Can I still EBF? Or have I messed it up?

[SoniSoni]

Baby is today 17 days old. He's being triple fed at the moment and its exhausting. He had TT but it was divided very quickly at day 2. Because of the damage already done to my nipples by day 2 and my lack of information that the output is what mattered (i.e. poopy/wet nappies) that all is ok. But by day 4/5 I wasnt producing milk fast enough that I gave baby top up formula as he was constantly crying with hunger and because my nipples were on fire (both were mishapen - "lipstick nipple"). For a whole week after I had the baby blues and felt so guilty that I ruined our BF journey by introducing a bottle to him so early on...I also felt by then that he had a bottle preference. But since having gone to a few infant drop in sessions and a visit from an IBCLC, I have the right flange size for the times I express which I do after every bottle feed (I have hired the Medela Symphony and express 8x in 24 hours) and baby's latch has been checked and is ok. Apparently his TT is also ok. But why does my baby still cry in hunger after being on the boobs for 45 mins? tbf he does the suck-suck-suck-swallow rhythm which makes me think my milk flow is frustrating for him...or am i not making enough milk at 17 days pp? I really want to be able to BF 90% of the time with the odd BM bottle. I want to drop the formula completely. Every time I express all I get is about 50-80ml total which is almost enough for 1 feed...but then other times baby is still hungry and will want another 50ml formula top up!

I always put baby on boob first, even if its for 5 minutes before he starts crying. then I'll give him a bottle to top off if he needs it (which he always does!).

My question for you mums is - has anyone else experienced similar with their babes and were they able to turn things around in the coming weeks, and be able to EBF/mostly BF? What am i doing wrong?

Any advice is welcome. Have I messed things up?? 😞

Your baby is much better at extracting milk than the best pump in the world, so any amount you express is irrelevant to how much you actually produce. I couldn’t express for love nor money and I exclusively breast fed both times! Both kids were fine.

Are you offering second boob after he’s finished with first? Your body will make enough milk, just let him suck for as long as he wants.

I wouldn't judge based on pumping, I never got much pumping but EBF until mine was nearly 2 years. Are you offering both breasts? Are you doing compressions during the feed? Lots of skin to skin? It is normal for babies that age to feed very frequently, some babies prefer to snack often. I'd stop pumping, plan to spend a few days mostly at home doing skin to skin and basically feed the whole time.

As noted, babies are generally much more efficient than a breast pump. Even the hospital grade ones. Do as much skin to skin to help boost milk production and release oxytocin. Offer both boobs when you feed and look at different positions which might be more efficient for your son to feed

My eldest preferred to feed with me lying down at that stage and she was next to me, my youngest did better with the rugby ball hold. Unfortunately babies have not read the manual.

Is he coming off by himself after 45 mins or are you taking him off. Eldest baby would suckle for comfort after she'd finished and fall asleep.. she would then cry when I took her off as she'd been cosy and content until I moved her.

It’s normal for early days feeds to take 40-60 minutes with baby falling asleep during / needing a nappy change during then back on.

If BF is important to you just focus on that. As someone suggested have a couple of days mostly topless and just feed. How is babies weight?

You can turn it around. I had to put baby on formula on day 3 because of jaundice. I kept up BF as much as possible. Using a Hakaa pump alongside feeding got the most output from me compared to an automatic pump. The schedule was brutal. I spoke to a lactation consultant as well for support.

I think by week 4/5 baby was almost EBF. I remember having the usual bottle of formula ready after a BF and baby just didn’t want it. And that was it.

Keep it up but if it doesn’t work out it’s ok to not EBF. For my first child we had a very similar story with jaundice but he didn’t really want to latch apart form night feeds, so we stuck to formula during the day. At 8 months he decided to latch on (while standing!) and you could see he’d suddenly realised it was nice! We did a lot more BF during the day after that and it carried on past 2 years.

This sounds very similar to my experience, although we didn’t get the tongue tie diagnosis as early and also I had a C section so my milk was slow to come in. I stuck to the triple feeding for nearly three months and it almost drove me mad (although we had managed to vastly reduce the amount of formula by that point).
Long story short, I ended up having to exclusively breastfeed from 5 months as LO had a cows milk allergy and refused the dairy free formula. I then fed until he was 2! So, if I could manage the switch at that point, I think there is plenty of hope for you to do it! Good luck!

