Breastfeeding - where am I going wrong?

[Syp832]

I’ve just given birth to DS2, he is only 2 weeks old and I really want to breastfeed him but i have no idea how to do it.

he was jaundiced and very sleepy when born so wouldn’t breastfeed and I ended up having to top him up with formula when he was 2 days old. Ever since then breastfeeding has gone on a downward spiral and I don’t know how to get it back. He is currently bottle fed with expressed milk and formula about 50/50.

he is 2 weeks old but has only ever breastfed for 10mins or more about 3 or 4 times because he was too sleepy. But he is now beginning to wake up and be more alert, so I think he could feed well if we could just work out the latch.

it doesn’t help that the first 2 weeks of his life were hectic because we moved into a new house and had to get some urgent works done, so we haven’t had much chance to just sit skin to skin and focus on feeding. I’ve also had a toddler at home with me for the first two
weeks. But things are a lot calmer now and toddler will be going to childcare, so I think we should be able to focus on feeding. I just don’t know how to do it. I’m currently pumping but only getting 30mls or so at a time, although baby is small at 6lbs so maybe that’s not too much of an issue.

does anyone have any advice? Or like a step by step plan I can follow to get us breastfeeding? I spoke to a lactation consultant whose main advice was just to pump regularly and try putting baby to my boob but not to force it. I just don’t see how that will get us breastfeeding.

i never managed to breastfeed my eldest due to PND, and him also being too sleepy /jaundiced to feed. I just really wanted to do better by my second son, but it feels hopeless right now.

Do you keep producing the milk even if he doesn’t latch on?

one lactation consultant I spoke to said to stop trying to put him to the breast if he gets upset because the breast should be a ‘happy place’ and breastfeeding shouldn’t be forced. It makes sense, but equally I’m not sure we’ll ever get there if we waited until he always.

You can try giving a little bit of formula first so that he is not really hungry and a little more relaxed before attempting to latch.

Is he crying or is he pummelling your breast as if fighting it?

Try putting him on when he’s not too hungry or is just waking up. Or after a small bit of expressed milk. Keep persevering he’s only tiny so you have lots of time and opportunity. Try some skin to skin inbetween feeds too. Give him lots of access! :)

I could have written this, even down to sprinkling water to keep DD awake long enough to feed!

We had to top up with formula. I tried expressing but quickly dropped it as DD would feed for like 40 mins, so I barely had time to feed her and pump before it was time for another feed. Life was much simpler when I dropped pumping. We topped up with formula until she reached a certain threshold of weight, then pretty much exclusively breastfed, but it was useful that she would take a bottle so DH could take her out alone.

Ask someone who knows what they're talking about to watch you try to feed and perhaps guide you if you need to make a change. You've got this ❤️

He’s kind of fiercely crying going on and off the breast. He’ll try to go on and then immediately pull off and cry badly, and then try to go back on again etc

Thanks! Did you worry about milk supply when you stopped pumping? All the infant feeding people I’ve spoken to have said that protecting my supply is the priority and to not worry much about the actual breast feeding at this stage. But that feels like we will get stuck in a cycle of pumping.

yes I do really want to get some in person support. Problem is that son has always been too sleepy to feed properly whenever I have had people to come and try and support in person. He’s beginning to wake up more now though so maybe I’ll try again for some in person support

I remember this with my DC in the very early days in hospital and the midwives giving out those free ready-made bottles. I think if you don’t offer a bottle your baby will get used to your nipples. I agree with PP who have said take your baby to bed for 23-48 hours and snuggle skin to skin.

Thanks all. I think tomorrow morning once my eldest has gone to childcare I’ll spend the day in bed skin to skin and just nurse and try not to offer a bottle for the whole day, and see how it goes

If you are co-feeding then the night feeds need to be breastfeeding at this age. The baby feeds in the night tell your body what to produce the next day.

I struggled (jaundice, latching issues, supply issues etc) and kept getting different tips from different people, the best thing I did was get a private lactation consultant out to my house who watched me feed and then manually corrected what I was doing and gave me tips. The specialist also weighed the baby before and after a feed to see how much milk was being consumed.

