Breastfeeding any advice appreciated

[FTM2B1]

I'm a FTM to a 2 week old and I'm attempting to EBF. My LO was BF the hour after birth but was taken to the neonatal ward 24 hours after birth and was nil by mouth for 48 hours before I was able to feed her again.

When she had her home visit with the midwife she had lost 8% of her birth weight. This was within normal range, the midwives at hospital had been happy with her latch and positioning and feeding seemed to be going well. She has been feeding around 10 times throughout a 24 hour period but can fall asleep on the breast and feed or appear to feed for nearly an hour.

When we had our midwife check up at 14 days, she had lost another 8g - the midwife didn't seem overly concerned and asked what I'd been eating. She advised I wasn't eating enough and while I am producing enough milk, it's not quality milk. So I've been advised to up my food intake and continue feeding, on the advice that when the milk is of quality baby should become more efficient and feed in around 20 minutes a session.

The trouble is im now really worried that I'm doing something wrong and my eating more won't solve the problem. She has been feeding so much I was convinced she would have gained weight. I've tried to do a bit of research but all the information is overwhelming and contradictory. (Including the school of thought that mum eating more of the right food improves milk quality - apparently thats a myth?!).

I've tried letting her feed for as long as she wants until she unlatches, I've tried switch feeding when she appears sleepy, I've tried taking her off and letting her re-latch. I've checked her latch and it looks consistent with when we were in hospital... I can hear and see swallowing and she frequently unlatches with milk around her mouth. We are getting the right amount of wet and dirty nappies each day and the colour of the poo is as should be.

I'm going to ring the breastfeeding helpline tomorrow but was wondering if anyone else had had a similar experience or could offer their perspective? I feel like I'm doing all I can for her and also not doing enough and completely failing her all at the same time.

My son had a very slow weight gain and he fed CONSTANTLY. Pretty mich all day every day.

I bought some super-high in protein yogurts that helped my milk. Also lots of oats - I would have a flapjack at the 3am feed so it would be in the morning milk.

Good luck!

Firstly, congratulations on your new baby girl!
secondly, you’re doing a great job. Some babies do take longer to gain their weight back, switching breast too soon could mean your baby isn’t drawing out enough of the fattier milk. But if she’s having wet and dirty nappies as expected it might just be that she’s taking a little longer to put the weight on. Please try not to worry!

It’s early days yet at two weeks and you are still getting established. It doesn’t sound like the midwife is too worried about her weight, so you try not to fret either.
If she’s doing wet and dirty nappies and her latch is fine it is just a case of establishing a supply. You’ll get there. I think it often comes as a shock how long it takes to establish breastfeeding, because it looks so simple!
In terms of what you are eating, it takes about an extra 500kcal a day to ebf, so make sure you are getting a good balanced diet. The odd bit of chocolate doesn’t go amiss at this stage either - not because it’s nutritionally beneficial, just because you can!
You aren’t failing her.

As pp have said it sounds like you and baby are establishing breastfeeding well. The nappies are a really good indicator of intake so if they're normal I wouldn't be too concerned.

You can have a look into breast compressions as I think that is supposed to help move the fattier milk down?

Definitely agree that oats are good to eat too. I was another that had oat bars at 3am and it was brilliant!

I recommend calling the lovely people at the National Breastfeeding Helpline for advice and support.

www.nationalbreastfeedinghelpline.org.uk

Hi, probs not much help but sounds like you are doing an amazing job, I am ebf my now 5 month old, who was 2 months prem.
I had the same worries at the beginning, slow gaining weight, worried that she wasn't having enough due to frequent feeds (every hour first few weeks!).
I pumped as often as possible to improve supply, plenty of skin to skin, my girl too would fall asleep so I tried not to make things too cosy, but also bare in mind that bf takes up energy for them too.
Also the weight charts are the same for formula and for bf babies and all babies are different, as long as your baby seems satisfied, heathy and not dehydrated, and sounds like nappies are fine then chill, the more you worry the harder it is too, some breast madsages before feeds will help release hind milk (the creamy fatty milk) and also don't swap breasts until after baby has been doing a fluttery type of suck almost like they jaw is shaking a bit on your nipple, this is your baby getting at that hind creamy milk, this is what will help with weight gain.
My Baba takes about 30 mins feeding around 3 hour apart now, but once 5pm comes she cluster feeds until 10ish, every pattern and baby is different and things change as soon as you think you've got a routine lol,
Well done, be confident your doing fab x

