Breast feeding help needed

[Flutterby8]

I gave birth to my daughter earlier than expected due to having to be induced because of pre-eclampsia. She is 6 days old now.
It was a very quick labour where her heart rate dropped and she needed to be removed quickly with an episiotomy.
She has been fine since, just me struggling with my blood pressure post delivery.

I am trying to breast feed but i am struggling. She will latch on, give a couple of sucks then come off or look like she is asleep.
Im trying to feed every 3 hours but she is hard to wake up and keep awake enough to latch.
I tried a nipple shield the other day and she fed better than normal which was good, but she didnt seem satisfied.
Overnight she will feed for hours on end and not settle resulting in her being offered a top up bottle too.
Midwife checked her over yesterday and she is a bit concerned about her weight loss as its not far off being 10%.

Im really struggling.
I dont feel i have enough milk to provide to her because she rarely seems satisfied. My breasts dont feel full. Ive tried expressing with an electric pump and did not get much out. A few mls at most.

She finds it hard latching and staying in place. She was checked for a tongue tie but i never got a firm no it isnt or yes it is. I was told unlikely.

Where do i go from here?
How do i get my milk production up?
How can i keep her latched and awake for the duration of a feed?
I want to do the right thing and have been asking the midwife for help. Midwife has been great throughout.
Any advice?

Congratulations!

There's quite a lot in your post so I might miss something.

It's completely normal for your baby to be fussy and seem unsatisfied but your milk at this age, especially at night time. You most likely are producing enough milk. Babies are putting in their orders so to speak for the next day, so the more they feed at night, it up your supply! It's hard work for the mum but usually completely normal!

Secondly, full boobs don't equate to more milk.... what I mean is, your breasts may feel empty but that's not necessarily true.

A lot of women never get much from a pump, but successfully breast feed their baby. A baby is much more efficient at getting milk out than a pump.

The latch is an issue, have you watched YouTube videos on how to hold the nipple/guide baby on. It's a new skill for the baby as well as you and it can take some babies a little while to get the hang of it. I did mine! My midwife wouldn't discharge me from hospital and my baby wasn't latching properly. She taught me some tricks. But in the meantime she showed me how to hand express into a syringe and feed the baby like that.

The weight thing is always a bit scary but keep listening to what yo midwife says at visits and the health visitor too. They'll be weighed regularly so if it becomes a concern they'll be able to come up with a plan. You can also call the national breast feeding helpline and also la leche league is full of resources.

One thing from your post that did concern me, but it may just be how I've interpreted it, is that you say your baby is hard to wake. What do you mean? If you struggle to wake your baby or they seem limp, it's an emergency and you need immediate help. I hope that's just the way you've worded it/ I've read it!

I hope that helps a bit. It's so hard in the early days, I had so many breast feeding issues, was so close to giving up at 3 weeks. I only planned on breast feeding till 6 months, but here I am at 14 months!

Would it be possible to get a qualified lactation consultant to visit you at home to
help with positioning?

Hi OP, first of all congratulations on your baby! Sounds like it's all been a bit traumatic for you, so hope you're doing OK. I'm by no means an expert so I'd definitely recommend having a read through of the kellymom website and also having a look to see if there are any breastfeeding groups local to you who may be able to offer real life support (especially useful to check latch and positioning).
To answer some of your questions:

• totally normal for bf babies to lose close to 10% of birth weight at the start. All 3 of mine have lost around 9% and gone on to be mega chunky!
• totally normal to feed all night. This is cluster feeding and is how your supply is built. It is exhausting but necessary at the start and doesn't last forever!
• expressing and fussiness are no indication of supply. You're looking for good nappy output and weight gain after the initial loss. I've never been able to express, yet ebf all my dc until they weaned!
• breastfeeding is not all or nothing. If you'd prefer you can combi feed and keep a formula feed. Often people feel as though they have to choose one method, but actually I have several friends who combi fed successfully.
• Best way to build supply is feed feed feed. Lots of skin to skin. Put the baby to the breast as often as possible - don't worry about timing or routine at this stage.
• keeping her awake (I think face to face support would be valuable here but just generic advice) - wake her with a nappy change, tickle her feet, breast compressions to keep the flow going as she feeds, if she's struggling to get a good mouthful then squash your breast between finger and thumb and this can help her to latch. Also make sure she's in really close (tummy to mummy) and I often support the weight of my breast as I feed by holding underneath as they can be quite weighty! You can also experiment with different positions eg my first preferred rugby hold for a good latch whereas my second hated it! Try a few things out and see what works for you.

