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

Your problems sound similar to the ones I've had recently.

Blocked milk duct - hot water bottle (over your clothes so as not to burn yourself) for 20 minutes then run over the lump towards the nipple. Do it for longer than you think you need. Phone the doctors and say you've got mastitis and ask for anti-biotics. Hopefully you'll release it, but you want to have that prescription ready in case.

Time spent expressing - I've just switched from a fancy electric pump to a basic tommee tippee hand pump. I get my full usual amount in 5 minutes. The trick is to hold the trigger down for a few seconds each time.

Fussiness - I use nipple shields when he's starving or very tired and lazy and practice the latch when things are calm. We've pretty much settled on day latching and night time shields.

Hope that helps.

To add - I feed entirely on one side and express from the other. He just never got the hang of one side.

Oh no, blocked ducts are so painful - weird suggestion but use a comb or brush and try to massage the lump - look for any milk blebs/blisters on the end of the nipple as this could be causing a blockage. I found a haakaa and epsom salts with warm water cleared mine. Then lots and lots of feeding, including dangle feeding x

@Whatissleep79 if you want to keep BF (and nothing wrong with not if you've had enough) then 100% get and lactation consultant out, one who can divide tongue ties ideally. Unfortunately the midwives and HV are not the experts in this area - my little boy had a missed tongue tie which once divided made everything so so much easier and i only wish that i'd seen one earlier!

Even if this is not the issue, there may be something else which is meaning your baby is struggling to feed and the consultant can help!

As for the blocked duct, don't panic, it can happen even if you're doing everything right! Hot shower and massage and then try to feed from that side where possible. I had blocked ducts occasionally and never had mastitis but make sure you get onto your GP if you start to feel unwell x

Thanks very much everyone! I took your advice ( even got a hot water bottle and kept it on too) looks like it’s gone down a lot.
Also woke every few hours last night to feed to get supply up. She’s still struggling a bit on boob when it’s not super full (like it is in the morning) her latch and feed is excellent when it’s like that so don’t think it’s a tongue tie ?? It’s when it’s droopy 😂 she screams then.
I will ask my hv for a lactation consultant recommendation
Thanks for all your support
@neverenoughchelseboots how do nipple shields help?

It makes your boob like a bottle teat so they just suck rather than latch.

My DS can latch when he's wide awake but only opens his mouth slightly at night and wants that less-effort way of feeding that bottles give. So it means I can still BF without him getting frustrated.

@neverenoughchelseboots

It makes your boob like a bottle teat so they just suck rather than latch.

My DS can latch when he's wide awake but only opens his mouth slightly at night and wants that less-effort way of feeding that bottles give. So it means I can still BF without him getting frustrated.

Great thanks I will try that! I’ve ordered some

Hi me again !
So she’s been cluster feeding for last 2 hours and I have a blister on one nipple! They are totally empty and she’s obviously hungry still , now crying incessantly. Made some formula and she had a bit but doesn’t like it and not had that much and crying lots.
What do I do in this situation ? 😭

So the thing about ´empty’ boobs is that the milk never completely stops, it just slows down. So don’t worry about feeding her from empty feeling boobs, it will still be helping. If she was really hungry she would have drunk the formula.
Has she got wind? That might be why she’s crying.

Or maybe right now she just wants to suck without getting any more milk? Try a dummy?

If you have a blister then her latch isn't deep enough. When getting her latched one you need to make sure you are bringing her in chin first and aiming your nipple up and to the back of her mouth. Not sure if that makes sense?? Google Flipple technique! Can you get some face to face BF support at all?

Boobs are factories not warehouses - never empty, just a slow production line sometimes cluster feeding is baby telling your boobs to speed up and make more milk quicker. Definitely agree with getting someone to double/triple check the latch because blisters aren't right. A dummy was great for mine when she wanted to comfort suck but I introduced it a bit later when breastfeeding was well established and I could read her cues.

Your boobs aren't "empty"- they work like a factory not a warehouse. IE they work on demand so if she's sucking they'll produce milk though not as quick a "let down" as when you haven't fed for an hour or 2.

I've ebf 3dc and my experience is that bf can be hard work. Babies are fussy when they're trying to increase your supply - it's the fussing and constant one-off feeding every 5 minutes that stimulates your breasts to produce more milk. If you want to breastfeed get a snack and a cuppa (or better send DH to get them so he can be useful), curl up in bed/on the sofa and just go with the crazy feeding frenzy. The skin to skin contact with your baby will also help to increase your supply. You don't say how old your baby is but if ebf/expressed milk they need to feed overnight if they're waking.

My experience is that bf eases up significantly around 4m but it can feel relentless before then and nothing can really prepare you for that.

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@Whatissleep79

Hi me again ! So she’s been cluster feeding for last 2 hours and I have a blister on one nipple! They are totally empty and she’s obviously hungry still , now crying incessantly. Made some formula and she had a bit but doesn’t like it and not had that much and crying lots. What do I do in this situation ? 😭

Bless you you're doing so well, this part is so hard but I promise it gets so much easier!

do you have nipple balm? I would get that on asap and after every feed. The only advice I got was feed through it but I would definitely have another opinion on the tongue tie as I was told she was fine but the tongue tie specialist showed me how severe it was we wouldn't have got further without sorting that.

