Should I offer the second breast at each feed?

[lindseymbrown]

My dd is 12 weeks old on Monday and is ebf so far. However, although she is putting on weight, she isn't putting on lots, 6oz in last two weeks, so has dropped down another percentile. She really guzzles down milk on the breast but then gets fussy. Should I offer the second breast at every feed? I think she would take it, but how do I know if she's hungry or just sucking because she likes to suck? Should I supplement with formula? Also she doesn't nap for long in the day, maybe she is still hungry? But then again she sleeps well at night? I've been feeling so run down lately I am not sure I could feed much more?

[*Ali*]

Yes I would offer the second breast at every feed. It is pretty normal for most LOs to take both sides by this age. Some don't and are happy with one side but I would offer it and let her take what she will, especially if you are concerned about her size.

Is her doctor or health visitor concerned about her growth? There are several reasons why LOs drop percentile so that are not due to growth problems or lack of supply. These could be that they were born late, mum was given fluids during birth which inflated their birth weight, parents are small and so on. The position on the curve is less important than the overall trend of growth (as opposed to remaining the same  or losing weight).

If she is actively feeding, I.e. Suck, suck swallow type rhythm rather than just sucking, then it is safe to say that she is hungry for the milk rather than just comfort. If you do think it is just for comfort will she take a paci/dummy?

Offering formula is a very personal decision that only you can really make. I don't think it sounds necessary for her growth, I'd certainly try double sided feeding first, but I guess the question is whether you think it is necessary for your own state of mind if you are struggling with breast feeding and want a helping hand.

Hugs. It is hard. Many people start to find BFing less problematic after the 4mo point. It does get easier 

[lindseymbrown]

Thank you for your reply. I think I will give double sided feeding a try first. My question now is how do you know when to swap sides during the overall feed? Even when dd is fussing, I can still get milk out my breast?

Her hv or gp have just told me to monitor her weight as she has dropped from 91st to 50th. The only reason they suggested for this is that given she was a big baby, 9lbs 7, that she probably fed well in-utero and now can't sustain that? She also only poos about once per week so is on lactulose and we are monitoring her bowels.

Do you think offering both sides can help to boost supply too? Thanks.

[Martini~]

I had the same story with my kid. In first week he gained only 110g which was in the lowest end of limit. And my pediatrician told me "offer second side". And I tried... next week my LO got on weight 220 and we have that result week by week for last 6 weeks. So it definitely may help!

In first weeks I offered second side when two conditions were met:
- baby is not swallowing, only sucking with short moves; there can be pauses between sucks, but still you shoulh hear/see how baby swallows
- time (15-20min for first side)
You also have to look if she is not sleeping, because sometimes not active sucking is a result of baby getting asleep.

After couple of weeks and knowing my baby better, I can see when it's time to change sides. Sometimes it's even ten minutes as he was eating very actively, sometimes it's 20minutes as he is calm and eats slowly.

I always offer both sides, but not always DS is interested. When after sucking second side, he is still sucking, I come back to first side. However I try to make my feed no longer than 30-35min as I know that there is nothing there for him - it happens very rarely.

FX for your you LO!

[*Ali*]

Yes any time suckling at your breast will increase supply good luck. Let us know how it goes.

[*Ali*]

And I would offer the second side when she doesn't want the first side any more. So when you would usually stop the feed then offer the second side.

Are there any BF support groups or lactation consultants you could get IRL help and support from?

[jessmum46]

Just wanted to pop in as I saw your LO is on lactulose for constipation.  It is actually well within the normal range for an EBF baby at 3 months to only poo once per week - my DD went up to 2 weeks at times.  Breast milk is very easily digested with minimal waste, so after the early days where a few poops a day is normal, many EBF babies will go very infrequently.  That's not the same as constipation which refers to infrequent hard and difficult to pass stools.  When your LO does poo what is it like?  Soft, yellow, seedy poo is normal and although we are not a medical advice site (and therefore cannot advise you specifically with regards any treatments) if your LOs poo is like that and not hard I would consider re-discussing with your doctor if treatment is really necessary. 

Good luck with the double sided feeding