Baby not gaining enough weight been told to top up with formula

[ZoeCl]

Just wondering if anyone has had a similar experience to this and has any advice. I seem to have a low milk supply but no one really knows why. My baby is two weeks old, and breastfeeding got off to a really great start (or so I thought) his output seems really good, lots of wet nappies and poos, he feeds a lot, some days it's constantly but I figured he's just building my supply. We do loads of skin to skin and I've had his latch checked several times and it's perfect, no issues with tongue tie or anything in his mouth, no issues with my breasts and yet we get to the two week measurements and he hasn't regained his birth weight (he did gain weight though, but only 100g) so I've been told to top up each feed with formula. Instead so far I've now added in pumping after nearly every feed but I only get 15ml or half an ounce altogether from both breasts (15mins a side) and it's now getting pretty exhausting as that seems like it's still not enough. Yesterday he was feeding literally non stop for 9 hours aside from when I pumped between those feeds and my husband took him to burp him. Ended up with only 30ml/1oz of expressed milk to top up with after the hours of feeding and he was still acting ravenous and my boobs were aching and coming up empty by this point so I finally gave him the formula and he ended up drinking 50ml of that and then he finally fell asleep for four hours. So I guess my question is, what else can I do?? Is it just not possible for me to make enough milk? Also my breasts never get firm as though they are full. Never have - one side sometimes will get firm lumps like after he slept for the four hours. But never properly firm. I'm worried it seems like everything works but the milk just runs out too quickly no matter what I do... Oh I also do use nipple shields at the moment but my lactation consultant said they aren't interfering as his latch is good and when he pops off they are full of milk and milk is leeking from his mouth. So everything looks like there's milk there but he's not gaining the weight and he isn't ever satisfied :/

If the shields are full of milk he's not latching properly able to remove it, can I ask why you're using shields? It's normal for babies to take until about 3 weeks to reach their birth weight so him not reaching it by 2 weeks is normal. How was the birth, were you given IV fluids during or before it? Who has checked his latch for you? Do you experience pain if you feed him without the shields?

I'd say you're doing a brilliant job. You're still only 2 weeks in and it's very likely you're not up to speed with demand yet - as it changes so quickly.

Personally I would just keep doing what you're doing. I hate formula top up advice as I really think it massively jeopardises breastfeeding at a really crucial time.

What are you trying to boost milk production?

Make sure you're eating well and drinking litres and litres of water. A huge bowl of porridge is a great way to start your day and oats are supposed to be great for milk.

Are you in touch with your local La Leche League? They are a brilliant source of support

Pumping doesn't really reflect what your milk supply is; breasts aren't like bottles- they don't empty. Think of it like turning on a tap:- if baby latches well and feeds the milk will be produced in response.
Just feed feed and feed! How far off his birth weight is he?

Two weeks is still early but they will put so much pressure on you. If you call around some places will weigh before and after a feed to make sure baby is getting enough milk.

Some babies do take longer to reach birth weight unfortunately, if you formula feed it more often then not does start the slow transition onto formula feeding (I made it to 11 weeks) but it was hell. If I could go back I would tell myself I was happy with nappy output and baby seemed content enough and that I should wait it out.

You also don’t say how the labour was, if you were on any drips for induction or pain relief this can also affect birth weight. There is a lot of information online about birth weight not being taken until 24 hours after birth in this instance but it is not something yet recognised within the U.K. as having an affect.

My youngest is 0 now, but I remember that night feeds are the ones that increase breast milk supply. Also there are sumpplements that can be taken to increase supply. I remember finding this website useful kellymom.com/

My youngest is 10

It’s no big deal to give a little formula. My son
was 4 lb and not gaining enough weight at 2 weeks. He had maybe four or five formula feeds total advised by the midwife. Then bf for three years.

I made it to 6 weeks with a baby that just wasn't getting enough to eat. We were both miserable. I went to breastfeeding groups. Had numerous one on ones with the health visitor team. Nothing worked and I was heading for PND. Then I topped up with formula. Life improved immensely. Don't feel like you have to keep breastfeeding if it's not working for both of you.

me too, although I struggled on to 11 weeks but ds was still only 7lbs and I ended up topping up. He went from a screaming unhappy baby to a lovely content one overnight. I carried on bf as well until I went back to work at 6 months.

I beat myself up about it so much, cried over the first few bottle feeds as I felt I'd failed him, but the important thing was that he blossomed into a thriving, happy baby.

When ds2 arrived I was much more relaxed about the feeding issue, was very prepared to top up if necessary but DS2 was a brilliant breastfeeder so no issues.

Please don't beat yourself up if BF isn't working and ignore all those who say any woman can breastfeed if they persevere.

My doctor told me to eat sweet things 🤷🏻‍♀️ he said sugar helped. Don't know

But just wanted to say 2 weeks is too early to feel your breasts bery full, at least for me.

