Overnight cluster feeding newborn

[whyyy321]

Is this normal? Second baby but first was formula fed. Has been feeding almost constantly since midnight, maybe dozed for 20 min twice? Had something similar for 2 nights, maybe 3 days ago. Baby is 6 days old so happened day 3,4 and 6 I think.

Was weighed day 3 and lost 8% body weight, weighted yesterday day 5 and hadn't gained (but hadn't lost).

Is this cluster feeding? Or is she hungry and I have a poor supply? She's content on boob but angry off, I just checked and there is still milk coming if I hand express despite 6 hours of constant feeding.

I don't mind if it's actually meant to happen! Desperately want bf to work this time. Surely she's full and knackered??

I did see a ibclc with my son but it was COVID so just on zoom. If I'm honest, I'm a bit "scared" to see one as I think they'll push expressing for supply which I get is probably what is necessary but I am struggling to face expressing a) I have no time and b) I expressed for 4 months for my son and the idea of doing it again feels somewhat traumatic. My husband goes back to work this week and I just can't see how I'll manage to pump and I'm worried that if I don't adhere to their plan it'll tank my already fragile mental health (I had PPD with my son and I'm very cautious of pushing myself back down that path this time, as I don't yet feel depressed this time just very tired and "normal sad" at 3am kinda thing).

I'm just wary of setting myself up to feel worse.

I think what the lactation consultant should be checking is that the latch is deep enough for the baby to be receiving the high calorie hind milk not just snacking on fore milk. If she suggests pumping and it’s a no go for you, you don’t have to but if might be reassuring to know baby is definitely getting what she needs. There is always formula for top ups if expressed milk is a no go, giving an extra bit of milk in a bottle never takes away from what you are giving.

A good LC should be working with you to achieve goals that are compatible with your life. As an LC I decided I couldn’t face pumping with my third and we just went to formula top ups on the breast. We’re not all militant (actually in my experience few LCs are, you get less rigid with more knowledge and experience)

A really good plan, devised with you should get you all more sleep, your baby some more milk and hopefully some calmer days and nights.

I'm sorry you had a rough time previously.

A.good IBCLC will want to hear your goals and shouldn't encourage expressing for any more than a day or two as we see so many women sent home from hospital on a feeding plan that involves breastfeeding and pumping and are given no support to stop when frankly this is completely unsustainable.

The best thing for your supply is to get your baby effectively latched and this is the absolute first thing I would want to do before even discussing the pump.

Please ask/search around local FB groups etc for who they would recommend.

You could be me five weeks ago. My eight week old did not feed well at the start we had to have daily weighings and go to the hospital and see the paediatrician and it sounds like you're getting great support to carry on breastfeeding. I was immediately told to express and then do formula feeds and top ups, they wanted to admit us back to the hospital so they could watch me feed. However, I trusted myself, I breastfed my oldest til gone three years and I stuck with it and the nights of cluster feeding was painful and the days of contact naps but she started to gain weight. She started to take longer feeds longer breaks between the feeds and she's now a very very chunky monkey and squishy, but it took a lot of time.
I echo what people have said about a tongue tie we had a tongue tie that was only identified after three weeks despite five professionals saying she didn't have one, but it took us a good 2 to 3 weeks for me to really feel like it had been fixed. Also with the weighing is it the same person on the same scales in the same environment each time because we had one where they said that she had only gained 10 g and then the next day we went to a different place with different scales and a different Midwife weighing her and she had gained 500 g in one day was not possible so I would take the lack of weight gain with a pinch of salt

Thanks all, it's useful to hear others have struggled too. I've reached out to a ibclc today who was recommended when I asked a bf support group I'm in, so will see what she says. I've explained my feelings about pumping in my message to her.

I'm just getting so overwhelmed as she's unhappy anywhere except me - my son (bottle fed) would be settled by othets. I feel so guilty as I'm barely getting to see my son and also feel guilty as I'm so touched out by her by evening.

It's all a phase I guess. I'd just love to hand her to someone and her not immediately wake and want back on boob.

Unfortunately not being settled by others goes hand in hand with BF. That's why BF is hard, absolutely everything is on you. And it will largely continue until you stop. However, it is also an incredibly fast tool to settle the little one if you make it past the newborn stage. I have a 1 year old and I've never had to pace up and down the room to rock him for ages when teething, jet lagged or sick, never had to deal with split nights etc. He cries, I shove a boob in his mouth and everything is OK. It does mean I haven't had a regular full night sleep in a long time (he sleeps through for 11 hours to be fair except when teething or ill, which at 1 is quite frequent as I am finding out) so it's give and take.

I had to pump a bit as I went back to work full time at 7 months and I agree it's awful. I only managed it as someone else was going the feeding in the day while I was at work, I wouldn't have managed to pump and care for baby at the same time.

