Feeding FAQ: 0-8 weeks – Breast Feeding

Question – Worried about milk supply

My second baby is due any day and I am fretting over breast-feeding as I failed miserably with my first for various reasons, and ended up with bleeding nipples and a very poor milk supply. Having read some other people’s suggestions about increasing milk supply, I’m a bit confused, so would love some clarification.

The advice seems to involve fenugreek, fennel, Weleda mother’s milk tea and blessed thistle. I can’t seem to find a UK company that makes Weleda’s tea. Should fenugreek and fennel be taken together?

Answer:

I’m sorry to hear you had such a hard time breast-feeding with your last baby and wish you the best of luck this time around. I’m impressed that you’re so keen to succeed. Firstly, do be reassured that having trouble feeding one baby doesn’t always mean you have difficulties the second time around. Part of breast-feeding success is the teamwork between mother and baby, and some babies do just seem to take to it better than others, making it easier or more difficult for their mothers and changing the likelihood of bleeding nipples and other problems.

You’ve obviously been spending some time researching ways to increase milk supply. I would suggest that you try to establish a good milk supply by feeding and expressing frequently (as outlined in The Contented Little Baby Book) before trying special teas or herbal remedies. You could also contact specialist breast-feeding consultants through groups such as the UK’s National Childbirth Trust or the La Leche League, who have branches across the world.

While many people take herbal remedies such as fenugreek without any obvious adverse effects, and feel that it does increase their milk supply, it’s important to remember that we are taking them as a drug. Even though they are herbs and should be safe (apart from possible allergic reactions) in the amounts used to flavour food, as herbal remedies they are being taken in larger amounts for the effects of the chemicals they contain, just as we would take medications from the chemist. Anytime we do this, we need to be aware of possible side effects. For example, fenugreek, while generally considered to be safe, contains substances that may thin the blood and may reduce blood sugar levels. It can also have effects on the digestive system, such as diarrhoea, and some asthma-sufferers have reported that their asthma worsened when they took fenugreek. It’s also possible that people allergic to peanuts, soybeans, chickpeas or regular garden peas may find they react to fenugreek. Do note that this herbal remedy should not be taken while pregnant – it has been traditionally used to bring on labour, though its safety and effectiveness in this area isn’t known, and could increase the risk of miscarriage or early labour.

Another issue to remember is that any drug or herbal remedy carries the possibility of interactions with other drugs or herbal remedies you may be taking. So fenugreek could potentially increase the effect of blood thinning medications (which you might be put on in a medical emergency, without a chance to discuss any herbal remedies you are taking) and of diabetes treatments, with dangerous consequences. For all these reasons, I recommend that you discuss any herbal remedies with your GP before taking them. This should also mean they are listed on your medical record, just in case you were taken into hospital in an emergency. This includes herbal teas, as again they are being drunk for the medicinal effect of the herbs they contain.

One last point: remember that anything we take into our body while breast-feeding may end up in our baby’s body via our breast milk. Their little bodies can be more sensitive than ours. It’s definitely a time for extra caution and checking first with a medical expert.

Sleeping FAQ: 0-8 weeks – Night Waking

Since moving into his cot my 7 week old is waking more in the night

Since moving my 7-week-old baby from his moses basket into his cot he has started to wake up more in the night. He used to take a 4-5oz feed at 11pm, then sleep until nearer 3am, take couple of ounces and then settle well and sleep till until 7am. But now after his 11pm he can wake any time between 1am and 3am. I am confident that he is not hungry, and try not to feed him before 3am. But I often spend from 1am till 2.30/3am going to him, rubbing his tummy or putting his dummy in to get him back to sleep. At 3am he will then take between 2-4 ounces then wake again at 5am. Once again I go to him, put his dummy in then eventually give up at 6am and take him downstairs for his first feed. I am exhausted trying to cope with this as I have a 4-year-old as well so the daytime nap timings are not easy to put in place.

He naps at 8.30-10am, 12-2.15pm, 4-5pm.

He takes 4-5ozs at 7am, 4-5ozs at 10.30am, 3-5ozs at 2.30pm, 2-3ozs at 5.15pm, 3-4ozs at 6.30pm, 4-5ozs at 11pm and 2-3ozs at 2.30/3am. He weighs 11lbs 13ozs.

