midwife said I need to top up DS with formula - don't want to do this is there any way I can up my milk supply?

[stellamel]

Have posted before but things slightly different now.

DS is 15 days old, feeds none stop, except at night where he manages 3 hrs of sleep at a time, before wanting feed. My breasts feel 'empty' most of the time because of the constant feeding, if I squeeze them a little comes out but no more. He has stayed the same weight since Sat, has only had one pooey nappy in 3 days, but plenty of wet nappies tho.

Because he hadn't gained weight yesterday MW wants me to top up with formula, which I don't want to do, but I also don't want to hurt my baby. He gets really fussy in the eve, from 6-10pm when i go to bed and feed him lying down - then he goes to sleep. He won't sleep in the day unless in the car or walking in pram. He cries after 5mins off the boob, until I put him back on.

When he's on 'messes' about a lot stopping and starting and just using my nipple like a dummy. He can feed properly - I can hear him drinkng, but he does less of it than the messing Around.

Have ordered a sling to try and help.

Tried expressing in the night last night and only managed 1/2 oz.

Am desperate to continue BF but feel like I am going to have to switch to formula soon as am a wits end.

Am sacrificing time with my 3yold dd too as she can't have mummy's attention cos I can"t get off the settee.

Please, please any advice on how I can sort this out, am devastated to be failing my DS, I tried and failed to BF my DD so this means everything to me.

TIA

thank you for all your advice, I will let you know how it goes with the BF counsellor today x

I had a lot of support from a BF counsellor that helped me keep BF when a GP told me to top up DS2 so i'm glad you're meeting with one. Turns out he's just a small, skinny kid (he's 19months now).

For what it's worth, I've never been able to express milk but have breastfed exclusively both my boys (until 5 months) and my milk keeps coming even when my breast feels more than empty (they kept swallowing). Drink lots of water and try to relax and get the support you need - lots of hugs.

BOth mine took a longer time to regain birth weight than the HVs were completely happy with, stellamel. I just kept on going. My mother was a HV and midwife and she checked my latch and generally supported me when she could.

I ended up feeding them both for eight months and it was actually easy once we'd got through the first three weeks or so. Once the supply got going with my son he started putting a pound week on for several weeks in a row.

Second the advice you've had about getting someone to check the latch.

I feel a bit uncomfortable when a midwife is called a lunatic! We always have to remember i) we are not there ii) we may not know the whole story - no one can ever post every little detail on a talkboard.

In addition, most of us are not midwives!

For what it's worth, stellamel, I agree with verylittlecarrot's questioning of the weights.

Any of them could have been wrong - and a 13 ounce (apparent) weight gain in a week, after a large (apparent) loss sounds a but iffy to me.

tartyhighheels - check with your peer supporter trainer/coordinator about the normal rate of pooing in newborns. You'll find it is unusual for a young baby to miss days, and it can be part of a picture of a baby not getting enough milk. It is not a symptom, but it is a sign the feeding needs to be looked at carefully in case it could be improved. Missing several days is only usual in older babies.

My DD is 8 weeks old, and I've topped up about once or twice a week since she was born when she's seemed really hungry without compromising my milk supply. I've just made sure that she's never missed a feed because of formula, and she's only been offered formula when she's been sucking away with no let down for 20 minutes.

That's what's worked for me, so topping up isn't always the end of BFing if you're both generally happy with it.

I may be stating the obvious here btw, but when DS is fussing, do you try and get a burp up? I find the let-down often makes DD gulp a fair amount of air (even if I don't think she has) and often if I can get her to burp, she continues the rest of the feed without fussing.

Having said that, my DS had a tongue tie that took ages to get agreed on by the MW/HV so no amount of burping/support was going to make him feed better.

If you do go on to formula, either as a top-up, or as a more permanent thing, it's by no means the end of the world and remember this - NOT a failure! Sometimes it's just the best way to make both you and DS happier.

if he's still having plenty of wet nappies you really don't need to worry.

Sounds like you really need to feed yourself up to avoid the 'empty' feeling you describe. Not really understanding why the midwife is expecting him to put on weight in such a short space of time; as long as he is maintaining weight and not losing it. If it goes on for weeks and he's not putting any on, then she's got a point about formula.

At this early stage, formula supplementing may actually decrease your own milk supply and possibly put you out of sync with his demands (i know this first hand as it's exactly what i did with dd, something i won't be repeating with dc2, who's 2 days overdue as i write this!)

