hospital wanting to give formula to newborn

[Zerub]

I'm thinking about baby number 2, and starting to wonder about all the things that went wrong with dd. When she was born she was fed formula through a tube in her nose, for a week until she started bf'ing properly. My question is, was it necessary? Actually, since that is irrelevant now, the real question is, if I'm in that situation again, what should I do?

She was born by elective cs at 38.5 weeks - diagnosed as footling breech the day before. She weighed 5lbs 9 - they were worried about her weight and said she couldn't afford to lose any, but she was on the 2nd centile and has remained there (she's 22mo now) - so I think her weight was fine! DH & I are both small. She was also slightly jaundiced.

She fed in the recovery room at midday and again a couple of hours later. Then wasn't interested. Woke a couple of times in the night, had 2 sucks, went back to sleep. They made me express at 1am and she had 15mls off a spoon (I've got my notes so I've looked it up). At 5am they tested her blood sugar and said it was ok. At 11am she still didn't want to feed and we gave in to pressure and agreed to give her formula (I couldn't express any). So she had that off a spoon every 3 hours. That night I agreed to them putting a tube in her nose. After that I attempted to bf every 3 hours and topped up with formula via the tube. Milk came in on day 5. By day 6 she was feeding ok and we stopped the formula.

It was all quite stressful, we had to stay in hospital longer than I wanted, and I wish she'd had colustrum instead of formula (didn't want her to have any formula). And I wonder if she would have started bf'ing earlier if she wasn't full on formula? And if my milk would have come earlier if she'd been sucking more?

So should I have just said, no leave her alone, she'll feed when she's ready? Or what?

[AussieSim]

I had a v similar experience to you zerub, my DS was born at 35.5 weeks and was also jaundice. The jaundice makes them lazy with sucking I was told. They gave my DS bottles of formula without even consultng us in the first 2 or 3 days when I couldn't be with him. I really felt that DS was 'tortured' by being forcefed more than he wanted every 4 hours. I was expressing but my supply never caught up to how much they wanted him to have each feed and they refused to let me feed him more frequently. I was in for 2 weeks.

It wasn't till I got out of that damn place and got the support of a good midwife that we established breastfeeding and we had no problems with his weight.

So next time I will tell all of them to f-off and leave me and my baby alone. Or better still just go home asap.

[aloha]

I had a similar experience, although without the distress of the nose tube so I really, really feel for you Zerub. I had midwives insisting that ds - also 38 weeks but 8lb 8oz, poss cos I'm 5'8" and ds is nearly 6'5", was 'starving' and I had to give formula. I was terribly, terribly upset, esp as it coincided with baby blues but I agreed. Later (much later() a breastfeeding counsellor came to see me, saw the volume of colostrum that ds produced and agreed that everything was fine and I didn't need anything else. The hospital also tried to insist I stayed in longer but dh put his foot down v firmly and whisked me and ds home (hooray) where all was fine (except for the sleeping, but that's another story...). If it happened again I'd a/get a b/f counsellor in before even discussing formula and b/leave when I wanted to and bugger 'em. On the good side, ds is absolutely fine and getting the formula in him so early made me pretty relaxed about having it later on.

[aloha]

Obv ds didn't produce any colostrum! That was me...

[GeorginaA]

I had it too... ds was 41 weeks & 8lb 3oz and they kept telling me that ds was starving and needed a bottle. Usually late at night when dh wasn't there to back me up.

I forced them to do blood sugar tests, pointed out ds was fine and just fought them every step of the way. Finally managed to sign myself out on the second day, was so glad to get out of there.

So very stressful when your at your weakest emotionally and physically.

[GeorginaA]

Incidentally, I still feel very bitter about the pressure they put me under in those first few weeks (he didn't regain his birthweight until 3 weeks old, and the pressure was CONSTANT to formula feed him instead - baby friendly hospital my arse). It's one of the reasons I really wanted a homebirth this time but that is not to be. Like you, Zerub, I'm very nervous that something similar will happen this time around.

