Being told to top up after BF (4 day old)

[FrumpyPumpy]

A relative is struggling with BF, milk not yet in, jaundiced DS been fed with syringe. Not feeding for long. Being told to top up with formula (still in hospital).
I am waiting for her to call me, have given her the LLL number, but am going to say:

• Keep feeding
• Yes will be little and often til milk comes in
• Topping up will not help stimulate her supply
• IF she MUST top up then express at same time
• Keep feeding
• Keep feeding

Anything else? Am I wrong? I just want to tell her the right thing so am prepared to be corrected.

Thanks (it's 14months since I was there and is all a blur).

Yes you're right. Getting baby to latch on effectively as much as possible is the best way to get milk coming in.
And ss you say if baby must have formula then she must pump as well. Make sure she's asking for lots of gelp with the latch as that's the trickiest bit if memory serves. My youngest is 15mths now so I'm having to think too!

Hand express and cup feed.
does she have access to local bf counselors peer supporters?

Lots of other numbers here www.breastfeeding.nhs.uk/en/fe/page.asp?n1=4 and she might be able to get a home visit.

National Breastfeeding Helpline
Operated by the Association of Breastfeeding Mothers and The Breastfeeding Network
Tel. 0300 100 0212

La Leche League
Tel. 0845 120 2918

National Childbirth Trust
Tel. 0870 444 8708

The Breastfeeding Network - breastfeeding support in Bengali and Sylhetti
Tel. 0300 456 2421

?Skin to skin
?Keep baby close, let him feed constantly / every 5 minutes / as often as he wants
?check latch with lactation professional
?do breast compressions to ensure maximum milk is delivered at every feed

Do give details of:
kellymom.com
Jack newman's website

Thank you very much.

Posting from phone, pls forgive brevity

Jack Newman has videos showing breast compression but basically you just squeeze the breast like you would squeeze a tennis ball (not the nipple) and this causes more milk to be released. Allows baby to get the max even when they only latch on for a few minutes before snoozing off.

All good stuff and useful numbers.

She needs to ask why the advice is to top up. There are so many disadvantages and drawbacks to topping up esp at this early stage that it should only be done (if the aim is to breastfeed) for sound, medical reasons.

These may exist of course - the baby's blood sugar or jaundice may be posing a real problem and she may not be able to express sufficient and/or the baby is unable to get sufficient milk direct (these circumstances are rare - babies do sometimes need more than they can get direct from the breast but usually, expressing or more effective positioning sorts it).

She is expressing for top ups, hopefully short term thing, ds blood sugar is low and beingonitored, has been under lamp all night. Fingers crossed.

All good thoughts. Expressing is best done after the feed (levels of prolactin, the milk making hormone are raised for up to one hour after feeding).

Skin to skin good, so draw curtains and let baby sleep on mum's chest inside her nightie top.

Not getting any milk when expressing doesn't mean no milk there. If milk not yet in, then hand expression may show more results than a pump.

It's difficult with a jaundiced baby as the jaundice makes them sleepy, so they don't feed so well, but equally getting milk helps with the jaundice, so MWs may think some formula will help baby get over jaundice and feed more effectively. I would want the formula cup or syringe fed to avoid nipple confusion.

x-posted sorry Completely agree with TikTok. Personally I'm against any top up with formula, but if it's medically necessary then it's a different matter.

Hopefully the jaundice will improve today after the night under the lamp. Sitting next to a sunny window is helpful too.

She needs to express/feed a minimum of 8 times in 24 hours in these early days to ensure a good milk supply for later.