Breastfeeding advice please !

[Whatissleep79]

My dd was born weighing 10lbs and jaundiced. She was very sleepy and would breastfeed often but fall asleep quickly. Over the next 3 weeks her weight fell and the midwife advised me to bf on one boob and express on the other, then feed the expressed milk. She gained weight and we were discharged.
However, now I’ve been doing mainly expressing as she’s very impatient on my breast now ( too used to bottle now and not wanting to work hard maybe ?!) and either cries or comes off after a while and is hungry again five mins later
I bf in the morning when very full and may
be once in the day , the rest is expressed bottle.
I just can’t keep up the pace though, to express takes 45 mins - hour, 5x a day. Then feeding it back ( although dh helps) The demand is increasing at 4 weeks up to 150ml a feed and don’t feel like my boobs can keep up!
I do sleep 5 hours over night just because I got really unwell recently and desperately needed the sleep. Perhaps missing feeding / expressing during that time is the issue but I feel I should be able to make it up during the day
Any experienced bf who can help me ? Thanks mums

How old is baby now? Does she latch well?

I'd personally just stick to breast to make it easier for yourself and leave the expressing now. Feed on demand/cue ie any time baby is fussing or even just awake and willing to latch on then feed to increase your supply (sit in front of telly with a nice snack and drink, it's more enjoyable than washing bottles and pump bits!).

Babies can remove milk from the breast much more effectively than a pump. After a couple of days of fussing, your supply will probably increase from the breastfeeding and things may settle.

Also the reality is that BF babies are on the breast a lot so it can be normal for baby to want milk again after 5 mins. It does all eventually settle.

That being said, you will know your baby best

Put the baby to the breast and keep her there all the time. That's the best principle.

It sounds like expressing was needed to begin with to get her weight back on track but now you're not going to be able to keep that up. You'll knacker yourself!

What age is she now? If you stick to breastfeeding you'd be going through cluster feeding stages anyway. When they go through a phase of cluster feeding you can convince yourself they're not getting enough milk from you because it seems that way when they cry so soon after feeding. But they're signalling to your body to increase supply as they're growing so the feeding is almost mechanical to tell your body to produce more milk.

It's bloody hard work as sometimes they do just want to feed constantly but the cluster feeding comes and goes with growth spurts, eventually settling completely.

If it’s nipple confusion have you tried using a nipple shield for a little while to get her used to the breast? Then wean away from the shield as they’re not a long term solution

I had very similar with my daughter. Prior to that experience I'd have said the same thing as others - that babies get more milk out than a pump, just breastfeed more etc. However if you don't know the reason why baby was tiring herself out while feeding it could happen again once you stop the top ups.

My daughter lost a lot of weight early on and I was sent to A&E a few times due to weight loss and then slow weight gain. She latched well and tried so hard at the breast but after realising she wasn't gaining I noticed she wasn't swallowing while feeding or would only swallow once every 10 or so sucks. I went to breastfeeding support groups and tried all advice but ultimately she couldn't extract milk as she should.

The best thing to do would be to seek professional breastfeeding support. The IBCLC I reached out to was so useful and could advise on upping my supply so I could express enough (breastfeeding, expressing and bottle feeding 7- 8x a day is tough!) as well as how to reduce bottles once issues were resolved. She advised me not to just stop bottles as this can significantly impact weight and instead to reduce an ounce or so daily every few days after weighing to check she was gaining as she should.

You're doing so well and it isn't easy. Your local breastfeeding support group should be able to offer some advice and if you wanted to speak to an IBCLC they should be able to recommend someone in your area.

It’s completely normal for a baby on breast milk to want to constantly feed and be fussy for at least the first 6 weeks and then just be like it in the evening.

What do you want - baby back on the breast, express and mix feed, exclusively pump, move to formula?

If you want to breastfeed I'd sack off expressing (at least for the most part) and topping up now baby is gaining weight. Just feed feed feed as often as baby shows signs. Bottles are easier for babies to get milk from unless you pace feed so some will try to get that as the easy way out. You could keep one bottle feed for your partner to do to help you get a bit more sleep (I did that until 7/8 months when feeds started to lessen a little and it was a god send) and we used formula for that one so it was easy. Also be aware that the amount you can pump is not the same as the amount that baby can get from breastfeeding- babies are much more efficient so pumping is not usually an indication of poor supply.

I am exclusively expressing and till 3 months I think it needs to be at least 8 times a day (to get the supply ) .I do for 15 min (hand free pump both sides ) and its done.Definitely not over 20 min...

I would stop expressing and just keep her on the boob. She might be a bit fussy for a few feeds but if she has a good latch then it won't do her any harm.

Exclusively expressing has fewer benefits than breastfeeding, there are a few studies where the babies came out the same as formual babies rather than breastfed babies. Your boobs and your baby talk to each other about what nutrients and type of milk is required when all of this is lost when expressing. As is all of the benefits of the physical closeness of actually feeding.

Plus mum ends up wasting time pumping and bottlefeeding, all that sterilisingand pump cleaning. Just skip the middle man of pumping either breastfeed or formula feed as you are currently getting non of the benefits of either.

