Breastfeeding dilemma

[shininglight16]

Hi mums,

I'm going through a very stressful time and I really need help.

My baby was breastfeeding fine until one day I got a stomach ache which meant that I avoided breastfeeding her that day and gave her formula 3 times instead. Ever since, and coinciding with her turning 6 weeks, things have reversed and she doesn't seem too keen on breastfeeding. She will latch on the left breast and suck on it but keep pulling away and then back. She's constantly pulling the nipple back and forth, turning her face away and then latching on again. The right breast is a different story though, she hardly ever wants to latch on to it and cries inconsolably despite the repeated attempts to soothe her/calm her down and try again. I'm unsure whether she's getting enough milk whilst breastfeeding, expressing is okay but I'd much rather have her on the breast than drinking expressed milk from the bottle.

I'm not sure what it is that's causing her to pull away from the breast and come back, please for those of you who've been through the same, how do you get the baby to latch on properly and get her tummy full by feeding throughout?

I'm also struggling with understanding what an ideal feeding schedule should look like, could you please give me an insight on the following, I'm a FTM and the doctors/midwives have been pretty useless, I feel so lost and confused:

1. Earlier my baby gave clear hunger cues, now since she's turned 6 weeks it is hard to determine why she's crying, is she hungry, bored, sleepy, tired, overstimulated, gassy? Can't tell, her cries and hand movements are the same, how do I distinguish?

1. Should I feed every 3 or 4 hours? When we say every 3 or 4 hours, we're counting from the time she finished her last feed, correct?

1. She has long wake windows, that stretch up to 4-5 hours, how can I get her to sleep within an hour or so?

1. Let's say she finished her feed at 7am, she stays up till 9am and then cries, it's hard to establish whether she's hungry again, do I wait till 10am or do I try to put her to sleep? Super confusing.

1. How much ml should she ideally be consuming per feed at 6 weeks?

1. What are the best ways to make a baby sleep and how long should day time naps and night time naps be?

1. How do I get my baby to get back to breastfeeding exclusively? I've also been giving her one or two formula feeds per day as I'm always worried/unsure that she's not getting enough from the breast. Earlier, she gave clear signs, she would fall asleep on the breast, latch off on her own once she was done, and take 15 mins from each breast, being latched on throughout that half an hour stretch. Now she comes off the breast so many times, cries in between, refuses to latch on but latches on for say 5 minutes after a while etc that I can't tell how much she's had. Her weight gain has been very slow and I'm unsure whether she's getting enough. She has also not being having bowel movements daily and goes up to 5 days before she poos. Her urine output seems to have decreased as well so I fear that she's not getting much milk from me, but when I express its fine and there are times when we give her formula, she throws up quite a bit.

1. Finally, should I strictly stick to a every 3 hour feed routine and wake up my baby of she's sleeping? She does sleep for long stretches at night and has been doing so since she turned 4 weeks. She can go upto 6-7 hours between feeds, is that normal?

I'd also like to hear how you're coping with your own sleeping schedules, any tips/advice on how to get on with normal day to day life and sleep would be appreciated.

Any suggestions/advice would be welcomed, I'm quite distressed and feel I'm failing as a mom. Please help 🙏

Sorry forgot to add, I'd like to understand when to express, what are the best timings, what intervals should I have, how long do I express on each breast for and how do I manage when I'm breastfeeding as well...how long do I wait after breastfeeding to express for the next feed? It's all super confusing and a schedule with timings that has worked well for you would be greatly appreciated!

Bumping... hope to get a response soon 🤞

My advice is to stop trying to plan/time feeds etc and just put baby to the breast at any given opportunity. If she fusses, breast. If you think she's hungry, breast. If you think she's bored, breast.

The latching on/off sounds like she is trying to up your supply which is very normal - more so because it has likely dropped if you have dropped feeds to replace with formula.

Have a look at Lucy Webber on Instagram she has loads of great advice and helped me loads when I was new to breast feeding.

I know it's much easier said than done, especially when it's your first baby, but try not to worry so much and just go with your instincts/what feels right and suits you and baby. She doesn't know what wake windows etc she is supposed to follow 😊

This all sounds like normal 6 week old behaviour. They become really fussy around 5 weeks for a fair few weeks. They wake up more and it becomes a lot more work to get them to sleep - they don’t just drift in and out of sleep as easily as they did as a total newborn. DC1 liked to be breastfed to sleep in a dark room with white noise. DC2 (who is also 6 weeks) likes motion so lots of pram/sling walks or car drives. Both of them have stopped falling asleep on the breast in a bright room/tv on by 6 weeks. They should be sleeping every 1-2 hours and you really need to work for it. It does get easier again when they can tolerate longer periods awake and are more active.

