Breastfeeding expectations / help

[Maybemaybenot76]

Due my second very soon and hoping to breastfeed. My first was a struggle, couldn’t latch properly (or, I couldn’t latch him) - I ended up exclusively pumping for him and then combi feeding from around 3 weeks. I had zero help from anyone with breastfeeding.

This time round I’m determined, but what typically happens? Milk wasn’t in for me straight away, we syringe fed colostrum but it wasn’t enough - baby was crying constantly, so we formula fed whilst in hospital.

Is it the same again? Are you supposed to give formula whilst in hospital, but put baby to breast to encourage your milk to come in? How often do you do this? Until your milk is in?

It's completely up to you how you want to do it but it's recommended to put baby to breast as often as possible to encourage your milk to come in and establish breastfeeding. I personally did not want to breastfeed during pregnancy so didn't try it until my milk came in at day 3 when I changed my mind about everything! I did colostrum syringes combined with formula in the first few days. Been breastfeeding ever since!

Lots of mums will just breastfeed from the very start whereas some will do a combination of breast and formula. I think it's best to keep an open mind, keep offering your breast as often as you can, and if you are able to bring some expressed colostrum with you then that will be a great help. Best of luck!!

Just from my own experience
baby was on my boob constantly the first night.. and I mean from 10pm to 5am. Exhausting.
wouldbt take formula at all - was sick if we gave it.

milk came in eventually but that time on the boob was great.
latch was painful for the first few weeks but you gotta keep trying. Remember to bring baby to boob not the other way.
I pumped early on (although I have read recently you shouldn’t) and have always had an oversupply but I can’t see how that’s bad !

drink plenty and eat foods to help your supply.

wishing you much luck this time round.

I just breast fed - milk came in on days 4 and 3 I think. Newborn tummies are tiny - I don’t think they are designed to need formula right away, they have ‘brown fat’ that is designed to keep them going until the mothers milk comes in - that’s why babies typically lose weight at first. You just keep giving them the breast whenever, you can’t necessarily tell milk has come in except that nappies start to change.

So you put baby to breast even if milk isn’t in, and don’t give them anything else for days on end? I know with my first they wouldn’t let us leave until we’d given him formula since he seemed hungry and my milk wasn’t in. I know now I don’t actually need them to approve us leaving, but I didn’t then.

So in the early days, baby's tummy is absolutely tiny, they need really small amounts of colostrum quite often. The more they latch and suckle the more they will stimulate your milk to come in after a few days but there will still be colostrum in between times. Even comfort sucking where they're not actually hungry is encouraging supply to build. Your body will produce based on demand so the more they feed, the more milk should be produced. Certain things can help like resting, eating well, eating oats, keeping hydrated, lots of skin to skin contact and allowing the baby to latch really regularly.

In your hospital there should be an infant feeding coordinator who you should ask for if you're having any difficulties. They can assess for tongue tie etc. They can also lend you hospital grade pumps if need be. The midwives etc should help you with latch and positioning but they can be busy so I attended lots of workshops before ds so I had an idea of what to do. I also found my la leche league group really invaluable for advice and support from mums who've already been through it and trained group leaders. Some will meet in person so can offer hands on advice and others meet on zoom. It would be good to know what support groups are in your area and you can join before baby arrives.

Most babies do drop weight initially. Ds had a tongue tie so he dropped over 10% of his birth weight but we fed every 2 hrs (and in between if he looked at me funny) day and night and that got things going for us again. Having support and encouragement is what sees you through those moments where you do doubt yourself.

I waited until week 4 to introduce a dummy and pump as that allows baby to practice latching and feeding and helps your supply get established to suit your baby's needs.

From my own experience what I would also say is get a sling for baby and have a go at practising feeding in it. Total game changer for the cluster feeding which is really intense. Have your partner well up to speed on what to expect so they know that your baby might feed for over 10 hrs a day on and off (ds did) so you'll need them to step up with the cooking and housework etc. Dh attended bf workshop's with me so he knew to expect that so he was on the ball from the get go. I'd also look at safe co sleeping, when you're up bf at night it's easy to fall asleep with them in bed with you, so if you're set up and positioned right then you're creating a safety net for yourself and means baby can sleep while you dose which is really good especially since you've a child already. Don't invest in a pump until baby is here and you see how you go. I found a manual pump was best for me at the start as and when I needed milk but now I rely more on my electric pump but I wish I'd got a hands free one I could use on my commute to/ from work. So hold fire until you see what would actually suit you. I would also just say that being in a bf support group helped me see that bf looks lots of different ways than the baby to boob you normally see. Combi feeding/triple feeding/, exclusive pumping etc are no less valid and our group is really diverse in the ways women are breastfeeding. So if it doesn't look a particular way from the start, it doesn't mean you can't get there or that it doesn't count as much.

