8 weeks and failing miserably

[@llli*hubelle]

Hi,

My son is 8 weeks old and we have had problems feeding from the start. He had jaundice and was readmitted to hospital and we never really got feeding properly established. I've also rarely managed to get him to latch on properly so have had super sore breasts and nipples pretty much the whole time. We have been to so many feeding clinics and it all goes great when we are there but then we get home and the whole thing falls apart.

He seems to be starving the whole time and approaches the breast like a shark. When I can get him latched on he either falls asleep almost immediately or has a fight with the breast, complete with hitting it and throwing his head around from side to side, which really isn't helping with the pain! He never ever comes off happy, I usually end up taking him off after 45 mins on each breast and he is then frantic until he gets some formula.

He is failing to put on a good amount of weight so the paediatrician has suggested we top him up with formula after a feed. I hate doing this as I really really want to succeed at feeding him myself but it feels like we are on the slippery slope to total formula feeding.

I am trying to express too so that I can do at least one top up myself but I get such pathetic amounts of milk; sometimes I can't get any but most times it is around 20mls from both breasts.

Sorry for such a monster post but any suggestions on how I can improve things and maintain my milk supply would be wonderful.

Thank you very much.

[@llli*auderey]

Hi mama, congrats on your new baby, and good job hanging in there so far.

Can you give us some more details, like:
- how often does he feed, on any kind of routine?
- exact & complete weight history, and was it all on the same scale with no clothes on?
- how many wet diapers per 24 hours?
- how much supplementing?
- how are you pumping? type, frequency, duration, before/after nursing, etc
- have you ever done before & after weighs on a sensitive scale?
- were the clinics you went to one-on-one help with an IBCLC? or what?
- how you decide when to take him off the breast
- anything else you can possibly think of?

[@llli*djs.mom]

Some babies are just sharks. That is the way they eat. I would not have this be the reason you worry. I would do some skin to skin time and try to really keep track of HOW MUCH supplementing is being done and how often. Only then can we tell you how much to be backing off. If you are topping off every feed with formula you are definitely killing your supply. But it's all supply and demand. So if you let you child demand it, as long as you are still making SOME milk, you can certainly get your supply back up. I would start every feed at the breast, never supplement more than two oz at top off and if he still seem hungry, finish at the breast as well. And then because if the formula you are going to miss your next natural que at the 1.5 -2hour point. So that is when you should be pumping. Every 1.5-2hours AFTER a feed. So that your body get the signal to make milk when it naturally would when if you were exclusively feeding.

[@llli*phi]

with PPs.

I just wanted to add that pumping output is a very poor indicator of supply (although supply will decrease if you are supplementing).

Also nursing while walking around with your baby (either in a sling/carrier) or in your arms can help with fussiness at the breast. Also adopting a reclined position and letting your baby latch himself can also cut down on fussing and pain.

[@llli*mommal]

Don't worry mama- you're not failing, and you're certainly not failing miserably! You're having a rough time but lots of mamas here have gone through the same sort of thing and then gone on to meet and even exceed their breastfeeding goals. You can too! Please do answer auderey's questions- the more detail you give the better able we will be to help.

[@llli*hubelle]

Wow, thank you all for responding so quickly! Really appreciate this.

Firstly to Audrey (I answer in CAPS to make it helpful):
- how often does he feed, on any kind of routine? C. EVERY 3-4 HRS. EACH FEED TAKES 60-90 MINS INC. WINDING, HIM FALLING ASLEEP OFTEN AND THRASHING
- exact & complete weight history, and was it all on the same scale with no clothes on? BIRTH WEIGHT = 7.4. THEN DROPPED TO 6.6 DURING HIS JAUNDICE PERIOD. BACK TO HIS BIRTH WEIGHT AT 2 WEEKS. NOW AT 8 WEEKS HE IS ONLY 9.2. DIFFERENT SCALES, NO CLOTHES.
- how many wet diapers per 24 hours? 8
- how much supplementing? CURRENTLY, 90 MILS = 3.1 OZ. NOTE: MORNING BREAST FEEDS SEEM TO GO BETTER SO THERE IS A SUPPLEMENT BIAS TO AFTERNOON/EVENING.
- how are you pumping? type, frequency, duration, before/after nursing, etc AM PUMPING TOTAL OF 2.5 OZ (ON A GOOD DAY). HAND PUMP. 5-6 TIMES / DAY (WHENEVER I CAN)
- have you ever done before & after weighs on a sensitive scale? NO
- were the clinics you went to one-on-one help with an IBCLC? or what? YES
- how you decide when to take him off the breast A) WHEN HE FALLS ASLEEP OR B) WHEN HE THRASHES TOO MUCH
- anything else you can possibly think of? I THINK A MAJOR CAUSE MIGHT BE THAT DUE TO HIS SLEEPINESS DURING THE JAUNDICE PERIOD WE THOUGHT WE SIMPLY HAD A GOOD BABY IN A ROUTINE. IN RETROSPECT, HE PROBABLY WASN'T FEEDING ENOUGH; SO I WAS NOT ESTABLISHING A FULL MILK SUPPLY.

Case in point, he is currently chewing on my breast and not really feeding as I (well, my husband) write this...

Pls note I have also tried lying down but the latch is even worse when I do this...