The fussiness at the breast is probably a combination of overtiredness and trying to up your supply - 6 to 8 weeks is notorious for huge growth spurts. If you want to EBF you must ditch the idea of feeding to a schedule. As soon as baby is anything but content try breast. It might mean you are breastfeeding all day which may feel like a huge regression compared to say 2 weeks ago. But 5-8 weeks really is a tricky age where babies are extremely fussy and need a lot of help to soothe. I suspect trying to feed to a schedule will harm your supply a lot more than the odd bottle of formula. If still unsettled after breast then try something else to get sleep. Repeat ad infinitum until an established routine occurs between 3-6 months.

Second Lucy Webber on IG. If you scroll back to April there is a fantastic post n life with a 3-8 week old. The crux is it isn’t easy!

Any fussing - stick a boob in her mouth! It doesn't matter if it's hungry/tired/bored, breast comforts all those things. Don't schedule it, just whenever she wants. If she's gaining weight and filling nappies and no other worries then don't wake her to feed. She'll let you know!

Breastfeeding is supply and demand so if demand dipped because a feed was replaced with formula then supply will dip. The pulling on and off is probably her trying to put in orders for next week and turn supply up again. Skin to skin and plenty of access and supply should increase again.

In terms of expressing - depends what you want to achieve. If you're giving a formula feed then expressing the equivalent feed at some point should try and maintain equilibrium. You'll often get most milk first thing in the morning or in the middle of the night. Being more realistic - express when you've got an opportunity if that's what you want to do. But also - think about what you want with expressing. It's hard work and you don't want to be a slave to it or give yourself a huge oversupply or find you're not spending time with baby as tied to pump. It's a bit of a balance.

It's ok to feed baby when you are ill, it's actually great for them for immune benefits so you don't need to avoid it. Obviously if you're feeling rubbish and need the break that's different but wasn't sure what your reason was.

It sounds like you’re doing an amazing job OP. Just to say, when counting hours between feeds you’re meant to calculate from when you started the feed, not from when you finished. This makes no sense to me, but there we are!

I was also going to recommend Lucy Webber on Instagram, she gives incredibly reassuring advice. If one side becomes a particular problem it might be worth getting her checked for anything such as ear infection that's causing discomfort when she lies on that side.

Hi OP, first - it sounds like you’re doing a great job and much of what you describe is normal and not necessarily a sign that your baby isn’t getting enough milk from you and needs top ups.

I would really recommend trying to follow an EASY routine which stands for Eat, Activity, Sleep and something for You.

So, first the baby Eats. Breastfeed for as long as the baby wants and offer both sides each time.

Once feeding is over, the baby should not be fed to sleep if possible but be awake. This is the Activity time in the routine. This is the time to burp the baby if necessary and then this is when nappy changes should happen. If the baby had fallen asleep whilst feeding, this will wake her up. At this age, this might be all the awake time that your baby can manage but as they get older, this is when you will do tummy time and interact with each other, start to play etc.

Once the Activity time is over (and it might be just 30 or so minutes at this stage, including the feed) your baby needs to go back to Sleep. The baby is likely to become pretty cranky and this is when you might wonder if they are hungry. However, if they’ve had a full feed, take comfort from this - the problem shouldn’t be hunger. Babies can become very upset when they need to sleep! A 6 week old will not be able to stay awake for very long - their “wake window” will probably not exceed an hour and may be less - 4-5 hours is waaaay too long - so if your baby is fed, has a clean nappy and has been awake for 45 minutes to an hour, the overwhelming likelihood is that crying is due to needing to go to sleep. At this age, it is likely your baby will want to sleep on you. If you don’t have one, I’d really recommend a sling. If your baby cannot yet go to sleep in their own cot/Moses basket etc, pop them in the sling and they should go to sleep within a few minutes. Your baby might prefer being pushed in the pram - work out what they like. I use a dummy at this stage as babies love to suck something to soothe themselves to sleep. Remember, at this age they do not know how to put themselves to sleep and need to be taught. It is quite rare that you can simply put them down in their cot and they will go to sleep on their own. You could try patting them, white noise etc. Try a few different things and work out what they like. I recommend not putting them in a darkened room during the day as you want to encourage them to distinguish between night and day as much as possible.

In theory, once the baby is asleep you should have a bit of time for You. This is certainly possible if the baby is in a pram/cot/Moses basket but you might be a bit more limited if they are in a sling. They will probably now sleep for a couple of hours, maybe 3/4.

