This is an enquiry on behalf of my SIL. she has just had a tough birth and the baby was born very sleepy due to pain relief (diamorphine). It is the evening of day three and the baby has not managed a proper breastfeed yet and has been given formula in the hospital ( they are home now) as they were worried about dehydration etc.. I don't think SIL's milk has come in properly yet, she is exhaausted after several nights with no sleep, but I know she would be gutted if she has to give up breastfeeding.
I am not local so am giving advice remotely, all I have said is to try as much skin to skin as possible and keep putting the baby to the breast as often as possible.
If anyone has advice or success stories of establishing EBF after a poor start it would be great if you could share and I will pass them on to SIL to encourage her.
Yes, I had a rough start but managed it with support. I would get advice from one of the breastfeeding helplines - nct have one though I think it is only office hours - also her health visitor should be able to help and point to her towards local support groups.
In the meantime, yes I think just put baby to breast frequently, if baby falls asleep while feeding keep him awake by rubbing feet and ears gently. If your SIL has problems overnight she should be able to call midwives at her hospital for advice.
Thanks G&T, SIL has been told not to express for 5 days for some reason but if i were her I would do a bit of expressing to stimulate the milk if she can't get the baby to latch on and give it some milk with a syringe or a spoon.
It's only eight years since I had my youngest but the advice seems to change all the time, and i don't want to add to the confusion!
We did it - I had a crash section under GA followed by diamorphine and DD1 didn't feed from the breast until 6 days after birth. However I stayed in hospital for feeding support for almost all of this time and had daily visits from breastfeeding support workers, an infant feeding midwife and also was provided with donor breast milk from the milk bank which was cup fed to DD1 by a midwife each time she was unable to stay awake long enough to feed from me (so, every feed really). I was helped to hand express my colostrum, which was given to DD1 with a small syringe, then I was told to start expressing when my milk came in (about day 3 or 4) and provided with a hospital grade pump.
Your SIL needs to get real life support - it was hard going establishing bf with DD1 but after the first week and a bit she really got going and we continued for 12 months with no further problems. Can she call La Leche League for advice and a referral to someone local who can help? We have a local breastfeeding support service staffed by volunteers who will come to the house and give you face to face help, is there anything like that local to your SIL?
I have advised My brother the get on the phone tomorrow and find a breastfeeding support service, they live in a biggish city so there should be someone available and the midwife is also visiting them at home tomorrow. I feel like getting in the car and driving over but its half term so I would have to take three large boys with me!
Definitely not too late. My baby didn't latch for the first 4 weeks and now I ebf. Your sil needs to get pumping and get someone to help get baby started- it's hard but if she's determined, it's not too late!
The not to express for 5 days thing sounds like a midwife who has heard that using a pump before the milk comes in is usually not as effective as hand expressing but has forgotten to suggest hand expressing. If milk has come in or getting lots of colostrum then a pump may actually help. Lots of that and lots of skin to skin contact. Check the reasons for concern about dehydration, is the baby actually at risk or are they simply being over cautious and encouraging giving bottles to prevent something that might never happen. Check wet and dirty nappies, try the cotton wool ball in the nappy trick too.
Just briefly - NCT helpline is 8 am to midnight, so def not just 'office hours'
Hand expressing would normally be essential at this stage and should have started on day one....she would normally be hand expressing every 2-3 hours and getting it into the baby. She needs to see someone who knows what's what asap. Skin to skin, v important also.
I had DD early January and had a lot of problems trying to feed a sleepy baby after an EMCS, I didn't get to try and feed her for a few hours after birth (as I was in surgery for a while after she was popped out), DD was 2.5 weeks early and a bit jaundiced so she had lots of reasons to sleep most of her first two weeks! We were also made to give her formula bottle top ups in hospital as her blood sugars were low on day 2.
The advice I had was as follows:-
- Skin to skin as much as possible - Wake baby up and try and feed every 3 hours if she/he is not waking themselves. Strip them down to the nappy, feed in a cool place, tickle her feet, change her nappy, blow gently on her face, stroke her cheek. It's hard, sometimes she won't want to wake despite your best efforts! - Hand express the colostrum into a syringe to feed to the baby - Once my milk came in (day 3 not including the day of the birth) I was given a pump in the hospital to express to give DD top ups instead of formula.
I went home day 4 and was told to try and feed every 3 hours. DD lost weight on the first 2 weigh ins and so I was told to express after each feed or attempted feed (so 8 times a day!) to increase supply and to also feed DD some expressed milk atr each feed to make sure she was getting enough milk. DD fed at the breast maybe 25% of the feeds some days and 50% others, never for more than 5 - 10 minutes. We gave her the expressed milk via a feeding tube strapped to my husband's finger as I was worried about introducing a bottle. However it was a two person job so when he went back to work after 2 weeks I switched to topping up from an bottle of expressed milk. DD has always been happy switching between the two despite my worries on nipple confusion.
DD has got better at feeding and under the midwife's guidance and as she started to gain weight we dropped the top up bottles to 50% of the feeds by week 3 and to 25% of the time last week. I am now doing a top up every day or so partly so she continues to be used to taking a bottle. I dropped the expressing from 50% of feeds at week 3, twice a day to week four and now once a day. I think that my supply is good (it's a bit like a tap at times!) so it had worked for me.
I am sure that your SIL will get the support she needs from the midwives. Nobody warns you HOW HARD breastfeeding can be but if she can persevere then I found things were much easier after 2 weeks (although still a bit of a struggle!). Now I am sometimes getting 3 hours of sleep in a row life is so much better than the maximum 1.5 hours I was getting when on the "try and feed-then feed top up - then express" cycles!!
Sorry for the mammoth post but I really feel for her, and hope that my full story will help her to see the light at the end of the tunnel in some way. I also found it very emotional at times, but again the tears stopped after 2 weeks and I feel so much more "normal" now!! As I often read on these feeding threads - remember that "This too shall pass". We are now at week 5 and DD is thriving.