Help with breastfeeding

[NewtoTTC87]

Hi all,
First of all apologies for the long post.
Hoping someone you out there can give me a bit of advise or reassurance as I’m feeling helpless and desperate.
Had my dd (first baby) just over 2 weeks (she is 16 days old)
ago via elective csection so she was a week early.
she was born a nice healthy weight of 7.6 however by day 5 had lost 7 percent then on 10th day lost further weight. She has now gained around 1.4 ounces.
the midwives put me on a feeding plan, and asked me to express after every feed to supplement her with it. They advised to stop the long feeds and feed her 20/30 mins max on breast then to pump - quality over quantity apparently.
I first used an Amazon bellababy pump howeve was painful as flange was too big. Then let’s bought an elvie - only to find out that actually this isn’t the best pump to increase supply but more useful for bf mothers on the go. Now I am renting a hospital grade Mandela pump…

even though I have got the 21mm flange I still feel like it’s too big for my nipples. My nipple goes white after pumping and always gets mishapen as the vacuum also
sucks my areole.

In addition, the maximum amount of milk i
can get is 40ml after a feed - this is 30 ml via the pump and a further 10ml via hand expressing. Sometimes it’s very low and only can get 20ml from both breasts.
i topped her up with formula last night as I can’t seem to get ahead with pumping so always playing catch up.

i have now been pumping 3 full days. Eating all the oats and extra calories and drinking at least 3 litres of water.
she does plenty of wet nappies however is still quite jaundiced.
I don’t know what to do. Not sure why I can’t seem to pump any milk. Is it because I have low milk supply or is it because my nipples are too small for the pumps?

i reallr didn’t want to give her formula so I am gutted.

has any mums been in this situation? Is there light at the end of the tunnel or am I not going to be able to breastfeed much longer.
I am happy to persevere although all I seem to do is feed and express so it’s a lot. im tired and sore.
any thoughts recommendations advise welcome

many thanks in advance

No wonder you sound exhausted, that's a really punishing schedule! I know you have been advised to follow this by the midwife, but in my experience they are often not experts on breastfeeding and will just be focusing on the weight loss.

The best way to encourage your milk supply is feeding. Your babies long feeds are called cluster feeds, and it is their way of "putting their order in" for the next day. By limiting the amount of time they are at the breast, you're preventing them from increasing your supply. Pumping will never be as efficient as your baby. Can you go to bed / commit to sitting on the couch with baby for a few days, do plenty of skin to skin and make sure they are allowed access to feed whenever they want it?

Are they latching properly, and can you hear that they're swallowing? If so, it sounds like you just need to give it a little bit of focused time for a few days.

You could call the breastfeeding network hotline to see if they have any further advice.

Finally, I know you didn't want to give formula but there is nothing wrong with giving the odd formula top up if it helps increase the weight gain. Perhaps you could ditch the pump and give one full formula feed per day for the next week (maybe your partner could give it before bed while you get a bit of sleep) while you're increasing your milk supply, you can always wean baby off it again once they are back to birth weight.

Good luck, those early days are so tough.

There's a lot in your post that hopefully someone knowledgable can help with - that person isn't me, I'm sorry! But I just wanted to send you love and say that I know it's rough.

The only thing that stuck out to me is the amount you're getting out pumping - you're getting that after a feed? For a few weeks I was attempting to exclusively pump whilst some extreme nipple damage healed. I struggled to get more than 30ml at any given time, let alone after a breastfeed!!

My breastfeeding journey was wild, up and down, all over the place. A really tough time. But we got to a manageable place in the end. A bad start doesn't necessarily mean you can't get there eventually - but whatever happens you will be doing great ❤️

Hopefully someone here will be able to give you some great advice. Is there any lactation consultant you can talk with?

Sending so much love, these early days are tough and I relate to your desire to food. As a PP said though, try to be kind to yourself about any formula top ups. You're doing your best.

