Bottle feeding: how much for a 3 day old?

[June2009]

Hey

Just saw the midwife today and she advsed me to feed my 3 day old 60 ml of formula per feed.
She only manages about 30ml so we just called the mw office and I spoke to someone who told me that 30ml is absolutely fine and that in fact 60ml is too much.

The other thing that has worried me is that she has been very hard to wake up.
The visiting midwife today said I had to wake her up after 4 hours to feed her.
The mw office told me not to worry if she doesn't and to let her wake up by herself so that she acutally shows interest in the feeding.

I'm all confused now.

What do mumsnet experts say?

bit of background:
We have been very worried about her feeding.
I went in to give birth determined to breastfeed but after a 24 hour labour, epidural and c-section drugs and flat nipples and poor latching (plus i've not slept and never done this before) the mws at the hospitals advised me there that they should keep her topped up with formula as we could not tell if she was actually feeding from my boob. I tried expressing but got a very lame few drops that were not enough for a feed.
We've had skin to skin contact and I have had colostrum come out which she has had when I've managed to get her on the boob at the hospital. I got back home yesterday evening but since this morning I have tried squeezing my boobs, so has the midwife who came round, and there is nothing coming out at all whatsoever...which is why today I have had to use exclusively formula. I put her on the boob this afternoon and she sucked a little bit and fell asleep on it but yet again I don't think there was anything to actually eat, she just likes the skin to skin and falling asleep on me.

Hi, congratulations on the birth of your first child! If you want to continue breast feeding then you must speak to a breast feeding professional near you - Le Leche League or NCT, who can properly support you, before you feel forced to give up. Good luck X

Sorry I dont know the answer in terms of how much formula to give but I did want to say that it sounds like you are not getting good help at all.

At day 3 your milk wont have come in yet, so you are producing colostrum only and you wouldn't be able to express much at all. The best way to produce milk is to put your baby to the breast as much as possible and your milk will come in.

Also it sounds as if your baby is sleeping quite a lot, if you let her sleep cuddled up in your arms you are more likely to notice is she stirs and needs feeding.

Am just off to bed but do hope you get some decent advice on here.

And sorry forgot to say congratulations!!

agree with previous posters. if you would like to breastfeed you need to put baby to breast as often as possible

it IS important to wake baby every 4 hours or so, maybe even more frequently if you want to establish breastfeeding
a baby who is sleeping a lot won't be feeding much. and a baby who doesn't feed enough often sleeps more.
it's a vicious cycle. but i would def be waking her at least every 4 hours to feed

would echo suggestion to speak to la leche league.

Hello and congratulations. It sounds like you've had pretty poor advice up to now. I completely agree that you need expert advice, preferably face to face.

Is there any jaundice at all? My DS was slightly jaundiced and I was told I shouldn't let him go more than 4 hours without a feed, the sleepiness being due to the jaundice. I think that a normal, healthy baby would wake up when they need a feed. But I'm no expert at all.

The other thing is that there's quite a technique in hand expressing, and the amount that comes out is really no indication of how much milk you have. Especially this early on. If your DD is appearing to feed and seems happy and satisfied then she must be getting something from you.

FWIW, DS had an incredibly poor latch (undiagnosed tongue tie) and we got off to a very poor start with b/f. But I did manage exclusive feeding for a fair while and mixed feeding for several months after that. I think you've been very unfortunate up to now, but it isn't too late to get some decent advice and really give it a good go. Best of luck.

I'm probably wrong about the sleeping thing then, in light of thisisyesterday's post. Nothing about our first few days was "normal".

June....this sounds so confusing, and no wonder you feel anxious.

To be honest, the breastfeeding support you have had so far sounds absolutely dreadful...I mean it

For the midwives not to be able to tell if she was actually feeding is a disgrace. This is their job. And to tell you to give formula because they couldn't tell..oh dear

Very few people produce more than a few drops of colostrum at a time on the first day or so - this is normal. The normal time for milk to come in is day 3-4 - it would be very unusual for your breasts to be able to express significant amounts before then, and squeezing is not the way to tell what there is inside. The baby can be helped to suck effectively and it is really unusual for a baby to need full formula feeding, when the mum wants to breastfeed, on day 2-3.

