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?

3 hourly isn't frequent enough, I'd be offering much more frequently.

Do the breast compressions and keep switching sides whenever your baby slows or stops suckling - you can offer 3, 4, 5 sides per feed if you keep switching.

You're doing a great job, just take a few days to do nothing but feed.

I breastfed 4 and on average they fed every 1.5 hours in the daytime; more in the evening esp in the early weeks. Every time they cried, I offered the breast having checked they weren't wet, dirty or in pain. The 3-4 hour idea is mostly from bottle fed babies and you cannot overfeed a breastfed baby. I also couldn't express more than an ounce or two but actually feeding is very different. Not being able to express much doesn't mean your baby isn't getting much.

Offer some formula or offer the breast - it will all be ok in the end.

I really don’t want to formula feed. I love breastfeeding.
i have an appointment with to check tongue tie on Tuesday.
my baby is really sleepy today so I’m worried. I really didn’t want to go on this journey again. Everyone at the hospital said my latch was great etc. I feel like a failure.

If it's been an hour since her last feed, wake her up and offer the breast again. Do breast compressions and switch as soon as she slows down.
Breastfeeding isn't pass or fail it's just a bodily function.

Is your baby jaundiced? Get her by the window. Aim for 50-60mls a feed.
Try on breast, try with expressed then if she hasn't had much top up with formula. Only until your milk is established.
This was the plan I was put on with my firstborn after we got re-admitted to hospital. It took me 2hrs to pump 5-10mls milk and I put myself through hell. I should have just topped up with formula until my milk came in properly and my son was over his jaundice

I don't want to override what your midwife is doing, she has seen your baby and I have not and she knows your whole history, birth circumstances, risk factors etc and I do not.

However. 10% is common and does not need any dramatic input unless there are other concerns such as reduced nappy output or other risk factors.

You are doing brilliantly. You absolutely do not have to stay using top ups right now unless there is a clinical reason that your midwife has advised you about.

I would suggest feeding responsively and ensuring 8-12 feeds in 24 hrs so do wake her if needed.

Switch nursing and breast compressions. There are some good guides on YouTube. These methods really help to get baby feeding actively and support your lactation too.

Watching for effective feeding. Your baby should start with rapid sucks then fall in too a rhythmic suck/swallow pattern with pauses. They should swallow every 1-3 sucks.

Because of the further loss then some expressing after a feed and offering the milk you get. Don't worry about volumes, she is feeding too. 10ml is 10ml, that's an extra 10ml she's had!

You are growing a whole human. Trust your body. If you find she is getting more and more sleepy, had signs of jaundice or if she isn't doing 5-6 heavy wet nappies plus at least 2 nice, yellow poos the size of a £2 coin in 24hrs then contact your midwife.

Please don't underestimate how difficult and challenging breast feeding is! No one warns you or prepares you for it...I naively thought it was as easy as putting baby on and away you go.

I had to combi feed my DD due to low supply from breast surgery and was really reluctant to give her formula at first. Essentially I had to put my own thoughts and feelings aside and just make sure she was happy and fed and content and actually once I accepted that it was a massive relief and weight off my shoulders.
I still fed her for comfort a little bit, but her main source was from formula. She is the least sick baby I have known out of all my mum friends who exclusively breast fed!

There's no wrong or right in this situation as long as baby is happy and you're happy and relaxed x

If it's any consolation I really struggled with #1 gaining weight until I switched to breast every time he cried, when he was about 3 weeks old.

You’re not a failure op you’re doing so well, you just need some tweaks and more frequent feeding.

Honestly op. I was the same
Hellbent on breastfeeding
But please do top up with formula in the early stages. I'm not saying don't keep trying on the breast etc. you can do both until she's more awake/able.
Keep on with trying on breast first, breast massage and expressing. Looking back I wondered why I put so much pressure on myself.
I went on to BF my son for 18 months so just because you use formula doesn't mean that's it forever.

There's a brilliant Facebook group called UK Breastfeeding and Lactation Support. Lots of lactation specialists who can advise and do a latch check for you. Both my babies had formula top ups early on as they got to the to tired to suckle stage. I breastfed the first until 12 months and my second is now 3 weeks and back on just breast milk. It's really hard at first but you'll get there.
Also to add 10ml at 5 days with a haaka sounds like you have a good amount of milk in there. I was only getting that amount with a full on hospital grade breastpump.

So she’s been feeding from my left breast for 30 minutes now. Mouth full of milk, I’m dribbling from my breast when she releases. She’s gulping etc. she does release and cry out, she seems so hungry. I don’t get it.

Can you tell me what your plan was? How did you get your child to gain weight and exclusive breastfeed again? How did you formula feed. Thank you xx

Has she been actively feeding non-stop for 30 minutes? Can you see her swallowing?

You dont have to give up breastfeeding. To keep production up offer the bob for the stimulation then offer formula in a bottle. Call your hospital that you virthed at and ask to speak to the IBCLC most conauptant led hospitals have one. Only they can confirm if it is a supply issue or not. Midwives are not lactation consulants.

Yes to both! Everytime I try to take her off, she starts going again.

I have a tongue tie assessments on Tuesday thankfully!

I would switch every time she stops or comes off, don't keep her on the same side.
Switching will get more milk into her and increase your supply.

That sounds like a good idea, it may be that she's not transferring milk very effectively if she's feeding for a long time and having to work really hard to feed - it could be that restricted tongue movement is making feeding hard work for her.

My DS2 was a big, hungry baby. I used the little pre made up formula bottles to top up for a few days until my milk was fully in as he always seemed to want more. Breastfed til he was 6 months in the end. You could always try a little top up after bfeeding.

Oh I didn’t know this.

https://www.lllc.ca/breast-compressions-and-switch-nursing

Switch feeding and compressions are both ways to get more milk into your baby.

I really don’t want to formula feed. I love breastfeeding.

I had to give DS some formula from day 2 in hospital as he was so hungry. But it saved my breastfeeding rather than ruined it and we mix-fed for 8 months.

I intended to do the same with DD but at day 10 she refused the formula.

We used an IBCLC lactation consultant in this situation. Anyone can offer breastfeeding advice, but IBCLC requires particular training.

they had me pump after every feeding.

dd was a lazy nurser and I had large breasts which made things difficult. We used a nipple shield to help with latch. Then For the first few days, we put the breastmilk in a syringe with a tube attached and taped to my nipple. DH stood behind and every time dd sucked, he pushed the syringe a tiny bit. So she got extra milk with her very feed.

after a few days we graduated to an sns. That is basically just a container with a tube and the baby sucks the milk out while nursing.

top ups only interfere with breastfeeding. You want to keep baby on the breast.

if I ever didn’t pump enough milk to put in the syringe or SNS, then we could have filled them with formula, but we only had to do that the very first syringe session before I pumped the first time.

we were able to gradually cut back on sns sessions and it was fully gone by 6 weeks. We never did get to ditch the nipple shield despite trying, but that ended up being ok.

My daughter lost 10%. Keep her on the boob. Express. It never used formula