A mish mash of a thread: let down, leaking nipples, expressing etc

[MrsSixx]

This is a bit of a mish mash of a post, apologies.

Anyway, every BF book or site I read talks about let down and the physical sensations that accompany it such as tingling or pins and needles. Well I have no physical sensations at all when I am BFing and can only tell Beth is getting milk because it dripples out of her mouth. I have also had absolutely no nipple leakage, not even a tiny dribble, either at the end of my pregnancy or since I have been breastfeeding.

I appreciate we are all different but is anyone else out there like me? I feel, after reading all the books and speaking to friends who breastfeed, that my milk should be spraying out all over the shop! This is turn concerns me about my ability to supply

I have been exclusively expressing the last few days as I have thrush (argh) and am lucky if I get 3.5oz in total from both boobs per 40 min session (apart from my 5am session when I get 6oz). I know the literature says volume from expressing is not a true reflection of what baby gets but it might explain why Beth seems to have been cluster feeding almost constantly since she was born. I was told by my midwife only to feed from one boob at a time and Beth may well have only been getting 1-2ozs per session in that case. Perhaps even less as she always falls asleep so quickly when on the boob and I spend an age trying to wake her up!

Since feeding EBM via a bottle she is like a different baby. She takes up to 4ozs at a time (which I am pumping furiously to keep up with) without falling asleep and goes the full 3 hours between feeds. She is now sleeping in her cot all night without any fuss whatsoever (apart from waking for her feed) because she has a full tummy. Previously I could only settle her in my bed latched to my breast which, although a wonderful experience on the one hand, scared the crap out of me for a multitude of reasons on the other.

I know it's very early days but I am half tempted to stick to expressing. Yes it's time consuming but clearly leaves my daughter far more satisfied and content. The last two days of bottle feeding EBM have coincidentally seen a marked improvement in her jaundice too, which I am pleased about as the MW is coming tomorrow to give her another blood test (now her third).

Hmmmm.

 

[petal040]

I can't feel my letdown either

3.50z is good going - some people find it very difficult to get anything when they pump - especially if their LO is young (the milk production kind of changes when baby is around 6-8 weeks old, and some people find they get more from pumping after this has happened). I think you have plenty of milk if you are able to pump as much as you are Well done for keeping it up - pumping is hard work!

Cluster feeding is normal in the first few weeks. There are also a lot of growth spurts during this time - it often starts to improve after the 3 week spurt.

It is true that volume from expressing is not a reflection of what baby gets - it is a different sucking action. Some women with abundant milk get nothing from pumping.

You know LO is getting enough if she is having enough wet and dirty nappies, and her weight gain is normal. Can you hear her swallowing? Has she been weighed recently? It is normal for babies to lose weight at first, then they regain it. From now onwards, I think your LO should be putting on 4-7 ounces a week.

Why did your midwife say only to feed from one breast? If there is no specific reason to do this (e.g. green poos due to LO too much foremilk), you can offer both if you feel better doing this. To make sure she is emptying the breast, you could try waiting until she finishes one side of her own accord, then change her nappy, then offer the other side. If she takes it, fine. If not, that is also fine.

I'm not sure why her behaviour would have changed since starting the bottle - I wonder if there could have been a problem with her latch that was causing her to fall asleep etc?

I'd say, if you feel expressing would be best for you, then do that. I think it's really admirable that you are - as I know expressing can be tough. Hopefully some more experienced posters might be able to offer you some more advice about this.

That was a bit of a disorganised reply - but I hope it helped!

 

[quaints]

Breastfeeding takes a lot more effort than bottle feeding, so it's very easy for a baby so young to get tired half way through and fall asleep before they get to the end of a feed. The foremilk is quite sleep inducing, so you need to give a little encouragement to get her to stay awake and get the real calories. Keep rubbing her hand or take a break/nappy changed and return her to the same breast. Over time she'll eventually stay awake more throughout and after feeds but very early days yet.

