have been starving my baby :(

[firstontheway]

DD was born last Saturday weighing 7lbs 2, and was re-weighed for the first time yesterday evening and she's dropped to 5lbs 9

We went into hospital, and they discharged us today saying she's not dehydrated but to bottle feed formula 3 hourly. Previously I had just been breastfeeding her, but realise now I was starving her, even though I was engorged and had milk, I can only get about 2mls when I hand express and nothing but a drop when I use a hand or electric pump.

On a positive note, a lovely midwife came by today and she has put on over 100g overnight, and she helped me to latch baby on to the breast (which she was refusing to do last night/ this morning once we'd offered her a botle). Am contacting my GP this afternoon re: starting domperidone, collecting 2mls EBM in a syringe to give her before I give a bottle, then using a pump to express for 20 mins or so after I've bottle fed her. If she continues to accept the breast, I'll offer it whenever she will take it (esp pre bottle feeding) and for comfort. Is there anything else I can do? Is 2mls EBM really going to do her any good when I'm drowing it in 60mls formula straight after?

I jsut feel so guilty that I've been starving her all this time, and I wanted to breastfeed her so so much. I'm crying all the time, and I'm not sure where to go from here. Any advice? Thanks

If you are engorged and yet you think your milk is not transferring to her can I suggest you try to see a Breast Feeding Counsellor? Maybe your latch isn't right, and you need someone to look at it in RL.

And yes - any BM you can give her will be good for her

Good luck You sound like you care so much for your DD

Thanks- latch has been seen by a few people, plus a bfeeding support worker on Tue, and all of them say her latch is perfect. She opens her mouth really wide, and she does gulp and suck/ swallow- but I just don't seem to have any milk there

I'm glad even a small amount makes a difference though. I was thinking that it's such a tiny amount, it would just mix in and get lost with all the formula.

I know exactly where you're at - I was in almost exactly the same position a year ago. Readmitted after 6 days with weight loss & dehydration. I was devastated so don't underestimate the knock to your confidence at a v overwhelming time.

One of the things I found worst was getting so many versions of what I should do, which I am sure you are getting as well, and which I am about to do to you!

The thing that cracked it for me was feeding every 3 hours, rather than on demand. This in my opinion allows the baby to digest the milk they've had and make some room for more, so hopefully they are properly hungry by the next feed & will feed well, and also hopefully won't get sore tummies in between. (Though my ds had horrible wind for ages, so not always true!)

So the routine was feed, top-up, pump, every 3 hours, day and night.

I have to admit I dropped the pumping after the first 24 hours and was able to drop the top-ups, 1 by one over a few days, after 2 weeks or so. I then breastfed until he was 6 mmonths.

But also, if it doesn't work out for you that way, don't beat yourself up. You're doing your absolute best for your dd, any bm is good, and you need to build up your confidence.

Hang in there, it will get better all the time

just to say just beause her weight has dropped does not mean her development has been damaged over such a short space of time,and the baby naturally gives nutrition to the brain at the expense of the rest of the body .

Actually in retrospect I reckon I pumped for about 3 days - it's all a blur!

Just want to say, completely understand how you feel. Was the baby very sleepy to start and did she feed infrequently which got milk production off to a bad start? I think if the milk does not get used when it first comes in, the body thinks there is no need for it. (Correct me anyone if I'm wrong) So if you keep putting her to the breast your milk supply will increase again.

Sometimes when you feel so upset, the letdown is completely affected, you feed the baby and just want to cry because you feel you are failing her, but you CAN'T do anything wrong by just offering her the breast as well as formula.

Lots of sympathy with your situation and don't feel you have to stop feeding her your milk because you have done anything wrong. I had similar and ended up breastfeeding for two years after a rocky rocky start with lot s and lots of formula.

Firstontheway - I have a 2 week old DS. He also fell a bit too far below weight on first weigh-in three days after birth.

