Feeling uncertain and overwhelmed

I have a 5.5 week old baby, born via emergency c section after a two day failed induction. Our breastfeeding journey has had its ups and downs. My milk took a while to come in, baby was showing signs of dehydration and we had to supplement with formula from about day 5 to 2 weeks. I got some help with latching and some encouragement from our nurses and we were able to exclusively BF from then on. He’s been waking up only once in the middle of the night to feed, and sleeping 3-4 hour stretches at night.

He’s had the right number of wet diapers since that first few days and his weight has increased as expected, which made me feel a bit better for a while.

I’ve had a lot of anxiety over breastfeeding, including that baby wasn’t getting enough, that his latch isn’t always great and that he sometimes slept for longer stretches, and it would decrease my supply even further. It also gave me anxiety when he would nurse for 1 hour (which he did consistently since the beginning) and kept showing hunger cues minutes after he was done. It was mostly at night (when I was most tired). I came to understand cluster feeding is normal, but I wasn’t prepared for it and many of the health professionals I contacted with weren’t very encouraging. I used to cry at almost every feeding. Sleep deprivation certainly didn’t help.

Another thing that worries me is that I don’t feel a let down at all. I don’t leak from the other breast while baby is nursing, I hardly leak at all. I sometimes feel my breasts a bit fuller, but mostly during the night. The difference in my breasts from the beginning to the end of the feed is minimal. This all leads me to believe I have a low supply.

His latch has always seemed shallow but I can hear him swallow for a short while when he begins to nurse. I usually do compressions and try to switch breasts. I try to burp him and change his diaper midway if he’s falling asleep.

We did get him checked for a lip or tongue tie and the dentist said it was at the limit, but not needing intervention. She advised us to get him seen by PT because his jaw was a bit tight, and we have the appointment scheduled.

For the last 2 weeks or so he started spitting up little amounts, which usually didn’t happen. He’d sometimes unlatch and arch his back and our pediatrician said it might be from reflux. Then he started unlatching shortly after beginning and crying, which he now does most feeds. We’ve tried burping more often and keeping him more upright, but sometimes it will just continue until we take a break. I can hardly ever tell when he is done, because he’ll either fall asleep or we just have to take a break because he just keeps unlatching. This paired with being preoccupied with wake windows makes me constantly watch the clock and wonder how I’m supposed to feed him enough and keep my milk supply.

For the first couple of times I’d just go “well, that wasn’t a very successful one” and hope the next feeding would go better, but it’s been happening almost every time and I can’t help but fear he’s not getting enough. I’m back to questioning if I’m reading hunger and fullness cues right, if he’s even getting any milk at all… Sometimes it’s very overwhelming, and I feel bad that I’m not providing baby not only his food but also the calming and nurturing moments I could be.

I tried pumping and a Haakaa a couple of times, but never got more than 10-15ml at a time. I started fenugreek and it did seem to increase my supply a bit at first (either that or it was wishful thinking on my part) but it doesn’t seem to be making a difference now.

I realize this is all over the place, but I think that translates how confused I am about all of it. I don’t know if I should start pumping more regularly to try and increase my supply, because I’m scared I won’t have enough when he does nurse. Is my BF journey condemned? Should I try to pump or use the Haakaa? Or should I just keep going until he’s weighed again at his 2 month appointment (although it’s so long from now) and see how we go from there?

Thank you to anyone who takes the time to read this and share some advice.
 
@sandhillsanglican Thanks for this post, you have been through so much and no wonder you are feeling overwhelmed.

I agree with everyone who said an IBCLC can help - if you can't get to one, the next best option is peer support like La Leche League

La Leche League country links

It is important that you are able to get support for your own mental well being at the same time to ensure that you are being taken care of - that can be with family, friends, professionals but it is so important that you get all you need for yourself. Too often the focus becomes baby, baby, baby and mums are often not checked in on and we know know that it is critical long term for the whole family to do well.

Sometimes more than talking is needed and therapy and/or medications come into play - pretty much all are compatible with nursing your baby - you can always check the LactRx app or LactMed to see.

Not everyone feels letdowns - this is not an indication of milk supply - some women feel them in one breast, some never, some every time, some only in the morning.

Pumping - generally speaking when we have EBF babies we don't need to pump. Now, some mums find the first couple of weeks they will have leaking when nursing, some don't, some do for months - the ones that do can capture that milk using things like a haakaa or breast shells.

Pumping to increase supply - this is usually done after nursing the baby (within 30 min); but often things like hand expression is better in the early weeks. We would not expect large amounts of milk to be removed after the baby had been nursing and this can be discouraging as mums often feel like that means they don't have supply based on those normal smaller amounts.

Behavior at the breast - often mums are confused in the early weeks what is happening on the breast - you mentioned non-nutritive suckling was noted and to do rapid switch nursing to help with that. I would say one step further, here are some videos to compare what is happening on the breast for transfer - see good drinking vs nibbling - have someone video your baby on the breast and do a comparison.

