Struggling but determined to BF when having to FF my 5 day old for jaundice

[digitalgirl]

Sorry - this is a bit long.

My DS was born at 36+5 last Sunday. Had started breastfeeding as soon as he was born, but colostrum was very limited so assumed it was more of a practise for DS than a feed. Was told in hospital that I had to top-up feeds with formula as DS is jaundiced and dehydrated - and was kept an extra night. Convinced I wasn't breastfeeding properly and asked for help - was shown how to position and DS has a good latch - but after a night of bottles he wouldn't suckle. Wasn't allowed to leave the hospital until I agreed to 'top up' with formula in order to combat the jaundice. They would have preferred me to stay in order to establish breast-feeding, but my milk hadn't come in and I didn't think staying on a sweaty, busy, uncomfortable post-natal ward would make for a better environment than being at home.

I've been offering my breast before and after every 3 hourly bottle feed. I've been lying on the sofa getting as much skin to skin as possible. But up till today DS refused to actually suckle. He would latch on but fall asleep.

Finally on day 5 my milk has started to come in (after a painful session with a breast pump yesterday). Thought I had a breakthrough this morning when DS spontaneously suckled on my breast after a routine bottle feed. Then he didn't for the rest of the day. Each feed I expressed a few drops of milk onto his lips so he would always get a taste for the real thing before getting the bottle.

If he's hungry he'll furiously root for the breast and latch on, but then immediately get frustrated when the milk doesn't immediately arrive, even if I've expressed a few drops in preparation. He'll push it away, then have another go, then cry and fidget.

The rest of the time he's too sleepy to do anything but accept the bottle and feed whilst asleep.

This evening he did the furious rooting thing. Got very frustrated very quickly so I alternated with bottle and offering breast more often to see if that would make a difference. In the end he finished his feed and was still hungry, but couldn't get what he wanted out of my breasts and had a massive cry, was very upsetting for me. I didn't want to offer another bottle because I thought that would just make it worse - and that this was the best time to get him to suckle again.

It was tough, but in the end he managed 5 minutes on each side.

This was my first day of my milk coming in, will it get easier now or should I be expressing in between feeds to get my supply up so it's easier for him to suckle?

Am off to bed for a bit, but will check for responses in the morning. Thanks in advance!

Don't feel bad likessleep. Sometimes I'm more worried than others don't take it personally. It's good to know that other people have been through the same thing & that next time if I have any probs, big or small, I'll be able to come on here. It didn't help me that my mum & sister are both oddly anti BF so were encouraging me to FF at a point when I really needed support to continue BF. Me & my sister were both FF & my sister refused to even consider BF, in fact she said it was disgusting. Apologies for veering off topic but am I the only one who thinks it's very odd to regard BF as disgusting?

Claire236 - no you're not! I remember when Jordan made that comment about not wanting to breastfeed - can't remember exactly what she said now but she was obviously grossed out by the idea. I thought that was really sad - that's what our breasts are there for (primarily) and I took such pride in my body being able to produce the only food DD needed for the first 5 and half months of her life. Now 9 days away from the arrival of Number 2 and hoping desperately that he takes to BF as well as his sister did - planned CS this time at 39 weeks so who knows?

BTW Digitalgirl I think you are doing great and reading the other posts on this thread shows that it IS still possible to establish BF even if it's very difficult at the start if you are determined enough and make sure you get the support you need. It might be worth making a list of all the reasons you want to BF so that if you find yourself feeling like giving up you can use that to keep you going. I really did have an easy time with DD compared to a lot of people but I remember the terribly sore nipples and dreading feeding time for the first couple of weeks until it stopped hurting (every couple of hours, 40 min feeds, I felt like a cow!) My DH (helpfully!) said I could FF instead if I wanted to and that just spurred me on all the more as I had been so determined to BF in the first place. My main reason was because it's so good for the immune system. I was FF and caught every illness going as a kid. We also have a strong family history of food allergies on my side. I read that BF until 6 months reduces the risk of allergies as well as boosting the immune system, and DD (now 19 months) is as strong as a horse, we catch things and she doesn't, and I can count the amount of colds she's had one hand. As for food - she loves it all and there has been no sign of a single allergy to anything. Of course I don't know for sure it's down to the BF but it's what will keep me going this time round if it's not plain sailing with DS. So keep it up and I hope it goes well with the BF counsillor (I saw one once about boosting my supply and she was great).

