Oh Wise BF-ers of Mumsnet, I need your advice.....

[MissusH]

I am bf-ing my 6 day old dd2 after struggling to bf dd1 so am a newbie at all this!

All seems to be going ok so far - no problems with the latch which was one of my main worries...

However, she does not seem to be emptying my breast fully at each feed. The mw says she is a "lazy feeder" who is taking just enough to top up at each feed then falling asleep on the breast (she has only lost 2% of her birth weight so far so they are not concerned).

I have followed their advice to keep her awake so she can take more (tickling her cheek, massaging my breast etc) and she is taking a lot more and is feeding for longer. My main concern now is that if she doesn't drain the breast I could get blocked ducts/mastitis. At the moment she is taking 3/4 of the breast but I still have a lumpy, engorged bit on the outside (if this makes sense?).

The mw has advised that I express the rest of the milk after dd has finished feeding just to empty it and to stimulate my supply.

What are the expert opinions on this - yay or nay...?

Or do you have any other ideas?

nay.

you don't empty breasts. they're like taps.

all you need to do with your 6 day old is offer your breast as often as possible. lots of skin to skin.

after offering one side, try offering the other. she may or may not want it.

I am no expert, but if she is feeding ok, latching ok, has not lost much weight then I wouldn't worry about it.

I wouldn't bother experssing because it's early days and you are going to be engorged a bit. your body is still learning to regulate the milk supply. if there is always some left over then it knoiws it doesn't need to make as much.
if you express then you;'ll carry on producing that much, even if dd isn't drinking it.

just go with the flow is my advice

would have thought you had enough to do without expressing! Can't believe mw suggesting that. As said by tiy your body is still adjusting.

The lumpyness takes a while to subside.
I wouldn't express as you will just stimulate your supply by doing this rather than letting your body adjust to what dd needs.
Also expressing is time consuming and tbh i never did it unless abs necessary as would rather have used that time to get some rest!
It's early days so i would try to see how it settles and dd sounds to be doing great

I was always told do not try expressing until 10 weeks. Boobs are just lumpy especially when your milk has so recently come in. I've had mastitis and boobs get red and you can actually see/feel the blockage and you can massage the area towards the nipple and stop it even happening. You sound like you and baby are doing fine.

Fancy calling such a tiny baby lazy, poor wee thing!

Oooh definitely give yourself much more time to adjust everything to suit... Six days is early days indeed in the great scheme of things. I can't understand the advice to express the remainder - you will just teach your system that it needs to produce milk your baby doesn't need? I think it highly unlikely that baby isn't taking what she needs if you are offering as and when. Lumps and bumps are all part of the deal at the start. Mastitis is an infection, you wouldn't get it just from a failure to empty the breast, there would have to be infection present as well.

Your midwife is wrong.

As for calling your newborn DD "lazy" - fgs!

Your midwife is lazy for not keeping herself up to date with her knowledge, in fact.

Don't worry about expressing. You won't empty your breast - not possible - and if you express and overstimulate your supply, you run the risk of mastitis.

Try feeding your DD with her chin towards the lump - may require acrobatic feeding position (from above, with her lying on bed, maybe?) but def the best thing to clear a lumpy bit.

sounds your supply is adjusting after milk coming in
I used to massage gently enough to make myself comfy.
I never tampered with supply by expressing that early. As others have said it's early days and vital to let baby demand feed.
Sorry dd awake gtg

Newborns are sleepy creatures. She sounds like she is doing fine. My firstborn lost about 15% of her bodyweight by day 5, so don't fret. Your LO will probably start putting weight on over the next week.

Mastitis is horrid and worth reading up on (try www.kellymom.com so you know the symptoms if ever you get it), but it's true that your breasts can feel overfull, lumpy and sore at this stage.

Personally I suffered frequently from blocked ducts (and a few times from mastitis proper - which happens when an untreated blocked duct bursts and the milk enters your breast tissue. The body reacts by sending lots of white blood cells to fight the "foreign body" in the breast, and you can suffer flu- symptoms like a fever & whole body stiffness (and it can come on very rapidly, in the matter of an hour).

In order to avoid mastitis proper, if you get blocked ducts try to treat them, for example, using a cold compress between feeds and taking ibuprofen (to reduce the inflammation), using a warm moist compress just before feeds (to dilate the ducts prior to your baby helping you suck out the blockage), and feeding frequently from the affected breast first. You can often see blocked ducts, they appear as pinkish blotches on the breast tissue, and can feel like small hard lumps.

If you have a problem with oversupply, you could use a couple of cabbage leaves (see Kellymom for details) - I found they worked really well. Just don't use that remedy more than 2 in 24 hrs as it is quite effective at reducing supply and in the early days you should be aiming to establish a supply (however, I used it when my milk came in and I was very uncomfortably engorged, and am still feeding 9mths later).

Good luck to you, you are trying to give your baby the best start ever, and breastfeeding is not easy, however natural it is! I am sure many MNers will sympathise with you, and I hope you have the support and love around you to help you keep going with it in these early days. A few months down the line, you will be glad you persevered - it is convenient, free, good for baby's health, and a fantastic way to bond with your LO.