Good luck with your little one!

My advice would be to get as much help on hospital as you can - so many people who can help there, usually. Your health visiting team will often have a breastfeeding cafe / drop in as well so find out where and when these are and then you know where support is if you need it. we also had one that ran in a local church just run on a free drop in basis.

Hopefully for a little reassurance.

Ask for all the help you can get!
Ask to speak with the Infant Feeding Specialist at the hospital, hoping they have one. I was under the care of one for a few weeks, the hospital lent me a medical grade pump because my milk came in early and with a vengance (for every 60ml my baby drank I was pumping 160ml!). The specialist let me take the pump home and video called me for continued support. Just ask for help where you need it, push for extra support. And talk to the midwives, my baby was crap at feeding and one of the best ladies I dealt with was doing the tea round and caught my struggling to latch and at a low ebb! She told me she’d come back to help me and came back with a cuppa and a pack of biscuits, told me to relax and helped me get my baby latch for a 17 minute feed - a record as by that point the most he’d done was 4 minutes 😵
Also, request a health visitor who specialises in breastfeeding (if they have one) - they switched my HV to try to help me.
We dropped direct feeding around month 5 when my boy got to distracted by everything around him! But 3 months later I’m still pumping and combi feeding about 50%bm/50% formula.

Good luck!

What gestation was your first baby born at? I listened to this really interesting podcast recently which suggests that many babies born before 39 weeks (but not actually considered prem) may struggle with breastfeeding in a really specific way but this is not routinely checked for or supported correctly so mums end up without the right knowledge or advice even if they go and get support. I recognised so much in here from the stories I've read on MN and thought if this was better understood it could change so much WRT breastfeeding and people's experiences.

Anyway perhaps it will be helpful information for you whether or not you feel like it applies to your first baby, and however things go with this one.

https://themidwivescauldron.buzzsprout.com/1178486/13706096-late-preterm-and-early-term-infants-why-these-babies-struggle-so-much-with-breastfeeding

Thanks all.

He was born at 40+6 but was SGA at 6lbs3. One midwife suggested that perhaps he was just “too small” for my “big boobs” (D cups!)

There was zero help at the hospital. I repeatedly asked for help and the only thing that happened was a health care assistant wheeling in a hospital pump. Once discharged, the health visitor toldw that since my milk was now in, the infant feeding team wouldn’t see me as that was for those struggling with supply issues.

I did combi feed (pumping) but gave up as this combined with the effects of a lockdown and pandemic was sending me over the edge.

DS is almost 4 and about six months ago we discovered he’d had a lip tie all along! We never noticed it but you’d have thought a professional would have considered it earlier on.

Yes that doesn't sound very helpful/supportive of them! I think lip ties are commonly missed but the other stuff is really dismissive.

I wonder if you could check out the local branches of NCT, LLL (La Leche League), ABM (Association of Breastfeeding Mothers) as well as any local IBCLCs if they run groups or just work in the area - these orgs tend to have good breastfeeding supporters, and IBCLCs are meant to have a really high standard of training. And if you still have a sure start centre, they often used to run breastfeeding peer support groups, again often run by an experienced breastfeeding counsellor.

Also, you could ask your midwife if there is a contact number for the infant feeding team and just contact them yourself and ask if there is a threshold for referral or if you can self refer.

There is experienced support out there. It's just such a shame that it is so patchy/postcode lottery and that you end up having to seek it out yourself.

I’m not sure if this is useful for you, but I simply didn’t have the supply to feed my first and combi fed from a week in. Somehow, my supply had magically increased with my second - it was all significantly easier. I don’t know if it was my confidence, the amount of colostrum pumping I did in advance of labour, or being confident to just keep the baby on my boob, but second time around was better.

My daughter fed for 2-5 minutes every 2-3 hours during the first 7-10days. I think I had my experience of cluster feeding around 7-10 days.

