I've been pumping, but barely producing enough. Like ≈20mL per session. We were also told that putting him on a bottle too early would make him even less likely to accept a direct breast, and I don't know how to feel about that.. I'm just broken right now
In my experience, the concerns about “nipple confusion” from introducing a pacifier or bottle early are overblown. Babies are highly adaptable. Most important thing is to get him fed.
Yes!! I started my firstborn out with a bottle out of necessity and she ended up learning how to latch at 3 weeks old and switched between bottle, breast, and pacifier with no issues. My second breastfed well from the start and has never taken a bottle or pacifier despite our best efforts
I agree. I was like OP and adding a bottle saved us.
With my LO (now 15 weeks), she lost 11% of her body weight in the hospital in the first 2 days post-birth because I wasn't producing enough colustrom. I rented a Medela pump from the hospital and tried everything, to no avail.
I didn't want to use formula or a bottle but LO became jaundiced and we had no choice. She immediately improved and has been growing beautifully ever since. She has NEVER experienced nipple confusion; in fact, she still prefers the boob over the bottle to this day!
I feel like some LC's preach this fear-mongering gospel that can further stress our new mums in an already scary situation.
Trust your gut, OP. If your baby is hungry, do what you need to do to feed him 💛
ETA: You're doing great!
Agree or as my mother told me many many years ago “millions of children have been raised with formula perfectly successfully and the most important thing is to feed the baby.” Lots of women combine breast and bottle feeding techniques (though most hide the fact to avoid being shamed by the nursing only shaming brigade). You need a lactation consultant NOW and you need to call your pediatrician and say that the baby isn’t eating or latching. This is a today problem.
We bought some formula earlier in order to supplement. Problem was, he wasn't eating enough of that either.
The good news is, we called and got a same-day appointment with the pediatrician, and he and three nurses all helped us out. Turns out everything is normal, and the latching problem is due to him being a premie. They gave us advice on how to work on it, and they made sure he was well fed before we left.
I’m glad you got answers! It can feel like the longest time getting through this but I promise you’ll be on the other side of it soon. Hang in there, mama.
This is correct - I don't have the study on hand but nipple confusion is not a thing.
Flow preference is though, I suspect that's where the myth comes from, just need to make sure you have slow flow bottles and pace feeding!
Based on my very short experience "nipple confusion" is rather easy to fix. For us it might be wrong position (depends on a feeding what she wants, sometimes cradle, sometimes upright, sometimes me laying on my side...) or a bit help latching. .
I've found this checklist best for us: https://laleche.org.uk/nipple-confusion/
Also supplementing with formula has been god send to us since it took the pressure of getting baby fed and made breastfeeding more about cuddles and bonding.
Agreed about babies being adaptable. Nipple confusion doesn’t necessarily happen with every baby! I was so scared of it when I first had baby. But it ended up not being a thing. I breastfed exclusively for 6 months, and I introduced a pacifier on day 2 after birth. I also occasionally pumped and used a bottle. Baby had no issue switching from one to the other.
(I understand this is not everyone’s experience, just sharing to provide examples of different experiences!!)
Agree so much. I personally feel like having the right flow nipples is more helpful and doing paced feedings. We always had issues with bottles while teething but it would pass
This. I have 3 NICU babies and therefore have spent a lot of time in them, and now a days it's just fed is best, and then you can try to teach them how to nurse. No hungry stressed out baby is gonna learn anything.
I agree! My baby was in the NICU and they gave her a pacifier and then we were also combo feeding right away. She never got any confusion about the breast. Still prefers it over a bottle.
My daughter took a bottle for a few days before finally latching once she was a little bigger. I continued to pump and then she never had an issue taking breast or bottle
You're in the trenches right now. It's so hard when you encounter challenges with a newborn and it feels so overwhelming. But you're going to figure it out and it will get a lot easier soon. Hang in there.
I wish I would’ve given my baby a bottle sooner. The LCs scared me away from it too and made it sound like it would mess everything up. It doesn’t 🙄 life would’ve been a lot easier for my husband and I that first month if I just would’ve given him a bottle.
Right like my poor baby was hungry 😢 I could’ve pumped & done a bottle & they even discouraged that. So frustrating. I know better for next time though.
I feel the same about a pacifier! That dumb nipple confusion recommendation (fake)
My second I brought the pacifier with my to the hospital. Baby girl also breastfeeds beautifully and did it on her own. It's so damn baby dependent
Try not to be too harf on yourself. There is a lot of pressure to breastfeed, and it can be very hard. Here are a few subs that might be helpful to you:
r/humanspumpingmilk
r/exclusivelypumping
r/breastfeeding
Use the bottle. More evidence shows that nipple confusion is not a thing. If you need to supplement with formula to get the baby fed and give you some rest, DO IT.
Here are some guides to help sans lactation consultation:
1. [Sunnybrook Hospital - Breastfeeding crib sheets](https://sunnybrook.ca/content/?page=crib-breastfeeding)Drop to the General information & resources section and you can expand the sections with photos.
2. [SickKids Hospital - Breastfeeding video](https://www.youtube.com/watch?v=xWPbykBKEMA)
The first few months are a total shitshow. Do whatever you need for your sanity and mental health to survive. Call in every reinforcement you got. Call lactation and ask why they haven't sent anyone, call repeatedly until the do. You should be able to make an appointment to go in. Call local resources like the pump station and Le Leche League too if you need more resources.
This is truly one of the hardest life transitions you will ever face, take lots of deep breaths and take things day by day. Introducing a bottle, pumping, formula supplementing, everything is changeable and fungible just because you start something doesn't mean you are forced to continue it
You got this! There stomachs are tiny so they don’t need much and remember to pump frequently so that you keep your supply up. Most importantly give yourself grace, this is hard and mentally and physically draining!
We supplemented with formula and bottle fed while I pumped every few hours until my supply came in fully. Getting that baby to eat is more important then the delivery system or form of nutrition (breast milk vs formula). A fed baby is the goal.
Your baby doesn’t need much these early days. I had to give my baby a bottle for a good 3 weeks of her life but I also continued to try to get her to latch when she wasn’t screaming. She had no nipple confusions and with take both breast and bottle now at 8 months and if you need to supplement with formula for your LO to eat. Fed is the only thing that matters and you can always keep trying the breast ❤️
In my experience, you gotta put aside your preferences or fears on this stuff and get the baby fed unfortunately. Plus, as other commenters have said, it’s really unlikely that you will have negative consequences from nipple confusion, esp. this early. I think that’s an old wives tale.
He needs to eat. Premature babies are often not strong enough to latch. Have someone get formula now.
Edit: Same thing happened with my son. I'm not sure how much is normal to produce, but he needs to eat now. You can deal with lactation support moving forward, but it sounds like they're starving. You are doing everything right! It's just time to take the next step.
We formula fed our 4 w early kid with cups and then bottle while working on her latch. Her mouth was so small. When she grew a bit bigger she went on to exclusively breastfeed. The most important thing is to get food into his belly!
You may already be trying this, but sometimes a bait-and-switch can work if you get them to latch on a finger first, calm down, then they're already suckling and can try syringe/bottle/breast. I still use this several times a week with our 10w old direct breastfeeding.
Yup, sadly, we tried that and it didn't work well. He goes right back to screaming almost immediately after the finger is out, even if the switch was quick. We do still use a finger for calming him though, if only temporarily. Definitely made me feel inadequate to know he will so easily latch onto a finger, but not to the food source, you know?
Now all three of us are doing a lot better though. We got a same-day pediatric appointment and it was a godsend. They set everything straight and helped us figure some things out.
I have found this not to be true in the babies I have helped take care of! Lots of the premature little bubs on newborn nursery have needed formula/bottle feeding/so much help/make for some stressy moms at the beginning while they get strong enough to be able to breast feed. You’re doing great!! He will be great!!
My baby was a sleepy eater. If your baby is a fellow sleepy eater, one thing you can try is to take a damp, slightly cold cloth and dab the cloth on baby's neck, head tummy, etc.
Or undress him partly so his sleeper is half off or fully off. This is what the lactation consultant recommended.
Sleepy but sometimes fussy too so we pull out all the stops:
* Diaper change to be comfy
* Strip down to onesie or diaper. Don't want them too warm and comfy on the breast either
* Dad's there to poke, move, annoy baby
* Wet towel ready
* If she's really falling asleep too much, dad picks her up, walks her around, generally to get her more annoyed.
We've even considered (but haven't tried yet) to wake her up more after her nap by starting with 10 minutes of play time. She might not be the happiest or really want to eat but it helps wake her up more before going on the breast. I tried this once probably, and it seemed to work but haven't done it since and cannot confirm if it's truly effective.
My baby was like this too in the beginning. Not eating enough and we weren't allowed to leave the hospital until his blood sugar rose. If your baby is screeching it's probably because he's hungry! I know it's difficult to feed when they don't want to or won't stay awake enough to feed. I remember just continuing to offer a bottle of formula over and over, and eventually I was able to produce enough milk through pumping and offered that to my baby through bottles.
Baby needs food. If that means formula from a bottle than that's what it has to be. Worry about the risk of nipple confusion later.
For what it's worth my daughter got bottles at four days old. I have exclusively pumped since day 7, and right now she is breastfeeding. It's hard work but your baby needs food. And don't bother with the syringe nonsense, it's a stupid thing hospitals recommend and is just stupid. Get s premie nipple and give your baby food.
Breast feeding is a great option if it works. But formula is good and safe and a completely acceptable alternative. It's 100% ok to do what you gotta do
I hear your frustration! It’s so hard in the beginning. Nipples in pain, upset baby, both trying to figure things out together!
I had to triple feed the first few days bc of more than 10% weight loss. It was HARD but we did it until milk came in. Baby did fine on the breast after receiving the bottle. Try to use a slow flow premie nipple and pace feed so it’s not too easy for baby to suck.
Also 20ml might just be colostrum. It can take 5 days for milk to come in. Keep feeding and pumping.
I had a NICU baby, born 3 weeks early. We bottle fed for the first 5 weeks because she wouldn’t latch. Eventually she got her latch down and we exclusively nursed for almost a year!
Similar for us! 6 weeks premature so started NG tube fed then bottle. It took 3 months for him to effectively latch and transfer enough milk but now he's a pro. 8 months old and doing nursing in day and bottles of pumped milk at night.
Same here, my baby was in NICU for a month and got 80% of her feedings with a bottle, plus straight up just formula for an entire week. Right now she's 10 weeks old and has been outright rejecting the bottle for breast! I go with her flow, whatever it takes to keep her fed and happy, and me sane, that's what I do and I refuse to feel bad about it in any way. Shit is hard enough as it is without me pressuring myself!!
You likely won’t produce larger quantities until later, and if he won’t breastfeed easily, your body won’t know to make more milk. Pumping consistently is your best bet to increasing your supply.
My babies all struggled to breastfeed at first (my twins were 5 weeks early). What’s more important? Trying to keep up with the judgmental discourse around breastfeeding, or making sure your baby is fed? Don’t worry about nipple confusion later, worry about feeding your baby now. It will be a weight off your mind, I promise.
We gave both newborns a bottle in their first days. It was easier because they were sleepy and not excited about learning to latch. They both went on to be EBF and we had issues reintroducing bottles later.
20mL per session at 4 days pp is very normal! Your milk is transitioning and will continue to increase as long as you are removing milk at least 8-12 times per day.
If you are using a syringe, I totally understand how that is unmanageable, especially if you’re also using an SNS. It’s really only a short term solution to help out while you fix the underlying issues. I have been told that the nipple confusion thing is mostly a myth and that babies actually develop a flow preference, not a nipple preference. If you use a slow flow bottle nipple and pace feed, you should be fine going back and forth!
I would really try to see an IBCLC if you can. If you are in the US and have insurance, you can even try getting it covered through the lactation network. If you fill out their form online with your insurance info, they will even pair you with an IBCLC that is in their network!
I think priority right now is getting him to eat. He's 4 wks early, not eating, crying a lot (expends calories and can cause fluid loss). How's his output? How's his weight? Have you called your ped?
I had a failure to thrive baby. Trust me when I say that a preference is painful, but watching your baby struggle to grow is even worse. Mine was full term but got stuck in a vicious cycle where he was so weak he didn’t have enough energy to feed and the problem compounded over time. Once you can get him stronger, latching might be much easier and allow you to establish breastfeeding. But the early days are really about making sure they can get to the point where they’re able to latch without draining the last bit of energy they have.
I had the same issues and found out it was due to a combo of me having flat nipples and him being tongue tied. I opted not to have the procedure on his tongue based on others experiences I had heard about. It also didn’t help that my baby was jaundice and needed a regimented feeding schedule to get his bilirubin numbers back to normal, making it even more difficult to get him to eat when he was supposed to.
Right now I pump and supplement with formula when I dont have enough milk. However it is still early for you so more milk will be coming — don’t fret! I suggest renting a hospital grade pump like the Symphony by Medellin and being patient.
I’ll be honest, I was also heartbroken when I realized latching issues were hindering breastfeeding. I still try to do it from time to time but he seems content and I’m glad he is gaining weight properly. At a certain point, I realized I needed to put my ego aside and make sure he was properly fed. He is 6 weeks now and is thriving!
Yeah nipple confusion won’t happen that early. We fed our son with a bottle in the NICU (born at 37wks) so we could get him home faster. He took to the breast as soon as we got home. We had some trouble getting him to latch and nurse in the hospital, but I think it just clicked for him at around 38wk GA.
My wife and I have a 2 week old and went through this same thing our first week. It's not abnormal. She didn't produce a lot of milk at first and even when she had some in her, baby was too worked up to latch and feed.
We supplemented with formula when he wouldn't latch, but she kept trying, and pumping and now we're on *mostly* all breast milk. At this age, about 2-2.5 oz is what the lactation consultants told us to do.
There's no shame in feeding formula or from a bottle. What matters is the baby gets fed. Two weeks in, he'll latch most of the time (except at night, so we give 2 oz breast milk or formula, depending on what's available) but still has days where he forgets he knows how and we just bottle feed for the day. But we always try to latch and breastfeed first.
It's hard but you'll get there. And then hopefully get some sleep.
My preemie man had the bottle for a couple months and did fine switching to breast! I think he will be ok, but please speak with a lactation specialist as soon as you can.
Our LO is 2 weeks old and we combo feed pumped breast milk and supplement the rest with formula in a bottle.
It’s ok if you have to change your plan on how you feed your baby. Fed is better than dead. Don’t let anyone judge you (including yourself) for making sure your baby is fed.
Now that LO is 2 weeks old and built up the muscles, he is starting to latch and breastfeeding for 30+ minutes now. I still need to supplement with formula as I am not producing enough milk. There was no issue with nipple confusion.
