breast feeding, expressing and not putting on weight

[GrainneDan]

I've read all the entries regarding this topic, thanks to everyone who has contributed their words of wisdom! I'm hoping for more...

My little one is 25 days old and up until yesterday was exclusively breast fed (apart from a scary 12 hours over last weekend on a paed ward with viral gastroenteritis where she had diorylite via an ng tube). Unfortunately she hasn't yet re-reached her birth weight of 3.56kg (more stress for me!), so the HV has advised expressing and top ups of formula. When on the paed ward I expressed only 40mls (that was the total from both breasts??) and yesterday, about 10mls from one breast (it was sore and I was upset, so gave up after 20 mins) . I am so worried and convinced that the reason she isn't gaining weight (despite 2-3 hourly breast feeds) is that I'm not producing enough milk or she's not getting any hind milk (although she does "feed" for up to 40 mins on a single breast and I thought this would be enough time?). This is compounded by the fact she had her longest sleep to date last night after the formula (4 hours)...

Does anyone have any advice/comments? I'm on the verge of giving her only formula, I'm so worried about her weight? Thanks.

I can understand your concern, GrainneDan.

Without knowing the full story, it's hard to be sure what's happening, but are you only offering the breast one side at a time? If so, then this is the first thing to change - feeding one-sided only reduces* the supply of milk (which is why it is the first thing to try when mothers are burdended with an overwhelmingly abundant milk supply).

To increase your milk (and the milk going into the baby)

• feed on two, three or four breasts per session, switching between breasts when the baby seems to lose interest
• use breast compression (google)
• keep your baby skin to skin with you for as much of the 24 hrs as possible so you can feed often and responsively (2-3 hourly may not be enough to build up and maintain a supply)
• feed often at night

Hind milk has nothing to do with keeping the baby on the breast for a long time and anyone who is suggesting to you that it does should not be helping you to breastfeed - it really exposes their lack of understanding.

What is her weight exactly now? Is she gaining or losing? What about her poos and wees?

If you're keen to bf, and you sound it , then there is every chance of you rescuing this situation

Grainne - where are you?

Hi.

Thank you so much for your reply. I will do what you suggest!

She was 3.56kg at birth and is now ~3.2kg and has been about that for a week. Poos and wees are plentiful, although I have noticed more wee since topping her up with formula?

I'm going to catch up with a BF expert to check her latching on technique (and my expressing technique) to hopefully get things back on track.

Thanks again for taking the time to reply,

Good that she is not actively losing, Grainne, but I don't think this means all is 100 per cent ok.

Good that you are going to see a bf specialist.

How much formula is she having? Are you able to use ebm instead of formula?

Had someone told you to feed one side only???

I'm not sure what's going on with her weight either and it is a huge concern. O can only be happy that she wasn't very little to start with? Fingers crossed lots of feeding will beef her up a bit...

Yes I was told to single breast feed because she had symptoms of colic to make sure she got hind milk rather than lots of lactose rich fore milk??

Expressing not going great. Painful and I only seem to get ~10mls?? I think I'll have a go with the domperidone, if only to reassure me that it's not supply.

Thanks!

re: expressing. This is going to sound really silly, but I find that my posture whilst pumping makes a difference. I have no idea why. In other words, if I slump, hardly any milk comes out, whereas if I have reasonably good posture, it makes a difference!

I am not accusing you of bad posture

Did the pump when you were on the paed ward make a difference? They are usually the high tech ones, aren't they?

Sorry if this isn't brilliant advice, but your neglected breast must be hurting!

GD I'm sorry you have been given bad advice (not on this thread).

You need to feed from one side, and when feeding slows, offer the other side, and when feeding slows, offer the first side again and keep going!

You need to keep this up for a few days, so get some support for you, i.e. making you meals, shopping etc.

Set up 'feeding stations' in your house. I.e. in front of the TV with remote, snacks, drinks, phone, novel. Or in bed!

Don't let her go for more than 3 hours without waking her for a feed (but in reality try to feed more often than that).

Don't waste time, energy or stress on expressing and bottle-feeling! You can top-up directly from the breast!

Expect an improvement in 2-3 days!

Don't think about hindmilk/foremilk. It isn't relevant!

HTH

ilovemydog
I find the same thing re: expressing and posture, thought I was imagining it!

Grainne, feeding one sided only is only ever sensible when the mother is over-producing, or when the baby is clearly thriving and only ever wants one side at a time.

It's never a good idea to deliberately offer one side only with a very young baby, as the risk is you reduce the supply.

Hope things go better from now on.