I wish someone could tell me what to do

[Myrightboob]

DD2 is just over two weeks old. She’s generally a very happy baby. Quick delivery, no complications. I suffered from quite severe post natal anxiety and depression with DD2 who is 5, but this time I’ve felt a million times better.

We got off to a great start with breastfeeding but I’m not sure what to do now. She’s being sick a lot. Sometimes straight after a feed, sometimes an hour or more later. Sometimes just milk, sometimes curdled. Several times a day and getting worse. I’ve seen a specialist feeding midwife and she told me it’s probably just a case of positioning and my fast let down/oversupply and it’ll be fine soon. She also said she has a slight posterior tongue tie.

The latch and positioning is hard work. It was easy and pain free with DD1 but since I had her gravity has not been my friend and my boobs are now saggy and my nipples are so low, so the initial latch I can manage but it gets shallower as the feed goes on. I’ve got a crack at the edge of my nipple where it meets the areola. She clicks during the feed at times which I know can’t be good. I’m starting to dread each feed due to pain and also knowing she will bring a lot of it back up.

Daytime is fine but nighttime is a real struggle because of the whole holding her upright for 30mins after a feed thing. I get so tired. By the time I’ve fed her, held her upright, changed her nappy and settled her back down, she wants to feed again. I try not to change the nappy too often but she’s always done a poo and it’ll leak if I don’t do it at least twice.

I try and only feed on side at a time as feeding both usually ends up in a huge amount of milk coming back up. The right side the latch is better but the let down is really fast. The left side is problematic but the let down is better. Neither side is more likely to result in her being sick - both seem to do it.

With my first I ended up with prolonged PND because she refused a bottle and she was a terrible sleeper. She was BF for two years and I got very little sleep. So we’ve already tried a bottle with DD2 and she’s taken it well.

I’ve thought about moving to formula either gradually or just straight away. I’ve thought about it every day, several times a day. I’ve thought about how it’ll prevent bottle refusal. How it’ll mean my DH can share night feeds. How I’ll get to spend more time with DD1. How it might help with the sickiness as I could get the anti-reflux formula and pace the feeds better, monitor intake etc.

I don’t judge formula feeding at all. I think it’s a completely valid choice and before DD1 I was never that fussed about breastfeeding. Yet I go the supermarket and I stand in the aisle and I can’t bring myself to buy it. I hate how it smells, I fear formula-fed poos, I worry it’ll make the reflux worse. I worry that longer term I will find it a faff compared to breastfeeding which I know from first hand experience can be so easy.

I know I’m rambling but I just feel so frustrated. I am an overthinker at the best of times. Very indecisive. Here I go again, not able to decide what to do. I wish someone could just tell me what the best decision is. But logically I know that no one has a crystal ball and no one can tell me what the right decision is.

This will be my last baby and I don’t want to regret anything. I’ve found myself quite teary about it all.

Not sure why I’m posting really. Grateful for any advice but also appreciate no one can tell me what to do.

I didn’t have the exact same issues as you but I just wanted to say

you’re allowed to use formula if you want
you are also allowed to keep bfing if you want

i really really struggled with bf, i totally beat myself up about “failing” at it and agonised over switching to formula. I wanted someone to give me permission I suppose. I stopped bf and pumping, and switched to formula, by that point I’d done the best I could. My child was fed and I felt my mental health improved hugely.

I tried again with 2nd baby and pretty much failed again. Hard as he was my “last” baby and I wanted to do it “right”.
he had reflux too and it was tough up until he was about 6 months. I remember taking him to a baby sensory thing and not moving for the whole session as he’d spew over everything . I’m rambling too 😂

im sure someone will be along with more helpful advice on bf. have you spoken to mw?
But you are doing the best for your child whatever you do with feeding

@Sittingintheshade I saw our local BF specialist midwife today who helped with latch and position and said that it’s probably not reflux, just a case of baby getting used to my supply and let down.

I can’t help but worry that it’s proper reflux and that it’s going to keep getting worse. She dismissed my concerns quite quickly and I know I’m lucky as DD2 is relatively settled despite the sickness, but holding her for 30 minutes after every feed overnight is so hard.

It absolutely is tough with reflux and being upright. We did use gaviscon or whatever the baby version is - can’t remember now! Not sure it helped much tbh - but it almost stopped overnight around 6 months.

I can’t comment on letdown, but any bfing literature I read said that you and baby have to learn. I’m glad you are getting support from mw. Is your partner supportive with feeds etc?
could they possibly do an expressed bottle feed to give you a break and a chunk of sleep at night?
sleep deprivation is horrendous and makes everything seem 100 times harder

Thank you @Sittingintheshade

DH is supportive and is basically doing everything else - looking after DD1, all housework, nappy changes and holding upright after feeds during the day. I do the night shift but do call him in to help when I need to (we are in separate bedrooms due to his snoring and DD1’s tendency to sleep in our bed).

