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Infant feeding

Get advice and support with infant feeding from other users here.

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Original poster

Low collustrum - can't hand express

62 replies

NotAgain77 · 23/04/2021 05:34

Hi - my baby is 2 days old. I started hand expressing at 36 weeks and got some small amounts of collustrum which stupidly I didn't harevst I then got admitted to hospital and put on a lot of medication for complecations and since then I got nothing from hand expressing.

Fast forward to day 1 of babies life and I am advised when he is 12 hours old that my supply is low so I need to top up with formula. I resisted until 24 hours when I was told it is in the clinical needs of my child to give him a top up. So I did but by cup. I have a feeding plan involving putting him on the boob, trying to get a feed and then if I can't topping him up with a cup and then sitting on a pump for 15 mins to stimulate my supply.

I've just had to give him 15 ms of formula as he hasn't weed for a while. I did this by syringe but was advised this was pointless and I should do it by bottle. The feeding specialists don't see to be able to decide on the best way to give the formula.

Baby still seemed hungry after the formula so I tried to latch him onto the boob, but now he's not interested. Even though he does some to be rooting. My fear is he is only interested in formula now and the easy mode of delivery.

I battled to breastfeed my firsf son for 6 weeks and didn't manage it. Which I still regret.

Any advice?

OP posts:

Doona · 23/04/2021 05:58

Ohh I remember this. Its hell until your milk comes in (day 4?). What I did is try to latch on (failure!), do lots of skin to skin contact, keep expressing even if there's nothing (the stimulation is supposed to increase supply) and then feed the baby what you express plus any formula if they need it. It took me weeks to get good latching on with my babies, even with experience, it's so hard (and baffling) at the start. Good luck, OP.

EarringsandLipstick · 23/04/2021 06:00

Congratulations on your new baby!

I'm so sorry you're having these problems & frustrated for you that you are getting such poor support.

There is no need to express. You are only day 2 post birth - your milk won't come in for another day or so.

The colostrum is sufficient for baby now. BUT if baby is showing signs of dehydration (happened with one of mine, he had tongue tie & was a very sleepy baby so not latching) he will need formula.

Don't panic at all about this. You are correct to continue with a cup. Do not give a bottle, and don't allow them to pressurise you.

Here's a good way to approach it. Offer breast. If baby not latching / sucking, then stop trying, offer formula in a cup. Baby should then sleep soundly. Next feed, try breast again.

Doing this should ensure that baby gets the hydration he needs but is stimulating your supply by sucking too. This is the key thing.

Remember there's very little there before milk comes in. So don't expect it needs to be long feeds either.

With my 3rd baby, he was a big baby, and frantic for milk. Happily latched on but roared in frustration when nothing there. So I also gave him formula in a cup, kept offering breast. Once milk was in, he was fine.

If you had a section, milk will come in typically one day later.

It's great you'd like to give b/f a go again. I would be confident that when your milk comes in, it'll be a lot easier.

Congratulations again!

EarringsandLipstick · 23/04/2021 06:02

I am advised when he is 12 hours old that my supply is low

This is categorically rubbish. You don't have a supply at 12 hours.

If they say this again, calmly push back.

Don't express. The key thing is to ensure supply by putting baby to the breast as often as you can.

EarringsandLipstick · 23/04/2021 06:04

I did this by syringe but was advised this was pointless and I should do it by bottle.

Ignore this entirely. It doesn't matter what way baby gets the formula. But to establish b/f you are correct to avoid the bottle.

EarringsandLipstick · 23/04/2021 06:05

My fear is he is only interested in formula now and the easy mode of delivery.

Don't worry. It's only day 2. He'll be fine. Keep offering the breast. I promise it'll seem easier when your milk comes in. 💙

EarringsandLipstick · 23/04/2021 06:08

keep expressing even if there's nothing (the stimulation is supposed to increase supply

Sorry to disagree with Doona but I wouldn't do this.

You'll become exhausted, and get very little. Supply comes from putting baby to the breast at every feed. There's no need to express. I never got much from expressing & basically didn't bother.

LapinR0se · 23/04/2021 06:09

Keep your baby hydrated and nourished with the cup feeding until your milk comes in. The last thing you want is a baby who is too lethargic to even try and breastfeed when you have milk.
Then do loads of skin to skin and let him latch naturally.

Wobbitcatcher · 23/04/2021 06:09

Try not to panic, I am useless at hand expression and appear as though I have no milk but I’ve fed both my babies and they are huge so I definitely do.

Keep trying, keep latching, top up (think of it as medicine your baby needs right now) just do what you need to do until your milk comes in and then get as much support as possible. Contact your local la leche league (mine were invaluable)

I harvested colostrum in pregnancy for this baby but still couldn’t hand express so I used a hand pump but got the syringe in before the milk left the cone shapes flange (as colostrum just gets stuck in all the valves) a bit of skill needed but worth a try!

Doona · 23/04/2021 06:50

Sorry to disagree with Doona but I wouldn't do this.

Yes, I'm not an expert at all! Just saying what I did. Could be totally wrong!

Bear2014 · 23/04/2021 06:59

@Doona this is exactly what I did too and it worked for both my DC whGood luck OP!

EarringsandLipstick · 23/04/2021 08:03

@Doona

Sorry to disagree with Doona but I wouldn't do this.

Yes, I'm not an expert at all! Just saying what I did. Could be totally wrong!

