MW advising formula top up (6 day old). Agree with her rationale but reluctant...

[smackapacka]

So here I am again - struggled for 10 weeks to BF DD1 2 years ago. Just had DS on Friday via elective C-section (at 39 weeks) and I just don't seem to have enough milk.

He's had unrestricted access to my breasts. My diet and fluid intake is good. I think my latch is OK. He has been co-sleeping with me (which I am not keen on for safety reasons), and he has still lost 10% of birth weight (from 8lb 1oz). He has had wet nappies but no dirty ones since yesterday, and now MW is concerned that my supply isn't satisfying him (becuase each feed is LONG and FREQUENT). I think I agree with her logic but on the other hand I feel it's very early days and that he is just stimulating the supply. How worried should I be that the last poo was 24 hours ago and was still meconium?

My DH bought Fenugreek togday but took it back after advice from chemist was that I shouldn't take it. I am going to BF clinic tomorrow and could ask about prescription for medication to increase supply, but just wondered if anyone else had any advice please?

There is formula in the kitchen ready to be cracked open if need be but I'm just not convinced my boy is suffering.

I had exactly that situation and ended up mixed feeding from the end of his first week until his sixth, then got back to just breastfeeding, so don't worry - it needn't be the end for you necessarily if you don't want it to be. Mind you, my ds never much liked the formula feeds so it was easy to persuade him back to the breast. It's so worrying, but you'll be fine, whatever happens, and more importantly, so will he!

Your posting here so your instinct is to question what the midwife says.
Maternal instinct is a pretty powerful thing.
Babies do lose weight after birth, it is unusual if they do not.
If you do top up with formula that will be less suckling from baby and less stimulation of milk supply. I think it is so much easier for a baby to get formula from a bottle and so they often prefer it if given the option, not a great thing to do if you are in the early days and keen to establish a good supply and get baby settled on breast.
You don't mention baby being unsettled. Each feed is long and frequent - sounds pretty ideal to me, stick with it I think it must be going well - baby is feeding, was a good birth weight and is content.
My own opinion is that some people can be all too quick to say give formula to ensure feeding, afterall you can measure what is taken and see it going in. But the human race established itself on breast milk, formula is a very recent invention! Your milk will be of much better quality than women's of years ago due to our better diet. Your baby will let you know if it is not working by being obviously hungry and unsettled.
Also I found that if I ate bigger portions (of healthy meals) I produced more milk.
If you want a proper second opinion I'd talk to a trained breastfeeding counsellor as recommended above.

I gave my DS top ups in the short term after excessive weight loss - 17%. He was feeding often and latch was fine but he wasn't taking enough milk in.

He soon got a bit stronger and was off all top ups and back to excl BF - I was very reluctant to top up but it isn't always the slippery slope.

When he was a bit stronger he could feed more effectively, it was the best thing to do. He will be 1 in a couple of weeks and still feeding

I too felt awful when I saw how happily he guzzled the Formula but sometimes they just need some extra calories to help them get back on track.

Sometimes, if bf has really not been going well, and cannot be turned round quickly, then the baby needs formula to perk him up so he does start to regain the energy to bf well.

If this moment occurs is more of a judgement, than a science.

The point of formula in these early days is for the baby's sake - not for the breasts to rest and build up a supply. As has been said, this is absolutely not what happens.

It's perfectly possible for full and happy bf to happen and to last for a long time, even after a glitch like this.

Hope things get better, smacka.

morning! How are things?

I had a similar situation to you a couple of months ago. DD2 was born a bit early and was very small. (pictures on my profile)

She didn't feed vey well and although didn't lose her 10% she did lose weight and have to go into SCBU for UV light treatment as she was very sleepy and thus feeding not well.

I did top up and I expressed too to top up as well as with bits of formula.
After a few days it became clear that she did not need the top ups anymore as we started to get the hang of feeding (maybe at 2-3 weeks old) she is now fully breastfed.

Sh did not have a great deal of dirty nappies either and still now doesn't always have them everyday. I just try to keep an eye on them.

Morning

Lovely messages again, thank-you.

Renaissancewoman - DS was VERY unsettled. Together with the lack of poo I do think he wasn't getting enough from me.

I give him formula last night, and during the night together with BF, pumping and giving him expressed milk, and he is much more content. I don't just mean that he slept, but the constant hungry cry and rooting stopped. He slept in his moses basket next to me which meant I didn't have him in bed with me (don't think it's safe in our situation). So it was a better night foe everyone.

I love the thought of giving him the calories now as Tiktok says to get him back on track with BF but I do feel less stressed about it today. If he does mix feed for a bit, or go on to formula then I'll make my peace with it.

I ruined 10 weeks of DDs life with the failure to BF (which I think led to me not bonding with her and eventually PND), and I'm not going to go down the same route again.

