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Infant feeding

Get advice and support with infant feeding from other users here.

Advice needed please-is it worth carrying on? (sorry-long)

13 replies

cat811 · 04/01/2009 19:05

I've had klots of difficulty with bf since ds (15 weeks) was born-emergency cs, then he was in scbu, was bottle fed, I was anaemic-my milk took ages, and I seemed to have low supply-ds didn't want it as he got immediate milk from a bottle-however, we eventually seemed to get there-about 3 weeks ago-where I was feeding him (during day) and FINALLY feeling convinced he was full, and he fed happily-think this was under advice from hv who said that instead of expressing when dh gave the night feed, I should try feeding him first myself.
However, since Christmas eve, ds has started sleeping through, so no longer wakes up at 2/3ish. Since a few days after that, he has basically refused to bf-he latches on, sucks a few times, then comes off, and either cries, or sucks his fingers madly. I've tried when he's hungry, when he isn't., just before a bottle, just after a bottle-any way I can think of-he just won't suck. There doesnt seem to be milk there when I squeeze, but as he's feeding less, i seems to be dropping now (I know expressing is no real indiction, but I'm expressing less than I was too weeks ago-very little now)
After weighin him on fri and finding he's still not gaining well, we started trying to top him after after each 'feed'-he takes 5/6oz and then is really happy for next 3 hours or so.
My question is-do I try to conitnue with trying to get him to feed first, even though i;m pretty sure he's basically getting nothing? Evenm if there might not have been a supply prob before, there is bound to be more and more ow as he doesnt really feed.

I'm happy (ish) to stop bf totally if it is best for him, but am worried I would wonder 'what if I'd kept going'. I can't see how it could get any better though-even if this is a nursing strike and he comes back, surely milk will have reduced enormously by then? (expressing doesnt seem to increase my supply-tried it for weeks when he was struggling to feed before-the only thing that increased it was him feeding)
I feel really cruel trying to get him to feed off me when he clearly doesnt want it, and is only content (and full) once he gets a bottle. What should I do?
Thank you if you made it to the end! x

OP posts:
moondog · 04/01/2009 19:13

Maybe him not waking reduced demand on your breasts which means he was fighting a bit at them? You could consider feeding him at night more often (waking if necessary).

He is taking a hell of a lot of formula which reduces demand on breasts which is a signal for them to make less. You will not be able to sustain breastfeeding for long like this.

Your best bet (if you want to continue breastfeeding) is to contack a breastfeeding counsellor.Forget GPs and HVs.Most know sod all. Look at links on right side of this blog set up by a v knowledgeable MNer.
Here

tiktok · 04/01/2009 19:15

cat, I think this is a situation where you will be helped by talking it through with someone knowledgeable - try the NCT bf line on 0300 33 00 77 1, but there are others you can try, as well.

I can understand why you are concerned, and it's good you are thinking of ways to fix the situation. What I'm not clear about is whether he has continued to have bottles, what the precise weight pattern has been, how often he was feeding before the change when he started going through the night, and whether you have other signs things are not going well.

Certainly, what you are doing now - 5-6 oz formula top ups at every feed - is going to have a massive impact on your milk supply, downwards. So thinking of other ways to i) keep him well-fed and ii) preserve your milk supply is really quite urgent.

Sorry not to be able to help more, but as I say the best help will come with someone properly trained you can talk to.

In the meantime holding him skin to skin and not forcing him to bf when he's 'telling' you he doesn't want to will be important steps in turning things round.If you are happy to offer to feed him at night, when 'striking' babies are often more amenable, this will help, too.

bubbleymummy · 04/01/2009 19:19

It sounds like you've come a really long way. Well done you for persevering and getting bf going after such a difficult start. To me, it would seem a shame for you to give up after coming this far esp as you do seem reluctant to give up!
Have you checked your DS's mouth for signs of thrush/teeth coming in? This can sometimes discourage them from breastfeeding. Your supply will drop if he isn't feeding as much but it won't disappear until you stop completely for a while so don't panic. Keep putting him to the breast as often as possible and this will stimulate it - as you have noticed before! I mean even when you aren't expecting him to be hungry - just try it!
Have you tried having a nice warm bath with him? Lots of skin to skin contact and v relaxing for you both.My DS used to love feeding in the bath Also, you say he has started sleeping through - have you done anything to aid this? Sleep training/dummy use etc? You could try offering him a dream feed when you go to bed ...Just a few suggestions. I'm sure some other mummies will be able to offer more advice. HTH

