Not enough milk or milk too thin: advice needed please

[WinkyWinkola]

How likely is it for a woman to not have enough milk to feed her baby or that her milk is too thin for her baby?

Can inverted nipples mean that the baby is simply unable to latch on and get the supply he needs and that's with using shells?

Then after struggling for days with a 3 wk old baby relentlessly feeding hourly day and night, giving him formula on the advice of mw meant a great night sleep and rest for all concerned.

So, how can this have been avoided? Or doesn't it matter?

Inverted nipples can be corrected and much can be done to improve latch, do you have access to a good breastfeeding adviser?

Most women will produce enough milk if they are feeding on demand and the baby can latch on well. A very small proportion of women find it difficult to produce enough milk, and domperidone can help them, again on the advice of breastfeeding experts.

The human body is very clever and the quality of milk will not be an issue - milk is an easy substance for the body to milk - after all that same body has managed to produce something as complicated as a baby!

As for how much it matters - well if the mother is happy, and there is no problem with the baby digesting formula milk, then how much it matters is entirely down to the individual's perspective.

Her milk will not be 'too thin', thats certain.

Its possible that, if the baby was not feeding effectively, her supply may have suffered - milk production is stimulated by the removal of milk from the breast. So if milk is not being removed properly, supply may well diminish.

The best thing to get a BFC to actually observe a feed - see how the baby latches, check for tongue-tie (which can affect latch), advise on feeding with inverted nipples and so on.

Whats going on now? Is the baby still being BF and the FF was a one off, or was that the end of BF for them? How does the mother (is it you?) feel about whats happened?

Based on the information you've given in your OP, I would hazard a guess that the baby wasn't latching correctly, hence him feeding day and night to try and get enough. Shells can inhibit supply too.

If the baby wasn't getting enough milk, and was restless and discontent, then obviously having a tummy full of formula milk would have knocked him out!

I would say that it could have been avoided by being closely monitored by an ABM/LLL/NCT bfc, and making sure the latch was correct. And I would've shot that mw too.

In regard to 'not enough' milk. We had a nightmare with breastfeeding (baby wouldn't feed resulting in severe dehydration, gastric tubes, my milk drying up etc..). Basically I had about 10ml of milk every few hours. In in the end got a lactation consultant - I highly recommend this if you're struggling in any way.

We managed to get my milk back (hard work, but can be done) with much pumping and medication. A specialist nurse from the SCBU at the hospital gave my doctor a recomendation that I should be prescribed domperidone which has the side effect of enhancing breast milk (do an internet search on this). This combined with 30-45 mins of pumping after each feed (nothing much comes out at first but it stimulates your brain to think you need to produce more) and 2 weeks later my milk was back to normal. You can also try fenugreek (alternative medicine) which helps milk supply. Take lots, the lactation consultant did note you end up smelling like maple syrup, but it helps.

Having said all of this, it was my first baby and I was determind to breast feed. After 3 months we started adding formula feeds as the baby was still hungry and it was just too much hard work to keep the crazy pumping system going. With hindsight I think I became fixated on the whole 'breast is best' and didn't make the first stage of motherhood very easy for myself. If it happened again, I'd just do mixed feeding and give myself more time to take it easy and enjoy hanging out with my baby rather than stressing about breast milk.

A happy mum generally means a happy baby. There's nothing wrong with a bit of formula, it is a tool to be used when you need a bit of back up. Do not give yourself a hard time about it.

I forgot to mention you can find some really useful videos here www.drjacknewman.com/video-clips.asp

They show proper latching on etc.. to help guide you when working out if you're babies getting in a muddle.

Are midwives trained in helping with breast feeding?

They do get some training as part of the midwifery course. But its not always updated regularly, and its nowhere near as extensive as the training a BFC has had.

I've been thinking about this more, particularly the last question 'does it matter', and while it may not matter to an individual mother, it matters a great deal to mothers and babies in society as a whole. A midwife who cannot give adequate breastfeeding advice and who cannot even point the mother in the direction of someone who can give adequate breastfeeding advice is negligent and her employers need to provide her with better training.

Well, this is what I don't get. Breast is best etc is promoted throughout pregnancy but at the first sign of trouble, it's straight onto formula on the recommendation of someone who isn't actually trained to identify real issues.

I'm not attacking formula here. More the inconsistency of the message and how confusing and demoralising is that for new mums.

It's a friend who's been having trouble bfing but now her DS is snoozing for hours on end and so is she and now she's out of the wilderness she feels. But the real problem with the bfing was never tackled, was it? That's what I'm concerned about.

The trouble is, Winky, that it's quite cheap to put out the "Breast is Best" message, to print posters and bang on about it in antenatal classes. But it's much, much more expensive to train MW's and HV's in proper breastfeeding skills, and if they themselves ff or were ff it's far more likely that they're just going to recommend ff-ing to a mum who's struggling to bf. Also, HV's don't have the time to sit with a mum who's struggling with latch, or thrush, or whatever - it's much more time efficient to just get the mum to give baby a bottle.

Of course, this is pretty short sighted as adults who were ff are far more likely to cost the NHS money in the future, but that's a whole other story.

We have a formula feeding culture - I remember a friend of mine who was pg, and determined to bf, but bought bottles and sterilisers etc, because that's just what you do, isn't it? Babies have bottles, and dummies, and strollers! It's pretty mind-blowing, as a first time mum, to think that actually all a newborn needs is you! You look on a "Congratulations on your new baby!" card and what do you see? A bottle, or a dummy, or a pram. Babies don't actually need any of it!

Is your friend still nursing now? Or was that the end of the bf-ing for her? Is she ok with that? If she wants to relactate then one of the bf-ing helplines can help her with that.