[Relish*]

Thank you so much everyone. He has fed much better today having had a top up of about 30mls of EBM after 3 of his feeds. He seems to be more content (and consequently so am I!) and more 'awake' during his awake time.

I think we may be caught in a cycle of not getting enough energy/calories = not having the strength to stay awake and feed properly = not getting enough energy/calories, etc etc. I'm expressing straight after feeds and I notice the milk is very creamy, I think the fattier hindmilk, so giving him this which he'd otherwise be missing out on seems to be satisfying him more, giving him more calories and making his awake time at the breast much more productive. My instincts tell me this is the way to go, so hopefully it pays off. We have an appt next Wed at the CHN, and I'll also take him to the chemist to get weighed on Saturday to see how we're going.

The Lactation consultant is a great idea (duh, why didn't I think of that) and I know the hospital does have one which I'll get onto after easter if his weight doesn't improve. I contacted them today to see what the waiting time was like and they said I could get in to see her within a few days if need be after Easter.

Do you have flat nipples? A nipple shield may be a better middle ground if he likes the bottle so much.

I've had a friend recommend nipple shields too, so I will definitely give it a go if he still hasn't put on weight next week. My nipples certainly aren't flat though, they're massive!

Sounds exactly like my son. For me, its a latch issue. He's not getting a good enough grip to bring enough milk in and then he loses it. I've seen 2 x lactation consultants, 2 GP's and had regular appt with my MCHN and nobody has been able to work out what is going on as his latch LOOKS fine but there is obviously issues. I hope you can sort it out as I've been pumping for 5 months now and I'm so worn down. Please dont listen to people who say "relax, it will be fine" as that's what I did and I never got it resolved. If I'd listened to my instincts and kept going until I'd found a solution that wasn't that stupid, depressing breast pump when he was younger I might not be so miserable now.

You poor thing, I can't imagine doing this for five months! I've also been told his latch is fine, but I knew it wasn't because it was horrendously painful feeding from my left boob. I've ended up fixing it myself (I think/hope!) and it's getting much better, I think his lazy suck meant he wasn't attaching properly but it ahs been much better today. The pump was great last time when used occasionally when I wanted to boost supply or had extra but it's getting old pretty quickly. I'm hoping we only have to do this for a few weeks and he eventually gets strong enough to feed better - hopefully the LC can help come up with some ideas if not.

Just a suggestion - check yourself, or get CHN to check that he doesn't have a tongue tie.

Thanks, this is good advice...the CHN thought he might have a slight tongue tie, but the GP dismissed it. It will be something I look into again if we're still in this position next week.

I had a similar issue with my fourth, although I refused to leave hospital until he was attaching. I went home too early with my twins and ending up expressing exclusively for them for 14 weeks and just didn't want to go there again. DS4 lost just over 15% of his birth weight though, so they were happy for me yo stay in until he was gaining and then it was CHN weigh-ins every 2 days on discharge.

I found DS4 just wasn't really interested in feeding. His guts were full of mucous that he kept vomiting up for days and he was very sleepy. If I didn't get him attached straight away, then I could kiss that feed goodbye - by the time he'd attach, he was too exhausted to suck. I refused to introduce a bottle (agdin because of my experience with my twins) but was syringe-feeding him every 3 hours if I couldn't get him to attach. I ended up discovering that if I syringed 3ml as soon as he woke, he would actually wake up enough to attach and feed. It only took a few days of this before he was breastfeeding like a champ! I also have an incredibly strong let-down, so I think he just needed to get a bit stronger to cope with it.

Good luck, I know it's stressful. But trust your instinct and try to enjoy your newborn.

The syringe is a brilliant idea, I never thought of it. Do you just get a syringe from the chemist or is there a special type I could use? If I don't see any improvement in the next week I would like to try this. DS sounds very similar, he was very mucousy and sleepy for the first few days and I wish in hindsight I'd asked to stay in hospital longer than two days.

It could be a lot of different issues. Could be to do with him, could be to do with you, could be just that he's learning etc. As PP said it could be flat nipples etc but I wouldn't start on a nipple shield without specialist advice. Over the internet we can't assess the situation so it's hard to give advice and I don't think throwing 100s of ideas at you would be helpful, it will just confuse the issue.

Is there a breastfeeding clinic at the hospital where you had him? They have lactation consultants there who should be able to assess a feed. Unfortunately midwives and doctors, while they know a bit about breastfeeding, aren't breastfeeding experts.

You could hire a private lactation consultant to come to your home and assess the situation and set you up with a plan. I found that once I got an LC I just listened to her and nobody else, this made things a lot easier on me because I didn't need to worry about conflicting advice etc.

Your experience is great but each baby is different (like every person on the planet is an individual!) so feeding your DS will be different to feeding your DD, so don't be hard on yourself.

There is a pinned thread in this breastfeeding forum on finding an LC. Also if you call the ABA (1800 MUM 2 MUM) they can refer you.

It is a pretty common experience, I fed almost exclusively with EBM for the first couple of weeks while we got attachment/sucking right.

Oh just another thought - if you are topping up with EBM, have you got a decent pump? Hiring a good electric pump saves your wrist and is quicker and more efficient, which when you have a newborn means a lot! The ABA hires them out, as do many chemists.

All the best.

Thank you, this post is lovely. It was a difficult night last night and I was feeling really down on myself, DH said something that resounded with me when I was whining about having BF for a year and still not knowing what i was doing - He said 'Yes but you haven't breastfed this baby for a year!' So true.

I have a First Years electric pump this time which I bought when I was pregnant thinking I'd probably never use it - so glad I did now! It's great (and fast!), much better than the manual one I used last time.

