice given by many midwives is inconsistent re: breastfeeding - if you don't feel you're getting the right kind of help, then the various organisations - LLL, etc can be brilliant, even over the phone. Baby cafes are very useful too.

Good luck x

NCT lines
La Leche League