Breastfeeding Prep.

wmpdd3

When I had my daughter last year, my milk didnt come in. She didnt really latch on well as she was early and could suck a bottle either.

She was cup fed for the first few days, just enough to keep her blood sugar up. When she wasnt asleep she was skin to skin with me trying to latch on.

I expressed in hospital with my own avent electric pump and the medulla one. The most I managed was 1 oz after 15n mins on each breast.

If this happens this time what can I do?

Should I stay away from cup feeds and just persevere with the suckling?

Also she got jaundis after 3 days and stayed in an incubator for the next 3 days, she was only out for 10 mins every 2 hrs for feeding, but I had no food for her, so she was bottle fed. Any one over come this.

I have no.s for La lache etc but I would love to know if anyone managed to solve a problem like no milk.

I met mothers of very premmie twins who just started pumping and were getting 3oz within a few days of the birth.

I have many friends who also breast fed and were gread helping with latching on but none had the same problems with supply.

January

Apparently pumping can lead to it's own supply issues in the early days.

How Strange

wmpdd3, I didn't have any supply issues but from what I've learned since breastfeeding my son constant skin to skin and suckling is the best thing to do. Your milk doesn't come in until day 3-5 so the more the baby sucks the more colostrum they get and they're also stimulating your milk supply.

I'd recommend you email Jack Newman with the query you just posted. He's a Canadian doctor but also a bit of a breastfeeding guru. He usually will mail you back within a day.

How Strange

Sorry, I should've said if you google him you'll find his website with loads of fantastic breastfeeding advice but his email address will be there too.

Das Kitty

I tried hand-expressing a few drops every morning in the last month or so of pregnancy. I had plenty of colostrum but it did take a good 3-4 days before my actual milk arrived.

Every baby and pregnancy/post partum period is different. You could have no issue this time even if you do nothing differently.

I would also say not to watch the milk being expressed if you're worried about how much is going to come out as I found it was a sure fire way of stopping the flow. Try to concentrate on your baby and stoke him or her.

Good luck missus!

Cat Melodeon

Same here, it was day 3-4 before my milk came in, that's pretty much par for the course, and can be delayed if you don't get to latch baby on lots as it's not just the post-partum hormones that stimulate milk production, it's the actual physical contact with baby. Ten minutes every 2 hours seems a bit too little to me (I'm not an expert) so if you did end up in a similar situation this time, I'd be trying to get hold of the hospital lactation specialist and get them to work out a schedule for you, baby and the nursing staff that takes your previous experience into consideration.

Diet can also help - fennel tea and porridge oats are famous for helping supply - and drinking plenty of water is important. The only thing I'll say about that though is that in my personal experience, diet only helps once your milk comes in, and getting milk in really depends on how much contact you can have with your baby. Maybe ask about kangaroo care (skin-to-skin) if this baby ends up in the Special Care Unit too.

A couple of other things - I've read that if the cord is cut before it has finished pulsing, babies are more likely to be jaundiced, so maybe include that in your birth plan?

Also, expressing is nothing like nursing, and what you get out with a pump is nothing like what baby can get out. I simply couldn't express anything beyond a few drops before my baby was 3 weeks old, but he was getting plenty himself.

And if you do end up having to supplement, always latch the baby on for ten minutes or so first (before every single feed) and only give cup feeds when you've that done. It's pretty intense even if your baby is perfectly healthy (I was trying to feed my lad every 90mins or so) but it quickly stretches out to 2.5 hours and then longer depending on your baby and your supply.

The resources I found excellent were Jack Newman's site (as mentioned above) and Irish support groups like Friends of Breastfeeding and The Breastway, both of which have online resources and discussion forums.

I hope it all works out problem free for you this time and you need none of this!

wmpdd3

Brilliant advice, never knew pumping could reduce you milk!!

I'm googling that Jack guy.

Never knew they would have a lactation expert, but all the midwives spent ages trying to get her to latch on, the head nurse was especially helpful, even though she was in so much demand from other in the hospital.

The midwife waited till the cord stopped pulsating last time too but I will make sure it is in my birth plan this time too. That was the worst part, seeing her stuck in that incubator with those bloody eye shields on!

Great advice about getting baby to latch on for 10 mins before any cup feed. I think I wasted too much time attached to the pumps rather than just skin to skin.

I feel alot more confident to ask for the help I could need if this did happen again. Even my friends were feeling helpless as they never had supply issues.

I never thought of concentrating on the baby rather than the amount of food she was getting, will remember that.

I will practice hand expressing in the months before my EDD, plenty leaking already!!

foxinsocks

The midwives in Drogheda were FANTASTICALLY helpful explaining things this time round. They explained jaundice to me, what causes it, and the fact that breast fed babies get it worse. I'll see if I can reproduce how it was explained.