I’ve not got into a routine with expressing yet but even the days I have done, I haven’t been able to relax enough to leave DH to it. I know I need to work on this but whilst he’s great, he isn’t a natural with newborns.

Funnily enough I’m not even feeling particularly sleep deprived (yet!) I think I’m just overthinking as usual.

Today my nipple is very sore again and DD now has nappy rash. Feel like I’m failing.

You’re absolutely not failing! The nipple pain is awful too (that’s what did for me, the dread of the pain and knowing it would keep happening - I tried shields but I couldn’t even work those right. Honestly, you name it, I bought it. Shields, slings, etc etc)

I forget how upside down everything is when you have a newborn and another child. It took me a while to get into a routine. probably wasn’t till a month or so and DP was back at work - and I could get on with things my own (right!) way!

Overthinkers unite!!! Poor dd, hope the nappy rash clears up soon and she’s not bothered by it. Daft humid weather is not use!

My second was a sicky baby and I wasn’t used to it at all! I spoke to a GP about it who basically told me the warning signs to look for but said some babies were just sicky, possibly taking more milk than their little stomachs can handle, and that he’d grow out of it. I was googling reflux and CMPA and all sorts. Turns out he was right and when he was a few weeks old he just stopped puking.

I also had a more painful latch with my second. I find holding my boob / shaping it really helps. I often have to shape it for the duration of the feed, which is a bit of a pain as then I don’t have a free hand, but it keeps him in the right position.

I found the breastfeeding support network really useful during that time.

It sounds like you’re doing a brilliant job and obviously if you want to switch to formula then you absolutely can. But if you do want to keep breastfeeding I promise you it will get better if you give it time. Maybe set yourself a mini target of four weeks and reassess then? And then reassess every couple of weeks. I found it got a lot better by six weeks, then again at eight weeks, and by 12 weeks. Was just a way as it was with my first. Obviously though at any point in that period if you want to stop please do just give yourself permission to do so.

Oh I forgot to say I also had a bit of an oversupply in those first few weeks and a fast let down which I think baby struggled with. Once they calmed down that helped a lot. Again lots of advice out there on how to manage these issues. Good luck!

Switching to formula won’t help the oversupply and may wreak havoc with your supply in fact… as you’re managing BFing and experienced in this, I’d stop worrying about the sick. If it’s not upsetting baby it’s not likely to be reflux and it’s just messy- get the wee burp cloths at the ready and just mop it up… if she’s a happy puker then you don’t even really NEED to do the upright for 30 mins thing either… obviously if it’s upsetting f her, ignore that.
BFing lying down becomes possible in the next few weeks, can you look at the safe sleep guidelines and cosleep?
clicking and latch issues could indicate a wee tongue tie- but it could just be that as soon as you fed the latch slip you need to persevere in unlatching and latching on again properly. Change position if that helps the sore side.

Join yummy mummy BF support on Facebook- lots of very experienced support workers there and other mums.

I would imagine that even if FF solved some of the issues, it may also raise new ones like constipation or bottle preference or supply issues etc… so for now I think BFing is better all round… and it sounds like you’re doing a great job!!

We had posterior TT and fast let down too. Lots of reflux style symptoms, but it wasn’t reflux, more trapped air due to the tt/fast let down combo.

What helped was 1) getting the tt cut. 2) side lying feeding position- as this slows the flow. Both on advice from a lactation consultant. But the side lying position would have been impossible before the tt was cut, as she just would have slipped off.

If you have introduced the bottle that might be causing the nipple pain as it risks messing up the latch.

I'm not fully understanding the bottle refusal fear. From 6 months they can take a cup, no? Anyway basically all babies can be trained to take a bottle if you try hard enough and are consistent. I would just focus on bf right now because you're right that formula might make reflux worse.

DS was terribly reflux, the consultant who did his barium swallow when he was two weeks old said it the worst case he'd ever seen. We propped his top cot legs on books so he was lying at quite a steep angle, so we didn't need to hold him after each feed. It did mean that sometimes he slid all the way down the cot and crqshed at the bottom, but I did help with the puking.

Other than that, I can only say try not to overthink. I know well how bad it can get, how you can while away whole weeks agonising over the best approach to the whole thing. But honestly, whatever you do will be right. Your child will be fed, you'll all survive it and in a year you'll forget this was ever an issue. In the meantime, all the options are good; just pick what suits your family best. You'll be okay.

