please help - but milk drying up my tiny baby needs my milk

[lou222]

i've expressed my milk for nearly 3 months for my premature 2 lb boy
and about a month ago started b feeding him
he's been home a couple of weeks now and my milk is drying up
i've just expressed for 40 mins and only got 20 mls
i've been expressing a little as really sore but mainly breastfeeding
i am desperate to keep going but i know he is really hungry
what can i do to up my supply?
i really don't want to give him formula but the midwive is saying we should!!

I could never express much more than 20ml when I was breastfeeding, and DS1 went through a fase of not latching on properly and did exactly what you describe, still rooting, suckiing like mad, crying. After a while I got cracked nipples too. Then the HV helped him to latch on properly, and hey presto, happier baby and cracked nipples disappeared like snow for the sun.

So my advice would be to get somebody to show you how to latch him on properly. It does take some practice with those little ones that don't do it properly naturally, for whatever reason. But it will make all the difference!

hi lou
i am bf peer support for my local area- keep babe attatched orten, more nipple stimulation=more milk supply.call bf helpline, or ask hv if nct bfcousellor in your area can visit, or can go to bf peer support group, or hospital should have bf support midwife, bf counsellor who they can ask to help you. skin ti skin, relax, go to bed with babe and snug up. give your breasts time to build milk supply, as long as you have wet nappies your babe is feeding. if babe is going from one breast to another he/she may be not betting a full enough feed- the longer they stay on one breast the richer "hind" milk comes in adn this is the creamier bit that fills them up. sore nipples will go, don't use scented soaps, rub in b/milk, keep dry, maybe try lasinoh, or camillosan if suitable. relax.
nct b/f helpline-0870 444 8708
good luck

by the way- don't be too hard on yourself, you have every right to be knackered, if you weren't you'd be the first!!
i might be inclined to stop the expressing for a while and concentrate on babe to your nipple. the more practice babe has at your nipple the easier you will both find it to make it work for you. some babes can get confused with bottle feeding technique and bf technique- they are different arts! and if you can find a diff position to feed babe-ie underarm, lying down, babe rooting on your chest, rather than the "textbook" position we all expect to see, you may find it doesn't hurt so much.everything else can wait, so take the time you need to sort out feeding that suits you and your babe.
did you have any luck with tel numbers?

hi i went to the cafe/clinic today that is when they told me i had an incorrect latch
they showed me the right way but i can't seem to do it now i'm home and they are already feeling just a teeny bit sore nothing compared to the pain it was though but i don't want to get back to that pain or go back on the shields

Hi lou, I am so glad they were able to help you at the baby cafe. It might be trial and error learning how to get him latched on comfortably, but don't be afraid to take him off and try again until it feels right - if you slide your little finger into the corner of his mouth it will gently break the suction and you can take him off without it hurting. I know it might make your ds cross in the short term but it is better than you suffering the pain of a bad latch.

Is there any way you can contact the people running the baby cafe to talk things through? Also, do not be afraid to go back or feel that you shouldn't have to ask to be shown again. No one should mind, and remember that breastfeeding is a skill that both of you learn so you should not feel silly asking for help.

Really glad that you have had some help, do keep posting.

i'm so glad that you saw someone- bloody well done!!!! xxx rest and relax, you will get it right. can you go back to baby cafe? is there a breastfeeding peersupport group near you- your health visitor should know, or "sure start childrens centre" near you, they should have some contacts. if you can find a breast feeding peer support group, you can pop along and spend some time just chatting and not rushing getting the latch right, and not rushing feeding. when the latch is right you will notice immediately.

i'm going back on monday suppose i just need to practice
i can't seem to get him to open his mouth wide though
i've probably confused him with shields and bottles at night!!

Have not read the whole thread so you may have already suggested this but I found LaLeche League very useful. Coudl you see if there is a local group - they have experts that you can speak to on the phone. Good luck I know how hard it is to keep bf when you are sore and tired xx

have you tried rubbing some milk into your nipple then teasing his upperlip with the nipple to get him to open wider? then roll the nipple in, starting with the bottom of the breast first, so he gets a decent mouthful, the nipple should flick as his mouth reaches for it. wish i could be ther to show you.

could try phoning local NCT, they will have s.one in your area

if you lie babe on the bed( make nest so he doesn't roll off etc), you could try hanging over him, so yout breast "falls" into his open mouth,again tease his mouth open with your finger lightly tickling his top lip. sometimes this position does help sore nipples too.

Glad you can go back in a few days time - and practice is a good plan You now know that it need not hurt.

One trick I have tried is to brush baby's top or bottom lip with your nipple just before bringing them in to latch on, to encourage them to open wide. Some babies react more to one than the other so try each one out and see what he does!

