Inefficient feeding - 5 week old
Hi ladies, looking for some support and advice please. I apologise in advance for the very long post. Evidently, I have a lot on my mind! I have a 5 and a half week old daughter who just isn't feeding efficiently at all...or at least I don't think she is. I had a lot of problems feeding my 18 month old daughter, and it plagues me to this day that I was never able to EBF her, so much so that I feel it is interfering with how I am breastfeeding this time. I feel like I am in a constant state of anxiety and worry, and always questioning every little thing from how many dirty/wet nappies my LO has to how sunken her fontanelle is. I just can't relax, and feel like it is having a negative impact on my milk supply.
With my 18 month old, I never sought help until too late because I felt like I was a failure. I'm blessed with the fact that my mother in law is an IBCLC, but last time I felt like I had to show her how great I was at bfeeding (always felt the need to try impress her - but that is another story!), when the reality was that I was in pain feeding all the time and shouldn't have let my pride get in the way. After having a bout of mastitis, and finding that my daughter had stopped gaining weight, I eventually asked her for help. It led to an eventual diagnosis of tongue tie at 4 weeks, but by that point, my supply had dwindled a lot. I set about taking herbs, pumping after/before/during feeds, using an SNS, domperidone...absolutely anything and everything to get my supply up, but I was never able to EBF despite all my attempts.
This time I was prepared for the fact my daughter may have a tongue tie (due to the genetic link) and was able to be pro active about maintaining my supply. My MIL and I decided I should pump after every feed, apart from night feeds for the first 2 weeks due to this being the most critical time to set up my 'factory'. I'm still pumping on average 3 times a day now. I haven't been able to have my MIL see me feed my LO in a while, because everytime she visits, I have either just fed her, or when I try to feed her, I tense up because she is watching me, and my let down doesn't happen, so I have to go and feed elsewhere. I feel I would benefit from seeing someone else but don't want to offend my MIL, and wouldn't know who else to go see.
My LO had a PTT snipped at day 11, although it wasn't cut very deep at the admission of the person cutting it, due to the scissors just 'bouncing back off it' as they are blunt ended. She recommended seeing someone else who can cut it deeper using a different technique if problems persisted. My LO also has a very pronounced ULT. I have managed to get an appointment with a recommended Dr who will snip her TT and ULT privately a week Monday. This was the soonest appointment they had. In the meantime, I am stuck questioning everything all the time, and wondering if I am starving my LO.
The past week or so, something feels like it has changed. My boobs are very rarely full between feeds and I use a breast shell to collect milk from the boob I'm not feeding from, which used to get full, but now isn't even getting half full. She never seems to come off 'milk drunk', never has, and can sometimes be on me for upto an hour or more at a time. This has me questioning my supply. I know pumping isn't an accurate portrayal of my supply but I can pump an oz to 2oz after feeding her, or 3to 4 oz in between feedings. So as usual, logic is telling me my supply is ok but I can't ever see her doing deep, long sucks apart from during my let downs. Is this normal? What does normal bfeeding look like? I have never really seen other women bfeeding up close. Like what should the pattern of it look like etc? Any videos? For example, my LO does little sucks, then when I have my let down, goes into deep sucks, but only as the let down is happening. Then she has a break, with maybe a few more little sucks, and a few deep ones. Then starts the little sucks again until another let down happens, and repeats the process a few more times. I thought she should be in the deep sucks majority of the time? Even after my let down? What eventually changes that makes mothers/babies more efficient at bfeeding the older they get? My LO feeds better from one side than the other, and very rarely stays on the worse side for more than 10 mins. Mostly latching on and off the whole time, unless I'm having a let down. Could this be a slower flow possibly? I've tried breast compressions on both sides but very rarely makes a difference to her sucks. She also has a lot of clicking, kind of feels like a loss of suction when it happens, but I'm pretty sure that is the ULT/PTT and hopefully that will resolve after they have been revised?
Her nappies seem to be OK, although I'm always questioning whether her wet ones are wet enough. What would be determined as 'a heavy nappy'? Her poops seem fine, always yellow, very rarely seedy though. Does that matter? The frequency of them started to change about 5 days ago. They went from being about 6 to 8 times a day to about 3 to 5 a day. I'm also not sure on the size of them, as in whether or not they are big enough. She normally has several small/medium ones and one a day that covers about 3/4 of the nappy. How do I know she is pooping enough?
Weight wise, she was born very heavy - 10lbs 7oz, never expected her to be that big as her sister was only 8lbs 1oz. She went down to 10lbs 4.5 oz at day 5, but was back to birth weight at day 10. At her last weight check when she was 4weeks and 5 days, she was 11lbs 5oz. So that has equated to just over 4 oz a week since her lowest recorded weight. Does this seem OK? Is there anything anywhere to suggest that higher birth weight babies gain slower? I always presumed with her being such a big baby she would want feeding more, and therefore put on more weight, but this hasn't been the case.
Anyway, I'm sorry for all the questions and the long essay, but I would really appreciate any help any of you can give me. I'm so passionate about bfeeding and really, really want it to work this time. I'm tired of feeling like a failure. What can I do to help us both be more efficient? Other than breast compressions and swapping back and forth between breasts when she stops the deep sucks? Thank you.
Re: Inefficient feeding - 5 week old
Welcome to the forum! I think the major challenge for you is likely to be allowing yourself to let go of the stress and anxiety, because everything else you describe sounds pretty normal.
Nursing babies tend to go through phases of active, rhythmic, strong suckling, and phases of gentle, fluttery, gentle suckling. This is during the same feeding. Here's an example of how this might work:
- Baby latches on, sucks deeply as she tries to generate the first letdown. Not much swallowing during this time.
- Letdown begins, and baby goes into a "suck-swallow-breathe-suck-swallow-breathe" pattern for a while, maybe as little as a minute.
- Letdown ends, and baby transitions to a more relaxed sucking style, more of a "suck-suck-pause-suck-pause-suck-suck-suck-pause" pattern
- If baby is still hungry, she will generate another letdown (maybe even a third or fourth letdown) and return to the rhythmic "suck-swallow-breathe" pattern
- At the end of the feeding, baby will transition to shallow, light, irregular comfort sucking
Baby's weight gain seems slow, but this could be an artifact of measuring or birth interventions. Did you have IV fluids during birth?