13% weight loss at Day 9 - shall I start formula feeding?

[AlienLady]

As above the title.
we are being admitted to hospital. I really want to carry on breastfeeding. I was actually going to try combine feeding tomorrow to start hopefully gaining weight but I’ve been admitted today and I can’t stop crying. I am not sure what the outcome will be or what I want to do. I’m not sleeping. I feel like I am failing as a mother even though I am trying to give my DD the best start in life. I wish the midwife on day 5 weighing told me to supplement with formula to begin and not just expressed milk (I hardly got any) and maybe I wouldn’t be here.

You are not failing. I'm sorry you've been admitted, that must be stressful but there will be good support on the ward. Are you breastfeeding or pumping and bottle feeding? Absolutely no shame in combi feeding if that works for you. Has your DD been checked for a tongue tie? If breastfeeding, does she have a good latch? These early days are so hard but they do get easier.

I'm no pro but have been there, expressing failed for me and baby was dropping weight. we were admitted and they started topping her up. whilst I was in every time my baby moved I fed her, if she burped, I fed her, wriggle, fed her, before nappy change fed her, after nappy change fed her, never left her more that 2 hours between feeds. She slept on my chest in my pj top during the day for lots of skin to skin. Some midwives were more understanding than others, I topped up at every 3rd hour feed. don't let them time breast feeds or make you swap sides every 5 mins, let her feed until she's done then offer again when she next wiggles.

can you ask them if they have a breastfeeding specialist who comes in? who can check latch, position etc?

There is no harm in topping up at all and not everyone can express. By 4 weeks I was feeding without top ups and DD was gaining weight - we just had a bit of a bumpy start.

@AlienLady on your other thread, you have had so many lovely replies from posters offering you lots of support (i think you are at nearly 200 replies now!). If you go back and read them all, you will see lots of successful stories from posters who have offered formula when baby's have been having a big weight loss and it hasn't affected their breastfeeding journey at all. I can tell by your posts that you are super stressed by what is happening, but you need to think of your mental health, your baby's physical health and supporting your older child as well.

If you want to keep breastfeeding, then keep going but stop after 20mins. Do the switch feeding and breast compressions as you've been recommended. Then give baby the little bottles of formula. We gave around 40ml every feed. Get someone to bring a load to the hospital for you if you haven't already got them there. Once baby's weight is up, you will be able to consider what you want to do next. That might be formula, it might be breastmilk or it might be both. There is no shame in whatever option you choose.

Trust me from someone who has been there with both of mine and has successfully combi fed for 6months plus, right now, getting you both back home is the most important thing.

Wishing you lots of strength and baby lots of weight gain in the next few days!

Hi there it's a midwife with infant feeding experience. Your baby will be seen by the neonatal doctor at some point in the night I presume. They work 24/7. I am hoping you will be seen by a lactation specialist tomorrow, they tend to work 9-5 Monday to Friday. I wonder what kind of birth you had. If it was Caesarean section or you suffered a large blood loss your milk might have been slow in coming up. There could be other reasons your milk supply is low. Listen carefully to what the neonatal dr has to say. In our hospital we manage anything below 12.5% weight loss in the community. Is there any room for negotiation? Don't despair even if you need to give a bit of formula. Get some sleep and then start pumping after every feed to increase your milk supply (or at least as many times as you can in 24 hours). Always offer the breast first. I feel you would benefit hugely from a comprehensive lactation specialist review (sadly, many neonatal doctors don't know as much about breastfeeding as lactation specialists). You need to somehow make it till morning. Please don't beat yourself up. First baby is a massive learning curve, you are not alone. I hope it helps

I was exactly the same last summer and being readmitted was awfully as no one on the ward really bothered to help us!

Pumping wasn't really working for me either!

We did formula top ups after BF didn't really have a schedule we just offered more if the feed hadn't felt good we called it out combo feeding mash up but it worked and I carried on until 9months and we're signed off the HV for weigh ins at about 3months!

During this my dad was in hospice care and passed away when baby was 10 weeks old so getting out of being back in hospital was my number one priority so he could meet them!

I can now look back and be proud even at the time I felt utterly rubbish..... bloody hormones!

Hang on in there it does get easier

Have you been seen by a fully qualified lactation consultant? Has baby been checked for tongue tie? Any jaundice? Is baby alert, hydrated and well?

