Milk delayed. Have to give top-ups. Now not sucking right.

[thelady]

I bit desperate here. Baby born by em CS on Friday night (23rd). No-one noticed until yesterday that my milk hadn't come in - she was sucking for 10 - 15 mins every hour, wouldn't settle, wouldn't sleep.... After 5 days of no sleep, I was getting desperate too!

Gave topups after each feed yesterday and today - aptamil readymixed between 25 and 40mL after each feed - and she was a different child. Sleeping peacefully. Feeding well.

This afternoon she fed off both breasts - about 15 mins each - then took 25 mL topup. Woudn't settle, so attempted to latch her on - refused - gave more topup. Still wouldn't settle. Gave other breast - took, but not sucking well and only for 10 mins. Awake again less than an hour later, latched on after a lot of frustration on both sides, but again not sucking well.

I can't not give top-ups as they're threatening paeds etc. with her weight loss (born at 4.02kg and down to 3.6 yesterday) so we really need to get this sorted.

Help? Please?

Have you seen a Breastfeeding counsellor ? They can help with latch and positions. Is she jaundiced (may make her less alert) , been checked for tongue tie ?

How do you know your milk hadn't come in?
What do you mean by not sucking well?

Not sleeping and wanting to feed all the time is quite normal for a newborn

Have you tried the clutch hold? Holding her under your armpit on a pile of cushions? This worked best for me after an em cs and a delayed start to my milk coming in.

Are you latching her on yourself? Have you tried allowing her to find your nipple herself? I think this is called 'breast crawl' and can be highly effective. What about feeding lying down? Also better for a cs.

Gotta run but you must see a breastfeeding counsellor if you haven't and get as much help as you can. The bottles may cause more problems than they solve but I can understand you just wanting to get her to gain weight and soon. Are you in bed with her, skin to skin and just eating and feeding?

You eating obviously and her feeding. Don't be afraid to shut out the world while you get this established.

Sorry for garbled message. Good luck and congratulations. Will check back.

is your milk in now? can you just take to bed and feed and feed and feed, with top ups as required?

Please call the NCT Breastfeeding Line 0870 444 8708 and see if you can get a BF counsellor to come out to you to help with latch and positioning.

I'm not an expert, but hopefully tiktok et al will be along to help you soon.

Milk is on it's way I think - not engorged but certainly lumpy and a little leaking.

m/w will drop off pump tomorrow - they couldn't find one locally yesterday or today.

Feeding in bed is tricky right now as I had a bit of bother with the cs wound yesterday and lying on my side is v. uncomfy.

It's not me that is pushing for rapid weight gain - they will take her back in if she doesn't pick up fast. DH is doing everything except for babycare so there is nothing distracting from the feeding. He rushed out in between cleaning the hotel this morning and doing dinner for guests this evening to get a steriliser etc so that I can use the pump tomorrow. Amazing man! Then he worries that he hasn't time to cook me something special for dinner . Sorry - I could go on about how wonderful he's been for hours.

Do you really think skin-to-skin will help stop her falling asleep on the breast instead of sucking?

I don't latch her on per se - she gets very very frustrated if anyone tries to move her head or shape the breast. I bring her close, and she bobs around hunting for the nipple etc. until she's happy. Problem is that now she's going on and coming off an awful lot - not latching on and then screaming in frustration. Admit I've been in tears with it myself.

I tried the clutch hold in hospital, but couldn't get the hang of it, and with the wound etc. am finding sitting up in bed v. uncomfy. Nowhere else to sit that I could put cushions next to me, so I will try again next time she wakes.

I'm about to phone an NCT counsellor now.

Thanks for the advice.

Ask the MW if they have a trained BFC who can come and visit you

A good breastfeeding counsellor will help SO much - there's no substitute for having an expert right there watching you both.

Best of luck.

Hmm - if I tell you we had to drive nearly 60 miles each way for an NCT antenatal class will you get the picture.... The nearest BF support group is 12 miles away, and I obviously cannot drive right now.

I've the number of the counsellor who gave part of the NCT class, and she's going to call back tonight. MW didn't even offer to watch me feeding this morning - and daft me didn't think to ask either.

how much has she lost in lbs and ozs. You may have seen my threads about Callum and his poor weigh gain. It took him 6 weeks to get back to borth weight. I have only topped him up with EBM, and feed, feed, feed.

If she is having a good feed, I would leave a few of the top ups, because she will refuse the breast if she isn't hungry.

phone ABM They are very helpful..

I had a v-shaped cushion and used to sit up in bed, as I found that would ease the pressure on my scar a little bit.

Your DH sounds fab; having his support is a great asset.