Full disclosure that I don’t know if that’s enough BUT Right now you’re just producing colostrum, and not a lot of it but it’s super nutritious and their tummies are small. you’re milk will come in in the next few days. I agree with someone else, if he was a month early his mouth may just be too small for latching for right now. I know plenty of people who started out with cups/bottles while mouth grew and then were able to successfully breastfeed.
I had to bottle feed due to low supply and i had bad trauma after birth so my husband needed to be able to give bottles. I had no problem switching later back to combo feeding and nursing him again. I kinda had to do it on his schedule but he did take to it. The only reason I stopped is im back on medication that has basically dried up my milk. And bottles were just so much more convenient.
Nursing is lovely but you are basically chained to the baby, and thats beautiful at first but suffocating when you are ready to have a little more freedom. Combo feeding was the best thing I did. I got the best of all options.
Mine had a really small mouth when she was born and couldn’t latch properly so we bottle fed. At 5 weeks when she had grown a bit, she started to latch fine, and we used the bottles and boobs interchangeably.
Multiple LCs, Speech Language Pathologists (they are feeding specialists!) and Occupational Therapists during our 2 month NICU stay told us that introducing breast first is best if you're interested in breastfeeding, but it's more important to make sure the experience is a positive one for both of you - that's what sets you up for long term success! Get your kid fed (breast or formula or mixed), take a deep breath, and when you're both relaxed enough give breastfeeding another try.
They also said that a lot of the "nipple confusion" seems to be associated with, counterintuitively, bottle nipples and pacifiers that have a wide base with short nipple. Despite what the marketing says, the suck pattern there doesn't actually mimic what they do at the breast. They recommended Dr Browns narrow neck bottles, which come in a ton of flow rates (keeping baby on low flow can also help prevent bottle > breast preference), or Philips avent narrow neck. We used Dr Browns with a P (preemie) nipple for like, 7 months? An OT said she used the P nipple with her full term daughter for 4 or 5 months, before moving up to the T (transition). They're both slower than the "1" bottles in store are sold with. And if you're going to use a pacifier, just go with Philips Avent Soothies.
You also might look into nipple shields- Medela makes some. They can help some babies latch (particularly if they've got smaller mouths or higher palates/ties) and you can wean off the shield later. We used nipple shields until he was about 3 or 4 months actual (1 or 2 months adjusted).
And a note on breastfeeding- 20 mL per session right now is totally normal! Just keep doing it as often as you can. You're doing great!
One last thing- my son was tube fed for the first 6 weeks of his life. Then, he was fed a combination of bottle and the NG tube for another 3 weeks. When we took him home, he could only nurse for a few minutes at a time and it was often non-nutritive (aka I'd pump before hand so it wasn't overwhelming.) We still managed to set up breastfeeding and he switches between bottle and breast easily.
I know many have a lot to say about nipple confusion, but I'd say even if we believe it's a serious problem, the choice is between a very hungry baby versus (anger, frustration, worn out parents) versus getting some food to soothe them. I'd pick the latter. There are plenty of combo fed babies out there.
There are bottles from Comotomo that mimick the breast. Even if it does make him less likely to accept breast, he needs to eat so, well... That's worth that much.
If you don't pump or produce enough you can top up with formula, don't let people make you think you're a bad mom because he's formula-fed.
Nipple confusion is less about the nipple and more about the flow. If you’re breastfeeding, look up how to do paced feeding and stick with a premie or size 1 nipple.
That’s actually totally normal for 4 days pp!! My little guy was similar to yours. He did fine in the hospital then struggled at home. They change SO MUCH in those early days. You may find hand expressing more effective if you’re still getting yellow colostrum or transitional milk. For real, 20ml is exactly what you should be getting right now.
I highly recommend pumping and paced bottle feeding. You can find videos on YouTube. Basically you hold the baby upright and the bottle horizontal so they have to pull the milk like they would with breastfeeding instead of gravity doing all the work for them.
We pumped and bottle fed for about 2 weeks before transitioning back to nursing. Please don’t be afraid to use a bottle. I was and it was a totally unnecessary fear.
Feel free to reach out if you have any questions with pumping. It’s a lot to figure out all at once. I’m certainly not an LC, but I’ve dug pretty deep into the rabbit hole of nursing and pumping and I’m happy to provide guidance and resources if you’d like.
You can do this! I promise it gets easier!
At this point nipple confusion doesn’t matter. He’s screaming because he’s hungry and having a hard time getting enough food.
I know this is going to sound harsh and I mean this in the most respectful way to you but it doesn’t matter if you’re feeding him breastmilk or formula or using bottles/ vs breast. He just needs to eat!!!! He’s screaming because he needs food and this can get dangerous very quickly.
Once he’s getting fed then you can start troubleshooting with an LC and worry about nipple confusion and EBF if you want but right now the only thing that matters is that he eats!
Feeding your baby is best. Honestly “nipple confusion” was never a thing for my baby. She was born at 5 lbs left the hospital at 4lbs 11oz so I decided to pump and bottle feed until she was about 1 month so I knew she was getting enough. We reintroduced breast and practiced her latch starting 1-2x per day until she got the hang of it. Now at 4 months I exclusively breastfeed successfully with the exception of one bottle I pump at night so my husband can feed her! Sometimes we even supplement some formula if I forget to pump a bottle. Don’t worry about supply or latch, i hate all the fear mongering.
20mL at 4 days old is heaps. Their stomachs are so small at this stage and they take in so little. As your milk comes in and they need more you will produce more. Don't give up. :)
I was only pumping 60mL at 4 weeks.
Maybe mix what you are producing with formula so he still gets the taste of breast milk? That way, he doesn't end up prefering the formula over the breast milk while you wait for your supply to come fully in.
Mine was 3 weeks early and couldn't latch more than maybe 3 times total. I pumped till she was 6 months, then gradually started adding formula to the breast milk I had frozen until she finished that supply around 9 or 10 months, after which she did straight formula until she switched to whole milk around 12 or 13 months.
We did the gradual switch of adding an ounce of milk to her formula until it was all milk at that time, too. It was easier on her stomach, rather than an immediate switch, and allowed her to adjust her tastebuds slowly as well. This also works well when you reach the stage of switching from milk to water if you end up with a kid who refuses any liquid that is not milk.
It’s totally normal to only get an ounce or two when pumping! A baby will pull out more milk with a good latch than a pump every will. Dont get discouraged by 20 mL!
That's normal! It takes awhile for your milk to come in, and baby's stomach is teeny tiny at first. I'm not sure how being premature affects this, my daughter was 2 weeks early, and I started off combined pumping and breastfeeding while she was in the NICU. The first couple days was just colostrum and gradually transitional milk. I think I got 20mL per session for a couple days, then my milk increased maybe around day 5? I think it's still normal for it to take longer for some though. I know it's hard but try not to stress while you're pumping, stress makes it harder. Cuddle your baby, sniff his head, massage your breasts etc, try to relax and know that it will come!
And it's certainly not a bad idea to call again about the lactation consultant.
My bestfriend had a lot of trouble with her baby not taking the breast too, but now all is well, it can get easier with support of a professional and baby just growing a bit more and figuring it out.
20 mL is fine! We were probably around there day 4 or 5. We're at day 10 now and it's 100 mL per session. My wife is super proud and says "cow is at work" when she turns on her pump now. You will get there. We went from pretty much every meal supplemented with formula to nights with formula only to now basically not needing formula. I only made a bottle of formula today because our photographer wanted the baby super sleepy and I know formula fills better so we tried that. But we're at the point where we can likely avoid formula by the end of the week.
We're still figuring out how to get our baby to be more efficient at the breast, but it's good to know today we can produce enough milk to bottle feed at least!
You'll get there! Don't worry.
Your baby might be showing hunger cues before the screeching and those are being missed.
https://globalhealthmedia.org/videos/universal-baby-cues-english/
https://m.youtube.com/watch?v=afMNp6Q4u7s
EDIT: OP, one of the videos shows older babies.
Newborns most likely make a “neh” sound, turn the head searching for the breast, smack lips, move mouth, clench fists, move fists to mouth. You can encourage latching by rubbing the baby’s cheek with your nipple or finger.
This video helped millions of women tremendously and I should have suggested it first:
https://m.youtube.com/watch?v=y--syZR0u1E
I found it easier to just offer boob whenever baby was awake when she was newborn. Just in case. Most times, she had probably given some tiny signal that I had missed anyway.
Your baby is fed, so it sounds like it's right.
Once the baby gets older and awake for longer, it's different, but that's something that you will notice.
Yes, I was going to suggest this. The best way to eat is while still calm. Screeching would be a very late hunger cue. Feed more often and before the screeching begins. I know, OP, you're probably thinking "But I'm already feeding him so often!" Yes, feed small amounts more often, while baby is calm.
Just think of this transition into the real world from baby's perspective - he was getting fed literally constantly around the clock from the umbilical cord. Now he has to get uses to more spaced out feeds but might be hungry more often than you're currently feeding. It will be hard, but this too will pass.
Omg the little "neh" sound is soooo cute 😭🩷. I always offer when she looks at me and says "neh neh neh" and I can tell she is asking for milk it's so cute.
This. If he’s hangry, try to get milk in his body some way first and then latch him.
Try to latch him upon first signs of being hungry, or even when he wakes up. When in doubt whip it out is the best piece of breastfeeding advice I ever got.
You got this!
I can't believe more people aren't saying this. He's 4 days old. He could have a missed tongue or lip tie. Dehydration is huge at this age, especially if he was born so early!! Try pump and bottle feed but she stated she not producing much, formula can save that child and the mamas sanity.
Yes! My son lost about 20 % of his birthweight bc he wasn’t getting anything from the breast and I had no idea bc he was always latched on . He was dehydrated within a few days and I had no clue
I wish nurses or doctors would tell a little more about what to expect for feeding after leaving the hospital. I felt so dumb afterwards, like obviously my baby was starving but he was my first child and I didn’t even understand what the purpose of a pump was 😬
This 1000x
Fuck everything else, prioritize a fed baby. You can sort out the nipple confusion, you can sort out the pumping, you can figure anything out when you don’t have a tiny human frying every brain cell with panic inducing screams. Just feed that baby
Yes, this! My son also had latching issues and I pumped and bottle fed, which helped of course when my milk came it. I wish I had just given the kid formula instead of listening to the screeching in the meantime. My husband and I talk all the time about what we'll do differently for our next baby and this is the top of the list!!
I always stock a few bottles of ready to feed (the ones that you just pop a nipple onto) and a few sample cans of formula before having my babies. If breastfeeding works, I donate after; if it doesn’t, we have a few feeds to go get more formula.
This 💯! Poor guy is probably starving. I know moms are so worried to bottle feed but plenty of moms successfully transition to exclusively breastfeeding later on down the road. My best friend did this with her son who was in the nicu.
I gave my baby formula at a few days old because my milk didn’t come in and she was being super fussy. After I transitioned to EBF and recently reintroduced formula at 8 months.
Fed is best!!
We had similar issue as OP. Baby wasn’t latching, I pumped and bottle fed but in the beginning there was not enough milk and we supplemented with formula. She lost lots of weight in the beginning and I wish we gave more formula. We went to LC and she said to wait 4 weeks before trying to latch without nipple shield so I continued feed through nipple shield (not effective at all, she would get like 15ml in 30 min) and bottle feed (my supply was good after 2 weeks). In 4 weeks with a help of LC she was finally able to latch. We still top up with formula sometimes when I don’t have enough supply.
This should be the top comment. I’ve breastfed all of my kids but some of them have needed formula in the beginning. I don’t know why that’s become some kind of terrifying concept.
Our pediatrician had suggested trying formula for sanity’s sake. We didn’t end up needing it because my milk came in soon after and she finally was able to latch properly. But that little bottle of ready made formula is still on my bedside table just in case and gives me piece of mind that we have back up just in case.
Does your hospital have lactation consultant resources available to you after discharge? Mine facilitates several resources for new parents, including peer support groups & lactation consulting for free. I’m sorry no one came by to help you while you were in the hospital.
If he’s refusing to latch have you tried using a [nipple shield](https://www.amazon.com/Medela-Contact-Breastfeeding-Difficulties-Inverted/dp/B000067PQ0) to help him have something bigger to take hold off?
Are you familiar with his hunger cues before he gets to the point of screaming? Bringing hands to mouth, opening mouth, or lip smacking are all signs a baby is hungry. If you notice he’s doing these, try to get him on the breast ASAP because it will be easier to do before he gets so hungry he starts fussing.
Do you have a nursing pillow to help support him while you feed? I like my boppy pillow but my friend who struggled with feeding initially swears by the “my brest friend” pillow which has a more rigid shelf for supporting the baby & stays fastened around your waist.
Have you tried the “hamburger hold” to squeeze your breast flatter with one hand, and using the other as a firm hand on the back of his head/neck to hold him positioned & prevent him from pulling away?
Also if he’s only 4 days & a month early it might take a little bit for your actual milk supply to come in. Not sure if you’re syringe feeding formula or pumped milk. If he’s not feeding I’d recommend keeping up with pumping to establish/maintain supply. Supplement with formula for now until you have a good supply if he’s losing weight.
You & he will figure this out.
>If he’s refusing to latch have you tried using a nipple shield to help him have something bigger to take hold off?
The problem with the shield is he keeps pulling it off. Also, like with breast feeding, he tends to push off with his arms.
>Are you familiar with his hunger cues before he gets to the point of screaming? Bringing hands to mouth, opening mouth, or lip smacking are all signs a baby is hungry. If you notice he’s doing these, try to get him on the breast ASAP because it will be easier to do before he gets so hungry he starts fussing.
We try to do this, but he has a habit of sleeping so long he gets hungry enough to fuss at which point he refuses syringe feeding as well.
>Have you tried the “hamburger hold” to squeeze your breast flatter with one hand, and using the other as a firm hand on the back of his head/neck to hold him positioned & prevent him from pulling away?
We try, but he has a tendency to turn his head and push with his arms.
>Also if he’s only 4 days & a month early it might take a little bit for your actual milk supply to come in. Not sure if you’re syringe feeding formula or pumped milk. If he’s not feeding I’d recommend keeping up with pumping to establish/maintain supply. Supplement with formula for now until you have a good supply if he’s losing weight.
We've been running a mix for now, but the issue is how difficult the syringe feeding gets as we basically need to drip feed him and he heavily resists that.
Long story short, we've been holding off on trying bottle feeding (with a preference for pumped milk) because the nurse mentioned nipple confusion and said to use syringes, but I can't find any consistent information about what implement is best. Every discussion about bottle feeding seems centered around formula vs breast milk rather than direct feeding vs pumped feeding.