Thank you all, some good solidarity here which is just what I need! Also some helpful tips. I might ask the BF midwife again about the tongue tie and I might get a lactation consultant in.

She was weighed by the HV today and apparently she’s put on 300g in a week. I’m not surprised she’s gained weight but also 300g in a non-sicky baby would be impressive, right? It was only when she left that I realised she had the scales on the carpet whereas the midwives had taken the scales into our hallway for a hard floor. But anyway, I’m glad she’s gained as it shows the sickness isn’t doing her any harm. However, being the overthinker that I am, I am now concerned about over-feeding (I know they say you can’t overfeed a BF baby…)

@MisschiefMaker she’s only had a bottle four times, one every 2-3 days and only 2oz or so. I really don’t think it’s causing the latch problem. I also tried VERY hard to get DD1 to take a bottle and it didn’t happen. I spent a lot of money on different bottles, shed a lot of tears and ended up with severe PND as a result so it really is something that happened to me and something I need to avoid happening again for my own health.

I agree with the suggestion to address the tongue tie, boob shaping (I think it was a C hold (?!) that really helped us out with poor latch and tongue tie issues to get a deep latch) and on laid back breastfeeding if you can manage it, to slow the letdown, also hand expressing a wee bit off until the initial letdown so the next one when she’s latched isn’t as fierce. And feeding off the same boob as you’re doing also really helpful.

The only other suggestion I was going to make was regarding the cracked nipple. I had one particularly vicious crack and the best thing I found was something called Jelonet to promote moist wound healing. You’ll need to take it off for feeds but using small strips of it between feeds helped massively when lansinoh etc wasn’t touching it.

Why don’t you bf till 6 weeks and then think about bottles? I find it much easier to set a time and date that things will change than constantly worry everyday that maybe we should do this or that.

Op I literally could have written this with ds. He was the exact same. Has your dds tongue tie been assessed for release? Ds was assessed and I was also told it was a positioning issue and they refused to cut it because he was gaining weight. However it turned out he was gaining because of my oversupply and forceful letdown so when that regulated at around 2.5/3 months he suddenly dropped a number of centiles in a few weeks because he couldn't get enough milk efficiently. Feeding was sore for me as well, I found side lying helped and using a nursing pillow for extra support but really the only difference was when the tongue tie was eventually cut (we had to go private for this at 5 mths). Laid back feeding positioning helps slow flow as well. As they get older they do get loads better at managing a fast flow as well.

Ds was very refluxy as well and spewed a lot and we also had to keep him upright after feeding. It's tough at night but it doesn't last forever. Things I found helped were blue tooth headphones and Netflix, sleeping in the early evening when dh got home from work for an hour or two. We introduced a soother around 4 weeks and it made a huge difference in helping ds keep things down. The sucking seemed to help settle him and manage the reflux. Feeding from your right breast with them lying on their left hand side helps wind come up naturally. When you have a let down take baby off and let it spray into a muslin or shell. Take it in turns with your partner. At weekends I fed ds and dh did the sitting up for a bit with him so I could go straight back over. Silver cups are the ticket for healing and if you're very sore on one side you can pump or hand express it after feeding on the other side to give the nipple a break. Nipple shields might help you too.

If you want to continue breastfeeding I'd strongly recommend joining a support group like la leche league. I've found them a really good source of support and advice and there's always another mummy who's been there and got the t-shirt and can tell you what helped her. They can also help with issues around positioning etc. It also was really useful for showing me that breastfeeding looks like lots of different things from exclusive pumping, combi feeding, feeding solely from breast, triple feeding etc etc etc.

The early weeks are SO tough. You are doing amazing and you deserve the right support. I would really recommend fighting for tongue tie release and then see if that makes a difference for you. It shouldn't take long, couple of days from referral to release. We went private and I booked it on the Friday and it was cut on the Monday morning by a local dentist. I think until you've ruled that out it'll be hard for you to know what the exact issue is and then make whatever decision your gut is telling you. It's worth looking into because any tongue tie can cause issues with other feeding/speech development etc so I do think it's worth the fight tbh, even with bottles ds would spew, click and drool out the side because of his.