You have done an amazing job - I know how lonely it is to pump for weeks - and you continue to do it despite having had (from what you say) very patchy support.

i have tried dropping my nipple into his mouth and tried rubbing his nose but i really just can't get him to open wide and have now gone back to the nipple shields as it is painful again
i don't think i can cope overnight much more and may give in to formula for the nighttimes as i am just getting no sleep

Lou,

I know the SCBU nurse have made it sound as if formula is the answer to your problems, but actually it isn't. The more bottles he has the worse his latch will be, as he will be "bottle sucking" your nipples, instead of breastfeeding properly.

Also, how will giving formula at night give you more sleep? You'll have to get out of bed, make a bottle, feed him, wind him, settle him back to sleep and then go back to bed yourself. You'll actually get much more sleep if you can nurse him at night, can you feed him when you are lying on your side? If you can get this technique sorted then you can doze whilst he's feeding. This can help during the day too as you can nap whilst he's feeding/napping, and then you will start catching up on your sleep too.

You have done really well so far, your tiny boy is lucky you are so dedicated, but don't give up now, where are you? Phone a bf support line and see if you can get someone to come and see you tomorrow, or just talk it through some more. Take it one day at a time, you can do it!

Hi, Hope things are improving for you. Lansinoh is fab and you should notice a difference soon. I used to apply it before and after every feed or expressing session. Rest really does help. If you can take to your bed between feeds and just get a nap, the next feed will be better.

I didn't have a prem baby but she was a very lazy feeder and didn't gain for ages. My milk never "came in" so it was hard work for me to build up my supply.

I used to rugby ball hold her to feed one side and express off the other at each feed. (well not if I was out!) The idea is that you trick your boobs into thinking you've got twins! This way you get more milk expressed coz you've got all the letdown hormones working from feeding your baby on the other side. I could still switch sides coz you never express out all the milk that a baby can get to.

Also the 3am feed was my prime time for milk production, I used to be able to get about 4x the amount I got the rest of the day. Eventually I could get enough for DH to give DD a bottle of EBM at bedtime, as a NEVER had enough milk for her at this time of day, and I could get a headstart on sleep, thus helping the night feeds.

Other than that the midwifes recommended drinking whenever you're feeding ie fluid in-fluid out. and spreading your calorie consumption throughout the whole day, as you are now working 24-7. I managed to BF DD for 10 months and was only told about fenugreek tablets in the last month or so, I think they make a difference but don't know if its a placebo effect. Either way I will be using them if I have another.

Good luck, it does get better, I think the first few weeks are hell for most of us.

Hello Lou, hope things are improving for you!

If you have thrush on the nipple/in the breast you may find some pain on latching even if your technique is improving. So don't be too disheartened if there is still some pain.

I had a very challenging time (to put it mildly) bf'ing DD2 ended up at the Breastfeeding clinic at the John Radcliffe in Oxford, what an amazing place that was to go for help. You could stay for the day and they would help you feed after feed it built my confidence so much. Is that anywhere near you?

You say you are struggling to get your baby's mouth completely open. I was advised not to wait to see the mouth fully gaping, by then it is too late, the moment passed and the mouth would be starting to close as they can't hold that wide-open mouth position just like it's tiring for us to do. As much as possible try to anticipate and bring baby to you RAPIDLY as you can see they are starting the 'gape', I remember the bf counsellor saying 'NOW NOW NOW!!!' but I was too slow by the time I got there DD's mouth already starting to close and I was struggling with the pain of an incorrect latch. Sorry if this is sounding patronising as you have been feeding for some time now.

Also I was told that initially a bad latch doesn't stop them gaining weight as the breasts will 'jet' a certain amount without the baby needing to feed particularly efficiently. But this does change over time and they will need to learn to feed efficiently or the weight will start to slow/drop and they won't be content after a feed etc.

Keep asking for help, it is worth it!

thanks again
i don't want to give in to formula but am just so exhausted at night
for example last night i gave him 100 mls of my frozen ebm it only took 15 mins to feed him and he settled after
when i am bfeeding him it takes over an hour quite often 2 and then along time to settle him as he still seems hungry as he just cries and cries
that is what is making me think formula would be easier at night so he would be more content as i only have about 4 bottles left in the freezer.
i'm going to the bfeeding clinic again on monday but my nips are extremely painful again so i know i am not doing it right
and no nothing you tell me sounds patronising as i clearly have been feeding him with an incorrect latch for so long without realising it
i think as he was so weak to begin with and just had a couple of sucks and then zonked out that now he has a good suck i think that is a good latch !! I realise now that's not the case
thanks again you are all keeping me going

Lou the bottle feeds will always be faster, they don't have to work to get the milk like they do when they are bf'ing, there's no 'calling' for the let down. Plus they get more enjoyment and comfort from bf'ing so they probably take longer as they are enjoying it more! But no help to you at 3am, I know.