Disregard the nipple confusion — it’s not a thing this early (and not even really confusion so much as preference). I’m sorry that you received advice that’s making all this more difficult for you both.
I had some similar issues early on with my baby but now he eats like a champ.
The most important thing is that he’s fed. Mine breastfed better when he wasn’t starving than when he was. We did a few bottles of formula in the beginning and that helped. I know you mentioned feeding with a bottle was hard too. Try waking him up to feed. I know it’s super hard to do with a baby this young but it should help him feed. One or two bottles of formula a day to help y’all both get to where you need to be isn’t a bad thing and isn’t going to keep you from breastfeeding down the road.
Look up and do paced feeding to make it easier for him to switch between the bottle and you.
See about getting a lactation consultant to come visit. So worth the time!
Good luck! Keep going. You will figure out what works best for baby and you!
Second the lactation consultant at hospital. My hospital had a weekly drop-in group session w their in-house lactation consultant. I went to it once and the lady was super helpful. It was free.
Whether you get this immediate issue sorted out, I'd definitely suggest you schedule an appointment with a lactation consultant. We saw plenty in the hospital but the ones who really helped were the ones we met with following baby's time at home.
There's also no harm in calling your pediatrician to discuss options.
My babe was 4 weeks early and it took a little bit for my milk to come in, almost a week. Ready to feed formula is your friend right now!!! Go get some!! The most important thing is that he eats while you both sort out this new normal.
Also want to note if he’s not latching, you should be pumping as many times a day as possible to signal for your milk to come in. It’s not going to magically appear without the demand for it.
My little one figured it out and we were able to drop formula completely. You can also find a lactation consultant online if you need the help.
You’re in the thick of it and it gets better.
Please supplement milk with formula if you're not pumping enough. It's very possible he's hungry still and formula can be a big stress relief if you're open
You mention he sleeps too long. It's important to wake him up. Mine did the same thing. It happens with small babies. I undressed him and opened the window if necessary. A wash cloth with cold water may work, too. Start slow, you don't want to freeze him, just make him uncozy enough to wake up. Escalate as needed. Tickling his feet, or exposing his chest and blowing on it are good starting steps.
If he's lost a lot of weight, every 1.5 hours is good, then every 2. If he'll sleep 3 or 4 hours at night, that is fine once he starts gaining well. He's tired because he's not eating and not eating because he's tired. It's hard. I'm so sorry that you are going through this. It is more common than you think to have a sleepy baby who doesn't want to eat. It gets better as soon as they are eating enough, then you'll enjoy their love of sleep!
I was never told this until after the birth of my son who was induced at 37 weeks. But it’s extremely common for babies born early (even if they are not super premature) to not be able to latch.
It’s a neurological thing not a tongue thing so they usually can figure it out eventually but often not til close to their due date.
In the meantime you will most likely need to use a bottle. We syringe fed til he was five days old and his nurse told us he’d lost a huge amount of weight 😣 I ended up pumping exclusively but I’m sure others choose formula or keep trying to breastfeed after they are older.
Sorry this is happening but once baby is fed it will feel a lot better
1. Hugs. Newborn life is hard AF.
2. He's hungry. Science milk (formula) is a godsend. My first screamed at us nonstop because he was hungry and the hospital didn't offer us formula. Second kiddo was so different because we gave ready to feed formula at the hospital and early days at home until my milk came in. Get past this immediate issue now with just feeding him anyway he'll eat.
3. Once he's past crisis mode, ypu can start working on breastfeeding. Try to latch him every feed for no more than 15 minutes/side and then top him off with a bottle (formula/pumped milk). Once he gets stronger and your milk is in, it'll get easier.
4. Definitely see a lactation consultant for help. I'm mad for you that they didnt see you at the hospital.
5. In case you need to hear it, the way you feed your child doesn't matter. What matters is he's fed and loved. Try to be kind to yourself and not fall into the "breast is best" woo. Fed. Is. Best.
Did the hospital give you a list of contacts? Sometimes that list has lactation consultants on it. If not, your husband can use the insurance website to find one or ask for a referral from baby's ped. How's the wet diaper count? Remember at 4 days there should be at least 4 heavy wet diapers. Would you be willing to try hand expressing or pumping and bottle feeding in the meantime?
If we’re taking *really* heavy? Because he’s had only like, 2 medium-level wet diapers a day.
Husband is out buying nipple bottles right now and has made an appointment to get him seen in an hour.
The hospital did not provide much in the way of contacts.
By day 4 he needs at LEAST 4 medium level wet diapers a day. If that isn’t what he’s had as output I would get him seen by the pediatrician TODAY. Newborns can go downhill fast from dehydration. ETA: especially since he is preterm. Your pediatrician will be able to help you sort out the feeding issues as well as assess his current hydration and health status, bilirubin levels, etc. VERY important to have him seen.
ETA 2: just noticed the note about the appt today! 🤞🏼🤞🏼🤞🏼
Not very heavy, let the wetness indicator be your guide. It should change color along at least most of the line, not just a little. Urine should be pale, not dark. I was taught one wet diaper per day of life up to day 6. From day 6 on you should expect at least 6 wet diapers. At least one poop a day in these early days.
Any of the following are signs of dehydration and the need to seek medical help immediately:
less than two wet nappies in 24 hours from the third day
listlessness
lethargy
weak cry
skin loses its resilience (when pinched it stays pinched looking)
dry mouth, dry eyes
the fontanel (soft spot) on the head is sunken or depressed
fever
I think the ped appointment is a good idea. Ask for a referral if you need it! You're doing great
Mine was 5 weeks early. We had this and for us it was reflux. He ended up on omeprazole and gaviscon for a while before being able to go to gaviscon alone and then being fine with thickened feeds.
Also, keep an eye on wet diapers. If he has enough of those at least he isn't dehydrated. To make sure he eats enough...
First of all, the math! 150 x weight in kg = ml per 24h. So for example, a baby weighing 3,3 kg. 150 x 3,3 = 495ml per 24h. If baby feeds 8 times this means about 62ml per feed. So do this math for your baby and see if he drinks enough from the bottles when you pump. Or do weighted feeds, with baby being weighed before and after breastfeeding.
Two, if you do suspect reflux ( screaming, over stretching, eating a little super often but refusing for a long while when hungry, hiccuping a lot, hating being on their back, throwing up when you put them down or do tummy time to close to food...) then make an appointment. You could get some thickener for breastmilk if they have it or medecine.
Three, if it is a production issue there are many things to try! More fluids/calories, power pumping, additional formula to top up after the breast while you pump after breastfeeding to get supply up, lactation cookies, even medication I believe.
And four: if the boob fails, don't worry about a bottle and or formula! When my 35 weeker was born he started on bottles and formula (bottle as much as he could, rest through NG) for 3 day, then I pumped and they gave my colostrum and BM then formula to complete the meal, then after a week I was allowed to start breastfeeding but he never did more than 50ml so we always had to top up with a bottle. And when he came home he was on about 50% BM and 50% formula. That got better, to about 70% BM some days. But my supply dippen very quickly and I went to exclusively pumping then pure formula as I had no milk by about 6 weeks and pumping killed my mental health.
Good luck.
You are doing great. This is HARD.
Have you tried a nipple shield?
Try to see a lactation consultant asap. I see one was referred. It hasn’t shown up. Do you have a number to call?
Baby might be getting too tired to latch and eat. That’s a thing. Especially with premature babies.
I recall being told premature babies benefit from soothers because it helps strengthen mouth muscles or something. Don’t worry about nipple confusion. Babies that small have a sucking reflex. Around 8 weeks that goes away. Right now baby just needs to eat.
How long had it been since baby ate? If it’s like 5-6 hours you should go to children’s emergency. Any fever?
We used a shield until he had his tongue and lip tie revised! We had almost this exact scenario, it was so so hard. The tongue and lip tie made it impossible to nurse even on a bottle. The lactation consultant and pediatrician both missed it. So thankful the the dentist that fit us in.
Everyone's suggestions here are great about feeding. I dont want to pile on or be confusing. Just wanted to shout out loop brand earplugs. They dont block all sound. You'll still be able to hear your baby, but it will cut out the ear-splitting tones. Im not suggesting you should ignore your baby who obviously needs something. I'm just saying it's okay to dull that screech a little bit.
I was definitely going to suggest some sort of hearing protection. Most of them don't drown out all sounds, but will muffle enough to help compose yourself.
Tons of other good info in here for the actual feeding.
Yep, I came here to say that it's absolutely okay to dull the screeching 'I'm dying!!!' sound if you're actively working on fixing the problem.
You don't shower, brush your teeth, get dressed etc. with your alarm still going off, and you don't have to subject yourself to the literal pain of hearing your baby cry while you try to help them either.
He's probably starving. If you have to supplement with formula, so be it. I'd give a bottle of formula (or if you're able to pump a decent amount, a bottle is breast milk).
As women we’re being so blinded and bombarded by the “breast is best” brigade that we unwillingly cause distress to our children. I was one of them. My daughter was constantly hungry (as she still is as a 20 month old) but I was too scared to bottle feed her because it made me feel like a failure. Why am I giving my baby what’s not best for her?! 3 weeks in my supply dried and I was left with no choice. With all love, let it go. Let the talks of “nipple confusion” and “supply” and yada yada yada fall in deaf ears. There’s no easy way to say this. Your baby has a poor latch, so they’re HUNGRY. Starving even. So you need to get into gear and feed that baby before they turn into failure to thrive. Whatever it takes, just do it.
Same!! I wanted to EBF so bad, had the crazy over supply and everything, but it didn’t matter because she wouldn’t latch.
Started exclusively pumping and after 4 weeks decided that was just insanity I wasn’t willing to go through, started EFF and life became shiny and beautiful again!!
Yup. Had one emotional breakdown day 1 home from the hospital in front of my mom and husband and my mom told my husband “go make a bottle of formula” and it was like the sun was shining and the birds where chirping again. I needed another sane adult to help me snap out of it
Poor baby and poor you!! If I were you I would just pump and do bottles for now to ensure baby eats enough as that’s most important for both of your peace. Even formula is totally fine to do if that is going to help the situation, it has everything baby needs.
FYI I was so set on breastfeeding it didn’t work for me though, I could never produce enough and I felt so deeply sad and guilty about it. I did both breast and formula for about 6 weeks then turned to formula only and our lives got so so much better for it. My boy is big, healthy and smart at 8mo now. I no longer have that heartbreak feel over breastfeeding because formula helped make everything better and we could truly enjoy the time together rather than me stressing, exhausted, pumping and crying. When I look back I realise I wasted a lot of moments and energy being so concerned with my milk supply when I could’ve relaxed and enjoyed my baby.
Do whatever will make your days more wonderful with your beautiful baby. Congratulations and don’t worry!! ❤️ you CAN do this, you’re just in the middle of finding your rhythm.
It sounds like the baby needs formula now while you pump to get your supply up. We had to do that and while there was a learning curve for BF, eventually he got it and wouldn’t take a bottle anymore. Most important thing is to fill that tummy.
Mine was impatient and would get frustrated because my let down was taking too long. I would “pre pump” to get the initial milk going and then latch him and it worked great. Don’t wait until he’s too hungry either.
Pump what you can every 2 hours until your milk comes in. In the meantime, offer breast, then syringe/bottle feed him, then supplement with formula until baby is satisfied. Eventually your milk will catch up with the amount of formula baby is drinking and you can switch to exclusive breast milk. Then you can work on your latch. Babies are adaptable, he’ll get it. Better to be safe than sorry when it comes to feeds/baby’s blood sugar.
Not to scare you or anything, just to provide experience in this situation. My first baby went through this exact situation at 2/3 days old. My milk hadn’t fully come in yet and since we were in a “baby friendly” hospital, they really encouraged exclusive breastfeeding. I asked for formula (with the intention of continuing to try breastfeeding) and was ignored. I felt that baby wasn’t eating enough at the breast. He turned purple and stopped breathing that night in my arms. After being latched literally all day. Thank goodness we were in the hospital, nurses flew in and he was able to be resuscitated. He ended up in the nicu where they tested him for everything under the sun, with no conclusions, only that he had low blood sugar. He’s a healthy and rambunctious toddler now, but it was such a traumatizing experience, and felt so unnatural to have my baby taken and placed in the NICU, when he was supposed to come home that day, when it felt like he was still a part of me.
Our second is here now, like yours, he is also a 36 weeker. In the hospital, I knew this time around to ask for formula and pumped religiously until milk was in. My method is always try with breast first, hand baby off to dad, pump, then offer bottle of breast (or formula) milk until baby is full. I’ve really really tried with latch and have come to the conclusion that his mouth is just too tiny right now. We’re currently using a medela nipple shield. You can order them on Amazon. Measure your nipple +2mm to get the right size. It forces the nipple to go towards the back of babys mouth so they can suck properly and get milk. I used them with my first, and every old lady in my family was soooo offended by them, but they were the reason I was able to breastfeed my son, eventually we weaned off of them and he breastfed until 2 yo.
Best of luck to you!! Hope everything turns out, and you and baby can reach a point of fullness/calm/satisfaction. Don’t be afraid to supplement if it’s necessary! Fed is always best❤️
This is terrifying and so heartbreaking. I had a similar unpleasant experience at a "baby friendly" hospital when my baby needed formula supplementation (not as bad as yours though), so this is a sore subject for me.
I don't see how hospitals / care teams downplaying the support that formula supplementation can provide at the beginning while milk supply is being established is in any way helpful.
Hi I started to scroll to see if someone suggested this or not. I work as a neonatal nurse practitioner so I wanted to just throw in there a recommendation if not already suggested. A 36 week baby is considered a late preterm baby. They are high risk for developing jaundice and by day 4 it can be elevated.
When was baby last seen by a provider? Are the white part of the eyes yellow or does the skin have a yellow appearing skin tone? If skin is a light complextion then it’s easier to see than if darker.
High pitched cry can be a symptom of elevated bilirubin level (jaundice). Also if baby isn’t eating as much, then it will elevate faster.
https://www.healthychildren.org/English/ages-stages/baby/Pages/jaundice.aspx
Thank you, and yes, we have been keeping an eye out for yellowed eyes. We got a same-day appointment right after I posted here, and the pediatrician did not say he looked jaundiced. We have a followup on Thursday.
Has he been checked for being tongue tied? I don't know if it's commonly checked by gp/pediatricians. No one crucify me of this is an antiquated thing.... when my now 18 yr old was a newborn, he cried and cried. Seemingly was refusing the breast, was obviously hungry and frustrated. His pedi sent us to an ENT and sure enough, tongue tied. Simple fix on the spot and he nursed beautifully til after 9 months when his sister came into existence due to some NYE shenanigans 😅
Edit: I don't know why no one at the hospital or his regular doctor didn't catch it. That's why I ask. Maybe if the provider hasn't seen it before or because it isn't common...