Gotta get to bed now, but hope this helps.

Expressing this early can make your milk supply go mad imo I had a big problem with DS after he was born (long labour-lots of drugs) so he was really sleepy and was rubbish at feeding of any sort. I expressed into bottles as he wouldn't latch on and as a result got mastitis as i was producing enough for the 5,000! Perhaps pull her off the breast every 5 mins or so so she doesn't fall asleep so quick? I was told not to put too many clothes on DS when feeding in the early days as he would fall asleep as soon as he was snuggled up against me. Not sure how PC this advice was...to cut a long story short, we had huge difficulties to begin with but by 6 weeks had properly established PFing and continued to do so for a further 7 months... hope this helps

like you i struggled to keep my new born awake for any length of time to feed. But as DD2 is not loosing weight she is clearly getting all she needs. Different babies feed at different rates and some suck harder than others. Your milk flow will sort itself to fit with how much dd2 needs, expressing will only increase milk flow. Stick with it and don't get stressed by it all. Enjoy feeding your baby! Good luck

At 6 days my breasts were hugely lumpy and engorged. Both times my milk came in with vengeance - way too much for one tiny baby to cope with. I wouldn't recommend expressing quite yet as your milk supply needs to adjust to your baby's needs. I'm pretty certain my body tends to think I'm having triplets given the state of my supply straight after birth and it needed to reduce hugely, rather than be increased, but everyone is different. It sounds like you are doing fine.

One of the best things for lumpy bits is to massage the lump while lying in a hot bath, you can usually clear it that way.

It is great if you can persuade them to take longer feeds and avoid snacking. Once mine had apparently finished feeding / dropped off the breast / fallen asleep, I would aways change their nappy (to wake) and then offer the other breat, and they would usually take a fair bit more, meaning they went longer before the next feed was demanded.

(hides behind sandbags waiting for tiktok's opinion of mw )

poohah. lazy baby

if you are feeding without pain in your nipples and she is weeing and pooing, just spend lots of time alone together getting to know each other and to figure out how you best feed together.

and stay away from that midwife

lol at sandbags madmouse

Loads of fab advice ladies - many thanks!

nelly I have found that taking her off the breast for either a nappy change or just to rub her back/wind does wake her up (a bit) - it just seemed the instinctive thing to do...

Will try the warm bath/massage and ignore the mw's advice...

On a slightly different note - any recommendations on decent breast pads???

Today I have gone through my own body weight in crappy Boots ones and 4 dry bras (I too seem to be making enough milk for an army - DH thinks I should hire myself out as a wet nurse!!)

Am off to bed now, back tomorrow....

Sounds like you are doing a fab job!
The best advice I heard on avoiding blocked ducts and mastitis was to avoid wearing a bra. I've only worn them when going out or if we had special company and would be taking photos. And I haven't had a hint of trouble with my boobs, which surprised me as they're funny old things.
If she won't have more of the first boob, there's no harm in trying her on the second.

Congratulations and best of luck.

xx

Tommee Tippee breast pads are thin & discreet, but soak up loads. They are a bit pricey though. Sainburys pads are soft and thick, comfy but not great for leaving the house in (unless you want people staring at your strange-looking norks!)

i found tommee tippee breast pads most absorbent,i dropped one in bath once and it swelled up to almost tennis ball size! If your nips do get sore johnson and johnson do some with a little hollow for your nipple to go in which i found v comfortable. carry on the good work with bf, ignore MW, go on to kellymom.com it's full of brilliant advice.

I got mastitis 3 times and it's horrid. The best bit of advice that I got was:

If you get a lump then comb it towards the nipple with a wide toothed comb (like an afro comb). It really worked and although I got a blocked duct again I managed to get rid of it quickly.

The Johnsons are the comfiest I've tried when I've worn a bra. If not wearing bra and pads, a muslin round the other nip in the first weeks useful!

xx

I love Lansinoh breastpads, but they are essentially Tommee Tippee in different packaging. However, John Lewis online do them in big packs, 66 for about £6, and deliver for free, which is handy to know when you are running out and can't be bothered to traipse into town.

MissusH

Only read your OP, but your MW is utterly, utterly under-trained in bfing and I would dismiss anything she says in future about bfing and possibly even put in a complaint.

From what you write in your OP, both you and she are doing fab.

I am frankly quite at her calling a 6 day old baby lazy. As for expressing, this early on will increase your chances of mastitas and engorgement.

Your suggestion that your LO is taking 3/4 of the breast is nonsensical. Bf doesn't work like that. If your 'normal' lumps bother you, put a warm flannel on them and then massage the lumps the next time you feed.

There is nothing wrong with your supply. It most certainly does not need stimulating.

thanks all - I knew I'd get decent advice here

I bought the tommee tippee pads yesterday and result - so much better!

Right, am off now - got to feed my lazy baby !!!!