If you do a search for breast crawl, there are some threads showing babies latching on all by themselves, and it sounds like you're halfway there with it already. There could be lots of reasons for her frustration....too fast or too slow a let down, too hungry, not hungry enough, the list is endless. There are some good articles on Kellymom including latching diagrams etc

I would definately recommend skin to skin. Someone will be able to tell you why, but it helps the baby feel secure and does seem to encourage feeding. It's also a rather lovely feeling having this little warm being snuggled up against you

Have you seen your HV yet? They can get a bit of bad press on here, but some of them are very clued about BFing (but not all unfortunately)

You sound like you are a very strong, determined mum. Good Luck

and congratulations!

Sparkly - she lost 15 ounces from a starting weight of 8lb14. I have seen Callum's progress - and have been mightily impressed.

I will phone ABM tomorrow I think - I can't use the landline in our quarters (too far for the radiophone) and 0844 is too expensive on my mobile.

The NCT counsellor suggested hand expressing if she won't take the breast at least every 3 hours, and trying the breast crawl when she's not too stressed. Tricky as she gets very cross if she doesn't get latched on herself, instantly, at the moment, but worth a try!

Daisy, the HV hasn't been in touch yet, but I only got home last night. I'll see several different midwives over the weekend, and suspect the HV will come in early next week. I'm told she does everything 'by the book' and am not sure if that's a recommendation or not.

I will try skin-to-skin after the next nappy change.

hello
just wanted to send a quick message of encouragement - my little girl was also born by emergency section with a nightmare delivery that left me in ICU and her in SCBU. we came home and then the fun began. she lost 10oz (starting weight of 6lb 12oz) and didn't gain an ounce for 3 weeks - and spent those three weeks crying every time she was seperated from the breast, so I got no sleep at all and felt worse and worse and worse. tried expressing and got very little - looking back am sure my milk took a while to come in properly (not surprising after 7 litre pph!)so in desperation gave her formula top ups. we also had some problems with latching, but kept going with skin to skin contact, expressed after every feed while she had a top up and after 2 weeks of doing this (during which she gained some weight and I got to recover a bit!) gradually cut out all the formula top ups. Now, she is 6 months old and has just had her first taste of solids - exclusively breastfed since 6 weeks. So, you can get past this, and it can all work out brilliantly - despite the early problems we both love bfing now!

My ds was 4.08 at birth and lost about a pound immediately post natally. It was because he was a "heavy" baby at birth and was then adjusting downward to his "real" weight. Like Callum, he tok c. 7 weeks to regain his brithweight - never losing weight after his inital large loss, but some weeks gaining nowt.

Fortunately, I was never under any pressure to top up with formula. I used the breast feeding support group at the maternity hospital with the hospital based breast feeding specialists, so I stayed "under" them rather than the HV, who I only saw for the "official" checks. They did get me to "top" up wih EBM from c.2 weeks and lent me an electric expressing machine and also referred me to the consultatn paediatrican (who I saw when ds was c.6 weeks - so hardly an urgent case) just in case. To give him his due, he did that apparently strange thing of look at the baby, see it was healthy, reassured me that he would eventually start rogressing back up the charts and told me to top the faff of expressing (but not stop breastfeeding) and enjoy my baby.

Major weight loss is not something to be complacent about - but you do need to look at he baby as a whole - wieght is only one of the "symptoms" that should be looked at.

thelady.....15ozs, is just a smidge over 10%, which as far as I know is an acceptable amount to lose. She should regain this by day 14

Have heart, there are lots of positive stories on here, and just feed feed feed.

Let us know how you get on

Hopefully hunker, tiktok, moondog and co will see this soon.

TL, have you tried hand expressing?

Another message of support - it sounds like you need it.

After an emergency section, my dd lost just over 10% of her body weight which meant an extra day in hospital for us until they were happy she'd stopped dropping.

Once home, it seems that magic 10% figure meant that I got similar threats to you from the MWs - all to do with adhering to guidelines, I suspect.

My dd was an inefficient feeder and I'm pretty sure it took ages for my milk to come in too. Something like 10 days if I remember, and even then it wasn't the event everyone else seems to experience. She fed pretty much constantly and cried the rest of the time and I, like you, found finding feeding positions difficult. A V cushion sitting cross-legged with a couple of other cushions on top seems to ring a bell.

