HV says to introduce a top up of formula but am hesitant..

(91 Posts)
loveroflife Tue 21-May-13 11:48:46

I have ds three weeks old and he is ebf. It has been very, very hard for me as he feeds all the time for hours and hours, no pattern and he also refuses to sleep so I sit on the sofa all day feeding him and in the chair throughout the night feeding.

He honestly sleeps for about 4 hours in 24 hours but has to fall asleep on me first.

HV arrived today and says when DH gets home get him to start giving him 90ml of formula at 9.30ish which would see ds through to 1/2am and allow me to rest.

My mum says to stick with the breast as the formula will become a bit of temptation to use in the day and my supply will adjust accordingly and slow down. I also have very full breast after about 2 hours so if I do let DH do the feed and ds does sleep for 5 hours I will surely need to express in that period as I will be very sore?

Does anyone have any advice, I have come so far feeding as failed to stick with it with ds1 but am utterly exhausted and can't go on with the cluster feeding literally every hour of the day. To give a clearer idea, ds2 feeds for up to 2 hours then has 30mins break and then wants to go back on again. had him weighed today and he is 1lb under his birth weight and his nappies are wet and dirty. Checked for tongue tie and HV says that is all fine. HELP!!

flanbase Tue 21-May-13 23:16:33

How are people to know that what works for them wont work for others or everyone? They can write what they want

larlemucker Tue 21-May-13 23:30:06

I was exactly the same. DS fed every 40 mins for the first 2 weeks. I hadn't bern to bed for 3 days when the midwife advised topping up.
He never had more than 3 oz at a time but it meant I could shower, sleep etc.
I expressed once a day to keep my supply up and once the cluster feeding had calmed down we started slowly weaning him off the formula.

That was 3 months ago. He is now 5 months and ebf.

I would suggest trying the top up if it means you get a break so you can carry on bfing otherwise you sound like you're that knackered you'll end up stopping completely.

No one tells you how hard it's going to be!!!

WouldBeHarrietVane Tue 21-May-13 23:40:26

The reason switching sides is better for babies with slow weight gain is because when breasts are full a whey protein called FIL tells the breast to slow milk production down.

So when one breast is not used in a feed that breast remains full and the FIL tells the body to produce less milk. When both breasts are emptied in a feed (switch nursing) there is less FIL and this tells the body to produce more milk. All explained here:

kellymom.com/bf/got-milk/basics/milkproduction/

The BAMS book I mentioned before is a highly respected evidence based bf textbook. There is a specific section about increasing weight gain where mothers have concerns. The advice listed is to make sure baby is well latched, breastfeed more (ie offer more frequently) and keep offering additional sides at every feed until baby is finished ie switch nursing.

Using breast compressions and avoiding dummies are also recommended.

janey223 Wed 22-May-13 00:01:57

Sorry I haven't read all of this but when DS was still under birthweight at 3 weeks we had to go to the a&e paed to have him checked over (by that point it was only an oz or something too as he'd been on topups after every feed of either bm or formula). It's standard here that if they haven't reached their birthweight they need to be seen, was sent that day.

The paed there told me to not let him feed for longer than 30-40 mins at a time as he would be too tired to fees properly and to take him off, burp & change then either back on or topup.

He despised boobie though, screamed on/off full time but that was undiagnosed reflux+allergy.

tiktok Wed 22-May-13 09:22:22

Flan base it is absolutely not my personal opinion. I gave a link that explained what I was saying. If someone has an opinion only and personal experience only then that is fine. Just don't present it as something generally applicable. How do you suggest I and others respond when we read something here that is likely to do harm if followed by others? Do we say nothing because its ok to present personal opinion as fact? And as for suggesting mothers check with their doctors about breast feeding.....this is fine when it comes to health and medical issues but research - and not just opinion - shows clearly this may not be helpful if we want to understand breastfeeding concerns.

dozily Wed 22-May-13 09:32:47

loveroflife it's possible the c-section infection is what's making you feel sick - please tell the midwife as soon as you can if you haven't already as I would imagine it might need treating.