I don’t think that’s a worrying amount of weight loss?

unfortunately majority of HV’s have literally ZERO knowledge on breastfeeding. Like literally zero. Which is dangerous because when they impart advice on first time mums it can cause detrimental problems.

when my son was 4 weeks old he only gained something like 80g but given that he’d gained twice that amount the week before the HV insisted something was wrong with my supply and told me to start giving my son formula top ups after every feed. I took her shitty advice and It wrecked my supply. Obviously it wrecked my supply as I had only been breastfeeding for a couple weeks But this was my first time breastfeeding, I had no idea about milk supplies being established and all the rest of it. I just felt traumatised at the thought of my newborn not getting enough milk and my breast milk not being enough!

anyway, my advice to you and I wish I had done the same sooner is, if you can afford it, get an lactation consult to come over. It was the best money I ever spent and she said she had no idea why the HV told me to start introducing formula when I had only just started breastfeeding and that she wasn’t concerned by the low weight gain.

One other thing that came to mind is
have you checked for tongue tie? That can affect efficiency of milk transfer. If you get a lactation consultant to come and visit you often they check for tongue tie anyway.

if you’re in Sw London I can recommend an incredible lady.

i really faced pretty much every challenge when it came to breastfeeding so I really know how hard it is. Hang on in there and feel free to message me anytime if you have any questions or need any support.

sending hugs xxxx p.s. Of course you’re not failing her. You sound like an absolutely brilliant mummy

8% is OK and 8 grams is basically nothing - they don't usually even calibrate the scales down to single grams, they often round to the nearest 10 grams. Although agree that you would hope for some gain 2 weeks in rather than maintaining weight.

Don't worry though, what you eat does not affect quality of milk. Also, it would be extremely unusual for a newborn to settle down to 20 minute feeds - it's totally normal for them to take longer to feed. Your midwife seems to have some strange ideas about breastfeeding.

Carry on doing what you're doing - sounds like you're doing brilliantly. I had one who had to go to NICU for 24 hours and we really struggled to establish BF.

Follow Lucy Ruddle & LMJ Feeding Support on social media for some drip drip good evidence based quality information.

Def ring BF helpline tomorrow - they should be good.

Do you have any local support groups or drop ins? Those are usually great to go to.

This just reminded me to tell you that ‘switch nursing’ is a great way to boost supply. After each let down of milk, or once thé baby stops actively sucking, you switch to the other boob and keep switching. And so long as you switch so that they’ve been on each boob 2/3 times they will have got the richer/fattier milk so don’t worry about that 😊

I’ve been breastfeeding on and off (but mostly on) for the past ten years and sat through many breastfeeding support sessions in that time… unless you’re starving yourself, I’m not sure there’s any evidence to suggest that you need to have quality food in to get quality milk out.

well done for getting this far! Despite the many years of breastfeeding starting was the hardest thing I’ve ever done. At that stage my babies could feed for a long time - an hour out of every two at times (yawn) and for hours at a time in the evenings/overnight (look up cluster feeding). The sad truth is some midwives are not hugely trained on breastfeeding (the first one I saw said that I’d never get any milk out of my breasts… ha…)

if you have money you can pay to see an certified breastfeeding consultant who may help. If not (and it’s really not necessary) can you find details of local breastfeeding support groups (either run by the NHS or community based). They can be great for advice and stories.

if you’re on social media, follow some people like @makesmilk, the analytical armadillo, and Kellymom for some more support.

and… formula isn’t terrible. If you end up formula feesing or mixed feeding, they’re all valid ways of feeding your baby and you really can’t tell the difference as they grow up.