I think hospital just wanted to get nutrition into your baby the quickest easiest way which as your baby has already worked out is from the bottle. I don't think that was the best thing to do for a Mum who wanted to establish breastfeeding. I agree with cantsleepwontsleep above that in order for him to really get breastfeeding you have to stop the bottles for a bit. Just keep going, it really is early days and I'm sure he will get it and love it soon. Just keep going is all you can do and get yourself some nipple shields as sometimes when breastfeeding gets going it can hurt until your nipples get used to it, you don't want that to be a further hurdle. I know so many people who had problems breastfeeding for the first few weeks but those who stuck at it got there in the end. Well done for our efforts so far!

So good to hear everyone's experiences on here. Both good and bad, it does spur me on.

This morning was really tough. The routine goes: Waking DS up, offering the breast, cup feeding him my expressed breast milk and then topping up the rest with a cup of formula, offering him the breast again and finally when it looks like a no goer putting him down to spend a painful half hour with the electric pump for the next feed. This takes a minimum hour and a half, then I get another hour and a half's break till the next feed. I know there are women who've had it tougher than me but somehow at 4 in the morning it seems so very very hard.

Am regularly breaking down in tears. I know this is partly hormonal. It's not so bad when DS isn't particularly hungry, it takes ages - but we get through it. It's when he cries with hunger and turns himself purple with frustration at not being able to get what he wants from my breast that makes it really hard.

DS hasn't done any breastfeeding today with each feed, except when we co-bathed, he suckled for about 5 minutes each side - was still preceded by a crying fit. When will he start accepting the breast?

We rang the helpline again today and were told that we're doing all the right things and to keep going. But for how long, when will I start to see results?

My milk supply hasn't particularly increased today, but it hasn't decreased. I'd be happy if I cold see some progress there, at least then we could cut more forumla out. I've started taking fenugreek tablets.

He doesn't really like my breast milk as much as he likes formula. He takes ages to drink the EBM, but then oges absolutely crazy when offered the formula. It's literally a feeding frenzy.

Really really looking forward to tomorrow when we can call someone to come and see us.

you have had great advice here so will just tell you what happened to me

dd was born full term difficult delivery and was jaundiced soon after, we stayed in hospital for 4 nights and I struggled to BF, the burses/ midwives threatened me, only way I can put it, that I must FF or she would die

I did Ff but kept trying to Bf someone taught me to hand express and when I came home it was a combination of persisting with Bf and expressing

eventually it normalised and I breastfed dd for over 2yrs

many tear I shed on those first days if it wasn't for dh I am not sure I would have managed it

sfx yes - it's the 'keep feeding formula or they die' line the midwives spin that really freaks me out. Even though I've been told not to reduce the 60ml of formula I've been replacing it with EBM and topping up with formula only to 50ml. I figure 10ml of it could probably end up on the bib anyway. Will probably get told off in my next visit (tomorrow).

DG - I think you are doing brilliantly and am full of admiration for your determination! Hopefully you will get a chance to see/speak to a counsellor before your visit tomorrow so you have some good ammunition against the 'must be 60ml formula every 3 hours' rubbish if they try and tell you off
Maybe if they start, ask for advice specifically on how to increase/improve bfing as this is so important to you - then stare at them until they give you some. (you sound strong enough to do this!)
Good luck and you have lots of support on here

Digitalgirl, so pleased for you that you have such good advice here, TikTok and others are absolute gems. I was in much the same situation as you with my DD. You really brought it back to me; it was a terrible time.

I think you will get things sorted out with perserverence. The most important thing is to pump 8 times in any 24 hour period to keep up your supply and just hope your lo will learn to latch on. I wish I hadn´t tried beyond a 10 minute try for latching on, it is so so difficult when your baby screams and screams rather than latching on.