Do you tickle her in front of her ear to encourage her to keep feeding? Newborns are very sleepy but they do need encouragement for sure.
Also when you say you are feeding every 3 hours, I would say that is the minimum that she should be feeding if she is that young and has lost a bit. Does she wake to feed? Have you been looking for feeding cues! Any time she rouses or wakes up I would try to feed her. That will stimulate you to make more milk. When you say she rarely seems satisfied, how do you know? If she’s falling asleep after a feed she is probably satisfied, but anytime she seems fussy, cries or even snuffles/grunts a bit I would offer the boob! It’s definitely tough at first, i remember from my first dd. Now on dd3 and it’s so much easier! It does get better.

Breast compressions help for a sleepy baby. Lots of babies drop below 10% just keep feeding every 3hours and if offering either expressed or formula top ups do it after a feed or try half way through if baby sleepy sometimes extra milk then can make them more interested in finishing a feed. It’s early days, you’ve got this.

I had similar issues with my first but he was overdue. I successfully fed for a couple of years once we got going. Then my second had problems as well!
Things I found helped
Just let them feed as much as they want especially in the early hours. The more they suck the more milk you will make.

Milk seems to still come out of empty breasts. My 15 month old is currently feeding from what appears to be empty breasts but I can see the milk on her mouth.

Lots of skin to skin. Try to rest and sleep (easy I know). Eat well, high energy stuff doesn’t have to be healthy cake will do. Drink drink and drink some more. Even now if I haven’t drunk enough it really hits my milk supply

The Hakka type pumps are good for collecting let down whilst feeding on the other side. Being in the bath is good for let down and easier pumping when you get out

Strip the baby so they are a bit chilly and they stay awake for the feed. Mine were always nodding off mid feed. Try and feed whenever they are awake. Every 3 hours at night and much more often in the day. Lots of skin to skin on the sofa in the day.

If you have to top up with formula do it after a bf and they should calculate exactly how much formula to give. I have to give my eldest 30ml every 3 hours after a bf.

Good luck, bf can be a bumpy road at the beginning for many of us but it does get easier

First of all congratulations! I recognise parts of your story. I will probably repeat some of the suggestions from the posters above...

Please get a lactation specialist in.

The efficacy of pumping depends on the pump, the shields and how you use them. While in hospital they gave me a heavy duty pump. It worked untill they gave me the wrong shields... switched shields and production was normal again.

Very recent study gives the advice to have at least one hour per day skin to skin for the first 5 weeks, especially for premature babies. Increases your supply.

Rest (sleep...) and good food and enough fluids also help with supply. And make sure your body is warm enough as well.

I needed to pump every three hours to increase my supply... it took a while to be established...

We were adviced to use a wet and slightly cold wash cloth to wake our DD for a feed (when she fell asleep while feeding).

Best of luck!

Wow, thank you so much to all of you who have replied. I am so grateful for all of your advice and experiences. It makes you feel less alone when you can speak to 'real people' about your worries and get their opinions.
I will try to reply to everyone but i am a tad sleep deprived so if I miss anyone out i apologise!

@miltonj the weight loss discovery really upset me to be hinest. I suddenly felt like an absolute failure by not being able to provide for my daughter. Ive tried so hard to nail the feeding and to hear how much weight she had dropped just broke me a bit. I expected some but not that much.
With regards to the not being able to wake her. I think i worded it badly. Every 3 hours im trying to get her to feed and when getting her up from a sleep it takes alot to rouse her. Unless i get her down to a nappy she doesnt want to know. She will easily fall asleep whilst latched as well but she isnt floppy like an unwell baby. Midwife said alot of what im finding is normal newborn behaviour and because she was born a bit earlier its harder. Its just often a struggle to get her to focus and latch when first woken up. There are lots of tips here which im going to try going forward.

@RavenclawsRoar i looked into breast feeding groups but none of them seem to be running locally at the moment? Not sure if this is a common thing with covid now? We have been monitoring the number of nappies and have been worried as no poo has been passed for almost 2 days. A number of wees though. Until today when all that changed! Think she was just a tad constipated. Ive started all the feet tickling, ear poking and breast compressions to keep the latch so im glad you said this as I feel im doing something right.

