"Switch feeding" - a good idea or not?

[verylittlecarrot]

My tiny 9 week dd is very slow to gain weight, averaging just under 3oz a week. She has a good latch, and feeds enthusiastically for the first few minutes of each feed, but then she settles into lazy sucking with the occasional swallow...this can go on for 20-30 minutes, then repeats with the second breast. In the very early days of bf I worried about this "comfort sucking" but have subsequently chosen to go with the flow, as I believe she's still getting some milk when she swallows, and I guess it's still providing some stimulation to me. Feeds can take a long time but I just let her get on with it. I've never had sore nipples or discomfort from this, and during a long feed I'm aware of at least 3 or 4 let downs which get her gulping again for a little while. I tend not to interrupt her, although I try the usual tricks to keep her awake. Fedds roughly every couple of hors, sometimes goes a bit longer.

I have been advised today by a lactation specialist to "switch feed"; however I've tried this before and instead of awakening dd's interest each time I switch, she seems to get bored more quickly, if anything.

Is it really better to try to switch feed or should I just keep going at dd's pace, allowing her longer feeds on each breast and letting her tell me when she's done before offering the other side?

Maybe try breast compression?

loads of bfing clips here, covering compression etc. dd did the same thing, tbh, and i was advised to switch feed, take supplements, everything. i think she wasn't hugely interested and also my supply wasn't great. or maybe the other way around, who knows? anyway, keep up the good work, i know it's difficult getting advice from all-comers. breast compression did work for me a bit, as did watching for the pause when she was really feeding. i take it your latch has been checked? (mind you, about 50 bfcs told me mine was fine and it was actually quite shite.)

Carrot, is your only concern that she's gaining weight slowly, or do you have other worries about her? What I mean is, maybe this is a natural growth pattern for her, and trying to "fix" it might just confuse you both. Just wondering.

Tried it - still do occasionally, but doesn't seem to make much difference. Not sure if my teeny weeny boobs hold enough milk in the "secret reserves" to be able to squish out.

Suspect I have lowish milk supply, or perhaps "slowish". DD doesn't seem dissatisfied, and often comes off with huge satisfied drunken strech look. Just takes us a long time to get there.

Have also tried to increase milk supply by:

1. pumping: had to abandon tommee tippee pump as short funnel off flange caused nipples to chafe - ouch. Have just taken delivery of new lactaline pump today in hopes that I might be able to boost supply by expressing. However my somewhat feisty lo doesn't really allow me to put her down for the time I need to express. Need to draft in some extra help to get hands free to express. DD must be carried at all times, put her down at peril...Think Dr Sears calls this a "high needs child"...
2. Galactogogues: have begun "more milk plus" herbal pond slime drops today. Gag. Eatimg loads of oatyhobnobs. Notsogag . Am sceptical about whether these will be effective but willing to try!
3. Feed on demand, always give both boobs, (except in middle of night) co-sleep, carry in sling etc

The girl just won't fatten up for me!

never did my boys any harm

Bugger- noy quick enough at typing.

Aitch: loads of people have said latch is good. Certainly it feels OK, looks like the diagrams, and has never caused me any discomfort or soreness at all. When dd begins a feed there are some smashing gulpings going on. They just peter out after a few minutes, though. BF counsellor today seemd fine with the latch. What was wrong with your latch that they were missing?

Welliemum: She is a gorgeous baby, alert, smiley, strong tho' teeny, and sleeps well at night (wakes gently to feed then snoozes again) and will sleep well in the sling. Other than the weight, the only thing I'm a bit concerned with is that she can suffer badly with trapped wind / colic and can seem in awful pain with it sometimes. I've just fed her to sleep to relax her out of a nasty bout this evening.

How much did she weigh when she was born?

How much does she weigh now?

Is she producing wet and dirty nappies?

Would you be worrying about her if you didn't know how much she weighed?

Is she being weighed on the same electronic scales, naked, each time?

Oh - the one other concern is that she is completely unputdownable. The girl simply will not tolerate pram, crib, baby hammock, bouncy chair thing. Must be arms or screams. There are some things you can't manage even with a sling. Am currently washing hair once weekly and will begin to smell like a sheep before long if I don't think of a way to sort this.

What was her birth like?

Have you considered cranial osteopathy?