Didn’t want to read and not reply as I feel for you so much here.

My DS is now 15m and still EBF. DS lost 12% and we had so many issues. But it does just work out. It took til he was 12 weeks for me - my supply regulated, feeds dropped, life became easier, he started sleeping. You’ll always feel like you’re doing something wrong but now I realise that’s just part of the fun with BFing. Your supply WILL be enough. The bad sleep is normal. Just ensure you’re hydrated and looking after yourself. Consider pumping so you can get a bit of time to yourself - even an hour or so.

promise you baby is fine and loving the milk. Soon, it’ll just get easier!

Relate heavily to shoving the boob in. I do this regularly and it helped in the night too. As soon as he was 6m I could get him to sleep quick, he’d stay asleep provided he was full, that’s it.

I will be on here for advice though when I need to stop 😂

I disagree a bit with her not being settled being a BF thing ... both mine were fed the same way and #2 was always much more attached to me, #1 could be handed to anyone if she had a full tummy. So being their only source of food is definitely part of it but not a guarantee!

Something of an update and a hope for some more advice!

Saw the LC today and she feels latch is good and baby is feeding well, however she suspects I might actually have supply issues due to possible 'insufficient glandular tissue'. However she's not totally sure as she's based that on breast shape and I don't have the other factors usually associated with it (eg polycystic overies). I could collect about 100-120mls when pumping for my son when he was 2-4 months old, it didn't increase beyond that but I never changed my pumping style or did power pumping after I got to that volume so I dunno if that's that I couldn't make more or just that I didn't because I didn't 'order' bigger volumes as he grew (as he would have with cluster feeding).

She suspects ill be told to triple feed tomorrow at the weigh in, but that's a definite no - I can't manage expressing after every feed with a toddler and a baby that won't be put down.

She's so skinny and it's upsetting me to the point I'm worried it'll impact my mental health again this time (had pnd with my son).

So I'd like to add formula top ups- has anyone had experience of how to do this without tanking supply, especially given I'm reluctant to do much pumping (could manage two sessions a day maybe, when dh is on lunch or around in the evening). Any help appreciated (LC will send a plan too but just curious about lived experience).

I'm not sure if my experience will help as it's slightly different-
I combi fed my DD from birth pretty much. Husband gave 1 or 2 small formula feeds during "his shift" at night (9pm-midnight). I breastfed the rest of the time. My DD had issues with latch- tongue tie and high palate diagnosed at 5 weeks and tongue tie snipped. I don't think the tongue tie separation really helped much as I still had to hold my breast in a certain way for her to maintain her latch. Weight wise she was OK, nobody was ever concerned but she did drop from 25th to just above 10th centile and looked really gaunt and skinny. I continued breastfeeding on demand and husband gave formula top ups a few times per day. By 4 or 5 months she'd stopped taking a bottle and I was exclusively breastfeeding and she was piling on the weight. I carried on breastfeeding until she was 2.5 years so don't feel like introducing formula will end your breastfeeding journey!

At this point, calories are the most important thing. I would top up with formula ASAP. You've done your best, sometimes BF doesn't work out and getting the baby to gain some more weight is more important than our personal goals.

@HumberBridge2 that's interesting and reassuring!

@LivingOnCoffee567 to be fair I'm literally asking for advice on how to add formula top ups now, as her weight gain is paramount - this isn't me hanging on to a "personal goal"?

Triple feeding is exhausting and not sustainable so it’s good you know you can’t and won’t do it!

I would personally (from my experience) wake for breastfeeds often, try switch feeding, but would also use formula for whole feeds for 1-2 feeds a day. You could pump 90m after a feed during these times while he’s having formula (better than power pumping, 90m after you start a feed your prolactin levels peak so this is a good time for even a short extra pump), especially if it’s a time of day your husband is around and your eldest is in bed. I found giving top ups after each feed so much work and will tank your supply if you’re not able to pump (and as I say triple feeding is not sustainable). Is baby sleeping well overnight? If so, it’s not what you went to do but getting feeds in overnight even if you’re waking them to do it is a chance to get extra milk into them. I didn’t do this with my slow gaining son till too late and I wish I had done it sooner!

We had quite a similar experience to you with DD2. Although she didn't lose that much weight at first, she was very very slow to gain so we got put on a top up plan quite quickly by the community midwife. I also didn't want to triple feed after trying and completely failing at it with my first so we did formula. I think the midwife suggested 40-50 ml per feed but you should try and get your own plan from the infant feeding team or the LC you saw as they'll know your situation best.

