still waiting.......

Hello girls. Just after a little advice and a bit of reassurance that we're doing OK.

My little girl was born last Tuesday almost 4 weeks early. She was born via urgent c-section after her growth rate slowed dramatically.

As she was so early, it has taken a while for her to gain the suck reflex properly and in the hospital I was hand expressing my colostrum and she was being syringe fed. She would occasionally go to the breast and I was offering it every feed, she would latch, suck for a bit and then let go.
On the third night, after hours of trying to get her to feed, her screaming, me crying, threats of a nasal gastric tube and the room in disarray I finally relented and allowed her to be topped up with formula. So- the rest of the time in hospital I pumped, offered the breast and topped up with formula.
I am home now, it is day 6 (she was born at 3pm so not true day 7 until this afternoon) and my milk still isn't in fully.
I am still expressing, using hand and the pump, every two to three hours and every feed she gets offered the breast, she will still latch and usually will suckle on and off for 5-10 mins. She latches really well, does a few big sucks and then kinda falls off and needs to be put back on. After 10 mins of breast or if she starts getting upset she gets given anything I had expressed after her last feed. At the moment, after working on it for a while, I'm getting about 50 mls which seems to be keeping her happy. If she is still hungry, she will take 10-20 mls of formula.

I am hoping that when my milk comes in (hence the still waiting......) feeding will be easier for her and she will suckle for longer and not need the bottle any more.
Can I have some reassurance please that it's still early days and there is still time for the milk to come!! I am exhausted after feeding her and then having to pump for 30 mins as well. Please don't comment if you are going to give me "formula is bad" comments. I feed guilty as it is that we've had her on it but if it was that or losing her to the SCN and a gastric tube- it's a no brainer to me!

Also- any advice people have to encourage my milk to come in. We are doing lots of skin to skin, regular pumping and getting her to suckle when I can. Any other tips?

50 mls in half an hour is pretty good by my standards for expressing! (Coz I'm not much good at expressing myself)

How often is she feeding? Have you tried changing her nappy & reattatching? Tickling her chin etc to wake her up & try get her to feed longer?

Keep putting her to the breast often. Every chance you get, weather she's hungry or not. It'll get more into her & help stimulate more supply (which with 50mls doesn't seem to bad to me, but I'm no expert!)
Do you have her unwrapped for feeds? If she's wrapped she might be too warm & snuggly to stay awake?

Sounds to me like you're doing all the right things glenny. You've had a bit of a rough start :hug:
Have you tried giving the ABA a call for some support? And do you have access to an LC through the hospital - it's really good to have someone actually come to you and work things through with you if you can.
Getting 50mL is pretty good, by the way.
How often is she feeding in 24 hrs? How much weight did she lose? How many wet & dirty nappies are you getting at the moment?

You are doing an amazing job. Your little one was really quite early (we get so blase about 36 weekers these days because we see so many really tiny prems - but your little one is really quite early)
I strongly recommend you get an appointment with an experienced Lactation Consultant. I may be able to recommend one if I know where you live. near term babies have their own set of challenges with breastfeeding. It is really important that you have a plan and support to move forward.
I think that prbably your milk has come in. It's hard when it's your first time, to know what to expect. Sucking for 5-10 mins is good, and so is getting 50 mls. 10-20 mls of formula is not much.
I wonder, have you had her weighed since you left hospital? What have her weight gain been like? What about wet and dirty nappies? How many is she having? Was she jaundiced at all?
Every day will bring changes in your little one. she is just on her l-plates right now, but with time and support you will be both breastfeeding fine very soon.

I'm getting about 6-8 wet nappies a day and we get a good dirty one every 2-3 days. She was 2.8kg at birth, lost about 200 gms by day three but had regained 70gms at day 5. We're taking her to be weighed again on Friday.
She feeds about every 3-4 hours.

I rang the ABA- they were fantastic. Very reassuring, they said it was normal for her to be a bit sleepy as she should still be tucked up safely in the womb. They also said that as long as she is still latching when she does go to the breast, hopefully she'll stay for longer once the milk comes in.

Clover- I unwrap her for feeds, the problem with her staying on the breast doesn't seem to be sleepyness though, I think she gets frustrated that she will suck but not really get anything. Mind you- we do need to tickle her etc to keep her awake for the full bottle.

At the moment I feel like everything is kinda on hold until the milk comes in. I'm trying really hard to make that happen quickly but I feel like I'm just waiting and we'll kinda have to start again then. I have spoken to a lactation consultant and will prob get her out once my milk does come in to help me reestablish BF properly.

Barb- I'm in Brissy- Northern Suburbs,

I didn't think my milk had come in as everyone says it spurts, and it makes your breasts full and hard. When I say she sucks for 5-10 mins, that's not continual sucking- that's just how long she's happy to go on, suck 2-3 times and come off, just to be put back on and repeat. She very rarely will stay on longer than that.

Glenny, if you're getting that much out then your milk is in. It's just different for everyone and having an early baby may make a difference too. Hopefully the sleepiness will improve with a little time :hug:

While this is my 4th time, i only had painful engorgement for about 2 days, rather than a few weeks when my milk came in. It'd never settled that quick for me before, so I asked here for advice & a few people never got that hard, full, engorgement, even with their first.

I'd talk to the LC now, rather than prolong it. They are a great help :)

Rather than giving the formula, could you offer the breast again? Maybe the other side?

How long have you sat at feeds? Do you stop & just give the EBM after a few minutes? Or do you wait til she stops by herself, then offer the bottle? Have you tried just sitting & switching sides every time she seems to be finished? You may have to sit for an hour or 2, but it may be that she needs more time?

You are both still learning & doing great. You will get there :)

Hun, the time to act is now - please don't put it off. You will be fine. Wake her and feed her every 3 hours - 4 is kinda long for a baby that age. also express after her feeds every 3 hours and feed her the expressed milk - you need to let your body know it needs to make more milk. Hiring a breastpump from ABa would be a really good idea. I will suss out an LC for you