So, you then keep following this same pattern on repeat (though it’s not quite the same at night: you do not do the Activity part at night, save for changing the nappy where needed). A 6 week old will probably need to feed roughly every 3 hours, but it may sometimes be 4 and may sometimes be 2. Try not to think of this as a schedule but a routine - where the length of time between each cycle may vary but the pattern is always the same.

Occasionally, there might be a need to feed again briefly after the Activity time. On the whole, this should not be needed and my philosophy is to try and follow this routine but if the baby won’t settle after a few minutes of trying to get her to sleep, it’s possible that she may need a little more milk to get her there. Once fed fully, sleep will then come - but I would give it 15/20 minutes of trying to get the baby to sleep before you decide that more milk is required and, if possible, offer more breastfeeding as opposed to formula as you can’t overfeed a breastfed baby.

As for expressing, I would try not to put too much pressure on yourself here. If you follow the routine above for a few days, the baby should respond and fall into it. If the baby’s nappies fill okay and she gains weight, I would not wake her for feeds, but feed her when she wakes up. If she sleeps longer than 3/4 hours, that’s great (so long as she’s filling nappies and gaining weight)! If you do want to express, I would recommend doing this a little time after you’ve fed the baby so that your milk has recovered post feeding and so that you have milk for the next feed if needed. So, maybe after the Activity time and whilst the baby sleeps. You will get more milk in the mornings and at night but I really do not recommend pumping at night - get all the sleep you can then. And I certainly would try to avoid pumping more than once or twice a day - any more just puts so much pressure on you. You will have more milk if you are well rested and not stressed.

I also really recommend Lucy Webber’s Instagram for tips. She also has a book about breastfeeding and the ‘fourth trimester’. Babies pulling off the breast, writhing around, grunting, shouting, bashing with their hands is all normal at this stage. This will ease as she gets a bit older. This stage is just really tough but none of this means you are doing something ‘wrong’.

For tons of useful advice on everything else, I’d recommend reading The Baby Whisperer, which is where the EASY routine comes from. If you try the routine, make sure you persist. Within just a few days your baby should respond if you stick to it. I hope this is helpful. Good luck.

I'd go against some of the above reply, feeding to sleep is completely natural (and feels like a superpower when the alternative might be rocking/bouncing to sleep!) and you don't have to avoid it if you don't want to.

Hi op,
Sorry you’re having a stressful time with feeding.
I would really urge you to get some face to face support with a feeding assessment as soon as possible via your health visitor or GP, they can refer you to the infant feeding team or if funds allow seek a lactation consultant appointment privately. Slow weight gain coupled with lack of poos and decreased wet nappies do indicate likely reduced intake. This could all be very fixable with skilled support.

To echo above reply’s definitely ditch ideas of a feeding or sleep schedule. Spend as much time with baby laying on you skin to skin as possible and just feed when she stirs.

Hi OP, as you can see there are different schools of thought about how best to do things and none of them are ‘wrong’ - you will work out what’s best for you and your baby. Personally, I find the EASY routine works for me because it’s much easier to know what the baby needs at any one time (for example, if the baby has been fed but seems upset, I know it’s very likely to be that he needs sleep, or if he’s been sleeping for 3 hours and starts crying I know it’s hunger) - but I do sometimes feed the baby to sleep where he seems to need a little more. You will know what feels right for you and can adapt things to suit your baby as you wish.

But your first priority should be to ensure that the baby is getting enough milk - reach out to your health visitor for help/advice, the infant feeding specialist team can also help or, if you are able, maybe consider seeing a private lactation consultant. Once you are confident the baby is gaining weight sufficiently, you can work out what style suits you. By the time the baby gets to 12 weeks, things should get a bit easier.

Just to echo a couple of things and to add another suggestion. As pp has said the timing is from the beginning of a feed - this can make things quite congested in the day, I know! Again, I just try the breast any time there is crying or fussiness, I never underestimate the hunger of a tiny baby - it's a bit insane. I pat and shush and use white noise to encourage sleep and it's a good skill for them to learn for naps as they can transfer it to night time sleep. Obviously this is all very idealistic and sometimes I do just feed to sleep though.

For latching and encouraging baby back onto the breast, I would recommit to skin to skin and I've read some good things about having a bath with your baby which kickstarts baby's instincts through skin to skin and relaxation, and boosts your milk producing hormones. Apparently. Just check out the safety advice around this as I'm not an expert.

This might be helpful
www.medela.com.au/breastfeeding/blog/breastfeeding-tips/getting-baby-back-breast-deal-breast-refusal

Sorry I just realised this is an older thread!