I´d be very wary or cup feeding. My DD became an expert at it within a couple of feeds. She would bf ok from mornings to afternoons but (I presume) as soon as bfing took more effort would howl for the cup. Within a short period she refused all bfing, first in evening, then afternoon, then night. So anyone thinking of cup feeding, do it very very slowly...

I managed to express and bf for about 6 weeks till it just became just too exhausting with another child to care for and take to school. I think bfing as much as possible and giving expressed milk as necessary is the way to go for now, in the hope bfing will become established.

Hope you find a good bf counsellor. They really are a fantastic help. And they will expect you to be a nervous wreck. I know I was.

Oh, very important, pumping should NOT hurt and it sounds like you´re pumping for a very very long time - one and a half hours...? I think I was recommended 20 minutes each side. Tik Tok et al please advise.

If I had to do it again I would also get a double pump and half the time expressing. I would also check that the shaft of the pump was the correct size. eg. you shouldn´t rub against the plastic.

DG my DS was a very, very reluctant feeder. A BF counsellor suggested I did the following and it helped enormously. Unfortunately BF didn't work out for us in the end but DS did latch on after trying the following whereas he would not ever do it beforehand:

1. If bottle feeds have to be given then take off your top and put your DS in a position akin to BF and feed him with your nipple right next to his mouth. This helps him to associate feeding with your breast a bit and it makes your breast a lovely snuggly place to be instead of somewhere he might feel anxious (as my DS did)
2. Hand or pump express before you try a BF so that you get a let down, which means that your DS gets a quick fix and does not get frustrated by the wait for milk flow
3. If he latches on, use a syringe to drop extra milk into his mouth so that the milk seems to be flowing quickly without too much effort like it would if you were bottle feeding. If you feel it would help you could give formula at these times instead of EBM, as he likes the taste

1 and 2 worked really well for us and I really hope that something works for you soon. Do keep trying - my DS had only fed twice, by force in hospital, when we started the above at about 5-6 weeks. By 8 weeks he was happy to be around my breast and latched on and fed. You can get there in the end.

In the meantime, how are you expressing? In the end I expressed full time for my DS and did it for 18m, so if you need any advice there I have a bit of experience. I am full of admiration for you.

digitalgirl sorry to hear you are having such a hard time of it.
Sorry if this sounds odd but I don't understand why they are so keen for your DS to have forumla to overcome jaundice.
Both my DSs had mild jaundice (both born on time though) and no one ever suggested they had formula, was just advised to feed them on demand. I thought jaundice was very common (think I read that something like over 50% have some jaundice)
Surely if your DS's jaundice was that bad then he would need to be admitted to hosital to have phototherapy?
Not too sure what else to suggest other than the more you feed the more mil you will make so perhaps try to ease up on the bottles, offer more b-feeds, esp at night, and keep up with the skin to skin.
Co-sleeping can make b-feeding generally and specifically latching on much easier IME, sleepy babies often latch on better than when they are wide awake.

digitalgirl can you turn the pump down a bit. there is no need for it to hurt, it won't make more milk. Pump each side until the stream slows down, then take a break and pump til slowdown again then stop. if you double pump switch them round. If you do not double pump see if you can, it ups your supply and is less hard work.

it is a process that will take a bit of time. i did it for a few weeks when ds was in scbu. I must say a session at 3.30am did miracles for my supply.

my ds2 was early, and had jaundice also, the hospital insisted i topped him up with ff, which they gave to him twice and each time he was sick, (i found out later on he has a milk allergy) he was slow to feed and still jaundiced at 7 weeks so had all the tests and was normal so they decided that he had bfjaundice. they told me to top him up with cooled boiled water also.
my hv went mad when they did this and when she found out they tried to ff him also. sadly she has now retired but she was very pro bf and my gp reffered to her as the oracle!!

anyway,
they do get there in the end, he's new to this also and has to learn what to do.
good luck with bf, i really miss it but ds2 wanted to stop (at 16mths) not me!

DG, can you co-bathe more than once a day? It doesn't matter what time of the day or night you do so.

Don't worry about 'how much milk' you have and how full you feel. It is not an indicator of how much you body can make and get into your baby. It sounds odd but true. I was never engorged in the early days though I had a similar rocky start.

