24 hour weighing - lost again. What shall I do?

[AlienLady]

Midwife came yesterday - Day 5. DD lost 10% of her weight
Midwife came today and she lost a further 0.3g.
I have been trying to feed her every 3 hours since yesterday.
She seems sleepy today and not that bothered so I’ve had to strip her just to get her to take some milk. Midwife wanted me to give her a top of expressed milk so I got my haaka out and tried expressing for the first time. I got only 10ml out of my left breast. What do I do? It’s my birthday today as well and I am so upset as I thought I was doing a good job. Do I do a formula top up and how?

First of all you are doing a good job bso please dont equate that with breast feeding.

Just move straight to formula and feed her now otherwise she will end up dehydrated and in hospital (speaking from experience)

Get some ready made aptamil today and feed her 1-2oz every 2 to 4 hours and call your midwife for support
Take care
Xxxx

Exactly as @Zamazenta says, completely stop your association between breastfeeding and doing a good job!

A fed baby is a happy baby (and a happy mum) and your milk will come in at some point. Assuming you want to breastfeed, have baby on the breast for half hour but then finish up with formula.

Could you afford a session with a lactation consultant? If so that might be helpful. And keep looking after yourself, and getting plenty of fluids in.

Oh love. You are absolutely doing a good job. Breastfeeding is a skill that neither you or baby know how to do at the start. How is the latch do you think? Remember people can’t really tell from the outside. Do you hear baby swallowing milk? Does feeding feel comfortable? Does baby seem satisfied? You could ring the national BF helpline for more individual immediate support. And like pps say, top ups are fine.

A formula top-up is fine.

And you may end up mixed feeding, which is the best of both worlds in many ways.

I had similar issues with my DS who was also very small. He spent some time in SCBU with low blood sugar after being born. I gave ready made formula every couple of hours, we did have to strip him to get him to stay awake for a feed but he got stronger quickly once he was eating more.

I don’t think a Haka will be actively pumping, you probably need a proper breast pump to stimulate supply or keep it going if you need to FF but want to go back to BF later. I hired one from my health visitor, we ended up sticking with FF as he wouldn’t latch but he had expressed feeds for the first couple of months alongside the formula.

As others have said, don’t equate feeding with being a good mum. A good mum will recognise when her baby needs to be fed, whether that’s formula or breast milk. Sometimes BF just doesn’t work out but it’s very early days and some FF now wouldn’t mean you couldn’t BF.

OP you're doing amazingly.

If you want to increase supply you could try pumping every few hours. A manual pump might work best where you pump it yourself. xxx

BUT BF isn't everything! But I would say don't feel forced into giving it up completely if you don't want to x

I did a mixture of breast and bottle right from the beginning, he had no problem switching between thankfully.

You do whatever suits your baby. Fed is best, however that may be.

You are doing great and happy birthday 🎂

You need a proper hospital grade pump. A hakka just catches the let down from the side you are not feeding from. I had similar issues twice and things improved after day 10 but we were triple feeding for a while…

I would try feeding on demand rather than on a schedule and having lots of skin to skin with her. Sit with her cuddled up to you and offer her a feed as often as you can.
Both my sons lost a bit of weight at the start but were soon very chubby babies. breastfed them both on demand, which was a lot.

How lovely to be celebrating your birthday with your new baby! Definitely one to remember.
As others have suggested, get some ready made formula and start giving some top ups. Babies are so fragile at this stage and it is a really delicate balance getting enough nutrition into them so that they are then alert enough to want the next feed.
Doing this won't mean your bf'ing journey is over. It may mean it's not quite the journey you anticipated but, this time next year, with a house full of 1st birthday cards and piles of toys and a possibly toddling child, you really won't regret that you did the best for her in these circumstances

This is potentially dangerous advice though if the OPs baby isn’t feeding at all. Some babies are not interested in feeding and do need to be forced.

I only got 10ml from my Hakka. Which I gave her after she suckled. I then gave her some formula :( but she only managed 4 ml (1x 1ml syringes) before she started gagging so I’m assuming that because she’s full?
This is really stressing me out as my breastfeeding journey never started with my DS as I got sepsis after birth and he was tongue tied so my milk supply wasn’t good.

If she’s 5 days old can you feed her from a bottle now?

Feeding every 3 hours for a newborn when breastfeeding is quite unheard of at this young age. They are quite often on the boob a lot more than that to start to build supply and conform. I would recommend a lot of skin to skin to encourage more feeding at this early age

Not conform I meant comfort

Can you get some bottles from her? She's possibly just gagging because it's coming from the syringe and she's not sucking it herself if you get me. My 12 week old gags on the Calpol syringe but drinks from a bottle perfectly.

