Active Management of Breastfeeding....6 weeks in and a struggle.

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Hopefully someone might be able to offer some advice or has been in a similar situation. I think I'm leaning towards packing in breastfeeding altogether but after having been giving it such a go for 6 weeks any advice would be welcome.

I have a lovely wee 6 week old and breasts which do not seem to want to produce enough milk no matter what I do! DS lost 12% of his birth weight in his first week of me trying to EBF. Latching on wasn't a problem on either breast (which was surprising as I have had a breast reduction on the left breast previously), but he seemed unable or unwilling to swallow so was fluttering away at the nipple but not taking anything in. He would spend hours 'feeding' but not taking anything in. This has improved and I can hear him swallowing, but he doesn't do it regularly through a feed and would still happily suckle for hours.

I was advised by the midwife to get a pump and supplement with this but also to top up with formula. The original advice given was to feed for 30 minutes, pump for 30 minutes and to top up with formula at every feed. Along with plenty of skin to skin. Which was manageable whilst my DH was at home, but I couldn't continue when he went back to work as it meant each feed with burping, pumping etc was taking at least an hour and a half. So I went to pumping three times a day during the week as well as feeding on demand and topping up with formula milk after every feed. Which was worked as he is gaining weight and following his percentile chart.

I've spoken with my HV and a lactation consultant at the local baby cafe and they have advised me to keep going but to pump for 15 minutes rather than 30. But it's still an awful faff to do and I don't seem to be producing anymore milk, 30mls a day is the most I've ever been able to express so I need to top up with formula. I know that obviously expressing isn't as efficient as feeding but I would have thought that this constant feeding/pumping would increase my supply. Instead DS needs a formula top up at every feed and is taking 4oz but would take more.

The lactation consultant also gave me some NHS pamphlets about this type of feeding, it's called 'Active Management of Breastfeeding' and for 10% of healthy babies who struggle to take enough milk and it also says that most babies on this plan are breastfeeding well by 6 weeks of age. This doesn't seem to be happening with us and I'm tempted to move just to formula.

Does anyone have any ideas why my supply isn't increasing on either breast? Has anyone had it suddenly improve? I've also been eating enough oats to rival a donkey and when I can spent days in bed just bfeeding.

If I was to stop combined feeding and just move to formula (he's getting formula at every feed) do you just stop offering the breast as often and dry up your milk?

Sorry that this is a bit of an essay, I'm just finding this quite stressful and want to know if anyone else has been on the same situation. I'd love to be able to breastfeed, when he is latched on and swallowing it's lovely but I don't think its going to work. Alongside this I've had quite a few painful weeks due to infection and also having to go in and out of hospital with high blood pressure after labour.

Thank you for reading.

Hi I am sorry that you're having trouble breastfeeding despite reaching out to all the right avenues for help. I am breastfeeding my 2 year old and 3 month old and I did struggle in the beginning. I consumed copious amounts of oats, lactation cookies, smoothies etc but what really worked for me was lactation supplements - check out Threemamas.co.uk organic supplements

Seems like you're doing everything you can but I would recommend breast stimulation at least 6 times a day to really make your body work.., hand expression can work even better than pumping (if its a faff sterilising your pump all the time as it was with me)

also maybe try a silicone haakaa breast pump (they are very cheap nn branded ones on eBay/amazon) it works whilst you are feeding your baby on one side - they're very quick to clean and helped me a lot to catch those valuable drops of milk

p.s you really are doing a great job :) don't give up x

Your supply probably isn't increasing much because nothing is stimulating it. It sounds like baby isn't sucking but is instead is just drinking the letdown when it happens (so your supply has increased some if this is happening). And clearly the pumping isn't effective.

So either you look into why baby can't suck (eg tt, high palette, premature birth) or won't suck (eg bottle/formula preference) and work on those or you get a different pump and try and find one that works for you (both breasts and pumps vary a lot so recommendations aren't that helpful) there are then methods to get that extra supply into baby. Please come back if you want specific advice on any of those and I'm sure someone will help.

And if you're finding cleaning the pump a faff just stuck the whole thing in the fridge and clean once a day. It's safe to keep a bottle of bm in the fridge for 6days so you don't need to sterilise the pump after each session.

If you want to move to just formula and Given you seem to like bf when it works, just bf if you're uncomfortable from the milk, it'll dry up soon enough and baby should bf easier when you do in the meantime. Just remember that it's your choice, you sound conflicted and you shouldn't feel pressured or railroaded into feeding your baby any particular way.

I had a similar experience with My first DD - for the first 6 weeks she seemed cross the whole time if not on the boob, but wasn't putting enough weight on if I exclusively breast fed. I tried expressing but found it awful - plus it took ages and I never got more than about 15ml. As a last resort before switching to formula feeding I took fenugreek tablets. Was really sceptical, but within a few days I suddenly felt my supply was good, and baby stopped just snoozing on the boob and started drinking. Might be worth a try? Hope you are able to find a way of feeding you are happy with.

I would look at using a supplemental feeding system, like the Medela one for when you’re giving top ups. It encourages latching, and stimulates your breasts whilst making sure baby is getting formula.

It also helps prevent bottle preference.

Just wondering what type of expressing you’re doing?

I never tried an electric pump but I did try numerous manual pumps and got very little milk out. I found I got far more by using a haakaa (?) and also by hand expressing.

I don’t think that quantity expressed is always representative of actual supply...: sometimes expressing just doesn’t work even if the milk is there.

Sounds like you’re doing a great job, the first few weeks are the toughest and that is without any additional difficulties.

Ultimately, do whatever you will feel happiest with and least stressed by. With DD I stopped bf at about 2 or 3 months as it was linked to my pnd. With DS we’re 9 months in. I did what worked best for both os us each time.

You must be exhausted, is my first thought.
You’ve had good suggestions here, if you want to keep trying.
Personally I’d give up now.
I breast fed one of mine but dd was very premature and too weak to suckle and I found expressing agonising. I had to give in and turn to formula and it was such a relief.

This was me 5 weeks ago. My baby had tongue tie. My supply was never enough and the pumping formula feeding cycle was making me miserable. Once her tie was cut I then spent a few days in bed just feeding on demand and not supplementing. I went from 800ml formula to 200ml formula in a day. I still need to give 100-200ml formula a day (1 or 2 bottles,) usually when she is cluster feeding but I have managed to simplify my life. Good luck this breastfeeding thing is so difficult.

This was me 5 weeks ago. My baby had tongue tie. My supply was never enough and the pumping formula feeding cycle was making me miserable. Once her tie was cut I then spent a few days in bed just feeding on demand and not supplementing. I went from 800ml formula to 200ml formula in a day. I still need to give 100-200ml formula a day (1 or 2 bottles,) usually when she is cluster feeding but I have managed to simplify my life. Good luck this breastfeeding thing is so difficult.