One thing is to find the way to hold him initially
that works for you - for me in the early years just lying on the bed with the baby beside me and letting it latch worked best until I got the hang of it. Google the sandwich hold too - you can squish your boob near your nipple like a pancake to reduce the size for the babies mouth, gently rub your nipple against his nose and when the mouth opens gently guide it in. It is frustrating and takes a bit of practice.

I did also cheat a bit in the beginning and got nipple shields as it was sore and also was probably between a bottle and a boob for the baby. I know if they are not cleaned properly it can be bad and don’t get the baby used to a boob properly so they have mixed reviews but it worked for me when I was struggling. I told the lactation specialist and she said it was fine as a temporary thing.

One of the reasons you get a worse supply when pumping is your body isn’t flowing with the hormones it releases that stimulate milk supply when you are with your baby. If you do pump try to do it next to your baby if you can, give him a cuddle first, stroke his face ir out your hand on his chest while doing it and just bask in his loveliness as it will help things flow! 30mls is not bad for pumping at 2 weeks, keep feeding or pumping every two hours and your supply will increase. It is exhausting but it will get easier.

You need the advice of a lactation specialist.

You need to get baby checked for tongue tie.

You need to get the latch checked.

There see some things you can do yourself:
Make a point of relaxing.
You've been through a huge amount of stress. Can you get someone to come and take over the running of the house?

You need to breastfeed at night, every time. Breastfeeding between 11pm and 3am is vital for getting your supply established.

Buy and drink some pro lactation tea.

Make sure you are eating plenty of protein, veg, calcium, and fruit. Someone needs to look after you.

For latch -
Make your hand into a letter C, thumb up, fingers together and down - imagine crab or lobster claws.
Grip your opposite boob and squeeze it flat, holding the boob well behind the areola. Keep holding it firmly.
If you're squeezing your bojb with your left hand, baby's head will be in the crook of your right elbow, and the other way round (right hand, left elbow).
While holding your boib firmly, tickle baby's cheek beside his mouth, his upper lip, or his chin with the nipple and when he opens his mouth, push it far in.

I’ve been in a very similar situation and managed to get back to EBF in a few weeks so I speak from experience! There’s a lot of well meaning advice on this thread but some of it is quite misguided.

It is NOT a good idea to keep trying to “force” a crying/distressed/hungry baby to latch, it will be stressful for you both and just build a negative association with the breast (and doesn’t work IME). I completely agree step 1 is to protect your supply so I’d suggest hiring a hospital grade pump and ensure you’re pumping every 3-4 hours until your supply is well established.

The next thing I did was use nipple shields to get my baby feeding well from the breast. At first I’d hand express before offering to get the milk flowing which really helped as the bottle is “faster” in that respect, also expressed milk onto/around the shield so there was milk already there and ready. Then when she was on with the shield, breast compressions to help her out with the milk flow. After maybe a week she was able to feed well with the shields and I didn’t need to express first or do the compressions. During this time I’d offer top ups of expressed milk if needed, but we were building confidence and positive association with the breast. Another tip is to offer a small bottle feed before you try to latch so baby isn’t hungry or distressed when trying to latch.

We then weaned off the shields by removing them part way through the feed and gradually reducing the time using them until she was able to completely latch without and I then just fed as much as possible for a week to wean off top ups.

Good luck and you can do this!

Thanks everyone, I’ve tried a few of these tips already this morning with some success.

i managed to get him to latch on for a few minutes on each side over the course of an hour. I heard some sucking and there was milk all round his mouth so im assuming he got something in! Probably wasn’t longer than 10mins in total though. He struggles on my right side but had some success using a nipple shield on that side. Question though - with the nipple shield he sort of just face planted on it and started sucking on the nipple bit rather than doing the wide open mouth. Is that ok when using a nipple shield?

