Breast feeding issues with 5day old baby (posting on behalf of OH)**Update at 19days*

[Sunflowers]

When jocelyn lost weight (she lost 14% by day 4 going from 9lb 8oz down to 8lb 1oz) we had to feed 3 hourly, she bf for 30 min, then was topped up at 60mls/kg and then I expressed for the next feed. Was utterly exhausting as it took 2.5 hours to do it all (because of extreme spd and settling a withdrawing baby due to the high doses of morphine I was on by the end) and only left me 30 min day and night before starting all over again! 4 hourly is much more sensible!! You'll get there with the pumping and it will all be helping your milk volume for while she's feeding - and she'll get there with the feeding too, some babies just take a little longer to learn how to be efficient at it! Has anyone checked her for tongue-tie btw if she's possibly not latching properly?

Jocelyn was sole demand bf by 3 weeks of age - at 2 and a half weeks we just went for it and she just fed fed fed but didn't lose weight despite the harder work! So it IS possible to get back to demand bf and I breastfed her for 21 months. We also used TT CTN bottles for top-ups and she switched between the bottle and boob just fine, we continued to give the odd feed (usually in church as I am in a church choir so she had ebm via a bottle if she wanted a feed in church!) by bottle with no problems at all!

Well done, sounds like you're doing really well! It can take longer to have your milk come in post section, that may well be what's done it given you were bluelighted in as well!

 

[Celesse]

Her tongue was checked by a lovely Paediatric consultant. Her tongue is slightly short and her gum line is a little unusual. She couldn't see anything that could be fixed.

 

[Seraphim]

I hope everything progresses well.

Congratulations on your lovely Abigail

 

[anothersquish]

As my OH has said we are back home now. It was almost a self discharge cos of the attitude of some midwives and the fact they all wanted me to do things slightly differently. Some didn't even believe she had been latching on at home.

We are now on a pretty strict 4 hourly regime. We start with gentle skin to skin time and allow baby to wake up slowly then encourage her to take to the breast. She is currently interested in licking and sucking the end of the nipple, but rarely latches on correctly, however she is latching sometimes.
Once she has had enough, by either falling asleep and loosing interest or starting to get frustrated and scream we move on to giving her EBM and then formula top up.
I then expressing using the Medela Swing breast pump https://www.medelasuction.com/UK/breastfeeding/products/swing.php

I currently express 5 mins each side, twice. I've gone up from 20mls a time, to 38mls last expression. I have also been put on domperidone to increase my milk supply.

Current bottles we got so we could manage at home are the Tommy Tippee closer to nature ones. They are making LO work harder than the hospital ones and we intend to get Breastflow ones.

My current plan is to continue with the 4 hourly plan over the weekend, allow my milk to increase and look for a pattern with the baby that will allow us to encourage her to be more interested in the boob.

Some general advise following on from this....I would go with 2-3hours during the day and 3-4 hours at night hun if you can. Less but more often.
I would also express for longer each side. Express until you get NO more milk, not even a drop for a little while, this can take five minutes at first but if you just leave the pump going a little longer (as long as its not painful, if it is crank the suction down!) it will get longer and longer and you may well find you get more than one 'letdown' so dont stop even when the flow is reduced just to drips.
If you struggle with supply at all then increase the amount of expressing you do, go to every hour during the day and as often as you can manage at night and ignore whether you are actually getting much milk or not (when I was doing it I didnt get much but it really kicked milk production into overdrive very quickly!)

 

[Celesse]

Baby has now decided that she will breast feed and has been latching on beautifully since 3ish yesterday morning. She is still taking EBM and formula after breast feeds. She has started to initiate feeds herself and when we have woken her up to fit into the routine she hasn't fed much. She wants to feed about every 2-3 hours.

I'm a little confused about how to go about pumping now. I am trying to pump every 4 hours, but am worried that I will be empty when she wants to feed. I also need to keep pumping to keep up the supply, as I am clearly not making enough milk yet. I am getting about 40mls per expression now, and she is taking another 20-60mls formula on top of this. I am not really timing how long I pump for, but am allowing the breast to run dry.