Videos to see transfer

Then when you can see what is happening; you can add firm breast compressions to increase transfer in combination with the rapid switch nursing.

Firm breast compressions and video

When you can see baby transferring well this will help you know that baby is eating - this alone can make a huge difference for mums.

Once your baby trusts that they are going to be drinking the whole time with feeding management techniques, they should calm down more, this will help the nursing sessions improve for both of you.

It is important to understand that there are normal periods where nursing seems to go a bit sideways in clusters/growth spurts - typically in the evening we see this after a baby nursing all day well.

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There are lactogenic herbs/foods that can help improve your supply, you mentioned fenugreek - was that recommended by your IBCLC? Usually they are recommended based on your medical history as some can decrease supply!

List of lactogenic herbs/foods articles

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There are also medications that can help (if needed) to boost your supply and they will be different depending on where you live. We don't usually go to these until we know there is a supply issue.

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Babies who are having difficulty staying latched often to better in holds that are gravity supported (laid back/sidelying) or if they have oral restrictions/jaw tightness the Concorde hold vs using a cradle/cross cradle which means we need to hold them to stay latched.

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Skin to skin can help with latching, boost your supply, catch the earliest feeding cues - wearing your baby is a great way to do that during the day.

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LactMed database

LactRx app for phones

Lots of other great tips already, just wanted to add some more! Cheers!
 
@skelendke Thank you for taking the time to write such a kind and comprehensive response to my rambling post. I do struggle with asking for help, and not prioritising my own well being. It’s something I need to work on.

I have watched the videos on IBC online. My baby’s mouth never opens quite as much as the baby in the very good drinking video. I can see him drinking for some periods, but not the whole time. Compressions help some of the time.

I did try the Concorde hold and it helped on the first night! I tried using both that hold and cross cradle, which is what I was taught to use mostly, but I’m afraid my hand always gets too tense and ends up being counter productive.

Unfortunately last night was the toughest one yet, baby would only drink for a couple of minutes before unlatching and crying a lot. We stopped, tried to soothe him and try again, but it was very difficult. He seemed very tired and hungry but was unable to latch for more than a minute. He did drink a bit on those minutes and eventually was able to sleep for a while. I think it was a mix of overtiredness, hunger and gas. This morning there was a lot of crying but after soothing he was able to stay latched and drink for longer. We’re doing a skin to skin nap now, and I’m hoping today goes a bit better.

I have booked an appointment at home with an IBCLC for next week! Hopefully we’ll manage until then. Again, thank you for your advice and kindness, it helped!
 
@sandhillsanglican I too struggle with asking for help - I think a lot of us do and that's why forums like this are so great to be able to share info and tips - glad that the concorde hold helped for a bit - we pull that out when we see babies having issues with sustaining latches/small mouth/slipping - while we sort out why that is happening.

Evenings are the worst - clusters are horrid, plus add in purple crying - gah! I'm sure that the IBCLC will be able to give you some more personal advice and you will continue to see success.

Often if we plan for a cluster/fussy evening, we can manage them better - so latch a few minutes, off the breast - dance around, play heavy bass music, run a fan, walk with baby in a carrier, bath, sign, story, etc. in between nursing sessions (that will be shorter during this time due to prolactin levels).

There is developmental crying that happens as well in the early weeks and a lot of the times when we know that is coming, we can use a lot of purposeful distractions to help manage these hours too.

Purple crying info and tips

Witching hours info and tips

Take care!
 
@sandhillsanglican I’m so sorry you are going through this. I went through similar struggles and became a lactation consultant because I was so passionate about helping moms who went through what I went through. I can’t say for sure without an evaluation, but It sounds like it might be oral motor difficulties or a tongue or lip tie. Sounds like pumping could be optimized and you might want to find an IBCLC, or therapist who specializes in ties. I have a whole post about it on my website if you are interested in learning more about the symptoms. https://nurturenourishservices.com/tongue-tie

I also see clients virtually, if you can’t find a specialist locally. I’m an IBCLC, OT, and craniosacral therapist, so I went down the rabbit hole on helping moms with this exact issue.
 
@mudpuddle The first 2 weeks were so tough! All of it on even less sleep. I have had better periods though. And this sub helped me realize a lot of us are in the same boat! I hope you get the help you need as well.
 
@ajbarton97 I haven’t done weighted feeds, I don’t think they are very common here. I did have an appointment with an IBCLC before he started unlatching frequently. At the time I had some left nipple pain due to a blister and the main concern was the 1h+ feeds. To be honest the consultation felt rushed and I didn’t find it very helpful, she helped a bit with the latch, told us that he was doing a lot of non nutritive sucking and that’s why the feeds were so long, and to try and rapid switch, and referred to the PT because of the jaw tightness.

I will try to book an appointment with another IBCLC that can hopefully see us at home and help further!
 
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