another breastfeeding trouble thread

[littlesheriff]

hello
sorry, i know this topic has 20,000 posts and so this must all be covered somewhere, and i have tried reading through and it has been helpful. however, everyone's situation is subtly different. this is my first ever post. i am posting on my partner's behalf, who gave birth to DS1 13 days ago. things didn't go 100% to plan - he was 2 weeks late so had to be induced, then needed an emergency caesarean, then my partner got a bug or a reaction to one of the drugs, and had 2 days in quarantine after the birth. then DS1 was tongue tied which inhibited his latching. this was sorted 5 days after the birth as luckily our hospital is doing a trial and offered to sort it out. anyway, this combination of factors, and perhaps others, meant the milk coming through has been delayed and we are still not sure how much is coming through. after being so depressed in the hospital for a week after, with seemingly no results from expressing using their fancy machine, and the prospect of spending christmas and the week after in hospital, we decided to top up bottle feed, and let him get what he can off the breast.

we both appreciate that if the breast feeding doesnt work out, it isnt a "failure" and not through lack of trying, though it is kind of hard the way society seems to push it.

anyway, we were wandering whether others had similar problems, how long it can take for milk to properly come through, and whether there is anything else that can be done? we have heard of a hormone a GP can subscribe, or perhaps acupuncture? fenugreek? at the moment it is feeding on demand (about 1-2 hourly, feeds for 5-20 minute per side, though hard to tell if he is feeding or comfort sucking), with some pumping using an electric medela pump that we have been lent (though barely anything comes through it, even if there has been a 2 hour gap after the previous feed). at the moment it seems like pretty much nothing is coming from the left side, and a bit more from the right side. it is hard to stay positive and keep with it, especially as the forumla as such a quick way of satisfying him!

any help appreciated, many thanks, and seasons greetins

congratulations to you and your DP

i have no proper advice to give, as i no experience of tongue tie etc. But I DO know from long personal experience that what you can pump is NO indication of how much milk you have

when my babies were tiny i could hardly pump anything but they were happy and grew and had plenty wet & dirty nappies so they must have been ok

once when ds was 2 YEARS old he had a bug and went off food and survived on bm for nearly a week. of course, this increased my supply and out of curiosity i got out the pump to see what i coudl express. There was not enough to cover the bottom of the bottle

if i REALLY only had that much milk then my toddler would have been in hospital. and he was fine

bump

all i can say is let your DS be at the breast as much as possible

tell your wife to go to bed with your LO and have loads of skin to skin to really stimulate her supply

even have a bath together

DD slept with me or on me at all times during those first weeks - can your wife feed lying down?

just let him feed, feed and be at the breast

my milk came in around days 3/4/5 and DD fed 2 hourly night and day for around the first 2 weeks

upshot is my supply was well established and she started to feed very well

it sounds like your DW is doing well - does she have to express? I don't know much about it but would have thought letting your DS be at her breast rather than expressing would be less tiring?

FWIW, DD is now 12 weeks and i can barely pump anything but she is thriving

jsut to reassure you feeding every 1 - 2 hours is normal and usual for a breastfed baby and a 20 minute feed is good going

breastmilk is digested in around 90 mins and his tummy is only the size of a marble (IIRC)

Also, if input is worrying you, check the output. If he is producing full nappies, then that proves something is going in.

look at the baby.

feeding every 1 - 2 hrs sounds good. babies like to feed a lot at this age and it is normal. it is not just about milk but about comfort. Longer gaps of 3 -5 hrs at night is normal but they can also cluster feed which is again normal. Cluster feeding can happen at any time of the night or day.

look at the number of wet and dirty nappies your baby is having. at this age he should be having at least one dirty nappy a day and 4-6 wet ones.

is his weight generally going up? usually a baby is back at birth weight by this age. is he normally quite content at the end of feeds. they can go into a drunken milk sleep at this age. [fuzzy emoticon]

let him feed on one side until he comes of on his own. offer the other side if he is awake or even sleepy. great if he takes it, no stress if he doesn't. it doesn't matter how many sides they want (cluster feeding goes to 3, 4, 5 6 'sides') just roll with it.