And have a hug - you're doing really well, you know

Ooooh, I've had 2 Velcro babies, it does your head in, doesn't it. Sympathies.

Hunker's questions are good ones.

With dd1, I was given endless grief about her weight. She was slow to gain weight initially because of bad latch (no-one ever managed to work out what the problem was). But even after the feeding improved and she started to gain weight, she was still tall and skinny, and I had to beat off people trying to fix this, because I could see she was active, alert, smiley, etc etc.

She's just turned 3, eats like a horse, and - guess what - is still tall and skinny, ie it's just how she's made.

I would be guided by instinct quite a lot here, If you feel that she's fine, she probably is.

Bloomin birth weight scales were wrong. 3 weeks early, small baby; we were told 7lb 11 oz which seemed unusual as she was v small. 2 days later hospital scales had her at 6lb 10. I know they lose a bit of weight but this much? In 48 hours? Not v likely. esp as she was feeding OK we think.

I think she was probably just under 7lb at birth, maybe 6lb 14 or 15.

She has gained from day 3, always in tiny increments. Now weighs 8lb 2 (and a half, whoopee) ounces.

Yes to poo (every day or 2 days now). Plenty wet nappies, light colour wee.

Arms and legs are definitely less chubby than they were, she has grown in length rather than width, and is quite long and slim. She doesn't look worryingly skinny but is very "dainty". must admit, wish I could chub her up a little.

gazillions of different scales. drives me nuts.

Birth. Oh God. 2 days in labour after waters broke. Bub was posterior. My lovely hippy dippy home water birth ended in hospital, epidural, iv antibiotics, synto (pito? can't remember) to speed things up, and then ventouse with 2nd degree tear. They wanted to do episiotomy and forceps for foetal distress, but I managed to persuade them to use ventouse instead and rather violently pushed her out as I recall. Gave them all hell, mind.

I have considered cranial doodah, whilst I admit I'm sceptical as to the science of it, I know others swear by it and so I may give it a go for dd.

Wellimum: did the velcro babies become less sticky

And thanks for the hug hunker! Felt like a Bad Mum for not picking her up immediately out of her bouncy chair for 3 minutes this evening whilst stroking her with one hand, imploring her to stop crying, sweating and trying to work the bloomin breast pump to express enough to allow me to get a feeds worth for tomorrow morning when I need to leave her with dh to go to a funeral for an hour.

...of a baby of one of the girls in my antenatal classes. God. I am grateful for my "problems".

Hunker is probably asleep and she'll give you much better advice than I can but, for what it's worth in the meantime:

Weighing on lots of different scales is rubbish, and so is frequent weighing, because their weight will appear to bob up and down depending on what scales were used and whether they'd just done a big poo, etc, etc. If she's generally gaining weight over the weeks (which she is) that's probably as much info as you can reliably get from random weighing.

Am very sceptical of the idea of health professionals treating the weight chart rather than the actual baby. I did some reading about this a while ago and there does seem to be a general opinion that encouraging babies to get chubby just for the sake of it is probably not a good thing.

What about looking for a neutral second opinion - do you have a nice GP who could look her over? Because if she's fine from the medical point of view, then you'd be justified in feeding her whichever way works best for you.

I didn't get dd2 weighed and it was lovely not to stress about weight. I could see she was happy and growing out of her clothes and that was all I needed to know. But it's a bit of a leap of faith at first.

Velcro babies: Yes! They do become put-downable, it won't always be like this!

about the funeral; that does put things into perspective.

And I agree with Hunker, you're doing really well, especially after such a difficult start!

I don't have any advice, but my DS liked to have long luxuriant feeds, and my supply was/is fine. But he is a porker, so I knew that.
My top tip on keeping clean, is to take the baby in the bath with you - I had a changing mat at the side, got in and then picked him up from there - reverse process to get out. You get a nice long bath, they get lots of skin to skin and as much booby as they like, and the baby shampoo does wonders for your hair. You get quite good at propping them on your knees to wet/rinse your hair.I like Halos and Horns with detangler...and DS is 16 months now and we still co-bath, and now share a shower too.

Big hugs, especially for the funeral.

carrot, you sound like you are doing a great job and that you are calm and relaxed about this, which i think is the key.

