Breast feeding - whats going wrong?

[Cel119]

My baby is 10 days old. I have been breast feeding since birth. She lost 10% of body weight so have been advised to feed 3 hourly. When I start these feeds they last an hour at times before I give up and have to move. She starts feeding and sucking well and 10 minutes in she is lightly sucking and barely doing anything. I burp her put her on the other breast. She may do the odd strong suck and then back to light sucking. If I put her down she starts crying and chewing her hand signifying hunger. So I pick her up and she immediately falls asleep on the breast again. I put her down, she cries and wants to feed. The last weigh in after 3 days was 10g weight gain. After all the time I have spent feeding her I am very disappointed and feel p*ed off. I dont know what to do, or where to go from here. I am told the latch is perfect. I am contemplating going to formula as I have had enough and feel im wasting my time for nothing. My son is having to entertain himself and partner doing food. I dont even get time to brush my hair and when i do housework i am running around quickly before she starts up again. I actually am starting to dread her waking and feel sh** when I wake in the morning knowing its a day of this again, for absolutely no gain.

What is going wrong? What am I doing wrong?

How often were they feeding before? When I had both of my children I was told that they needing feeding at a minimum every 3h. At this age a sleeping baby won't necessarily wake for a feed.

My daughter had to be stripped down to a nappy every 3h to wake her enough to feed for the first 3 weeks. I had an alarm on my phone. She got better by 2 weeks and mostly work during the day before hand but over night still needed to have her nappy changed to wake her enough for feeding.

My son was born with 100% tongue tie and couldn't maintain his blood sugars which meant he couldn't wake to feed. He slept for 12h at a time and didn't wake even when striped off and having his nappy changed which then meant he was starting to struggle to maintain his body temperature. Giving breastmilk and formula by syringe every 3h meant he was then able to his blood sugars and we were able to go home by the time he was 48h old but he still needed waking for every feed. He had his tongue tie cut when he was 8 days old. He only lost 6% by day 5 but had only regained 30g by day 8 and wasn't feeding very well. The next day he gained another 30g. By day 20 he was back at birth weight.

1. Look into breast compression and waking tips - change the nappy before swapping sides to wake the baby more before offering the second side.

1. Rest, for the first few weeks you job is to feed the baby ignore the housework and every thing else.

1. Other causes of feeding issues - my daughter had weight gain and feeding issues due to severe silent reflux and food allergies. My son had tongue tie. His involved the whole tongue being attached and whilst the midwives could all see it, they couldn't tell me if it needed to be cut or not. When we did see the infant feeding team for an assessment they were surprised that I had been able to breastfeed him at all and enough to have only lost 6%

It is completely normal. Breastfed babies are constantly on the boob, it's not just feeding it's comfort and being close to you. Baby has put some weight on so it's fine, they all loose weight after birth that's normal, don't fixate on the numbers. Giving a bottle would be counter intuitive as you need to establish a good supply in the early days. From my experience breastfeeding was hard work until about 9 weeks (had mastitis and latch was painful) then it did get much easier. I wish I knew that with my 1st as I gave up after 6 weeks. I went to a breastfeeding group and they did say keep going until 8 weeks and it will get better. It was true, no need to sterilise, no spending money on formula, no sorting bottles in the middle of the night, the health benefits to your baby are huge. With breastfeeding there is no schedual no matter what age the baby is. It seems odd you have been advised every 3 hours as it doesn't work like that, you just feed on demand which sometimes feels like all the time but as they get older it does get easier. Go easy on yourself your baby is tiny and you are tired, you are doing a grand job.
Edit to echo a pp comment about hydration, you need to drink loads of water.

I would take a couple of days to just stay on the sofa or in bed with your baby, skin to skin as much as possible, and feed as much as possible.
Keep swapping sides - every time they slow down or fall asleep on the first side, swap to the other, then back again and again until the baby won't suckle any more.

As others have said, three hours is absolute minimum so for example if your baby is sleeping, wake them if it has been 3 hours. If they are willing to feed sooner then do!

My lactation advisor (? It was decades ago) told me bluntly my baby was a lazy feeder and that I was to pinch his ear and just keep him awake to feed. He also had lost weight and was about to go on the bottle. His twin sister was an exemplary feeder.

