Help! Is it too late to breast feed?

[PotPourri]

I've been struggling through bfing my 3.5 week old DD. I'm very fair skinned and bruise easily, so was in agony even with constant paracetamol. I used nipple shields for over a week after the first 12 days and this seemed to be making it bearable - but then she got colic/hunger - not sure - so I started feeding from one breast at each feed to ensure she was getting the hind milk.

However at the HV visit she had lost alot of weight. Then when I took her in a week later to be weighed she had lost another 5 ounzes (11 in total from her birth weight). So, I bit the bullet and decided to top up with formula. She seemed much happier (once we found a teat that is like a nipple - she couldn't get her head round the silicone ones). I was then feeding every 6 hours myself (so 12 hours for each breast). The upshot is that on Saturday I realised she seemed hungry after a long feed from me, and when I tried to express there was only a drop coming out! In my despair I gave up yesterday and decided to go on the bottle full time. However today I realised that this is not what I want to do. She is sleeping much better and seems much more alert on bottles alone.

Is it too late to get back to breast feeding? I have accepted the idea of mixing as I know the priority is for her to thrive. And how do I make sure I have enough milk? Am really worried that I have mucked it all up now by stopping so early before my milk is even established. I have an overwhelming feelingg of guilt and failure. I have fed her twice today from both breasts at each feed and then topped up with a bottle to see if I can get things flowing again....

Any help/advice greatly appreciated

[beansprout]

PP - there will be people who know more about this than me, but apparently it is all down to supply and demand, so could you express inbetween feeds to boost your supply?

[moondog]

Someone v experienced will be along soon, but I think you need to get the supply and demand thing straight in your head. As long as you are 'topping up' you are reducing the demands made on your breasts,thus steadily, less and less milk will be made.
Have you phoned the ABM helpline yet?

[franch]

Hope you manage to sort this out potpourri. I'd ring a helpline asap. The numbers you need are here . Try ABM as moondog says, or La Leche League, or your HV may have given you the no. of a local breastfeeding counsellor?

[frogs]

Hi potpourri, and congratulations on your baby!

The first thing to remember is that 3.5 weeks is still very early at that stage the baby's demands and your milk supply are still getting to know each other, so I'm sure it would be possible to get back to whatever bfeeding routine suits both of you. The amount you can express is no indication of how much milk you are producing babies are much more efficient at extracting milk than hands or pumps are, and will always be getting something, even if it does't look like much to you.

I'm sure tiktok and mears will have some suggestions about how to increase bfeeds while decreasing bottlefeeds -- it would be worth checking with them and/or some of the bfeeding helplines, as I know there are lots of people who've done this successfully, and you might as well benefit from other people's experiences.

With regard to reducing the pain for yourself, particularly if you need to feed more often for a while, it's worth trying to alternate feeding positions, so that the same part of the nipple doesn't get hammered each time -- ie. try feeding lying down, or with the baby under your arm in the 'rugby ball' position. I even in desparation once fed the baby practically upside down, just to get through one of those early feeds.

Also remember that HV's should come with their own health warning, as should scales and weight charts.

You haven't mucked it up at all your baby has been getting the best possible start, and topping up with a little formula isn't the end of the world. When we lived in Africa, the women used to bfeed each other's babies so that new mums could get some sleep formula is just the modern, western version of that!

Take care, and all the best.

[mears]

No it is not too late PotPourri. You need to feed more frequently to increase your milk supply. You also need to make sure your DD is getting enough milk as you increase your supply. Most importantly you need support from a B/F counsellor to reassure you.
I supported a friend to increase her milk supply with a similar history to you. Her DD persistantly lost weight and was actually admitted to hospitalwhere she started formula top-ups after every feed. She was a big baby at birth (10lb 120z) and slept through the night within a week of birth. Consequently she was not stimulating her mum to make milk as night feeds are important in the early weeks.
I showed my friend how to hand express milk because she didn't manmage to get anything using a pump. Her DD was not positioned well at the breast so we corrected that. That also leads to poor milk production.
She breastfed every 3 hours and was initially giving a 4oz top-up of formula. If baby did not feed well she expressed milk. She was amazed at what she could get hand expressing. After a few days of more frequent feeds, she started decreasing the top-ups by an ounce each day. It did take a few weeks and she chose to keep a lunchtime bottle feed of EBM. I suggested cup feeding the top-ups of formula but that wasn't very successful for her. Her baby was 4 weeks old when we started this and by 12 weeks she was exclusivley fed on breastmilk. All breastfeeds and i bottle of EBM. She had to set an alarm for a night feed after a few weeks of avoiding it but her DD actually fed best at that time. She went on to exclusively breastfeed till 6 months. It definately can be done.

[tiktok]

PP, mears is right and her suggestions are excellent. I'd add that as she implies, it may not be easy to get to full bf, or quick - but it can be done.