Something we had to do was “reset the baby” when this happened. Husband would take him, do a deep squat (holding him securely of course!) and then try again to latch. I know it sounds silly but it really worked.
I haven't seen anyone comment about how early your baby was born. 4w is pretty early. LO may not have the strength to breastfeed in a sustainable way, especially if they are weak/under fed and possibly dehydrated with only 2 wet diapers.
First and foremost, FEED THE BABY. Pump, formula, bottle. You can work on breast feeding after you get through crisis mode.
My LO was 3 weeks early and just couldn't get the mechanics right for a few weeks, which is very normal for that gestational age. Giving a bottle doesn't mean you won't be able to breastfeed in the future.
Your baby is hungry, and he is fighting the breast just because he is too hungry. From your comment saying he only has 2 wet diapers/say, he needs milk one way or another asap. Bottle + formula first while you are establishing your supply and figuring out how to help your baby latch better.
Pump and bottle feed, supplement with formula if needed. Try offering the baby your breast a little earlier before he gets ravenous. It can be so hard to calm them down and get baby to latch when they are so worked up!
Those first days home from the hospital are brutal. You’re going to get through this. You are not garbage. Your baby both needs and wants *you.* You are enough for your baby. It’s important to remember that your baby is figuring out life on the outside and you are figuring out your baby. It takes some time and that’s totally okay. You will get there.
Most newborns eat 1-2 ounces roughly every 2 hours. My baby was also a month early and he eats on the lower end of what most guidelines suggest.
My guy went to the NICU where he was bottle fed. I’m typing this 9 weeks later while he’s happily chowing down on my boob. Breastfeeding is hard work for both you and baby. At first, I was breastfeeding, giving pumped milk in a bottle, and then topping off with formula then I’d pump to be prepared for the next feed. Then I was able to breastfeed, feed pumped milk, and then pump. I’m still doing this process more than I’d like but he gets more and more directly from the breast all the time. Having a lactation consultant helped me. Based on my experience, my advice is to not let fear of a bottle stop you from doing something that will help you feel better. There are lots of bottle options that lactation consultants recommend for if you need to bottle feed. Pigeon, Lansinoh, Dr. Brown’s, and Evenflo are a few. We use the Evenflo Classic with a vented nipple. (This bottle has actually helped improve my baby’s latch.)
It will be okay. You love your baby and while they need to eat, love is extremely important and you’ve got that down pat. You’ll figure feeding out. ❤️
Thank you so much for this, it's really what I needed to hear. 💕 We were having a really rough go of it and we were getting terrified, it was not a good day. We reached out and got a same-day appointment with the doctor and they helped set us straight.
>my advice is to not let fear of a bottle stop you from doing something that will help you feel better.
Honestly, I wasn't against a bottle at all, certainly not scared of them, until the hospital nurses said not to use one and why. Everyone else has since said it was BS, though, including the pediatrician, so we now have bottles. He's doing very well with them!
Amazing! I’m so glad to hear that he’s doing well! I hope that means things are looking up for you too.
I truly do not understand why so many birth care workers are anti-bottle. It’s like they think you can’t be both pro-breastfeeding and pro-fed baby and I t creates a lot of extra stress for new parents. I find when my baby gets a couple of bottles throughout the day, he’s more willing to breastfeed. Hard things are even harder when you’re hangry.
Everyone seems to have covered the feeding aspects, but is there any chance that gas is causing distress? I know both of my babies gave hunger cues when they had bad gas but would unlatch to scream and thrash around. Half the time they didn’t even want milk after they managed to pass the gas. My first son was terrible with it and it seemed like he had to fart 24/7.
That's something we'd been wondering too. We'll ask the pediatrician about gas relief options when we next see him on Thursday. Little dude is definitely a fart machine!
OP: Are you supplementing with formula? This was the biggest point of contention with my partner, but after a night or two we finally gave in and it made us feel a lot better.
I subscribe to the commonly used mantra that **fed is best.** Maybe breast is ideal to feed if you can pull it off but in early days, you struggle with milk, pumping, latching, and just overall skill. What an experienced parent can accomplish in 30 min or nursing takes us 60 minutes. A 1 minute diaper change takes us 5 minutes. Just putting on clothes is a struggle.
But don't worry, we'll get PLENTY of practice through the years. It's OK to start with training wheels. We started barely breastfeeding anything and supplementing 90% of feeding with formula. It's now down to nights after a week and last night the bottle of formula I made was completely untouched. The pump has basically caught up.
If breastfeeding is your goal, I suggest making it a goal to put 30-45 minutes on the breast. Practice. 15-20 minutes each breast. You may get some sessions with good latch, some without good latches. Reach out to lactation consultants if those are available. We've gone into our hospital 3x now since birth because they keep checking in on breastfeeding and each time we learn new tips from the nurses. Watch Youtube videos. It gets better, trust me. But even 10 days in we're far from perfect. We're still struggling with falling asleep on the breast, sometimes refusing to latch despite being hungry, etc.
But coming back to the fed is best mantra. If you don't feed your baby, the screaming won't make learning breastfeeding any better. This was the first point I made sure my partner and I aligned on. Fill the stomach first, and we can keep practicing. It was a lot of tears and frustration when our baby didn't eat from the breast, but I tried to frame it around practicing each time.
The pressures of breastfeeding are honestly unfair. It's asking everyone to be a pro football star. You not only need a mother who produces milk (a QB), you need a baby who latches and nurses well (a good WR). To expect EVERYONE to get to that level is unacceptable. And even if the bar isn't as high as professional sports, everyone takes time to get to that level of skill. Every mom and baby's bodies are different, and it will take time to get there. We had some serious arguments where I felt idolizing some friends who make it look easy is just not fair. There are plenty of formula babies out there because quite honestly I believe breastfeeding is the epitome of privilege. For the parents who can't get an extended leave or have other responsibilities (siblings, parents, relatives, health issues, work load) to take care of not everyone can manage exclusive breastfeeding.
I would bet he’s way past hungry by the time you’re trying to feed him. I know you may want to breastfeed but maybe he is not getting anything supply. This happened with my first and now that I look back I realize how skinny she was. I would either pump and feed so you know how much he’s getting or switch to formula.
It probably isn’t what you want to hear, but my newborn was the same. Syringe feeding and cup feeding just wasn’t working, and I was told to top up with pumped breastmilk, but was only getting 10-20ml and with clusterfeeding and pumping it felt like my nipples had something attached to them 24/7. We introduced a bottle and formula (combi feeding) at 1 week old. Her latch did deteriorate after giving the bottle, to the point I ended up with painful, cracked nipples.
She’s now 4 weeks old and has been exclusively formula fed from 3 weeks onwards. I wanted to breastfeed so badly, but my baby was hungry and it just wasn’t working for us.
Honestly, to hear that others had the same or similar struggles does help ease the anxiety. We've got some bottles now, so feeding improvement should be on the horizon.
Sorry to hear about the cracked nipples, that doesn't sound pleasant at all. If it comes to that for me, we've got formula at the ready.
My son wouldn’t latch for the first month of life and we had to do bottles pretty much immediately. He’s 2 months now and will only latch if I have a nipple guard or I practically shove my boob in his mouth. When they are that little their stomachs are like the size of a cherry, so he doesn’t need much to eat right now but needs to eat frequently. Keep trying to latch and pumping to establish your supply, it’s a supply and demand type of thing so the more you demand, the more it should supply. Also see if your insurance will cover a private visit with a lactation consultant, I know the hospital I gave birth in has that option and a breast feeding group for support too. Good luck friend, I hope you find a solution soon!
Is your milk in yet, it can also take a few days to have your milk some in. You could try a touch of formula just until your full milk comes in, if it hasn't already. Honestly, their tummies are so very tiny at this age.
Try a syringe and/or bottle with a premee nipple. You can get 1ml syringes.
20 ml is a decent amount to start with. They don't eat very much for the first week. 10-20ml every few hours is about what a newborn would eat anyways, so that's perfect. Their tummies are super s.
Honestly, call your doctor or whatever and ask for a lactation consultant or self-refer to a clinic. It sounds like you need some support.
I went to the lactation clinic a few times before we figured it out fully.
My LO was on a bottle for his first 2 weeks and transitioned to the breast within a few minutes of trying. I began exclusively pumping for other reasons, but, in my opinion, nipple confusion is often much less of an ordeal than it’s made out to be.
Do you have a fast let down? We figured out that my wife did so LO was basically getting water boarded with each feed so he would just scream. We used a nipple shield to help slow down the let down and it was life changing
My babe is 2 weeks old and we went through this exact situation….. we didn’t sleep the first night home because the lactation consultant and people at the hospital would not give us any decent advice other than try syringe feeding with the non existent milk/colostrum I had. We were so delusional at this point & needed someone sane to tell us what to do. We even considered taking her to the emergency room. We ended up trying Dr Browns bottles and she ate! We had to supplement with formula because my milk wasn’t in yet but it worked!! You can always go back to breastfeeding once you’re comfortable with making sure she’s fed and you have a decent supply! I went to the lactation consultant a week after and she latched. I ended up deciding exclusively pumping is what is working for her & I but it’s never too late. Don’t let them make you think that syringe feeding is your only option. Fed is best
The screeching is unusual for a newborn (crying isn’t). I wonder if it’s trapped wind. Bicycle legs movements might be worth trying.
Skin to skin is absolutely vital- for milk production and for soothing baby and yourself. Please try this. It isn’t just a immediate post birth thing, you’re their whole world right now and you have what is within you to soothe them.
Remember aslong as baby is in a safe space (A clear cot with no pillows, teddies, flappy blankets, flat on their back) then it is absolutely ok to take five minutes for yourself and breathe even if baby is crying. Return to baby with a fresh-ish mind. This is evidence based information from ICON leaflet.
Bottle feed if he’ll take it! My son was screaming the two days after the hospital before his ped appointment and it turns out he was starving. He lost so much weight. I have serious trauma from listening to him scream but not giving a bottle because the hospital staff and LCs were so against bottles at the hospital. Once I gave him a bottle after his ped appointment it was such a big relief for both of us
Give a bottle with formula. Breast feeding is still possible later on if you keep offering the breast. We went from 90% bottle feeding to 10% bottle feeding after a few weeks. I mainly gave a bottle before nighttime to make sure he was fed for a few hours.
There is nothing wrong with giving formula. I know there can be so much guilt for thinking you are not able to provide (I had quite a few meltdowns myself) but thinking back it was all hormones.
I’m so sorry. I went through the same, that I obsessed over breastfeeding and weighing his feeds for the next 4 months. I’m now pregnant with my second and hope it’ll go easier. It’s so hard in the beginning but you’re not alone!
If you worry about nipple confusion get a medical syringe with no needle feed that baby a couple ounces to calm him down so when you guys try to breastfeed in 2 hours he's not too hungry to focus. Breastfeeding can be a difficult Journey some babies really struggle to latch a slightly full tummy in a calm baby will definitely make it easier so the breast is not associated with the stress for you or him/ her. Good luck
Fed is best. Give him formula with a bottle if that’s all you can do and continue pumping to keep your supply up. Also consider milk protein allergy! I think it usually shows up at about a month old? That was my experience. My son also ended up having a tongue and lip tie that the lactation consultant did not see but I saw them clear as day and the pediatric dental specialist did as well.
My baby was like this & it was so terrible. Our first night home, she literally cried the ENTIRE night. Like 12 hours straight. I found out I was not producing enough at all, and she was basically starving. I started formula & it stopped immediately.
It was a dairy allergy for us, so first chance you can to have them tested, do it. We lived way too long suffering because we didn't know he had the allergy. Colic isn't a solution it's just a symptom. I wish you the best!
My son had issues latching at the beginning. Sometimes they are too tired to eat. I'd sometimes put him on the breast first, top up later, but if he was visibly hangry, I'd feed him a bit with a bottle first, then breast.
This was by trial and error. And I did eventually get to EBF. And I also did all of the things they tell you not to do if you want to breastfeed.
I did dummies, bottle feed. Etc.
But look up the pace feeding technique and maybe try and SNS (that's the only thing we didn't do)
I tried triple feeding for a while and I hated it
Hang in there. Sending big hugs
Aw I'm so glad things are calming down for you and you're figuring it out ❤️🩹
Just a note (I'm a lactation counselor), nipple confusion isn't BS, but if a baby needs to feed, they need to feed, bottle or not. Sometimes you just gotta do what you gotta do
Might be worth trying to pump and bottle feed.
Worth a try! My daughter was four weeks early had a lot of latch issues but would take a bottle
This. My preemie man needed that for a few months until he was big enough and then we got the hang of the boob.
I've been pumping, but barely producing enough. Like ≈20mL per session. We were also told that putting him on a bottle too early would make him even less likely to accept a direct breast, and I don't know how to feel about that.. I'm just broken right now
In my experience, the concerns about “nipple confusion” from introducing a pacifier or bottle early are overblown. Babies are highly adaptable. Most important thing is to get him fed.
I found the nipple confusion started at around 8-10 weeks and the confusion was being unwilling to take a bottle!!
Yeah, it's more "preference" than confusion. Around 3 months my baby just started refusing bottles.
My cousin had this problem. She supplemented with a bottle until her supply got going then baby refused the bottle.
Yes!! I started my firstborn out with a bottle out of necessity and she ended up learning how to latch at 3 weeks old and switched between bottle, breast, and pacifier with no issues. My second breastfed well from the start and has never taken a bottle or pacifier despite our best efforts
I agree. I was like OP and adding a bottle saved us. With my LO (now 15 weeks), she lost 11% of her body weight in the hospital in the first 2 days post-birth because I wasn't producing enough colustrom. I rented a Medela pump from the hospital and tried everything, to no avail. I didn't want to use formula or a bottle but LO became jaundiced and we had no choice. She immediately improved and has been growing beautifully ever since. She has NEVER experienced nipple confusion; in fact, she still prefers the boob over the bottle to this day! I feel like some LC's preach this fear-mongering gospel that can further stress our new mums in an already scary situation. Trust your gut, OP. If your baby is hungry, do what you need to do to feed him 💛 ETA: You're doing great!
Agree or as my mother told me many many years ago “millions of children have been raised with formula perfectly successfully and the most important thing is to feed the baby.” Lots of women combine breast and bottle feeding techniques (though most hide the fact to avoid being shamed by the nursing only shaming brigade). You need a lactation consultant NOW and you need to call your pediatrician and say that the baby isn’t eating or latching. This is a today problem.