I don't know the pumps you've mentioned very well, however I wanted to say that my boobs just do not respond to an electric breast pump; I have to use a manual pump. I am now back to work so pumping 3x a day as baby is still feeding 3x a day and I get perhaps 3oz each feed from my manual pump. It's much kinder to my nipples and takes me less than 15 minutes now that I'm used to it/ so is my body.

Also echo the idea of skin: skin in bed for a few days to increase supply, and the thoughts on "putting an order in". I took so much advice with my first and had a harder journey; with my second I fed her every time she wanted for as long as she wanted and we had such a smoother journey as she sorted the supply for us, if you like. Just a thought x

Desire to feed* didn't read back, sorry!

It sounds like you've had a really tough start with breastfeeding, so well done for persevering. It sounds like you've had an exhausting time, especially with recovering from a C-section too. Please be kind to yourself and try to not beat yourself up for giving a few formula top ups. You've not failed your baby, and there's nothing stopping you from reverting back to exclusive breast feeding once these initial problems are overcome.

I've just a couple of suggestions you could try.

First, I can understand why your midwife and health visitor have suggested limiting time at the breast if baby hadn't been gaining weight well after an initial big loss. Jaundice can make babies sleepy and more prone to exhaustion so allowing prolonged feeds isn't always necessarily optimal, especially if baby's latch isn't good. Have you had the baby's latch checked by a knowledgeable professional? Some midwives and health visitors are more experienced than others and whilst a latch can sometimes appear ok from the outside, it may need a bit of tweaking before it gets better. If the latch isn't great, then letting baby suckle and suckle isn't actually going to help as the milk transfer will be limited, baby will become more exhausted and feed less effectively, and your milk supply won't be stimulated as effectively either. If you haven't already, try to book in with a lactation specialist to check the baby's latch.

The other thing you could try is pumping from one side whilst baby is feeding from the other. Sometimes, being hooked up to a pump can inhibit or reduce the natural let down so the amount you're able to pump is reduced. Allow baby to feed from one side, pump from the other, and hopefully the baby's suckling will induce your let down and increase the volume you're able to get. It may help, it may not.

Try not to worry if you don't manage to pump huge volumes. Generally speaking, once baby's latch is really good and they're feeding regularly they can remove milk from the breast much more effectively than any pump.

If you're finding expressing painful, I would suggest looking to see if you can get an insert for the pump with a smaller flange. You may also need to turn the suction down until you get the right fit as you don't want to damage your nipples.

Wishing you all the best.

Hi OP. That sounds stressful. I had a similar experience with my now 3 month old. My midwife advised similarly. I fed my baby for 20 mins each side, then I fed her the pumped milk from the last feed, then I let her carry on feeding if she wanted to, then I pumped. It was definitely challenging and I basically did nothing but sit on the sofa eating biscuits and asking DH to bring me water. 30-40ml is a good amount to be able to pump per session. I was only topping my baby up about 30-40ml 4 or so times a day and it worked well. She started gaining around 180-200g per week. It takes a few days to get your supply up and body responding to the pump also. On day 5 or 6 you might find you get more milk. I still use this method now and then to boost her weight gain and I can only pump 50ml per go. Remember you're only getting the dregs of what your baby doesn't have and as you increase your supply, your baby is able to take more, so you might not get loads more pumped out. You'll find you get the most in the morning and then later in the day you'll have a hard time getting much. Hoppy, alcohol free beer also helps. Good luck. It's like having twins having to pump and feed your baby. You just have to eat too many biscuits and try to settle in to it.

Thank you all so much for your messages and suggestions. This has made me feel so much better. Husband is saying all the right things but hearing from fellow mums who have been on this journey is so much more reassuring. It’s good to hear that rocky start doesn’t mean it’s the end of my bf journey.
I have had a breast feeding specialist round and she did say my latch wasn’t great. In addition, she done a tongue tie referral as she thought this may also be a contributing factor - probably should have mentioned this in my post. Sorry I’m exhausted. I am now showing meticulous attention to my latch.
I will take points on board and persevere. We’ve already spent the day in bed doing lots of skin on skin and feel so much better.
We have a midwife apt tomorrow to see if she has gained weight too.
Thank you all so much again. I will keep you posted on x