I hope last night was a little better smile

flanbase Wed 22-May-13 09:49:48

Tiktoc - The link you posted says at the top of the blog that it is just opinion. You are using others opinions to back up your opinions smile

Midori1999 Wed 22-May-13 10:03:52

Flanbase, what Tiktok says is evidence based. This link explains the concept of fore and hindmilk well and has further links explaining in more detail. This website is evidence based and run by an IBCLC, which is the most qualified breastfeeding professional there is.

kellymom.com/bf/got-milk/basics/foremilk-hindmilk/

WallaceWindsock Wed 22-May-13 10:19:18

Hi OP that sounds exactly like my experience of feeding DD two years ago. I had a useless HV who said no tongue tie and that she was latched fine and to just keep feeding. The thing was that I wasn't moving from the sofa because she just screamed with hunger all the bloody time. I was exhausted and after a month started to feel that something wasn't right. I ended up expressing all her feeds and bottle feeding them so that I could physically see that she was getting enough milk. Four months down the line my supply dropped and I started to mix feed and by 6 months she was completely on formula.

I always believed it was something wrong with my milk or my let down reflex which had been the problem. DD was still taking bottles at 18mo because she didn't seem able to extract fluids from any of the cups we had bought so I took her to GP. She has a complex form of tongue tie, really hard to spot and we now know passed down from her Dad. I have a 9wo DS who also has the same form of tongue tie but luckily he naturally gets feeding and has been a breeze in comparison.

So my advice would be to push and push and push with a GP or someone who knows their stuff to get a yes or no on tongue tie. It certainly sounds like TT and if you could get that sorted I expect that feeding would be so so much easier. You said you had probs feeding DC1? Could that have been TT as well - some forms do seem to be hereditary. Good luck and hope you get it sorted.

flanbase Wed 22-May-13 10:33:45

the link used Midori was a blog that says it's based on opinion. It wasn't Kellymom.

flanbase Wed 22-May-13 10:44:42

The header of the blog TikTok linked to states "Articles published on this blog are my opinion only, and may not necessarily reflect the views of any organisations with which I am associated. Please be aware that articles posted on this blog are not intended as a substitute for professional medical advice. If you have a medical problem relating to breastfeeding, please seek further advice from a Lactation Consultant (IBCLC) or trained Breastfeeding Counsellor."This is clearly not evidence based no matter what is quoted or said as the author removes a responsibility for the words written. Just saying. I understand the mumsnet site to be opinion based and not as a substitute for medical advice. If I have this wrong then happy to be corrected.

mindalina Wed 22-May-13 10:45:04

I don't know much about breastfeeding, tbh, being a bit of newbie at it (DD is 12 weeks), so don't have advice in that respect, and you are getting loads of good advice from lovely people here. However what I have just read about is this dysphoric milk ejection reflex which I think I have a mild case of - I get that lurching sensation and a wave of mild anxiety on letdown. I just thought I'd mention it as a couple of posters have mentioned that awful feeling in the stomach, and this might be reassuring. Best of luck smile

Midori1999 Wed 22-May-13 10:46:57

Yes, the link is a blog, but it does actually explain fore/hind milk quite well and the pictures are especially helpful, IMO. However, that doesn't change the fact that what tiktok (and others) are saying Regarding block feeding being counterproductive in the OP's situation and fore milk/hind milk not being something she needs to worry about etc (regardless of links they have posted) is evidence based.

Midori1999 Wed 22-May-13 10:48:22

Flanbase, mumsnet is opinion based, but Tiktok is a breastfeeding professional/counsellor.

flanbase Wed 22-May-13 10:55:22

That's good but still it's opinion. I think it's good for people to be able to say what worked for them. There is no professional responsibility on here.

Soupa Wed 22-May-13 11:03:17

Nct bfcs use evidence based research and are qualified, their contributions are likely to be accurate.

Whilst the wonderful thing about bf and breasts is that their are many variables and experiences there are also ways if feeding likely to have certain consequences.