Are you topping up with 60mls/50mls of formula every 3 hrs? If so, i am not surprised your baby is sleepy. He needs a sleep to digest all that formula and probably not because he is jaundiced. Please feel strong in the morning and offer less formula. I know that the nights are the hardest. I still remember sitting on the stairs at 4am, weeping while dd screamed in her cot because I was so exhausted and could not face another feed.

Digitalgirl, I won't offer more advice on what to do. I remember when I posted on Mumsnet receiving conflicting advice: Use a cup! Don't use a cup! Offer less formula! Offer no formula! and totally freaking out. So I don't want to complicate things in that department, especially as I am not an expert like tiktok.

When you see a RL bf counsellor, hopefully Jenny!, she will be able to help you. And I am sure she will offer sound advice. And the midwife is coming today, isn't she?

The main thing is that I'm offering a virtual cheerlead from the sidelines! I have been there and it was bloody awful. They will weigh your ds today and you will be able to see how he is doing. Starlight asks about your dp, and that is a good question. I hope that he is doing everything to support you so you don't have to do a single thing other than what he can't physically do!

You ask how long this will go on for, and of course it is difficult to say. To be honest, it took quite a long time for my jaundiced DD to wake up and get the message about how to latch on. (We're talking weeks not days, so she did have quite a lot of formula but also lots and lots of time with my boob). I wish you could see her now, a brilliant bfeeder and round and pink and smiley and nine months old on Wednesday. I don't regret any of the formula I gave her, but I am glad that I persevered with the bf as much as I could. Keep up the good work and we are all rooting for you!

DG I just noticed this thread this morning and have spoken to my friend who lives near us and also had probs establishing breatfeeding. She also saw the wondrous Jenny and has given me her (Jenny's) phone number in case you want to get in touch.

If you do, I don't have your email address but I do have Bucky's (I think) and so could get the number to you tonight that way if you want. Alternatively I can use the "contact a member" thingy if you make sure your settings say you will accept messages.

Take care

Once again, thanks for all the rallying. I keep coming back to this thread to remind myself that it's all worth it. I think we might just get through this!!!

Domestic and MrsHappy Have called Jenny the BF counsellor and she is coming over tomorrow afternoon

Also, had a visit from the most helpful midwife today, I only wish she had seen me on day 1, instead of the woman who nearly pinched my nipple off trying to prove I had colostrum. Despite the other two midwives saying I had a good latch, today's MW showed me the correct technique where I could seeDS open his mouth wide enough. He'd only just had a feed before she came so not the best timing. He didn't suckle, but at least I'm feeling more confident about this latch.
Jenny is coming over half an hour before a feed is due so hopefully we can go through the motions together.

Thanks for the expressing advice, I only pump for 30 minutes, swapping between breasts every 5 minutes. But my milk is flowing a lot more freely today (woohoo!) and have worked out how to set it so it's not so painful. Am happy to swap boobs for now and give each one a little break, even if it does take forever. madmouse I didn't get much at my 4am pumping session - is it case of boosting the following days supply?

starlight Yes, my DH is very very supportive. He's been running around sterilising things, prepping formula, making me dinner, fetching me cups of tea. He's completely supportive of this and I don't think I could have got this far without him. My family are very pro-BF. My mum's coming over tomorrow to ease the pressure of DH so at least he can get some sleep in between feeds too. I've got no excuses!

foxytocin today I'm managing to express 20ml of breastmilk and we're topping up a further 30ml with formula, so beginning to cut down on it.

DS was weighed today and is up 30g on his birth weight, he's gained 100g since Friday. So he's definitely a healthy little monkey, even with the last traces of jaundice.

Just waiting for that day when he actually relearns how to breastfeed and the cup-feeding stops being his main supply.

DG re the expressing, is there any way you can get hold of a double pump? Because it would decrease the amount of time you need to spend attached to a pump (20 minutes max) and pumping both breasts at once boosts supply. You asked about the effect of pumping in the middle of the night - if your DS is not feeding in the night then you definitely need to pump if you can. Not so much because you will get gallons out at that time, though some people do, but firstly because your body has more of the milk making hormone at night which boosts supply, but secondly because if you don't pump or feed effectively for 6-8 hours you are looking at a very long stretch between stimulating your breasts, which will decrease supply.