These were the midwife's instructions which I followed to the letter (they sound the same as Puppster's post):

Feed for 20 mins one side whilst simultaneously (if you can) expressing with a pump on the other for 20 mins and then immediately feeding what you've collected in the bottle. Bit more BF after that if he seems to want it.

Do this every three hours religiously - 0300, 0600, 0900, 1200 etc.

That's what I did for 8-9 days. Without fail, on the dot. DH gave bottle when he was home.

By Day 8-9 DS had regained most of the weight and I switched to demand feeding. Today - Day 14 - he is 100gms above birthweight and officially passes muster.

My top tip for getting through 80 3-hour cycles of feed-pump? One of those mini Ipod TVs (perhaps you have one or can borrow one) - download some TV from ITunes and watch it whilst feeding to take your mind off the horror

Hope it works out!

P.S. My advice is Babymoon. Go to bed, snuggle up to baby, have no visitors unless they are entirely unjudgemental and cook your meals and chat warmly and don't mind you feeding constantly. And offer some formula to set your mind at rest. And don't get hung up on expressing, because it may not decrease your stress but increase it. I mean the sheer technicalities of how much, sterilizing, sitting with wretched thing etc. That was my experience.
Doctors will tell you she has to have x amount of formula a day, but that is to make sure she's textbook fine. Only you will know when the milk starts to flow and you have to give yourself a chance by letting her feed from you.

I found my baby got loads of foremilk and no hindmilk (hence like yours not dehydrated)because I never let down properly due a bad latch or stress or caesarian who knows what, but once baby was truly latched on (Bfng counsellor showed me how to shape nipple into V from below with finger and thumb on needle threader principle ifswim and bring baby to the breast firmly) my letdown increased dramatically and he got plenty of hindmilk.

Actually I also agree with Swanriver - all that expressing is v stressful! But it did work.

I also agree with Puppster about putting baby down between feeds, because it again encourages baby to take a "proper" feed and suck vigorously to get the hindmilk. But the gap between feeds could be as little as 2 hours from start feed 1 to start next feed. I don't think you have to leave as much as three hour gaps in the day, but it should be a maximum of three hours, if you are trying to stimulate production, especially at night.

So if baby sleeps for four hours between feeds that is probably too long unless she is feeding more often than three hourly the rest of the time ifswim.

You haven't been starving her -- and absolutely agree with Mrs Baldwin's advice. It echos the advice I received in hospital after having DS.

And swanriver is right about the calculation of the feeds going from the start of one to the start of another. So, if you are doing 3 hourly feeds, and she starts feeding at 12:00 and goes until 1:00, then her next feed would be due at 3:00.

Oh, and don't believe that what you're expressing is a reflection of how much your baby is getting. A baby is much better at getting milk (and without getting into TMI, I can assure you that they can consume loads... )

And congratulations

It's so nice to have them home...

Thanks everyone, I appreciate the advice. It's good to know as well that other people have been through it and come out the other side still managing to breastfeed. TBH she never really slept at all, she was very fussy and sucky from birth and my tiny amount of milk came in on day 2-3, breasts became engorged etc as she was on the breast non stop. She would settle on the breast after a while but cry when we put her down.

We saw midwives etc, but they all said this was normal and some babies are more sucky than others etc, and no-one thought anything was wrong as she looks very healthy tbh. But has been a completely different baby since we started feeding her formula- just happier, more content and actually sleeping. I will stick to the hourly regime, but will collect a bit of milk from hand expressing first to give her as sometimes she doesn't latch on before her bottle feed as she's too hungry. And because I have such a poor milk supply, when I express using a machine it just 'smears' on the inside of the pump, nothing even touches the bottle yet.

Am hopeful I will be able to get my supply up a bit though, am happy even to mix feed if I have to, and use the breast for comfort- I loved breastfeeding and loved that I was the only one who could do it. It made me feel so proud. I think as well, my diet has been very poor since delievery- I put on a lot of weight during pregnancy as I was so hungry, and immediately after I delivered that reversed and it was taking me half an hour to eat 1 slice of toast, I just couldn't seem to mangage any food and thought it was just my body adjusting and didn't take into consideration how it would affect my milk supply. Plus exhaustion I suppose will get better now she is at least sleeping between feeds. Have eaten proper meals today and feel slightly better now I've seen the midwife.

firstontheway - what a story. I am so glad you saw a helpful midwife who is turning the whole thing round.