Question 1: should we reduce the time of the feed (eg. to an efficient 40 mins per feed) but increase the frequency (eg. to every 2 hours)?

Question 2: should I still continue to pump?

Thanks again everyone!!

[@llli*auderey]

Hi! my first and main advice is to ditch the schedules. The best thing for baby and for your milk supply is to nurse at early cues on demand. This will likely be an average of every 2 hours but rarely exactly that. Leave him on as long as he wants; even dream feeding is stimulation for you, and will help your body make more milk. Every 3-4 hours is not frequent enough, at 8 weeks, for either of those. Baby might well nurse for 45 mins or longer every 2 hours - yes, that means nursing from 6 to 6:45 and then again at 8.

3 oz is kind of a huge amount to give an 8 week baby; I agree with PP about minimizing that. (I think you're saying you give 3 oz after every nursing, on average?) Most moms have more milk in the morning, so that makes sense - but how can you tell when he needs more or less supplement?

The first priority, of course, is always making sure baby gets fed. Second is making sure your supply is good. Baby is better than pump for increasing supply, and since you're really not getting much with the pump, my first reaction would be to nurse those additional 5-6 times instead of pumping. But my second reaction is that a hand pump is totally inappropriate for what you're asking it to do; if you're going to keep pumping you need to get a professional grade double electric. I think the best thing would be to nurse all the time AND add extra pumping with a good pump. This might help you replace formula feeding wtih expressed milk, too.


did you have any weighs between 2 and 8 weeks?

[@llli*hubelle]

Thanks Auderey!

3 oz is yes what we give him. The cue is coming off the breast but still crying and thrashing, and then wolfing down formula (we normally give 3 oz in several batches to be sure he really wants it).

On what you are saying, we'll try and reduce the supplement. And also reduce the breast pumping (certainly manually until we can get an electric pump - if not, altogether). We'll also do more frequent breast feeds (and probably aim to squeeze at least one additional feed during the night).

he was 7.4 at 2 weeks; 7.8 at 3; 8.3 at 5; 8.10 at 6.

Off the top of your head, is his thrashing at the breast to do with a) bad latching b) his frustration at poor milk supply? Any ideas?!

thanks again!

[@llli*auderey]

Ok, so, babies fed by bottles cannot control the flow - it drips into their mouth and they have to swallow. So what he is taking by bottle is not a good indication of hunger. Although it's great you're doing it in several batches. Check out these resources
http://kellymom.com/bf/pumpingmoms/f...ottle-feeding/
http://kellymom.com/bf/got-milk/basi...rease-formula/

What's great is that he's gained continuously. It does look slow, though. When did you start the formula supplements? I would want to know if he really only gained 8 oz in 2 weeks (6 to 8 weeks) even with all that formula. (Using a different scale might mean a huge inaccuracy.) And I would want to make sure I got some accurate weights from now on, on the same scale. You can rent a scale from the IBCLC which will help you get a handle on milk transfer (before/after weighs) and weekly gain. That will help you start troubleshooting whether the issue is milk transfer or supply or what. The thrashing at the breast might be for several reasons, including just normal baby fussiness.

Other more experienced moms on here will tell you what to do, but I think what I would do is get baby to breast a whole lot more, starting now, get a double-electric and start pumping to increase supply right away like today,rent a scale from your IBCLC or hospital as soon as you can get it, and don't worry too much about reducing the formula supplements for the moment until you can get a scale and see if he's actually transferring milk. Because 24 oz/day of formula should be most of his intake. Which means either he's way overeating (if he's getting milk from you), but that doesn't make sense since he's not gaining, or he's not transferring milk well (either due to latch or supply). And baby needs to eat while you figure this out.

[@llli*filmmommy]

My daughter often had trouble falling asleep at the breast and also wanting to eat CONSTANTLY. Same thing with thrashing. I spent many a night crying due to the many problems we encountered. All is great now, it took almost 4 months to get comfortable with everything (she's 7 months now). I literally had nights where she ate for 2 hours straight, and thrashed around a lot, causing me significant nipple damage. She had colic for a while, but sometimes just seemed unhappy/fussy for no reason. My husband often says he can't believe I stuck with it, but I was determined! This is probably something no one but me would recommend on this site, and I ONLY recommend it if you're sure your son can switch back and forth from breast to bottle easily. Since our girl also had to supplement with formula at the hospital, but I kept breastfeeding before or after the supplement, we found out very early she had no problem switching back-and-forth. To maintain our sanity, my husband gave her expressed breast milk in bottles on occasion (once or twice a day...more if I was really frazzled with her falling asleep) while I pumped, just to make sure she'd eat enough before falling asleep and to keep our feedings under an hour each! She'd usually take her bottle down quickly and then pass out. That would give me time to pump a little longer, since pumping doesn't stimulate production as well. If she didn't pass out, I would nurse after the bottle, because she'd be calmer. If you could get a good pump, you could try that maybe once a day. We sometimes didn't have enough EBM and had to supplement with formula, but that was very infrequent and ended after about the 6-week mark. I tried a lot of creative things that are probably not considered LLL-sanctioned, but we did what worked for us and everything is great now. I also was getting tired of sitting on the couch nursing and watching TV (she often gave me a few minutes break to go to the bathroom, then wanted to eat again). I wish I would have enjoyed it and not found it so stressful!