 

[lyre]

i never leak at all ever either and i also cant get hardly anything out when i express. its like there is no evidence of milk! apart from when it gets vomited back up all over me!

my lo does seem to have to work hard to feed and can take up to 40 minutes on one breast and an hour on both. however, he is satisfied at the end and he takes his time, having breaks here and there. i know i have enough milk as my breasts to get engorged if i dont use both in the night etc. so i wouldnt worry about supply and it is much easier for them to bottlefeed so they will take more. i would def offer both breasts once you're sure you've fully exhausted one.

more experienced breastfeeders will probably have more suggestions but just wanted to let you know that i'm similar x

 

[MrsSixx]

Thanks for the replies.

My latch I think is good - it's been checked by several midwives now. I can hear swallowing and her ears wiggle etc. However, I do have quite flat nipples....maybe this makes things extra hard for her. Weight gain was good initially (she lost 8% and gained it back within 10 days) but then seemed to slow right down again. She has plenty of wet nappies but she did go a couple of days earlier in the week without a poo, this seems to have sorted itself now she is taking EBM and she is regular again.

I try as hard as I can to keep her awake during feeds - changing her nappy, tickling her feet, blowing in her face etc but she can be a very sleepy little bugger probably not helped by the jaundice. Her SB levels were quite high at the last check, just below the level needed for phototherapy.

The good news is I seem to have mastered the art of compression now and the frequent pumping sessions have definitely helped my supply. I am now getting more milk per session. Also, I have had her weighed today and she is 8lb 13oz so has gained 4.5oz in the last 5 days

I feel it has all clicked into place since I started expressing but am going to have another go on the breast as soon as this thrush - which is already much better - has gone (unusually Beth doesn't have it). By hook or by crook she is getting my milk!

 

[dacosta]

I'm experiencing a very similar thing with baby Alexa, now 6 days old. My milk is in but waking her to feed can be a bit of a struggle and then once she is awake she has a few sucks and dozes off again. Eventually after a few hours of struggling with different positions, nappy changes she might finally latch on and have a good suck for 15 mins - however sometimes during the night she must only be getting a few sucks of foremilk and then dozing off. I even put her down last night to wait a few more hours to see if that helped. I'm hoping this all settles soon and we manage to get a latch right every now, but until then it's a big worry.

She's weeping fine and is pooing although it's very green and is only just now starting to turn a mustardy colour.

It's very difficult to know if we're getting anywhere, if we're doing the right thing, if something can be done better. Midwifes have told me pretty much every trick on the book but we just don't seem to be getting the hang of the latch. I can see the appeal of expressing and feeding that way and can imaigne it's much more reassuring to be certain that little one is getting the milk she needs.

 

[Marleysgirl]

As someone else said - 3.5oz (100ml) per expressing session is good, I'm on both Fenugreek and Domperidon and have only just got my supply up to that, thank goodness Andrew is small and only requires this amount!

I also have no leakage and cannot feel any let-down.

After a few weeks of unsuccessful BF attempts (Andrew couldn't sustain a latch despite midwives saying we were doing it correctly), I became an exclusive expresser. I find it pretty time-consuming, and only really manage because OH is at home just now, he does the feeding at the same time as I'm pumping. But I am really glad that I am continuing to do this (4 months & counting!) as it means that Andrew is still getting all of the goodness of my breast-milk.

 

[TigerLady]

This is a bit of a mish mash of a post, apologies.

Don't ever be sorry for asking questions!

Anyway, every BF book or site I read talks about let down and the physical sensations that accompany it such as tingling or pins and needles. Well I have no physical sensations at all when I am BFing and can only tell Beth is getting milk because it dripples out of her mouth. I have also had absolutely no nipple leakage, not even a tiny dribble, either at the end of my pregnancy or since I have been breastfeeding.