Congratulations and good luck.

Congratulations on your new arrival!
A realistic expectation of a newborn feeding isn’t evenly spaced 20 minute efficient feeds. Your body is learning what it needs to produce for her and she is learning how to feed effectively too.
Breasts work on a “supply and demand” and these demands will change as she grows too. Therefore feed times will be unpredictable and will stay fairly unpredictable as babies have growth spurts, teething, developmental changes and illness.
But this is also why breastfeeding is so great! Our bodies respond to what our baby needs in that moment of their life, be it antibodies for an illness, more watery milk if they seem thirsty or less milk when there growth is slowing down.
Eating a healthy diet helps us feel good and avoid illnesses but in terms of breastfeeding your body will prioritise creating the milk over anything else unless on a really restrictive diet. Drinking plenty of water might have more of an effect on how much milk is produced.

I'm not a lactation consultant, but the midwife saying you're making poor quality milk because you're not eating enough doesn't sound like she knows very much! Poor quality milk? What? The only real way to increase milk is to remove it from the breast more often. The only food that helped me make more milk were fenugreek seeds and they were gross.

My baby wasn't gaining weight and it turned out that I had low supply. Her paediatrician wanted me to put her on formula but I paid a private lactation consultant to come out, who put me on a (gruelling) feeding/pumping plan. It worked! My baby is 4 months old now and EBF. I took her to meet some friends yesterday and they were all commenting on how chubby she was (she has rolls on her rolls!). I was overjoyed because at one point I was hardly producing anything.

So, my advice is to feed, feed, feed and get some advice from a lactation consultant! I bought baby scales, which not everyone would agree with. I weighed her every few days at the start, then weekly, and, once I was convinced she was consistently gaining, I stopped. It was helpful to me but might make someone else anxious.

I also want to add that I did not find out that my baby wasn't gaining much until she got weighed at a routine check up at 4 weeks old. I had no idea that there had been a problem as she always seemed to be feeding and was having several wet and dirty nappies a day.

Turns out she wasn't getting enough milk due, due to my poor supply (hence the nonstop feeding). And once my supply issue was resolved, her wet nappies were much heavier than they were before. These issues had lulled me into a false sense of security, which is why I literally cried in shock when the Dr said she had hardly gained anything since she had been discharged from hospital.

I got help, got scales, never looked back!

^this
Keep going. Well done

You sound like you’re doing really well. BFing is HARD to get started. The first 6 weeks is vital for establishing your supply.

Hearing swallowing, seeing milk on her mouth, and lots of nappies are all excellent signs.

Feeding will feel CONSTANT and EXHAUSTING a lot of the time, because you’re both learning a difficult skill. It WILL get better. My baby is 9 weeks old and we’d cracked efficient, painless feeding by 6 weeks or so.

You really sound like you’re doing a brilliant job. Well done for persevering

Your Health Visitor is talking rubbish. I would actually be putting in a complaint about that because she shouldn’t be giving outdated advice to vulnerable mothers who are already questioning their ability to breast feed.

My son was EBF and very slow to gain weight for the first few months of his life even though everything looked fine and he was doing everything he should have been. Ultimately it turned out he had a tongue tie and a dairy intolerance and once those two issues were addressed his speed of weight gain increased. The HV’s kept trying to make me give formula but I stood my ground and spoke to a Breast feeding helpline and a Lactation Consultant so I was actually getting correct advice from people who knew what they were talking about.

You are doing amazing!!!

Forget the HV and get proper support from someone who is highly trained to give it.

Has baby been checked for a tongue tie? My 5 month old was similar and once her tie was cut she was much more efficient.

It’s so normal for feeds to be long and frequent at this stage but for us it was an indicator of an issue.