I have to admit he thrived being bottle fed but even then he had a bigger hole in the tray so that he didn’t have to work “so hard” at getting the milk.

(I am sorry to say thirty years on here is still rather lazy!)

It sounds normal to me, my DC lost about 10% of birth weight in the first 10 days. The more you feed, the better the supply. I didn’t do any housework either, seemed to be constantly feeding and wasn’t told every 2 hours, 3 hours etc. La Leche League were very helpful.

That sounds normal. You shouldn't be doing housework, that's DH's hob for at least the next 2 months. Your job is to cuddle and feed the baby, pretty continuously. Find somewhere comfortable, put something on tv and get an extra long phone charger so you can message DH to bring snacks and drinks

The cesarian is likely to have meant baby lost more weight than a vaginal born baby. This is totally normal and is a by product of the birthing process being different. 10-12% loss isn't unusual, and therefore likely seem to be slower to go back (some places recommend waiting longer before weighing a cesarian birth baby to avoid seeing scary losses).
I really wouldn't worry yet about the scales if she is gaining. She will hopefully find her curve over the next few weeks.

Keep swapping sides. I used to change nappy before and during the feed to keep awake. We had to do maximum of 2 hourly feeding for about 2 weeks due to jaundice. It nearly killed me, but it was soon over and after the first month feeding got easier, then after 3 months became infinitely easier and he's now almost 3 and still going.

Those first weeks do feel like feed feed feed. But I promise it gets easier.

Get checked privately for any oral restrictions like a tongue tie if you can, as the nhs and lactation consultant missed this for me and after weeks of endlessly long feeds and weight loss, once we got it sorted, her weight improved, slowly.

I will say though she was and still is at 9 months a very long breast feeder and 90% of feed time is syill for comfort. She can still be on me for 45 minutes, but I know that only 10 minutes of that is actual feeding!

It does get better with the time investment needed, but rule out an oral restriction and if that's all okay, ignore the countless professionals who will probably all give you different advice, positions, try to blame you, and instead trust your body and baby to do it however that looks as everyone is different.

Hi Op,

Things to do in combination that make a big difference.

1 - get your latch checked by a feeding expert who can look at tongue tie too.

2- In the meantime look down and check that your baby’s body and head are lined up. Sometimes the head faces the breast but the body has rolled outwards - you can see some of the inside of the top shoulder and of the chest - if this happens pull the baby’s chest closer so the top shoulder is flat against you.

3- Now look at the babies neck - it should be stretched upwards - if you look at the ceiling (by moving your head hit your eyes ) at the other end of the room you are sat in you will be in the same kind of position. Your baby’s chin should not be near their chest it needs to be stretched up. You might need to start further away and get the chin against your breast to trigger the latch then wait for the head to bob and the mouth to get really wide before latching. If the chin doesn’t touch first and the head isn’t reaching up then the latch won’t be as good as it can be.

4 - switch sides - as many times as possible. It keeps baby more awake and the relay hung triggers your oxytocin which helps the milk let down so the baby feeds more easily. The more switches the more milk.

5 - use hand compressions to help more kill transfer. Just use gentle pressure as your baby’s sucks slow. Don’t worry about timings or position - just gentle squeezing on the sections of the breast you can reach.

6- feed everytime your baby stirs - the more feeds the better.

7- get people to wait on you and to help you feel happy. Put the best Netflix series on and get some good food. This can change really quickly.

8- watch for poo - the more the better and at least two good size ones a day.

good luck

My experience is that breastfed babies vary tremendously, but they all lose weight to start with and can be slower to put on weight.
DC1 slept a lot, had to be woken for feeds, and sometimes suckled for 12+ hours a day. A normal feed was about an hour for him.
DC2 was a much more efficient feeder, his feeds took about 5-10 minutes a side and then he was done.
DC3 had to feed to fit in with his siblings schedules, he was also pretty efficient. I think he understood pretty quickly that any feed could be interrupted if eg siblings had to be collected from school! You try to time it to be convenient, but it just doesn't always work like that.
You need time, and plenty of fuel and rest. Your job is keeping the baby alive, everything else is secondary. The house work should not be your concern, and DH should be the main carer for the older sibling at this time, or at least take them out for exercise a few times a day. You can do the reading and TV watching with them, but the baby has to be your priority.
Sucking prompts milk supply. The more the baby suckles, the more the supply will increase. Once breastfeeding was established, I used to find I'd spend about every third day spending all day feeding while the baby had a mini growth spurt. It just doesn't work like bottle feeding, it needs to be on demand. I do recall feeling shocked at how much time I spent feeding the baby, I did feel like a milking cow for a while.
If you haven't got a sling, it might be worth looking into.