When babies are born, they have extra haemoglobin in their blood. This breaks down over the first few days, turning into bile, which makes skin and eyes appear yellow. This bile clears through motility through the bowel. Breast fed babies don't have as much bowel motility as bottle fed babies, because breast milk is much easier to digest. Therefore, breast fed babies stay jaundiced for longer. Izzy was noticeably jaundiced on days 2-6 (ish) but the midwives checked her with a magical light wand thingy, and her readings were within the normal range for a breast fed baby. After my milk came in she started having more regular poohs, and the yellow went away pretty quickly.

They also helped explain about milk supply. Izzy's first feed (not including the glucose drip) was a formula feed. She would have been given about 30 mls. This is the normal amount of formula for a baby her size (5'14"). BUT, if her first feed had been directly from boob, she would only have gotten between 5-7 ml of colostrum (about a teaspoonful). This is the NORMAL amount, colostrum is superfood, it has all the calories/nutrients/antibodies/wonderfulness that a newborn needs, even though they only get tiny amounts each feed for the first few days. When Izzy was delivered she was put straight to breast, still in the operating room, but she was too cold and sleepy to feed (which is why, along with diabetes related issues, she ended up in special care). I knew I wanted to breast feed though, so in order to avoid having to 'top up' like I had to with my first, I started to hand express. I wanted to make sure that even though there was no baby for the first 30 hours, that my breasts weren't given the opportunity to slack off! I even set an alarm to wake me up in the wee hours, even though they tried to tell me to just sleep to take advantage of not having to mind the baby.

They told me that when I did get Izzy back, I would need to start actually waking her for feeds, both due to her size, and her slightly rocky introduction to feeding. They basically applauded me when I breastfed for 30 minutes + at each feed. She's 10 days old now, and I still wake her for feeds, even at night (though I leave the night feeds to 4 hours apart). My milk came in towards the beginning of day 3 and she's been a guzzle machine ever since. The nurses in special care deliberately withheld a feed from Izzy, to make absolutely sure she was HUNGRY when they introduced her to the breast properly. They weren't afraid of her having problems, even though I had only managed to hand express maybe a teaspoonful of colostrum over the first 24 hours. Getting her to latch on was tricky, and for the first few days, I actually asked for midwife help, because I knew that the faster Izzy and I got the hang of it the better. And I knew that me getting tearful, and her getting hungry and frustrated wasn't going to help either of us learn!

There's no real secret to breastfeeding, just if you're worried about your supply, feed, feed, feed, feed, and then feed some more. Your baby is at least 10x more efficient than even the best pump out there. Cuddle your baby as much as you possibly can too Sometimes they can be a bit quick to say 'you aren't making enough milk' and they make you top up with formula, which then makes any problem even worse. If your baby isn't hungry, it won't suckle enough, and if it doesn't suckle enough, you won't be making enough milk. Ask for help from the midwifes if latching on is a problem, they're experts, and that's what they are there for. If a midwife sees you struggle, and offers help LET THEM HELP.

Thankfully the amount of women out there who genuinely cannot make enough milk is actually teeny tiny, otherwise the human race would have died out a long time ago. So if you feed as much as you humanly can, it's unlikely you'll have the same problems.

1oz is a pretty respectable amount of milk for using a pump by the way. Remember, your baby needs a lot less breast milk than it would need formula. Plus even if the pump only managed 1oz, your baby would likely extract a lot more.

I rambled, and lost track of what I was typing! So here's a summary:
1. Ask for help if getting a proper latch is troublesome. Ask for help repeatedly, with each feed, until you can be successful with a minimum of fuss. I did, and Izzy is a wee piglet now.
2. Cuddle and feed LOTS and LOTS. If this baby winds up in special care, make a pest of yourself if you have to, in order to hold your baby as much as possible. Leave her on the boob for as long as she'll suckle, even if it seems she's feeding more than sleeping
3. Enjoy it! And be confident in your ability to provide for your baby, because you absolutely can do it. My lack of confidence, and my inability to ask for help first time round led to having to top up with formula for the first 6 weeks. This time, I asked for the help, and I didn't resort to the formula, and now I have a fully contented full up baby

How Strange

Also look up laid back breastfeeding. It's the new latest thing but is in fact a return to natural biological breastfeeding methods. The idea is that baby wriggles up to your breast while lying on you even just after being born and by feeding in this way there shouldn't be as many latch problems.

You feed lying down with baby on your chest and you can feed in this position for at least the newborn stage.

Das Kitty

How Strange wrote: »

Also look up laid back breastfeeding. It's the new latest thing but is in fact a return to natural biological breastfeeding methods. The idea is that baby wriggles up to your breast while lying on you even just after being born and by feeding in this way there shouldn't be as many latch problems.

