What's the Best Way to Go About this? I need a plan

[Johno & Aurelias Mum]

So, new baby is due in a few weeks and I am going to try breast feeding again but I need a plan.  With Johno, I had a go in the hospital and it seemed OK ish but no one really checked.  I wanted to see the BF counsellor but she was busy that morning.  No one in hospital seemed overly bothered so I was discharged the afternoon after he was born.

Tried again at home, putting into practice what I'd seen in classes.  By two days old, we weren't doing well.  Midwife came and I had to hand express into a teaspoon and try that in a syringe - not great success but I presume she thought my milk hadn't come in.  I got a pump and tried again but basically Johno had gone off the idea, he screamed eveytime I lifted my shirt!  I had another midwife with the most enormous bust measurement herself trying to demonstrate on herself what I should do which was tricky because my flat chest had risen only to a B cup at the best!.  She was full of theory and not much practical help.  At the same time as it was so hot, my mum was suggesting he needed feeding something even if it was a bottle.  I think the midwife gave up at that point.  Following day, Johno would have to go back into hospital if he wasn't feeding to have a tube in his nose as he had lost weight and was de-hydrated so to avoid this, I bought some formula and that's the way we went, mixing that with EBM for a while.

So that was last time.  Now this time, I think most people think I will just bottle feed from the start but I want to give her the chance that Johno had so I'm going to give it a go.  Now, with the help of this site, I know there is a lot more help out there than I was aware of last time but what's the best idea.  Do I try and contact a counsellor in advance, do I wait until she's here and give it a go?  What do you think?  I've explained all this to the midwife this time and she's been v. non-committal about it so I'm expecting that isn't going to be a great source of help either.

Now my other concern is that with two of them, I won't have the time to sit there endlessly practising or expressing or whatever so I need a plan in advance I think.

[lisi's mum]

Jenny, the very best thing you can do is make an appointment now with a LC. Meet her before the birth, talk about your situation and anxieties, and have her visit you in hospital or as soon as poss after your LO is born.

Once the two of you have got the latch sussed you don't need to spend time endlessly pracitsing, all in all what with bottle prep and sterilization it's probably rather quicker and less hassle! Have you though of getting a special toy your ds can play with while you bf, or book, dvd etc...

here's a link to a good handout on starting out http://www.breastfeedingonline.com/1pdf.pdf
 and a handy video showing correct latch http://www.thebirthden.com/Newman.html

and a link to the FAQ on nursing a newborn with a toddler https://babywhispererforums.com/index.php?topic=67026.0

Good luck and let us know how you get on!

[Samuel's mum]

Have you also seen our sticky thread up top about 'second time around' - lots of useful tips there.

Was he not actually latching on last time? Was he excessively sleepy? Did anyone look at your latch - which is at the heart of everything? Did you manage to get a first feed soon after delivery?

I would suggest a few things straight off. Read a bit about how milk production works so you know why that first feed is important, how supply develops (often takes 3-5 days for milk to come in for example and how frequently you feed will make a big difference). You could buy a book like 'The womanly art of breastfeeding' by La Leche League and cover all the basics and it will also talk about latching and troubleshooting.
And because that early breast stimulation is so crucial if she isn't feeding immediately you do need to get pumping and syringe feeding and it needs to be a double electric pump (pumping after a couple of days is too late. If your breasts don't get proper stimulation in the first 24 hrs it can be hard to get breastfeeding established in the longer-term and in the short term your milk will not come in after 5 days). I would have one around on the flukey chance the same problem happens again but for confidence as much as anything. A lot of this is about confidence. But really don't assume the same problem will arise or that it's even likely it will - every baby is different and it's a fresh start.

It sounds as though you were missing out on some latching advice last time. Expressing and syringe feeding isn't a cure if your baby isn't feeding - it's just going to get your supply going and give baby something to eat while you get other support. I would definitely phone a counsellor now or even try and find one face-to-face e.g. local breastfeeding cafe/meeting now. Forget the midwife.
You could phone the NCT breastfeeding line for example - ask about hiring one of their pumps and talk through your history at length. Find out what they would have said last time. If you didn't particularly gel with that counsellor (or even if you did) phone another line like the breastfeeding network and get another view (and ask them about local groups too. They run the cafes). Take Johno to a group too so he can see babies feeding. And when you go to a group it's not just about talking to a counsellor but meeting other successful mums and new mums who have just gone through all this.

