6 days in and help needed!

[Fufulina]

Hi - my DD is 6 days old, and I am finding BF pretty tough. My main concern is that she is not feeding enough - she feeds on average 4 times in 24 hours - and looking at the notes I've taken, that's for about 90 minutes in total in a 24 hour period.

She is not jaundiced, the MW has just been round and she's active and what not, and she weighed 4550g at birth, 4320g on Tuesday (day 3) and is now 4160 (day 6). She was born by planned c-section at 42+6.

She sleeps for up to 6 hours between feeds - although I have only let her go that long once, even when I wake her up after 4 hours - she hates being on the boob until she's ready, so we invariably have an hour or so or wrestling before she latches on. When she does latch on, she seems very efficient, and gulps it down, and wthere's no bobbing on and off.

To complicate matters I am having to use nipple shields becasue she couldn't get to grips with my flat nipples and enormous boobs - and I think that is also affecting things.

My questions are:

1. Has anyone else had a baby that feeds so rarely and sleeps so long at this stage?
2. I am expressing (on the advice of midwife), but does this not then compromise the amount of milk there for the next feed?

Thanks so much in advance. Who knew breastfeeding would be so damn stressful!!?

1. I haven't but she's a pretty big baby... Did she have a feeding marathon in the first couple of days? (ie feeding every 30 mins-hour or so for 24 hours?)

This is connected to the answer to the second question. Not sure why the midwife has advised you to express? Presumably to keep up the supply. In one sense, she is probably right to recommend this if baby is not feeding frequently, as milk production is very much demand then supply: if your baby feeds more, more milk is produced. So it doesn't diminish the next feed - instead (over a day or so) it actually builds up the amount of milk produced. Especially in a 6 hour gap.

So, do you mean 6 hours between the start of each feed? If she's a very efficient feeder this might be at the bottom limit of what is a normal range (but you'd be better checking with a fully qualified BF counsellor). If you mean 6 hours between the END of one feed and start of another, that sounds really too long to me.

It is, I think, unusual for a baby to go so long at this age, but I don't think it is unheard of. I would ring the NCT, LLL etc if they have someone on duty today?

Why are you using nipple shields BTW? Is it hurting? If so, you definitely need advice from a professional BFC.

New born babies often loose 10% of their body wheight in the first 10 days so I would not worry too much yet.

Your milk production will increase if you express so I would not worry about that either.

I remember the first two weeks being quite a nightmare for DD1. Like yourself I have been given quite a generous sized brests, it took a bit of time to find exactly what position to feed her in, hold my brest or not... try to experiment a bit a t first. As I said the first two weeks where hard in fact I almost gave up after 10 days because I was constantly worried she was not getting the correct amount and I ended up eventually Bfeeding her for 2 years. I would advise you to persevere for a while (at least an extra week unless realy too worrying for you) before you really make your mind up.

Good luck and congratulations!

From my own personal experience I'd say she's lost too much weight. Not familiarwith grams but by my reckoning she's lost nearly a pound in weight. My dd lost far too much weight and I went to see a breastfeeding counsellor. As it turned out I wasn't making enough milk and with the help of my fabulous breastefeeding counsellor we sortedit all out.
I really would try and get to speak to a lactation consultant though.

I have blogged my storey
here and there are also links to various organistions on my blog.

She should really be feeding every 2-3 hours. My dd was also a very quiet baby- I personally think she was too weak to make too much fuss.

Not saying that you have anything like me but from my own experiece your baby doesn't sound like she's getting enough milk-

Thanks very much all. Will get in touch with a breastfeeding counsellor. She's not yet lost 10% of her birth weight, has lost about half a pound (she was bang on 10 lbs when born. And at the moment, I have got lots of milk, I think - I leak all the time, and when I express the boob that I haven't fed from I get around 70ml.

On average she's going about 5-5.5 hours from the start of one feed (latching on)to the start of the next.

Nipple shields are to help latching - my nipples aren't sor at all, she just couldn't latch without help - when I was feeding her in hospital - my bookbs were maleable enough to make a teat for her - IYSWIM, but now they're full of milk, I can't manuipulate them.

Anyway - thanks again for the advice, will see if I can get in touch with NCT.

Have you thought of expressing a bit of milk before putting her on the breast, to make it easier for her to latch? I have often had to do this, being amply endowed. It also allows me to build up a good stash of foremilk in the freezer for later use.

