Help please- struggling with grazing newborn

[woofie]

Ds2 is nearly 3 weeks old and I'm very keen to bf exclusively. However, I struggled to bf ds1 4 years ago-he was constantly on the boob for the first 3 months but never seemed satisfied- I started giving him a formula top up in the evenings at about 12 wks against my better judgement, and sure enough by 4 months or so ds1 completely refused the breast. So our bf relationship was curtailed early and I felt v guilty about 'failing'. I've since read lots of literature which says that a mother's supply is almost always adequate for her baby, so started bfing ds2 with renewed confidence... However, things are not going swimmingly

Just like ds1, ds2 would spend all day on the boob if he could, but rarely sucks effectively. He's a grazer- he'll go at it for a couple of mins then fall asleep. I tend to take him off and try to wake him up by changing/ burping etc but the same pattern recurs again and again, so that I can be sitting feeding for a couple of hours at a time, but he's still unsatisfied and grizzly at the end. Not much fun for ds1. He has a marked preference for left boob- the right one seems to send him to sleep almost immediately.

I am trying to express at least 3 times a day, but I often get only half an oz - 1oz, and sometimes diddly squat, which frankly just makes me feel more anxious about my supply. I can't realistically express more often than this around the marathon boob sessions, or I'd have no time whatsoever for ds1 not to mention basic personal hygiene!

He was born at 50th centile and lost a fair bit- he's still not regained his birthweight although he did put on 4oz last week. He often misses a day with poo- haven't had a dirty nappy today for example- but produces plenty of wet nappies. All of this adds to my concern that bf is not yet really working. I've never felt engorged, don't leak etc... I know these aren't valid indicators of supply, but combined with the paltry volumes of ebm, I can't help but worry that I'm not giving him what he needs.

Sorry for the mammoth post, but I cd really do with some sound mn advice on this. I'm perfectly prepared to be baby-led, but when this means all-day grazing, unsatisfied baby and slow weight gain, am I doing the right thing? Should I make him wait longer btw feeds so he's really hungry and suckles more vigorously? I should add that he has several v alert awake phases in the day so I don't have serious concerns that he's failing to thrive. I really want to make this work but it's SO difficult! Thanks

One more thing- he's a very long and thin baby as was ds1. Perhaps he's growing lengthways instead of getting fatter?!

Woofie - sorry things aren't going well. Some babies are just sleepy. DD was and it was horrendous, so I sympathise.

When are you expressing? It might be less time consuming for you if you do it at the end of a feed.

I think that the more you cary on doing what you're doing the more he'll start being more awake.

BUT the best position by far for my very sleepy DD was the recline position. Essentially, what you do is lie half back in a chair while baby straddles the leg which is the same side as whatever breast you're feeidng from. Skin to skin contact for this position is amazing. Don't help baby latch on just put him in the right sort of area, perhaps a little below the nipple, but lying straight up your tummy IYSWIM. Baby may well bob his head and latch himself on. If not you could mucge him in the right direction. Give it a whirl.

You know this already but the lack of engorgement and leaking and the amount you express will not be an indicator of how much milk you have. They are really not. I know how you feel though, as I was exactly the same.

How are your nipples doing? Any local bf group? They might be able to suggest something new to try.

Thanks latrucha- and much sympathy to you hanging on for yr due date in this weather! I'm sure the heat isn't helping ds2 stay awake either.

I remember you mentioning the recline position before- I'll definitely give that a go. I've found that the rugby ball position sometimes tricks him into thinking less preferred boob is favourite boob too, so improves his suckling.

It's encouraging to hear that you never felt bursting with milk either but managed to make bf work long-term. I keep scaring myself reading threads about women expressing 4-8oz at a sitting... After a v long feed I often find that I can't express, so need to wait half an hr or so til I've had another let down.

And my nipples are bearing up surprisingly well after 10 days of soreness & bleeding. I've been in touch w local La Leche League- unfortunately the local group has just stopped as the leader's on mat leave. Will investigate alternatives.

On the upside, he's a lovely baby - generally content and a good sleeper at night despite feeding unhappiness.

It freaked me out too - all those things like audible sucking, engorgement, leaking - I never had any of them. The Breastfeeding NEtwirk have now removed them from their indicators of successful feeding . The only really reliable thing is wet and dirty nappies - around 5 a day.

3 weeks is early days. Is your HV being supportive? BFN supporterline is 0300 100 0210, if you feel you need more encouragement.

Also, love this website.

Woofie, it does sound like he's not quite getting enogh milk. The lack of poos, particularly, worries me.

The nipple pain, combined with not-enough-milk in him, strongly suggests his latch isn't quite right. If he was latched on better, he would get more milk, and might feed more vigorously (or you could try breast compression?)

Where are you? I can have a look for local groups for you. Or maybe you could call the National Breastfeeding Hotline? (0300 100 0210)

woofie - expressing 4-8 oz in a sitting is very unusual. It is not a point of comparison for you

As ever, the best guide to bf going well is the baby. A baby who is miserable and who is not at birthweight at 3 weeks and who falls asleep after a couple of minutes is a sign to check out the bf....it may be just slow to start, or it may need some active help to get better.

You need real life assessment of things, I think.

notquitecockney- I've worked hard on the latch, but it's still difficult on the right boob, as he bobs off quite a lot. When he was first born, he couldn't seem to open his mouth very wide, but now we do the nose to boob and nipple to roof of mouth fairly successfully on left side I think. I do breast compression a lot on both sides to stimulate sucking- it works to an extent. I'm in York- thanks for the offer- if you know of any support networks I haven't discovered that would be great. Nipples are not sore now btw, just in first week really.

tiktok- midwife seemed happy with our latch, but she hasn't observed trickier right side.

How can he not be getting enough when we're spending so much time feeding?