Some hospitals have double pumps they can loan out (ask MW/HV). You can also hire them from expressyourselfmums.co.uk and from the NCT. I bought Ameda Lactaline which is a fantastic pump and I think better value than hiring - it is £85. Alternatively you could borrow someone's electric single pump and have both running at once (noisy though!).

Both my boys were born at 36 weeks. Both had Jaundice. I was advised both times to formula feed, in fact with ds1 they took him off to give him a bottle. The secret for me was to keep expressing every 2 hours and spoon/cup feeding it to the baby (plus letting baby suckle, but to be fair both boys didnt breast feed from me for about a week)
The sugar levels stayed stable but the jaundice was bad, and lasted for a fair few weeks-but they got over it, ds1 under the phototherapy light and ds2 by himself.

I was SO determined to breast feed, if I hadn't insisted on expressing and cup feeding the resulting tiny amount then I would have failed, the midwives in the hospital were utter shite, had no time to help and no suggestions other than bottle feed.

I feed for 2 years with ds2 and 15 months with ds1.

Thought I'd give you all a quick update.

We've definitely had a breakthrough. DS breastfed at almost every feed yesterday since 6am, except the 9am feed.

After a visit from the breastfeeding counsellor she asked us what we had done at the first feed and perhaps to repeat the same thing and see what happens. She also advised us to start introducing some flexibility to the feeding times now, perhaps leaving it up to 5 hours between one of the feeds in order to give ourselves a break at night.

She said not to drop all the formula cup-feeds straight away, but to work out which feeds DS doesn't seem to be so hungry at and perhaps one day at a time drop the formula top up.

So now DH and I have worked out a system - which although is still intensive - pretty much guarantees we can get DS on the breast for at least 10 minutes, sometimes even up to 20 or 30 minutes:

1. Allow DS to wake-up of his own accord, or wake him up if we feel it's been too long since the last feed (e.g. more than 4 hours).
2. Offer him the breast. (currently always refusing this)
3. DH takes him and cup-feeds him EBM.
4. Offer him the breast again. Sometimes he takes, sometimes not - if not we top up with a cup-feed of formula.
5. Offer him the breast again. Here it's a real struggle as he really tenses up and fights it, but at the same time is rooting for it. Eventually he clamps on (ouch) and starts to suckle. I usually do breast compression whenever he pauses to encourage him to keep going.

When offering the breast I do all the tips an tricks going to make it easy for him. From expressing onto his lips to making sure I've already got the let down.
The battling thing is quiet hard going. He really works himself up which makes me really tense and it seems the only way I can get him to stay latched on is to really force his head to stay there which I hate doing but it seems to work. The difference in him after a breastfeed is amazing, he's completely relaxed and all soft, snuggly and floppy.

What we have noticed is that he prefers the right breast. The only time I've ever successfully got him onto the left breast is after he's had 10 minutes on the right one.
Is there anything I can do to get him to take the right one? Or should we just keep going with what works until he eventually works it out for himself.

Sometimes this whole process can take up to a couple of hours (especially if I take expressing into account) - so it's still really hard work, but hoping for it to settle down over the next week or so.

I'm taking this as though yesterday was day 1 and we've still got another two weeks to go before he settles into his own routine where we can feed on demand and actually start to get on with rest of our lives (i.e. leave the house, perhaps even go for a walk)

wow, DG, you are doing fab fab. in order for him to take the left breast, try the football/rugby ball hold.

DG that is great news

hi digitalgirl congratulations on the birth of DS

Glad you have turned the corner so to speak, I had DD1 at 37 weeks she was severly jaundiced I got all the give her formula or she will die thing. She was readmitted to hospital for phototherapy and given one bottle of formula whilst in there, I used to put her to the breast each feed, then top up with EBM, then maybe a few mls of formula at the end. Then it was more BF less EBM no formula then exclusively BF. I went on to BF for 12 months.

I had DD3 8 weeks ago at home and she had jaundice but I had a lovely MW who let us get on with it as it was normal. She said if we were in hospital she would have been heel pricked every few hours and we would have been told to give her formula.