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?

Wow, OP! What fantastic updates.
It sounds as though your DD is getting the hang of bf'ing and as though your milk is really coming in. I am delighted for you. When is she next being weighed? I am sure it will be a positive outcome and I think that reassurance would really help your mindset.
There is loads to learn about bf'ing. I was amazed! After all, it seems like such a natural thing. It turns out it's incredibly complicated! I spent the first few weeks it seemed glued to my phone reading MN, KellyMom and various other websites getting all sorts of tips. The swapping breasts is important but don't do it too soon as your DD needs to get the hind milk as well as the fore milk; certain foods (such as oats) and drink (fennel tea - not as bad as it sounds!) can really help milk production; skin to skin is so important; there are all sorts of tricks to wake a dozy baby on the breast and get them feeding more whether that is stripping them down, lightly tickling their feet, stroking their cheek... just so much.
I think it's important you get DD weighed again just to get that reassurance that she is doing well. Then, if you can, focus on establishing bf'ing which, at this very early stage, may well involve exclusively bf'ing, quite possibly without expressing as your body is getting used to everything. Once it's established, you can try expressing and your body should catch up quite quickly and realise it needs to produce more. Or you can skip expressing and introduce formula for feeds you're not around for.
It sounds as though your DH and your DC1 built up a lovely bond through bottle feeding and that it gave you some precious time to yourself. It may well be that that is what you decide is more important this time. Or that you simply get exhausted by the demands of life as a family of four when one of them is a newborn baby who is being bf. As others have suggested, have some ready made formula in as then there is an emergency supply if you change your mind.
For years to come, medical staff will be asking you about the type of delivery, how baby was fed etc. It isn't judgement, just helping them build up a medical background so that can best determine how your child is. I don't know how anyone could judge you anyway if you had sepsis! A life threatening medical condition and bf'ing would be completely incompatible!

ok two thoughts. She’s five days old. She’s also learning to breastfeed. As with learning anything new, it’s an up and down road. She has clearly learned to latch, she is drinking (you have yellow poos) and don’t all babies lose weight over the first week? Isn’t that normal?

Next, long 90 mins feeds are normal, someone once said think of the first hour as a three course meal, and the suckling in the last 30 mins as her putting in her order for her next meal.

What it means biologically is that she is stimulating your supply. In the early days my kids fed 10-12 times a day easily. One experienced colleague told me not to think in terms of ‘feeds’ but the day as one long breastfeed. After six weeks a pattern will emerge. And by 4 months he could drain both breasts in 15 mins!

How you getting on! Been thinking of you

Hi,

midwife didn’t turn up yesterday so not sure how much she weighs now. She fed for long periods yesterday and was up most of the night cluster feeding. Plenty of poo nappies.
I couldn’t bring myself to express, there was no time and when I tried I only got a few drops.

Not sure whether I should be topping up with formula instead?

OP if she's feeding well lots of wet nappies and poos you don't have to top up with anything!!!!! Just keep BF!!! You're doing a great job x

Her feeding loads isn't a sign you aren't producing enough and she's not getting enough

The best indicator of her getting enough is wet nappies and poos.

In a few days the feeding with calm down xx

That sounds great. As a PP said, feeding lots isn't a sign that your supply isn't enough. Lots of nappies is a great sign.

Hopefully you can get her weighed soon and that will put your mind at rest.

I wouldn't supplement with formula if you are getting lots of wet and dry nappies.

Sounds like you've made great progress though. Midwife must not be too concerned if she didn't prioritise you so take that as a good thing too.

Her feeding lots is her putting her order in for three days time so that is normal too, it works on demand and supply with a couple of days lag.

So went to the tongue tie assessment. She has lost 0.3G of weight again.
they think she’s got 50% tongue tie so booked in for 2 weeks.
they want me to express after every feed or give formula if I can’t get enough.
I am so upset. I thought feeding was going really well.
Is this the end of my breastfeeding journey?

I think if you can afford it I'd go private and have the tongue tie sorted for the best chance.

Until then keep BF as much as you can, pump, express etc

A pump will be better than expressing and you could bottle feed this

Is 2 weeks too long of a wait?

Too long if you're topping up with formula but not too long if you're able to express and top up with breastmilk.

And herein is the perfect example of why babies should be checked for tongue-tie before discharge.

OP I know how disheartening this must be and utterly depressing to see her weight go down despite your back breaking work over the last few days. Just keep reminding yourself this isnt your fault, you have done exceptionally well feeding and doing everything else you have been doing, and above all, that this doesnt mean the end of your breastfeeding journey.