If the latch isn't right it's a bit like trying to drink through a straw with a small hole in it - you can suck and suck and still not get what you should if the hole wasn't there. Baby then gets tired from all the suckling for not much reward and sleeps.

Have you thought about syringe/cup/finger feeding a little expressed milk (maybe an oz?) before a feed so DS is a bit more vigorous at feeding? Obviously not enough to replace a feed but just to wake him up a bit?

Have you seen Jack Newman's videos? They are great for ideas for tweaking a latch so that it is more effective. Not really a substitute for a face to face consultation but it may help you until you can get to see a BFC. Here is a list of bfing groups in Yorkshire. Hopefully there is one close to you.

Found this in addition to TruthSweet's link.

Thanks so much for all the links everyone - I will follow them up tomorrow and let you know how I get on. Can't believe I hadn't come across those groups myself. Ds has just fallen asleep on the breast almost straight away again- ho hum. Should say that he isn't miserable a lot of the time- v alert and calm. It's usually after the long and unsatisfactory feeding sessions (and when I try to put him down in a crib to sleep, bimit don't mind that- we have a sling!)

Thanks thesecondcoming- that's a really encouraging story. No I'm not particularly big- average really, but mw says I have 'perfect equipment' - guess she means good shaped nipples for bubba.. Am going to try to get someone to check latch again tomorrow- there does seem to be consensus that that's the root of the problem. Glad you managed to continue successfully with dd

Yes, having an older child definitely makes it harder. Feel like I've been totally neglecting my 4 year old for the last 3 weeks, bit luckily I have lots of family support and he's pretty resilient. Best of luck with your new arrival- no reason why bf shouldn't be easier this time.

woofie - but you're not spending a load of time feeding....he's falling asleep after a couple of minutes. Just being at the breast may not be enough....

As I say, you need some good RL input to sort things out.

Yes, fair point tiktok It's been particularly bad today in the blazing Yorkshire sunshine- we have had better days when he has at least a few effective feeds- I was just expecting the sleeping-eating confusion to have resolved by now. He also sometimes does 2 poos in a day- it's just all quite erratic at the moment. Will def try to get latch checked tomorrow

woofie - it's such hard work in the heat isn't it! Ds3 (dc4) is 5 weeks, and is the only one of my 4 who has fed 'well' - the others were varying degrees of rubbishness, from ds1 who was mix-fed, to dd who was a v slow gainer, to ds2 who took WEEKS to get going but eventually we managed.

Two things I think have made a difference with ds3 (beside just him being a different baby). firstly, I felt REALLY done in after his birth - it was a bit traumatic, and I just couldn't walk for about a week, so all I felt able to do was sit in bed or on the sofa and feed him, whenever he wanted, even if it was for hours at a time. And I think that really made a difference to supply.

Secondly, the maternity care assistant who came over when he was 3 days old, and had a look at him feeding - she said his latch was basically right, but a good way of making sure was to lead with the chin, get the lower lip against the breast, and then kind of hook him up over the nipple (does that make sense?). Somehow, the words she used really made sense, and if I did that he latched on much much better.

The other thing I did on Mars' advice was breast compression for the first couple of weeks, and that did seem to encourage him to take a bit more milk.

Don't get too hung up on the poo thing. My 5 week old was pretty erratic for the first three weeks, but certainly feeding fairly effectively and very contented after feeds.

She has now settled into a pattern of pooing several times a day (darn it - we were so smug when we thought we might be dealing with a one-a-day girl).

I couldn't sort my latch and positioning out without someone there to help. Spent hours looking at pictures and watching videos and getting more and more confused. If you find this happening to you I'd step away from the computer - it will only stress you out.

Any luck with gettinbg RL help Woofie? Almost impossible to get help about a latch without someone looking.

Hope you're getting some cooler weather up there too.

lilybolero- great that it seems to be fourth time lucky for you. I tried to do exactly the same my staying in my MLU for 5 days after the birth in order to try to crack latching on with lots of midwives on hand to help. I came out feeling pretty confident, but to be fair we moved house the next day, and the stress of that probably didn't help matters!

veronicacake- yes, I wouldn't have been worried about the poo as I've read that bfed babies are often not that regular as it's so easily digestible and doesn't leave much waste. But my mdwife raised her eyebrows when I told her and keeps asking if he's pooing more. He seems to be in a regular pattern of 2 days on, 1 day off.

latrucha- I owe you one! Went to Treasure Chest this afternoon and they observed our latch on both sides and apparently it's textbook. My mw had said it was ok too. The bf supporter suggested I switch boobs every few mins as he seems to become drowsy- previously I'd been struggling on the same side trying to ensure he reached the hindmilk. I don't want to speak too soon, but so far today it's worked like a charm. He's fed for 20-30 mins at a time, during which I've switched 2 or 3 times. She gave me the confidence to stop the feed when he's obviously stopped sucking hard and os just doing the odd slurp for comfort and assured me that he wad getting enough in that time. As a result he's been so much more content this afternoon and even did a 2 1/2 hour nap allowing me to play with ds1! Result! Such a simple adjustment, but touch wood it seems to have made a huge difference.

Thanks so much to everyone for all the comments and suggestions. I'll let you know how we get on x

Apologies for the typing- doing it one-handed while feeding...

woofie that sounds very good.

Switching sides is a good tip when a baby is sleepy and not gaining - there is so much mis-info about 'getting to the hindmilk'. Sleepy babies not sucking well don't get much of anything. Switching improves intake and increases amount of milk made - not something to do if the baby is not presenting any issues but low weight gain is not helped by artificially long periods of time on one breast.

There is so much misunderstanding of this

Fab news Woofie. Hope this is you both turning a corner! I thought their website was hilarious, BTW. Facebook would faint at the sight of it!