Baby not getting enough milk - help!

[MrsBumblebee]

My 13 day old baby doesn't seem to be getting enough milk, and the MW is starting to mutter about formula top-ups. She's a bit worried because he's dropped a little bit of weight (although he's still just over his birth weight) and hasn't had a poo-ey nappy for five days. I also think his urine has decreased a bit, though I'm not entirely sure. The odd thing is, up until five days ago he was producing a dirty nappy at almost every feed.

I'm keen to keep bfing him, so really want to work out what's going on. His latch isn't perfect, as my nipples are very cracked and sore, but I think it's getting better. Also, the NCT bf counsellor thinks that he's actually feeding pretty well once he's on the breast - he seems to suck and swallow pretty deeply. On her advice, I'm feeding from both breasts at each feed - he's generally on the first side for about 20 mins of good sucking before he falls asleep, then he wakes up and goes on the other side for anything between 10 and 25 mins.

Does anyone have any other tips for what I might be doing wrong?? I've had mastitis, but that seems to have cleared up now - I don't know if that could have affected the amount of milk he gets? I'm also now using a nipple shield on one side, to give the breast a chance to heal, but I've only been using that since last night, so it's definitely not the cause of the problem.

Sorry about the long post - does anyone have any tips??

Have you tried Lansinoh ointment? I used it when I was bf dd and it was great - put some on after every feed - you don't have to clean it off to feed next time. Or even a bit of breastmilk wiped gently around your nipple - don't know how it works - maybe the antibodies - but it can help with healing too.

Remember breastfed babies grow at a different rate to formula fed babies, which may be what your m/w is comparing your ds with.

Birth weight at 13 days sounds fine to me.

Great that you've spoken to a b/f counsellor

In the early days when my nipples were hardening up and getting used to the chomping I occasionally took a paracetamol before a feed. I took about 3 weeks to feel totally sorted b/f ds and much less time with dd.

Keep asking for help though. The more you feed the more milk you make.

Make sure you're comfy with cushions etc - always helps

And congratulations!

MrsB, it sounds as if you are doing well now. It is concerning if the baby loses weight, but maybe you were only giving one breast at a feed (judging from what you say) and now you have changed this it will boost your supply.

Keep your baby skin to skin as much as you can, day and night, and get lots of feeds into him

You ask for tips, and people will offer you plenty of those, but the main thing is to ensure the baby removes the milm frequently and effectively - if this isn't happening, then nothing else will make a difference.

Good luck with this

bobsmum - no babies should lose weight, though

Breastfed babies grow more quickly than formula fed babies at the start, so the midwife's comparison of MrsB's baby with formula fed babies is not really relevant.

Sorry to sound as if I am having a go, but I feel it's important to be accurate

Tiktok is giving you very sound advice. I was advised to feed skin-to-skin frequently by the neonatal unit and it noticeably increased my milk supply in the early days. I was also advised to relax in the bath even if it was only for a few minutes. Other than that, as much rest, food and drink as you can manage might help. A lot of my BF friends found that improving their diet dramatically improved the quality of their milk.

If you feel your baby is OK, and you really want to bf, if I were you I would hold off on the formula for a while, at least until you have tried all the good ideas other people here have put down. Plenty of fresh water, always have a large glass by your side and drink 1 every hour or so, that way your body is not struggling for fluid. Trust yourself, as well as taking advice from professionals and second opinions etc of course!!! GOOD LUCK I hope things get easier soon.

MrsB, have you read the analogy of breasts and hot taps? There's an awful lot of rubbish written in babycare books about single side feeding and making sure the baby has 'finished' the first side before switching, all of which, coupled with slow weight gain, made my first two bf experiences unsuccessful.

I read the hot tap analogy when ds2 was a few days old and suddenly it all made sense and I'm still bfing 9mo on..

I'll try and explain it but kellymom.com has a page on it if I make no sense .

If a hot tap has been off for a while, when you turn it on the water runs cold for a while, before it gets warmer, then gets hot. If you then turn it off but use it again quite soon the water is still warm. However, if you leave it for a long time, it's cold again.

Breasts are the same. When you begin a feed after a longish gap, the milk that comes out at first is the watery foremilk (or cold water). It becomes richer and creamier (or warmer) as the baby feeds until it's the very high calorie hindmilk (or hot water). If you swap to the other side you go through the same process. If you then swap back to the first side the milk is still really creamy but the milk has had a chance to trickle down so the baby doesn't have to wait too long for a let down. Once the baby gets bored of that side, when the let down stops usually, then you can swap to the other side again.

I used to swap sides 4-6 times a feed, as soon as he stopped actively feeding (falling asleep or not really sucking) I'd put him on the other side and repeat until he either refused to latch back on or was so fast asleep I could put him down. I think the technical term is 'switch feeding' and it's recommended for babies who are slow gaining weight.