You were badly let down by the people whose job it is to help you establish bf. With that amount of weight loss - are you absolutely certain it was as much as that? Check the metric to imperial. A 20 per cent weight loss is very large and one would expect a baby with this amount of weight loss to be showing signs of lethargy and illness in the days before the weight...also, it's unlikely she was producing poo or even wee. One of the early signs of ineffective feeding is lack of poo - and this is a sign midwives should teach mothers about.

I am pretty doubtful the weight lost was as much as this, to be honest, but clearly there was something up, and it's good you got help soon enough. Poor support from the hosp to tell you to bottle feed, though

Putting her to the breast often, responding to every feeding cue, keeping her skin to skin, are the most important things to do now. At 6 days, I seriously wonder if you need to use meds or even express - I don't undestand the logic of this if your baby is now feeding effectively. It sounds as if you have the right person around to check this is happening. If she isn't transferring milk well, then yes, express. But at 6 days your supply should be fine.

Please do not worry about hindmilk/foremilk or making sure she has 'proper' feeds - this is outdated advice and will not help get the volume of milk into her that she needs.

Above everything, do not blame yourself. It's the maternity ward that should be shot

Have you been told why you should give her domperidone?

This is a serious medication. Usually given as a last resort in a baby with clinically diagnosed reflux. I would be asking ALOT of questions about why anybody feels this is necessary.

Your baby is still so tiny and still learning how to feed. You have been badly let down by the hospital.

Feel sad for you as I know how awful it is when you are desperate to bf and it's a struggle. Advice on here is great - well done for getting it together to post - I couldn't when DS was a newborn and struggled.

If you feel able to, try a breastfeeding cousellour.

Rabbit - I am pretty sure she is the one taking the dom....it has a known side effect of boosting milk supply.

Thanks Tiktok. That's pretty much what the midwife said, she has filled in an incident report etc, becuase on all of my visits I had mentioned concern about the feeding but was assured it was normal. She was having a lot fewer wet nappies than I expected and began to have red crystals in her nappy which I know are a sign that baby isn't getting enough to eat, but was told this was normal as this is how a baby excretes urea in the early days? She was also weighed a day later than she should have been as no-one turned up when they were expected to according to my notes (student midwife said she would arrange for someone to come Thu).

I was surprised at the extent of the weight loss too tbh- though it makes sense when I see how little milk I'm getting. But she looks perfectly healthy, was always very awake/ alert, no sunken eyes/ fontanelle, and although less than expected she was weeing and passing stools (changing from meconium to normal poos). Conversion is correct- 3.2kg down to 2.52, unless the birth weight was wrong, or recorded wrong.

I feel a lot happier now thinking at least I have a plan, have stopped the constant crying, but can't shake off the guilt. For not feeding her, giving her formula, not having enough milk... everything. Just trying to transfer that guilt into determination to get my supply sorted and see how I go.

I can't comment about the weight loss, but please don't think that what you're expressing is what your baby can get. My DS fed a lot but put on half a pound a week at times - yet when I started expressing I was luck if I could get a couple of ounces in half an hour, so please don't use that as an indication of your supply - some people just don't respond well to pumps.

If you are going to pump, I always got my best results pumping on one side while DS was feeding on the other. Lots of hormones flying round and I got let downs much quicker.

Good Luck.

Don't feel guilty...

Look, you make decisions on the information you have available (I b/f DS for 12 months and it turned out he had a dairy/cow milk protein allergy. That's total guilt as had I known, would have gone dairy free!)

The most important thing is that your DD is out of hospital and getting feeding established...

I think you need to find some expert bf support. Please call one of the helplines.