Things that helped us continue to bf alongside the top ups were using the smallest teat size possible with the bottles and paced feeding to keep the milk flow more like the breast. I also still breastfed at every feed first before offering the top up (especially overnight feeds to keep supply up). It's probably going to be down to luck to some extent as to whether you can keep going with both as my first developed a bottle preference quite quickly, but I combo fed my second for nearly a year so it's definitely possible.

She wakes regularly at night, generally feeds eg 9, 12, 3 and 6 at max, night also wake more often that that/cluster 3am onwards, so I feel she's got opportunity to bf overnight and I would prefer to stick with just bf at night for ease!

I wondered about dh doing the top ups (could do breakfast, lunch and evening as he WFH) and I could then manage a short pump around these times too. But I'd offer breast first unless I had to go somewhere (in which case I could pump).

Bottle preference is a worry but KC thought she should be ok as she's got a good latch and happy at the breast (I have no idea if that means anything).

If I do have the issue with glandular breast tissue then increasing supply is a moot point and really I just want to protect what I have now, in a combi feed model I guess until she weans and gets calories from food.

I didn't mean to offend, quite the opposite. You said in the opening post that you desperately want BF to happen and there is an undertone of guilt in your post and a desperation to succeed at BF. Sometimes it just doesn't work and it's not your fault. Formula is totally fine, you've done your best and all I am saying is that at this point, I would give formula now without worrying about supply so much. Breastfeed and then offer formula straight after. That way you know she has taken any breastmilk there is but then you are filling her up as well.

This happened to a lot of women including me. DC was cluster feeding and it was week 3 midwife panicked me when he hadn’t put weight on after dropping birth weight and said she would be back Monday to weigh him. I caved and started formula because I was worried he’d end up in hospital. Regret it because had I preserved we would have established it but I just had zero support and no referral to feeding team either.

It’s my understanding this interrupts your supply though?

I found that there’s very little actual
evidence bottle preference even exists. It gets used to frighten women into continuing to EBF.

OP I had to combi-feed because of low supply. Caused by multiple medical issues. I did approx 50/50 BF/FF for the first year and eventually BF to 3.5 years. There’s no reason you can’t BF longterm if you’re combi-feeding (I actually BF far longer than several EBFers from BFing support as they were so fed up with the intensity of EBF they stopped completely at six months!).

I initially did a top up after every BF. I ditched triple feeding after two weeks as it wasn’t working and was counter-productive. I actually got a supply increase once I was getting more sleep and wasn’t as tired. At about 12 weeks I switched to separate feeds, alternating. So 3-4 BFs and 3-4 formula bottles a day. Length of BF and amount of formula determined by my baby. No night feeds as she slept through by eight weeks.

I didn’t pump again until I went back to work at 12 months and wanted to make sure I was comfortable.

I combi fed my babies and would offer formula after each breastfeed for my first baby. For my second I did alternate breast and formula in the day and generally just breastfed at night unless she was very wakeful then I offered formula. I used to keep a sterilised bottle and pre made formula next to the bed so I didn’t have to go up and downstairs.
Best of luck, you are doing great.

Thanks all, sounds like adding in formula doesn't have to ruin supply as long as I'm careful and only offer formula after bf at the start. The LC said supply regulates around 8 weeks.

I'm really struggling tonight, last night she was up from 330 and tonight she's managed 45 mins in the cot. Dh had her 11-2 so I don't even feel I can ask for help. He's going back to work tomorrow and I'm so scared for how I'll manage this, she won't let me put her down during the day and now she won't go down at night either. Once he's at work I won't even get the odd hour I've been getting in the day, and she feeds all evening so I can't get space then either. She's doing horrible frantic chompy feeds tonight and I'm sore and have been crying most of the evening and night. I'm so scared this will tip me in to pnd again.

It sounds really tough @whyyy321 sleep deprivation is a form of torture. I remember the suffocating feeling of having a baby who won’t be put down.
Are you cosleeping? So you can side feed and roll away? I’m sure you tried everything but thought I would mention it incase.
If I were you I would get some formula this morning and see if it helps settling her. Your mental health is paramount.
If she doesn’t settle with the formula then you will know it’s time to take her to the GP to see if she is uncomfortable for any other reason.

I did find once mine was properly fed (ie properly supplemented) she was so much more settled and content. Like a different baby. The reality is that not everyone can make enough milk for their baby and so formula is essential.

I was in a similar position to you and heard so much about formula ruining supply and just feed feed feed, whilst nobody recognised the reality! Triple
feeding only works if the low supply was caused by baby not being able to latch on frequently or effectively early on - it doesn’t do anything for other causes of low supply (and can be counter-productive)
I found this helpful:
https://fedisbest.org/resources-for-parents/cluster-feeding-normal/

Good luck. If you give some formula and she’s more settled you’ll know what the problem was, otherwise you could make a GP appointment to see if anything else is going on.