I'm no expert, but second the stuff about if she's happy, alert, weeing and pooing and gaining weight in regular, if small, increments, then she is fine.

My DD is a bit of a leisurely feeder as well and even at 16 weeks can be on for up to 45 mins at a time. I'm never sure whether it is comfort or not either, but she gets v narked if i try to take her off so i just let her get on with it.

have you tried fenugreek capsules (from hollland and barrett). some of the women on my PN thread have had good results with them.

can't help with the velcro thing, but it will get better I'm sure

sorry about your friends baby, that is so sad

carrot - switch nursing does tend to increase the volume of milk made, which is why it is sometimes recommended when there is thought to be a supply problem.

It does not guarentee that more milk will get into the baby

Yes, that weight gain is slow, but as we say so often on here, weight is only one aspect of any health assessment, and the way the baby is is the major factor, and as that is unmeasurable, and relies on judgement rather than plotting on a chart, it's a tricky thing to be sure about. I have helped a handful of mothers who were sure their baby was fine tra-la-la and yet anyone who actually saw the baby could see a baby who was miserable, desperate and underfed. However, in every case (and because there are so few of them I can remember them individually) the baby was not gaining 3 oz a week, but rather less, if anything.

You sound sensible and informed and your baby, from your description, sounds small but fine!

It is your choice whether to do the switch thing or not - you have to decide if it makes life easier or not, and satisfies your baby more, or not.

Mothers in non-industrial societies tend to feed far, far more often than two hourly - that's pretty frequent for us, but in other societies babies are observed to feed several times an hour, day and night, and the mothers don't even notice it. The babies are close to the breast all the time and have a little slurp whenever - and that's probably how mothers have done it for 99.999 per cent of human existance, and how breastmilk, and the production of it, have evolved. This is not something that fits into a modern, western way of life, and breastfeeding is flexible enough to accommodate us - mostly. Your baby is probably more like a bush baby of the Kalahari, or a cave baby

Thanks everyone for your fantastic and kind words. It's been a tough old time, this morning's funeral was heartbreaking and I'm so lucky that I could come back and snuggle with the baby carrot. She can feed lazily as much as she wants today and any day...I'll do switch feeding and have a crack at expressing later.

d&bb2: My "more milk" drops contain fenugreek. Tastes and looks like pondslime though. uurgh.

cmotdibbler: love the co-bathing to wash hair idea. I've only bathed with her once to try to relax her one night she was inconsolable with colic. I really need to do that again. ta for the prompt!

welliemum: GP checked her for the routine 8 week check on Monday and wasn't worried. She saw her naked so I suppose she'd have seen her level of "skinniness". She didn't seem concerned. It was reassuring, I admit.

Cuddle your babies one extra time today, please Mums, in memory of a little angel who only stayed with her mummy for one short day.

vlc

x

just to answer your earlier question, carrot, i could never tell what was wrong. the one time the feeding Really worked the super-duper bfc just moved dd minutely and suddenly it was all ears wiggling and proper gulping, which she kept up for ages. i didn't get to the superbfc until late on, though, so it was all a bit fucked by then.
and when i took dd to cranio (again, sadly, after bfing was kaput) the woman felt in her mouth and said 'she'll not have been a very efficient bfer then, her 'vomer' is out of alignment.' i'm saying vomer, i have no idea if that's what she said but it sounded a bit like that. who knows? the cranio worked insofar as dd wouldn't lie on her tummy beforehand and was fine on it afterwards (after the longest nap she'd ever had in her life), so something was wonky there.

and yes, i have obediently and gratefully kissed and cuddled dd today, and thoguth about how bloody lucky i am. sending peaceful thoughts to your friend.

thanks Aitch. wish I could have some time with a super bfc like yours. The lactation specialist I saw at the baby cafe was nice, but...you know when someone sort of does an "Emperor's new clothes" on you? By which I mean, they make an observation "Ah, she's comfort sucking now, see, time to change sides"; and I think "but that's how she always feeds after the first few minutes, suck suck suck suck suck suck, swallow, repeat...she still swallows though?" but I dutifully change sides. BFC then remarks in a pleased way "See? That's much better now" and I think "er...seems exactly the same to me actually" A midwife in hospital once "corrected" my latch - to exactly the same as before....

