OK so here is an update on the situation - which really isn't much better..
Early this week we had our clinic visit for 2nd weigh in and Chloe had only put on 50g. The clinic nurse was a little concerned and asked about my milk supply which I knew was lacking after our previous issues where this thread originated. I had already started back on motillium the day before seeing the nurse. She advised me to start giving her 2 x 60ml FF per day for the next week to get her weight up again and that i had to come back in a week for another weigh in to see if she gains weight. She is still in 0000 and would be in 00000 if she didn't have the length she has. The 0000 are still large around her upper body.
So I've been taking the motillium as advised and also got some Aktavite as seen on this site. My milk has increased and I can now express 60-80ml (previously would get 40ml and only 20ml when my supply died) but for some reason Chloe is fussing on the BB still so I'm thinking she has figured the bottle is easier and why worry about BB anymore. As she isn't feeding properly I'm giving her BB first, then once she starts fussing or they feel empty I give her EBM, or for 2 feeds per day 60ml FF.
Any suggestions on how I can keep her interested in BB?? Obviously I need to follow the clinic nurse with the FF's to make sure she gains weight this week but don't want this to turn her off the BB if I can avoid it. I've went and bought the Tommee Tippee Breastfeeding bottles that are supposed to mimic the nipple to make moving between BB and bottle easy but I've also got some Avent bottles with a newborn (#1) teat. Any other suggestions???
Either way since the additional feeds she is much more settled and has started back sleeping through the night. For about 5 days she was waking anywhere from 3-5am and I'd have to feed her. For 1.5 days I was feeding her every few hours and boy can I admit that it was very tiring and I was completely over the whole thing and being tugged on and was just hoping for someone to say "put her on the bottle, BF is not working for you"..
I know that I'll get alot of "Pro BF'ing" responses here but to be 100% honest I'd rather do what is best for Chloe (which I know BF'ing is over FF but I don't feel it is if she is not getting enough from it) and if she is not thriving while BF'ing anymore then I'd rather change to FF and make sure she is doing well. There is nothing worse than seeing her unsettled due to hunger.
As Chloe gets a bit bigger and stronger she may well fix this herself.
In the meantime you seem to be doing the right things - giving her boob first, etc. There is a risk that "fussing" is not providing you with enough boob-stimulation to make enough milk - so expressing as often as you can until she really gets sucking is probably a good idea.
And it is preferable to "top her up" with EBM rather than formula if you have it.
BUT - she is still a little tacker, and it is totally normal for her to feed every 2-3 hours during the day and also to need a feed or 2 during the night. In fact the night feeds are part of increasing supply!
So - horrible thought I know - but middle-of-the-night expressing would also boost your milk supply, and middle-of-the-night feeding if she is awake would be a good thing. Being grumpy for several hours a day is also normal for new babies. So is cluster feeding (where they want to feed very often, like every hour for a few hours, and are unsettled) - so if she seems hungry, it may be best to give her the boob back again, rather than think "you only stopped sucking half an hour ago, how can you be hungry".
Have you had someone recently observe how you are feeding her - imperfect attachment will also lead to fussing and so on. Some clinic nurses are also skilled in lactation, or an independent lactation consultant (there's a list available here: Australian Lactation Consultants Association Ltd - ALCA), or a day-stay at a lactation clinic could all help here. And what you see as "fussing" may actually not be "I can't get milk out of this boob, Mum", but some other issue.
There is no reason to change to formula entirely whilst you still are making some breastmilk and are able to feed her OK - the only issue seems to be that you are not sure she is satisfied. And you are taking steps to deal with that. There are quite a few people on this board who combine BF, EBM, and FF successfully.
But beware of using formula too often - that can then lead to a sort of spirally effect, where your boobs make less and less milk. Once you have had her weighed again you may be able to reduce the amount in the 2 bottles.
Sorry for the brain-splat. Hope there's something useful in here
Hang in there
Kate
Last edited by Kmn; September 27th, 2008 at 11:56 AM.
My DD and I had a very rocky start to our breastfeeding relationship and she was exclusively fed formula for the first 3 days of her life (given without asking me but that's a whole other story).
It was very important for me to breastfeed her, so I ditched the bottles. I would breastfeed her then top her up with EBM and/or ABM from a spoon or small cup. I needed to help stimulate her breastfeeding response, because obviously it was a lot easier to get the milk out of a bottle than my swollen breasts.
It's do-able if it's what you really want to do. My first impression of breastfeeding is that it requires a lot of determination so if you set your mind to it, it can be done.
Kate - I do think that it's potentially a supply/attachment issue. Early on and up till last weekend her attachment was perfect. My LC in hospital said she attached really well and was a great feeder, which she has been. After about the 1st week home she was attaching herself with very little assistance from me. I have no pain, no damage from her other than the initial stuff in hospital. I am topping her up with EBM on all feeds except the 2 with FF. Simply because my supply isn't huge so it's hit and miss with expressing and the amounts I'm getting. YEsterdsay I got 1 x 60ml EBM and then 1 x 80ML but today only got 30ml.