Happy birthday, OP and congrats on your squishy newborn 😊 You are doing a great job - don't be disheartened. As pp have said, given its Sunday, could a family member pop to the shops and get a pack of the 6 x 90ml formula bottles that come with pre-sterilised teats? They come in cow and gate and aptamil for sure. Maybe others too. Today, sit with baby on your chest skin to skin under a blanket and let them feed whenever they want but offer a feed every 2hrs rather than 3hrs if not. If you think they are not actively swallowing anymore, offer them just 30-40ml of formula after they've stopped feeding and see if they take any extra. Overnight tonight, let them cluster feed as much as they want (especially 2am-4am as our bf hormone is highest at that time). Then tomorrow, see if you can get an appointment with a local lactation consultant. Tongue ties can be genetic so if your DS had one, it could be that your new baby has one too. But even if not, they can check the latch and give you some more tailored advice than you will get from the midwives, who are often not bf specialists. If baby loses too much weight, the midwives will recommend you pump (with a proper pump, not a hakaa) and give formula in addition to bf, but that is quite hard when you have an older child (i know from experience!). But day 5 is really early, so some proper bf advice might make all the difference and avoid you having to go down that route.

Compared to me, 10ml from a hakaa is amazing at day 5, so I reckon a bit of extra help from a specialist might work for you. Good luck 💐

https://lcgb.org/find-an-ibclc/

I don’t know where you live OP but I had amazing support from my midwife infant feeding team and health visitor who both referred me to specialists for help free of charge.

Agree with others to spend the day skin to skin with baby, offering the breast as much as possible. Ensure baby has a decent feed at least every 3 hours, and if not express with a proper pump not a hakaa (just for 20 mins- 10 mins each side) and give the ebm. If you're only getting 10mls or so then I'd give 30mls formula. There is a calculation to work out how many mls per kg baby needs, but really the midwife should have gone through it with you. Keep a close eye on output- baby should be having at least 5 wet nappies and 2 poos in 24 hours. If baby isn't meeting this then phone your midwife. Also there's no benefit to weighing every 24 hours, it's overkill.

It is such early days and this will just be a blip whilst you and baby are getting the hang of things! I ended up mixed feeding for a couple of months due to weight issues, but I'm now still breastfeeding 2 years down the line!

Happy birthday and congratulations on your new arrival! Be kind to yourself. This stage is the worst for the hormone crash post partum which makes everything feels worse.

I would go with lots of skin to skin and offer the breast more frequently than every 3 hours. Every 2 or more if baby is awake. Try some breast massage before feeding so the let down comes quicker and baby doesn't get too tired trying to get the milk flowing. And then some breast compressions once the feeding has started to slow to get a bit more milk in to them and maybe trigger more sucking.

Check out the videos by Global Health Media about latching and positioning. There's some really good ones about seeing if baby is attached and actively sucking. globalhealthmedia.org/topic/breastfeeding/

Get a referral/contact for the infant feeding team at the hospital and see them ASAP or lactation consultant if you can afford it. And maybe some support fr either National Breastfeeding Helpline or a local Breastfeeding group such as La Leche League for some in person advice.

And maybe see about stopping all visitors that aren't helpful. Right now your baby needs to be held close by you so passing them round all the cousins isn't helpful, but people willing to look after your older child while you're doing skin to skin with baby is.

https://breastfeeding.support/what-is-breast-compression/
Don't panic. This happens often and it will turn around. I wouldn't recommend a haaka- it'll remove that easy access milk that your baby would take at the breast. Double pump if you have a pump after feeds, or hand express in the short term.
Lots of skin to skin.
I would recommend breast compressions and switch feeding (swapping between breasts when baby stops actively feeding). Breast compressions can be really effective for a sleepy baby. Make sure to get in at least 8 feeds in 24 hours but your baby can't spend too much time at the breast. Ask to be referred to local bf support, or try the national bf helpline 03001000212

www.nationalbreastfeedinghelpline.org.uk/

Just to add to the advice above in case it hasn't been mentioned, breast compressions can help in keeping a strong flow and therefore keeping baby awake and engaged when feeding. I would do breast compressions throughout all feeds for the time being. I found them very effective personally. The Breastfeeding Network website has a page about it.

Hi op, I’ve been here with my first DS. Firstly, you're doing a great job, giving formula top ups is a perfectly valid choice, depending on how much you want to preserve with breastfeeding would influence the method. Let me know if you want a suggestion.

What I would say is every 3 hours is not generally enough to build a supply, I would up it to every 1.5 in the day and every 2 at night which should help ramp up your supply, have you had the latch checked?

Feeding on demand is not appropriate advice in these circumstances.

You're doing a wonderful job, OP. I couldn't breastfeed my babies and I'm a fantastic mum though I do say it myself! There will be so many ways you will be needed to go above and beyond as they grow. This is nothing. Get a proper pump, don't be afraid to use formula and don't fall into the trap of becoming sad and anxious because your ideas aren't going to plan. All you need to do is react to the circumstances you're currently in. Our plans as parents almost always have to be altered to suit our children. A good parent knows when to put a cherished dream aside and parent the child you have in front of you. They need formula? Fine! Your goal is to have a thriving baby at this point. Whatever you do to achieve that will be awesome.

I went though a stage of weeping because my baby wouldn't eat steamed asparagus like my friend's baby did. Looking back, it was just about wanting everything to be my idea of perfection. She still doesn't eat asparagus but it was a useful learning curve for me. You're not being ridiculous like I was but the principle is the same. Are they ok? Yes. Do you care? Deeply. Is everything going to be fine if your baby needs formula? Yes.

Sometimes knowing when to step away from a goal is the hardest part of being a parent.