I 'gave in' to formula too, after three consecutive weeks of no weight gain, and trying very hard with positioning etc and battling thrush, I was so worried about dd not getting enough nourishment for essential growth and development so I made the decision to stop bfing completely. Interestingly the HV was not worried, but did say if she crossed over two lines (on the weight chart) we'd have to look at supplement feeding. So at least I wasn't pressured to make my decision but I probably did make it too soon, but no point in regretting that now - she's about to be 2!

You are doing brilliantly! Don't lose sight of that. Don't feel bad if you give formula at night to help you get a rest, you're doing this on your own and you need as much sleep as possible to help you cope and be a happy mummy.

Hi Lou
Looks as if you are getting lots of good advice from others here and I don't have anything else to add on that front. But just wanted to say that you have been doing a fantastic job with your DS. Having recently had a DS at 29 weeks I have some idea what you are going through. But doing it on your own is really tough and I am full of admiration for what you have achieved already with your feeding him - and for your determination to continue.

You mentioned that you now think your latch might not be quite right, having thought (and been told) that it was. I experienced something similar - as you say, when your little one becomes bigger and stronger (which is brilliant) it becomes more obvious that the latch isn't right. I spent quite a number of weeks after coming home from SCBU trying to get comfortable and wondering what was wrong. I got advice, which kind of helped, but in the end we muddled through and it just gradually got better - I think my DS's mouth getting better also helped. I too had been told in hospital by a BF counsellor that the latch was fine. But to give her credit, at that time it also felt comfortable...ish - two weeks later it felt rather different.

Do hang in there. But I agree also with the advice not to stress too much if you do need to use some formula. I was very close to quitting at times but did manage to keep going without formula in the end. But only you can judge what is best for the both of you - everyone's circumstances are different. You have been through a hugely stressful experience and have coped brilliantly. But you need (and deserve) some rest, and IMO at least, giving the odd bottle now might be the best way of keeping going with the breastfeeding in the longer term (I know others will disagree, but my son has coped fine with tube, breast and bottle feeding with EBM and after our early problems we are still Bf at 8 months)

Lou, here is a link to help you with your latch - seeing the bf support person is probably a good idea, but it may help to remind you of the technique in between visits. Particular points to help you to get your baby to open wide are here

WIDE MOUTH / GAPE

Need mouth wide before baby moved onto breast. Teach baby to open wide/gape :

? move baby toward breast, touch top lip against nipple
? move mouth away SLIGHTLY
? touch top lip against nipple again, move away again
? repeat until baby opens wide and has tongue forward

? Or, better yet, run nipple along the baby?s upper lip, from one corner to the other, lightly, until baby opens wide

My dd (now 2) was born 2wks late weighing 4lb 10oz and, luckily, she did take to bf very well and really just fed and fed and fed for first 2wks after which she was very colicky which meant feeding took ages and I started to wonder what on earth I'd done wrong.

I, too, used to spend ages pumping sometimes with little/no results. I was recommended the Contented Little Baby book and although the routines can be a little restricting and a bit difficult to stick to religiously, I found it helpful as a guide and it helped to ensure I always had enough milk to feed/pump.

Skimmed through from the early posts, so sorry if this has been said but I needed to drink LOADS of water for the whole time I was Bfing and it is something I notice other bfing mums doing.

I completely empathise with the cracked/bleeding nipples, once things were working well they cleared up really quickly thankfully.

haven't read whole thread but wonder what pump you are using. i couldn't get anything out until i used Ameda Lactaline pump - using it right now! dd a poor feeder and it has boosted my supply, doing it regularly.

agree with ruty - for me it was the Avent Isis with the cushiony soft cup that stimulated the let down better. Also try a warm wheat pack on top of breasts before pumping.
My LO was not getting enough milk from me in the first couple of weeks & I was recommended to put back on the same side after he seemed to be finished before changing to the other side to see if he could get more out that same side after a little break for trying burping, waking him up a little bit & a few mins for him to recover too as sucking is hard work for their little jaws.
Sometimes I did find what with settling & changing a feed could take up to nearly 2 hrs. At times they can just want to feed/suck all the time all day & night, even if it seems like they've only just had something. Their tummies are still small & sometimes tbey might just want that extra few ml to make them feel full for a while before they go again.
Hope you get some joy at the clinic.

Hi lou222, first of all Well Done You, you have done so well for getting this far and your liitle man is doing great by the sounds of things he is gaining some weight. Wet and solied nappies are more of an indication that he is getting enough.

My first baby fed for hours on end, even after latch was sorted out. I had some pain for about 2 months, I know how hard it can be and i hope the cafe were of some help today.

My advice to you is to see if anyone at the cafe can show you how to feed lying down as this hepled me sooo much, you can lye in bed and baby can feed when he wants. If you have no other ties (ie other kids etc) spend the day lying around with him, drifting between feeding and sleeping.

Also, i know its really hard, but try to relax, before each feed get comfy and breathe deeply and try to not focus too muchg on gettimng it right, I did this with both boys until i realised it came easier when i didnt focus too hard on it.

I hope that this has been some help, i feel you pain lovely, take care xx