Two weeks seems a really long time to wait for a breastfeeding baby who is losing weight. Was this an NHS clinic?

This sounds really poor OP and is in no way your fault, the NHS system on tongue tie seems to be a complete lottery. My DS had a tongue tie and we were seen in clinic when he was 5 days old and it was cut the same day. Is there any way that you could go privately as pp have said? I think that pumping would maintain your supply in the meantime but it is time consuming especially if you have another DC.

Not the end at all. Get a good pump and start using that and keep putting baby to the boob as well. Some hospitals don't cut tongue ties super early as there is a chance that if it is cut too early when it heals it re fusses so has to be cut again.

You are doing an amazing job and if you want to keep breast feeding you can. If you are worried that baby will get nipple confused ask your infant feeding team about cup feeding instead of bottle for the top ups.

Yes an NHS clinic

so out of desperation, I rang a private clinic to try to get it cut sooner.
She however gave me a free 30 minute phone call. Her points were:

— they won’t cut the tongue tie for me if it’s not gaining weight. I need to address this issue and obviously my child is tired so a tongue tie won’t fix this immediately

• your child being on the breast for long periods of time does not indicate they are getting enough milk, could be using you as a pacify
• she said she would do max 20 minutes each breast, whilst doing breast compressions and then top up
• she doesn’t agree with using a cup, my child can’t suck so how will he know how to use a cup and it’ll go everywhere. (I did try to use a syringe and cup yesterday but it’s true, she was spitting a lot out)
• if I alternate when to supplement, eg do one before a feed, one after. The child won’t get confused and use a bottle but pace feed it.
• nothing wrong with formula - if you don’t get your child energy levels up, it won’t be effective from drinking from my breast anyway

focus on your child’s energy levels - that should be focus. Spending hours on the breast isn’t a good indication that he’s getting enough of the milk - and with the weight loss that obviously ringing true.

She had someone who came to the clinic who supplemented before her breastfeed and her child had the best breastfeed.
She thinks the NHS are 18 years behind and not sure why they give cups.

What do you guys think?

Also, why give only 30 ml, if the child wants more, give the child more.

What was the job role/qualification of the person who advised you?

https://milkmatters.org.uk

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I think lots of that is useful advice.

Try and think of it is the main aim is to get her to gain some weight, second aim is to protect breastfeeding and get her full time on the breast if poss.

So to do that, breastfeed first (and I agree with no longer than 20mins) then top up. Pace feed carefully and let he have as a much as she wants. Once she's gaining weight you can look to reduce these top ups. Breastfeeding is a lot of effort for the baby if they aren't transferring well, you might just find that once she puts a bit of weight on she'll find it easier and the top ups can drop quite speedily after that.

Agree that wanting to feed frequently also isn't an indication that she's getting a lot, but it's a good sign that she's alert and letting you know she wants milk.

I've taken so long writing that that I can't remember what the other points were but in general I think youve had good advice. Hang on in there, it doesn't mean the end of your bf journey at all. Best of luck x

And to add, probably the tongue tie will need to be cut. I have never heard of gaining weight being a stipulation of having that done but I suppose it prioritises the weight gain.

Well I used to the cup first and she spilt most of it. I can’t waste precious breast milk really so looks like a bottle will be better.

OP do you live near Brighouse or was that just coincidence? We were cup feeding for a few days but tbh baby needed so much milk after then it wasn’t efficient at all. Once he got on the bottle he was much better and gaining weight. My DS was 5lb 6 when born and dropped to 5lb so getting him to gain weight was a priority, tbh it overtook my desire to breastfeed as he just didn’t have energy to latch. I did pump though.

OK, so using a cup with a tongue tie is not always successful. DD2 had a 90% tongue tie and I was actively told not to use a cup by a private specialist who used to work at the biggest tongue tie clinic in the country, because the tongue tie means the cannot lap effectively. We used bottles. That might be why you had a lot of spillage.

I would second everyone saying to get it divided privately if funds allow. When I phoned our nearest place on the Thursday, it was done by the following Tues.

Topping up with a bottle absolutely does not mean the end of your breastfeeding journey. DD2s tongue tie wasn't found until she was 8weeks old. I had been breastfeeding and topping up for the whole 8weeks. I still went on to breastfeed with formula top ups for (currently) 7 months. You will likely do even better than us at getting off any top ups because the tongue tie has been found much earlier and DD2 wasn't having poos because she was losing so much weight. So please don't be disheartened if you need to give the odd bottle of formula to give an energy boost for more cluster feeding.

I agree with this too ^