Calling all experienced mums/breastfeeding professionals! 4 day old newborn and need advice :/

[Limkanon]

Tia to everyone willing to offer advice/share their experience/reassure me that I'm not going mad! Settle in, it might be a long(ish) one as I need a rant.

I gave birth a baby boy via emcs on Wed morning 5.30am (now Sunday night). He latched well and I fed (or assume I fed) colostrum successfully from Wed until Thurs afternoon. Nurses checked the latch regularly for me and seemed happy. On Thurs I noticed he seemed unsettled and my milk didn't appear to be in yet. The experienced mother in the bed next to mine was topping up with formula and suggested I try the same while awaiting my milk, so I did, despite always having a vision of 100% contact bf. I "topped up" with formula until discharge on Friday afternoon and baby was doing well, 8% weight loss, and lots of wet/dirty Nappies.

Cut to me being home.. Friday afternoon became uncomfy with using any formula at all, still wasn't sure if my milk was in, unsure re latch, sleepy baby etc and anyway, decided to stop formula and just ebf at the breast. Did so from fri pm to sat 11pm and not one discernably wet/no dirty Nappies in 24 hours following. Became freaked out that my baby was dehydrating in front of me and restarted formula top ups 24 hrs ago to a welcome return of Nappies.

Now offering one/both breast every 1-3 hours, letting baby feed and then topping up each feed with 30 ml formula. Still unsure re latch and don't know if milk is in. Hate not seeing how much he is getting from the breast.

I'm basically all over the place, and have had no guidance. I'm offering breast first every 1-3 hrs, followed by a formula top up. Baby is still sleepy and distracted at the breast, but always takes the formula easily after finishing the breast .

Nappies good. I don't want to get into expressing breast milks as a solo parent, I have enough on my plate. In a perfect world, I'd get off the formula and ebf but would need to be feeling significantly more confident. Am I going wrong somewhere? How can I get to where I want to be from here? Help!

You need someone to see your latch and watch a feed. I would offer both breasts at least every two hours in the day and try a little expressing to replace the formula where possible. Call NCT, LLL, ABM - goggle for helplines and see what groups you have locally. The quicker you get support and a plan the more options you will have.

Sorry just saw about the expressing - hmm have you seen the Hakka - cheap and easy. Sterilise then keep in the fridge for in between using… would that make it more viable? If not then it’s extra important to see a bf specialist.

Don't panic, very early days. It's not ideal to have the to ups introduced so early as they don't have to work for a bottle, so they quickly prefer it. But all is not lost. I would up your own water intake, to at least 2-3 litres. Make sure you don't take lemsip or sudafed as they will dry up your milk. You may need to temporarily express a bit, which you can just do by hand. Look into the suction pumps that can pick up spare drops of milk, they can increase supply well.
Finally, get baby on the breast pretty much all the time. Offer every 45 minutes of so and see how that goes. The more frequent feeds will boost supply .

CherryB - all good other than the water. Just drink to your thirst OP - extra water won’t affect your supply only milk removal will.

Can you try hand expressing to check whether your milk is actually there and is flowing easily?

I would recommend a haaka as well, you can attach it to your opposite breast as you're feeding and catches any let down/leakage. Then feed that amount as a top up after your baby has finished their breast feed.

Are you doing all the other bits and pieces around breastfeeding too? Plenty of water, lots of calories for you, skin to skin - seriously just get into bed clothes off and rest there, keep baby on the boob even when asleep, let them suckle as they desire… keep an eye on nappies but remember the absorbency of them is really good and baby bladders are only tiny so potentially keep them on a bit longer just to see how wet they get over several hours?

Milk supply in the breast works on a supply and demand basis so the more your baby is at the breast the more milk you will make. So I would try to gradually up the time on the breast and reduce the formula (if you want to stop the formula that it - nothing wrong with it of course if it’s working for you). Once you are off the formula don’t be alarmed if there are days/nights when you’re baby wants to feed for hours on end. It’s called ‘cluster feeding’ and they do it to up your milk supply (not necessarily because they are famished).

Offer the breast constantly - expect short feeds every twenty minutes. Top up without fear as long as you keep that access to the breast open.

Thanks so much everyone for your fast replies. I'm really touched by the number of people wanting to take time to help out. So far, I'm seeing:

Ask the public health nurse to evaluate my latch and watch a feed - she's coming tommorow!
Access local support group, lactatiioon consultant - will pursue
Offer boob(s) first and every 20 mins to 2 hrs-the more the better
Calories, water intake, skin to skin
Express using the haakaa - I have one-offer this as top up, and reduce the amt of formula topup until baby ebf whether from btl or breast

Some great tips to be getting on with here, and more welcome. Thanks so much very one x

You will know your milk has come in because you will feel engorged and uncomfortable and you will experience prickly let down once a feed has got going.

Keep going. Just keep going. I think one reason bf is tricky is that ff is exactly the same from the 1st new born bottle to the last and bf is a whole other adventure!!!

Just keep going x

Hi 👋 I breastfed
My 2 boys for 2 years and had lots of dramas at the beginning of my first !

Often only a lactation consultant can review the latch and if there is any tongue tie (a good friend of mine is a lactation consultant and we've had hours of breastfeeding chats !)

The supply and demand of milk takes about 6 weeks to establish. Often people give up as they think the baby is not getting enough and is on the boob constantly - this cluster feeding for hours and hours ( in the first week I remember he was on the book for nearly 18 hours in a day!) is pet of the supply and demand , effectively "putting the order in" but it takes Time.

