Newborn not effectively breastfeeding

[Phoebewinnie]

I’ve got a 2 week old newborn, she lost a lot of weight a few days old and we ended up back in hospital where she was put on a feeding plan with me pumping and topping up with formula. We found out she had tongue tie so had the procedure to release it around a week ago.

Since then she’s put all her weight back on and I’m still pumping every 2 hours and topping up with formula. She feeds every 1-3 hours, often having a main meal and then wanting a snack a short while later! I try to put her on the breast before every feed using a nipple shield, she gets a good latch but either falls asleep very quickly or just lazy sucks after a few gulps. I haven’t noticed that she has any less expressed milk or formula after we try breastfeeding either.

I really would like to breastfeed for ease, the constant pumping and sterilising just seems so unmanageable already when she is feeding so frequently and irregularly. However it’s been two weeks of breastfeeding with no real improvement despite lots of efforts and skin to skin and I’m concerned she will never get the nourishment she needs from breastfeeding so it is an additional but pointless step in an already intense feeding regime.

Has anyone experienced anything similar? Would be so disappointed but thinking of giving up but would also want a more manageable way of pumping and giving bottles.

I did and I didn’t bother pumping. I stuck religiously to the timings and amount of formula so he wasn’t full of formula constantly. I offered bf whenever he rooted or gave another signal. Lots of skin to skin as well. Did get there in the end

She's put in weight do I would Stop pumping and stop with the bottles and just breastfeed her. When ever she wants it.

Lots of regular bfs will get your supply attuned to her.

As long as she continues to have wet and dirty nappies and puts on weight then she is getting enough.

The first weeks is hard. She will want to feed loads. This is really normal.

Then it will start to get easier and then it will get easy.

I agree, I would stop pumping and offer breast as often as she's asking. This will increase supply to los needs. Newborns often fall asleep on the breast as it's harder to get the milk out. Plus if she was tt then she's having to relearn how to use her tongue and she needs to strengthen the muscle. My dd had her tt cut at 4 weeks she took another 4 weeks to learn how to feed properly again, and dropped 2 centiles in that time too!
One way to strengthen the tongue is to put you pinky in her mouth and let her suck it then gently pull you pinky out, this encourages her to suck a bit harder. Do the a few times a day.
I would prioritise breast now and only use formula when you feel necessary.

Mine never put on weight on breast alone. Like you we ended up back in hospital due to weight loss and we were put on a pumping regime with formula topups.

Once we got back home I pretty quickly stopped the pumping. I could only really do it naked on top and I had two foster kids at home so had to be in my bedroom away from everyone to do it, and I just hated it.

I used to formula feed at certain times every day and then whenever she wanted to, she would be at my breast. She spent most of her life attached to my breast to be honest, even though I was never sure she was getting much, and she didn't 'need' it as she had formula as well. But it was so handy as if she was at all fussy I stuck my nipple in her mouth and it instantly calmed her. She always refused a dummy so I used to think 'how would I calm her if I didn't breast feed?' She nursed to sleep every night. We coslept (I tried to get her in a cot but she screamed every time!) and it was so handy to put a nipple back in her mouth if she woke in the night.

To make my life easier, if we were going out I used to use the pre-made bottles of milk so that all I had to do was empty it into a baby bottle and it was ready to go instantly. We also used sterilising tablets so had a big bowl of water out constantly where we would put washed bottles to sterilise them so it wasn't too much of a faff.

I stopped the formula when she went onto whole milk at a year but she still loved breast feeding. At about the same time I stopped doing it on demand when we were out as I'm on the large side and it was embarrassing if she started pulling my top up exposing my stomach! But at home she had free access until about two and then continued to nurse to sleep until 3 and then after that although she would go to sleep in her own bed she'd inevitably end up in with me where she'd attach herself and go back to sleep! I insisted we stop that when she turned 5 as although she still loved it I had had enough!

Yet all that time my breast milk did not make her grow but I'm hoping it at least helped her immune system. And she loved it so much whether she 'needed' it or not! To be honest I'm not even sure anything was coming out the last few years! I used to ask her if it was and she said yes but I think she just didn't want me to say we would stop doing it if she said there was nothing there!