You sound very determined!
Personally, remembering the mangled state of my nipples at 17 days in (shudder), I couldn't think of anything worse than trying to pump. It's really important that you get them healed and comfortable so you can enjoy the BF journey. I would say it's better to do the odd formula bottle then risk damaging them more while pumping between feeds.
I thought mine would never heal but they did, slowly, and I ended up doing EBF until 6 months and carrying on feeding until 4. I could have never believed how positive the journey would eventually be when I was a couple of weeks in so don't lose hope.
(But I could only bear to use a pump from about 4 months in)

Not messed up at all. I was in the same boat and now EBF after 3-4 weeks of combi feeding. Keep feeding or pumping every few hours to build your supply and offering the boob so baby can practice latching. I found every "failed" feed so disheartening but now I can see they just needed time to practice and the formula helped keep them fed in that time and the expressing kept up my supply, so it was worth it in the end but it felt like so much work.

Sympathies, it's not easy. Remember though, breastfeeding is really not the be all and end all. I'm now quite grateful for our drama at the start because he takes a bottle now and I can confidently leave him with DH if I need to, whereas I know plenty of people who can't ever be away from baby for even an hour because they totally refuse a bottle.

Thanks ladies - yes I am offering both breasts when he does latch on...and yes I always compress to help baby to know there is milk there. And im doing lots of skin to skin. And when he is on the breasts, he will come off by himself before i offer the other one. And someone asked about baby's weight....he got weighed again yesterday (day 16) and he has now surpassed his birth weight which is good... but then I am not surprised since he's being combi fed (day 5 he had only lost 5%). Today, after my post, he managed to latch on for a couple of hours on and off across the day and there was audible swallowing and sucking (yay!) but after he came off he cried so much and ended up having a full bottle feed after... this is where I am confused... is his tongue tie recovery stopping him effectively withdrawing milk from my breasts? or is he just a greedy baby?

Maybe he's cluster feeding. They go through these seemingly insatiable periods, cry for more as soon as they've finished. You just have to keep putting them to the breast even if it seems like there's nothing left. It will turbo charge the supply.

He may be a hungry baby. His weight gain would chime with that. It is entirely possible he finds bottle easier. That doesn't mean he can't do breastfeeding. You could try an interim step of a supplementary feeding system so he is breastfeeding but less frustrated by it. You run a small tube alongside your nipple so he gets both at once.

Nursing Supplementers – La Leche League GB https://share.google/bBy7FgvkcHp4iON5G

One of the community midwives near me was a lifesaver, she gave me a nipple shield and showed me some different positions and how to check her latching, it made everything seem to work so much better. She had tongue tie too, which wasn't originally picked up but was dealt with at around 3 weeks. Our girl was on formula as well as breast milk for the first three weeks ish and as my supply caught up, she just didn't need the formula anymore. But for the first week she would have certainly had more formula than breast milk, so it can be done.

She's 6 months old now and has gone from 7lb birth weight to 13lb which seems OK. She hasn't tracked the growth curve perfectly and is a bit lower now than initially but she has followed a smooth path and is healthy and happy. We've just introduced some puree'd foods in the last week which she seems to love so I'm expecting her to start putting on weight a bit faster. She feeds for around 45 minutes to an hour then it will generally be around 2 hours after the end of her last feed that she is ready for another. She goes from 10pm or 10.30 to around 5 or 6am without waking most nights now, probably 2 in 3.

I would consider ditching the bottle and just keep switching sides and cluster feeding. It will take a few days for your body to catch up with milk demand. Plenty of rest, good and fluids for you.

Have you someone to look after you and the baby so you can just feed feed feed?

I went through agony with damage from a tongue tie and slightly imperfect latch with my first and nipple shields were my saviour - they come in different sizes.

Feeding from a bottle is much easier for the baby which is why they say to not introduce them until breastfeeding is well established.

Don't panic. This is totally resolvable. Just because baby will take a feed after they've been breastfeeding it doesn't mean that they are not getting enough milk. Cluster feeding is very normal at this stage. It's the baby putting in their order for future milk.

Have you tried using nipple shields? That can make it easier for them to latch. We needed them for the first six weeks or so after tongue tie division, and went on to feed for a long time after.

The other thing you can do to help if you feel you need to give top ups is to do it in way that is less likely to create bottle preference. Finger feeding is great because it mimics the natural sucking motion. If you do bottle feed use the paced feeding method.

You're working so hard. I expect that in a few weeks baby will be a champion feeder.

This explains finger feeding well. https://www.ouh.nhs.uk/media/zwjlokaf/104268feeding.pdf