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Breastmilk not enough?
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Posted 11 April 2012 - 05:32 PM
I am sorry for such a long post but I just wanted to make sure I gave all the relevant info. It is our first post on here, but have been reading the site for weeks and found it very helpful.
We had our first child two weeks ago, a little boy named Kelly.
It was a difficult delivery and ending up with an emergency c-section and that combined with some feeding issues my wife experienced in hospital meant that for the first few days home we had fed him formula.
Now we have been trying to get him back on the breast but with nipple confusion and the horrible catch-22 of not having enough supply so still having to supplement with formula has meant even more nipple confusion.
So Mum has been busy pumping like mad all week and trying to get him back on breast, but she has been having a hard time, when he finally does latch on after an hour of crying he will feed but will still be hungry, resulting in having to give him formula.
So what we are trying to do at the moment is pump as much as possible to get supplies up, which is working really well at the moment, and feeding him breastmilk by bottle. Our theory is that once Mum can supply him everything he needs from breast (hopefully now) we can then get him back on breast safe in the knowledge he is getting enough.
FYI, baby has been getting around 90mls of formula, 6-7 times a day, and only waking up once in the night for a feed. All in all pretty good, though he is now showing signs that he wants a bit more so we are going to be feeding him 120ml from today on.
So today Mum has gone out for a break and I am in charge. I had 180ml of breast milk in the fridge, so when he woke up I fed him 90ml - not enough. So I put another 30ml in a bottle and he drank that and immediately was screaming. I burped him, checked his nappy, but no, he was still hungry! so I gave him the other 60ml and he drank it all. But he was still hungry! So I ended up making 30ml of formula and he drank that too!!
So for a baby who has been getting full on 90ml of formula he ended up having 210ml for lunch today before he was full.
So my question is, what is going on? is it possible that Mum's breastmilk is just milk coloured water? He cannot be getting anything from it at all. Where the hell is it all going? 210ml is loads for such a tiny stomach.
We really want to breastfeed but this last couple of weeks has been a real strain on Mum and I can tell she is ready to pack it in and just go with formula. To be honest I can't say I blame her.
Is it possible that some people just cannot make milk that can adequately feed a baby?
Posted 11 April 2012 - 06:17 PM
some people cannot make enough milk, but it is rare (im one of them)
is your wife taking meds to increase supply?
have you tried a nipple sheild to help bubs attach to the boob?
have you tried a supplementary nursing system, to cut back on bottles, and stimulate the breast while feeding?
lots of skin to skin contact, and if possible go to bed/couch for the day and just cuddle and boob all day.
the australian breastfeeding association will be able to help you over the phone, or a home visit. 1800 686 268
Posted 11 April 2012 - 06:33 PM
Breastmilk works by supply and demand and if you are feeding formula, you are damaging your supply, as then your baby will not take much breastmilk as he has had formula. You need to get him back onto breastmilk from your breasts as soon as possible, before the damage is done and he really does want the bottle instead of the breast. He is drinking all that formula from the bottle, because a bottle is easy to drink from and he is just guzzling down because it is there. He needs to milk the breast, by constant nuzzling and feeding and even feeding every two hours in a 24 hour period. The constant feeding at the breast will stimulate your milk supply and you will then find that he will be contented. Little babies need to feed every 1-2 hours during the 24 hour period in the first few weeks and many babies have 17 feeds, while the average is 11 feeds. But if formula and bottles get in the way, you will find he may prefer the bottles and you will never get him back to the breast. Formula does not have the antibodies and nutrition that your baby needs and formula fed babies get constipated and sometimes become obese children, because of the constant bottle feeding of formula.
Posted 11 April 2012 - 06:41 PM
Please phone the Australian Breastfeeding Association helpline ASAP, because you really need help and you can talk to a counsellor any time - night or day. Please don't go down the path of formula and bottles, or even bottles with expressed breastmilk - use a syringe or an open cup and give your baby little sips.