Do you have an electric pump machine? They are easier if you're having to express more often. Maybe worth the investment

You've had some good advice already. La Leche League and Kellymom are great resources.

Is baby falling asleep after a few mins of feeding? Is or has baby been jaundiced?

Just to add, the reason baby slept for 4 hours after having formula is that it is harder for their stomachs to digest. Breastmilk is really easily absorbed so at this point they often feed more frequently. It is also easier for babies to feed from a bottle- it takes so much less effort, plus if the teat is stimulating their suckling reflex they will just feed and feed and feed. It's not to do with them being hungry, it's an automatic reaction. That's why paced bottle feeding is important, so you and baby can recognise when they don't need any more milk.

It sounds like she's just cluster feeding, no? theyre supposed to do that.

Don't overthink the pumping. You'll find it hard to get much milk from the pump if the baby keeps drinking it all! youre supposed to wait at least half an hour after every feed and half an hour before every feed to pump so if the baby is feeding a lot it's impossible to find the time. I would just stick to feeding the baby and see how it goes. If she's not grouchy then she's not hungry. Formula at this young age does affect the microbes in the gut so it's not something to resort to until you really need to. And the more you use it the less milk you'll produce so it's a slippery slope.

Why are you using nipple shields if her latch is good? Just curious.

Milk supply is highest at 3am btw.

I had similar, reluctantly did the formula topups and persevered with breastfeeding. We settled on cup feeding in the end to avoid nipple confusion.

This later morphed into one bottle of formula at bedtime which my husband gives so I get a little time to myself before the night shift. 8 months old now and still BF with the one topup - it can be possible to combi feed long term.

I second the IV fluids thing, I’m sure DD had an ‘inflated’ birth weight as we were under monitoring for her tiny size throughout pregnancy, she was born on 25th centile (expected <10th) but lost 13% of her body weight in the 1st week. Has followed 9th c ever since.

I think you need to follow the advice the health visitor has given. The baby is not getting enough so you do need to top up I'm afraid. Do what's best for the baby you can still breastfeed too

Has anyone mentioned breast compressions to transfer a little extra milk down?
Also are you switching sides or trying baby back on same side? There's mixed opinion I think but the thinking is that the higher calorie milk is near the end of a feed so trying same boob gets them more of that?

My son took a while to regain his birth weight (I think it was at least 4 weeks but I'm not sure now).

Anyway, he would feed for ages, and then we topped up with both expressed milk and formula. We were advised to do top up pretty early. It worked for us and I continued to breast feed til he was 14 months.

Combination feeding gave us flexibility - once he was gaining well we rarely used formula, but kept a stash of the ready made bottles, and I carried on expressing and had a load frozen. This meant my husband could do night feeds when I needed sleep and I could go out when I felt ready to.

Feeding direct would be more efficient than shields. Used them initially with ds, about three weeks in could not be bothered to faff around in middle of the night and he latched straight on. Have you tried expressing while baby feeds on other side? It boosts the supply and gives you something to offer as a top up.

Mine couldn't latch at all and nobody told me you have to feed almost immediately after birth. I had staff manhandling my boobs and making me feel like shit when nothing worked.

I couldn't establish a supply and they put so much pressure on me to top up with formula.

If I had to do it again I'd not top up, I still feel annoyed about how I was treated like an idiot 😒

Meeee! I had this problem in March. I saw a lactation consultant and topped up with expressed milk and a little formula for around 2 weeks until my own supply increased. She is almost 6 months and still exclusively breastfeeding! Here is the original thread.

www.mumsnet.com/talk/_chat/4498941-Breastfeeding-is-this-a-problem

Don't supplement. It can take time for babies to return to birth weight. Mine took 3 weeks and then gained steadily from then.

I got told this, I ignored them. Some drs are not pro breastfeeding and still use old charts based on formula fed babies

I just demand fed so was feeding up to 12 hours per day at that age

I was Googling this the other day and it said to increase milk supply eat nuts and seeds, apricots, nectarines and peaches. And drink loads of water.
Mine has increased a bit. I express every 3 or so hours as well to try and keep it going.

I had low supply. Tried everything, including domperindone. Saw so many consultants and they confirmed low supply and I wouldn’t be able to exclusively breastfeed. I was feeding, then bottle, then pumping and it was absolutely exhausting, I didn’t really appreciate my baby as was so tired and felt all I did was feed. I stopped pumping, stopped feeling guilty, and just did formula and breast. I felt like a weight had been lifted, and bonded with my baby so much better. Please don’t feel guilty, fed is definitely best.

First, are you getting enough fat in your own diet? And enough sleep? Drink whole milk, eat oats and dark chocolate etc. And feed as much as you can which it sounds like you are doing.

Second, don’t believe anyone who is too definite in their advice. Some people simply can’t produce enough milk, that’s why it was invented. If that’s unluckily your situation then top up with formula for a while and don’t blame yourself.