I'll go to clinic this afternoon, and take it from there.

Again, thank-you

Oh and he did a big poo that woke me up at about 5.30am too.

phew.

I was hoping you weren;t answering as you were dealing with a big poo Glad to hear it!

i think midwives are too quick to prescribe formula when what you (everyone) need(s) is help.

my lovely mw was banging on about formula before my milk even came in with DD1, i did try to give her some, from a spoon, but she wouldn't take it, so i took that as a sign and gave up.

BUT at 5 days old, when my milk had only just come in we were rushed to hospital because she was 'dehydrated'. now she had lost 10% of her birthweight, but it really undermined my confidence. i spent the whole time we were in hospital crying (and feeding her of course, i can multitask you know). but at the hospital they had a wonderful breastfeedling counsellor who completely sorted me out, scotched any incorrect theories that i had been told by other medical professionals (the best was 'you should only feed a baby for 10 mins, after that they are using more calories than they are gaining.' what?!?) and told me i no longer needed to top her up.

jump forward 2.5 years and the same mw didn't breathe a word about formula - presumably because i'd already fed one baby successfully, but if i hadn't undermining my second attempt would hardly be the most helpful thing in the world would it?

so in summary, get all the help you can, ring la leche league, go to your breastfeeding clinic, ask your friends, you definitely have enough milk (as long as you feed on demand).

obviously if you decide that formula is right for you, then that's the right thing to do, but if breastfeeding is for you don't necessarily expect to be able to get it started on your own - no amount of reading can prepare you for what it's actually like, and the baby has never bothered to read the books. there is help available and you should definitely ask for it.

good luck!

ps glad to hear the poo news. it does sound like he did need a top-up when he got one, but it would have been better for someone to have given you good advice before it got to that stage.

So - as everyone has taken the time to help, I thought I'd come back with todays news.

He has fed 3 hourly from breast only, but has been sleeping in between. Now I'm pondering whether this means that he's settled or whether he is weak and weary.

BF clinic was OK. Bit too much head shoving and boob grabbing for my liking. However, the plan is to feed and pump every 3 hours. I'll return to clinic on Monday (he's being weighed on Saturday).

He's awake and alert now after having a bath and another enormous brown poo, so I'm going to pump.

Oh and I'm drinking fennel tea. Yuk.

Sorry, just want to check i assume you mean every 3 hours at least? you mentioned unrestricted access in op so sure you do.

I had a similar situation when my LO was 1 week old - my MW suggested expressed BM from a cup. She also helped me to work out that he needed to feed for longer from each boob in order to get more hindmilk.

It's amazing all these people who can't get their babies to feed. I could never get mine to take a bottle...

Please hang in there and dont beat yourself up about topping up with formula. I has to do do the exact same thing with my DS - who is now 4 months. After the third week his Paeditrician wasn't satisfied with his weight gain and bowel movements and advised topping up wtih formula. I was devastated and felt like a failure but reluctantly followed her advise for a few days. Four months on and DS is EBF and has more than doubled his birth weight. IM not sure if my milk took a while to come in or if he wasn't latched on correctly but my fears about the odd bottle of formula spellling the end of bf was not realised.

Please hang in there and try not to beat yourself up about it!!!

Thank-you. I'm still not satisafied he's getting enough from me, and that he isn't pooing enough. BF is long and painful and I'm fast coming to the conclusion that this isn't what I want to do.

If I didn't have a toddler to contend with I could afford to sit down and feed freqently for long periods of time but it feels like this is benefitting no-one (oh and together with the 3hr pumping). I know it's early days and I should just allow things to take shape but I can feel that slide into PND again. Baby cries, I feed, I cry and then 30 mins later the whole cycle repeats.

I am pumping now as I write this and I think that I'm just going to mix feed for a bit longer then move over to formula. There are other factors that have led me to this descision... when DH goes back to work I'm on my own in the evening, things like that. So there we have it! I really appreciate all your support and advice. Thank-you.

smacka the clinic sounds a bit rubbish. i have experienced some grabbing myself and it is not good. would you ring a helpline to speak to someone you know is trained properly?

also you could talk to them about what and how you want to feed. it would be worst of all worlds if you ff and feel unhappy about it.

I think that I don't really want to do this enough anymore to justify all the input from helplines/clinics etc. It's 11.15am and I have just got out of the shower whilst DH is out with our daughter (becuase of constant feeding). It's just not sustainable. The MW came out this morning and he's gaining weight so I think we'll just carry on as we are whilst I have supply.

If I thought that he was getting what he needed from me, or I didn't have a toddler to deal with or it wasn't painful then I'd try harder but it's not working for us.

Just to say, fenugreek is really good, I take it (8 caps a day) and Domperidone, and if I forget/cut down on either one, the milk supply dips down. I have been taking them both for nealy six months with no problems.