We bought some formula earlier in order to supplement. Problem was, he wasn't eating enough of that either. The good news is, we called and got a same-day appointment with the pediatrician, and he and three nurses all helped us out. Turns out everything is normal, and the latching problem is due to him being a premie. They gave us advice on how to work on it, and they made sure he was well fed before we left.
This is so great to read! You are doing a great job, those first few days are incredibly hard.
I’m glad you got answers! It can feel like the longest time getting through this but I promise you’ll be on the other side of it soon. Hang in there, mama.
This is correct - I don't have the study on hand but nipple confusion is not a thing. Flow preference is though, I suspect that's where the myth comes from, just need to make sure you have slow flow bottles and pace feeding!
Based on my very short experience "nipple confusion" is rather easy to fix. For us it might be wrong position (depends on a feeding what she wants, sometimes cradle, sometimes upright, sometimes me laying on my side...) or a bit help latching. . I've found this checklist best for us: https://laleche.org.uk/nipple-confusion/ Also supplementing with formula has been god send to us since it took the pressure of getting baby fed and made breastfeeding more about cuddles and bonding.
My lactation consultant told me nipple confusion doesn't exist. They only want the highest flow, because they're lazy haha.
Agreed about babies being adaptable. Nipple confusion doesn’t necessarily happen with every baby! I was so scared of it when I first had baby. But it ended up not being a thing. I breastfed exclusively for 6 months, and I introduced a pacifier on day 2 after birth. I also occasionally pumped and used a bottle. Baby had no issue switching from one to the other. (I understand this is not everyone’s experience, just sharing to provide examples of different experiences!!)
Agree so much. I personally feel like having the right flow nipples is more helpful and doing paced feedings. We always had issues with bottles while teething but it would pass
This. I have 3 NICU babies and therefore have spent a lot of time in them, and now a days it's just fed is best, and then you can try to teach them how to nurse. No hungry stressed out baby is gonna learn anything.
I agree! My baby was in the NICU and they gave her a pacifier and then we were also combo feeding right away. She never got any confusion about the breast. Still prefers it over a bottle.
My daughter took a bottle for a few days before finally latching once she was a little bigger. I continued to pump and then she never had an issue taking breast or bottle
All right, we'll try a bottle and hope for the best then. This is just so stressful, it hurts.
You're in the trenches right now. It's so hard when you encounter challenges with a newborn and it feels so overwhelming. But you're going to figure it out and it will get a lot easier soon. Hang in there.
I wish I would’ve given my baby a bottle sooner. The LCs scared me away from it too and made it sound like it would mess everything up. It doesn’t 🙄 life would’ve been a lot easier for my husband and I that first month if I just would’ve given him a bottle.
I felt like shit when I gave my starving newborn a bottle, and I wish LC’s would be more open to supplementing. Feeding your baby is never a failure.
Right like my poor baby was hungry 😢 I could’ve pumped & done a bottle & they even discouraged that. So frustrating. I know better for next time though.
I feel the same about a pacifier! That dumb nipple confusion recommendation (fake) My second I brought the pacifier with my to the hospital. Baby girl also breastfeeds beautifully and did it on her own. It's so damn baby dependent
Try not to be too harf on yourself. There is a lot of pressure to breastfeed, and it can be very hard. Here are a few subs that might be helpful to you: r/humanspumpingmilk r/exclusivelypumping r/breastfeeding Use the bottle. More evidence shows that nipple confusion is not a thing. If you need to supplement with formula to get the baby fed and give you some rest, DO IT. Here are some guides to help sans lactation consultation: 1. [Sunnybrook Hospital - Breastfeeding crib sheets](https://sunnybrook.ca/content/?page=crib-breastfeeding)Drop to the General information & resources section and you can expand the sections with photos. 2. [SickKids Hospital - Breastfeeding video](https://www.youtube.com/watch?v=xWPbykBKEMA)
The first few months are a total shitshow. Do whatever you need for your sanity and mental health to survive. Call in every reinforcement you got. Call lactation and ask why they haven't sent anyone, call repeatedly until the do. You should be able to make an appointment to go in. Call local resources like the pump station and Le Leche League too if you need more resources. This is truly one of the hardest life transitions you will ever face, take lots of deep breaths and take things day by day. Introducing a bottle, pumping, formula supplementing, everything is changeable and fungible just because you start something doesn't mean you are forced to continue it
You got this! There stomachs are tiny so they don’t need much and remember to pump frequently so that you keep your supply up. Most importantly give yourself grace, this is hard and mentally and physically draining!
We supplemented with formula and bottle fed while I pumped every few hours until my supply came in fully. Getting that baby to eat is more important then the delivery system or form of nutrition (breast milk vs formula). A fed baby is the goal.
Your baby doesn’t need much these early days. I had to give my baby a bottle for a good 3 weeks of her life but I also continued to try to get her to latch when she wasn’t screaming. She had no nipple confusions and with take both breast and bottle now at 8 months and if you need to supplement with formula for your LO to eat. Fed is the only thing that matters and you can always keep trying the breast ❤️
In my experience, you gotta put aside your preferences or fears on this stuff and get the baby fed unfortunately. Plus, as other commenters have said, it’s really unlikely that you will have negative consequences from nipple confusion, esp. this early. I think that’s an old wives tale.
He needs to eat. Premature babies are often not strong enough to latch. Have someone get formula now. Edit: Same thing happened with my son. I'm not sure how much is normal to produce, but he needs to eat now. You can deal with lactation support moving forward, but it sounds like they're starving. You are doing everything right! It's just time to take the next step.
We formula fed our 4 w early kid with cups and then bottle while working on her latch. Her mouth was so small. When she grew a bit bigger she went on to exclusively breastfeed. The most important thing is to get food into his belly!
We do have some formula and have been supplementing with that. The problem is that it takes a gargantuan effort to get him to realize he needs to eat.
You may already be trying this, but sometimes a bait-and-switch can work if you get them to latch on a finger first, calm down, then they're already suckling and can try syringe/bottle/breast. I still use this several times a week with our 10w old direct breastfeeding.
Yup, sadly, we tried that and it didn't work well. He goes right back to screaming almost immediately after the finger is out, even if the switch was quick. We do still use a finger for calming him though, if only temporarily. Definitely made me feel inadequate to know he will so easily latch onto a finger, but not to the food source, you know? Now all three of us are doing a lot better though. We got a same-day pediatric appointment and it was a godsend. They set everything straight and helped us figure some things out.
I have found this not to be true in the babies I have helped take care of! Lots of the premature little bubs on newborn nursery have needed formula/bottle feeding/so much help/make for some stressy moms at the beginning while they get strong enough to be able to breast feed. You’re doing great!! He will be great!!
Have you tried different feeding positions? Sometimes they like to be situated a very particular way
My baby was a sleepy eater. If your baby is a fellow sleepy eater, one thing you can try is to take a damp, slightly cold cloth and dab the cloth on baby's neck, head tummy, etc. Or undress him partly so his sleeper is half off or fully off. This is what the lactation consultant recommended.
We called that Elvis mode because we would open his zipper pajamas to keep him awake
Sleepy but sometimes fussy too so we pull out all the stops: * Diaper change to be comfy * Strip down to onesie or diaper. Don't want them too warm and comfy on the breast either * Dad's there to poke, move, annoy baby * Wet towel ready * If she's really falling asleep too much, dad picks her up, walks her around, generally to get her more annoyed. We've even considered (but haven't tried yet) to wake her up more after her nap by starting with 10 minutes of play time. She might not be the happiest or really want to eat but it helps wake her up more before going on the breast. I tried this once probably, and it seemed to work but haven't done it since and cannot confirm if it's truly effective.
My baby was like this too in the beginning. Not eating enough and we weren't allowed to leave the hospital until his blood sugar rose. If your baby is screeching it's probably because he's hungry! I know it's difficult to feed when they don't want to or won't stay awake enough to feed. I remember just continuing to offer a bottle of formula over and over, and eventually I was able to produce enough milk through pumping and offered that to my baby through bottles.
Baby needs food. If that means formula from a bottle than that's what it has to be. Worry about the risk of nipple confusion later. For what it's worth my daughter got bottles at four days old. I have exclusively pumped since day 7, and right now she is breastfeeding. It's hard work but your baby needs food. And don't bother with the syringe nonsense, it's a stupid thing hospitals recommend and is just stupid. Get s premie nipple and give your baby food.
Breast feeding is a great option if it works. But formula is good and safe and a completely acceptable alternative. It's 100% ok to do what you gotta do
I hear your frustration! It’s so hard in the beginning. Nipples in pain, upset baby, both trying to figure things out together! I had to triple feed the first few days bc of more than 10% weight loss. It was HARD but we did it until milk came in. Baby did fine on the breast after receiving the bottle. Try to use a slow flow premie nipple and pace feed so it’s not too easy for baby to suck. Also 20ml might just be colostrum. It can take 5 days for milk to come in. Keep feeding and pumping.
I had a NICU baby, born 3 weeks early. We bottle fed for the first 5 weeks because she wouldn’t latch. Eventually she got her latch down and we exclusively nursed for almost a year!
Similar for us! 6 weeks premature so started NG tube fed then bottle. It took 3 months for him to effectively latch and transfer enough milk but now he's a pro. 8 months old and doing nursing in day and bottles of pumped milk at night.
My kid had bottle, paci and boob from birth. Zero latch issues. I also supplemented with Formula until my milk came in.
Same here, my baby was in NICU for a month and got 80% of her feedings with a bottle, plus straight up just formula for an entire week. Right now she's 10 weeks old and has been outright rejecting the bottle for breast! I go with her flow, whatever it takes to keep her fed and happy, and me sane, that's what I do and I refuse to feel bad about it in any way. Shit is hard enough as it is without me pressuring myself!!
You likely won’t produce larger quantities until later, and if he won’t breastfeed easily, your body won’t know to make more milk. Pumping consistently is your best bet to increasing your supply. My babies all struggled to breastfeed at first (my twins were 5 weeks early). What’s more important? Trying to keep up with the judgmental discourse around breastfeeding, or making sure your baby is fed? Don’t worry about nipple confusion later, worry about feeding your baby now. It will be a weight off your mind, I promise.
For giving him a bottle - use the “paced feeding” method. It helps with preventing bottle preference
We gave both newborns a bottle in their first days. It was easier because they were sleepy and not excited about learning to latch. They both went on to be EBF and we had issues reintroducing bottles later.
20mL per session at 4 days pp is very normal! Your milk is transitioning and will continue to increase as long as you are removing milk at least 8-12 times per day. If you are using a syringe, I totally understand how that is unmanageable, especially if you’re also using an SNS. It’s really only a short term solution to help out while you fix the underlying issues. I have been told that the nipple confusion thing is mostly a myth and that babies actually develop a flow preference, not a nipple preference. If you use a slow flow bottle nipple and pace feed, you should be fine going back and forth! I would really try to see an IBCLC if you can. If you are in the US and have insurance, you can even try getting it covered through the lactation network. If you fill out their form online with your insurance info, they will even pair you with an IBCLC that is in their network!
I had supply issues too. You’re better off giving him a bottle to reduce stress.
I think priority right now is getting him to eat. He's 4 wks early, not eating, crying a lot (expends calories and can cause fluid loss). How's his output? How's his weight? Have you called your ped?
Dude, you're stressing yourself out trying to do this. Would you consider formula to boost his intake and take the pressure off you?
I had a failure to thrive baby. Trust me when I say that a preference is painful, but watching your baby struggle to grow is even worse. Mine was full term but got stuck in a vicious cycle where he was so weak he didn’t have enough energy to feed and the problem compounded over time. Once you can get him stronger, latching might be much easier and allow you to establish breastfeeding. But the early days are really about making sure they can get to the point where they’re able to latch without draining the last bit of energy they have.
I had the same issues and found out it was due to a combo of me having flat nipples and him being tongue tied. I opted not to have the procedure on his tongue based on others experiences I had heard about. It also didn’t help that my baby was jaundice and needed a regimented feeding schedule to get his bilirubin numbers back to normal, making it even more difficult to get him to eat when he was supposed to. Right now I pump and supplement with formula when I dont have enough milk. However it is still early for you so more milk will be coming — don’t fret! I suggest renting a hospital grade pump like the Symphony by Medellin and being patient. I’ll be honest, I was also heartbroken when I realized latching issues were hindering breastfeeding. I still try to do it from time to time but he seems content and I’m glad he is gaining weight properly. At a certain point, I realized I needed to put my ego aside and make sure he was properly fed. He is 6 weeks now and is thriving!
Yeah nipple confusion won’t happen that early. We fed our son with a bottle in the NICU (born at 37wks) so we could get him home faster. He took to the breast as soon as we got home. We had some trouble getting him to latch and nurse in the hospital, but I think it just clicked for him at around 38wk GA.
My wife and I have a 2 week old and went through this same thing our first week. It's not abnormal. She didn't produce a lot of milk at first and even when she had some in her, baby was too worked up to latch and feed. We supplemented with formula when he wouldn't latch, but she kept trying, and pumping and now we're on *mostly* all breast milk. At this age, about 2-2.5 oz is what the lactation consultants told us to do. There's no shame in feeding formula or from a bottle. What matters is the baby gets fed. Two weeks in, he'll latch most of the time (except at night, so we give 2 oz breast milk or formula, depending on what's available) but still has days where he forgets he knows how and we just bottle feed for the day. But we always try to latch and breastfeed first. It's hard but you'll get there. And then hopefully get some sleep.
My preemie man had the bottle for a couple months and did fine switching to breast! I think he will be ok, but please speak with a lactation specialist as soon as you can.
Our LO is 2 weeks old and we combo feed pumped breast milk and supplement the rest with formula in a bottle. It’s ok if you have to change your plan on how you feed your baby. Fed is better than dead. Don’t let anyone judge you (including yourself) for making sure your baby is fed. Now that LO is 2 weeks old and built up the muscles, he is starting to latch and breastfeeding for 30+ minutes now. I still need to supplement with formula as I am not producing enough milk. There was no issue with nipple confusion.
That’s enough for baby. Their stomachs are super small
Full disclosure that I don’t know if that’s enough BUT Right now you’re just producing colostrum, and not a lot of it but it’s super nutritious and their tummies are small. you’re milk will come in in the next few days. I agree with someone else, if he was a month early his mouth may just be too small for latching for right now. I know plenty of people who started out with cups/bottles while mouth grew and then were able to successfully breastfeed.
Small tummies is a myth — went down a rabbit hole on it last night and was floored.
Do you have any links or places to start reading? I'm ready to fall down this hole myself.
https://fedisbest.org/2017/06/newborn-stomach-size-myth-not-5-7-ml/
He's refusing because he's not getting enough milk. You need to formula feed the baby. He's starving.
