Failure to thrive (another one) advice needed please.

[suwoo]

DS is 10 days old, weighed 8.9 at birth and was readmitted to hospital 6 days later at 7.4 which is a loss of 15%.

I protested about not giving formula and was allowed to carry on bf overnight (2 hrly) and see what happened. He gained 2 oz and we were allowed home. He hasn't been weighed again since but is due to be weighed tomorrow on the same scales.

He is doing 5 or 6 poos and plenty of wees per day.

At the maternity hospital I was advised to offer one breast per feed. I have since been informed by the lactation consultant that this is wrong and I need to switch feed.

My question is this: he is feeding for about 20-30 minutes on each breast, this is not active feeding I realise but a lot of suckling. Even when I latch him off after an hour he is still rooting. He's not still hungry is he? Is he just comfort sucking? I don't want to be counter productive and tire him out by allowing him this long on each breast.

Should I switch him between breasts after 10 minutes or so and end up with him having 3 or 4 breasts IYKWIM?

I also think I may have a slightly shallow latch, can this be a problem?

This is my third DC but the first one I have bf and it is really important to me to carry on.

tracybath - there are no rules except 'watch the baby'!

We know that milk supply is driven by milk removal. Most mothers will probably be fine removing milk from one breast only per session, as long as this seems to be what their baby responds to and thrives on but it makes no sense to deliberately not offer a second (or third, or fourth) breast and to keep putting the baby on the same breast again and again, as if the baby has to 'drill down' to 'the hindmilk' somehow.

Hindmilk is not sitting deep in the breast all the time. This is not how it works. www.kellymom.com describes it best.

Once it's understood how bf works, then it makes sense in the early days and weeks to feed the baby until he shows by his behaviour he is sated for the moment. Then if he shows signs of wanting more after perking up a bit, he can be offered the other breast. He may or may not take it.

This is so badly understood by too many midwives and others Often, mothers who are told their baby is not getting enough milk have been given this bad information - and they turn things round quickly simply by offering 2 sides whenever their baby seems to want 2 (or 3, or 4....).

dawnybabe - like I said, no rules, except watch the baby and that is what you have done

Some babies always want two sides, some babies sometimes do, some babies are a mix, some babies go through phases, etc etc. Some babies don't really have noticeble 'feeds' - they just feed whenever and wherever and their mothers go with the flow and who knows how many they have?

At the beginning, though, it's helpful not to have a rule about 'only one side'.

I'm so glad I can breastfeed this one I'm happy to go with whatever works.
I had an awful time with my first. I never asked for the proper help, I had no idea what I was doing, we ended up both in tears whenever I picked her up and my hv & dh both told me to stop for my own sanity. I just couldn't get the hang of it, I hated the whole thing and then felt like society was judging me for bottle feeding. I'm so proud of myself and dd2 for managing to do it this time, especially through the thrush, that's a bastard that is. So if I can do it, anyone can! However many boobs it takes!

I sent this email to my friend a while back who's sister was having the same problem. Sorry that it's just a C&P as I haven't got time to go through and change all the shes to yous etc.

She needs to offer the breast 1.5 to 2 hours after the the beginning of the last feed to stimulate milk production and to encourage him to feed more efficiently. If he doesn't seem interested after this time it doesn't matter, just tell her to try again later on. Then when he does start to feed offer the breast again 1.5 to 2 hours after that.

You need a good let down to breastfeed well. You can ensure you have a good let-down by applying a warm compress to your breast 5 minutes before breastfeeding or pumping. Try to feed in a quiet, relaxing environment - take yourself off to a room on your own if that helps. Use relaxation techniques such as deep breathing or visualization.

Breast compression also encourages a good let-down. It continues the flow of milk to the baby once he no longer drinks (open mouth wide?pause?then close mouth type of suck) on his own. Sometimes they stop drinking before they are full because they are tired or because the flow of milk has slowed down. By continuing the flow of milk for them when they have stopped sucking it gives them a bit of help so they will hopefully take a bit more milk and get a bit more full up. Breast compression also gets fattier milk to the baby which is more filling and so will satisfy him longer.

This website tells you how to do it drjacknewman.com/help/Breast-compression.asp

Changing sides often during a feed will keep the baby awake and drinking for lonher. When the intensity of his suck and swallow decreases, first try breast compression, then switch him to the other breast and encourage him to feed again. When his sucking slows down again, try breast compression again and switch back and so on, until you find he no longer wants to feed.

