How to juggle expressing for bm top ups with feeds?

[Tier500]

I need to start topping up my 9 week old baby as her weight gain is slowing. Practically, how do I do this? Should I pump after every feed? And then when do I give her the top ups - small amounts after every feed or do I save them up and add in a bottle only feed? And when can I stop the pumping regime? I’m gutted that this is necessary and feel completely overwhelmed by the logistics.

Breast compressions m.youtube.com/watch?v=4OeIwYDaLxQ&feature=youtu.be

Instead of the syringe, you can stick the tube directly in a bottle m.youtube.com/watch?v=5VhV6gDUYzw

@AsMuchUseAsAMarzipanDildo thanks so much for taking the time to respond in so much detail - all of your advice is really helpful. She feeds frequently day and night - mostly at least every 2-3 hours though often 4 and sometimes 5 hour stretches at night. We cosleep and she’s held or carried in a sling all day (from necessity as also have a 2 year old). I do respond to her cues. I think the issue is that the tongue tie and latch problems have made milk transfer increasingly inefficient with a knock on effect on my supply.

She’s still making the smacking noise today though not all the time - I hope things will keep improving. I do always use breast compressions and think they have really helped in recent days when her sucking has gone out the window.

Re pumping - I find it almost impossible to pump after feeds because I still have her in my arms. It’s also not always clear when a feed has ended because she’ll usually do a proper feed but then want to go back on the breast after a little play to feed again before sleep, sometimes w couple of times, and then I’m stuck with a sleeping baby in my arms or she’s strapped to me in the sling so I can’t get at my boobs. Would a single power pumping session done overnight do the same job? I was thinking of hiring a hospital grade pump and giving it a go for a couple of weeks.

Similarly, because she always takes at least 2 but more usually 4 sides per feed, I’m not sure it makes sense to try to pump while feeding her? If the best thing is to pump after every feed though then I’ll make it work.

I’ll look into the tube feeding. She has utterly rejected bottles and tbh I don’t want to confuse her when she’s working on her latch. I’ve given her the little I’ve managed to express over the last few days in a syringe but it was so slow.

It honestly sounds as if you’re doing all you can. It would be a lot with just her... so you’re pretty much Superwoman to manage all that with another child to look after.

Your instincts about her tongue tie affecting milk transfer and supply is what I was trying to get at... but probably not explaining very well.

A few days of power-pumping, at a time that works for you, might be more achievable than pumping after every feed - especially when, like most babies her age, she’s on the boob, off the boob, back on the boob 45 minutes later.

Really feeling in despair. I fed her at 1.15am - she was quite sleepy so only had 2 sides, having cluster fed from 8-11, and then I did a power pump session and only got 1oz. It’s so demoralising. I feel like I have no milk.

I keep telling myself that actually she’s been gaining a good amount each week and I just need her to gain a little more, but really I now feel that she’s starving and my supply has gone and I’m going to have to stop feeding her 😭

You do have milk, she's gaining an average amount of weight.
Things always seem worse in the middle of the night,
1oz after feeding so much is totally fine, honestly!

OP how much you can pump bears absolutely no relation to how much milk your DD is getting. With my DS2, milk would spray across the room when he unlatched and I could fill a bottle with expressed milk in minutes using a hand pump. With my DS3, I couldn't express an ounce at a time even using an electric pump and it would take multiple sessions to get enough milk for a bottle if I needed to be away from him for any length of time. Both babies were getting plenty of breastmilk but the difference in expressing was enormous.

There seems to be a lot of pressure on you at the moment. Try to take a step back. Is your DD thriving? Is she having plenty of wet nappies? Does she seem healthy to you? Let her have the time to sort out her latch - it can't be easy with her tongue moving in a different way than before - and trust her to tell you how much milk she needs. The purpose of power pumping is to make sure you have enough supply; it doesn't matter how much you can express each time. Another thing is that if you're stressed then you won't be able to let down and you just won't be able to express much milk. Some people prefer to express while looking at their baby, or even a photo of their baby, because it makes it letdown more likely.

You’re doing as much as you can, your daughter is happy and healthy. If she was starving she’d wouldn’t be weeing and pooing.

The difficult part of breastfeeding is often that it takes time for you to see a change. There’s a lag between increasing stimulation and increasing supply, between increasing supply and weight gain, between a baby having their tongue tie divided and getting the muscle memory to latch better.

It’s natural as a mum to focus on your supply. But as you said yesterday, she’s likely been unable to transfer milk effectively. As her tongue heals and she gets used to moving it more, her latch will improve. It’s impossible for me to say definitively over a forum, but one possibility for her taking fewer sides last night is that she actually had a really good, effective feed - so got more in less time.

It will take a good 24 hours or more to see the effects of power pumping. The first time is more to increase stimulation.

Easy to say, but try not to look at how much is coming out. Letdown is a bit like a watched pot. Lie next to and smell your gorgeous girl while you do it.

A lot of women don’t get a lot of milk with a pump. You may get more hand-expressing.

