Breastfeeding & top ups

Our bub was born at 3.95kg and lost more than 10% in the hospital, I was sent home none the less as it seemed we had sorted through our breast feeding issues, when we got him home he didn't wee for two days and finally the hospital told me to bring him back, he had not gained any weight and was told to comp him 50mls at each feed with formula or EBM. After a day or so he started weeing and was alert, pink and content so I dropped the comps, ECHC came out to see him and he had gained a little weight although was not pooing, she watched me feed him (she is an LC) and was happy with the latch and the suck and said just to continue, we went back to the hospital to see the discharge nurse / LC and he had lost the weight gain he had done and was told I had to go to the ECHC the following Thursday which I did, they then told me I had to start comping again as he wasn't pooing and 2 weeks 2 days was still 10% off birth weight (3.68kg). I returned today which is 1 day shy of his three week birthday and he had gained back all his weight and 20g over his birth weight so was now weighing 3.97kg (a weight gain of 290g in 4 days). So my question is, do I continue to comp him, drop it or reduce it, he has done quite a few spews the last few days so I feel like he could be getting more out of me. I had such a horrid time breast feeding my DD and have been working so hard on building supply for this one and persevering through all the challenges, I would love to not have to comp him but I want him to thrive... What would you do?

What would I do? Feed all the time, at least every 2 hours, day and night, and drop the comps, and reevaluate in a few weeks.

I'd do what Pumpkin suggested. I've been following your other thread so I know you had good results/insights with the feeding ultrasound and the expressing after feeds while he readjusts to feeding after the procedure so I really think you are doing wonderfully and feeding more often will really work to kick the comps out the door. Can I ask how often he feeds day and night? And how much do you express roughly after each feed? Do you feed him the expressed milk? Can you do that instead - comping with EBM instead of formula? DD lost over 10% of her birthweight too and one midwife pressured us to comp feed but I refused and just offered my boobs all the time and expressed like you are doing. We didn't have alertness/nappy issues though. So yeah, keep doing what you are doing, you sound like you are already achieving great milestones with him, but don't be afraid to drop the (formula) top ups once you are expressing enough and/or babe has learned to suck effectively.

Maybe Barb Glare might drop in with some professional thoughts too.

Hey ladylove, thanks for popping in over here too :) & thanks pumpkin.

RE: feeding every two hours, I dropped the comps yesterday and demand fed him every two hours (at his wish), we had his TT snipped last night so his out of sorts today, so I have let him go 3-3.5 hours btw feeds and have comped him with EBM exclusively. I have expressed after every feed as DD was at kindy today so had less distractions. I couldn't express yesterday as he was on a feeding frenzy but he got no top ups either. I still have one more EBM in the fridge and it's always my preference to comp with EBM, however I am finding it difficult to express after feeds when DD is around as she is playing up with the new bub and I feel bad for her that she has to sit and wait for me to feed burp settle for 1-1.5 hours and then I want to turn around and express for another 20 mins, then have an hours break and do it all again. Was much easier when I did it with her for 8 weeks as I didn't have another little one to care for. The LC / PN told me last night that I should be able to drop the comps fully in a couple of weeks once supply builds up when his suck is stronger. She also said now his gained weight I could comp every second feed for 20-30mls and just keep an eye on his output that would mean, i could manage expressing every second feed as well when I am not offering the bottle... It's all so full on.

and Ladylove in answer to your questions: When I express in the mornings I can get 80ml post feed in the afternoon I can get 20-40ml. I currently wake him every 3 hours to feed during the day, sometimes he wakes before this though and I let him go to 4 hours over night, he does need the longer stretches over night as he takes so long to feed as well and the LC said his rest is really important as he expends so much energy feeding due to his ineffective suck, although now that's dealt with I am hoping it will reduce feeding time thus expending less energy. I originally refused to comp but the problem is he lost weight and he wasn't pooing so it turned out he did need the comp. I am just praying between gaining weight and getting stronger plus the snip we can get rid of the TT asap. Plus I am munching on lactation cookies and the Welada tea...

It sounds like you will be not needing the comps in no time. Honestly, you are doing an amazing job! Really thoughtful and intuitive.

Thanks Ladylove. I'm trying my best. I am trying not to get too far ahead in my mind. I really appreciate your help / advice.

Honestly, it sounds like you have a really great supply :) I agree, I think you'll be ebf in no time!

It sounds like you're doing marvellously, hun.

Take your lead from your DS - he'll let you know if he's hungry, and he'll let you know if he needs more.

If you need to pump a bit to stay comfortable, that's fine, but don't start making rules and goals that are over and above what he needs, unless it's for a specific purpose (eg: you're going back to work, and need an EBM stash, or you're hoping to donate EBM, etc).

Stick with the basics: skin to skin, lots of cuddle time, some herbal supplements IF they help you, and IF you want them, and for most people, your supply will continue to ebb and flow as his appetite dictates.

Be kind to yourself! You have a very new little one there.

:hug:

Also make sure that you weigh wearing the same clothes (eg just nappy or naked) so that it is more accurate.