There are lots of things you can try to improve feeding and increase your supply but at this point take medical advice as to whether a little formula may be necessary as a temporary measure.

Please also remember-

-Giving formula does not mean stopping breastfeeding and you may be able to return to exclusive breastfeeding or continue to combi feed long term.

• You are NOT failing. Struggling to breastfeed isn't a failure. Using formula isn't a failure.

• You are important too. You need sleep and you need to be kind to yourself. A healthy, happy and mentally well mum is so important.

Were you induced by any chance OP?

I ask as the fluids you're given during induction can artificially increase birth weight slightly.
Once these extra fluids are excreted, baby's weight can seem to drop too far, when actually, they were slightly raised at birth

I was in a similar situation, and the only reason I continued EBF (exclusively breastfeeding) was because the health visitor who sent us to hospital was pro breastfeeding and told me that it's entirely possible to improve this without formula (if that's your wish) and we did. I pumped between feeds at the hospital to top up her milk and gave it to her in a little cup which was a NICU trick. She was born small (5lbs) and was also re-admitted with jaundice so weight was very important but she got better and put weight on this way. Most of the doctors at the hospital were quite pro formula and I'd of just done what they said if I hadn't been lucky enough to have a few knowledgable and supportive breastfeeding specialists who enabled her to gain weight through breastfeeding alone and gave me the confidence to request that route.
If you want to top up with formula that's obviously absolutely fine and fed is best! But if you do want to exclusively breast feed I had to reply to let you know a similar story with a positive outcome (continued BF til 1yr+ despite the rocky start)
Wish you all the best, follow your gut, it's so hard when you're feeling so vulnerable and just want what's best for them. Hope you get lucky with some supportive staff there x

So I’ve got discharged.
they did blood tests and everything was fine. They observed her and thought she was alert and hydrated.
sent me home with a feeding plan of breast and then 45ml formula top up. She drank 70ml of pre-made formula there too as I just couldn’t bring myself to breastfeed.

my DS had tongue tie and I ended up formula feeding from the start.
he had various health issues like bronchilitus and the first question I always got asked was “is he breastfed?” So it made me feel like it’s because I didn’t breastfeed that he had health problems. he’s now healthy. But now I am having problems with breastfeeding, what gives?

I am starting to hate breastfeeding now. I am not a fan of bottle feeding either. I think I am just shocked that I could have so much trouble with breastfeeding. No one tells you about the problems.

I think I’ll follow the feeding plan and introduce one bottle of formula a day. I was going to do this anyway.

My friend has a DD who is a couple of weeks older who is now showing signs of reflux and is ebf and isn’t throwing up all her feeds. I am dreading that stage too. it’s a rollercoaster.

Thank you all for replying to me. I don’t know what I would do without your support.

Honestly it's normal for bf to be very tough the first few weeks and feeding plans are way more common then you would think.

Do you have a local bf support group that you can pop to?
I was on a feeding plan with DS1 I would pump for 30 mins after a feed to help stimulate but its a fine balance act. As much skin to skin as possible if you have a kangaroo top or soft baby sling this can help. As you will relax more which will help your supply.

It does get easier (we did feeding plan for 2 weeks then went to bf full time). Just make sure your pace feeding the bottles - Google it this makes it easier for baby to switch between the 2. We also found Minbie bottles they couldn't gussel on the xs teet - check in with your local fb mums page someone usually has them available.

Hi there it's midwife again. Great to hear you are heading home. As others said feeding plans are unfortunately very common. We midwives are told to support breastfeeding. However we are often not allocated enough time to actually do it. And then women like you end up being traumatised by theexperience. It's very sad. You do need to get yourself some sleep first. I would also say, to give breastfeeding the best shot you need to find your local breastfeeding support group. You also need to pump a few times a day I would say. If you baby is having 45 ml formula top up after every feed you milk supply could go down very quickly. As I have said earlier, neonatal doctors often aren't the best people to advise on breastfeeding, sadly. You have done amazing so far, give yourself credit for where credit is due. I am sorry to hear your firstborn was unwell with bronchiolitis. Was he admitted to hospital? Breastfeeding mums get a free meal at hospital, bottle feeding mums don't. I suppose it's because the hospital thinks a hungry mum won't make enough breast milk. This might be the reason you were asked

Further to the earlier post... the hospital will always provide formula to a sick baby. I suppose it's only fair the breastfeeding mums would get a free meal

So to add to the confusion,
I have come home, my breasts feel really full..the fullest they’ve ever been and my child is breastfeeding beautifully. Great latch, chin where where it should be. Sucking how it should be. No pain. Let go of the breast herself after 20 minutes each other. this is after I gave her a teat and a bottle.