Many women don't feel the let down. I don't feel it when I pump. Don't worry about this! Also, some women don't leak. I don't tend to leak loads in between feeds until LO has gone a looooong time (which he almost never does)

I appreciate we are all different but is anyone else out there like me? I feel, after reading all the books and speaking to friends who breastfeed, that my milk should be spraying out all over the shop! This is turn concerns me about my ability to supply

Don't be concerned about your supply unless LO consistenly doesn't gain or looses weight for a couple of weeks or more. If she's gaining, you are golden!

I have been exclusively expressing the last few days as I have thrush (argh)

Oh no! I am so sorry! Good for you for pumping! I hate it and would dread to think what a pain exclusive pumping would be!

and am lucky if I get 3.5oz in total from both boobs per 40 min session (apart from my 5am session when I get 6oz).

That is actually just fine. Most BFed babies only eat about 3-4 ounces at a time... even when older. My LO is 5 months old and gets two bottles of EBM per day (sometimes 3), at least half of those bottles are still only 3 ounces.

I know the literature says volume from expressing is not a true reflection of what baby gets but it might explain why Beth seems to have been cluster feeding almost constantly since she was born. I was told by my midwife only to feed from one boob at a time and Beth may well have only been getting 1-2ozs per session in that case. Perhaps even less as she always falls asleep so quickly when on the boob and I spend an age trying to wake her up!

I would offer her both boobs when you start giving her the boob again. Just alternate -- start with right, offer left... next session, start with left offer right. Don't worry if she doesn't empty both or even refuses the second. Always let her feed until she is done... whether that is a few minutes or an hour.

Since feeding EBM via a bottle she is like a different baby. She takes up to 4ozs at a time (which I am pumping furiously to keep up with) without falling asleep and goes the full 3 hours between feeds. She is now sleeping in her cot all night without any fuss whatsoever (apart from waking for her feed) because she has a full tummy. Previously I could only settle her in my bed latched to my breast which, although a wonderful experience on the one hand, scared the crap out of me for a multitude of reasons on the other.

Maybe that will get better if you start offering both bbs at every feed. That way she will get more. And it could be that she was in a growth spurt when she was hungry all the time! That is normal.

I know it's very early days but I am half tempted to stick to expressing. Yes it's time consuming but clearly leaves my daughter far more satisfied and content. The last two days of bottle feeding EBM have coincidentally seen a marked improvement in her jaundice too, which I am pleased about as the MW is coming tomorrow to give her another blood test (now her third).

Hmmmm.

I wouldn't say you could be sure that expressing is better yet. Get her back on the boob when you can and start with offering both boobs. Give it at least a week or two of that. Then re evaluate... research exclusive pumping first, too. It is probably the hardest way to go -- and hard to keep up with your supply, spurts and LO's needs. It can be done, but takes real dedication, so don't make the decision lightly.

Hope the thrush gets better soon!!

 

[MrsSixx]

Well, I woke up this morning to find one of my nipples leaking which, ridiculously, made me go woohoo I have also taken the plunge and hired a Medela Symphony (hospital grade) so I can double pump when I need to. Best decision I have made so far! It's a bit of a beast but I really like it.

Beth's Serum Bilirubin levels have gone from high 200s ---> 181. She is being tested again this Sunday but I think most of the yellow has now gone.

Nipples/boobs are feeling better and Beth is latching on again. She's still falling asleep before I can even think about offering her the second boob though. We will continue to work at it.

I think we will aim for a mixture of expressed milk by bottle and normal breastfeeding in the long term. I have a feeling this is what will work best for us. She doesn't appear to be affected by any nipple confusion and I am committed enough to stick with the expressing (especially with my new super-duper pump). I just need to get a routine going

 

[TigerLady]

Glad to hear it is working out for you!

I do a mix, too, as I am back to work full time and have to pump at work. I have been doing it this way for 2.5 months and have had no problems. I think as long as you can let her demand nurse during spurts, it will be easier to keep your supply even with her. And then pumping when you'd like to other than that.

A good pump is key!! So well done hiring one!