Thanks everyone for your replies. I would love to give up the pumping but I’m worried what that would do to my supply if she’s not breastfeeding properly?

Also she gets really frustrated that she’s not getting what she needs and screams herself into a state so she will no longer take the breast and that’s when we give her a bottle. I hate seeing her upset and feeling like I’m not giving her the nourishment she needs.

Are you getting any professional help with breastfeeding? It might be worth getting some face to face help from a lactation consultant to see if things can be improved? My health visitor feeding team were also quite good and free but by the time I had their help it was a bit too late.

This is probably not what you wanted to hear but I had a very similar situation with my DD who also had tongue tie and for us it never really got better. I just couldn't get the sweet spot where she was hungry enough to BF but not too hungry where she would just scream for food. It didn't help that there was a heat wave and I was struggling to keep her hydrated and fed. In the end I felt that I was getting all the disadvantages of breast feeding without the convenience and decided to just stop pumping and spend the time cuddling DD instead and I haven't looked back. Whatever you do your baby has already benefited from your breast milk and there's not need to feel guilty if you do want to stop.

Pumping is TOUGH. I did it for my preemie twins - they weren't strong enough to breastfeed and weren't going to be discharged from NICU until they started gaining weight without being tube fed. I totally understand why you are doing it, but it nearly broke me! So much time pumping/sterilising/feeding...

The most important thing is to keep an eye on wet nappies and weight gain (that can dip a bit without it being a bit worry as long as the trend is ok).

I cut down both frequency andvolume of bottles over time. I offered breast and then have a top of bottle and put them back on the breast afterwards. Decreased the amount in the bottle by 10ml every 2 days. As soon as it was down to less than 40ml in the bottle I cut it from certain feeds at times they were less sleepy.

I did keep the pre-bed bottle for some time, as I thought being able to take a bottle was a useful skill (especially for twins and as I had an older one!), my eldest never was good at it. Bloody useful as one ended up in hospital with a chest infection and I had to leave the other at home with my parents for 3 days.

I kept up the pumping at the same volume even while we were decreasing bottles. That meant I had enough in the freezer to ditch pumping once they were six months but still had enough for evening bottle for some time and a stash for emergencies. One twin had amixture of expresses/formula from about 8 months, the other wouldn't touch formula - he's still a picky eater.

Breastfeeding (especially with challenging circumstances) is TOUGH in the short term, easier in the long term. But bottles are ok too if it doesn't work out. I bet nobody would know from my twins which one had some formula and which one never did. Your health and happiness is important.

My DD struggled with breastfeeding and lost a lot of weight - combo of flat nipples initially, poor latch and bad advice including 'let sleeping babies sleep' which is NOT ideal for a jaundice baby who will sleep non stop if left.

Luckily I ignored that and did plenty of feeds and dream feeds even though it was exhausting.

They told me to feed, pump, top up with expressed milk, feed, pump, top up. That was just too much on a 30 min cycle. I barely slept so after 2 days I sacked it off and I just fed every hour both sides and if she didn't take both sides I did feeds every 45 mins. Yes it was hard work but within a couple of weeks we got to a steadier schedule.

She put her weight back on and more by week 2 and was thriving.

I did not want to use formula so did my own research and took loads of help and advice from the infant feeding team.

Each to their own, and it's up to you how you feed your child as long as you can manage it/and not impact yours or their health. Including your mental health!

Also drink loads and eat plenty of calorie rich food. If you don’t drink enough you’ll struggle with milk production. You need to drink more than you think you need to.
Skin to skin helps because they feed abit. Fall asleep. Then root round and feed a bit more and your let down will be better if the baby is on you.
you could try a Hakka type pump as well. But get one with a lid, I learnt that the hard way.

I had a premie with a lip tie who was too weak to feed effectively.
Two things you could also consider: timing and length. It’s unfortunately easy to wait until they are too sleepy to eat and too hungry to sleep. It’s also easy to miss hunger signals as a new parent. She might do better if you feed the first time she sticks her tongue out or does that leg pumping movement.
Secondly, I found both with the premie and the full term baby that keeping them awake while feeding so they did 20 minutes rather than ten made things work much better.
However, don’t worry if she’s feeding all the time, she’s supposed to.