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?

FioFio: thanks for the encouragement. I know there's milk there (which is good, cos there's wasn't on Thursday) and am just trying to get the amount up.

Prettybird: Frances has always been alert - or at least she was until she went onto top-ups and conked out! Bright eyed, hunting for food at every opportunity. My problem is that I've nothing to compare her to - a statistical sample of one isn't much use, really.

The mw has disappeared with her notes, so I can't be sure, but she was born at 4.02 kg, and I think she was weighed at 3.85 today - anyway: DH says it was 60g more than Friday, so 2oz rather than 4 oz. Mw was expecting her to have gone all the way back to birthweight...

Right 2.5h since 30 mL topup (what was left after she sicked up the last topup ) and a 5 min nibble on the breast. Off to wake madam and see if she's peckish.

hi thelady

At least the idiot MW has now been fully outed for her ignorance... Again I'm only an amateur but 4kg is pretty big, no? 8.5ish pounds in old money? And as I understand it, weight dropping off a little in a big baby is not unusual - @I have seen other women on this least be advised by hopefully more adequate MW that big babies level down while small ones level up. So it doesn't sound to me (pinch o'salt for amateurism as given) like either weight per se or weight gain are an issue...

I think the issue is your supply really? In which case you are absolutely doing the right thing by shortening the 5 hours to 2-3 hours and once you're confident that a bit more of your milk is going in, I guess then you might be able to decrease the top-ups and get your supply fully going. I don't know what the normal recommendation is for reducing top-ups but I reckon if you very gradually do so, your DD is gonna start waking up sooner as hungry sooner, thus sucking more frequently and in turn increasing your supply. The laws of supply and demand suggest if you keep giving the same size top-ups, your supply might not have a chance to increase?

Anyhow, Your posts sound so much more confident than the first ones so you're obviously getting there. How's your wound feeling now?

least? LIST

My MW and HV both said that baby should have regained birth weight by day 14, so you've a few days to go yet.

Keep doing what you're doing, and believe in yourself.

I look forward to saying Hi on Thursday

thelady, your midwife is a bit shocking, isn't she..... To 'expect' a 10 day old to be going 4-5 hours?!? How often does she (midwife) go without food or drink, I wonder....and not to have heard of LLL....well....

I suspect that if you continue doing what you are doing, things will turn the corner. What worries me a little is that you are timing the length of feeds and judging their volume of milk in some way, and that's so misleading.

Absolutely appreciate your diff. position with the scar and everything But it sounds as if there could be more opportunities for just having her skin to skin with you, ie not putting her down to sleep in a crib or otherwise away from you. And not sure why the top ups are offered after the breast....if she's not settling, would further time at the breast not be ok? Maybe not seeing the full picture here, sorry!

ds took 7 weeks to regain birthweight - I now realise he was "catching down" from his high birth weight (4.08kg), c.91st centile until he could get onto his "own" growth cruve. And 'cos growth cahrts are a function of age, that meant that he had to drop thourgh the centiles, ending up chuntering along just below the curves, before starting to gradually move back up, spent some time along the 25th and then moved up to the 50th, which i where he has remained, now a healthy and active 7 year old.

But as I've said before, I was fortunate to have the support of professional breast feeding counsellor-midwives, who knew to look at the baby rather than simply the charts.

hey thelady; I hope things are a little better for you today, and that your DD is feeding better.

My plans have changed (doctors...pah!), and I won't be passing your way until Friday. I hope that's OK!

MW has a hle in her ass out of which she speaks
Tell her to come and tell my 8.5 mth old on 3 solid meals + snacks plus 2-3 hrly 24/7 breastfeeds that he shuld go 4-5 hrs...
Oh and his weight gain on soggy breasts was excellent.
The full to burst breasts used to neary choke him and invaribaly spurted in his eyes as he pulled off in alarm
2-3 hrly excellent idea.
Thelady I think you know what to do you sound like you know exactly what your own child needs.
Well dome for persevering, no wonder bf rates are so appalling in this country.

thelady, wish I'd seen this earlier. I saw a BFC who was a HUGE help, from Selkirk a year ago. I don't have her number any more but she runs a BF group at the Selkirk GP practice-- if she's still attached to them I'm sure they could put you in touch.

Selkirk GP practice phone number is 01750 21674. The BFC's name is Penny and I believe she was affiliated with the Breastfeeding Network (0844 412 4664). Also, once you're up to getting out and about, I'd really recommend finding a BF group (maybe at your local surgery?)-- I found this really helpful too.

Thanks for the info.

Made the decision a few nights ago that the stress of trying to bf was wrecking our relationship with our daughter. Haven't completely given up but for now bottles are the right thing for her.

The pump I had been given turned out to be faulty but we've been lent another by the hospital which seems to be working better.
Getting about 20ml per session, so not great but OK.

thelady, so sorry you've been going through this. I was wondering how you were getting on as hadn't heard from you since your OH posted about Frances' birth.

It sounds like you have been doing fabulously and I am in awe of how long you have persisted in the face of such manifest lack of professional support and indeed incompetence.

I decided within 4 days of having DD that BF wasn't working for us and never regretted the decision. AND I was not trying to cope with a CS scar on top of the latching issues.

I did express for 7 weeks and initially she got mostly EBM, but expressing is not as good as BF at maintaining supply so it dwindled to nothing within 7 weeks. Although I got more practised at expressing it was still bl**dy hard work (double duty feeding and expressing).

Don't let anyone try and make you feel guilty for taking the "easy" route. Hope the CS scar is slowly on the mend. Has your GP had a look?

Thanks buzzy ff doesn't feel like the easy option at the moment. Expressing feels fairly pointless as over 24 hours I have gone from 50ml a session to 5!