I don’t want to do the formula top ups but how can I go against the doctors advice as well now. Maybe my breastfeeding journey isn’t lost… I still would like to add one formula bottle. I feel optimistic.

Just top them up with formula and keep going with breast feeding and skin to skin as much as possible. Get a wrap and just wear them in you chest and offer every time they root for the smell.

Your milk will come in once you’re less stressed so don’t fight the tide and just make sure baby is fed and warm

You are not a failure

Babies are group projects not a reflection of your success or failure

My baby had some top ups at this vulnerable time and went on to breast feed happy til self weaning at 1

It’s ok to trust yourself but do listen to medical advice.
If it were at the point we’re not doing so would be dangerous they would have kept them in.

Be prepared to give formula but if they’re feeding well for now you don’t have to yet

lay around and cuddle with them and drink looooooads of fluids

I would continue with the feeding plan for now OP, your baby needs the extra calories and you need some rest. You can't continue on with not sleeping, the stress will affect your milk coming in.

As another poster said, it's really important that you get some support with this going forward so look up your local breastfeeding support group and maybe investigate some local lactation consultants that you can call if needs be?

Formula all the way

It angers me so much, this relentless pushing of breastfeeding on new mothers

Get your little one on the formula and move on

Stop being stubborn and follow the advice the doctor in hospital gave you and the midwife on here. It is important to give your child the formula at this point to help them catch up. Formula is not bad for children, it saves lives when breastfeeding isn’t working. They are recommending it for a reason and they check baby’s weight for a reason. It is worse for your child to lose weight than for them o have formula.
As someone who has been in a similar position, I find your reluctance to give the baby formula bordering on irresponsible. I know your past experience has been traumatising to you but don’t let that past experience harm this baby. Give the formula and pump after each feed to increase your supply. Pumping is annoying and it is hard work but it works.

I went through a similar situation... Admitted to hospital, etc. A very wonderful lactation specialist helped me. I used something called a supplementary nursing system to ensure baby was getting enough while also improving my milk supply. A supplementary nursing system is essentially a straw that you can put into a bottle of formula / expressed milk so the baby can be latched on and breastfeeding (and so giving your body the important signals to make more milk), but also having its fill from the extra milk. You'll want to ensure your baby is getting everything it needs, so I wouldn't not give formula if that's what the hospital have advised. I had a relentless few weeks of feeding, pumping, etc. but bf successfully till 16 months with the first and it's been very easy with my second, which I'm very grateful for. If you can afford a lactation specialist, I think it was the best money I've ever spent.

All this said though, please don't feel like a failure if you combine feed / decide not to breastfeed. I'm very pro breastfeeding due to the benefits for mum and baby - but formula has its benefits too, and your mental health and wellbeing are incredibly important. And fed is best! Breastfeeding support (for women who want to breastfeed) is woefully inadequate in this country. And women shouldn't be pressured into breastfeeding if it's not right for them. Separate note - I ended up complaining to my hospital for the appalling / unhelpful treatment I received when I was struggling with breastfeeding. I had my second baby at the same hospital a few months ago and it was a joy to see how much support they now offer mums who wish to breastfeed. If you had a bad experience at the hospital, it might be worth giving them some feedback at some point if you feel up to it.

Oh my goodness, yes, give your baby formula now, today. It is outrageous to wait. Feed your baby!

Fantastic that she is having really good feeds is your HV coming out to see you?
If so discuss with her the feeding plan isn't that its forever and then you gradually reduce.

Given your just out would follow it a few days/a week make sure weight is going up then discuss with HV. It was typical that you would then reduce the top up to every other feed then a few days later if weight still stable/going up then every third feed. After that you reduce the volume (I was reduced to 30ml) until no top up required.

Make sure you are pumping or as another pp stated a nursing system for milk stimulation. As said previously fins your local bf support group as these women are trained and also very used to feeding plans.
Failing that you can call the NCT feeding line for support.