I had a follow up apt with my LC around week 3 but I've not been back since. I will need to check if I can still see my LC through my hospital or if I need to find a consultant outside the hospital. Will try and see someone on Monday.
Claire - Thanks for your post. We've been successfully BF'ing since birth up till last weekend when we hit this hurdle. Chloe was also given FF in hospital as she had low sugar levels but it didn't affect her willingness to go to the breast. BF'ing certainly is about a lot of determination but at the same time it can be such a stressful process. Up till now it's been great so just a matter of getting through this part. My biggest concern is her lack of weight gain over the 2 weeks. Will see what happens at her next weigh in on Wednesday.
I have just fed her for about 30 mins on BF, which is considerable considering she's only been doing 5-10 each side lately. She seemed somewhat full on the 2nd breast. I gave her 30ml of EBM and she is content. No crying etc so I'm guessing she was satisfied with that feed. It surprised me as my BB did not feel like they had much in them but she was making the right noises to say there was milk there.
Well today I've spoken to an ABA consultant who was very sympathetic. I've figured out and confirmed by the LC that Chloe just doesn't want to suck anymore. I'm lucky to get her to do 2-5 minutes each side now before she screams the house down. The LC advised if I cannot get Chloe back interested in BF'ing then no matter what supply I try to achieve she won't drink.
Essentially she has discovered that the bottle is easier to drink so she is not interested in having to suck for longer than about 2 minutes or she screams blo00dy murder. She pulls off goes on pulls off goes on and the pattern continues. I have milk. Those first few minutes it leaks out the sides of her mouth. I can express up to 80ml but she just doesn't want to suck it out.
I asked the ABA consultant about just feeding constantly but she said that all it will achieve is upsetting the both of us and that if Chloe was happy to suck for a normal length of a BF then problem would just be supply, but it's not as I have supply just no child that wants to suck anymore. Give her a bottle and she is milk drunk quicker than you can blink an eye and sucks it down quicker than she can swallow it.
Have got a few things to try in terms of trying to get her interested in BF'ing again but if anyone has any suggestions please throw them at me!!
Could you give her EBM? That way she will continue to get 'the good stuff' from you and also will not get use to the FF taste and consistancy.
also you need to figure out what helps you let down quickly? i know if i am worried about somehing i will have a slower let down... in your case, worring about a slow let down may make it slower so its a bit of a catch 22.
Sorry i cant be of more help hope things improve for you both
ditch the silicone..enrich your diet and let her suckle .. maybe even dream feeds could help.. express often and give it ti her in a cup.. there is a bottle "adri" is the maker and its a boob, looks like one and feels like one , she has to latch to drink from it . so if she has to latch to it , she might aswell attach to the boob ..
when gab fusses and tugs i find that she has pain and i have to get the wind out of her .. or she has to poop..
i hope this post doesnt sound rude , its not meant to, but i m typing one handed
Sammiejane - Yes she will taken EBM and I've been topping her up with that for 3/4 of her feeds.
Charmalea - My diet is as good as I could get it at present. I have always been a healthy eater and I'm taking motilium and also drinking aktavite etc etc to help with supply. If i could get her to suckle then that would be the answer, but that is the problem, she won't attach/suck and considering she did not gain weight her last weigh in I don't want to deny her food (which I would be if I perserver trying to get her to suckle and not comp her) hence I have to comp her in some fashion whether it be EBM or FF. I am using EBM wherever possible but she gets herself very worked up and I do not want her to associate me with an unpleasant experience in that she is not enjoying our BF time as she is screaming the house down due to hunger and obviously frustration. It is also not helping me as I'm getting stressed and worked up because she won't attach and hence the cycle of me being worried so therefore even if she'd attach probably wouldn't get a let down and so the cycle continues.
If worse comes to worse and I cannot get her to attach anymore then I'll just express and use EBM for feeds as long as I can and comp with formula. I've arranged to see my LC from hospital this Friday but still have 5 days between now and then to try to work out some workable solution that won't stress me or her out of our brains but will ensure she gets what she needs. Her next weigh in is Tuesday so that'll give me a better idea of how she is going weight wise.
Tonight I am going to try using the nipple shields. The RN at my hosi suggested it as she might confuse it with a teat and suck better. I can then try to ween her from the shield back to bare nipple. I'll keep expressing to keep my supply going so just need to sort out her attaching. I will try all that I can to sort it out and get back to BF'ing but I won't do it if it means she is being denied food.
Sorry if that seems odd and I don't want to offend anyone but I went into this PG and birth/parenting with a completely open mind about what I would and wouldn't do (ran into many obstacles my entire PG) and I am BF'ing simply because she took to it like a duck to water immediately after birth which I really didn't expect. I did not and do not have any preconceived notions on how long I would/will BF and I've said from the start that I'll do it as long as it gives her what she needs. If she cannot or will not attach anymore then that will no longer be the case.
I really do appreciate all the replies as the more ideas the better and possibly something has worked for someone that I haven't heard or hasn't been suggested.
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hope things improve for you both 
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