[frogs]

Been there too -- it is very stressful, but as a 2nd time mum you're in a much better position to deal with it.

All of mine have been in the neonatal unit for observation because of my medical history. With ds (2nd child) the I was told he was dehydrated and jaundiced as he wasn't sucking properly. This was on day 5, with my milk well and truly in, you could hear him spluttering as it went down!

Stroppy junior doctor refused to believe me, stripped ds off and put him in the scales to be weighed. Ds then achieved his earliest triumph by producing a seemingly endless stream of wee which went all down the doctor's shirt sleeve. 'Can't be that dehydrated' I said innocently...

I think the onus should be on the hospital to PROVE (rather than say) that your baby needs additional liquid or food. The first few days before the milk comes in are tough on big hungry babies, but to listen to the weight police you wonder how the human race has survived before formula was invented.

Alternatively: home birth, or baby-friendly hospital? Those options weren't available to me, but might be worth checking out.

Good luck!

[GeorginaA]

Hmm, I'm pretty sure Mayday Hospital, Croydon was supposed to be "baby-friendly" ... was it bollocks.

[Zerub]

Mmm, Addenbrookes is supposed to be baby-friendly too! I want a home VBAC next time, but it may not happen...

If they test blood sugar and its ok, does that mean they don't need more milk, or is there more to it than that?

Its a laugh that they force formula on babies that are "too big" as well as on "too small" - guess there is a 2lb range in the middle that they think is ok!

[GeorginaA]

I just think in general they like to be able to see ounces drunk so they don't get sued if the baby dehydrates or something It's very frustrating.

As far as I know, if the blood sugar is okay, you can safely tell them to piss off Of course, once you're out of the hospital, they then rely on weight regain and they get twitchy if baby hasn't regained by 2 weeks.

[hercules]

GA I had both at Mayday- childfriendly they are not!!! DS was given bottle and I had loads of probs to get bf going. With ds they wanted formula for her and were disgusted when I said no!
I wrote and complained though but havent heard anything.

[GeorginaA]

I'm actually quite relieved that we moved away, tbh, otherwise I'd be in the middle of a battle to go anywhere else BUT Mayday!! No idea what Worcester Royal Infirmary is like though with the formula pushing. Anyone know?

[mears]

Zerub - you might find this link of interest here

Click on hypoglycaemia.

[Tommy]

I may be wrong but don't hospitals have stocks of donated breast milk for situations like this? If not, why did I send so much time pumping and freezing the stuff?

[Levanna]

Hi, I haven't experienced the problems people here have had (others, but not this ). But, I thought this might be of interest to you....it's information I recieved on my breastfeeding course:

Breastmilk production from birth-
Age of baby........Average volume per feed

Day 1 ........7mls (Day one can
Day 2 ........14mls comprise of an
Day 3 ........38mls average of 37mls
Day 4 ........58mls per day, Day two
Day 5 ........70mls an average of 84
mls per day....)
( 1 (uk)oz = 28.41 mls )

From: Humenick, s.s.:The clinical significance of breastmilk maturation rates. Birth 14(4): 175, 1987.

So, basically for the first day or two, you're talking one or two teaspoons of breastmilk per feed! If you've got concerns it might be worth contacting a breastfeeding counsellor (or peer counsellor) before you are due, for some support and advice....some are able to visit you in hospital to offer support too. Incidentally, my DD didn't really feed 'properly' for a good 24 hours after the birth, and she's fine .

[Levanna]

hope that makes sense! It didn't come out as it was typed....