If you're at all worried, then waking her up every 3-4 hours to get her to feed won't do any harm until you get some professional advice.

Congratulations on your new arrival.
I agree with Goodwilf that you ideally need to talk to a bf counsellor in person/by phone. But I know it's not necessarily going to be easy to reach people today.

Few quick questions - how are her nappies? At least 2 poos a day the size of a 50p or larger? (only relevant for the first few weeks). Mustardy yellow? Obviously wet nappies?
Are your nipples sore?
What happens when she feeds without a shield? Have you tried removing the shield part way?
Or pumping just before a feed for a moment to try and extend your nipple? Or extending your nipples using another method like with the barrel of a syringe. That technique is described part way through this page:
www.askdrsears.com/html/2/t021800.asp

Although it's not unusual for a baby to still be losing weight at this point it's obviously an area that needs to be watched carefully as 4 feeds in 24 hours is very unlikely to be sufficient for a newborn. She's approaching a 10% loss but isn't there yet and 10% loss of birthweight is usually considered a threshold where more attention needs to be paid.

I think expressing has been suggested to boost your supply and that makes sense to me. It doesn't take away from your milk overall. It sends signals to make more.

I think it is important to try and increase her number of feeds. If you are always waking for a feed, see if you can catch her in a lighter phase of sleep cycle and then she should be more easy to rouse and more receptive to feeding. That may be any time from 2.5hrs on. During the day I would try not to go longer than 4 hours from beginning of feed to beginning of feed. If she can take 30 minutes to latch on then that would mean waking at the 3.5hr mark.
Also think about extending feeds while she is on. Are you double-sided feeding? Returning to the first side again? (or even switching back and forth several times which is good for supply).

I would also have a think about where she is sleeping and perhaps think about spending some time skin-to-skin and hang out on the sofa (easier said than done if you have a house full of other children). If she sleeps next to the boob this helps your supply and also she may be roused to feed more easily and stimulated by smell and warmth.

I also had flat nipples (originally!) and a K cup boobs so I know where you are coming from on the fact it takes longer to get to grips with things. 6 days really is early in the bfing relationship for any size of boob and give yourself time to learn about things like latching. You may want to have a look at an asymmetrical latch which is described in the Dr Jack Newman latching handout you can find on www.kellymom.com. Or shaping your breast slightly with your thumb and forefinger either side of the areola. You may a nipple sandwich and then have a chance to get more breast in the baby's mouth. A counsellor can describe to you how do this better than I can here.

If you can have a go without the shields it does make things easier. I know the usual bf clinics may not be up and running at the moment. But there will be bf counsellors around. Your MW may know people locally. Or you can call one of the national numbers and ask if anyone local does home visits.

If her nappies are fine and at her next weigh-in she is starting to put on weight then it may be that she IS one of the minority of babies who do feed less than the norm. But as you are using shields and there may be latching concerns here in addition to her unusual feeding patterns I would really urge you to hassle for support locally and act on the safe side.

Sorry that was an essay.

And you were back online during my essay!
If no luck with the NCT do try the other helplines: NHS, ABM, BfN etc. Good luck.

Hi Fufulina,

Congratulations on your new daughter!

I have a new son (first child) who at 6 days old is exactly the same!!!! I worry that feeding so rarely is detrimental and have seen 2 midwives and a maternity support worker all for advice re the feeding. The problem, I find is that everyone has a differing opinion and I am just trying to do the best for my beautiful son.

With this in mind, I last saw the midwife yesterday and my sons weight has dropped from 3780g (8.3lbs) to 3500 (7.7ilbs)feeding anywhere between 3hr and 6hr intervals. I shared your concerns, however having spoken to the midwife NICE guidelines in conjunction with UNICEF suggest a healthy (tick) good colour (pink = tick) can be fed with 6 hr intervals.

My midwife suggested she would only be concerned if he had lost 10% or more of his bodyweight. He hasn't and neither has your daughter.

Has your milk come thru properly (mine has but only today) and we keep have to have little chats about trust, "I am your mummy and you have to trust that I want the very best for you, but you have to trust me that you need to feed like this" as I to am "blessed" with large breasts. Sometimes the chats work, other times not!

Also what about his nappies, are you having to change him regularly and what colour is her poo? If black like when first born, speak to either your midwife or a breast feeding support worker (ie la leche) but my sons have changed from black to a kind of yellow sometimes green colour and I am assured that this shows signs that he is digesting what pitiful amount he will accept from me.