And if people around you assume you won't even try - Tell them now what your plan is and explain you will need their support. You want them to be prepared too and not come out with a surprised comment when you are getting stuck in. After delivery as I say confidence is so crucial and one pair of raised eyebrows could be enough to make you doubt yourself.

If there's anything else come back. If you would find it helpful to discuss last time in more detail we can do that or anything else you can think of (nipple shape and size for example. Are you flattish? Do you need some drawing out? Are you up for discussing nipples in front of an international audience!).

[Erin (redstarfalling)]

HUGS!  Great suggestions already - please keep us posted on how you're doing.

[Johno & Aurelias Mum]

OK, nipples out for an internation discussion !

They are flat but I was encouraged by one of the mums saying on here that its 'breast' feeding, not 'nipple' feeding.

What I was planning was to use the pump a little bit before to draw them out.

Last time, I went to the class, watched the video and asked for help from the people around but looking back, my general feeling is that I was let down by everyone thinking it was everyone else's job to help if you know what I mean.

I didn't realise about that early stimulation but I was trying to feed Johno every couple of hours like Tracy recommended in the book.  However, as he became less and less interested they were getting less stimulated but the milk did come in and it was quite painful when he wasn't interested.

To answer specific questions:

No one looked at my latch, by the time the midwife looked on day 2-3, Johno wasn't even interested in trying so there wasn't a latch to look at!

Johno wasn't sleepy he was angry as hell actually, it was like he was hungry but that wasn't where lunch came from as far as he was concerned

We did get skin to skin after he was born but not much help with initial feeding in the night.  He was born about 8:30 in the evening and the delivery midwife went straight off shift.  It was about midnight before we got to the ward and it was pretty much lights out and go to sleep until the following morning.  Should I have been trying pretty much that whole time?  It was difficult because I had a catheter in and very swollen hands so I was very clumsy and unable to heave myself about in bed.  I do remember the nurse telling me not to stroke his cheek as that would make him want to feed.  Looking back, that's exactly what he should have been doing I think.

I will ring the NCT I think because the same woman is still the advisor - the one who didn't have time so I'm not sure how honest I can be with her about the problems last time!

As it turns out my family isn't going to be around this time so I'm pretty much on my own and I'm actually feeling quite confident about it being a fresh start this time.  I will also check out the other tips on toddlers.  Aurelia - clever little sister that she is - is bringing with her something that Johno particularly wants so hopefully that will help and we have a sofa in the playroom and in the kitchen so wherever he is we can keep an eye on him.

[Samuel's mum]

Yes, it's breastfeeding, not nipple feeding. But flat nipples can make the latch on tricky. And if the latch isn't perfect it's more likely you'll be rubbing against the baby's hard palate and that's what causes sore nipples.
Once milk comes in and you are engorged it's even more hard - it's like trying to breastfeed off a beach ball. Pumping first is a thought but not a great plan if you are talking about the first few days as if you pump colostrum even for a moment then you could lose quite a bit of what he'll actually be feeding on (because volume of colostrum is quite small for each feed). A good device is something you can make at home based on a syringe (it's described on this page under the heading about pumping):
http://www.askdrsears.com/html/2/T021800.asp
Ask a counsellor about what they advise for flat nipples.

If a baby can't get a good latch they don't learn that this breastfeeding thing is worthwhile as they don't get the reward of milk. Do you mind me asking? It's surprising his sucking reflex wasn't partly motivating him at the breast to at least try - did you use a dummy from the beginning (just to check - sorry if that's a daft question). I would have suggested you continued with as much skin to skin as possible and motivate him using various techniques e.g. stroking cheek, touching lips to wet nipple, expressing drips of milk into his mouth, warm baths together.

The NCT helpline is a national phone system. It's very unlikely you'll get the same person. But even if you do - be honest.