Seems like baby carrot only has a few minutes of good sucking and gulping in her at the beginning of each feed, then she runs out of steam and sucks very leisurely (or my milk really slows right down). However, each further letdown gives us a few more good sucks.

I'm hoping the fenugreek pondslime concoction will really kick in soon, and in the meantime will try to get pumping after feeds to up my supply.

And I'm going to find a cranio I think for her colic/ feeding / unputdownabilty / slow weight gain...whatever. Can't hurt.

she was super. she's got magic hands, well known for it. every other bastard just said it was going fine but it wasn't. mind you, i'd have been happy if she was weeing and pooing and putting on weight, but she wasn't really.
try the cranio. i also ate lots of porridge and drank guinness. it's nice, guinness... takes the edge off when you're pumping.

the lactaline pump is Excellent imo, so much quieter than the other ones so you can sit down and watch a bit of telly for once. i also cut holes in an old bra so i could double-pump. up here for thinking, down there for dancing...

seiously, have a look at those clips i linked to, they were terribly helpful to me.

find out if you can get a recommendation for a paed cranio person from a bfc, that's how i found mine.

Sooo nice to be able to chat to someone who's been there. Ta so much.

I'm grateful for each and every wee and poo that tells me she's OK despite slow gain.

One of the lactaline collection kit thingies is faulty so I couldn't double pump..bah. Persevered with the working pump on each boob after a feed this evening. Got a measly ounce for my efforts. Trying to feel pleased with that as a starting point.

Bub has been attached like a limpet to boobs pretty much without a break from 7.30 till now. She's got a cold and is pretty grumpy so I'm indulging the comfort sucking.

It is rather like having a permanent 8lb piece of body jewelry, tho'.

there are loads of us who've been there. you should remember that you're doing superbly well by sticking at it, superbly well.

no word of advice...just admiration

well done for coping so well, its so so hard when they are attached all the time like that

hope your DH/Dp/family/friends are is very supportive and doing eveything around teh house

you shoudl not be lifting a finger

Hi vlc, I say well done for getting this far! No real advice as I'm first timer, learning as I go but my little one is now 13 weeks.

For first 10 weeks or so, I had a velcro baby and constant feeding, but I now feel we've turned a corner in the last few weeks. For some reason, I guess maybe my milk supply settling, or perhaps she became a more efficient feeder, she suddenly started going longer between feeds through the day (3 hours instead of 1-2 hours)and feeding time reduced from about an hour and a half or more (slow feeder I think like yours) to less than an hour usually. She has both breasts at every feed, usually one after the other rather than switching continually - not relevant but I have one breast half the size of the other so she gets the small one first as I'm still trying to make it catch up!
(This is through the day, evenings still fairly constant feeding until she seems to get frustrated at lack of milk from breasts and she then has 4oz EBM which she guzzles happily and then sleeps well through the night).

My philosophy is that with the longer break between feeds, I think this meant she was then getting stronger flow for longer at the start of each feed and therefore taking more in shorter time. Someone who knows what they're talking about may have different thoughts....

With regard to weight, she was 2 weeks early and under 6lb but had gained some weight within about 10 days. I haven't had her weighed since as she has been happy and alert baby, feeding regularly and regularly filling nappies, and I've seen that she's grown and put on weight through outgrowing clothes etc. She did remain pretty long and skinny though until last couple of weeks when she has become a little chubbier.

Sorry can't offer advice but from my experience, things have improved with time.

Very sad to hear about baby's funeral and makes me feel very very lucky.

Good luck and well done again for having the patience to get this far!

Thanks for the encouragement ladies. Been one of those days today, constant feeding, baby frustrated and fussy at the breast, me attempting to express (without great results) in the short intervals between feeds, and not much else! I need to get better at expressing as I want to build my supply up; I'm not convinced I have a great supply and think this may be contributing to a bit of a catch 22 situation. I suspect dd is hungry and I don't think I'm quite meeting her needs.

Some days are more dificult than others, don't you find?

Teabag - I'm mighty impressed with your resolve in not weighing your little one. I don't go every week, but my health visitor calls me at home if I don't go to the weighing clinic to see if she can encourage me to go in!
Did you find expressing got easier over time? I'm only able to get an ounce at a time (and that's from both boobs, not each) and it takes a long time and is not v comfortable.