I’ve also contacted a tongue tie specialist and will give la Leche league a call today to help me come up with a plan.

i’m still not sure what to do about pumping and offering bottle feeds. He was crying a fair bit earlier this morning and I’m not sure if it’s because he was hungry as he wasn’t getting enough from me, and whether I should have offered him a bottle then? Instead I tried to get him to latch on and he calmed down and fell
asleep.

I was going to suggest nipple shields too. If he’s coming on and off and crying he might be getting frustrated because he can’t get a latch, the shields will help. You know he can use a bottle so it might be a good interim instead of pumping. They get a lot of bad press but we’ve been feeding 11 months now and weaned off them at 2m
absolutely saved things for us, I was ready to switch to formula otherwise

with the nipple shield he sort of just face planted on it and started sucking on the nipple bit rather than doing the wide open mouth.

its not ideal, keep trying with the wide open mouth but personally I would try once or twice at the beginning of the feed then let it go if it wasn’t working but baby was still getting enough milk. My priorities were baby fed and my supply not depleting because I was going to formula. And the shields stop most of the pain from a bad latch that you’d normally get. Then as baby got bigger I started working on wide open mouth more. I know some people say it’s worse for milk transfer and supply because the chin isn’t massaging the boob how it’s meant to, but it worked for us and kept my sanity

Did you find that they eventually picked up breastfeeding when offering the bottle at the same time? It’s just that I’ve tried to get him to latch at the beginning and then stopped after 15 mins if it’s not working and bottle feed instead. But after 2 weeks it doesn’t feel like we have made any progress with breastfeeding, although baby is putting on weight and doing well.

Fed is best OP and it’s probably best to cut down on formula slowly when he’s latching on successfully.

The thing is with pumping to protect your supply you are then emptying the breast and he’s only getting milk from a bottle which will mean he will develop a preference for a bottle over the breast.

The YouTube video I posted previously shows how to get a deep latch. Try to make sure he’s not crying and hungry (by offering a small amount of formula first) before attempting to latch him on.

Mine definitely did. At 2 weeks we were solely bottle feeding as she wouldn’t latch at all. By 5 weeks we were EBF without shields

I really don’t like this notion that they’ll develop a bottle preference and you’ll never be able to breastfeed, it’s that kind of attitude that nearly made me give up! Just ensure you’re using very slow flow teats and pace feeding from the bottle. You are much more likely to succeed if you’re calm, relaxed and not feeling pressure as opposed to an all or nothing attitude with a hungry baby, combined with the stress of thinking you’re going to end your bf journey if you keep giving a bottle.

Breasts do not get “empty” that is a total myth confirmed by my lactation consultant.

Keep trying and keep going but don’t be afraid to take a break if it becomes too much. I found we made very little progress for 3 weeks and then all of a sudden she just got the hang of it and we were fine. I think it helps as they get older and their neck starts to strengthen as they can support themselves a bit better.

Thanks but I’ve breastfed 3 babies for long periods of time so I do have some idea of what I’m talking about.

Offer baby the boob for every single feed. Even if you are offering every hour or two. You have to be patient and tickle their nose with nipple to get them to open nice and wide.

keep pumping if you don’t get baby on boob to keep supply up. But honestly you might have to try baby dozens of times a day. Also go to a breastfeeding support group (free tea and biscuits!)

Totally disagree. My boobs are full before a feed and do get empty. I don’t think lots of the things you’ve said are accurate and agree with PP

Hi op, just a few pointers that might help. To try and encourage a wide gape baby's chin needs to be stable on the breast, not in mid air. So, if you imagine you have to stick your baby's chin on the breast, well away from the base of the nipple, so the nipple is pointing right up baby's nose, or on the nose. Ensure baby is able to.tilt their head back, keep hands or fingers off the baby's head, support baby round the nape of the neck.
With a nipple shield they still need a big mouthful if breast, not just the shield, again try and get baby's chin on the breast first. This is a good video
https://www.tiktok.com/@kathrynstaggibclc/video/7170708844602035461
If you have a breastfeeding group locally they can help, and loads of skin to skin.