feb · 04/01/2009 19:30

i agree you should contact a bfc.
i have similar problems and have been using a supplementer which keeps him on the breast longer.
i've been using the medela sns if you want to google it.
good luck
xx

cat811 · 04/01/2009 19:49

Thanks for comments.
I did try an nct one when the problems all started just after he was born, but she said that as he had had a bottle to begin with, there was basically no hope for breastfeeding to work long term-she kept syaing what a shame it was that he'd been given a bottle, and that he would never properly bf as he'd had this experience (so i basically might as well give up, esp as he wasnt gaining weight then). this really upset me and has totally put me off ringing them again-I know its just one person, and i'm sure most other bfc wouldnt say that (I'm sure you wouldnt have tiktok)-but if I hadnt had people around me to support me at the time, and say that what she said wasn;'t necessarily true-I'd have given up.

If he's not feeding though-how do I keep him, well fed? Ive tried the whole cup/spoon thing, and it doesn't work. He is a VERY stubborn baby! Also, if expressing doesn't seem to keep my supply up, how do I do it if he isn't sucking?
I've tried feeding him at night (11ish) when he's woken the last few nights, but he's exactly the same-and when he woke up on NYE in middle of the night, I tried then (as I also thought he might be more amenable at night) but no luck. I think he's now getting upset when he even goes near , before he starts to suck.

OP posts:
bubbleymummy · 04/01/2009 20:30

If you feel let down by the NCT and don't want to try them again you could try one of teh other organisations such as La Leche League: 0845 120 2918 That was awful 'advice' that you were given, obviously not reflective of all bfc but I can totally understand why you're upset and reluctant to go there again!
Can you rule out things that might be upsetting him such as teeth/thrush (any white spots in his mouth?)/anything new in your diet? I know my diet over Christmas changed a lot - maybe you were eating more of something that has upset him slightly?
As far as keeping up supply goes, there are some herbal supplements that are known to increase milk production but you will obviously need to be advised on these by someone qualified. Keep pumping - even though you feel it has become less efficient - it is still doing something! Try doing it in a warm bath/shower because this helps stimulate the let-down. HAve as much skin to skin contact with your son as you can and keep offering him the breast before a bottle at each feed. It might help to change the way you feed him e.g. if he always expects a bottle in a certain chair he may be less cooperative when you offer him your breast there so try somewhere else! Ultimately you will need to gradually decrease the formula he is taking to increase your milk supply. Do get in touch with LLL - they are v helpful. Take care.

tiktok · 04/01/2009 22:30

cat, you can complain about what the bfc said to you - what she said was extraordinary and not true at all. You can call the bf line or the NCT London office and say what happened and details will be taken and I assure you it will be followed up....I hope you do this.

kathryn2804 · 04/01/2009 23:32

A lot of babies have a 'feeding strike' if they're teething. Could be that. I would keep persevering and try to offer him the breast every feed. Skin-to-skin cuddles before feeding time, even in a 5 mth baby, really works, keeps everyone calm and encourages milk production.

Grendle · 05/01/2009 00:56

Goodness, it sounds like you've been through quite a lot in just 15 weeks. It must be terribly frustrating and demoralising for this to happen just as you felt you had cracked it.

I wonder if your ds could be expressing frustration at the speed of milk flow at the breast? Milk in a bottle tends to sort of dribble out farily easily, whereas to get milk to flow readily from the breast, babies have to work a little harder initially to trigger the reflex that makes the milk come out more quickly. Their behaviour at the breast can be more fussy until this 'let-down' of milk starts. Some babies settle down and take one full 'let-down' of milk and take the edge off their hunger, but then seem impatient to wait to stimulate another burst of milk flow. Compared with bottlefeeding which is continuous, the milk flow in breastfeeding comes in waves. If you feel that this might be a possibility, then there are a number of approaches that could help. Breast compressions are a really helpful technique that some mums find helpful in this sort of situation. Others try using some of these tips to encourage the milk to flow faster more quickly. Frustratingly, the hormones needed to get the milk flowing quickly are inhibited by feelings of anxiety and stress, so it can be all too easy to get into a cycle, where a mum feels nervous about settling down to feed, because they are anticipating the same problem as last time, and then they feel tense, which inhibits the hormones and compounds the problem. Anything that helps you both to feel more relaxed at feeding times is worth trying.

