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?

was way

BTW try googling Breastfeeding Network helpline, NCT helpline and La Leche league helpline - all run a voluntary service up until 9-10pmish and they have trained BFC available to give very good detailed advice and support on the phone or may be able to advice someone who see you. When I had my first CS, I couldn't drive (because of the CS) and neither could DH (because he was a lazy sod) and an NCT BF counsellor kindly came out to me. Don't know if they still do it - this was 8 years ago...

Hi there, just wanted to add my support. I had an em cs with my ds, and it took six or seven days for my milk to arrive "fully" - obviously it's a gradual process, and it can be delayed by the trauma of a cs. All the advice about hand expressing etc is good, as is skin-to-skin and lieing down to feed. I found a cushion over my wound helped too.
I also wanted to add that perhaps cup feeding might help? My ds expressed his preference for a bottle pretty quickly. I started cup feeding , then switched to a bottle as it was easier, and after three consecuti ve bottle top-ups, he didn't want to latch on but gobbled down a bottle. However he started latching on better again after I took away the bottle option.
Keep trying with the abm - the phone line goes through to someone's house, and if it's not answered after a number of rings it passes onto someone elses number and so on, so someone ahould answer you eventually! Even if they answer you on the first ring in their house, it might have taken a while to get there, iyswim.
Anyway, you're doing really well, keep posting here, or try on the abm website, someone normally answers pretty quickly and a lot of bfcs hang out there.
and I'm sure TikTok will be along soon!

thelady...I agree with keeping on top of your meds. I was alternating the codeine, paracetomol and voltarol I got from the hospital in order to keep myself topped up and only had max 2 hours between psainkillers. If I let the pain get on top of me it made everything else that much more miserable.

I had a wound infection as well and it was so sore. I could only stand for five minutes at a time; after that it stung like you wouldn't believe.

Keep trying with the latch; it does takje some getting used to, for both of you, and if she has been getting bottles, she probably doesn't want to work at it on the breast when bottle teats it is so easy.

Could you try spoon or syringe feeding the top ups to avoid this nipple confusion?

I hope your MW has been round.

oh, and leaving your wound open to the air will help it heal more quickly.

The hospital told me not to use a sanitary towel as padding as the waterproof backing could cause more problems by not letting the wound dry out.

Again, thank you all for the advice and sympathy (both equally needed). I'm lucky in that the pain is well controlled by paracetamol and ibuprofen alternately through the day, so it's purely nerves re. the wound.

It was well healed, we thought, but has a build-up of fluid behind it which keeps leaking out through a small hole. The leaking is intermittant, and rather startling in volume when it does, so I have a sterile dressing taped over the top both for catching as much as poss and to keep it clean.

I should be taking daily showers, but not touching it just yet. I will take your advice about having a look at it next time - the past twice we tried to get a shower (DH has to be there for safety) the wound flooded and put paid to my hopes of being clean. Maybe tonight!

The midwife has finally turned up - major road closures locally meant a long detour for her. Frances has put on 180g in 2 days (more than 6oz), so we can cut back on top-ups (yippee!) and I now have a huge breast pump to try as well to stimulate the supply. The wound leaking is apparently "a good thing" as otherwise I'd end up swollen/sore, and I'm generally feeling an awful lot better.

I didn't top up after the last 2 BF sessions, and not only did she latch on reasonably well but she went to sleep afterwards without all the girning that resulted from formula. I can't drop the top-ups immediately, but I'm feeling so much better about the situation.

There are no BF Counsellors locally according to the MW - there was one but she left. I don't get rining out on the ABM number, I get a message that the person closest to me isn't able to take the call, and it cuts off. I'd love face-to-face help, but you lot have been pretty amazing so far, so thanks!

brilliant that you've had some good feeds and are feeling a bit better about it all - hoe it just gets better from hereon but don't hesitate to vent if not!

Sounds like you're doing really well! The weight gain would seem to indicate that your milk is arriving - not everyone gets engorgement, maybe yours is just coming in gently. I meant to say earlier that I stopped my ds's top-ups after a couple of weeks and he was breastfed fine thereafter. You'll have plenty of milk in a day or two, just trust your body.
And I'll check up about the ABM helpline - I'm disappointed to hear you were cut off, that wasn't my understanding of how it worked.
Keep your chin up (and your shoulders relaxed . . . )

You sound a lot more positive TL The other helpline numbers are on my profile if you wanted to give one a try. How much formula is she having as top-ups now?