Keep going you’re doing so well! This is the tough bit and I found after a few weeks it got easier

What kind of bollovks is the midwife talking???????????? Not quality milk?

And if not the same scales, unless it's a major variation, it can't really be counted.

Thanks for all your replies and reassurance. At her follow up check a week later she had gained 80g, which isn't much but was at least a move in the right direction. The MW again didn't seem too concerned and told me if she was back to birth weight by next week they'd discharge us. The only thing is that would mean she'd need to gain 250g this week, which seems really unrealistic to me since we had -8 and then +80. I just don't see her all of a sudden gaining 250g.

She has taken to cluster feeding at night time which is really stressful because she unlathes herself and then gets really frustrated and just screams her head off. She doesn't seem to settle and I was worried she wasn't getting enough milk.

I called the breastfeeding helpline earlier in the week but given the nappies and the MW not seening concerned, thwy didnt really offer much else by way of advice. I went to a local breastfeeding support group today to check her latch and they seemed to think it was all fine. They also said the cluster feeding is normal and since it was sometimes a comfort thing, and as she was feeding and settling throughout the day they didn't think it was an issue with her being hungry on a night - apparently it can be to do with the development of their nervous systems?

So overall, I'm pleased she had gained some weight and glad her latch seems to be okay. I'll ask about a tongue tie when I next see the midwife as I'm still feeling a bit apprehensive about whether the BF is enough for her, but we'll carry-on for now and hope things settle out soon..

First of all it sounds like you are doing a great job, congratulations! secondly as previous posters say - not sure that HV is on about : poor quality milk! And 8g is fine. Thirdly oats and brown rice is supposed to be the business. Fourthly if there’s a breastfeeding cafe or a la leche league meeting near you ( you’ve probably already had a look but in case not) I would really recommend, they definitely saved my sanity with ds1: just great to be able to be around other people doing the same thing, ask questions and compare notes and gurn a bit over tea. Ds1 was also feeding when he popped out, then whisked away at 24hr to ICU and in a box for 8 days, no boobs! It was awful. also turned out, after we got home and had been thrashing around for a few days that the poor chicken had tongue tie, like previous poster’s baby. The bf specialist midwife who ran the bf cafe was able to spot it and refer us super fast to get it seen to. If that’s the case with you ( doesn’t sound like it - sounds like you and baby are getting into your stride just fine 👌) But if it is the case don’t let the description they give you at the clinic before they do it put you off, it’s incredibly quick and baby will heal up unbelievably fast. Take lots of chocolate for you and stand ready to shove boob straight in. It will be ok! Anyway either way, all the very best xx

Depending on the NHS resources near you, I would thoroughly recommend a private lactation consultant. Most midwives aren’t trained to diagnose tongue tie, and only spot the really obvious ones. You sound like she’s feeding and putting on weight, which is brilliant. But if you want some reassurance, and can afford it, a lactation consultant would be incredibly helpful.

lcgb.org/find-an-ibclc/

Bit again, you sound like you’re doing really well, and persevering to give your baby the best nutrition you can. That’s amazing 😊

Depending on the NHS resources near you, I would thoroughly recommend a private lactation consultant. Most midwives aren’t trained to diagnose tongue tie, and only spot the really obvious ones.

100% this.

Please do not ask for or rely on a Midwives opinion.

If you can afford to, you need to see someone who is formally trained and qualified in assessing and treating tongue ties.

You are doing brilliantly. What a shame your midwife isn't as knowledgeable as she should be.
Proper latch and frequent feeds (sometimes with hardly a gap between them) is the way forwards.
If baby was ill, then she might be a bit slow or sleepy and will need extra patience.
Congratulations on making the best choice for your baby. It does get easier.

Check for tongue tie

drink lots of water

pump as well as feed

HVs and midwives really know nothing about breastfeeding so please don’t take too much notice of what they tell you.

try different positions

look out for plenty of wet nappies, if it’s hard to tell put a cotton ball in the nappy so you can tell when they have done a wee,