@MissBPotter ive been watching for feeding cues and trying to get her up and latched asap. She doesnt often wake to feed, i feel I wake her more personally. After a feed she generally will fall asleep still on the breast and will then relax nicely. On some occasions though she will not settle no matter how long I have been feeding for. last night she woke at 2am so i started feeding but by 6am she was still going and was really unsettled so I gave in and gave her a bottle. After that she slept soundly for 4 hours. I assume I just dont have the milk to sustain her needs still?

@birdglasspen thank you for the link and words of encouragement. Any help like this is definately needed at the moment!! Ive started to introduce one forumla feed in the evenings to top her up now to ensure she is satisfied which is helping.

@mayblossominapril when you say let them feed as much as they want, how much would this be? She seems to be able to continiously feed for 4 hours stints which is absolutely killing me. Is this normal? Ill admit im not eating or drinking enough. Since the birth i have lost my appetite somewhat and i am still in a reasonable amount of pain which isnt helping. Im trying to get better with feeding myself but i just feel lost as to when i can eat with a baby constantly attached to my nipples!

@StarsandStones thank you for the tip about the skin to skin. I will start doing this more going forward now. I tried pumping today for the first time and barely produced anything of any significance. She then fed for 2 hours solid, wasnt satisfied and ended up with a top up formula (before bed time). I like your tip about the wet cloth too, thats worth a try!!

Again, thank you everyone.
Ive been feeling utterly helpless since coming home from hospital. I feel like im letting her down by not being able to provide enough in these early days. I know its not meant to be easy but i didnt think it would be this hard either.
I know ill get there, its just so new and unexpected at the moment, shes not even supppsed to be born yet! I feel so underprepared and overwhelmed!

Hello! Congratulations on your baby! Such a precious young age!
First off, can I just say I totally relate... I felt helpless for a good couple weeks after I gave birth to my beautiful daughter last November. I used to cry everytime she tried to feed, not only because it was excruciatingly painful and I bled but I had issues with milk production and also her latching and staying latched!!
A lovely midwife told me that collustrum produced just before you have the baby and for the couple days after birth before milk sets in is the most important ... "Liquid gold" she called it! She also told me that if it is stressing you and the baby out each feed then there's no harm to just do what you can and top her up with formula if need be. There should be no shame and you definitely haven't let her down. You've done what you can and that's plenty enough.
Give yourself a pat on the back, chat to the health visitor or the midwives at your hospital and no doubt they'll come up with something to suit you.
I dried up quite quickly even though I managed to express a bit so she was only fed with my milk for 3 weeks at the absolute max that included topping her up with formula too. The level of formula out there is amazing so your bundle of joy will not be deprived of anything!
My health visitor also told me of a herb called fenugreek which is Apparently a natural way of introducing more breast milk. It was supposedly a cure for a type of illness in women and the side effect was that they were producing breastmilk! So it will be worth looking into that! I hope that helps xx

Hi OP, i could have written your post back in June. My DD and i had exactly the same issues (she was early, i had pregnancy induced hypertension and then she had sepsis). You've had loads of brilliant advice from others above, but one thing i would add is ask if your midwife can refer you to the infant feeding team. The drop ins may not be taking place, but i was able to get an appointment at their clinic. They watched me feed DD for around an hour, helped me improve positioning, gave me loads of advice and helped me devise a plan. They then monitored us with weekly weight checks until they were happy we were doing well (for us around 11 weeks). My DD was tiny so i decided to combi feed as i had lost all confidence in my supply by that point (as another PP said, also BFing first, then offering top ups - starting at 30ml and now shes 5.5months, we do between 70-120ml) but they would have supported me if i wanted to EBF.

Please don't feel helpless - so many of us have gone through this. In the meantime, look after yourself as well. If you don't have time to cook, it won't hurt to live off microwave meals for a couple of weeks. Our friends bought us a "new parents box" from Cook meals - it came with 14 freezable and microwavable ready meals and basically saved our bacon as i was not ready for DD to arrive! Milk production is also helped by fluid - im drinking about 3.5l of water a day so get a bottle, keep it filled up, have it always to hand and just keep drinking.

The poster above me has mentioned fenugreek but oats also help supply so try and eat porridge or oat bars for breakfast too.

It’s been a long time since I’ve bf but just wanted to say- You are doing a fab job. My two are much older now but I can remember all too well, how it can feel very overwhelming at the beginning.