You say that you are also concerned about his weight gain and feel that it is slow. That must make it even more difficult and worrying for you that breastfeeding isn't going as well as it was. Can you say a bit more about his weight gain and how much he's putting on? Is your HV concerned? It's actually quite common for breastfed babies to slow down in the rate they gain weight at around this age, and many do grow slower than the lines in the red book charts would suggest from around 3-4 months onwards. Charts that better reflect the growth of breastfed babies are available here.

You say you are expressing and also topping up after every feed now. I wonder if you might want to consider limiting the top ups to specific times of day, rather than every feed. So perhaps give a full bottle at set times, rather than topping up every time you breastfeed. There are 2 reasons to suggest this. Your baby could come to expect a bottle after every breastfeed, and this might actually compound the issues you're already having with keeping him at the breast (although breast compressions may well help). Some babies become reluctant to work as hard to extract milk from the breast when they know that a bottle will be available to them with a steady flow of milk as soon as they stop. This can become a spiral where mums end up giving more and more top up, and as others have said, it sounds as if you are topping up quite a bit at the moment.

You also say that you are concerned that this recent change may be affecting your supply. It's true that if you find yourself offering more and more formula, then your milk supply will decrease as the amount of milk your baby removes from your breasts decreases. However, by this stage your supply will be well established and flexible, so it's very possible that a period of longer and more frequent feeding would bring it right back up again. Mums can establish a milk supply from practically nothing -called relactation, so it is definitely not impossible.

There's some more info here that might help you to work through some of the other reasons he could be fussing during breastfeeding and seem reluctant to latch on well. Often mums find that at around this age their baby has grown quite a bit and that perhaps they may still be holding them in the same way that they did as a newborn, when perhaps their baby is much longer than they were and their head is significantly bigger. Sometimes going right back to first principles and adjusting the way they hold their baby and bring them onto the breast can be enormously helpful. There are some clear photographs here that may jog your memory. The key is a big wide open mouth with head tilted right back, coming onto the breast chin first and top lip just sliding over the nipple. for newborns, it's often said to start nose to nipple, but as babies grow they might need to start a bit further away than this because their mouths are bigger, so more like forehead to nipple, with their head starting in your cleavage. Other mums find that their baby has simply become more efficient at feeding and actually doesn't want to feed for as long any more. You could perhaps experiment with simply allowing him to feed whenever he wants and for as long or short a time as he wants. It could be that he wants lots and lots of very short feeds at the moment.

If he won't feed, then expressing is the best way to keep up your supply. To maintain a supply when a baby's not feeding, you'd probably need to pump as often as he would feed, so every 2-3hrs. Some women get on better with hand expressing, or find that hand expressing and/or breast massage before pumping can help to indrease their output. As with breastfeeding, stress and anxiety make expressing more difficult, so anything that helps you to relazx or distracts you from the pump may be helpful. cup of tea, shoulder or foot massage from dh/dp, watching TV or chatting rather than staring at the pump etc etc.

I agree with Tiktok that spending lots of time just cuddling could be really helpful. Some people really enjoy having a bath with their baby too, with no pressure to feed.

I also agree that you would almost certainly benefit from some 1-2-1 support in person or by phone. Are there any breastfeeding group snear you that you could visit (would your HV know?). If not, you could try the National Breastfeeding Helpline on 0844 20 909 20.

Do let us know how you're getting on.

MamacitaGordita · 05/01/2009 13:39

You've really been through a lot- so well done for persevering this long! The advice given already is excellent and there's not a lot I can add. I would just second the advice to try having a bath together, it's a new experience for the baby, skin-to-skin in nice warm water, and may re-introduce your breast in a different way.