 

[anothersquish]

Pumping is not an indication of supply, if you are aiming to exclusively BF then you need to gradually cut down on the EBM and formula you are supplying in a bottle, getting baby to suckle more will increase your supply and your body will match the demand after a few days.
With the pumping, it is easier and probably wiser to express the opposite side to the one she is feeding from at the same time or directly after she has fed. As you are also trying to up your supply I would also then pump the side she has just fed from after she finnishes to encourage your body to produce more milk. This will probably mean you are pumping every 2-3 hours, you may get less each time but the more regularly you express the more milk your body will make and the less you will have to use the bottles.
You are never "empty" your body ALWAYS produces milk, however the more less milk you have 'stored' the faster your body will produce so the 'emptier' your brests feel after feeding/pumping the better as you will produce milk faster. EG I can express 5oz from one side and then give Theo a full feed from that side....he is much more efficient than the pump and it shifts the body into overdrive in milk production
Basically trust your body, if she puts weight on has wet and dirty nappies and appears happy and healthy then she is getting enough. Put her to the breast as regularly as she wants and start to cut back on the formula asap, if you replace the formula with EBM/direct feeding then at least it will tell your body how much milk it needs to produce, until you eradicate the formula your body will not match her demands for milk as it will assume you dont need the extra oz per day that you are giving her as formula...IYSWIM! It does mean she will want to feed more, possibly every hour or so and probably for longer periods of time but this is GOOD as it stimulates your supply, it does take a couple of days but if you really want to get back to exclusive BF then you just need to stick with it. You get the same behaviours when going through a growth spurt.

 

[Sunflowers]

When I was cutting out the top-ups with jocelyn I first cut out the formula part for a couple of days and with the expressing I just expressed after every feed - that way i had a top-up of what ever ebm I could get ready for the next feed and I knew that I would have been filling up again in time for the next bf. If she's feeding more frequently then each top up won't need to be as big don't forget!

After a couple of days of that we then went back to sole demand bf with no top ups - as anothersquish says, she did want to feed frequently (very frequently, day and night!) but she soon upped my supply to what it needed to be! It might be a case of just making sure you can feed whenever/wherever she wants for a few days while she's upping your supply and then you should find things start to settle down a little!

 

[Feltzy]

This happened with my first baby, she was feeding fine and then a mw wanted to supplement to increase her blood sugar level, once she had the bottle she wouldn't go back to the breast. When I had my son a couple of weeks ago I asked about it in the hospital and they said I should have used a cup instead of a bottle, which is what they now encourage breastfeeding mums to do if they need to supplement for whatever reason.

I would tell your wife to do it how she wants to do it as I always regretted the fact that I listened to other people first time round and it ruined my chances of breastfeeding.

 

[Celesse]

Midwife has been out today. Plan is to remove 2 formula top-ups a day from the feeding plan and see how it goes. Baby is to be weighed again on Friday and if she has got back to her birth weight then me and the baby are to spend the weekend skin to skin, feeding exclusively on the breast in a kind of attempt to restart the breast feeding from scratch.

And just to make matters more complicated I have had to start antibiotics for an inflamed C-Section scar.

 

[madasa]

Seems like you have great advice already, so nothing to add here except by gum but you are one determined lady! And I want to smack the people in that hospital!! Well done you, anyway

If you're removing top-ups, can you squeeze in an extra feed or two somewhere else? Even if it means getting up in the night and doing a dreamfeed or something....? I'm thinking it's a way to a) get more milk into her and b) tell your body to make more milk....? While I wouldn't be worried about weight gain normally, I'd just want her to be nice and chubby for her weigh in so that they don't pressure you or give you any ghastly advice that could sabotage what you have achieved so far. Given their track record, that's not hugely unlikely!

 

[Celesse]

UPDATE: Baby is now 19days old and is now exclusively taking breast milk. Her last formula feed was on 26 March.

She is still taking 3 or 4 feeds of EBM a day. This time a week ago she was having 6 formula top ups and 6 EBM top ups, so I feel we are progressing well. We are following her lead. I think in another week we should be down to just breast feeds. The reason for keeping the EBM feeds is she just doesn't seem to manage to get enough at some feeds, getting distressed and clearly hungry.

She is sleeping well at night, waking up and demand feeding just once a night. She is bright and alert, and gives us plenty of poopy and wet nappies.

I'm really glad we stuck in there and want to thank you all for your advice and support.

 

[anothersquish]

Well done you

 

[CharlieP]

congratulations! x

 

[Mrs Muffin]

Excellent news

 

[MandaAnda]

Wonderful to hear!

 

[Seraphim]

 

[Oushka]

Fab news! Well done - thanks for the update

 

[Sunflowers]

Ahh celesse you've done really well!!

Sounds like you'll be back to sole demand bf pretty soon!!

 

[vanessayogini]

very well done!

 

[hivechild]

Congrats! That's great news and such an achievement.