She doesnt signal to feed usually but on the odd occasion will. E.g. today, she signalled half hour early and started crying so I fed her. She is getting plenty of wet and pooey nappies. At least 6 - 8 in 24 hours if not more.
I was told that the first bits of milk are watery and not as calorie dense as the milk that follows. But, again, thats vague as how long of feeding would it be to get to the nutrient dense stuff? Is it even measurable?

This is how I feel a cow chewing the cud whilst her calf feeds off her. Or a very popular vending machine.

All milk is good, but broadly speaking the milk from a 'full' breast has higher water content and the milk from an 'empty' breast will be fattier.

If you keep switching breasts and feeding really frequently, all the milk will be higher fat.

Some women (like me) got pissed off with my baby doing this when I had a just two year old being a little sod and demanding my attention too. I put her on the bottle as I didn't have the time to just try and make it work. Good luck.

The difference is marginal. What is much more important is this: if you switch often, you increase production. If you switch seldom, you decrease production. It is the main way you increase or decrease production.

That doesn't matter as much as it sounds like you might have been told. There used to be a brilliant blog post explaining it better than I could but sadly the blog is no longer online. MN formatting completely breaks links from the internet archive, but if you put this into archive.org, you can access an older version of it (go for 2019 or earlier).

https://thefunnyshapedwoman.blogspot.com/2011/05/foremilk-and-hindmilk-in-quest-of.html

Essentially though, your baby will get those calories. What we think happens is that when milk sits pooled in the milk ducts for a few hours between feeds, the fat from that pooled milk clings to the side of the milk ducts, which means there's a bit less of it in the milk itself. But as the baby drinks or the mum expresses, it seems like the flow of milk sort of dislodges that fatty layer and it will mix back into the milk that follows, and then the milk which is being produced "fresh" ie by the new letdown reflex hasn't separated yet. So you are not producing two kinds of milk. Your milk is one consistency, it's just that the milk which has been waiting around for a while has temporarily separated, a bit like expressed milk can do in the fridge (and mixes up again when you shake it gently). NB I do not think shaking your boobs has the same mixing effect, to the disappointment of husbands and partners everywhere

When you have shorter gaps between feeds, it doesn't happen as much anyway. But it's likely that you've got well into the "fresh" supply of non-separated milk long before your baby goes into the more sleepy/fluttery sucking.

And also, it's not watery or lacking in nutrients - it's literally just the fat content that is reduced in that very first bit. The nutrients other than fat are the same. But in any case it likely equalises much quicker than you're imagining.

You can strip the baby change down and do a nappy change half way through the feed to wake them up. They will be angry, but it generally leads to a better second half of the feed.

Is your baby jaundiced at all? That makes them sleepy and poor to feed.

My first was like this. Keep the baby cool (eg not too snuggly) and when they start to drift off tickle their feet to wake them up so they continue a proper feed. Mine were feeding more often than 3 hours at that stage I think.

Sounds normal to me. It’s just that you don’t know that before you start. Even though I’d done the hospital’s breastfeeding course before DS was born, they didn’t explain that a tiny newborn takes an incredibly long time to feed, it’s not a ten minute job! My DS was 5 weeks premature so had to be fed every 3 hours and it took nearly an hour to feed him each time, and as you say, he kept falling asleep mid feed. When he got bigger, that sped up a lot, and I was so incredibly grateful I’d persevered with the breastfeeding as it made life SO much easier to be able to stick him on a boob anywhere and everywhere (including the security queue at Stanstead airport once!) and not faff around with bottles and sterilising and mixing up powder.

In the meantime, get a kindle loaded with some favourite books you want to re-read (easy to read including turning the pages one-handed) and find a bunch of TV shows you never got round to watching and settle down to read and watch TV while he feeds.

Also, totally normal for newborns to lose weight in the first few weeks.