Top-ups - I didn't give through the day yesterday as she seemed to be sucking well, latching on well, and she threw up a decent volume after one feed....

Late last night, after she'd been on-and-off for aboout 2 hours I gave a top-up of the last bottle of ready-made milk from the hospital, and she took 60 mL (2 oz) and flaked out at around 00.30.

I tried to pump last night after her marathon session (she was never off the breast for long enough for me to try earlier!) but got quite literally a few measly drips. My breasts are soft, even compared with a day ago, and I'm going to have a look on kellymom for info on increasing supply. I can hand express a few drops after a feed, but that does seem to be it.

This morning she's slept over 5 hours (worrying for me as I thought she needed food more often) and although she latched on OK (I think) she didn't suck 'properly' and gave up after less than 10 mins each side. She's not interested in more BF - passed out in her basket - despite me offering. I don't seem to be able to get her to gape by brushing her cheek: if she wants food, she'll take it, but I can only get her to take more once she's stopped if it's in a bottle.

Wish I could find someone to help with latch on, so thanks for the info on alternative numbers Hunker

Hi again

When you say she didn't suck properly, I'm not sure what you mean - just sort of nibbling with her mouth open, or it didn't seem strong enough or...?

I really think you do need to speak to someone or try and get someone out if possible. Given she put on 6oz in two days, you may not have a problem at all, it may just be that you're not conscious of feeling the milk, and not seeing it, but it IS indeed going in. This is not an uncommon experience (I certainly had a 'god, I'm sure there's no milk' moment lots of times)

But you know your body better than anyone, and it may be that there is indeed a supply/latching issue also. A 5 hour gap in a new baby sounds long but not unprecendented but if this happens a lot I think you need to speak to someone.

Have you been cutting down the top ups? Maybe she doesn't actually need the extra bottled milk now if your supply is up and is only feeding with the extra stuff because it's there and easy to get? (Rather than she's still hungry as evidence that you're not producing enough? IYSWIM)

I'm not a BFC though so best to get proper expert advice still...

Just c aught up with this.

Firstly - signs of dehydration. Hobnob, the truly sunken fontanelle would be a very late sign of dehydration, ditto the dry mouth. Dehydration in a new baby is signalled earlier than this with dry nappy, lack of energy and persistent sleeping.

thelady - I don't think you have had good postnatal care, to be honest. They allowed you to go 5 days - 5 days!! - without spotting the fact your baby was not transferring millk effectively. However, weight loss was not dramatic, and should be poss to turn the whole thing round. Good she gained weight - was this a naked weight on digital scales? Hope so.

Nappies should be wet and she should be producing plenty of soft yellow poo - several a day. The 5 hour sleep is ok as a one off but a baby who needs to be helped to bf, needs to be skin to skin and feeding often even if little and often....long sleeps don't support effective bf at this stage. Keep her next to you and she will not sleep that long.

I hope a midwife will see you today.

Good luck.

I'm in agreement that postnatal care wasn't good - and she did have a very dry mouth! I'm not convinced she's swallowing when she sucks, although I do see the jaw moving and she certainly sucks hard enough. She falls asleep very quickly on the breast, although the big jaw movements start up again every so often if I manage to get her to stir.

I've been waking her to feed this morning - and am going to give top-ups using premixed formula as there was one awful, dry, glue-ey nappy yesterday about 12 hours after the first bottle of powdered formula that left her with a bright red bum. I don't want to cut the top-ups out completely, particularly as she often looks hungry (sucking her fingers etc) and if she's sleepy I worry she's short on energy.

I'm keeping a record of pee/poo and how long she feeds for just in case I manage to get someone clued up to help.

Progress report: there is definitely milk, but not much it seems. Pumping this morning got 20 mL after 15 mins, and she'd not been on that breast for 10 hours at that point.

She's not taking huge amounts of formula, but I'm not sure how much 'enough' would be for an exclusively formula-fed baby, so I've nothing to compare with. When she gets a top-up, she flakes out for 5+ hours, though, which suggests to me that she's probably hungry the rest of the time.