You feed lying down with baby on your chest and you can feed in this position for at least the newborn stage.

If I have another this is what I will be trying. The other positions require you to consider too much, not easy when your brain feels like mashed potato.

cbyrd

I expressed colostrum in the last few weeks of pregnancy too.. my milk came in on the first night :eek: my little man will not sleep in the moses basket if he's anyway hungry.. so he has his late evening feed around 11pm and then he's into his moses basket for 3-4 hours, when he wakes he's into the bed beside me and lying down he feeds away and i can doze..it's amazing how after a few nights of this he'll mooch closer to me when he's hungry and sometimes latch himself on..:) it's a learned thing.. there's a misconception that because it's natural it's easy.. it's not.. it takes time and lots of support.

with my last boy both the phn and my husband put pressure on me to give him a top up bottle on night 13.. this just fecked up the routine and led to breastfeeding not being as successful had i just perservered through the first cluster feed and let my supply increase.

I have to agree with drogheda's help being great. i had a 7 year gap between number 2 and 3.. i didn't get the advice with him (number3) cos i was in a semi private room and they just didn't come in... this time i was in a ward with 6 other breastfeeding mammy's and the help i got was fantastic.. even though he's my 4th you do forget a lot..
feed as often as you can
leave the housework
if possible leave off expressing til about 6 weeks
drink lots of water
eat well
read the literature the hospital give you
be confident
if baby falls asleep easily, rub the palm of the hand gently.. it wakes them up
good luck with it..;)

wmpdd3

Finally got around to watching all these videos, they are brilliant. I feel much more confident now compared to last time. Thanks to all!

wmpdd3

I thought I'd update this after the baby was born with how I got on.

This time I had loads of colostrum, def no supply issue, but as with baby no.1 I couldnt get baby to latch. I was in hospital for 36 hours and did get help from the midwives but both nights there was a medical emergency on the ward so they were busy.

When it came to going home, I was told as baby hasnt latched on he cant leave, would have to have a formula feed.

I gave him 1 oz and refused to give him anymore but we were released anyway. I expressed for the first 4 days, but still could nt get him to latch. It was now or never, I could see my supply was decreasing.

I then called Crudu in tears. The lady recommenced a lactation consultant who turned out to be one of the midwives from the hospital.

I got the consultant to call to my house exactly 1 week after baby was born.

Within 90 mins, she had him latched on the right side and feeding using nipple shield on the left side. I had no idea that shields could help with latching. I just thought they were for bleeding nipples.

Had I had these shields in the hospital, i wouldnt have had to give him the formula.

But even more upsetting, If I had used these in the first few weeks with my daughter, she would have been breastfed.

Now at 8 weeks old I have weaned him of the nipple shield and he has a pretty good latch.

I have plenty of milk, I express about 4 oz every other day. He had his 6 week check up a few days ago and he is average weight for a breast fed baby.

I dont blame the midwives, they have enough to do to be honest. I think PHN should also be lactation consultants. I am so glad i spent €80 on the consultant but should i have to? Now that I have overcome these issues think of all the others I could help.

I thing the government websites are completely useless, they have no answers!!! the websites mentioned above brilliant.

If I had a question about bottle feeding I could call any of the formula companies and they could talk me through it.

The HSE's helpline basically just said 'try skin to skin, but if he becomes lethargic etc, supplement him.

I have met a good few people who have cited latching problems as the reason breastfeeding didnt happen / last.

If I had known there were ways to overcome this I wouldnt have had this problem on baby no 1.

annamcmahon

It's great to hear that you are doing so well now but you're right that you shouldn't have had to fight so hard. Do you know that you can claim money for the consultant back from some insurance companies?

How Strange

Well done wmpdd3, you're at the stage now where it gets so easy and becomes like second nature. It's the huge huge reward for all the hardwork you've put in up to now.

wmpdd3

I dont have health insurance anymore.

foxinsocks

Gah, I used the breast shields on my first to get a latch, she had the same problems, she kept pushing me out with her tongue, which is something she couldn't do with the more rigid shield. It was the midwife in Drogheda that suggested and provided them. I even bought the shields beforehand this time in case she had the same problem, but thankfully I didn't have to use them. I should have mentioned those in my earlier post

Well done for getting help when it was needed, and congrats on a fully breastfed baby!

Izzy is now 5 months old (holy fup, how did that happen??). She is still exclusively breastfed, although for the last 3 days she has reverted to 3 hourly feeding at night, and hourly during the day, I'm exhausted! She had been sleeping for 10-12 hours overnight. I am intending on baby lead weaning. I have bought the Gill Rapley book, and I am convinced it should work well for us.

annamcmahon

It's the only reason I'm keeping our's until after this baby is born. LOL