The reason why things became so difficult for you and your baby are likely to lie in the very first days. I would be almost certain your baby was not removing milk effectively - I bet your baby did not start having frequent yellow poos after about day 5, and I would also bet you were told not to worry about the lack of poo (if it came up in discussion al all). One breast at each feed is not helpful to an already dodgy start, esp with nipple shields.

Alarm bells should have clanged loudly when your HV weighed her the first time. Then, feeding only once every 12 hours on each breast is likely to reduce your milk pretty rapidly, so it's not surprising things went really downhill from there.

But......they can be turned round. Feeding often, both sides, and expressing as well, can restore the milk supply.

I really wish you all the best here. You haven't had good support, and in the absence of it, you have struggled on doing your very best, and I hope you find the responses here are an encouragement....keep us posted

[PotPourri]

Thanks so much for your help and suggestions. I will try them out - incl trying different positions as I have not had much success with different ones, and didn't persevere. (Tiktok, most of what you said is on the money). I am going to go to the bf clinic at the local maternity hospital tomorrow.

A few further questions:

• how do I get a bf counsellor - i.e. not just the various volunteers and midwives that are at teh weekly clinic (and does it cost anything?)
  
• Does using nipple shields seriously reduce the supply? I got some today that are shaped more like butterflies, so the baby can be touching the breast directly with her tongue. Will that reduce the problems of using them (worried about the pain)?
  
• My baby also sleeps through the night - should I wake her? How long should I let her sleep And how long shoudl I do this for - a week/month? (I will do it but will be sorry to give up my sleep as it had helped me cope with the other demands of being a first time parent).
  
  I feel much better and very motivated. Thanks for your support. I was feeling very down and ashamed about my situation, but this has given me hope.

[SoupDragon]

Try the NCT Breastfeeding Line: 0870 444 8708

They can help you and/or put you in touch with a local breastfeeding counsellor

[poppy101]

I had a similar problem, my baby lost weight and I was practically forced to put baby on formula to top up. Supply does diminish, all I can suggest is, use a slow flow teat so that it is harder for the baby to get the formula.

Massage before you pump, drink a pint of water an hour before you express. Have you considered hiring an electric pump, or you could manually pump. Pump perhaps every 3 hours and see how much you get. Have you tried herbal tea before bed time ? Have you tried the rugby ball hold for the baby. Keep up with the breast feeding if you can.

[poppy101]

Unfortunately for me my baby is now 5 months old and has now decided that it no longer wants night time feeds by breast anymore. He sleeps from 6 til 6 now. Therefore even though I try and express, it is a little too late. My supply is now diminishing a little every couple of days. I feel that if I had continued to express on a regular basis every couple of hours and had bought an electric pump sooner, I would be okay. However, I left the expressing a bit too late. However, if I have another baby I will know what too do. Unfortunately if you haven't had any previous experience before, it is hard.

[frogs]

Glad you're feeling better, PP! First time bfeeding can be awful, and there's so little real support out there, and such a lot of misinformation.

What do you mean by sleeping through the night? Really through, like 7pm to 7am? If so, that seems like a long time to go without milk.

My dd2 was the only one of my three to sleep through from 4 weeks (7pm to 6am, but being woken for a 10.30pm feed), and she was the only one where the weight gain was an issue. Don't know if there is a proven connection, but with hindsight I do wonder. But you might be able to sneak in an extra feed or two without having to wake up properly...

Good luck!

[mears]

PotPourri - I know what you mean about enjoying your sleep and not getting up to feed. My friend said the same (she had another child too) and really did not want to wake her baby. However, in the end she did because the expressing and 3 hourly feeds was not enough. She also found her DD fed better in the quiet of the night. I can;t remember how long she did that for. Some babies are 'happy starvers' and do not wake for the milk they need to gain weight. Sometimes they need propting. Night feeds are important because your prolactin levels are higher at night. Higher prolcatin levels + breastfeeds increases milk production. I would suggest trying a 3am feed. If your DD does no co-operate, you could alwys express at that time. It will really boost your milk supply.

[mears]

Try feeding without shields fiirst if you can - they do not teach the baby to breastfeed. However, if you feel that feeding with them helps, try and express more. Shields can reduce milk production by up to 40% but that was with the old style. The new style ones are meant to interfere less. The other thing you can do to boost milk production is take Domperidone (Motilium) 10mg, three times a day for 10 days. You can buy it over the counter and we prescribe it for women with production problems, espeially those with babies in SCBU. It is a medication primarly used for bloatedness but the side effect is it ncreases prolactin levels. It should not be used instead of more frequent feeds but use if frequnt feeds/expressing has nit had an impact.

You breastfeeding clinic should have a list of local contact numbers of B/F counsellors. Good luck.

[pupuce]

BF counsellors are volunteers - there is no charge

[misstimms]

Please don't feel bad - you are doing wonderfully! You can re-establish a good milk supply using the methods everybody has suggested. I have looked after mums who have never breast fed (I work in a children's intensive care unit) their children for the first week or two, and we still manage to get them expressing successfully. Don't give up. try everything, and find what works for you. Good luck.