I know it's irrational, but it's very hard not to feel let down by a body that won't do what it's supposed to....

How much you express is not an indication of how much milk you have, so don't let that in itself discourage you.

She's 10 days old now ? imho she should be feeding more frequently than 5 hourly, top ups or not, and 10 hourly intervals between bfeeds is not sufficent to develop a supply to sustain her. Try not to use expressing a s an indicator of supply , it really isn't reliable and will demotivate you. Feeding more frequently is really the only way forwards to continue b'feeding, can you gradually reduce the amount of formula top up. Have you spoken to a bfc again ?

thelady, what you are feeling is anything but irrational. You had a difficult birth that ended in a section and have struggled to get BFing off to a flying start, but you sound really determined and positive.

I agree with prettybird about expressing, I could never manage to get more han 20mls in the early days.

The 5+ hours on the formula is probably down to formula being more difficult to digest than BM, so baby thinks she'd fuller for longer. I would be inclined to not leave her more than four hours.

Can you call your HV team? They may have had some training in supporting BFing women.

If you feel up to it, and there is a Baby Cafe nearby, they usually have a trained counsellor at each session.

gotta run, my DD is awake. I hope things improve soon....keep putting her to the breast as often as you can.

Good Luck

daisy x

thelady - flaking out for 5 plus hours is not good, sorry to be blunt about it. It's not good for a formula fed baby of this age (9 days) either....and it's true about expressing not being either an indication of what you are making or what the baby is taking.

A gap of 10 hours during which your baby is not on the breast at all is also just not the way breastmilk poduction can be stimulated...again, it's better to be honest, though.

I think you'll be helped most by someone who knows what they are talking about having a good long conversation with you and if poss, a visit from someone who knows what to look for.

Your baby may need the top ups, it's not poss to tell, but there are ways of preventing them from interfering with breastmilk production as much as possible. Hope you get the right help soon.

Breastfeeding support here is, basically, non-existant. The nearest Baby Cafe is 60 miles away, my midwife said that a BF baby could be left for at least 5 hours between feeds, and several mw have said that I'm going to be stuck topping up from now on.

Positive is not how I'm feeling. I spent most of this evening in tears - and am finding it very hard to fall in love with my daughter. The overwhelming emotion is fear, and guilt that she was left for so long without food in hospital.

I'm always putting her to the breast before top-ups, and try to offer the breast more than once if she still seems hungry before resorting to the bottle. It feels cruel, because I don't know if she's getting enough to satisfy.

I will make time to phone another BFC tomorrow. The NCT one has been v. supportive (I had her direct number rather than using the call centre), and has phoned back to check with me several times, but I think I need a fresh set of eyes/ears on this situation.

Three questions, please:

1. Should I be expressing at all? Will using the pump increase production, or just decrease what's available to her from the source?

1. At 10 days, do I expect her to go to sleep after each feed, or what? The m/w said to top-up if she didn't settle after a feed, and I do if I've tried offering both breasts and she's still sucking her fingers etc.

1. If I've given her a top-up and she won't settle due, I presume, to wind, am I wrong to let her use the breast as a dummy to settle her before putting her down?

thelady, alas nhs bf support is non existent in general. you need to see the nct counsellor again because that is about as good as it gets

1. no idea sorry
2. also no proper advice although can offer opinions if you'd like some.
3. no you are never wrong to use breast as comfort as it will improve supply and you should be doing this as much as possible.

Hi thelady,

Sure you'll get someone expert like Tiktok back on soon but if not:

I know I can't tell you what to feel but please don't feel guilty! You can't possibly have been prepared for what it's like postnatally, but your midwives should have been. Fear is normal (we all panic about parenting at the start I reckon) and as for falling in love - don't expect too much of yourself or her so early on, for many of us, perhaps most, it is bloody gruelling for the first few weeks and feeding is rife with emotion. Sounds like a touch of baby blues maybe and perhaps you need extra TLC from partner, local friends, family if possible?

But yes - tomorrow, get on that phone again and see if someone can get out to you and I reckon the experts would say please keep topping up but also please keep putting that baby to your breast as much as possible. Don't worry about using your 'breast like a dummy' since it's really the other way round as a wise MNer once posted: the dummy-users are sucking on a fake nipple...