There on some really good videos on this website showing good and bad latches, breast compression, good positioning, the pause in the chin which shows they are drinking rather than just sucking etc

www.thebirthden.com/Newman.html

Hope this helps

Great to hear he put on weight and you sound happy too

Hi Suwoo, Sounds like you have got is sussed now, really great to hear he is thriving. I'm feeling more than a bit nervous about trying to feed ds this time round (due in a week and a half) after a terrible time with dd three years ago. I've been reading books / the info on here to try and give myself the best chance of success.

I know this is the wrong thread but can I ask what you decided about the name in the end?!

I've just got round to doing his birth announcement magbags

One way to improve the latching on is to form your free hand into almost a letter C using all the fingers, with the thumb as the top. Then stick your hand under your boob and grasp it with the fingers underneath in the middle and the thumb on top in the middle until it may seem as if the boob is almost flattened, then stroke the baby's cheek gently towards the mouth to stimulate rooting and opening of the mouth. Poke the nipple right in while still holding your boob, then when you're sure it's a long way in, let go.
The let down reflex should kick in after a few mins. Unmistakeable filling up feeling, sometimes to the point of feeling like exploding. The sucking sound will change from suck suck suck to suck, click or silence, suck, click or silence (this is swallowing bigger mouthfuls). Offer both breasts each time -- this will not only give baby enough, it will prevent you from becoming overfull and sore on one side and possibly prevent mastitis. Keeping both drained as equally as possible will help your milk production.

Sounds like you're doing quite well with him regaining weight, well done so far and please post updates on how he's doing. I know with ds2 it was very important to me to know others had succeeded with a subsequent baby after not managing to bf with one or more.

"The let down reflex should kick in after a few mins. Unmistakeable filling up feeling, sometimes to the point of feeling like exploding."

I don't know if this is true for everyone, because I didn't feel a let down reflux for about two months, then I felt it for a few months and now I don't feel it anymore.

mathanxiety I'm not really feeling the let down, can you describe the sensation? Think the latch is ok now.

He gets weighed on Monday, will definitely update. Feeding now.

Thanks

Let down feeling is highly variable and individual - it's not necessarily something that feels like filling up and it's deffo not unmistakeable to everyone Lots of people never feel it at all. It can happen after seconds, anyway, not nec. minutes.

There are several let downs per feed, anyway. Most women will not feel all of them.

I've heard it described as a tingly feeling too, but for me, at least in the first few weeks of bfing, I felt very full with all but my last DD. The other breast will start dripping out a few drops of milk when the reflex occurs -- some friends of mine had the experience of milk squirting right across the room..
My DD lost over 10 percent of her body weight in the first two weeks I couldn't keep her awake while feeding her and she slept for long stretches between feedings, which I had never experienced before with the other four. I had to wake her every two hours around the clock or she would have slept. I felt really thick having to go looking for help. The dr advised supplementing with a bottle first at each feeding, then moving to the breast to keep my production going, and I also tried pumping but that was not too successful I gave her whatever I pumped, though, so not a complete bust . After about three weeks DD was up to about six ounces of formula and don't know how much bm, but I switched to bfing alone since she was much more awake, and she actually kept up the bfing until almost 4 yrs.
The letdown reflex wasn't something I really felt after a few months with any of the DCs, but definitely they were getting enough. If they missed a feeding any time, I would feel myself getting fuller, sort of a filling up sensation, but nothing dramatic.

The only sensation/pain I have felt has been the weirdest feeling like someone is pushing a metal bar through my breast

Very hard to describe but I reckon it could be the let down.

Suwoo glad to hear things are so much better.

Just wanted to add (having skimmed a bit) that if your DS starts snoozing at the breast, I have found that giving them a rock, blowing gently on the face, tickling a hand a little etc gets them sucking again.

Let down for me hurts like an absolute bastard for the first 3 weeks or so if that's any help to anyone

So pleased things are looking up

Going off topic a bit here but I am always interested to read people being advised to swap breasts as often as they feel necessary during a feed. It seemed to make sense to me, but when my ds was losing a lot of weight when he was born I was told by both a midwife and a breast feeding counsellor type person she sent round that I needed to feed from one side for one hour before swapping sides, even if this was done over 2 or 3 feeds. I did try it but it didn't seem to work very well and I soon went back to switching whenever it seemed necessary. During the day I would probably only feed from one side but for a night feed 2 or 3 sides.

He's been weighed today, 1 week after ast time and he has gained 2 oz. I know this isn't great and he is still 13 oz off his birthweight but the mw said she is happy as long as he is gaining something.

I am back on the fenugreek (9 a day) just in case supply is a factor.