Nurse - 'don't stroke his cheek because he'll want to feed?' Huh? Weird! Usually a baby has one good feed and then a block of sleep but should be feeding again and frequently within a few hours. You would have expected some more feeds before the next morning.

Glad you are feeling confident about it being a fresh start it is.

[RachelC]

Just wanted to send some {{{{{hugs}}}} and ~~~~~bf success vibes~~~~

[Johno & Aurelias Mum]

Thanks everyone for your help so far.

Emma, no he didn't have a dummy until he was a couple of weeks old.  His suck may well have had something to do with it.  Johno has never had a good suck - he could never do those any way up cups or to be honest anything that needed much of a suck like even a drinking straw.  He learnt to drink from a proper cup very early because of it.

I looked at those Avent niplette things but you can't use those at the end of pregnancy.

[sophiems]

hugs to you and hope you have an easier time of it this time. 

I would say with regards to your older child, if you have anyone that could be available to play with him for the first couple days to help you get settled, I'm sure it would help all of you.  If there isn't anyone, just have a little backpack available with 'new' stuff in there for him to play with just at nursing times (maybe even snacks depending on his age). 

[Samuel's mum]

A breastfeeding counsellor investigating a latch is also supposed to look in a baby's mouth. And consider sucking technique. Often sucking can be taught e.g. using finger feeding where sucking gets a reward or using a Haberman feeder if a bottle is needed.

Niplette things and pregnancy preparation has been shown to be fairly useless. The syringe thing is done just prior to a feed.

[clh]

{{{Hugs}}} hun, and GREAT for you giving it another go!    You've gotten great advice so far.  I just wanted to add that subsequent children can be nothing like the first in terms of latch and attention.  DS2 has been a dream, and I wasn't able to bf him until day 3.  (BTW, that's SO not ideal, & I was using the hospital grade pump from day 1... even thru day 2 when I didn't pump a drop.)  More {{{hugs}}} and encouragement!

[walker79]

Just wanted to add, I had very flat nipples and didn't even realise it until the minutes after my DS was born and we tried the first feed. The midwife rudely said "Oh you have flat nipples..." like there was something wrong with me. This did upset me a little but I carried on trying. A LC came to see me after the birth and helped me so much, I've never looked back. It's been over six months now and I'm still BF. I would say my nipples don't look like the ones in those demo videos but they do the job. I guess time and lots of feeding helps.
Good Luck xox

[Johno & Aurelias Mum]

Just wanted to add, I had very flat nipples and didn't even realise it until the minutes after my DS was born and we tried the first feed. The midwife rudely said "Oh you have flat nipples..." like there was something wrong with me.

It was a bit like this for me as if the one who did have a look sort of saw the reason and thought there was no hope so there was no point in trying.

DH will be at home for the first two weeks (sorry didn't mean to give the impression I would be all alone - just that last time, my mum, sister etc all lived close by.  This time they are three hours away and my Mum will be in hospital too so they won't be visiting.)  After that, we have a new Numberjacks DVD so I reckon we will be word perfect if we watch it every feed!

Thanks for all your help and encouragement.  We'll give it a go and at least this time be a bit more prepared and know where to look for help.

[*Stephanie*]

here's a link to a good handout on starting out http://www.breastfeedingonline.com/1pdf.pdf

Hi Jenny,

The quote that Katie gave you above is from Jack Newman's book, "The Ultimate Breastfeeding Book of Answers".  I was going to recommend this book (that is if you have time to read yet another book.)     It is excellent!

I've been taking breastfeeding classes, and one thing I have learned is that suctioning the babies mouth and nose could cause them to not want to breastfeed.  It's something about the force used and the baby having something shoved into their mouth.  The baby then doesn't want anything put in its mouth, and fights while you are trying to put your breast in there.  Also, it has not been proven that the suctioning actually helps anything -even when meconium is present in the amniotic fluid.  The babies that get the lung inflamation get it whether or not they were suctioned at birth.  (I can look for the proof of this information if you want it.)

So just one more idea to add to the discussion.

Good luck to you.  You can do this.  Your body was created to do this.

Stephanie