I think you need to try and feed her every 2-3 hours at this stage. Are you sure the MW said at least 5 hours - I would think she meant 'no more than at the most' and perhaps got her wires crossed?

You're gonna have rough days and nights like this and tears are good: get em out, wash your face and start again, one day, one feed at a time. And then have another blub later on. But be assured you're doing your very best for your baby by asking for help and thinking about her needs so much... Best wishes

I've not seen a counsellor, fishie - she's 60 miles away and has been as helpful as she can on the phone....

5goldrings4monkeybirds I have set my alarm to wake me 4 hours after her last top-up, and will try for 3-hourly after that. I'm very very sure the m/w said that 5-hourly feeding was fine - I queried because I thought that she was sleeping for too long.

Oh, and DH is being an absolute brick - keeps telling me I'm doing really well which I find very hard to believe - and dealing with everything for me bar the baby feeding. Mum/Dad arrive on Tues for just under 3 weeks, so DH will be able to catch up on himself - I'm sure he's finding this stage harder than I am.

really hoping tiktok or other bf counsellor is going to post again soon for you, I'm so sorry you're not getting better bf support locally
what did the nct counsellor say? it sounds like you are not convinced?
I have never heard that it would be ok for a tiny bf baby to go at least 5 hours between feeds and agree there must be some misunderstanding on this somewhere. aim for every 2-3 hours and see how you go.

i'm going to try to answer your questions but i'm not qualified so don't take as gospel (have you checked out kellysmom website btw?)

expressing plus breastfeeding as well will boost your supply - every time your breasts produce milk they are also sending a message to your body to produce more milk for next time.

if she hasn't settled after both breasts, you can try the first breast again, there is always milk there. I don't want to say, no you shouldn't top up, but bear in mind that many small babies will always accept a bottle even if not hungry. they really do just stick their fingers in their mouths a lot cos they can not cos of hunger. how long is she feeding on each breast? have you also tried offering the same breast twice in a row?

offer the breast as often as pos, even if it's just to comfort suck, it's all good for milk production

how are nappies and baby?
nightfeeds are really important for this btw - is the 10 hour period between bf that you mention at night?

just read your latest post - perhaps you could start another thread to check this 5 hour thing on, I really can't imagine in a case where there are worries about growth or milk supply that it would be a good idea. i know my 3 would go 5 hours on a rare occasion in the first few weeks but it wasn't usual. what did nct lady say about frequency of feeds?

I was told by my bf counsellors (who were specialist midwives at the maternity hosptial) that I have to wake my sleepy ds every 3 hours at 2 weeks when he wasn't gaining weight. This included at night - when he was already "trying" to sleep though!

Only when he started to gain weight was I a"allowed" to spread out the feeds. I have to admit I didn't alwys wake him up wuite that frequently during the night - but in my defense, I was fortunate enough to be able to xpress a lot and he was having a lot of EBM top-up.

Like your dd, he was an expert at pretending to suck especially when I woke him (tickling feet, wiping feet/face with cold damp cotton wool, sripping water nto his ear! ) - but I onlly belatedly realsied that the wee sod darling was only pretending to feed, as then the "hassle" stopped, as I eventually noticed/heard that he wasn't actually swallowing -even thoguht he jaw movement was complete with the ear wiggle! .

BTW - don't worry about expressing whenever you can - your baby will still get out waht she needs - and also simulate more production - when she does latch on properly

It's late, thelady, so excuse brevity

Yours is a rotton position to be in - confused and demoralised and tired.

Morocco is right, though - someone has been giving you some really awful advice if this is what they have been saying to you, that 5-hourly feeding is ok for a newborn, esp. one whose weight and feeding have been a cause for concern

Obv, you need to be cautious about dropping/reducing top ups, and you'll need support from the midwife before you do this (but avoid the one who told you 5 hrly feeds are ok). Frequent breastfeeding and expressing is fine - this is how milk is made and it is actually impossible for most women to build up and maintain a supply without frequent feeding, though a good start to bf (which you didn't have) means, for most people, expressing just isn't needed.

Hope tomorrow is better for you.