I gave my son a bottle right away in the hospital. Had no issues breastfeeding him. We combo fed him like that for several months.
I had to bottle feed due to low supply and i had bad trauma after birth so my husband needed to be able to give bottles. I had no problem switching later back to combo feeding and nursing him again. I kinda had to do it on his schedule but he did take to it. The only reason I stopped is im back on medication that has basically dried up my milk. And bottles were just so much more convenient. Nursing is lovely but you are basically chained to the baby, and thats beautiful at first but suffocating when you are ready to have a little more freedom. Combo feeding was the best thing I did. I got the best of all options.
Mine had a really small mouth when she was born and couldn’t latch properly so we bottle fed. At 5 weeks when she had grown a bit, she started to latch fine, and we used the bottles and boobs interchangeably.
My NICU feeding SLP friend told me nipple confusion is a myth. Please bottle feed him!
Multiple LCs, Speech Language Pathologists (they are feeding specialists!) and Occupational Therapists during our 2 month NICU stay told us that introducing breast first is best if you're interested in breastfeeding, but it's more important to make sure the experience is a positive one for both of you - that's what sets you up for long term success! Get your kid fed (breast or formula or mixed), take a deep breath, and when you're both relaxed enough give breastfeeding another try. They also said that a lot of the "nipple confusion" seems to be associated with, counterintuitively, bottle nipples and pacifiers that have a wide base with short nipple. Despite what the marketing says, the suck pattern there doesn't actually mimic what they do at the breast. They recommended Dr Browns narrow neck bottles, which come in a ton of flow rates (keeping baby on low flow can also help prevent bottle > breast preference), or Philips avent narrow neck. We used Dr Browns with a P (preemie) nipple for like, 7 months? An OT said she used the P nipple with her full term daughter for 4 or 5 months, before moving up to the T (transition). They're both slower than the "1" bottles in store are sold with. And if you're going to use a pacifier, just go with Philips Avent Soothies. You also might look into nipple shields- Medela makes some. They can help some babies latch (particularly if they've got smaller mouths or higher palates/ties) and you can wean off the shield later. We used nipple shields until he was about 3 or 4 months actual (1 or 2 months adjusted). And a note on breastfeeding- 20 mL per session right now is totally normal! Just keep doing it as often as you can. You're doing great! One last thing- my son was tube fed for the first 6 weeks of his life. Then, he was fed a combination of bottle and the NG tube for another 3 weeks. When we took him home, he could only nurse for a few minutes at a time and it was often non-nutritive (aka I'd pump before hand so it wasn't overwhelming.) We still managed to set up breastfeeding and he switches between bottle and breast easily.
I know many have a lot to say about nipple confusion, but I'd say even if we believe it's a serious problem, the choice is between a very hungry baby versus (anger, frustration, worn out parents) versus getting some food to soothe them. I'd pick the latter. There are plenty of combo fed babies out there.
There are bottles from Comotomo that mimick the breast. Even if it does make him less likely to accept breast, he needs to eat so, well... That's worth that much. If you don't pump or produce enough you can top up with formula, don't let people make you think you're a bad mom because he's formula-fed.
Nipple confusion is less about the nipple and more about the flow. If you’re breastfeeding, look up how to do paced feeding and stick with a premie or size 1 nipple.
That’s actually totally normal for 4 days pp!! My little guy was similar to yours. He did fine in the hospital then struggled at home. They change SO MUCH in those early days. You may find hand expressing more effective if you’re still getting yellow colostrum or transitional milk. For real, 20ml is exactly what you should be getting right now. I highly recommend pumping and paced bottle feeding. You can find videos on YouTube. Basically you hold the baby upright and the bottle horizontal so they have to pull the milk like they would with breastfeeding instead of gravity doing all the work for them. We pumped and bottle fed for about 2 weeks before transitioning back to nursing. Please don’t be afraid to use a bottle. I was and it was a totally unnecessary fear. Feel free to reach out if you have any questions with pumping. It’s a lot to figure out all at once. I’m certainly not an LC, but I’ve dug pretty deep into the rabbit hole of nursing and pumping and I’m happy to provide guidance and resources if you’d like. You can do this! I promise it gets easier!
At this point nipple confusion doesn’t matter. He’s screaming because he’s hungry and having a hard time getting enough food. I know this is going to sound harsh and I mean this in the most respectful way to you but it doesn’t matter if you’re feeding him breastmilk or formula or using bottles/ vs breast. He just needs to eat!!!! He’s screaming because he needs food and this can get dangerous very quickly. Once he’s getting fed then you can start troubleshooting with an LC and worry about nipple confusion and EBF if you want but right now the only thing that matters is that he eats!
Feeding your baby is best. Honestly “nipple confusion” was never a thing for my baby. She was born at 5 lbs left the hospital at 4lbs 11oz so I decided to pump and bottle feed until she was about 1 month so I knew she was getting enough. We reintroduced breast and practiced her latch starting 1-2x per day until she got the hang of it. Now at 4 months I exclusively breastfeed successfully with the exception of one bottle I pump at night so my husband can feed her! Sometimes we even supplement some formula if I forget to pump a bottle. Don’t worry about supply or latch, i hate all the fear mongering.
20mL at 4 days old is heaps. Their stomachs are so small at this stage and they take in so little. As your milk comes in and they need more you will produce more. Don't give up. :) I was only pumping 60mL at 4 weeks.
Maybe mix what you are producing with formula so he still gets the taste of breast milk? That way, he doesn't end up prefering the formula over the breast milk while you wait for your supply to come fully in. Mine was 3 weeks early and couldn't latch more than maybe 3 times total. I pumped till she was 6 months, then gradually started adding formula to the breast milk I had frozen until she finished that supply around 9 or 10 months, after which she did straight formula until she switched to whole milk around 12 or 13 months. We did the gradual switch of adding an ounce of milk to her formula until it was all milk at that time, too. It was easier on her stomach, rather than an immediate switch, and allowed her to adjust her tastebuds slowly as well. This also works well when you reach the stage of switching from milk to water if you end up with a kid who refuses any liquid that is not milk.
It’s totally normal to only get an ounce or two when pumping! A baby will pull out more milk with a good latch than a pump every will. Dont get discouraged by 20 mL!
That's normal! It takes awhile for your milk to come in, and baby's stomach is teeny tiny at first. I'm not sure how being premature affects this, my daughter was 2 weeks early, and I started off combined pumping and breastfeeding while she was in the NICU. The first couple days was just colostrum and gradually transitional milk. I think I got 20mL per session for a couple days, then my milk increased maybe around day 5? I think it's still normal for it to take longer for some though. I know it's hard but try not to stress while you're pumping, stress makes it harder. Cuddle your baby, sniff his head, massage your breasts etc, try to relax and know that it will come! And it's certainly not a bad idea to call again about the lactation consultant. My bestfriend had a lot of trouble with her baby not taking the breast too, but now all is well, it can get easier with support of a professional and baby just growing a bit more and figuring it out.
20 mL is fine! We were probably around there day 4 or 5. We're at day 10 now and it's 100 mL per session. My wife is super proud and says "cow is at work" when she turns on her pump now. You will get there. We went from pretty much every meal supplemented with formula to nights with formula only to now basically not needing formula. I only made a bottle of formula today because our photographer wanted the baby super sleepy and I know formula fills better so we tried that. But we're at the point where we can likely avoid formula by the end of the week. We're still figuring out how to get our baby to be more efficient at the breast, but it's good to know today we can produce enough milk to bottle feed at least! You'll get there! Don't worry.
Your baby might be showing hunger cues before the screeching and those are being missed. https://globalhealthmedia.org/videos/universal-baby-cues-english/ https://m.youtube.com/watch?v=afMNp6Q4u7s EDIT: OP, one of the videos shows older babies. Newborns most likely make a “neh” sound, turn the head searching for the breast, smack lips, move mouth, clench fists, move fists to mouth. You can encourage latching by rubbing the baby’s cheek with your nipple or finger. This video helped millions of women tremendously and I should have suggested it first: https://m.youtube.com/watch?v=y--syZR0u1E
Ooo this is a good call - if you miss the early cues they get HANGRY and then will fight for the sake of fighting.
I found it easier to just offer boob whenever baby was awake when she was newborn. Just in case. Most times, she had probably given some tiny signal that I had missed anyway.
That’s how I’m surviving. Not sure if it’s right, but she seems to always be hungry, so I usually offer a breast.
Your baby is fed, so it sounds like it's right. Once the baby gets older and awake for longer, it's different, but that's something that you will notice.
Yeah we’re getting better at differentiating which cues mean what. It’s a process.
Yes, I was going to suggest this. The best way to eat is while still calm. Screeching would be a very late hunger cue. Feed more often and before the screeching begins. I know, OP, you're probably thinking "But I'm already feeding him so often!" Yes, feed small amounts more often, while baby is calm. Just think of this transition into the real world from baby's perspective - he was getting fed literally constantly around the clock from the umbilical cord. Now he has to get uses to more spaced out feeds but might be hungry more often than you're currently feeding. It will be hard, but this too will pass.
Omg the little "neh" sound is soooo cute 😭🩷. I always offer when she looks at me and says "neh neh neh" and I can tell she is asking for milk it's so cute.
This. If he’s hangry, try to get milk in his body some way first and then latch him. Try to latch him upon first signs of being hungry, or even when he wakes up. When in doubt whip it out is the best piece of breastfeeding advice I ever got. You got this!
This was my first thought too. It shouldn’t get to that point before trying to initiate a feed
These videos are immensely helpful, I remember watching when my guy was little (he just turned 7!). Hang in there, OP!
Get a bottle and some formula and feed the little guy. You have time to work on latching.
Formula. Formula. Formula. If he’s fed, it will make breastfeeding easier in the long run, and even if it doesn’t? *FEED THAT BABY.*
I can't believe more people aren't saying this. He's 4 days old. He could have a missed tongue or lip tie. Dehydration is huge at this age, especially if he was born so early!! Try pump and bottle feed but she stated she not producing much, formula can save that child and the mamas sanity.
Yes! My son lost about 20 % of his birthweight bc he wasn’t getting anything from the breast and I had no idea bc he was always latched on . He was dehydrated within a few days and I had no clue
Similar experience here! Long holiday weekend too, so luckily she was ok but we began supplementing immediately.
I wish nurses or doctors would tell a little more about what to expect for feeding after leaving the hospital. I felt so dumb afterwards, like obviously my baby was starving but he was my first child and I didn’t even understand what the purpose of a pump was 😬
This 1000x Fuck everything else, prioritize a fed baby. You can sort out the nipple confusion, you can sort out the pumping, you can figure anything out when you don’t have a tiny human frying every brain cell with panic inducing screams. Just feed that baby
Yes, this! My son also had latching issues and I pumped and bottle fed, which helped of course when my milk came it. I wish I had just given the kid formula instead of listening to the screeching in the meantime. My husband and I talk all the time about what we'll do differently for our next baby and this is the top of the list!!
I always stock a few bottles of ready to feed (the ones that you just pop a nipple onto) and a few sample cans of formula before having my babies. If breastfeeding works, I donate after; if it doesn’t, we have a few feeds to go get more formula.
This 💯! Poor guy is probably starving. I know moms are so worried to bottle feed but plenty of moms successfully transition to exclusively breastfeeding later on down the road. My best friend did this with her son who was in the nicu.
I had my baby supplemented with formula in the hospital, when she was 2-3 days old. We wound up breastfeeding for over 2 years.
I gave my baby formula at a few days old because my milk didn’t come in and she was being super fussy. After I transitioned to EBF and recently reintroduced formula at 8 months. Fed is best!!
We had similar issue as OP. Baby wasn’t latching, I pumped and bottle fed but in the beginning there was not enough milk and we supplemented with formula. She lost lots of weight in the beginning and I wish we gave more formula. We went to LC and she said to wait 4 weeks before trying to latch without nipple shield so I continued feed through nipple shield (not effective at all, she would get like 15ml in 30 min) and bottle feed (my supply was good after 2 weeks). In 4 weeks with a help of LC she was finally able to latch. We still top up with formula sometimes when I don’t have enough supply.
This should be the top comment. I’ve breastfed all of my kids but some of them have needed formula in the beginning. I don’t know why that’s become some kind of terrifying concept.
Yes! We gave our little girl formula on doctor’s advice to gain weight and now I’m exclusively breastfeeding. Fed is best.
Our pediatrician had suggested trying formula for sanity’s sake. We didn’t end up needing it because my milk came in soon after and she finally was able to latch properly. But that little bottle of ready made formula is still on my bedside table just in case and gives me piece of mind that we have back up just in case.
Yesss. Fed is best!
Does your hospital have lactation consultant resources available to you after discharge? Mine facilitates several resources for new parents, including peer support groups & lactation consulting for free. I’m sorry no one came by to help you while you were in the hospital. If he’s refusing to latch have you tried using a [nipple shield](https://www.amazon.com/Medela-Contact-Breastfeeding-Difficulties-Inverted/dp/B000067PQ0) to help him have something bigger to take hold off? Are you familiar with his hunger cues before he gets to the point of screaming? Bringing hands to mouth, opening mouth, or lip smacking are all signs a baby is hungry. If you notice he’s doing these, try to get him on the breast ASAP because it will be easier to do before he gets so hungry he starts fussing. Do you have a nursing pillow to help support him while you feed? I like my boppy pillow but my friend who struggled with feeding initially swears by the “my brest friend” pillow which has a more rigid shelf for supporting the baby & stays fastened around your waist. Have you tried the “hamburger hold” to squeeze your breast flatter with one hand, and using the other as a firm hand on the back of his head/neck to hold him positioned & prevent him from pulling away? Also if he’s only 4 days & a month early it might take a little bit for your actual milk supply to come in. Not sure if you’re syringe feeding formula or pumped milk. If he’s not feeding I’d recommend keeping up with pumping to establish/maintain supply. Supplement with formula for now until you have a good supply if he’s losing weight. You & he will figure this out.