I would say, if you feel you're drained off each breast, and she won't take a bottle which means I doubt she's still hungry- give her a very good wind for 5/10 minutes, (over shoulder, sat on lap, even the tiger tree )not sure if that's the right name))

Then I would get them back on the breast and settle yourself down and let them suck, a lot of the time with bf it's for comfort. Get yourself comfortable, have you googled the rugby ball hold? It maybe too early to lie down with her and feed but worth a go!

Sorry it's been a while since I was in the newborn bf stage but this is what I remembered helped

You won't run out of milk OP. Keep feeding or give her to your partner for cuddles if you need a break for a little bit. Blisters are so painful, I've had them a few times. Make sure you are getting a deep latch. Look up Kathryn Stagg on Instagram - I find her content useful.

You ladies are so fantastic thank you! I must remember the warehouse / factory analogy as well.
If she just wanted to feed that would be okay , it’s just the frustration and crying she shows, like she hates my boobs. Dh is making comments about why I can’t get enough milk and donor milk and not helping either. Good intentions but not the right timing.
I tried a few of your suggestions
Dummy - spat it out multiple multiple times
The latch was awful as in frustration she was matching and re- latching multiple times, so every time latch was wrong I redid it. That’s helped with the blister so thanks !
I’ve swathed boobs in lanolin now.
After two hours of crying and fussing I got dh up and she settled in ten minutes on him.
She’s now asleep and I’ll feed on demand throughout the night as suggested.
I think also she rejected the formula as it’s a new one not the newborn prepared ones we sometimes use, she was making disgusted face every time it went it her mouth. So think she was still hungry just nothing decent was on offer.
She has digestive issues too with lots of groaning, writhing and grunting, wind and loud poos so I think this is part of the issue too. She’s had this since day one.
Thank you for your support , my dh doesn’t get it or his mum and my mum can’t remember

@ohnocovidchristmas everyone seems to love the rugby hold but I couldn’t get it when shown in hospital ( May be as I was shown straight after c section!) I do cradle hold. I probably need to try some other positions too . I’ll try that thanks

@User0ne I copy and pasted what you wrote and text it to dh. He said I should feed every three hours (his mum told him) and didn’t believe in cluster feeding. Thinks I’m doing something wrong

If this is any help, prolactin is highest around 2-3am so pumping and or feeding then will help

One nice way to feed when you’re tired is lying down - put baby on her side and lie down next to her with her face level with you nipple, or you can lie on your back and put her on your tummy, again with her face level with your nipple.
Cluster feeding is absolutely normal. The whole feed every three to four hours thing probably works for some breastfed babies but have a theory that it’s not the norm and that many women who successfully breastfeed their newborns end up pretending they feed say 10 times per day, but actually it’s more often than that and they just start rounding it down to stop the comments about their baby being hungry all the time.
Have you got appointments to weigh your baby regularly? It’s important for all babies, but in your case I think you should try to get her weight checked fairly often because you’ve gone from mostly expressing and some formula top ups to mostly direct feeding and offering a little bit of formula (have I got that right?). It’s probably going swimmingly but checking her weight gain would be good. Either you’ll be reassured that the increased direct breastfeeding is working well, or you’ll know she that really does need top ups.

And my baby did the fussy thing at a similar age where we couldn’t work out if he was hungry or not. I think in our case he was probably gassy and suckling helped the pain so he wanted mum and boobs but also didn’t. A newborn babies screaming for ages while we try all the possible things she could want on a loop is an experience most of us parents have at some point. You’re doing all the right things. It does get easier. Eventually when they are toddlers they start telling you the ridiculous nonsensical reasons why they are upset (my child cries every time I try to get him dressed. It’s winter, wearing warm clothes is not a choice) instead of just crying at you and hoping you’ll guess.

If you have a blocked duct, you need to try different positions. I think someone mentioned dangle feeding. Also try and get the baby's chin pointing towards where the blockage is. Don't massage too much as this can aggravate glands and only massage lightly (as if you were putting lotion on). You can also massage towards the armpit so blockage goes back into lymphatic system. I was told this by a lactation consultant.
It's so annoying when well meaning partners and parents think they know more about breastfeeding!
Also you don't need to ask HV for lactation recommendation. I would Google who your nearest IBCLC is - hopefully there is someone nearby. Do you find she is fussy in evenings only as that is quite normal!

@Fantail86 thanks for that info - what does prolactin do? Does isn’t tell your body to make more milk? I go to bed at 1am and last feed is often 12 ish so probably need to change bedtime
Having said that she fed every hour last night, I’m so exhausted! Today she’s full of wind and not very alert, just sleeping and feeding. Hope she’s okay
@Diggersaursarethebest yes hanging onto it will get better! Thank you for the encouragement
@Abridget7 thanks for that, I’ve found some consultants. If I can’t get this on track by Monday I’ll contact one. Her weight was good about ten days ago but we are due to weigh again over the weekend. Bought the formula she will take in case we need top ups too

@User0ne

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Great minds @User0ne