I really wanted to bf but struggled to feed my oldest. He was little and didn’t have a good latch at the beginning (even with lots of support from the midwives and hv). Little by little, it got easier and I fed him until he was 1.

Things that helped me-
Ask help and ask again. I found an amazing health visitor at a bf group and she helped me enormously.
My older son seemed to cluster feed in the evening for what seemed like forever. It was exhausting but was building up supply.
Rest when you can so you can heal. Make sure you eat and drink.

@yelnif thank you for sharing your experience, its definately relatable. Its the feeling of being helpless that is just incredibly hard. Ive cried every day since getting home, because it hurts to feed, because she wont stay latched, because she cried when she was hungry and because she hadnt had a poo for 2 days! Midwife said hormones have an awful lot to do with that and shes not wrong!
I have a midwife coming back this week to check up on my blood pressure and babys weight so i plan to have a long chat about feeding with her and see where we get.

@GuidingSpirit thank you for mentioning the infant feeding team. Midwife mentioned it briefly the other day and i think the plan is if we dont gain weight by the next visit they will poss refer me. Like you i have no faith in being able to have enough supply to solely feed by myself. I thought this would be the case while i was pregnant too. I topped her up with formula tonight and she is sound asleep in her crib unaware of the crying mess sitting beside her!
I need to drink more, i need to get a bottle and leave it by my chair permanently. The Cook meals are an amazing idea. My boss actually bought me a voucher for them which we need to get ordered. Its such a great idea because i havent set foot in the kitchen since getting home!

How are you doing?

I made pictures of my 'harvest' and also had to keep a diary with the amounts. At first it was almost nothing, then a lot more, about 160 ml if not mistaken. It took a few days of pumping every 3 hours (and skipping once at night for better sleep...).

It was a tough road for us. Took us over 5 months to find the correct feeding position. In the meantime I also pumped and we topped up with formula. The correct feeding position was one which was not in the books. I also didn't have enough to sustain her. As after these 5 months she had feeds almost every hour. We were advised by the paediatrician to start introducing solids, as the every hour feeding indicated she was hungry! But we also started (again) with formula. At the time it felt like I failed. Now I can laugh about it... we breastfed for a long time, she just needed more.

If you have a specialist visiting it would be nice if they can also check if you have the correct shields and correct position of the shields while pumping.

And maybe your OH can bring you nibbles or have packed lunch ready in the fridge. Eat often and little, this may help. As well as good pain medication!

Again: wishing you all the best.

I echo what the pps have said. I can only add that I only realised on DD3 that you shouldn't drink caffeinated drinks when bfing..."oh that's why she was waking up at such weird times".

Thank you @StarsandStones for your reply. DH is keeping a log of all of the feeding and nappy changes so we can keep on top of what is going in v's what is coming out.
I do think we may have turned a bit of a corner over the last couple of days though.

I had a different midwife come out to check on baby and her weight. She asked how things had been and I literally broke down into a hormonal, sleepy mess. I told her what had been happening. The trouble latching, never getting baby to the post feed coma stage, not feeling that i was producing enough etc. She asked lots of questions about the birth, my health, my diet, my sleep etc. Then she basically told me that she was surprised I was doing as well as I have been.
Ive been quite poorly since the birth, visits back to triage, high blood pressure, dodgy episiotomy wound healing, poor blood results, lost over a stone in weight (not intentional and I am eating), exhausted. She pointed out that I dont have the milk supply. My breasts arent full and even though my milk is coming, its not quick enough to sustain a hungry baby. Especially not one who is trying to feed for hours on end.
Were now feeding every 3 hours or so from the breast and finishing the feed with a bottle if she is still hungry (which she is alot). Shes getting more formula before bed so she gets some sleep too.
In between im trying to pump to increase my milk supply which is working on one side but not the other randomly.
Since doing this i have been more relaxed. She has been more settled and content (but has the most awful bowels, although not dehydrated). Ive been able to sit and watch tv with DH without having to constantly feed and its been nice to just get some baby cuddles in.

Ive been so caught up in the 'i must breast feed my baby' that i was ignoring the fact that I cant solely breastfeed right now. Ive not been well enough to do it and im nit getting a medal for sitting here for hours on end offering an empty breast.
Im still giving her breast milk, shes just getting a bit if a take away alongside it as well.

Everyone on this thread has been so lovely and helpful. I cant believe the kindness of absolute strangers!