Sorry Doona I didn't mean you were wrong as such 🙂

I just meant that there's no benefit, in the situation OP described, to express colostrum. Putting baby to the breast at every feed, is the single best way to increase supply.

It's not that expressing is wrong, of course, just not helpful here.

Although I'm not an expert either, I've b/f my 3 & helped a lot of people with b/f through a volunteer activity I'm involved with.

shouldistop · 23/04/2021 08:05

What are they on about? Low supply at 12 hours post partum? All they should be worrying about at that stage is making sure your baby's latch is good and that you're putting baby to breast frequently (Id say every 2 hours at this stage plus whenever the baby asks).
I'd try to find a lactation consultant urgently. I've found breastfeeding help in hospital with both of mine utterly dismal.
I can't hand express at all, my baby is 4.5 months and big and chubby so getting plenty of milk.

EarringsandLipstick · 23/04/2021 08:06

Good advice @shouldistop

Agree with a good lactation consultant too OP.

Doona · 23/04/2021 08:09

No, don't be sorry 😂. I really don't know, and I didn't want the OP to mistake me for someone who does! I found the whole thing difficult and mystifying.
Glad it's behind me tbh.

Doona · 23/04/2021 08:10

That last post was for earringandlipstick

shouldistop · 23/04/2021 08:14

I'd push back with the expressing too tbh. I was told to do this with my first and ended up expressing for almost 3 months, He hardly latched and I was too tired from expressing to really give it a go. He ended up formula fed after that.
My second was born with a tongue tie but did latch, it was sore but his mouth was wet when he came off the breast so I knew he must be getting some colostrum. For 3 days he was on the breast almost constantly, seeming hungry and then my milk came in and he was instantly more settled.
42 hours after he was born a midwife called me and said I should start pumping every 3 hours (baby was already going to breast every 2 hours), I said no I wasn't going to do it, I'd rather give formula if I couldn't breastfeed again. She said my milk should have been in by now but I knew it takes 3 days.
He was over his birth weight by day 6.
I'm not saying completely ignore medical advice but definitely get a second opinion from a lactation consultant.

Original poster

NotAgain77 · 23/04/2021 09:23

Thanks all. We have a really good latch. And I am putting him to the breast for at least 15 mins every 3 hours or when he is showing feeding cues (he was on the breast pretty solidly between 1 and 3am). He isn't getting hardly anything from me. No wet nappies and he is frustrated. This is why they've suggested the top ups. I have a lactation consultant and will send her the plan they've drawn up in the hospital. The hospital was day 2 has to be 30 ml of top ups she says 5-10 ml. Baby is so sleepy without topping up that he is going on the breast and falling asleep within a few sucks.

OP posts:

EarringsandLipstick · 23/04/2021 09:28

@NotAgain77

You're doing everything right.

Your milk isn't in yet. It will honestly be different even later today or tomorrow.

The hospital are also correct to offer formula. Some babies (my 2 boys, but not my girl) need milk before the breast milk comes in.

As you say, without the formula, baby will become dehydrated & sleepy, and you'll be in a vicious circle.

Great you've got the lactation consultant on board. The only extra thing I'd do is not worry about expressing.

Best of luck!

shouldistop · 23/04/2021 09:39

If the latch is good I'd put baby to the breast more often than 3 hours and see what happens. My 4.5mo still feeds every 2 hours during day time.
On day 1 you'd expect 1 wet nappy
Day 2 you'd expect 2 wet nappies
Day 3 you'd expect 3 wet nappies.
But actually with both of mine they were a little less than that until my milk came in.
30ml of top up is a lot for a 2 day old baby, baby won't be interested in the breast at all being so full.
The good news is that the latch is good so lots of skin to skin, lots and lots of breast and once your milk is in it will be a lot easier. The more your baby feeds at the breast the quicker your milk should come in.

Original poster

NotAgain77 · 23/04/2021 09:41

That is interesting. 30ml seems a lot to me. And I am nervous of getting into a feeding approach that I can't come back from. I will speak to my lactation consultant.

OP posts:

EarringsandLipstick · 23/04/2021 09:43

@NotAgain77

That is interesting. 30ml seems a lot to me. And I am nervous of getting into a feeding approach that I can't come back from. I will speak to my lactation consultant.

I wouldn't worry about getting into a pattern. Just don't use bottles. That way, it really doesn't matter as long as you keep putting him to the breast first, and regularly.

shouldistop · 23/04/2021 09:43

An article if you have the head space to read it

www.lllc.ca/thursday-tip-newborns-have-small-stomachs

Original poster

NotAgain77 · 23/04/2021 09:48

@EarringsandLipstick what would you use? I only have a syringe with me. They won't give me a cup.

OP posts:

Original poster

NotAgain77 · 23/04/2021 09:51

Thanks @shouldistop. This is what worries me. Surely he should be having v small amounts at this stage. And even 15 ml is too much. I am surrounded here by people feeding formula on demand from day 1, e.g. 30-40ml per feed.

OP posts:

shouldistop · 23/04/2021 09:51

They won't give you a cup? Are you in a uk hospital or elsewhere? Do you have someone who can buy a feeding cup and bring it to you? Once your milk is in if your lactation consultant says you do actually have low supply then I'd look into a supplemental nursing system if you have to continue topping up with formula

shop.medela.co.uk/products/feeding/supplemental-nursing-system/

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