Is there any way I can train dd to be a more efficient feeder?

[Thandeka]

We have had many a breastfeeding drama (would post link to other thread but on iPod and don't know how!).

Basically my 8week old dd takes an hour to hour and half for a feed and then often will need a 60-90ml EBM top up after. We give her top ups in a bottle as I found the at breast supplementer too much faff but prob need to go back to it. She had her Tongue tie snipped on Tuesday and after an initial incredible improvement she is back to how she was though have been told it may take a week or so to improve (am impatient!) am trying to get her to stick her Tongue out as much as poss to help her exercise her newly freed Tongue.

Basically as I spend the vast majority of my day feeding her (either at breast or pumping her top ups and giving them) I am starting to get fed up of breastfeeding- she goes 3-5hours at night but then her night time feeds will take 2-3 hours with the breastfeeding then top up then pumping. So lastnight I just pumped and gave her it all in bottle (didn't quite get enough for a full feed but had 40ml from before I added to it). Feed took an hour Inc pumping winding settling back to sleep, and I got more sleep yay!

But I don't want to go down pumping and bottle feeding route really (just had to last night as was exhausted and pissed off with constant feeding and wanted a break).

Basically I don't think dd is able to transfer milk very efficiently at the breast probably due to Tongue tie and bottle top ups making her lazy. Her latch is mostly fine but she takes long pauses while latched on before starting to suckle again, I tickle her under the chin and blow on her but she doesn't really get going and a lot of her suckling is "non-nutritive" apparently - so god knows what she gets at the boob (apart from mummy comfort- which is fine but would much rather a 20min feed and lots of cuddles instead!)

I do visit a breastfeeding group, run by a breastfeeding specialist midwife who is awesome, every week but it's not on for the next two weeks and just wondering if there was any mumsnet wisdom out there on getting her more efficient at feeding- when she slows to a stop should I latch her off and on again to restart the suckles? Should I give her all her top ups through the at breast supplementer so she doesn't have bottles (shame bout that is dh loves giving her bottles too and erm no way he is putting the supplementer on him - some men do apparently-yuk chest hair!). Will she just get more efficient as time goes on?

(it may also be a small supply issue as we do also have to give occasional formula top ups when boobs have been trained and no ebm- when boobs full I get about 90ml off them with pump but she prob needs at least 120ml so I think maybe as the milk isn't gushing out of boobs she has to work harder for it- or in her case not bother and just lie there half heartedly!
(oh and plenty of heavy dirty nappies and she is gaining weight albeit slowly).

Sorry bout the uber long post but she is on boob and what else am I going to do but type on mumsnet!

try breast compressions when she is sucking. wotked for us.
sorry for 1handed lefthanded typing.

Link

Video

hth

Forgot to add I do breast compressions! Thanks anyway! I just have a lazy dd! This mornings feed a particular marathon- hour and 16 mins on right boob now on left. She didn't even empty right boob but was starting to get frustrated with it so I swapped her. Unfortunately have had to go back to nipple shields on left boob as have crack that got worse after her Tongue tie snip as her latch adjusted and it won't heal. Owie!

Oh, poo ! And I thought I was oh so clever...

Do look around the Dr Jack Newman website - lots of good advice on there.

And sympathies re the BFing/pumping/giving bottle routine - I still have nightmares flashbacks to that period in my life 6 years ago...

DS3, now 2, developed a v pronounced preference for my R boob and would refuse L unless held in rugby hold - of course supply in L side suffered. Have you tried change of position?

Hopefully somebody else will be along with more helpful input for you.

I don't think lazy has anything to do with it - my DD fed for an hour and a half at a time too at that age and there wasn't anything wrong with her. All babies are different ...

Also don't dismiss "non-nutritive" suckling - this stimulates your breasts to make more milk, so it's actually very helpful to allow it while you are trying to increase your supply (which you'll need to do to get rid of the top-ups).

Just feed, feed, feed ... and this too will pass in a few weeks.

After a rocky start to BF my DS would always feed for an hour at least. He's become more efficient as the weeks have gone on - he's now 10 wks old. Sometimes he still takes a long time to feed if he's sleepy but can feed within half an hour. Your DD will probably become quicker on her own.

I have found that if I feed DS with pillows/cushions propping him up he seems to take longer(?). If I'm feeding him just with a cradle hold and no cushions he's much quicker for some reason, could be worth a try with your DS?

