Hindsight - what can I do next time? BF

[JoyEng]

Looking for advice please on what to do differently next time to establish EBF. Can you see any errors in my way that I should change for next baby?

Recently had first baby, she was a whopper, 11.5lbs via C-section. Milk came in on Day 5.

My wish was to exclusively breastfeed. I had my latch and technique observed by 5 different midwives and an infant feeding specialist who all said it was fine. She lost weight initially, a bit too much for midwives liking- who came back again to weigh within a couple days- she lost more. At this point panic stations began and we were advised to introduce tops ups after feed, suggestion made that my milk supply was lagging perhaps due to C-section. I'd never heard of this or knew it could be an issue, despite going to BF workshops. I also had to start pumping during top ups.

Baby was on me non stop 'feeding' but often would sleep on the breast after a short while, regardless of attempts to tickle/change breast etc.

Baby sleeping well at night, plenty dirty nappies etc but hardly sleeping during the day from around 4 weeks, never appearing satisfied in the breast- only after the top up. She regained her weight after week 6 and has continued steady gain ever since.

This has been going on for 4 months, I really hoped by now to reduce formula and be EBF but the habit is established and she is fussy on breast during the day, only taking breast for first morning feed, bedtime and the early hours ones (I'd say we are about 60% formula and 40% breast). Have tried lots of different strategies but I think it's too late and have accepted she will be combi.

Expressing/pumping wasn't much of a success in meeting the demand, I'd only get 1- 2oz for the equivalent of 1 hour so not sustainable.

Thanks if you managed to get this far.
Do you have any advice or experience on what I should do differently next time or what I should have done in hindsight?

I wonder if the tops ups were too soon and too often? When should I have expected my supply to have caught up? Should I have pumped before due date to stimulate milk?

I'm passed the point of beating myself up about etc so no worries in that sense it's just I want to be better prepared next time to establish breastfeeding (yes baby is only 4 months, but already planning next- all willing!)

Thanks so much.

A lot of women who have issue with low supply with their first often have the opposite problem the second time, you're body will get on with it a lot easier.
And you're milk will come in quicker too. My DC1 it came in on day 3 and DC2 it came in before the end of the second day.

But really don't overthink it, its impossible to predict, but you'll likely have much more confidence in your decisions second time round.

Thanks so much @Badgersonthedoorstep that's a good point about the body knowing what to do for next time 😊

It sounds like you've done everything perfectly. C-sections absolutely do mess with your milk (and FYI so does blood loss, which no one talks about). So you adapted and found a successful solution - all good!

I would do exactly the same again with any future babies. Go in with the hope of ebf, but be flexible if it's not working.

Thanks so much for the reassurance @GiraffeDoor I really appreciate it.

Sounds like you’re doing a great job! And it’s good that you’re not beating yourself up about this any more as it is such a waste of energy as what you’re doing is clearly working for your baby. Based on my experience (so not exactly a huge sample 😂), so much of it is down to the baby. So you could potentially change nothing and have a completely different experience with a future child.

With my first, I was determined to breastfeed. It was very hard, and they found it so difficult to feed. Support was limited due to the pandemic. They up dropping over 50 centiles in weight whilst I persisted in vain to try and breastfeed. Unsurprisingly, baby became severely jaundiced and required admission for phototherapy. I ended up pumping and giving top ups of expressed milk after every feed on medical advice. Things slowly improved but it was a difficult time and I was permanently feeding or pumping for the first two months. I think all of this might have been avoided, or at least minimised, if I had been less single-minded and given some formula early on instead of starving them. I could have caused real harm in my insistence to EBF. Fortunately, all worked out OK, but I regret some of my early choices.

I recently had my second, and the feeding experience is totally different. I was prepared to be flexible and took formula to the hospital. This one came out hungry and fed straight away after birth with no issues, and it’s continued like that. Obviously, I had the advantage of having fed a baby before but I don’t think the difference is down to me. They are just two different babies and this time I was prepared to go with that a little bit more.

That's really kind @Helihelicopter thank you so much.

That must have been so incredibly difficult, thank you for sharing this- it has opened my eyes that it doesn't always work and the insistence might do more harm than good- what a hard call to make when to persevere and when not to.

So promising to hear second time round was much better- thank you so much!

Sounds like you did exactly what your baby needed and that's the most important thing.

I have one suggestion- maybe consult a breastfeeding counsellor next time, if you need it. They do way more training specifically around breastfeeding than a midwife. (Although not sure if infant feeding specialist would be the same thing?). I found one who helped me so much and the things she suggested were very practical and very tiny things that made a massive difference in the long run.

Did anyone check them for a tongue tie? I had a very similar journey with baby #2.
And they had a tie, that was snipped at 16 weeks.
When they lost weight day 5 & 10 I wish I had pushed for it to be checked, but I didn't know!

I planned to EBF. Baby had substantial tongue tie and so from around day 10 we ended up doing a mad combination of breast, expressing (to get my supply established), and bottle feeding - both with the expressed milk and formula. Very difficult time. This went on until around 6 weeks until tongue tie was snipped - from then baby was only BF apart from one bottle of formula in evening. Never managed to drop that bottle. So things didn't go to plan to say the least, but the positive is that I continued to BF until 16mths so the difficult start didn't hinder BF long term.

The main thing I learnt is that feeding at some point during the night (midnight to 5am) is really important for establishing supply in the first couple of months (body produces more prolactin at night that stimulates supply). So if you feed baby a bottle of formula at say 11.30pm and they sleep right through the night then you will miss a night feed and your supply will be lower the next day - baby will then get frustrated at breast, which might result in them being offered a bottle, which further reduces supply. So it becomes a vicious cycle.

Thanks so much everyone- sorry for delay in replying- I managed to lock myself out of account which is linked to my old email that I no longer access.

A for sure thing in hindsight, is I wish I’d come on here sooner- I really appreciate the reassurance and advice. My friendship group have all EBF without a hitch and themselves never heard of supply issues etc, so it’s great to hear from you lovely folk.

Will definitely look into this @catsnore thank you!

@pinkunicorns54 tongue tie was very briefly mentioned once and glanced at/ dismissed week 2. What a shame it took so long for you- I’m going to follow this up, she is now 17 weeks, handy to know (as unfortunate as it is) it can take til now to be noticed/corrected.

@user3199 I’m sorry you had such a difficult start too- but so promising that it didn’t interfere in the long run and you BF for so long- that is amazing, such a boost to hear. The vicious cycle you describe is where I think it’s went wrong for me, I’ve kept the night feeds to breast only to keep supply- but overtime there’s been more and more need to top up in the afternoon where she gets fussy or only feeds for a small time and relies on the top up- which is now a full feed of formula. Oh hindsight! Thanks so much for the reply.

@JoyEng2 they checked at 11 weeks, told me no tie - despite having all the symptoms, I paid a private tongue tie specialist - she said there was!
Went back to the people who said they didn't have a tongue tie and they snipped it! Ask again! Good luck 🤞🏻

Hi, I couldn’t BF my first and did my subsequent children (including after c section). I’d say

1. remember it’s not just about you but about your baby’s mouth and tongue too. Mine had some minor issues (short tongue, high palate) that made it tricky. Your next baby may be different.
2. I expressed colostrum in later stages of pregnancy and froze it in 1mm calpol type syringes. Mine were provided by my midwife. This means your baby gets an energy boost which bigger babies tend to need in order to have the perseverance to learn how to feed

Thanks so much @Offyoupoplove that is great to hear.

I didn’t do the colostrum, will definitely do this and mention it to midwife next time- sounds a great way to make the best start. Thank you!