Thanks all, really useful advice. Having a hard day as she’s either falling asleep on boob or screaming after 5 mins and I have done two successful breast feeds but had to do rest bottle as would not stay latched and was screaming. I never realised expressing would cause these issues with bf.
I have to go somewhere tomorrow but I plan to stay in a couple of days and may be just wake to feed her regularly so she’s not super hangry and then my boobs get stimulated and also return to feeding part way through the night to increase milk.
@JustWonderingIfYou I never knew this! No one told me, my health visitor rang today and she said it was incorrect. Well a simple google showed you were correct. The whole reason I was bf was to provide all the benefits of bf and wish I’d been told it wasn’t the same by the hv or midwife team I’ve been seeing

@HollieD31

I am exclusively expressing and till 3 months I think it needs to be at least 8 times a day (to get the supply ) .I do for 15 min (hand free pump both sides ) and its done.Definitely not over 20 min...

Thanks, at 15 mins I hardly have anything but can get up to 100ml each boob of I go for 45/60 mins

@Whatissleep79

Thanks all, really useful advice. Having a hard day as she’s either falling asleep on boob or screaming after 5 mins and I have done two successful breast feeds but had to do rest bottle as would not stay latched and was screaming. I never realised expressing would cause these issues with bf. I have to go somewhere tomorrow but I plan to stay in a couple of days and may be just wake to feed her regularly so she’s not super hangry and then my boobs get stimulated and also return to feeding part way through the night to increase milk. *@JustWonderingIfYou* I never knew this! No one told me, my health visitor rang today and she said it was incorrect. Well a simple google showed you were correct. The whole reason I was bf was to provide all the benefits of bf and wish I’d been told it wasn’t the same by the hv or midwife team I’ve been seeing

That sounds like a great plan. It will probably take a bit of time for you both to adjust so don't worry if it seems slow, just increase breastfeeding over time

I remember those early weeks, sounds like she's upping your supply for a growth spurt etc. Are you using a haakaa whilst feeding on one side, I found that the easiest way to get a freezer stash started and maintained. I found trying to pump and feed on demand so tiring, so if you can - spend a day or two skin to skin feeding loads and she'll settle and up your supply too. Get the snacks and water in too 🙌

Thanks @KatieKat88 and @2021expecting
Is a haakaa a breast pump? I use Medela swing double pump. So pump both after a feed or when I feel full ( and she’s asleep)
If I wear a sling for a day or two and feed on demand will it make her favour being on me too much? At the moment she’ll actually sleep in her cot and I don’t want her to start rejecting it and wanting to be on me at night and not be able to put her down !

@Whatissleep79 it's more for milk collection when you're little one is feeding off one side, so you can collect the let down on the other side - honestly it's so much handier than pumping as well as feeding on demand. It'll increase the demand for milk supply too as its milk removal.

I use it on the opposite side when my little boy is feeding and then switch both round and catch the following letdowns. When I'm feeling full though I'd use a proper pump, manual or electric.

Ps yes definitely use the sling at times, the skin to skin and feeding on demand will help x

Have you had her checked for tongue tie?

Tongue tied babies often only feed in one side
They are generally ineffective and fussy feeders
Expressing and bottle feeding exacerbates this

I would get her checked and if she had been checked do so again in case she has a trickier posterior tongue tie which issues babies to be fidgety breast feeders

@Whatissleep79

Thanks *@KatieKat88 and @2021expecting* Is a haakaa a breast pump? I use Medela swing double pump. So pump both after a feed or when I feel full ( and she’s asleep) If I wear a sling for a day or two and feed on demand will it make her favour being on me too much? At the moment she’ll actually sleep in her cot and I don’t want her to start rejecting it and wanting to be on me at night and not be able to put her down !

To be honest when it comes to sleep I'd just do what works for right now. You may find sleep regressions turn it all to hell later regardless of you doing all of the 'right' things now! Or you'll be lucky and it's fine regardless. Do what's best for you both for now and worry about later when it comes.

She was checked for tongue tie at hospital and by midwife and was ok. She latched well I think and when the boob is full is happy and stays on - just an issue when it’s not full.
Ladies so upset today , woke up and one boob has a huge painful lump in it - not going away with pumping. I’ve been googling and not sure it’s mastitis as the lump is huge ( almost like the hardness when boob is engorged before feeding)
Just feel like giving up Bf and had 3 hours sleep, it hurts and I’m feeling 😞

The lump is almost certainly a blocked milk duct. I found that shower helps. You can try to hand express in the shower. That might sort it. Also play around with the position when you breastfeed - it can help baby to suck out the clog if gravity is also helping. Look up ´danglefeeding’ on the kellymom website. - this might be a bit tricky with a 1 month old though.

My post should say ´hot shower’. - as hot as you can without burning yourself.

kellymom.com/bf/concerns/mother/mastitis/

@Diggersaursarethebest thank you so much 💖 I’m following the advice on the link you sent me. I will have a warm shower soon and try the dangle feed. It seems to be affecting milk supply so preparing for her to be twice as fussy though :/

You’re welcome!