I have some idea of how you feel having been through a 20% weight loss and hospital readmission with ds. I can understand why you are feeling so shocked and all the other things you describe.

The most important thing to be sure of now is that your LO is transferring milk effectively when feeding at the breast. Has someone checked for a tongue tie? A bf expert will be able to help you with these things.

For us, domperidone and pumping after every feed helped to stimulate supply, then topping up with the EBM (& if needed formula). But, you need suggestions that are tailored to you and your particular situation. If it helps to know, we phased out the formula gradually over a few weeks and ds went on to feed for over 3 years. It was hard work at the start and when something like this has happened it's natural to feel really anxious about it all.

Take care of yourself.

I'm glad something is being done to ensure HCPs learn from this, firstontheway.

Urates in the nappy are not normal - they are common, but they should always be seen as a sign the baby may need to be feeding more often/more effectively.

Poo needs to be copious after about day 5 - I have heard a US person say it should be 'poop you can scoop' that is, not small 'skiddies' or dollops.

first, this has happened to me with both my babies. With ds1, he was taken back into hospital at 7 days, he had jaundice and was getting quite ill. I didn't really get the support I needed to maintain breastfeeding while/after he was fed up to get him well, and although I tried to express for a while it never really worked, he was essentially formula fed.

In ds2's case, he was referred to the hospital at 4 days and readmitted at 5 days with a 17.5% weight loss, apparently a record (hospital claims they'd never seen a baby with such a high proportion loss). Gulp! I was devastated that it was all happening again as I was so anxious to make bf work this time.

This time I got the help of a breastfeeding counsellor working at the hospital, this is a new development since ds1 was born less than 2 years earlier. She's based on postnatal but came up to the Paediatrics ward every day to see me and help me to latch on etc. I managed to stabilise his weight on breastmilk but we were pushed into top-ups after 5 days as he hadn't put any on. However, doing it this way is horribly hard work and I imagine a lot of women just give up, as I still fed him for at least 20 minuutes before offering top ups, and often at rather less than 3 hours between the start of one feed and the next. We used the hospital's convenient readymade bottles with teats etc so at least we didn't have to worry about mixing and washing up and sterilising, but with that this approach is incredibly time consuming.

Once we got out I gradually phased out the top ups from 6 to 3 to 1 and then none. I think the last top up was 2 weeks ago. When he was on 3 the hospital told me he wasn't gaining weight fast enough and wanted me to use more, but I looked up figures for reasonable breastfeeding weight gain and I'd been given a figure at least twice that, ds was only a little under the more realistic figures. His gain has then varied a bit, and I panicked, but really picked up this week.

Last Friday I was convinced the hospital were going to demand the resumption of formula top ups, but then he was weighed by the GP at his registration appointment there on Wednesday, and by the hospital on Thursday. Both GP and consultant at hospital were very happy with his gain and general healthy appearance. No more suggestion of top-ups.

The upshot of all this? It's very very hard work to do, and you will have to be prepared to seek out and keep asking for support from the health professionals, if that's what you want, that is help to maintain bf or mixed feeding at least. But it is possible.

Do come back and get advice from real bf experts on here, and I'd suggest finding out whether there are any bf support groups in your area, seeking face to face help from breastfeeding counsellors etc.

What not to do - don't feel guilty. It sounds like apart from the mw who came by today you haven't been given adequate support.

Puppster and mrsbaldwin's suggestions sound better than the hospital's advice if you want to maintain breastfeeding rather than ff.

Good luck whatever happens.

I can actually remember the paediatrician who came down to talk to me about one of my week old twins who was jaundiced weightloss etc saying
would it be so bad if this baby was fulltime formula fed - ie: why are you so selfish as to want to continue breastfeeding?
There is enormous pressure for some professionals to solve the problem the quickest way they can send you home and sign you off rather than support you in your slightly more dogged efforts to persevere. I am really struck Elkiedee by the pressure the professionals were putting on you over top-ups and how you had to arm yourself against them in order to have courage to phase them out.