The skin to skin is great. It helps stimulate her feeding instincts and it is a good thing to keep doing it and letting her feed on and off as much as she wants. I can understand why you felt the need to give formula but if you continue to do this your breastfeeding will be undermined. Good news is that it is far from too late to turn the whole thing round, and to breastfeed fully if this is what you hope to do. Tomorrow you can talk the whole thing through, see a midwife (maybe a different one?) and call any of the breastfeeding helplines. Your confidence is bound to be low so you'll need lots of support and encouragement - hope you find what you need. You can post again here and people will help.

Obviously your little girl needs to be fed and so no need to drop the formula until you are sure the bf is going well...tomorrow is still only day 4, so as I say, you really can turn things round

I have inverted nipples and had exactly the same problem as you.

I used an electric breast pump after feeding - doing it every 2 hours or so in the day to begin with - to get the supply up, and offered the breast each time. For the first few days I toppped up to 30 mls, then gradually increased that. All the while expressing and offering him to try and feed.

He was jaundiced and very sleepy too and it was all a bit of a nightmare!

Eventually, just as I was about to give up altogether a friend suggested using a nipple shield to improve the inverted nipple latch.

He then latched on straight away!

He is now 6 weeks and we are giving one formula bottle a day at night (mainly so that DH can give it) and the rest he is breastfed.

I know some people on here will say don't use them, but I have to say in my case, the shields were the only thing to keep me going.

Now you may decide it is too much bother and just go for the formula, but if you want to continue to breast feed, it is possible.

But get good advice, there may be simple things you can do to help.

Thanks for everyone's replies, it's obviously a very emotional time for me right now and any support is much appreciated.

There's a breastfeeding group I am going to tomorrow.
mags98 I got nipple shields, just sterilising them now and I will try them tonight as well.

This midwife I saw today also said that I should be able to produce 30ml of colostrum per feed, which didn't happen when I tried expressing with an electric pump. They only said to do 7 minutses per breast, when I suggested diong it more - which is what it said on the manual- the mw advised not to: at the time we were only trying to get the flat nipple situation sorted.
I thought women only get a little bit of colostrum, not 30ml per feed.

Twinkle: yes the mw said the baby looks a little jaundiced. She didn't mention anything about that being related to the sleeping. I did make a point of asking her because at the hospital the baby went something like 8 hours without a feed because she was sleeping. At the time I tried waking her up and feeding her but she just kept going on the boob and then falling asleep again.

Looking at electric pumps online now.

i am in my own little bf hell but i can give advice on the expressing.

I found an electric pump worked best for me, hospital grade, your hospital prob rents them out.

i had to hand express colostrum + hoover it up with a little syringe for the first 2 days, and only got about 1 ml MAX at each feed, and it took ages.

PERSIST, it gets easier + better - when my milk started to come in, that's when I switched to a pump. I have not had to give formula top ups since day 3 or 4 (can't recall)

also, one of my nipples was flat, but i still fed my dd for about 18 months - it doesn't have to be a barrier to successful bf.

i hope you get good real life support + help.

hth

It's good you're finding support on this board, June.

The midwife is very, very wrong about the amount of colostrum to be produced. This is so sad - you are battling against some very badly-informed midwives. Women do not normally produce 30 mls of colostrum at a time - and using a pump to get colostrum out is normally considered poor practice (though pumps are often used). There is usually a better response with hand expressing, and the precious drops of colostrum don't get stuck on the flange of the pump. When things settle down, you might want to think about complaining about the poor information you have had. I feel quite cross for you

I don't know where 7 mins per breast comes from - the Ark???!

Nipple shields need to be used with great care and while they can be helpful, they have a lot of drawbacks - it might be a good idea to see someone knowledgable before using them, June...babies can get 'hooked' on them and they reduce the effectiveness of bf (because the milk is not removed well) so while they may help a baby latch on, longer term they may not help you.

I think you need expert real life help. This prob means more than you can get at the bf support group, unless they have some people qualified to help real problems - peer supporters are great but this may be beyond them. It seems clear from what you have said here that the midwives you have seen so far are not good at this part of their job

june, it might be worth looking on the baby cafe site.
it will list any baby cafes in your area, and also tell you what kind of support will be available.

I used one recently and chose one near to me that is run by 2 lactation consultants (rather than just peer supporters)
as tiktok says, whilst peer supporters are fab at what they do (ie, giving support) you may need MORE than they can provide and need to see someone with more in-depth knowledge of how breastfeeding works and what is and isn't "normal" (and i use that term loosely lol)

I gave up bfing after confusing advice and being bullied into giving more and more formula by mws.

Stick with the bfing at least for the time being. I hate giving my daughter formula.