Failing at breast feed feeding late premie

[Bells3032]

My baby girl was born 10 days ago at 34 weeks. I had hardly any colostrum so the hospital suggested I use a pump to initiate, feed with breast and top up with 20-30ml of forumula.

At our check today baby has lost weight so we were sent to the hospital for a check. Everything is OK with baby bar the weight loss. So they've upped the formula but want me to feed for 45 mins and pump at the same time on the other breast. I can't seem to balance baby in a position that allows this though.

I have pumped for well over an hour today and this is all I got.

Sorry pic included now

Op don't put too much pressure on yourself. I was in the same position with my youngest who was born early. Took me 3 weeks to start being able to pump 50-100 ml.
What helped me was making sure I ate plenty ( was barely eating before)
Lots & lots of water
& tons of oat milk , oat cookies anything with oats in.
Also don't pump for longer than 40 mins every 2/3 h

Good luck & remember that fed is best 😉 xx

If it's not working, you can stop doing it. And it does sound like it's not really working for you and your baby. In fact it sounds cumbersome and really the opposite of the relaxed state of mind you need to be in to get the 'let-down' reflex.

I say this as someone who bf their premature baby (35 weeks) who was very small (pre-eclampsia induction). You get to choose what makes you feel comfortable. It sounds rather like the hospital is turning bf into some sort of medicalised 'prescription' experience for you.

Lots of babies lose weight over the first 7 days while bf is established, and then they catch up. I fed my baby little and often, little and often, anywhere and everywhere. I wore him down the front of my top a lot to keep him warm and calm - it seemed to help.

All my best wishes to you and your baby

The advise we give is to pump 10-12 times a day. Approx 15 mins each side, double pump if you can. Pump when you feel you want/need for example cluster pumping in the evenings. Keep offering the breast before any bottles. Would probably say 30 mins though.

Don't look at the volume of milk, the frequency will help build up your supply. What was your babies birth weight?

I'm sorry I don't have advice on preemie feeding, but congratulations on your little one . You are not failing!

I really struggled with breastfeeding in the first lockdown, there was no support and it was soo hard. I found threads on here and Facebook groups so helpful, and our local infant feeding team were also really helpful and would video call me. Is there someone like that available to you?

Also, as much skin to skin as you possibly can (I was amazed at how much difference it made to both me and baby), loads of food and drink and rest as much as you possibly can. I imagine all feel like impossible things at the moment! I hope you get all the support you need.

I don't mean stop bf btw! I mean the tandem/simultaneous bf and pump business if it's not working. You'll maybe get a better let-down reflex if you're more relaxed.

My little boy was born at 30 weeks and I expressed for about 2 months because he was too small to latch on properly. We had to top up with formula and in the end went to formula completely. I was getting similar amounts to that for the first few weeks and never got more 50ml per pump. It got better the more I put him next to the breast, higher number of shorter pumping sessions, when I drank lots of water and ate more and when I slept. Volume was definitely related to stress for me.
I found it hard to stop emotionally but I agree with pp that fed is best, try not to over worry about it as it will slow production.

I also agree with @SpindleSpangle don't try to pump and feed at the same time. Try and enjoy the time you are breastfeeding, being relaxed is really important for your let down. Pumping at the same time sounds far to stressful.

Firstly it would be fine to switch to just formula feeding now or at any point where you feel this is right. It is important your baby has a healthy happy mum so don’t send yourself mad trying to breastfeed if it is not for you.
In your shoes I would try to feed as much as possible, top up with formula and then pump if you want to afterwards. This pumping will not be to actually get any milk off but more to signal to your body to produce more milk.
It really is not unusual for a baby to be lower their birth weight at 10 days, if still below at three weeks that would be a worry.
Hopefully you have help because if you want to establish breastfeeding you really do need to eat, drink, sleep and feed. Anything added to that list will make it difficult. Again I say we are so lucky to have a safe alternative.

My DD was born at 38weeks but was tiny due to my pregnancy induced hypertension. She was also terrible feeder - she had a poor latch and was syringe fed for two days, then after she spent two weeks in NICU / SCBU for sepsis, my supply was none existent. She dropped to below the 0.4th centile at 3 weeks old and i was so stressed. I contacted the infant feeding team and with their advice, followed a plan as below:

• bf on demand
• after each bf, top up with 30-40ml formula until she was 12 weeks, when we upped the top ups to 70ml
• pump after each feed, 10mins per side only. Never miss the 2-3am pump. I kept this going until she was 3 or 4 months, even when she was sleeping through!! 😭😭😭 To help with time, i got DH to do the formula top ups whilst i pumped. I then dropped the pumping to eventually only doing the 3am pump.
• hired the medela symphony hospital grade pump. £47 per month to hire and so much more powerful than my home pump. Infant feeding team advised that it was one of the best for increasing supply
• loads of water and rest. I got recommend fenugreek capsules but they made DD very fussy so I gave up on them. I also bought some bfing cookies to eat, but still sceptical as to how effective they were!

I never ever got more than 50ml out of a pumping session and could sometimes only get around 100ml in total per day some days. But it didn't matter because the purpose of the pumping was really to keep my supply going.

I felt insanely jealous of NCT friends who were out and about with their babies and could feed anywhere - i felt much more tied to home and each feed was taking about an hour. But bf was important to me and i wanted to make sure I'd given it my best shot.

DD got back to her birth centile (2nd) and is now between 2nd and 9th, where i think she will stay. She is 6 months old. Our bf journey has been hard and I've just now switched to formula for during the day and i only bf breakfast and bedtime. I was on the point of switching to formula completely at 3 weeks, so am pleased to have got this far. But having said that, formula has been freeing after those difficult early days and im not sure i would do the same again.

Whatever you choose to do will be the best for you and your baby, but if you do want to carry on bf, hope the above helps!

So they've upped the formula but want me to feed for 45 mins and pump at the same time on the other breast. I can't seem to balance baby in a position that allows this though.

I don't think I would be able to do this either.
I combination-fed from the very beginning, because I didn't have much milk.

Don't put too much pressure on yourself.
The most important thing is for your baby to get enough nutrients, so give her as much formula as she needs. Pump after you feed. If milk production doesn't increase much after a few weeks, I think you can just stop. Some people do have low supply.

Thanks all for the messages, advice and support. She's deff got more. Energy today and gulping down her formula. But since we've upped the formula she's stubbornly refused to latch at all. Guessing it's not worth the effort to her if she's not hungry.

Honestly if she was a full term baby I wouldn't hesitate to just switch to forumula all together. I am getting next to nothing in the pump... No wonder she was losing weight. Just want her to get a bit of an immunity boost.

I never imagined it would be this hard physically or emotionally.

Sending lots of hugs as I know how hard it can be!

You can always have her on the boob and then if she’s getting unhappy give her a bottle afterwards. Nothing wrong with offering boob first. Also, I found I had more milk at night so you could also give more boob at night? When my supply was low my ds would always be satisfied with just the boob at night but day time feeds I would supplement. If you’re combi feeding she’ll still be getting the immunity boost from you plus you’ll have the reassurance that she’s not losing weight.

Best of luck! Xxx