The consequence of block feeding is reduced milk and or reduced weight gain. Nct, lll, ibclcs, bfn supporters etc all agree this as all use evidence based materials.

flanbase Wed 22-May-13 11:16:20

soupa - just saying that here we don't know for sure people are nct counsellors or whatever. Just saying and no offence and not suggesting anything wrong with anyone. I mean this in the best way and good intentions.

flanbase Wed 22-May-13 11:34:44

I used to carry my kids when they were small and bf from the left breast a lot I used the left arm mainly as right handed. I didn't always sit down to bf as looking after other children and doing housework. When I was co-sleeping I would bf from both sides. The breasts will do the job if you feed from just the one mainly or both equally - just my opinion. For the op -I still say get medical help as her baby is not back to birthweight

tiktok Wed 22-May-13 11:55:49

I linked to a blog which explained my point in a way which is not opinion. I am getting a tad irritated with this opinion thing . I can link to research papers and text books if you prefer flanbase but often a clear explanation is a better bet. My point is that if you present opinion as something generally applicable to all, you will mislead and in some cases cause damage . Someone follows this opinion and experience and they are worse off than before . A shrug of the shoulders and the 'explanation' that 'it was just my opinion' is not helpful.

Put it this way . Opinion and experience is fine as long as it is highlighted as this and not presented as advice or fact. If I see something here that is factually incorrect and which may harm someone, then why would I not put something to counter it? Something that is not my opinion or experience but which comes from an understanding of how bf works.

If you think the right thing to do is to say nothing then my opinion is that you are wrong: )

minipie Wed 22-May-13 20:02:25

to the OP

if your breasts are getting engorged in 2 hours that suggests you have plenty of supply, so it's not a supply issue

engorgement, plus DS feeding for hours and still losing weight (or at least not gaining) suggests the milk is not getting through to him properly

that suggests a latch problem and or tongue tie

also, if you had problems with ds1, it's possible he had TT too - it often runs in families - so again that is a possible pointer towards TT

it is NOT TRUE that no pain = no tongue tie. especially with posterior tongue tie it can take weeks before the pain starts (was the case with me)
so I wouldn't trust your HV to spot a TT as she doesn't seem to know that much about it.

you need a good BFing counsellor/lactation consultant to look at latch and TT. how are you getting on with finding one?

in the meantime, formula will help your DS not be hungry and give you a bit of a break, but you'll need to express to keep your supply up which is hard work (and you need a decent pump)

good luck!

if your breasts are getting engorged in 2 hours that suggests you have plenty of supply, so it's not a supply issue

Not necessarily. If baby has tongue tie, baby may not always be draining the boob properly. TT can look like over supply hence shouldn't risk block feeding unless sure.

Willdoitinaminute Wed 22-May-13 21:05:40

Loveroflife I hope you managed to get thought to someone today who could help you. Having read the posts tonight I do apologise if my suggestions were misplaced. It does get better and you will eventually get some sleep. Wishing you well.

minipie Wed 22-May-13 21:34:00

completely agree, i wouldn't risk block feeding. i just meant it's not that the OP doesn't have milk.

loveroflife Sat 25-May-13 19:27:06

sorry for the delay in responding - I can't seem to put DS down without him crying...

I don't know if he has silent reflux or if there is a problem but I can't put him down not even in the chair for 10mins to shower..it's very draining and I am trying to hard to stick with everything.

I spoke to a number of lactation consultants and am going to a drop in clinic next week to see if he has tongue tie so at least we will know one way or the other.

Does anyone have any advice on nights - I am literally sleeping for an hour or so at night while DH rocks him to sleep. He screams when in the cot and is better next to me in bed but I'm very much on guard about rolling over him and don't really sleep this way either.

Sorry to sound so negative, I had hopes of warm, snuggly breastfeeding but it is pretty tough and the constant feeding is taking its toll...

flanbase Sat 25-May-13 20:46:59

My eldest couldn't be put in the cot without shouting at full strength so I carried her around with me and did the same with my others. It is more intensive and the only break would be when said child was asleep in my arms. I co-slept and managed to do most things (apart from ironing) with one hand. It was a hard time and also very nice as well. I see the reward in that my children are well behaved and calm. I think this is from having carried them with me so they didn't have stress. I'm not saying that this applies to you as it's just what has happened with me.

Join the discussion

Join the discussion

Registering is free, easy, and means you can join in the discussion, get discounts, win prizes and lots more.

Register now