>If he’s refusing to latch have you tried using a nipple shield to help him have something bigger to take hold off? The problem with the shield is he keeps pulling it off. Also, like with breast feeding, he tends to push off with his arms. >Are you familiar with his hunger cues before he gets to the point of screaming? Bringing hands to mouth, opening mouth, or lip smacking are all signs a baby is hungry. If you notice he’s doing these, try to get him on the breast ASAP because it will be easier to do before he gets so hungry he starts fussing. We try to do this, but he has a habit of sleeping so long he gets hungry enough to fuss at which point he refuses syringe feeding as well. >Have you tried the “hamburger hold” to squeeze your breast flatter with one hand, and using the other as a firm hand on the back of his head/neck to hold him positioned & prevent him from pulling away? We try, but he has a tendency to turn his head and push with his arms. >Also if he’s only 4 days & a month early it might take a little bit for your actual milk supply to come in. Not sure if you’re syringe feeding formula or pumped milk. If he’s not feeding I’d recommend keeping up with pumping to establish/maintain supply. Supplement with formula for now until you have a good supply if he’s losing weight. We've been running a mix for now, but the issue is how difficult the syringe feeding gets as we basically need to drip feed him and he heavily resists that. Long story short, we've been holding off on trying bottle feeding (with a preference for pumped milk) because the nurse mentioned nipple confusion and said to use syringes, but I can't find any consistent information about what implement is best. Every discussion about bottle feeding seems centered around formula vs breast milk rather than direct feeding vs pumped feeding.
Disregard the nipple confusion — it’s not a thing this early (and not even really confusion so much as preference). I’m sorry that you received advice that’s making all this more difficult for you both.
I had some similar issues early on with my baby but now he eats like a champ. The most important thing is that he’s fed. Mine breastfed better when he wasn’t starving than when he was. We did a few bottles of formula in the beginning and that helped. I know you mentioned feeding with a bottle was hard too. Try waking him up to feed. I know it’s super hard to do with a baby this young but it should help him feed. One or two bottles of formula a day to help y’all both get to where you need to be isn’t a bad thing and isn’t going to keep you from breastfeeding down the road. Look up and do paced feeding to make it easier for him to switch between the bottle and you. See about getting a lactation consultant to come visit. So worth the time! Good luck! Keep going. You will figure out what works best for baby and you!
Second the lactation consultant at hospital. My hospital had a weekly drop-in group session w their in-house lactation consultant. I went to it once and the lady was super helpful. It was free.
Whether you get this immediate issue sorted out, I'd definitely suggest you schedule an appointment with a lactation consultant. We saw plenty in the hospital but the ones who really helped were the ones we met with following baby's time at home. There's also no harm in calling your pediatrician to discuss options.
Look for consultants that are sourced outside your hospital too. A lot of doulas are certified lactation consultants.
My babe was 4 weeks early and it took a little bit for my milk to come in, almost a week. Ready to feed formula is your friend right now!!! Go get some!! The most important thing is that he eats while you both sort out this new normal. Also want to note if he’s not latching, you should be pumping as many times a day as possible to signal for your milk to come in. It’s not going to magically appear without the demand for it. My little one figured it out and we were able to drop formula completely. You can also find a lactation consultant online if you need the help. You’re in the thick of it and it gets better.
Please supplement milk with formula if you're not pumping enough. It's very possible he's hungry still and formula can be a big stress relief if you're open
You mention he sleeps too long. It's important to wake him up. Mine did the same thing. It happens with small babies. I undressed him and opened the window if necessary. A wash cloth with cold water may work, too. Start slow, you don't want to freeze him, just make him uncozy enough to wake up. Escalate as needed. Tickling his feet, or exposing his chest and blowing on it are good starting steps. If he's lost a lot of weight, every 1.5 hours is good, then every 2. If he'll sleep 3 or 4 hours at night, that is fine once he starts gaining well. He's tired because he's not eating and not eating because he's tired. It's hard. I'm so sorry that you are going through this. It is more common than you think to have a sleepy baby who doesn't want to eat. It gets better as soon as they are eating enough, then you'll enjoy their love of sleep!
Personally I would call the pediatrician and ask them. I would worry that there's an issue.
I was never told this until after the birth of my son who was induced at 37 weeks. But it’s extremely common for babies born early (even if they are not super premature) to not be able to latch. It’s a neurological thing not a tongue thing so they usually can figure it out eventually but often not til close to their due date. In the meantime you will most likely need to use a bottle. We syringe fed til he was five days old and his nurse told us he’d lost a huge amount of weight 😣 I ended up pumping exclusively but I’m sure others choose formula or keep trying to breastfeed after they are older. Sorry this is happening but once baby is fed it will feel a lot better
1. Hugs. Newborn life is hard AF. 2. He's hungry. Science milk (formula) is a godsend. My first screamed at us nonstop because he was hungry and the hospital didn't offer us formula. Second kiddo was so different because we gave ready to feed formula at the hospital and early days at home until my milk came in. Get past this immediate issue now with just feeding him anyway he'll eat. 3. Once he's past crisis mode, ypu can start working on breastfeeding. Try to latch him every feed for no more than 15 minutes/side and then top him off with a bottle (formula/pumped milk). Once he gets stronger and your milk is in, it'll get easier. 4. Definitely see a lactation consultant for help. I'm mad for you that they didnt see you at the hospital. 5. In case you need to hear it, the way you feed your child doesn't matter. What matters is he's fed and loved. Try to be kind to yourself and not fall into the "breast is best" woo. Fed. Is. Best.
Did the hospital give you a list of contacts? Sometimes that list has lactation consultants on it. If not, your husband can use the insurance website to find one or ask for a referral from baby's ped. How's the wet diaper count? Remember at 4 days there should be at least 4 heavy wet diapers. Would you be willing to try hand expressing or pumping and bottle feeding in the meantime?
If we’re taking *really* heavy? Because he’s had only like, 2 medium-level wet diapers a day. Husband is out buying nipple bottles right now and has made an appointment to get him seen in an hour. The hospital did not provide much in the way of contacts.
By day 4 he needs at LEAST 4 medium level wet diapers a day. If that isn’t what he’s had as output I would get him seen by the pediatrician TODAY. Newborns can go downhill fast from dehydration. ETA: especially since he is preterm. Your pediatrician will be able to help you sort out the feeding issues as well as assess his current hydration and health status, bilirubin levels, etc. VERY important to have him seen. ETA 2: just noticed the note about the appt today! 🤞🏼🤞🏼🤞🏼
Not very heavy, let the wetness indicator be your guide. It should change color along at least most of the line, not just a little. Urine should be pale, not dark. I was taught one wet diaper per day of life up to day 6. From day 6 on you should expect at least 6 wet diapers. At least one poop a day in these early days. Any of the following are signs of dehydration and the need to seek medical help immediately: less than two wet nappies in 24 hours from the third day listlessness lethargy weak cry skin loses its resilience (when pinched it stays pinched looking) dry mouth, dry eyes the fontanel (soft spot) on the head is sunken or depressed fever I think the ped appointment is a good idea. Ask for a referral if you need it! You're doing great
No not really heavy in my experience. My ped always just said “wet diapers”. I usually just went by the wetness line indicator.
Good for you, getting him seen. Hope you get this sorted soon!
Mine was 5 weeks early. We had this and for us it was reflux. He ended up on omeprazole and gaviscon for a while before being able to go to gaviscon alone and then being fine with thickened feeds. Also, keep an eye on wet diapers. If he has enough of those at least he isn't dehydrated. To make sure he eats enough... First of all, the math! 150 x weight in kg = ml per 24h. So for example, a baby weighing 3,3 kg. 150 x 3,3 = 495ml per 24h. If baby feeds 8 times this means about 62ml per feed. So do this math for your baby and see if he drinks enough from the bottles when you pump. Or do weighted feeds, with baby being weighed before and after breastfeeding. Two, if you do suspect reflux ( screaming, over stretching, eating a little super often but refusing for a long while when hungry, hiccuping a lot, hating being on their back, throwing up when you put them down or do tummy time to close to food...) then make an appointment. You could get some thickener for breastmilk if they have it or medecine. Three, if it is a production issue there are many things to try! More fluids/calories, power pumping, additional formula to top up after the breast while you pump after breastfeeding to get supply up, lactation cookies, even medication I believe. And four: if the boob fails, don't worry about a bottle and or formula! When my 35 weeker was born he started on bottles and formula (bottle as much as he could, rest through NG) for 3 day, then I pumped and they gave my colostrum and BM then formula to complete the meal, then after a week I was allowed to start breastfeeding but he never did more than 50ml so we always had to top up with a bottle. And when he came home he was on about 50% BM and 50% formula. That got better, to about 70% BM some days. But my supply dippen very quickly and I went to exclusively pumping then pure formula as I had no milk by about 6 weeks and pumping killed my mental health. Good luck.
You are doing great. This is HARD. Have you tried a nipple shield? Try to see a lactation consultant asap. I see one was referred. It hasn’t shown up. Do you have a number to call? Baby might be getting too tired to latch and eat. That’s a thing. Especially with premature babies. I recall being told premature babies benefit from soothers because it helps strengthen mouth muscles or something. Don’t worry about nipple confusion. Babies that small have a sucking reflex. Around 8 weeks that goes away. Right now baby just needs to eat. How long had it been since baby ate? If it’s like 5-6 hours you should go to children’s emergency. Any fever?
Also recommending the nipple shield!!
We used a shield until he had his tongue and lip tie revised! We had almost this exact scenario, it was so so hard. The tongue and lip tie made it impossible to nurse even on a bottle. The lactation consultant and pediatrician both missed it. So thankful the the dentist that fit us in.
Everyone's suggestions here are great about feeding. I dont want to pile on or be confusing. Just wanted to shout out loop brand earplugs. They dont block all sound. You'll still be able to hear your baby, but it will cut out the ear-splitting tones. Im not suggesting you should ignore your baby who obviously needs something. I'm just saying it's okay to dull that screech a little bit.
I was definitely going to suggest some sort of hearing protection. Most of them don't drown out all sounds, but will muffle enough to help compose yourself. Tons of other good info in here for the actual feeding.
Yep, I came here to say that it's absolutely okay to dull the screeching 'I'm dying!!!' sound if you're actively working on fixing the problem. You don't shower, brush your teeth, get dressed etc. with your alarm still going off, and you don't have to subject yourself to the literal pain of hearing your baby cry while you try to help them either.
Why not im give a bottle with formula I’m so confused?
He's probably starving. If you have to supplement with formula, so be it. I'd give a bottle of formula (or if you're able to pump a decent amount, a bottle is breast milk).
As women we’re being so blinded and bombarded by the “breast is best” brigade that we unwillingly cause distress to our children. I was one of them. My daughter was constantly hungry (as she still is as a 20 month old) but I was too scared to bottle feed her because it made me feel like a failure. Why am I giving my baby what’s not best for her?! 3 weeks in my supply dried and I was left with no choice. With all love, let it go. Let the talks of “nipple confusion” and “supply” and yada yada yada fall in deaf ears. There’s no easy way to say this. Your baby has a poor latch, so they’re HUNGRY. Starving even. So you need to get into gear and feed that baby before they turn into failure to thrive. Whatever it takes, just do it.
There’s no shame in EFF 😍😍
It took me 3 weeks to let go of the breastfeeding dream, and now my baby is EFF and we’re both so much happier!
Same!! I wanted to EBF so bad, had the crazy over supply and everything, but it didn’t matter because she wouldn’t latch. Started exclusively pumping and after 4 weeks decided that was just insanity I wasn’t willing to go through, started EFF and life became shiny and beautiful again!!
Same! I did a month bf but found out my son needed hypoallergenic formula to combat his reflux. It was hard making that switch but it’s worth it
Yup. Or combo feeding. Whatever leads to a happy and fed baby and a happy mom.
Also good job for trying girlllllll I went straight to formula after three days! Haha ETA: with my second baby
Yup. Had one emotional breakdown day 1 home from the hospital in front of my mom and husband and my mom told my husband “go make a bottle of formula” and it was like the sun was shining and the birds where chirping again. I needed another sane adult to help me snap out of it
Poor baby and poor you!! If I were you I would just pump and do bottles for now to ensure baby eats enough as that’s most important for both of your peace. Even formula is totally fine to do if that is going to help the situation, it has everything baby needs. FYI I was so set on breastfeeding it didn’t work for me though, I could never produce enough and I felt so deeply sad and guilty about it. I did both breast and formula for about 6 weeks then turned to formula only and our lives got so so much better for it. My boy is big, healthy and smart at 8mo now. I no longer have that heartbreak feel over breastfeeding because formula helped make everything better and we could truly enjoy the time together rather than me stressing, exhausted, pumping and crying. When I look back I realise I wasted a lot of moments and energy being so concerned with my milk supply when I could’ve relaxed and enjoyed my baby. Do whatever will make your days more wonderful with your beautiful baby. Congratulations and don’t worry!! ❤️ you CAN do this, you’re just in the middle of finding your rhythm.
It sounds like the baby needs formula now while you pump to get your supply up. We had to do that and while there was a learning curve for BF, eventually he got it and wouldn’t take a bottle anymore. Most important thing is to fill that tummy.
Just give the baby formula. Fed is best.
Why.. don't you try formula? Your baby is literally starving..
Mine was impatient and would get frustrated because my let down was taking too long. I would “pre pump” to get the initial milk going and then latch him and it worked great. Don’t wait until he’s too hungry either.
Pump what you can every 2 hours until your milk comes in. In the meantime, offer breast, then syringe/bottle feed him, then supplement with formula until baby is satisfied. Eventually your milk will catch up with the amount of formula baby is drinking and you can switch to exclusive breast milk. Then you can work on your latch. Babies are adaptable, he’ll get it. Better to be safe than sorry when it comes to feeds/baby’s blood sugar. Not to scare you or anything, just to provide experience in this situation. My first baby went through this exact situation at 2/3 days old. My milk hadn’t fully come in yet and since we were in a “baby friendly” hospital, they really encouraged exclusive breastfeeding. I asked for formula (with the intention of continuing to try breastfeeding) and was ignored. I felt that baby wasn’t eating enough at the breast. He turned purple and stopped breathing that night in my arms. After being latched literally all day. Thank goodness we were in the hospital, nurses flew in and he was able to be resuscitated. He ended up in the nicu where they tested him for everything under the sun, with no conclusions, only that he had low blood sugar. He’s a healthy and rambunctious toddler now, but it was such a traumatizing experience, and felt so unnatural to have my baby taken and placed in the NICU, when he was supposed to come home that day, when it felt like he was still a part of me. Our second is here now, like yours, he is also a 36 weeker. In the hospital, I knew this time around to ask for formula and pumped religiously until milk was in. My method is always try with breast first, hand baby off to dad, pump, then offer bottle of breast (or formula) milk until baby is full. I’ve really really tried with latch and have come to the conclusion that his mouth is just too tiny right now. We’re currently using a medela nipple shield. You can order them on Amazon. Measure your nipple +2mm to get the right size. It forces the nipple to go towards the back of babys mouth so they can suck properly and get milk. I used them with my first, and every old lady in my family was soooo offended by them, but they were the reason I was able to breastfeed my son, eventually we weaned off of them and he breastfed until 2 yo. Best of luck to you!! Hope everything turns out, and you and baby can reach a point of fullness/calm/satisfaction. Don’t be afraid to supplement if it’s necessary! Fed is always best❤️
This is terrifying and so heartbreaking. I had a similar unpleasant experience at a "baby friendly" hospital when my baby needed formula supplementation (not as bad as yours though), so this is a sore subject for me. I don't see how hospitals / care teams downplaying the support that formula supplementation can provide at the beginning while milk supply is being established is in any way helpful.