Try to have dp keep your baby close, at the early nuzzles or stirrings, offer milk.

of course after a feed it is lovely to let a baby sleep on your chest too.

question:why is she trying to express?

wow, this place is great!

thanks for all the useful advice. she is trying to express as that is what the hospital and mf have advised. they said to do this after feeds, to keep the stimulation going. this was necessary as they had to introduce top-up formula to his diet as he was losing weight in hospital doe to the aforementioned hurdles. he is now 1/2 lb above his birth weight which is good. he isnt reallt satisfied/tired after breast feeding, certainly not compared to formula which totally knocks him out (not good imo). in fact he seems bored and frustrated easily with left breast, but definitely we want to keep persisting with this.

I would stop offering any top ups, stop expressing and only breastfeed. It sounds like he is gaining weight and doing very well, so he should be fine without topups.
I know what you mean about that doped and almost zoned out look after formula, I gave formula to my dd for a while, and I was shocked to see it. She now has only bm, and is putting on weight, and never gets that zoned out look that happened with formula.
If your dp just breastfeeds and does lots of skin to skin with dc, then that is all baby needs.

Well done for keeping at it despite all the obstacles.

I am no expert but can comment after my recent experience of one...

Re the 'left breast' issue. It is sometimes not the baby but rather the mom's positioning that makes it seem as if baby is frustrated with a particular side. I am right handed and prob held DD1 differently to the left breast. Have you tried a different position ie rugby ball?

Just a thought.

You' re all doing v well!! HAng in there!

I second offering the left breast in the 'rugby ball hold'. If you google that plus breastfeeding, you will get images and info on it. It is also a good feeding position for a still painful c/s scar. This position may give the baby the sensation that he is feeding from the right side thereby getting them to feed more readily from the left.

by offering the left side first at the next few feeds it can also help to stimulate the flow and supply in that side as sometimes if it is slower than the right side, they are balking at the slower / less bountiful side. If this works, after a couple days, both sides will even out.

good luck. it sounds like she is doing very well.

I agree with foxytocin. My ds didn't like my right breast and I dreaded trying to put him on it, putting him in a different position "fooled" him. Congratulations!

Congratulations and well done to both of you for persisting through all the difficulties.

When I had DS the complications weren't so many but he was also 2 weeks late, I was induced, had a ventouse delivery and then on antibiotics soon after the birth. We had difficulty in feeding in general but the left side was a particular problem. DS was eventually able to feed from that side but when I expressed I always got about 50ml less from that side compared to the other side and that side doesn't get engorged in the same way that the right side does.

For us nipple shields helped us to correct the latch (used them for about 6 weeks) so these might be worth a try (under guidance of a counsellor probably best) especially if there is a lot of discomfort on that side. When DS was a bit bigger I found that lying down was the best (and in the end only) way to feed him.

littlesheriff - difficult start for you and your partner and your baby

I am an NCT breastfeeding counsellor.

There are some good suggestions here already - check them out with the midwife. I get twitchy when I read suggestions to stop doing what the midwife and others have suggested you do. There may be good reasons for expressing and topping up for the moment' on the other hand, maybe now is the time to wind down these 'props' and to bf direct. Only you, in discussion with the midwife, can decide this...bearing in mind the midwife etc have seen your baby, know the history inc stuff which you may not have remembered to include in your post.

Basic principles apply: formula reduces the amount of milk stimulated and taken; frequent feeding is normal and good, esp at this stage; using both breasts (at least) at each feed is good; expressing is no indication, though to get virtually zero suggests a crappy pump with a bust valve/diaphragm; keeping the baby close to the body, skin to skin if poss, as much of the time as poss is excellent for bf; if formula has been used it needs to be reduced rather than just stopped, if it has been more than the occasional top up.

Hope this helps...there are lots of bf helplines which allow you to speak to someone in RL.