The MWs had me expressing after every feed (I got 10ml at most, most of the time nothing), feeding her the EBM form the previous feed and then topping her up with formula. It was an exhausting regime and if pressed to do it again, I wouldn't. Even though she slept so much better after formula, I personally felt that the exhaustion from the expressing regime (I got no rest - she was up again by the time I'd washed the pump and bottles out!) adversely affected my milk supply too. I should have just stayed in bed with her (I remember this occurring to me, but I remember being cautious about falling asleep and not making sure she was feeding well - I was SO tired! Another reason I didn't do this was that I found feeding whilst lying down painful too. It's easy to say I'd do it differently this time, but I'd definitely buy more cushions to make life easier next time).

It's difficult to be brave in these situations if there are health professionals telling you that you should be doing otherwise, but stick with what you feel is right for you and the wee one. My DD was otherwise alert and healthy (and that was according to my mum, who had had 4!). I have family in other countries whose health professionals are much more relaxed about BF babies regaining birth weight. The Regime meant my dd had regained in 3 or 4 weeks, but it needn't be such a crucial target as long as the lo is otherwise healthy.

Hi thelady,

Hugs to ya, you've got a lot on with your em CS. Great news that you've been getting more milk. And some feeds are going well, some not so well by the sound of it? This is normal with a Bf baby, whether or not you've had a section.

I've been there - 2 em CS and 1 planned and BF all three... I could not lie down and feed at all at start - I think it puts more pressure on your scar. Maybe best to try sitting up in bed or even better get out of bed and sit propped up on a dining chair (with your feet on the yellow pages if necessary). You can order online or send someone to Mothercare for a v pillow if you don't have one and if that's not high enough, add more pillows. they also do a firmer one that straps on round the back which lots of people recommend.

My other advice FWIW is PLEASE take the painkillers if you want to BF. Getting mobile, being able to hold your baby comfortably and being able to feed is much more important for BF at this stage than a little bit of stuff in your baby (it's all pretty safe for feeding mums/BF babies anyway).

Good luck with it and I'm sure each day will be different - we're all here for you if you need us.

Forgot to say - if you're not topping up, one thing to watch out for is dehydration. Ask MW what signs to look for (Usually sunken fontanelle, dry mouth, listless, doesn't cry tears). I was always worried about this because dd always had some of these signs (still does at 1 yo!), but MW, HV and doctors at different points have said she has been too alert to worry about.

Thanks for all the encouragement. My CS wound has 'leaked' twice in the past 12 hours, which is scary and horrible (would you believe that those were the first stitches I'd ever had!) and why I'm not lying on my side to feed.

Madam is not taking well to the aptamil made from powder today now that the readymade stuff from the hospital has run out - it took me an hour to settle her after the last top-up - but that may be because she's drinking it so fast ??

There's definitely milk there today - thanks for the tip on hand expressing which I'm about to go and try - but she seems to have forgotten how to get it out. She goes on, eventually (took 20 mins at the last attempt) and then just nibbles rather than sucking. I'ts getting really disheartening.

The midwife was supposed to come round 'urgently' with a pump and to check the wound today - and she's still not here. Wail!!

I've tried phoning the ABM but no reply. Going to google for alternatives.

The difficulty with pillows on the lap is the post CS 'apron bump' which gets in the way of everything. I'm scared of splitting the wound too ....

God, I sound like a complete wimp. I hope you don't think I'm always this pathetic when things don't go to plan.

Sorry your are having such problems. Ds used to take ages to get latched on - for a hwile I kept a log and 20 minutes was not abnormal. If she just "chews", take her off and try again, as she is not properly latched. I found "posting" my boob (seqeezing et between the flat of my hand and thumb into a sort of rectangle and getting that into the top of his mouth helped.

Dear thelady

I know it feels like you're doing awful things to your wound but trust me, it will be OK. If you're worried about leaking/splitting, you could use a clean sanitary pad pressed up against it and then a rolled up towel over that to 'brace' it and then load up with more pillows, putting the v pillow on top? This was you shouldn't get any pressure directly on your wound. Again, I think taking the painkillers is really important too for not putting worries in your mind about the wound healing.

Is your dressing off now? Is it mostly healed and stitches/clamps out/dissolved? Have you been told it's OK yet to wash it gently with warm water? If so, can I also suggest getting acquainted with your wound - get a mirror to have a look and have a gentle feel in the shower... This can give you more confidence in it since it will probably look and feel much more robust from the outside than it does from the inside IYSWIM. And maybe that'll help a bit with confidence in picking your baby up etc.

there's a belt you can buy though I've never used it which sort of braces your wound/scar but don't know if it's suitable so early on - ask your midwife?

And honestly 20 mins to latch on is perfectly normal at this stage - you're both learning to do it and she doesn't know what she's doing at all yet! I've spent lots of the first couple of weeks in tears with all 3 babies!

Good luck!