My advice; get as much help as you need, either from a family member, dh or go all out and hire a postnatal doula; you need someone who can cook meals and save you expending energy on household chores that you need to feed. Eat (lots - i found drinking things like Innocent smoothies really helped with my energy levels too), sleep and look after the baby and let someone else do everything else.

Oh, and i can't recommend the La Leche league breastfeeding counsellors highly enough - i wouldn't have breastfed at all if it hadn't been for them.

I've just been through a similar thing but my DS is 12 weeks. He dropped of the weight chart after taking 6 weeks to get back to birth weight and we ended up with a stay in the hospital for a night.
Would second and have tried all the suggestions of fenugreek, babymoon, lots of water and regular expressing to increase supply. I saw a brilliant NHS feeding specialist and she recommended a 'nursing supplementer' (medela is the brand - I got my off amazon). I wasn't keen on topping up with bottled formula and this is a device that feeds the baby through a tiny tube (in to its mouth)whilst you are breastfeeding. It keeps your supply up, gives the baby an incentive to feed well at the breast and doesn't lead to nipple confusion. It's fiddly but had done the trick and we are now seeing some weight gain- still off the chart but we're going up, up , up! Good luck and stick with it- it gets better!

Hi everyone, once again thank you for your interesting replies.

Saw the BF counsellor and she showed me 'exaggerated latching' method where you roll back the nipple, baby's nose against nipple and loosely hold baby's neck so he can flop his head back to reach the nipple, baby opens mouth wide then you sort of 'drop' the nipple into baby's mouth - straight away I noticed a difference in that the 'arghhhhhhh agony' feeling went, so - fingers crossed - that it was a latch issue that I may have solved. Really really hope so!

All this weight gain pressure is so wrong, and frequent weighing is pretty pointless, as any actual gain might be disguised by just having had a wee or a poo before weighing.

GP wanted me to top up because my daughter was always light (2nd centile), but I just didn't (with the support of HV and BF group, as she was always perky and healthy, just small.

The crying and fussiness you describe is pretty normal, but I remember hpw bad it made me fel. It will get better eventually.

Great to hear you've got some BF support in RL and it seems like you might be onto something with the latch.

Don't be afraid to go with your instincts and ask for more time to establish BFing if you need it. I really struggled with DD as she was very small when born (6lbs) so a large nipple + small mouth wasn't a great combination. It took a good 6-8 weeks to feel more confident and DD often latched on/off in those early days.

If in doubt, maybe get an appointment with your GP and get DS checked out there. A second opinion might help reassure you and sometimes I find my HV is a little over cautious with her advice (in a caring way but sometimes makes you worry).

tiktok, unless stellamel's little boy is obviously unwell (and he had NOT been feeding for 2 weeks since his birth, he would very unwell) then any supplementation is going to hinder the breastfeeding. I cannot imagine that the midwife has ever received training that instructed her to encourage women to bottle feed newborns. Her problem is that she cannot discharge Stellamel until the baby has regained his birthweight, and she's just trying to find a fast fix to her problem, not stellamel's. Furthermore, she must know that any mixed feeding at this age can adversely affect milk supply.

Given that part of her remit is the care of the new mother and newborn, she is being unprofessional and certainly not supporting Stellamel in her feeding. She is also almost certainly going against her trust's policy in advising top-ups this early.

So maybe not a lunatic, but unsupportive and unprofessional, yes. If she had serious concerns about Stellamel's baby, she would be advising that he went into hospital, not advising top-ups.

Stellamel, I am glad you've seen the counsellor now, and crossing fingers that you've got it sorted.

Widow- like you I have dinky baby daughters; well, they start off average but gradually slump through the centiles down to the bottom one- DD2 ended up on the 0.4th, and DD3 is heading there now. They are not thin, quite chubby in fact, just tiny and dainty. They also feed very effectively (I calculated that DD3 is taking about 950ml of BM a day, which is on the upper side of normal). I have been extremely lucky that all my health visitors have worked with truly starving children in the third world and are able to bring some perspective to it.

duchesse - you really don't have to explain to me the impact ff can have on bf, you know....you really don't

But nor can you (or anyone else here) be sure that we have all the facts at our disposal here on a talkboard.

From experience, I know that supplementing with formula is often suggested, before any serious attempt is made to make the breastfeeding more effective.