I hope she lets you get more sleep soon!

Have you tried switch nursing where you change them from breast to breast several times ? It means that they get more milk quicker, and tend to keep interest more. So, rather than waiting for her to be fed up with breast1, change over after, say, 10 minutes, then back to 1 after 10 minutes on b2, then back again etc.
As each time you swap they get a fast flow it gets the whole feed over faster.

Worked well for DS when he was tiny and feeding exhausted him

I think, like you say, you need to get out that supplementer again! ( and no, that's not a great mental image of a man with one !)

Yes it's a faff but it's helped me so much that a couple of months down the line I don't need it any more.

That and just hanging in for the tongue tie snip to get better.

I'm assume you're swapping breasts when she starts to fidget (and even swap back again).

I think you're right...she will get more efficient as she gets older.

I know you've been through a lot to get to this point, so you're obviously a determined person.

You'll get there, you're doing incredibly well.

Thanks for all the great advice and reassurance hour plus feeds are normal for 8 week old (think I was getting fed up and jealous of woman at breastfeeding group who has 20min feeds every 3hours, no top ups and can express 120ml at a time!).
Cracked out the supplementer last night - will try and do a couple of feeds like that a day. Also to keep my sanity her 2am feed is going to contine being ebm in a bottle- I get so much more sleep that way plus in middle of night her latch is crap as she is tired and I am often to exhausted to fix it properly and just let her get on with it- that way further nipple trauma lies! once she is better at feeding will hopefully get back to a boob feed at night.

There is a possibility some of her marathon feeds have been because she isn't very well - also last night she did start to suckle as well as she did straight after the Tongue tie snip, and as I type she is a bit better at suckling too (think she read this thread and didn't like me calling her lazy!)

not entirely sure I do have a supply issue as did the pump test described in the making more milk book as I have a hospital grade pump, and my output is 30ml an hour which is what she needs. But would like to boost supply a bit so I can store the extra and so she also gains weight a bit faster to get hv off my back!

Feeling more positive about breastfeeding again today so thanks! It is a bit of an up and down journey and the uber sore nips caused by her new improved Tongue tie latch (latch is fine I think but nips had got used to old latch so are suffering!)

OH MY! Dd has just latched off with a milk drunk smile after 22 mins! She will probably wake again in a sec but yay light at end of tunnel!

Oh I love that milk drunk smile ... In fact, there should be a for it!

Well done, sounds like you're battling through - you'll get there in the end!

Lovely to hear you are feeling a bit more positive today .

Just wanted to add, how much milk you are getting when expressing has nothing to do with your supply. Some breasts seem to be more amenable to producing good let-downs with pumping, and others don't.

I expressed exclusively for DS2 (he was premature) and like you had hospital-grade double pump, but really only rarely managed more than an ounce or 2 from both sides.
Mornings were always most productive, also pump at the same time time every day, try double pumping (or baby on one side, pump on the other - I never had enough hands to do this ).

Love the drugged smile - well done you, you are doing v well; long may it continue.

Happy Easter !

Hurrah DD is starting to feed a bit better still (having destroyed my nips in process as they re-adjust to her new improved post tongue tie latch). I am doing switch nursing much more and making sure I latch her off if she is slowing to a stop. We have been out and about the last couple of days so haven't been able to marathon feed her like I normally would- but finding she is satisfied after 40mins (ensuring active suckling as much as poss) and her 60ml top up so I suspect the other 45 mins she often has in a feed is the non -nutritive stuff and although great for increasing supply I also need to maintain my sanity (and life - we were trying to do house viewings- wasn't really going to work with baby on boob). Will let her have her marathon feeds whenever we are at home if she wants them but hopefully with her post tongue tie latch and increasing age and experience she will be getting better at it all in the next few weeks.

PacificDogwood- Yup am aware pumps don't accurately reflect supply and max I get is about 90ml but the making more milk book did say that with a hospital grade pump you could do this 4 hour test and it would be a close approximation of your supply. (pump every hour with hospital grade pump. Take yields from hours 3 and 4 and add them together and divide by two- this is your hourly average milk production rate multiply by 24 to get your daily rate.) I find all the sciency measuring stuff awesome [geek emoticon] and I am looking forward to doing a weight test with DD at next breastfeeding group to see how much she takes in (also in making more milk book!)