Introducing formula messes up the balance and stops your milk being produced so well. Over time the baby will end up taking more formula and the boob milk balance will keep dropping.

You can Skype / zoom some lactation consultants which I'd make a priority if they can't see you in person right away.

Good luck and well done - get a box set on and keep the feeding for hours and hours and hours (hopefully with a good latch !) as this will keep creating a milk supply but it takes quite some time.

Diarise and write down the wet nappies and poos and weight of the wet nappies of you are worried.

Good luck - you can do it !!! There are some women that can't breastfeeding but it's actually extremely rare . More often than not a lactation consultant can get any issues sorted

Lots of water , lanolin for the nipples can cause the baby to slip. Watch you tube videos on different latch techniques. And yes it's kind boggling why something so natural is so blinking hard at the beginning !

Keep it up as it becomes easy peasy over formula , no sterilising , lots of lazy mornings with a milk drink baby make it all worth it x

Xx

To add - put lanolin on nipples after a feed not before x

How is it going? You should both be under mf care until at least day 10, ask them to come out every day of needed.

It's not unusual for milk to come in more slowly after a traumatic birth. When you're feeling confident that your latch is good and your milk has come in, I found Kelly mum really good on how to gradually reduce top ups. Basically make a note of the total amount of formula baby is having in 24 hours and reduce that 24hr total by 30ml every couple of days. Then breast feed loads to give your baby a chance to demand more from your boobs. You can pump but it's not essential- I didn't

• just fed, fed, fed. Keep an eye on nappies to make sure there's no discernable change. If nappy production slows down, slow down the rate at which you reduce top ups but try not to go back up to more formula if you can. Once health visitor is happy with baby's weight gain, try to resist weighing baby more than every month or so as weight gain is not consistent and it will prevent you from feeling confident in reducing the formula. Nappy monitoring is much more reliable! Good luck - it can be done- I got down from 280ml in 24 hours to 30ml by about 10 weeks, which she then rejected at around 5.5 months so you can get back to EBF for sure. I did find it very, very anxiety provoking though and with the benefit of hindsight I realise that breastfeeding is not the be all and end all and mixed feeding can be an excellent option.

Thanks for all the additional replies guys. It's been a crazy week. I had a very remowned private lactation consultant come out to me on Tues afternoon. To make a long story short, this woman, who has 40 years experience and was the president of the national breastfeeding body for many years diagnosed me straightaway with hypoplastic breasts and poor supply. My baby was dehydrated and jaundiced, and v tired. All shocking to hear. We've had a 15 point plan in place the last few days to increase my supply but in short nothing is working, incl medication, lifestyle pumping. I was advised yesterday that my milk may be unlikely to come in and as worries re my baby's health and my emotional state were unavoidable I have switched to formula, a very emotional decision, and one I'm still adjusting to. At this point, as long as baby is fed I'm happy. I can't keep flogging a dead horse. I just want to enjoy my baby.

So, he has plenty of wet nappies, but had no dirty Nappies at all from monday 12pm to Thurs 1pm, part of the reason for formula. They have been incr the amount of formula and are trying to get me to get 90ml into him every three hours, but he is only 6lbs+ and not able for it. He gets v sleepy and it starts dribbling back out and I hate forcing him. But mo dirty nappy since 1pm yesterday again, so that's the latest worry! Any advice/reassurance on this? It can't be normal? He's taking between 60-90 ml per feed to be fair.

Lc said for next baby, if I can bear to go thru it again, I will need to plan ahead for my condition and come and see her when I am 6 months along to get a plan on place rather than firefighting once baby is here. Hope my story brings some helpful info/reassurance to someone else going thru this, as I have been so reassured by reading storied of the terrible guilt and upset that comes with switching to formula....

I would stop using the formula and nurse him pretty much constantly. That's what is going to secure your milk supply.

@HellToTheNope have you read the OP's latest update?

@Limkanon Do whatever you need to lovely. It's ok to feel emotional about introducing formula. I've been where you are, and it did all work out - we introduced formula as baby's main oral intake and then in time used BF for comfort, once DS was older and relied less on the quantity of milk (6 months+), we continued to mix feed.

Ultimately as long as baby is fed, that's all that matters. (Also have hypoplastic breasts and experienced trying to EBF a dinky jaundiced newborn, be kind to yourself, it's been a rough time for you too). Xx

Just saw your question @Limkanon - contact your MW or HV, they should be able to answer x

Formula was invented for just this situation. You are doing exactly what is best for your baby and yourself. I wonder whether feeding less formula more frequently might be a way forward to support your baby's little tummy? On the poo front, now you're using more formula, you know he's getting nutrients so it will come.

Thank you everyone. I could not have coped with judgemental answers. It's good to know that this is an online forum which is supportive and reassuring. Cried whilst investing in a tommee tippee feeding machine today but I'll get over it. Cried while watching my husband feeding him and chose to clean the toilet through the tears instead! What a mess ladies. Thanks so much again xx

Read your updates with mixed feelings. You poor thing, your gut feeling was spot on but you've got an answer and now you can move forward and watch your baby thrive.

Be v gentle with yourself, the hormone shift post birth is immense as is the one when you stop bfing, coupled with your sadness.

Glad you have a plan

Thank you so much for your support, it means more than you know x

Please dont cry, you are such a wonderful mum, doing the very best for your gorgeous baby who will be fed and will thrive.