Finally, whilst I am breast feeding upon demand, this is being dictated to by him. I am not waking him as I NEVER thank anyone who wakes me for a feed! Also like your daughter, if he doesn't want to feed there is absolutely nothing I can seem to do to persuade him otherwise.

Is your daughter crying, my son isn't just sleeps tons and my mother has suggested that he seems content with his lot and whilst I am fretting, he is simply growing!

Follow your instincts as my midwife said (easier said than done)- it appears my son, asks for food when hungry but otherwise is happy to stay in the land of nod!

I hope this posting helps, let me know how you get on. This is one of my more rational moments but I still have my moments of doubt, where I think I should be feeding every 2-3 hrs and I should be able to get him to feed but I can't.

Finally, I had no idea bf would be quite this stressful.

Yes my baby lost a lot of weight in the beginning and would have slept all the time if we had left her. I thought bf on demand was a good thing (I was following my child!), but she was simply not demanding, so lost a lot of weight and we went back into hospital. It wasn't good for any of us. Bf was very stressful indeed, but we did eventually get into a lovely rhythm and it is worth it in the end! It is just now that you have to put all the effort in, with that alarm clock at the ready.

I won't give "technical" advice about how often you should wake etc. as I am not an expert, but I would say that if your LO is feeding that infrequently then it would be good to talk with an expert and also to keep getting her weighed. Perhaps Tiktok or another MN expert will be along in a minute.

I honestly don't think that the size of your boobs has got anything to do with it! Big, small, whatever... Have you tried sticking a rolled up flannel underneath to raise em?

Good luck, it was this time last year that I was in your shoes, and I remember that it was SODDING HARD WORK and also a very worrying time. I was up and down with crazy hormones and lack of sleep, trying to feed an unhappy baby day and night while juggling countless "experts" telling me different things. Christmas last year was not a pretty sight in the Slattern household! You will find lots of support on MN and also I hope you get decent RL help. All the best.

10lbs at birth is big !

There is no guarantee your baby will remain a big baby (maybe you had a massively efficient placenta )and I think you should be prepared for the weight gain to take a while to settle down.

So don't be freaked out by overzealous HCPs talking about babies "falling off" centiles over the next few days/weeks.

It is normal for big babies to head DOWN centile charts towards average (known in statistics as regression to the mean) and tiny babies to head UP towards average.

My 9lb 15oz baby took 3 weeks to regain her birth weight (many many years ago...she's a teenager now!) and my advice would be to feed her as much as possible - both breasts a feed if she will - and work towards getting rid of those nipple shields if you can. She may struggle to latch on but skin contact increases milk supply.

If she remains hooked on the shields feed her naked (both of you) so you both get loads of skin contact? It should help supply.

How are things now?

Did you get hold of someone on one of the support lines?

The most important question is about her nappies. Is she having wet and dirty nappies? What colour are the poos, how big and how often?

It is really important to make sure that a 6 day old sleepy baby who is still losing weight is getting enough milk and this is probably why your MW has suggested expressing.

It's a good sign that you have plenty of milk, now you just need to be sure that she's getting lots. Do let us know how you're getting on.

Thank you so much everyone for the fabulous support and time to reply. After seeing the midwife yesterday we are waking her every 4 hours to make sure she gets a feed every four hours, and we have managed the last 3 feeds without nipple shields! Also - she has started pooing lots - 4 poos since 2 this morning - but seeing as how she hadn't pooed since Christmas Eve - I think thats all good?

Also - what we thought was colic for the previous few nights, was (I think) overtired and hungry and unable to latch on through frustration. so last night we gave her 90ml of EBM at her last feed and she gulped it down.

Thanks again everyone for the advice and help. How things can change in 24 hours in babyland!

Also - the waking at 4 hours means she is more alert and able to concentrate on feeding. The starving worry is dissipating - to be replaced, I'm sure, with a whole host of other worries in the next few days (years...?).

Thank you again,

Liz

Good for you both - you are on your way!

Sounds like you've got it cracked now! Well done!!

That sounds like an improvement . What colour are the poos? Lots of yellow soft squidgy poo is a good sign that something is going in, being processed and coming out the other end.