Wish I knew if there was any point in continuing with it.

I found I needed to express from one breast at a time alternating and try and do it every 3 hours so something like 7am, 10am, 1pm, 4pm, 7pm, 10pm and then once during the night.

50mL each time was quite normal for me and I only used an Avent hand pump. I did try using the hired electric jobby but didn't find it any better. Would then give her the EBM first at the next feed and top up. I did manage to get up to about 100mL sometimes I think but it was quite variable.

You have done so well to get her as much as you possibly could over the last few weeks I'm sure she's got good amounts of the colustrum antibodies and anything more you can get her is a bonus.

When it comes to formula I recommend you try a few until you find one that suits you and Frances best. I liked the ones that dissolved in cold water and I tried to get DD used to having room temp not warmed too much. I used the microwave at home but when I was out just took a portion of formula and shook it into a preprepared bottle of boiled water.

I know you're in a hotel so you may not be out and about too much but it was a real bonus for me not to be worrying too much about asking people to warm up bottles or take thermos flasks.

I kept bottles of pre-boiled water in the fridge in sterilised bottles and then just had to tip in the formula, a quick zap in the microwave and was not too hard even in the middle of the night. More of a faff that BF but OK in the scheme of things. My H used to cover the night-time feed 1 night per week to give me a break (we made it Saturday) which one bonus of the FF.

I was always told 4 hours, max, between feeds during the day as you need to make sure she gets as much as poss daytime to encourage no more than 1 night-time feed. And to wake if necessary.

I think you have my email if you'd like to chat? I'm here during your night-time!! Having said that I tend to check MN more often than I check my email...(sad isn't it?!)

BTW I'm due Dec 22 BTW and hoping she might deign to come early - but no signs yet!!

Frances is waking pretty much 4-hourly for feeds day and night now that she's on formula. We're using a ready-made formula that comes in cartons as the one time I gave her powdered stuff her bum went bright red - the same brand and everything.

After a terrible time with low trapped wind yesterday, and vomiting like a squeezed cream pot the day before we've been warming the bottles to blood heat. I hope I don't have to continue forever - but can't cope with the desperate screaming either.

Expressing is v. frustrating - when I wasn't bothered I got 50mL (the first time with the new pump) but I'm now not getting a let-down at all - just drips every so often. Fed up with people telling me that pumping every 4h will increase my supply when all I'm seeing is a decrease.

• what a lot you have gone through.

thelady, expressing 4 hrly is not enough, and you will see a decrease....which is what is happening. To build up and maintain a milk supply, especially with the difficult start you have had, the minimum you need to express is 8 x inc at least once at night. Most mothers will experience what you are experiencing doing it 4 hrly....less milk.

Who told you the 4 hr thing?? You have had really bad postnatal care when it comes to info about breastfeeding - it's one thing after another

I've been told 6x in 24 hours, and have been pumping at night too. The problem is that I just don't get much out! 10 mL is soul-destroying, and there have been several times when 20 mins pumping gets be a few drops.

Hi thelady, to hear you're still struggling. I was exactly where you are a year ago (without the added complication of a CS scar); I remember pumping constantly while DH fed my girl with the bottle feeling like I was spending more time looking after my boobs than after my baby.

I had another thought, which is that if you had your baby at the BGH I think you're entitled to phone the maternity unit there for advice; the midwives there might be able to give you more help than your community one.

Anyway, whichever way it goes for you I hope things start looking up soon!

mybabysinthegarden: thanks for the sympathy. The maternity mws missed the probs with suppl;y early, so I'm a bit leery of asking them now....

I'm using an ameda lactaline pump, which seems to work. As I said, the problem appears to be with production....

Oh, I see your point. Just wanted to add, similar to others below, I did come back from very low supply while pumping to exclusively bfing after a few weeks, though I had lots of support. You're really doing well and I think it's such a shame you've been so let down.

At this point I'd just go with what feels right for you. If you feel like expressing is a waste of time then stop now. You really can do without being attached to a machine day and night for very little gain.

Little Frances will thrive regardless and you can get on with bonding with her, developing good sleep routines, healing that CS scar and generally feeling like you're getting your life back!

Loads of {hugs} anyway from down under (and I should probably only whisper this, but feeling very hot and bothered today as 28 degrees C here and annoyed at being PG!)

Hello thelady I really feel so sorry about what you have had to go through. i had an em c/s with dd1 and my milk didnt come in for 10 days and apparently it is normal for milk supply to take longer after an em c/s. DD1 was starving and inconsolable she was also a big baby 9lbs 20z.Basically I was told to feed her on demand so she was constantly on my breast despite no milk and just colostrum, so at night we topped her up because she was distraught with hunger. I was told the more stimulation the better for the supply.Eventually I was able to exclusively BF, I have to say though I am stubborn and was determined to BF.I can appreciate how hard it is, Dd1 lost loads of weight but once my supply came in she was fine. I am really suprised that you were told 4 hourly feeds because bf is never set by time really.If you still want to bf the more stimulation will help.Good support is the key aswell.

Hi, just checking in to see how you're getting on. I found the direct number for the BF counsellor in Selkirk; I don't think I should post it on here but if you'd like it I can email or CAT it to you. But buzzybee's advice is very sage too.

mybabysinthemanger:I don't have the CAT facility, but you can email me if you're willing: ljnoble @ gmail . com

tiktok: I'm having enough trouble getting Frances to wake for feeds every 4 hours (have to change her nappy) and once I'm done winding her, changing her again, and pumping (especially as she won't settle anywhere but in someone's arms) it's 2h since I started.

I do really want to get this to work, but can't quite see how to manage expressing every 3 hours...?