Posted 11 April 2012 - 06:46 PM
Your wife needs a professional lactation consultant. Are you in Sydney? I can PM you the details of the lady I used - I wouldn't still be breastfeeding now if it wasn't for her.
Posted 11 April 2012 - 06:50 PM
In the end it's up to you whether formula feeding is easier and reduces the stress.
But I'd suggest breastfeeding more often if that's possible (and he's emptying the breast), to stimulate flow, and also to swap boobs several times whenever he finishes one (suggested by my lactation consultant when I had trouble with supply) - this lets the other boob produce a wee bit more while the first one is working, and then get emptied again which stimulates it some more. The baby empies the boobs more efficiently than a pump does, so if you can stimulate this way, I think it will be more effective than stimulating by pumping. Pumping can still happen between feeds, but as often as the baby can empty the breast, the better, stimulation wise.
Also make sure the nipple on the bottle is as slow flow as you can make it (eg. a no. 1 on an Avent bottle), to reduce the difference between how hard bubs has to work between bottle and breast.
Also google things to stimulate supply - fennel tea/tablet is a good one. My aunt's old wives recipe is lots of shark (I think it's called flake at the shops?) - who knows if that works! There is also something the Dr can prescribe to assist supply, can't remember the name but it might start with M?
Hope some of that helps!
Posted 11 April 2012 - 06:56 PM
As PP's have said - what about a lactation consultant? There should be one attached to the hospital that your baby was born at - maybe look them up. And if you went public they will probably be free to see. I probably would not have successfully breastfed first time around if not for mine, also.
Posted 11 April 2012 - 07:13 PM
HI guys, no one ever tells you that breast feeding is really hard. It takes most people a month to really get it right so if its something your wife really wants to do give it a little more time because you can't change your mind once you stop.
My story is similar to yours, emergency caesar, son ended up in ICU and I didn't see him until 8 hours after he was born. My supply didn't really come in on its own and he couldn't suck (eventually found he had a tongue tie and he did much better once that was snipped). Lactations consultants are amazing, find one!! There are meds to increase BM supply which your GP can prescribe as well as the old wives tale stuff.
I ended up on high doses of Motilium (and am still on a lower dose), I needed to supplement feed with formula (luckily my son would drink from anything although fed from the bottle at room temp so at least my breast milk had something going for it). My son is now 10months old, since starting solids he only gets breast fed and we hope to continue for a little while longer.
Good luck and however you end up feeding your son you are great parents.
Posted 11 April 2012 - 07:18 PM
Here is what I would do
I had supply issues with both my children, my eldest refused the boob from day 1 (fed EBM and formula until 6 months before being fully formula fed) and my youngest wanted it all the time despite me just not producing enough and he was topped up with formula from 3 months and we mixed fed until he was 15 months.
Posted 11 April 2012 - 07:22 PM
My DS refused the breast for 7 weeks. I had a low supply so pumped like mad and then had to supplement about 50% with formula. Then at 7 weeks he finally got the idea and we have been going strong ever since. He is now 27 months and is addicted to his milkies.
Keep going and get some help.
Posted 11 April 2012 - 07:25 PM
Definitely call the ABA...you can also join a milk bank to get human milk rather than feeding him formula and confusing him (human milk 4 human babies), and use a lactaid to feed him so he doesn't get nipple confusion. Also, I would consider calling a lactation consultant and getting some one on one help - it helped me enormously and now I can feed in a sling whilst shopping or having a pedicure - I look like a natural but I sure didn't start that way! I am so glad I persevered.
Have a look on EB too, there are some great threads with good tips from many lovely ladies.
ETA - Buy Ina May's guide to breastfeedung - some great tips.
Edited by Pandorasbox, 11 April 2012 - 07:28 PM.
Posted 11 April 2012 - 07:28 PM
You sound really worried and concerned for your baby. Babies can be really hard work in the first few weeks, and you sound like you're doing a great job to be supportive for your partner, and helping her to care for Kelly. That is fantastic.