What Tesseract said is very good advice. Lactation consultants are the people you want to take notice of, as they have done extensive training on breastfeeding, whereas some doctors and MCHN's and midwives, haven't gone to extra training and only have a small portal of information. Don't give your baby formula, if you want to exclusively breastfeed, as you will muck up the lovely gut flora that breastmilk gives to babies and I would be putting your baby to the breast as much as you can, as your baby needs to establish your supply and pumping doesn't get as much out as the baby can, so sometimes pumping (which isn't always needed) can deplete your supply, as bottles have shown to do if your baby gets a liking to the bottle. A syringe is a great idea, because babies like to have "flow" and get very disinterested if it is not there. Could you try your little finger to get him to suck and then pop him on the breast and taking your breast into your hand and gently squeezing towards the nipple will send more milk to where he wants it.

Thank you, I will try this! We're not anywhere near formula at this stage, I'd have to be desperate and it was one of those things where I knew the doc would suggest it and just adopted my 'smile and agree' face!

I'd say go and visit a chiropractor, your little ones neck might be out and sucking and being in the feeding position might hurt....

I never even thought of this... will be something to think about if it proves not to be a BF issue, thanks.

Your one and only port of call for your circumstances - a Lactation Consultant

They know and understand ALL the things that can go wrong with breastfeeding and how best to remedy it.

Google should be able to find one close by for you.

This.^
If you have previously successfully breast fed it is more likely to be an attachment issue perhaps causing problems with let down and flow.
Do they have a breast feeding clinic run by LC at the hospital you delivered in? It might be worth enquiring.
Good luck

The LC is definitely a go-er, don't know why I didn't think of it before

Thanks again for all the advice, I feel much more confident that we are heading in the right direction and will be thinking chubby thoughts before our weigh in next week!

This post has been edited by *Relish*: 05/04/2012, 10:17 PM

[Holidayromp]

Hi there OP

I couldn't read and not say something.

Please don't get too hung up on weight gain. This can become a viscious cycle and can muck up what could be a great bfing partnership. As long as your baby is happy, contented and has plenty of wet nappies it really is no biggy.

It takes two people to be successful at breastfeeding - your baby and you. Your baby can pick up on stress so try and be as relaxed as possible. I found with DS he was born via emergency CS that he was a great sucker on the left but had difficulties on the right. The problem was behind us by them time we left the hospital six days later as I kept putting him on the right breast until he got the suck right.

Good luck.

[Relish*]

Hi again,

Just wanted to post an update here... had DS weighed this morning (two weeks old, one week after our last weigh in when he had only gained 10g) and he had gained 240g in one week! Basically I just kept doing what we had been doing, still demand feeding but pumping after two or three feeds a day and topping him up if he still seems hungry. At night he's still a very lazy sucker, so I have sometimes just expressed and given him that feed from a bottle. No formula needed though which is good and I'm feeling soo much more relaxed and relieved. Hopefully as he gets stronger and more 'awake' we can phase the bottle out.

Thanks so much for all the reassurance and advice!

[Tesseract]

Hey Relish! Thanks for updating us, I had been wondering how you were going! So glad you are feeling good about it all! I had a very sleepy newborn too and things really did improve when she woke up a bit at about 2.5 weeks.

If you can get in to see the LC at the hospital it still wouldn't be a bad idea, just to check things out and discuss any questions you have.

I found weaning off the EBM top ups hard for me because I had started to use them as a bit of a crutch, my security blanket if you will! But I just offered 10 mls at a time, and eventually she started refusing them, but only because I was very responsive to her refusal and never encouraged her to drink it when she wasn't totally into it. The other thing that helped was realizing that my baby was a snacker, and quite happy to feed every 1-2 hours during the day. So I would feed her and if 20 minutes later she wanted more I would give her the boob again, rather than the top up. I also resisted the temptation to give her a bottle during arsenic hour(s), and encouraged her to cluster feed during this time, which is fantastic for supply. It was hard to learn to trust my boobs (although since you've bf'd your DD you might not be as anxious as me!), but it was a fantastic feeling to pack away that pump!

All the best! Tess xx

[TwiceTheWoman]

How fantastic Relish! So happy for you!

As your MCHN thought possibly a tongue tie, I would encourage you to still follow up with LC. If this is thought to interfere with your DS feeding, she will be able to refer you onto a Dr who acknowledges the extenuating difficulties associated with even mild t'ties. As noted in another thread today, some Drs are still not well educated with regard to BF.
My 1st boy had a tongue tie. No pain or anything. He just needed constant attachment to be able to get adequate calories. I had mastitis ++. Never experienced satisfactory breast drainage with him (he was my 2nd) Couldn't find a Dr. who would snip his t'tie, ended up with PND. 2nd son had a more significant t'tie. Had found a Dr who understood importance of early correction so she snipped @ 24 hours. No tears, crying - just straight to the breast. The loss of nipple pain was immediate. Meanwhile 1st son was having difficulty speaking & licking his lips. Had a chat with my Dr about this and we agreed to book him in for a light gas anaesthetic and a snip.
Please understand, your LC understands the extrapolating effects of t'tie, so maybe worth an assessment.
Re;
1. your "flat" nipples - not a problem if the baby can latch on ok.
2. using nipple shields - require some guidelines and the knack of using them - the full gamut of - types, introduction, care, ongoing use, any difficulties and weaning off from; again an LC will help out here.
Keep in mind a multitude of difficulties can be overcome in the early weeks as the baby's mouth grows considerably.

Congratulations on your wonderful perseverance for your dear little boy's weight gain.