From experience, I know that mothers may be told there is a feeding issue/issue with the baby's weight, and there is not.

But I also know that someone in real life is in a better position to make an assessment of a baby's needs better than someone on a talkboard, or on the end of a phone...and there are cases where babies are in need of supplementing. No, they don't need to go into hospital; no, they aren't at death's door; they're not even ill - but they do need more calories. Preferably breastmilk ones. We already heard the OP has difficulty expressing - and there may be no further opportunities to bf more often. We don't know. So who are we to say this midwife is 'unsupportive' and 'unprofessional', let alone 'a lunatic'?

As I say, we just don't know. And you don't know either, and you don't know what the discharge protocols are in the OP's area, either - it's only in certain places that midwives can only discharge when the baby has reached his birthweight. It's not everywhere.

So we do well, I think, to support stellamel, without dissing her midwife and without assuming that we have the full story...wouldn't you agree?

I notice that no-one here has suggested that you should see your GP about this. My Australian SIL was prescribed drugs by her GP to improve her milk production in a similar situation, (after she had tried a number of other strategies) which allowed her to avoid having to go the formula route.

Is this something that is just not done by GPs in the UK?

duchesse - I guess I was lucky, my HV is a member of the ABM

midwife can't discharge me until DS has regained his birthweight. The appointment on Wed was supposed to be my discharge one.

I don't want to put my son at risk at all, so will see what his weight is tmrw, if he has lost I will top up, if not I will ask for another week to see if this latch issue makes a difference.

He has a lot of wind, and keeps doing smelly trumps, so have started using infacol to see if it helps, not sure if this is another issue, or just a common issue.

My daughter had her birthweight back at 28 days, I was discharged to HV at 10 days.

Not reaching birthweight is less of a problem, if the child is not going down through 2 percentile lines very quickly and is otherwise well in himself and has wet nappies, there's usually no need to worry.

He's put 2oz on! am very pleased he's now 9lbs 1oz, so feel confident to push on with the breastfeeding.

excellent stellamel, happy that you are happy iyswim!!
Keep up the good work!

Stellamel - glad he's put on. Is it worth trying to find an IBCLC to go through things in detail (you might have seen my thread on here and what has happened to me)? To go over all the things that have happened and are still happening and all the things you have tried? I suspect they (Health Visiting team/midwives) will be expecting your DS to gain 4oz minimum regularly every week before they will stop the pestering for formula top ups/worrying. You have to remember they have the best interests of your child at heart but are coming at things from their own perspective of 'well giving top ups will sort it out'. It is likely it may sort out the weight gain but it is not guaranteed and may interfere further with breastfeeding so while it would be a good option to try from the weight gain perspective it sounds like you feel like you'd prefer to work on finding the cause of the feeding not working perfectly and trying to sort that out first providing your DS is not in danger (like me). If there's anything I have learned over the last week it is that general HCPs will not value/understand your breastfeeding relationship as well as you do and are more motivated to find what they believe is the easy solution - this is not a fault on their parts but not supporting you in your decision to breastfeed and helping you to make it successful is really a fault on their parts. If you think the low weight gain and dehydration were caused by poor latch it might be worth investigating all the possible causes of a poor latch to see if there is a physical basis that can be sorted out do you think? I am now rather convinced that mine have tongue tie but when I asked about that weeks ago I was told it shouldn't interfere with breastfeeding so it was never investigated. Sounds like it is important that this has something done about it but the best thing (while the baby is OK) is to monitor and to try and find the right person to speak to about the breastfeeding.

Have you tried nursing matters?

Please please don't feel that you are failing your baby (after all, didn't he make a bit of a dramatic entry into the world, you star, you!).
I have found that a bit of formula in the evening (Could be a job for DH whilst you take a bath or have some 'me time") has not hurt my BFing long term. In fact, it help keep me sane, gave me a break, gave baby a boost and helped us through the first manic weeks.
I appreciate that's not the party line on BFing, but we all do things that are not quite according to the 'right advice' (i.e somethings I only have four a day and a bar of chocolate, not Five a day!).
Give yourself a breather, a little bit of formula is like his little bar of chocolate instead of his organic veg; it won't hurt him and he'll still be happy and healthy.
Hope this helps and good luck. You're doing great! x

BTW, I must look like a bit of a nutter going on about BFing as I'm on another post because I'm beside myself that DS won't STOP BFing all the time!