First of all, you are not alone, it is hard to know what to do for the best, but every baby is really different I think. I've had 4, the first (boy) breastfed until 7 months, had quite a hard time with it, bleeding sore nipples, used to throw some of it, or all of it back up, an hour on an hour off (he was a big baby and always hungry) nipple shields and the likes. I did not enjoy bf until shortly before it finished, and I think we were doing mixed feeding for a while before I gave up, but no issues, and no real confusion. The second (girl) BF for a week, struggling to get wet nappies, moved to bottle no problem. Threw up once at about 3 months much to everyone's surprise. The third (girl) was bottle fed after a day or so, and very much a puker - every bottle some came up, but not the whole bottle - no distress, no windiness particularly, and a sunny baby, we just used to put a bib or towel on her for the mess, it stopped once she was getting to grips with solids. The fourth (boy) was only bottle fed, hardly ever puked, but had colic from about 5 weeks to 20 weeks. Would he have had colic if I had BF ? Who knows ? Possibly, possibly not? That is just my experience, but what it has taught me is you need to do what is right for you actually, otherwise you will tie yourself in knots. Sending hugs xx

For the sore nipples, try a nipple shield, they’re really great.

I would also second the set a time to re-evaluate, so that you’re not constantly worrying. Try some of the suggestions, and re-evaluate in say 2 weeks or whatever time period.

Give yourself a break OP.

Being a parent is hard, there is nothing wrong with making things easier and if that means expressing or using formula then do it. You do not need anyone's permission.

I haven't read the full thread... just your OP.

But please look to getting that tongue tie cut. Even if it is 'slight' it is clearly having an impact on how your little one is feeding!

My little one was the same, but got told no tie, until she was 11weeks old when I sought a private opinion from a TT specialist. It was cut at 16 weeks - and feeding got infinitely better!

We were stuck in a top up trap, which impacted my supply as I couldn't do the triple feeding they wanted me to do (boob, bottle, pump) as I have a 2yr old who needed me too!

It ended out feeding journey earlier than I would have liked!

By all means offer a bottle too, you can combi feed! But seek support if you want to try to continue bf'ing.

Although my fully formula fed 8month old is doing amazing now!

Also, I could have written what you said about your barriers to formula feeding.
Didn't want to take bottles out, it's a faff, so much easier to whack a boob out!

But actually it's nowhere near as bad as I thought it would be. Especially if we are only out for the morning and back for naps etc - as she fell into a routine fairly quickly. I know it won't be quite the same with a newborn.

But I don't regret my decision ❤️

Sounds like even if things are difficult she is doing well-she is happy and putting on weight so try not to worry and overthink.
-my advice would be:
get the tongue tie cut
-can you let the initial fast let down squirt out into a bottle for later so she doesn’t have to deal with the first rush of it?
-agree that if she doesn’t seem uncomfortable with the sickness you don’t need to keep her upright esp at night. You could get some raisers for the cot/Moses basket or just use a couple of big books to keep her at a slight angle.

good luck!

You’re doing very well. Do not let yourself be dismissed. This is reflux. Make no mistake about it. I added a pic so you see what I deal with multiple times a day

my ds almost 9months started at 10 days with the vomiting. At times twas cottages cheese at times cream cheese etc. Twas so painful to see.
had a tongue tie operation, latching got infinity better. He could then stick his tongue out which previously he couldn’t.
unfortunately the baby reflux is still here and heavy. But he’s happy.

As a bf mother watching your baby throw back up your milk is hard. You have to constantly be feeding them. It’s exhausting.

I pumped and still do as I hava a bit of over production. It’s a chore to breast feed, pump and care for my 2 year old as well.

my ds still has reflux. I tried everything under sun but it runs in the boys side of my family so nothing to be done. My nephews 10&11 need to take vinegar tablets even now as they still suffer from reflux badly and so does their dd who’s my db

You are not doing anything wrong. That’s the way with reflux. Formula won’t make it better

I haven't read all the replies, but the absolute best thing for your baby is that you are as happy and rested as you can be. If you are not bottlefeeding because of thoughts that breast is best the benefits of having a happier mum far outweigh the benefits of breast feeding. X

Long story short (I’m late for work) I exclusively expressed for DD. It wasn’t easy (managed a year, no idea how) but meant she got breastmilk in the best way for her.

Can you get a referral to a tongue tie clinic or just call a local specialist who can cut it (if you google you can find qualified tongue tie specialists) to see if that helps?

You can also express milk and feed breastmilk from a bottle if you don't want to give formula (I did that mixed with formula for 6 months as the latch never worked for us) but I only had one baby- you need someone to
Hold baby while you're expressing. I felt the same ick about formula at the start but started supplementing with it when my baby had jaundice and a dry nappy from poor latch and I couldn't pump enough milk out so it felt like a necessity to get baby fed and hydrated which made me get over it quickly.

I don't think you'll regret anything feeding wise when you look back on your babies being babies. Your only regret will be not feeling like you enjoyed your babies if you were stressing too much about the feeding! X