You might want to think about trying to feed her even more frequently. 4hrs is a very long time for a young baby. Most will feed at least every 2-3hrs. Spending lots of time cuddling skin-to-skin may also help things, with her in only a nappy and you naked from the waist up (if necessary with a sheet over both of you).

I'd suggest you call the national bf helpline to get yourself some specialist bf support too: 0844 20 909 20.

Glad things are better. I agree with the pp that you may find you head towards her feeding even more frequently - especially if a growth spurt hits as it may do soon.

I think skin-to-skin is definitely the way to go.

Just remember that when you pump and give ebm that will have an effect on your supply so it may be worth asking a bf counsellor more about that. And also asking a bit about the effects of using bottles early on (if that is how you gave the ebm).

Hope things go onward and upward.

Glad things are going better, 24 hrs in babyland is a long time and following the early posts, my concerns that I had / was starving the baby resurfaced .

We met another midwife yesterday and it appears we have been given similar information with 4 hourly feeds, waking him if not demanded. The breast feeding is still hit and miss but with practice, things will be easier.

The one thing which has made a huge difference is that we have removed some layers, as our midwife pointed out, when cosy warm in bed, do we want to get out? No and neither does he! That isn't to say we have him cold but the amount of layers have been reduced and we are now feeding him naked skin to skin to try to stop him falling asleep in my arms!

Please keep posting to let me know how your getting on and hopefully together we can master this minefield together!

KD

Hi all- well DD has discovered her tummy, and is feeding much more regularly and latching on like a trouper. I am now waking her every 3 hours, as when she does actually wake up, she seems hungry, so I think she needs help actually getting up, IYSWIM.

Her poos are explosive (9 yesterday, plus 3 wet nappies), but the MW thinks that maybe the antibiotics I'm on.

And she's now staying longer on the boob - for up to 30 minutes a time, so I think we're getting there.

KD - I hope things are getting better with yours? And so agree - the waking up is the hardest thing! We unbutton her (good for skin to skin anyway)and change her nappy. It can still take half an hour though to actually get her awake! Why she doens't do that at night is a mystery!

Thanks again everyone for the help and advice,

Liz

Hi all- well DD has discovered her tummy, and is feeding much more regularly and latching on like a trouper. I am now waking her every 3 hours, as when she does actually wake up, she seems hungry, so I think she needs help actually getting up, IYSWIM.

Her poos are explosive (9 yesterday, plus 3 wet nappies), but the MW thinks that maybe the antibiotics I'm on.

And she's now staying longer on the boob - for up to 30 minutes a time, so I think we're getting there.

KD - I hope things are getting better with yours? And so agree - the waking up is the hardest thing! We unbutton her (good for skin to skin anyway)and change her nappy. It can still take half an hour though to actually get her awake! Why she doens't do that at night is a mystery!

Thanks again everyone for the help and advice,

Liz

Glad things are improving Liz .

kd, it sounds like you're still having quite a tough time . I wonder if you might findbreast compressions helpful for making sure that when your baby is feeding they are staying awake and actively taking as much milk as possible?

You might find some ideas here too.

kd73 did your milk come in on day 5 or day 6? just wondering did you have a c-section cos milk doesn't usually come in that late if you've had a vaginal birth.

Hi

My milk came thru on day 6 and he had an albeit difficult forceps delivery, we didn't need the c-section.

Midwife coming again today so hopefully we can see a weight gain.

Thanks for all the advice, i'll be in touch.

kd

Following on from earlier posting, little man has been inconsolable tonight, have either been feeding or comforting him in my arms. On the few occasions, I have put him into his moses basket, he has become distressed and so I have ended up picking him up... am i making a rod for my own back by keep picking him up???

This is such a minefield...

Two differing opinions will prob arrive soon kd - either "be firm and they'll learn" or "go with the flow"!

I'm a go with the flow person - so I would say lots of cuddles/feeds/skin to skin contacts are what your baby needs right now. Worrying about what happens later is (IMO) a waste of nervous energy.

Live in the present for a while and then as you and your baby grow together you can decide which battles you feel need to be fought (there's sleep/food/tantrums/school work/under age sex...the list goes on!) and when.

My advice would be feed feed feed.

Your ds is stil tiny and feeding is not a smooth progression - chances are he's extra hungry because he's going through a growth spurt and needs 1-2 hourly feeds again to pump up your supply. This is toatally normal and very positive as it'll lead to an increased milk supply on your part!

Plan to do nothing for the next day or two but sit down and feed him.