Get as much support as you can. I had a few issues and had 3 appointments with the infant feeding team. Two were brilliant the third was awful and sobbed on my HV the the following day and she was lovely and told me to feed how I liked as long as it didn't cause me pain and she fed enough. My line managers wife is a lactaction consultant and I was going to see her next but things got easier. I think if I was to do it again I would contact her anyway.

As you were slow the get your milk last time and you were giving expressed colostrum it might be worth discussing expressing in the last few weeks of pregnancy. My daughter was at risk of poor neonatal adaptation syndrome so I was going to start collecting when I started my mat leave at 39 weeks but my daughter arrived at 38 weeks so I didn't get the chance

Thanks everyone.

So baby on breast as much as possible, syringe colostrum to him as much as possible, and give formula if he seems unsettled/hungry?

Unfortunately the midwives/health visitors that saw me in those first few weeks didn’t tell me about any feeding drop in clinics etc, but I’m not sure how much use it would have been anyway as we were straight in to lockdown a couple weeks after he was born.

I wouldn't worry about colostrum from a syringe, you should produce enough colostrum to feed him until your milk comes in, remember colostrum is like double cream so they need tiny amounts of it.

The only thing mine had was breastfeed every time he looked interested. He had nothing else until at 8 weeks we introduced an expressed feed from a bottle so dad could help out more. He only lost 3% body weight and had gained it back by day 10

I had really big nipples and he had such a small mouth I felt rugby hold worked for him, might be worth researching the different holds before

Sorry, also meant to say, if you syringe colostrum he's gonna be too full to feed from the boob and might hamper your supply, you want him hungry so he'll try to feed from you tonnes to get your supply going in those first few days

@justanotherlaura thank you, that’s helpful.

My nipples are actually really small, I did wonder if this was part of the problem with my first. I tried nipple shields which helped a little but he was still never satisfied, so I assumed not getting enough.

My baby also cried constantly so I just constantly put her on my breast. They're programmed to do that to stimulate the milk to come in.

I think usually giving any formula is detrimental to breastfeeding in the early days unless medically advised. He will feed less and this will mean your supply isn't stimulated.

It’s a newborn, they’re definitely going to be unsettled! You don’t need to give him formula, just keep putting him to the breast if he is unsettled - that’s his mechanism for building up your supply. Cluster feeding is normal and doesn’t mean they aren’t getting enough.

@Blaggingit123 Sure, but my first wouldn’t latch and nobody would help me. I didn’t know what to do, just that they were then forcing me to give him formula as he was “starving.”

So baby on breast as much as possible, syringe colostrum to him as much as possible, and give formula if he seems unsettled/hungry?
You only need the syringe bit of he isn't latching. If he latches ok then just do so as often as you can. My first needed a lot of help. He had some donated milk from a cup in the hospital but once we clicked latching at about 2 days it was all good. DC2 went straight for it. She was feeding at 15 minutes old and that's all she ever had till weaning.

Just to give you hope. My breastfeeding experience with my first was awful, in lots of ways. However with my second it was a dream - born and on the boob within minutes no pain and feeding, and I had a distinct thought of “this is what they were talking about” when everyone had given so much advice (which made me feel awful) with my first. Sometimes it’s the baby and not you.

Breastfeeding can be really difficult at the start, as in, baby might want to feed very frequently. This may seem like they are unsettled, but I would keep offering the breast over formula as the suckling is what makes your milk 'come in', and builds your supply. Often the frequent feeding makes people think they're not producing enough, they give formula and then don't get the frequent suckling from the baby which means the supply won't build. Formula is more slowly digested than breast milk which is often why FF babies seems satiated for longer and feed less frequently. As PP have said newborn babies have tiny stomachs.

There is guidance for how many wet/dirty nappies they should have in the first few days/weeks so look into that, as its a good indication baby is getting enough milk, and baby will be weighed anyway (babies can loose up to 10% of birth weight).

With all that said, if it comes to it and formula feels like the right thing to do for whatever reason, then that's great too.

I know if you have a c section it can take longer for milk to come in, but 3 days is about average and YES colostrum is more than enough for new babies until day 3/4. Their tummies are tiny. They will likely cluster feed at the breast (which can make you think they're not getting enough/need formula) but this cluster feeding is KEY to the process of establishing and speeding up your milk supply. The hospital should know this and be happy to see baby latching before they discharge you. If you had trouble with the latch last time then that's probably why they encouraged formula - sorry you didn't have the right support x