Others have suggested calling the ABA helpline - this is a great suggestion - 1800686268 - trained breastfeeding counsellors will take your call and provide information on breastfeeding and support for your situation. They are happy to talk with dads who are caring for a breastfed baby, so please don't feel like you can't call just because you aren't the one breastfeeding. If Mum is home and wants to talk about how she is feeling about breastfeeding and how it is presently working for her, they are also happy to talk with her - they are there to support mothers to breastfeed, not to judge them if they find that breastfeeding is not going to work.
Good luck with everything, and congratulations on your little boy.
Posted 11 April 2012 - 07:40 PM
No one ever tells you that breastfeeding is natural, but not easy! Mum and baby both have to learn to breastfeed together and it takes time. The first few weeks are always the trickiest, especially when you get off to a rocky start.
The basics of breast milk is supply = demand. The more you feed your baby formula, the more it interferes with this process. The breasts think that "less" milk is required, so they make less. It can quickly become a vicious cycle that can be difficult to break. It also doesn't help that babies are clever creatures-- they can feed so much easier from a bottle. They don't have to work as hard to get the flow going, it flows quickly and freely. Who wouldn't want to work less for a meal? They can sometimes develop a preference for the bottle over the breast which makes getting them back to the breast difficult at times. It also means they can drink enormous quantities in a bottle because it flows so quickly they don't get the "full sensation" that tells them to stop feeding as quick as they would feeding from a breast. I am not telling you this to dishearten you, more so that you and your wife can see where the problems are coming from.
I think it is important at this stage that you seek professional advice. The breastfeeding forum has a pinned sticky on how to find a lactation consultant in your area. They can visit your home, watch a feed and provide a plan to help get your wife's supply up and the baby feeding effectively at the breast. This might involve a supply line to encourage baby to stay at the breast sucking and stimulating supply while having supplementary feed coming down the line.
In the meantime, some things your wife can do to increase supply are herbs: fenugreek and blessed thistle. She can also see her GP to get a script for Motilium which increases supply as well. While these herbs/medicines increase supply, the supply/demand function of the breast means that they will only work at their maximum effectiveness if milk is being drained. In the meantime, pump after every feed. Pump pump pump.
Your wife should also give the ABA hotline a call 1800 MUM 2 MUM. The counsellors are there not only to offer practical advice, but just to lend a friendly ear. Feeding my DS1 was a nightmare due to low supply initially and I was on the phone in tears many times, but always got off feeling heartened and encouraged to keep going. They are not there to judge, just to help.
Congratulations on the birth of your little boy. At our recent ABA meeting, we were discussing what advice we would give to new breastfeeding Mums and the most common one was "persistence"! I was ready to throw in the towel so many times with DS1, but we hung in there, muddled through it and managed to have a lovely breastfeeding relationship. The first few weeks are always the hardest. Good luck
Posted 11 April 2012 - 08:02 PM
Great advice from PP. I also definitely think you should call, or email, the ABA. You don't have to be a member and they are incredibly helpful. Then look into seeing a lactation consultant tomorrow. It does sound like you're trying to do the right thing, so don't give up. I think it would be incredibly unlikely for there to be anything wrong with your wife's milk.
Just for some perspective, DS would happily take up to 250mL of expressed milk from a bottle, even when he was only 6 weeks old. We couldn't figure out where it was all going, as it was twice the volume his stomach was supposed to be able to hold!
My theory was that he was often wanting to suck to feel comforted, and of course with a bottle being so easy to drink from, he'd drink huge volumes trying to calm himself down. Maybe your son is trying to do the same thing - comfort sucking, rather than sucking for food. I also suspect that the breast was more comforting because it was warm and cuddly and smells like mummy in a way that's harder to emulate with bottles and daddy.
I also wouldn't take one feed as an indication that the breastmilk isn't enough for your son. Maybe he just enjoyed it so much more than formula that he stuffed himself full!
Posted 11 April 2012 - 08:03 PM
Is it possible that some people just cannot make milk that can adequately feed a baby?
