Confidence and following advice from Midwife

[luckychelle]

My DS is 20 days old now and we've had a pretty rocky start with regards to breastfeeding. He had jaundice and was very sleepy and apathetic when it came to feeding.

He was born 8lb 1oz and dropped to 7lb 4oz over the following 2 weeks. We had plenty of wet nappies but very infrequent dirty ones.

The inital advice from the midwife was don't let him go more than 4 hours without feeding, pump after and inbetween feeds and try and make him go for at least 25mins on the first side.

When he still hadn't put any weight on on Sunday she advised us to top him up and he's had between 4 & 6 oz a day since.

But recently his jaundice had faded and he's become much more alert. He'd gone up to 7lb 10oz on Wednesday. We had a big pooey nappy on Monday, one yesterday and one today...so I thought we were getting there. He's fed non-stop all day and all evening, which I assumed was him trying to up my supply.

But today he's dropped half an oz and the midwife said she wants us to increase to top-ups to 2oz every four hours. She said maybe he would then feed every 3 to 4 hours and would have the energy to feed better. And I would also get a rest (I'm quite anemic)

I rang a breastfeeding councillor this evening who said it's sounded like he was having a growth spurt and was trying to up my supply now his jaundice has all but gone and I as long as he keeps up with the wee and poo I should follow the baby and feed as much as possible (even though it feels like he's sucking on an empty boob...and he's so fractious about it!)

But I've lost all confidence in myself and what I thought I knew. What do I tell the midwife if I don't top-up and he loses weight on Monday?

I expected to have problems with cracked nipples and pain, but I don't feel a damn thing. This is so much worse than that.

That was really long...sorry.

Firstly, you shouldnt' expect to have craked nipples and pain... some people do but it's not the norm.

Follow your gut instinct if you can. Unless your baby eally isn't thriving, and you realy aren't producing enough milk, you won't need to top up.

Trust you body and your baby.

You don't have to answer to your midwife, only to your baby.

don't tell the midwife anything. the BFC is right, he is probably having a growth spurt, and every bit of formula you give is less signs to your body to produce more milk.
and yes, feed as much as poss- that's what will up your supply and give your baby what he needs.

he's dropped half an ounce??? that's virtually nothing. has he been weighed on the same set of scales every time? naked? you can get huge discrepancies between sets of scales.

I know it's hard not to lose confidence when you have HP's telling you you're wrong or not feeding your baby enough, but tbh a BFC knows a lot more than most midwives about breastfeeding

you midwife is talking poo. listen to the bfing counsellor.

Let him feed as often as he cues. Don't wait every 3 hrs like she advised. Frequent feeding early days is completely normal. Some babies even after bfing is established never go 3 hrs between feeds so I am afraid she is wrong on this issue.

Was he wieghed on the same scales as before? Is it digital?

If a small baby has a poo storing up and gets weighed the first time, then had a big poo just before being weighed the next time (as it sounds like could have happened to you), it can look like he hasn't put on much or any weight.

Feed feed feed your baby. I had very similar early days problems and never had engorged breasts or cracked nips but we as still bfing nearly 3 yrs later!

Babies get fractious at breasts for lots of reasons. You have milk. His pooing and weeing are testament to that.

Your anaemia shouldn't have any influence with your ability to make enough milk for him. Many women the world over are anaemic and produce more than sufficient milk to feed their babies. Honest.

I had similar problems with a sleepy "can't be bothered" jaundiced baby. I was advised to feed AT LEAST every 3 hours. For the first 2 or 3 weeks I felt awful, having to wake her every 3 hours (using my phone under my pillow as an alarm through the night) to feed, when all she wanted to do was sleep. I also tried expressing in between feeds during the day, both to improve my supply and to give me something to offer her after we'd tried a BF, as that was problematic at the beginning because she was so sleepy she had problems latching. It took a little time to get BF established, and for those weeks I was exhausted, and it took 3 weeks I think for her to start gaining weight, but then she really perked up and thrived. we did mix feed for a while (1 small bottle of formula a day) but only once BF was established, and that was OUR decision. She's now nearly 10 months and is doing FAB!

Hope things pick up for you and you get the support you need to get through this. I was really lucky and had a supportive HV and also help over the phone from midwives at a local hospital. It really did make a difference.

luckychelle - what happened to you is disgraceful, no other word for it

For your baby to be so underweight at 2 weeks is a testimony to the lack of bf support you had. The midwifery advice you had on feeding was truly terrible, I am not exagerrating. It is almost guarenteed to result in a low milk supply and insufficient intake and the need for formula supplements. The lack of poo was a Big Red Warning Flag that things were not going well, but even more, the weight loss

2 oz top ups every four hours may even be necessary at the moment, hard to say, but I would not trust the midwife to assess this, if she is the same one that gave you such crap info before.

However, the top ups do not need to be formula. They can be your own expressed breastmilk, and this will ensure more stimulation of your supply, too....good!

Top up, by all means, but make it expressed breastmilk...will that be possible for you?

Frequent breastfeeding - more often than 3 hourly - is often essential for new babies, esp those with jaundice.

Offer each breast at least once during each feed.

Good luck with this, and when things are better you can write to your PCT about the bad midwifery support you had.

I have been in a similar situation. Like you I had bad advice from mw at the start. I am still having problems now at 78 weeks.

If you increase the formula top ups, your supply will likely suffer. It is a vicious cycle. But your baby will gain weight.

If you follow advice of the bfc you will be able to gradually wean off the formula. But you may need to feed every 2hrs during the day and every 3hrs at night. Basically put the baby to the breast as much as you can! Be prepared for weight gain to be slow as you start to wean off the formula though, and don't wean off it too fast.

Good luck xx

Thank you all, just for agreing with me! I feel a little better now. Though not much.

It's worth noting I did half ignore what the midwife said about 4 hourly feeds. I was feeding on demnd whenever he was awake (typically 1.5-2hourly) and 4 hours when he didn't, then the HV came for the first time Monday and the visit conicided with the midwife's. After the midwife left she said 'actually, I wouldn't leave him more than 3 hours if he hasn't woken. I know they seem so tired, but sometimes you just have to be harsh and bully them into it.' I have more confidence in my HV.

He got to the stage last night where he refused to latch on for more than a couple of sucks and ws just screaming. We caved in gave him 2oz of formula about midnight. He went off to sleep and so did we in an exhausted heap. Next thing I knew it ws 6.30 and he hadn't woken like he has been doing (2-3am usually.) and I hadn't set the alarm. I'm so angry...feel like all that hard work he did yesterday may have been wasted.

I woke him straight away and fed him. Then I did again at 9.30 and will again if he doesn't wake.

I don't know what to do about topping up. I can't express much, typically 1.5oz a day (though I have got 1.5 so far today...probably due to that appalling long sleep.)

jaundice not enough breastmilk jaundice is lower down the page.

breast compression can help

videos including how to do breast compressions