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?

I*

Sounds like your milk has come in, 30-45 min feeds are completely normal when building a supply, feed her until she sleeps and settles and then give her up to an hour and do it all over again. My DS was slow to get going with a 12% loss, we did about 2 weeks of feeding 1-2 hourly and then we were away.

To add. She gained her weight back. You are doing amazing x

OP it sounds like you're getting there! Let her feed as much and long as she wants. It'll help increase supply x

I have three children all breastfeed until 10+ mo the HOWEVER they were all a little early and my milk didn’t come in properly until day 4. For every one of them I had to ready made formula feed top up for the first couple of days. My third went 10 hours without eating and was dehydrated with blood sugar of 2.4. They immediately handed me formula and gave him a fast acting sugar syrup. The syrup gave him the energy to drink the formula. When my milk came in the were only BF from day 4 on (or given expressed milk)

do what you have to until your baby is doing well enough to BF effectively

So after feeding her for an hour - I was also then able to express 20ml of breast milk too which her dad is giving her via a bottle. Does that show my supply is fine?
She kept spitting it out of the teat though so do I syringe it in?

I think it sounds like your supply is coming in now; day 5 is only a rough estimate.

Syringe it if you'd like but generally I think babies will eat as much as they need. Was she happy when she came off the breast or crying?

Just plough on as often as she will take it. A 10% loss is normal ime. You milk is only just in. We had this and at week 2/3 ds put on 17oz.

Forget not that if your dd was due a feed when she was weighed and had had a wee, her weight could easily have been down by 2/3oz.

Just keep feeding and remember a different midwife may have said something different. I'd have said at this stage, try every two hours.

And as others have said, breastfeeding is a very small part of being so excellent mother.

Happy Birthday x

@AlienLady sounds great - 20ml would be almost half a feed at this age. I think if you feed a bit more frequently, and your milk's in you'll feel radically more positive in a couple of days. You are doing a great job, and in no way is breastfeeding 'lost' yet 🌺

Breastfeeding definitely not lost yet. It is only just beginning and not at all a lost cause. I highly recommend Olivia Hinge Lactation Consultant’s stuff on instagram (she has also just written an amazing book). Lots of common sense stuff from her, and she is a midiwife too. I’m pretty sure she did a recentish post on weight loss after birth.

Remember that all sorts of factors can affect weightloss after birth, including fluids you may have been given in labour. You’ve had lots of good advice so far with breast compression and switch feeding. Personally I would implement 24-48 hours of you staying in bed, having baby skin to skin on you as much as humanly possible, and going no longer than 2 hours between breastfeeds. I wouldnt be concerned about your milk supply as from what you describe there doesnt seem to be a problem with this. Whilst you wait for another latch assessment and tongue tie assessment I’d be looking far more at what her nappies are doing, in particular her stool output. Dirty nappies are a very reliable indicator of milk intake in neonates, far more so than wet nappies.

Keep an eye on her lethargy if you feel it goes beyond normal newborn sleepiness. Is she jaundiced at all?

Happy Birthday, congratulations, and you’ve got this.

As an aside, I don’t that that daily weights are especially helpful and in my experience can be the source of lots of premature worry.

If I give her 20ml of expressed milk, do I still need to supplement with formula?
I got really happy she took 1oz of formula but that’s the thing with formula, you know if they have taken it or not and how much. You don’t know with breast milk.

No if you give her expressed you don't need to give formula. I didn't

If she’s taken the 20mls of expressed breastmilk and has also been actively feeding at the breast (which from what you describe it sounds like she has) I personally wouldnt supplement with formula at this stage. I would keep going with frequent breastfeeds, but with the caveat that it is impossible for any of us to assess what her energy levels are like / other factors such as potential jaundice / what her general status is ie low birth weight / born earlyish. So those things might alter your own decision making.

What are her nappies doing? That really will be an important guide for you about her intake.

OP if you're producing that much milk I don't think you need to supplement with formula unless she's coming off the boob still crying

How often and when should I express?

I pumped again and only got 5 ml :(

I wouldn’t express if you think you have a good latch i’d just focus on feeding her more frequently. Look at her nappies as a guide to how much she’s taking in rather the amount you can express, expressing quantity is a poor way of gauging supply.

what time did she finish her last feed? If it was more than an hour ago I’d get her back on, even if she’s sleeping.

OP, keep her on the boob, and make sure you feed her lots at night too (this boosts supply). You can also learn to feed her in the sling if you want your arms back at some point! Don't worry about expressing, just keep feeding her whenever she wakes up.

Don't worry about pumping for now, I had oversupply at one point down the line and still struggled to pump much!!!!

Baby has a tiny tummy right now so don't underestimate how little she needs

Just feed and offer boob as much as you can. she might latch on in her sleep and dream feed.

But don't let it take over your life and don't be upset she's only 6 days old and it takes a while to master.

My second is 10 weeks and we're still having good and bad days. I struggled a lot with my first too but persevered and we did get there in the end.

However if you don't want to carry on that's equally fine. But don't let anyone discourage you.

I breastfed for 3 years and never really got anything when I pumped

How are your baby's nappies? Are you getting plenty of wet and dirty ones? If so she won't be dehydrated and you need to focus on lots and lots of skin to skin and feeding on demand. Learning to breastfeed is a skill for both of you and it sounds like she's getting it now she's only a few days old and your supply is just getting sorted. You need to be relaxed though, stressing unfortunately will impact your supply.

If baby is not giving the expected number of wet and dry nappies then I would supplement with formula after the breast feeding and I wouldn't use a bottle but a small feeding cup, basically like the little jug you get with an iron and baby 'laps' up the milk like a kitten - this technique is also super useful when they have a blocked nose.

Agree with above, expressing at the pump is rarely an accurate gauge of how much you are producing. Especially when you are understandably stressed about it as the whole hormonal cascade needed for good let-down will be compromised.

I would personally concentrate on giving her frequent feeds at the breast, no longer than two hours between feeds, and more frequently if she shows any feeding cues inside those times. As exhausting as it is, these early days prime the breasts for their future supply. But as I said, the biggest indicator of what she is getting will be her poo output. Have her poos transitioned to yellow yet? How many dirty nappies has she had today?

Yes they are yellow and she’s had 2 poo nappies today

That sounds like a great indicator you're on the right track