The other benefit is that the same nipple isn't being mauled for hours on end so if one side gets too sore you can swap over for a bit.

I'd second Lansinoh for sore nips and someone on here recommends 'silverette' pads which apparently heal cracked nipples incredibly quickly. If you do a search for silverette by a poster called 'determination' you'll find a link.

Hope some of that rambling helps!

tiktok - didn't sound like you were having a go at all

Thanks everyone.
Tiktok, yes, I was only feeding from one side before now, so maybe that's beginning to help. And I'm probably not doing enough skin to skin, so I'll try to increase it.

Olihan, thanks for reminding me about switch feeding - it was one of the things the bf counsellor recommended trying, but to be honest I'd forgotten about it. I'll give it a go.

Thanks for the encouragement. Fingers crossed that there's good news on the weigh-in tomorrow.

Any views on the lack of poo? I've heard some people say bf babies can go days and days without a bowel movement quite happily, while other people say it's not good in a newborn. It's so hard to know who to listen to.

I'm not sure if it is supposed to be a problem if such a new baby doesn't go for a poo for so long but you are correct about BF babies sometimes going for a long time without opening their bowels. As long as your baby is able to pass wind threw and isn't throwing up all of their feeds there isn't any immediate emergency. If you want to speed up the poo getting through you could try some baby massage techniques with a little mandarin oil added to the carrier oil (my baby massage instructor's suggestion).

Please can we scotch this myth that it is ok for a bf to go a long time between poos? It is only normal when the baby is a few weeks old...in the early days (and certainly at 13 days) it is always a sign that feeding needs to be checked out to make sure the baby is transferring milk ok.

Sometimes, it is ok and all is well. Mostly, it turns out the baby is not feeding effectively/enough.

Why were you feeding one side only MrsB? For some babies and mothers that's ok, but it's not normally a good idea to do it deliberately....unless the baby seems to want it that way.

Hope all is well now

Tiktok, just to be clear, I was only feeding from one side on each feed (on alternating breasts). I'm now still alternating the breast I start with, but I'm offering the other breast as well at each feed.

I'm convinced a lot of the problems are still to do with my latch. I keep having people trying to help me get it right (MWs and bf counsellor) but he's still taking chunks out of my nipples, so presumably it can't be right. Yet he seems to be sucking reasonably effectively when he's on.

MW is coming today to check on how he's doing. To be honest, I'm really close to chucking it in, even though I was always totally convinced I wanted to bf . What with the feeding and the inconsolable crying, I just feel like I've got one too many things to try to cope with at the moment.

MrsB have you tried feeding lying down? It was / is a godsend to me. Stick the radio on / get a good audio book and you can get a bit of rest while baby feeds. I often fall asleep tbh!

As for the crying have you tried a sling to settle baby in when you're not feeding? You could put baby in a sling and go on a nice relaxing stroll... baby will probably stop crying, but even if not the crying will sound a lot less when he is scooched down in the sling - kind of more like muffled grizzling!

Have you anyone who can help you with the housework locally? If not... it isn't going to kill you to simply not do it, as long as you are clean and fed and baby is clean and fed and cuddled everything else really can wait.

If you can afford it, takeaways for a few days and frozen pizzas / ready meals, really aren't going to make a difference to your milk but will make a huge difference to the time you spend doing stuff!

Once your latch is improved your nipples will start to heal, promise... just a word of caution too, not all mw's are trained in breastfeeding and how to check a latch is right, although afaik BFCs are (but even there be cautious, I had a LLL Peer Supporter, slightly different from a full-on BFC I think, tell me my latch was right and it wasn't).

Normally I thought it was around six weeks that bf babies started pooing less frequently, although my ds started this at about four weeks and I suppose it might be even earlier in some babies, but 13 days does sound very early?

MrsB, do you have someone (DH/DP/friend) who can take your baby out for a walk for you so you can get a break, even if it's just for an hour?

These early days of bf are SO tough and it's easy to get demoralised, your whole life is upside down and you're learning a whole new set of skills with no instructions. Not to mention the small being who doesn't follow the instruction manual anyway .

It WILL get better, in a few weeks this time will be a distant blur but it's pretty overwelming while you're in the midst of it.

Whether to carry on bf is totally your choice. From experience I would suggest you take it day by day, or even feed by feed. The best advice I was given, that saved my bf, was to think 'I'll do it until tomorrow, then I'll see about formula'. At times it was a case of, 'I'll do this feed then I'll see what happens at the next one' but it took the pressure of making a decision off.

Has anyone suggested silverette to you? They're healing breastpads that lots of MNetters swear by. There's a link to it on the thread 'help needed for my wife' that's in BF at the mo. There's also loads of advice on there on coping with this stage.

Got to run, ds2 is awake.

Olihan just wanted to say thank you again six months on for the help and the nipple shells you gave me in the early days, I have now given these to a rl friend who is struggling with bf.