It's a quantity and delivery issue rather than a quality of milk issue.
The milk is fine, bub just hasn't been bfing well from birth and this does have a negative impact on milk production/volumes but not the milk itself. It still has all the good things in it.
PP's have given lots of excellent advice.
I'd also encourage you to seek expert help as well as posting here, with ABA for a start but I'd also seek out a LC.
LC's are often available at the Hospital where you gave birth, or in the community at CHN centres or private LC"s.
At 2 weeks and with the early problems try and see this situation as understandable albeit tiring, frustrating and stressful.
It is unfortunately very common and most of these situations can be turned around with time and help now.
Keep expressing after every feed until bub is bfing well, use an electric pump if possible (easier usually and less tiring for mum), express for no greater than 30 mins a session and express each breast at least twice. Time must be taken to rest and not be feeding or expressing always. Try to limit the actually feeding part to less than one hour, that is similar to a baby who is bfing well at that age.
If bub will not bf well then give as much ebm as you have and extra formula, you do need to be guided by baby, they do have times of extra hunger (ie we don't have the same static appetite over the 24 hour period). Feed volume to appetite, what else can you do?
Also a baby at this age may have a growth spurt and can become more unsettled in the afternoon/evening rather than overnight so this might be why your baby was more upset when your wife was gone. And you could also factor in the fact that mum wasn't available, maybe that didn't suit your baby at that particular time. It's hard to know absolute specifics.
I encourage you to encourage her to keep expressing and offering the breast frequently if bub will take it.
Get her to rest, bring her food and fluids, tell her she is doing a fantastic job, reassure her that these are "teething" problems and common.
Tell her that her milk is perfect and it is too early to have failed in bfing at 2 weeks.
Her supply has not established as yet and its very hard at the moment, but it's not bfing failure, if she wants to stop expressing or bfing I'd not call it a bfing failure, but a difficult initiation and launch of bfing. If she has the patience, support and timely knowledgeable there is certainly time to turn this situation around. Of course no one can guarantee the outcome.
All the best at the moment and in the future.
eta, pp below said you are awesome and I wanted to second that .
Posted 11 April 2012 - 08:05 PM
You are awesome for reading up and supporting your wife through this.
When we had DS I really didn't prepare for breastfeeding before the birth. I knew it could be difficult - but no one told me really how hard it can be to get started. DH thought, like so many, that they just come out and latch on. Yes, it does work that way for some - but not for us.
Luckily, as we had a home birth, the midwife came to us and was a wonderful support - often staying over an hour at a time, helping me try different positions, different tricks, and offering endless reassurance.
There are reasons why baby might struggle with breast - such as undiagnosed tongue-tie etc.
There are reasons why breastmilk *may not* be a substantial meal for baby.
Since researching breastfeeding more indepth this pregnancy, so we have a better/longer time this time, I have discovered that some women with PCOS may not produce 'mature' milk, as their breast tissue does not fully develop during pregnancy.
I am not a medical person etc, these are things I have discovered for myself. I am not offering these as answers, but maybe things to ask a lactation consultant, ABA member or MW/Dr...
I hope that your breastfeeding journey smoothes out keep your chin up and keep supporting your missus
Posted 11 April 2012 - 09:43 PM
I would also add to the advice above that it can require real determination to keep breastfeeding. By that I mean that it took 2 weeks for me to reach the point where I was producing enough milk. This meant putting up with a baby who was not getting enough milk, his weight plateaued, within 20-30 minutes of breastfeeding he was screaming with hunger again. It was hard, really really hard and it was only our determination to breastfeed that got us through (stubborn buggers us).
That was 2 weeks of breast only, no supplements. As others have said, by feeding formula, that is milk that the mother's body doesn't know the baby needs, so therefore won't produce.
I would also note that our efforts to breastfeed started 6 weeks after he was born due to a complicated birth and a 6 week stint in NICU. He wasn't able to feed orally at all during this time and only had a dummy to remind him about sucking. So don't give up hope if it's what you both really want.
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