My 8week DS sometimes has a total paddy at the breast (who knows why) but the times I've fed him in the bath have been brilliant, esp when things were difficult for us. The change seemed to chill him out and he didn't 'fight' me as much. Plus I'm more relaxed and comfy and that always helps the milk flow. Don't let your pants experience with the NCT put you off- try LaLeche League and get some proper RL personalised advice. Best of luck x

cat811 · 06/01/2009 18:13

Thank you for all your comments-very much appreciated. A bit of background if it helps - M had formula for the 4 days we were in hospital until sugars were back up (I was trying to feed him too but didn't really get anywhere as he enjoyed the bottle too much!)but when we got home they said we could try going 'cold turkey' on the formula, and as my milk had just come in, we tried-seemed to work, but then after 2 weeks he was still nowhere near his birth weight again, so mw told me that unless we introduced a bottle again (for 1 feed) he'd have to been admitted to hospital for tests-not knowing any better, we assumed she could do this, and were scared into starting with a bottle again. Hes tarted gaining v slowly, and a week later still wasnt back up, so had a gp checkup-all fine but they said to give a second bottle feed until weight gain was good. Wventually after this he started gaining, but not very fast. I was feeding myslef the rest of the time, and expressing at both bottle feeds which dh gave. I didnt feel bf was really working though-I never felt a let down, he never seemed to come off happy-would be just as agitated-only sukced for 3-4 mins on each side and I couldnt get him to stay on any longerand weight gain continued to be very slow (either 1 or 2oz, or sometimes none, on most weeks), though he still made developmental stages to hv satisfaction, In dec, a hv suggested I try to feed him first at night, before dh gave bottle, as stimulation at night apparently produces more milk-it seemed to be this that made everything feel like it was working-bf suddenly changed-he came off satisfied, full and sleepy, was feeding for 20odd mins on each side, and happy for the 3ish hours between feeds. I was finally enjoying it (though weight gain was still slow)-until he dropped his night feed over Christmas (and then see above the rest)
I am trying not to give a topup, and I wouldnt be so concerned if not for his weight-he's now almost on 0.4% and weighs 12lb 4(and was born on 75% at 9lb 2-although 2 weeks late) But he has seemed so much happier since we started topping up last fri, and I can;t help wondering if he has been in a constant state ofhunger since he was born (hence the slow weight gain) and is only now getting enough-so I dont feel I can stop the bottles. He still has hos 2 usula evening bottles, and I am trying to bf first at all other feeds, but he either cries and pulls away, or sometimes just sucks a few times, then replaces with his fingers (not always in distress-just seems to be saying he;d rather have them!)
I've tried breast compressions, but I genuinely feel that I have very little milk generally, and not enough for him (though I;ve heard many say that this is impossible-your body will always make enough) I'm takign fenugreek, eating and drinking as necessary, frequent expressing, and it seems to make no difference to milk at all.
I know the only way to get more milk (for me anyway) is to feed him more, and therefoe offer less formula, but he will not feed for more than a few seconds, and I can't risk him being hungry-I cant get him to feed if he doesnt want it, so there doesnt seem to be an alternative. I still seem to be able to express the same as a few days ago, so it doesnt seem to be affected too mcuh yet, but it's def not increasing, which is the only thing that I think would help him to feed better,.
I think he coudl be teething, and we've tried gel, but it isnt making him any happier about feeding from me.
I've tried every position-some he sucks for a few more seconds at-but will always eventually pull away and chew on his fingers.
I will try la leche and see if they can help-but I dont feel I can reduce formula until I have seen any kind of real weight gain-it doesnt feel fair when I know he;s starving

OP posts:
Grendle · 06/01/2009 19:19

I hope you get through to someone to speak to. you have an lot going on there, and it would be much easier to go through everything with someone over the phone or in person.

It is possible that the 4 days of formula at the start may have affected your ongoing milk supply. This can happen if a baby doesn't feed enough in the first few days and stimulate the supply well. You might want to ask someone on one of the helplines whether it would be worth looking into taking domperidone (a drug that can help with milk supply), if you would want to consider it.

It does sound like you've had a really tough time and you are doing well to still be bf your baby despite all that has happened. He will be getting many benefits from the breastmilk he is getting .

bubbleymummy · 06/01/2009 19:33

What you can express isn't a good indication of how much milk you are producing. I could never get very much unless I was very full to begin with but DS managed to drain them just fine! Your DS may just be getting a bit grumpy and impatient at the breast because he's having to work to get the milk whereas the bottle is much easier for him. Keep offering your milk and try things like feeding him in the bath where you're both more relaxed and the let down will be easier. Do try LLL and have confidence in yourself - you CAN do it. You've done so well to get this far. Don't worry about the growth charts - he IS growing even if it is slow. BF babies do tend to gain much slower as they get older than FF babies. Good luck and keep us posted. xo

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