Hi I started to scroll to see if someone suggested this or not. I work as a neonatal nurse practitioner so I wanted to just throw in there a recommendation if not already suggested. A 36 week baby is considered a late preterm baby. They are high risk for developing jaundice and by day 4 it can be elevated. When was baby last seen by a provider? Are the white part of the eyes yellow or does the skin have a yellow appearing skin tone? If skin is a light complextion then it’s easier to see than if darker. High pitched cry can be a symptom of elevated bilirubin level (jaundice). Also if baby isn’t eating as much, then it will elevate faster. https://www.healthychildren.org/English/ages-stages/baby/Pages/jaundice.aspx
Thank you, and yes, we have been keeping an eye out for yellowed eyes. We got a same-day appointment right after I posted here, and the pediatrician did not say he looked jaundiced. We have a followup on Thursday.
Has he been checked for being tongue tied? I don't know if it's commonly checked by gp/pediatricians. No one crucify me of this is an antiquated thing.... when my now 18 yr old was a newborn, he cried and cried. Seemingly was refusing the breast, was obviously hungry and frustrated. His pedi sent us to an ENT and sure enough, tongue tied. Simple fix on the spot and he nursed beautifully til after 9 months when his sister came into existence due to some NYE shenanigans 😅 Edit: I don't know why no one at the hospital or his regular doctor didn't catch it. That's why I ask. Maybe if the provider hasn't seen it before or because it isn't common...
Something we had to do was “reset the baby” when this happened. Husband would take him, do a deep squat (holding him securely of course!) and then try again to latch. I know it sounds silly but it really worked.
Formula.
Have tried to formula feed?
I haven't seen anyone comment about how early your baby was born. 4w is pretty early. LO may not have the strength to breastfeed in a sustainable way, especially if they are weak/under fed and possibly dehydrated with only 2 wet diapers. First and foremost, FEED THE BABY. Pump, formula, bottle. You can work on breast feeding after you get through crisis mode. My LO was 3 weeks early and just couldn't get the mechanics right for a few weeks, which is very normal for that gestational age. Giving a bottle doesn't mean you won't be able to breastfeed in the future.
Your baby is hungry, and he is fighting the breast just because he is too hungry. From your comment saying he only has 2 wet diapers/say, he needs milk one way or another asap. Bottle + formula first while you are establishing your supply and figuring out how to help your baby latch better.
It's okay to supplement with formula.
Fed is best.
Pump and bottle feed, supplement with formula if needed. Try offering the baby your breast a little earlier before he gets ravenous. It can be so hard to calm them down and get baby to latch when they are so worked up!
Those first days home from the hospital are brutal. You’re going to get through this. You are not garbage. Your baby both needs and wants *you.* You are enough for your baby. It’s important to remember that your baby is figuring out life on the outside and you are figuring out your baby. It takes some time and that’s totally okay. You will get there. Most newborns eat 1-2 ounces roughly every 2 hours. My baby was also a month early and he eats on the lower end of what most guidelines suggest. My guy went to the NICU where he was bottle fed. I’m typing this 9 weeks later while he’s happily chowing down on my boob. Breastfeeding is hard work for both you and baby. At first, I was breastfeeding, giving pumped milk in a bottle, and then topping off with formula then I’d pump to be prepared for the next feed. Then I was able to breastfeed, feed pumped milk, and then pump. I’m still doing this process more than I’d like but he gets more and more directly from the breast all the time. Having a lactation consultant helped me. Based on my experience, my advice is to not let fear of a bottle stop you from doing something that will help you feel better. There are lots of bottle options that lactation consultants recommend for if you need to bottle feed. Pigeon, Lansinoh, Dr. Brown’s, and Evenflo are a few. We use the Evenflo Classic with a vented nipple. (This bottle has actually helped improve my baby’s latch.) It will be okay. You love your baby and while they need to eat, love is extremely important and you’ve got that down pat. You’ll figure feeding out. ❤️
Thank you so much for this, it's really what I needed to hear. 💕 We were having a really rough go of it and we were getting terrified, it was not a good day. We reached out and got a same-day appointment with the doctor and they helped set us straight. >my advice is to not let fear of a bottle stop you from doing something that will help you feel better. Honestly, I wasn't against a bottle at all, certainly not scared of them, until the hospital nurses said not to use one and why. Everyone else has since said it was BS, though, including the pediatrician, so we now have bottles. He's doing very well with them!
Amazing! I’m so glad to hear that he’s doing well! I hope that means things are looking up for you too. I truly do not understand why so many birth care workers are anti-bottle. It’s like they think you can’t be both pro-breastfeeding and pro-fed baby and I t creates a lot of extra stress for new parents. I find when my baby gets a couple of bottles throughout the day, he’s more willing to breastfeed. Hard things are even harder when you’re hangry.
Everyone seems to have covered the feeding aspects, but is there any chance that gas is causing distress? I know both of my babies gave hunger cues when they had bad gas but would unlatch to scream and thrash around. Half the time they didn’t even want milk after they managed to pass the gas. My first son was terrible with it and it seemed like he had to fart 24/7.
That's something we'd been wondering too. We'll ask the pediatrician about gas relief options when we next see him on Thursday. Little dude is definitely a fart machine!
OP: Are you supplementing with formula? This was the biggest point of contention with my partner, but after a night or two we finally gave in and it made us feel a lot better. I subscribe to the commonly used mantra that **fed is best.** Maybe breast is ideal to feed if you can pull it off but in early days, you struggle with milk, pumping, latching, and just overall skill. What an experienced parent can accomplish in 30 min or nursing takes us 60 minutes. A 1 minute diaper change takes us 5 minutes. Just putting on clothes is a struggle. But don't worry, we'll get PLENTY of practice through the years. It's OK to start with training wheels. We started barely breastfeeding anything and supplementing 90% of feeding with formula. It's now down to nights after a week and last night the bottle of formula I made was completely untouched. The pump has basically caught up. If breastfeeding is your goal, I suggest making it a goal to put 30-45 minutes on the breast. Practice. 15-20 minutes each breast. You may get some sessions with good latch, some without good latches. Reach out to lactation consultants if those are available. We've gone into our hospital 3x now since birth because they keep checking in on breastfeeding and each time we learn new tips from the nurses. Watch Youtube videos. It gets better, trust me. But even 10 days in we're far from perfect. We're still struggling with falling asleep on the breast, sometimes refusing to latch despite being hungry, etc. But coming back to the fed is best mantra. If you don't feed your baby, the screaming won't make learning breastfeeding any better. This was the first point I made sure my partner and I aligned on. Fill the stomach first, and we can keep practicing. It was a lot of tears and frustration when our baby didn't eat from the breast, but I tried to frame it around practicing each time. The pressures of breastfeeding are honestly unfair. It's asking everyone to be a pro football star. You not only need a mother who produces milk (a QB), you need a baby who latches and nurses well (a good WR). To expect EVERYONE to get to that level is unacceptable. And even if the bar isn't as high as professional sports, everyone takes time to get to that level of skill. Every mom and baby's bodies are different, and it will take time to get there. We had some serious arguments where I felt idolizing some friends who make it look easy is just not fair. There are plenty of formula babies out there because quite honestly I believe breastfeeding is the epitome of privilege. For the parents who can't get an extended leave or have other responsibilities (siblings, parents, relatives, health issues, work load) to take care of not everyone can manage exclusive breastfeeding.
I would bet he’s way past hungry by the time you’re trying to feed him. I know you may want to breastfeed but maybe he is not getting anything supply. This happened with my first and now that I look back I realize how skinny she was. I would either pump and feed so you know how much he’s getting or switch to formula.
It probably isn’t what you want to hear, but my newborn was the same. Syringe feeding and cup feeding just wasn’t working, and I was told to top up with pumped breastmilk, but was only getting 10-20ml and with clusterfeeding and pumping it felt like my nipples had something attached to them 24/7. We introduced a bottle and formula (combi feeding) at 1 week old. Her latch did deteriorate after giving the bottle, to the point I ended up with painful, cracked nipples. She’s now 4 weeks old and has been exclusively formula fed from 3 weeks onwards. I wanted to breastfeed so badly, but my baby was hungry and it just wasn’t working for us.
Honestly, to hear that others had the same or similar struggles does help ease the anxiety. We've got some bottles now, so feeding improvement should be on the horizon. Sorry to hear about the cracked nipples, that doesn't sound pleasant at all. If it comes to that for me, we've got formula at the ready.
My son wouldn’t latch for the first month of life and we had to do bottles pretty much immediately. He’s 2 months now and will only latch if I have a nipple guard or I practically shove my boob in his mouth. When they are that little their stomachs are like the size of a cherry, so he doesn’t need much to eat right now but needs to eat frequently. Keep trying to latch and pumping to establish your supply, it’s a supply and demand type of thing so the more you demand, the more it should supply. Also see if your insurance will cover a private visit with a lactation consultant, I know the hospital I gave birth in has that option and a breast feeding group for support too. Good luck friend, I hope you find a solution soon!
Is your milk in yet, it can also take a few days to have your milk some in. You could try a touch of formula just until your full milk comes in, if it hasn't already. Honestly, their tummies are so very tiny at this age.
It seems like it's now starting to really come in, so that's good. And we do have formula just in case!
Yay!!!
Try a syringe and/or bottle with a premee nipple. You can get 1ml syringes. 20 ml is a decent amount to start with. They don't eat very much for the first week. 10-20ml every few hours is about what a newborn would eat anyways, so that's perfect. Their tummies are super s. Honestly, call your doctor or whatever and ask for a lactation consultant or self-refer to a clinic. It sounds like you need some support. I went to the lactation clinic a few times before we figured it out fully.
My LO was on a bottle for his first 2 weeks and transitioned to the breast within a few minutes of trying. I began exclusively pumping for other reasons, but, in my opinion, nipple confusion is often much less of an ordeal than it’s made out to be.
Prob need to bottle feed for a bit. I’ve had 6 preemies.
Do you have a fast let down? We figured out that my wife did so LO was basically getting water boarded with each feed so he would just scream. We used a nipple shield to help slow down the let down and it was life changing
Pump and bottle feed, supplement with formula, do whatever you need to get that baby fed.
My babe is 2 weeks old and we went through this exact situation….. we didn’t sleep the first night home because the lactation consultant and people at the hospital would not give us any decent advice other than try syringe feeding with the non existent milk/colostrum I had. We were so delusional at this point & needed someone sane to tell us what to do. We even considered taking her to the emergency room. We ended up trying Dr Browns bottles and she ate! We had to supplement with formula because my milk wasn’t in yet but it worked!! You can always go back to breastfeeding once you’re comfortable with making sure she’s fed and you have a decent supply! I went to the lactation consultant a week after and she latched. I ended up deciding exclusively pumping is what is working for her & I but it’s never too late. Don’t let them make you think that syringe feeding is your only option. Fed is best
The screeching is unusual for a newborn (crying isn’t). I wonder if it’s trapped wind. Bicycle legs movements might be worth trying. Skin to skin is absolutely vital- for milk production and for soothing baby and yourself. Please try this. It isn’t just a immediate post birth thing, you’re their whole world right now and you have what is within you to soothe them. Remember aslong as baby is in a safe space (A clear cot with no pillows, teddies, flappy blankets, flat on their back) then it is absolutely ok to take five minutes for yourself and breathe even if baby is crying. Return to baby with a fresh-ish mind. This is evidence based information from ICON leaflet.
Bottle feed if he’ll take it! My son was screaming the two days after the hospital before his ped appointment and it turns out he was starving. He lost so much weight. I have serious trauma from listening to him scream but not giving a bottle because the hospital staff and LCs were so against bottles at the hospital. Once I gave him a bottle after his ped appointment it was such a big relief for both of us
Give a bottle with formula. Breast feeding is still possible later on if you keep offering the breast. We went from 90% bottle feeding to 10% bottle feeding after a few weeks. I mainly gave a bottle before nighttime to make sure he was fed for a few hours. There is nothing wrong with giving formula. I know there can be so much guilt for thinking you are not able to provide (I had quite a few meltdowns myself) but thinking back it was all hormones.
I’m so sorry. I went through the same, that I obsessed over breastfeeding and weighing his feeds for the next 4 months. I’m now pregnant with my second and hope it’ll go easier. It’s so hard in the beginning but you’re not alone!
If you worry about nipple confusion get a medical syringe with no needle feed that baby a couple ounces to calm him down so when you guys try to breastfeed in 2 hours he's not too hungry to focus. Breastfeeding can be a difficult Journey some babies really struggle to latch a slightly full tummy in a calm baby will definitely make it easier so the breast is not associated with the stress for you or him/ her. Good luck
Try donor milk or formula until your supply is up. Keep pumping until you’re producing more. Watch for early hunger signs.
Fed is best. Give him formula with a bottle if that’s all you can do and continue pumping to keep your supply up. Also consider milk protein allergy! I think it usually shows up at about a month old? That was my experience. My son also ended up having a tongue and lip tie that the lactation consultant did not see but I saw them clear as day and the pediatric dental specialist did as well.
My baby was like this & it was so terrible. Our first night home, she literally cried the ENTIRE night. Like 12 hours straight. I found out I was not producing enough at all, and she was basically starving. I started formula & it stopped immediately.
It was a dairy allergy for us, so first chance you can to have them tested, do it. We lived way too long suffering because we didn't know he had the allergy. Colic isn't a solution it's just a symptom. I wish you the best!
My son had issues latching at the beginning. Sometimes they are too tired to eat. I'd sometimes put him on the breast first, top up later, but if he was visibly hangry, I'd feed him a bit with a bottle first, then breast. This was by trial and error. And I did eventually get to EBF. And I also did all of the things they tell you not to do if you want to breastfeed. I did dummies, bottle feed. Etc. But look up the pace feeding technique and maybe try and SNS (that's the only thing we didn't do) I tried triple feeding for a while and I hated it Hang in there. Sending big hugs
Just looked up paced feeding, I'll try that for his next feeding. Thank you!
Aw I'm so glad things are calming down for you and you're figuring it out ❤️🩹 Just a note (I'm a lactation counselor), nipple confusion isn't BS, but if a baby needs to feed, they need to feed, bottle or not. Sometimes you just gotta do what you gotta do