With a baby under six months of age the Moro reflex can still be very strong, and when they come into a light sleep they can often waken fully and find it difficult to settle back to sleep if they have kicked their covers off. If you use a 0.5-tog sleeping bag, this will enable you to also use a thin top cotton sheet to tuck him in well and prevent him thrashing around, without causing concern that he could overheat. Place the cotton sheet lengthways across the cot, and tuck at least six inches of the sheet well under the mattress, then push a rolled up towel down either side, between the mattress and the spars of the cot.

It would also be advisable to look at the amount of daytime sleep your son is having. Because his nights have become very unsettled he probably is needing more sleep during the day than recommended for his age. A vicious circle can soon evolve if this is allowed to continue. Rather than letting him sleep until 11pm in the evening, we would suggest that you begin to wake him at 10pm. As soon as he is well awake offer him a 3-4 oz bottle. Then let him have a period 20-30 minutes of quiet play under his baby gym.. This can be in a room which is quite light and has some background noise. Between 11/11.15pm you should take him to his room, change his nappy and then offer him as much as he will take of a fresh 2-3oz bottle of milk. Ensure that he is burped and tucked in really well following the instructions above. By having him awake longer at the last feed, and offering him a split feed, he should start to sleep longer and more soundly in the night. When he does wake in the night it is important that you offer him a big enough feed so that he settles back to sleep quickly, and sleeps through until 7am in the morning. It is pointless cutting back his middle-of-the-night feed if it results in him being more unsettled in the night and needing to sleep more during the day. Once he goes back to sleeping longer and better in the night, you should aim to gradually reduce the amount of sleep that he is having at his morning nap. Try keeping him awake five minutes longer every few days until he is going down nearer 9am. Once a shorter nap is established at 9am, you can gradually cut back the late afternoon nap. Once he is taking a shorter nap in the morning and later afternoon, you should be able to cut back the time he is awake at 10pm. Again do this gradually reducing the time he is awake by five to ten minutes every few nights, so that he continues to sleep well throughout the night.

Finally, do remember to keep increasing your baby’s feeds during the day. Once he is regularly draining his bottles it would be advisable to increase the amount you offer him by an extra ounce. Check the CLB book for details of which feeds to increase first. If you are unsure as to exactly how much your baby needs to drink for his age and weight you should discuss this with your health visitor or GP.

Sleeping FAQ: 0-8 weeks – Night Waking

Q. My six-week-old twin boys, who were born three and a half weeks early, have put on weight well, but can be quite sleepy by day. This seems to be affecting their nights. They are still waking twice in the night around 2am and 5am. The amount taken at 2am can vary between 2-4ozs. When they wake at 5am and again at 7am they are never very hungry. We also find that they take a large feed at 5/6.15pm, which means that the 10pm feed can be quite small.

I have tried two ways to deal with the 5am waking: the first way is to try to settle them with a dummy without feeding them, which takes some time; the other way is to split the feed between 5am and 7am.  Neither approach seems to improve their interest in feeding at 7am. During the day they are very slow to feed, sometimes taking up to an hour each.

A. To help the twins sleep for one long stretch in the night, it is important that they take a take a good 10pm feed. To ensure that this happens, give them the larger part of their split 5/6.15pm feed at 5pm, and a smaller feed at 6.15pm. Begin to wake them at 9.45pm and ensure they are well awake before you start to feed them. Take them into a well-lit room with gentle background noise. Once they have taken as much milk as they want, let them have a quiet kick until 11/11.15pm. Change their nappies and offer them a top-up feed before settling them back to sleep.

If the twins have fed well at 10/11.15pm, they should be able to get to 2.30/3am before they need their next feed. Although it can be tempting to feed and settle them quickly at this time, it is better to spend some time ensuring they are properly awake, so that they will take a full feed and will hopefully go through to nearer 6/7am in the morning.

Even if the twins are still swaddled, make sure they are tucked in well at night as kicking the covers off is another reason, apart from hunger, that tiny babies tend to wake up earlier in the night. Use a cotton sheet spread lengthways across them and tuck at least six inches each side under the mattress. Secure the sheet by rolling up two hand towels and tucking them down between the spars of the cot and the mattress.

As your babies were early, you may find that they need more sleep than the routines recommend.  Do not be in a hurry to push them on to the next routine, as this could lead to overtiredness, which will create another set of problems.   Try to aim for getting the babies sleeping until between 2/3am, then feeding well and settling them back until 6/7am. By taking one step at a time and not attempting to push them too quickly, they will be much more likely to start to sleep longer at night naturally.

 

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