Hope you’re having a well-earned sleep now and have someone to help look after your elder child, so you can rest. Go easy on yourself x

Thank you again for the support. I’ve had a good sleep and trying to be more positive! Speaking of sleep, ironically since the tongue tie was cut she has been sleeping really well. She had a big, good feed at 5am, did a poo so nappy change disturbed her, then was back on and off the boob (and smiling up at me) til she fell asleep at 6.30am. She stirred and had one side at 8.30 and is still asleep now. So counting from the start of the 5am feed it’s almost 6 hours for the left breast and 2.5 for the right. I’ve let her as am also exhausted but I assume I should be waking her? Should I have woken her to give her the other side at 8.30?

If she's satisfied after one side then I really don't think there can be an issue with your supply. The sleeping better would indicate to me that she's probably been getting more milk (and possibly less air giving her a windy tummy as is common with tt)

I don't think you have a supply issue, OP.

She’s still making the clicking/smacking sound when she feeds. I’ve tried different positions and they don’t seem to help.

I guess I’m worried that she’s been sleeping well because she’s weak and hungry rather than satisfied, but appreciate I might be a bit paranoid now!

I clearly need to get more milk into her somehow and the pumping output has been rubbish so far so I’m just hoping that she will start to take more milk from me.

Honestly OP, as long as the nappies remain constant it will be fine. I understand why you're so worried (because these babies love to terrify us!) but it really does sound normal. Please stop beating yourself up and be proud of what a good job you're doing! Also I've been feeding for 14 months and can't express to save my life. It does not signify milk supply at all.

I’m another one where pumping does not indicate supply. Could barely get a drop out withmy first, have done better with second but she won’t take the bottle.
My 5 month old usually has her mouth partially open whilst sucking, smacks her lips, sometimes suck her thumb at the same time and frequently chokes, not quite sure how she manages that
If you are getting plenty of wet nappies and some poos and she is gaining don’t worry. She will get better at latching and your milk supply will adapt
I find a hot shower or bath is great for let down

Op my 5wo pulls off the breast a lot, makes lots of noises, coughs, dribbles milk out of the side of his mouth etc. I think a lot of these things are normal and settle down when they get bigger around 12 weeks.
I really wouldn't

Wouldn't worry too much *

@sproutsnbacon your 5mo sucking her thumb at the same time is hilarious

Ha the thumb sucking is excellent! This is all so reassuring. I’m so pleased I started this thread as it’s really kept me going. I know really it’s not that bad but I’m also just hormonal and knackered and want to do my best for this gorgeous little thing.

I’ll try to get her weighed the week after next and just try to enjoy her in the meantime. Should I try to wake her for an extra feed in the night?

I wouldn't wake her to feed her unless it's a 10pm 'dream feed' to enable you to get more sleep. Otherwise no, the vast majority of babies don't need to be woken to feed them, especially not past the newborn stage.

God no, you'll inevitably hit some kind of growth spurt/ sleep regression soon enough and you'll have no choice in the matter glad you're feeling better about it, keep posting if it helps!

How are you doing today op?

I think my wee one is having a growth spurt, he was down to 8/9 feeds a day and the past couple of days he's had 10. I don't deal well with sleep deprivation so I've got a headache today.
Waiting for GP to let me know if he's getting a 6 week check - no one seems to know for sure

Thanks for checking in. I’ve tried to relax a bit today. The night feeds have been going well - she seems to latch better, it feels like there’s plenty of milk and she does lots of good swallows then passes out. She seems to love to cluster feed in the afternoons from about 3-6pm (rather than evenings like her sister did) and milk flow is so much slower which makes me feel like she’s starving. I do have to keep reminding myself this is normal.

Her latch still needs work - she pulls back on to the nipple and she’s still making the noise during the day (weirdly less so at night) - but I’ve been trying to correct it every time. I’ve asked the HV if I can get her weighed next week (no response...) so I guess it’s a matter of carrying on until then and hoping we see some improvements.

@shouldistop 10 feeds a day still sounds ok to me! She has a feed when she wakes up and then also feeds to sleep. The toddler wakes her all the time so there are multiple feeds to sleep! Sorry about the sleep deprivation though - it’s a killer.

I’m really pleased it’s going well and you’re feeling better. The milk drunk passing out is great and she’s clearly ordering more for her next growth spurt.
My dd had a really bad latch at first but she improved dramatically with a little practice and I’m sure yours will.

All sounds positive OP! Are you getting any pain with the latch?

@KatieKat88 no, no pain at all. I haven’t ever had any pain with this one. It was horrendous with DD1 whose tongue tie wasn’t diagnosed until she was much older so j wonder whether my nipples are just used to being abused!

Spoke to the HV today and she’s going to weigh her next week which is a result as they’re not doing any face to face appointments because of covid. She gave me the details of the local bf support group who are doing zoom calls atm so I might try them this week. I think things are gradually improving though. Her poo output has increased from 3 poo explosions/day to about 6 yesterday so I hope that’s a sign more is going in.