[mears]

The best way to get breastfeeding off to a good start is skin to skin contact within 30 mins of delivery. A heathy newborn is not at risk of hypoglycaemia in the first 24 hours after birth. There are a number of reasons why a baby may not feed in that time and, if after 24 hours the baby has not fed he/she should have a full medical review to exclude illness. A blood sugar level is of little value in a healthy term infant because is it has not fed it will utilise the ketone bodies it has stored as brown fat. Only a baby who shows signs of hypoglycaemia should have a blood sugar checked such as being jittery, having a low temperature.
If the baby will not feed in the first 4-6 hours the mum should be encouraged to express. That is not primarily to get milk for the baby but to stimulate her milk supply. Should any colostrum be obtained then it should be given to the baby so that it is not wasted so to speak. Therafter the mum should express every 3-4 hours to stimulate her milk production. Prolonged skin contact will help stimulate a baby to feed.
Unfortunately hospital practices can make reluctant feeders worse by having abaies wrapped up away from their mums. Over zealous blood sugar checking can increase mothers anxiety and contribute to the giving up of feeding altogether.
Baby friendly hospital endeavour to promote and support breastfeeding by educating staff.
A mother can refuse to give formula milk to her baby. Only medically indicated supplements should be given ie a baby showing signs of dehydration which it will not do in the first 24-48 hours. Babies are born with the capablilty of surviving until breastfeeding is established.
The guidance is different for 'high risk' babies who need to have regular feeds and would be unable to cope without milk such as low birth weight babies, babies of diabetic women, babies who have required resuscitation at birth. Baby friendly hospitals have guidance for the management of 'lor risk' and 'high risk' babies.

If I had a baby tomorrow who was in the low risk category and was declining to feed, I would tell the staff that they were to come no where near me with blood sugar testing sticks or formula.

[Ghosty]

I too had a battle in the hospital when DD was born Zerub ... I always meant to post the story but never got round to it ...
I am convinced that had I been a first time mum and not been a part of mumsnet for so long I would have given in and DD would have had formula.
This is what happened to me ... bit of a long story ... but bear with me ...
DD was a big baby (10 lbs 10 oz) and despite testing negative to diabetes tests at 28 weeks and 34 weeks the paediatrician present at her birth (c/s) wrote on her notes that she needed heel prick blood sugar tests at 3 hourly intervals to rule out diabetes. It said on the notes that if her blood sugar was less than 2.6 in 3 CONSECUTIVE tests then she would need to be supplemented with formula.
So ... first test (at 8pm) 3.0 ... fine ...
second test (at 11pm) 2.5 ...
The midwife tells me that DD needs formula. I disagreed. She said that the paed said so. I reminded her that we hadn't done the 3rd test yet ... and also pointed out that if they let ME eat something (they wouldn't let me eat until I had 'broken wind' FFS!) then it might help DD's blood sugar.
3rd test (2am ... still I hadn't been allowed to eat) ... 2.7 ... YAY ...
But the bloody midwife gets on the phone to the SHO and comes back with a bottle.
I said that she wasn't to give it to DD, that her levels were above 2.6 ... she said the doctor said she had to (bearing in mind I was still stuck in bed from the c/s and dd at that point out of my reach ...)
I said that I didn't want her to ... she said that she would give it through a syringe ...
I went ballistic ...
"If you go near my baby with that bottle I will press the emergency button!" ...
She called another midwife ... who, thankfully, backed me up ... but not until she saw that dd's last test was above 2.6.
The original midwife marched to the sink and poured the bottle down the drain and marched out of the room. I didn't see her again ...
They did however insist on doing another 3 tests on DD ... like a dog with a bone they insisted on there being 3 consecutive tests that showed above 2.6 ...
Poor DD had plasters all over her feet and it was a full week before she tolerated being touched on her heels.
Bastards.
My independent midwife was furious when she heard about it and photocopied my notes for in case I wanted to make a complaint. I didn't yet ... but I might still do so.
It said in my notes "Despite advice given Mother refuses to top baby up with bottle" ... like I was being a bad mother ...
If I could have walked I would have checked myself and dd out of there that night ... as it was I went to a private unit the next day so I didn't have to see that cow again.
What I am saying Zerub, you don't need to go through all of that again if you don't have to. Stick to your guns.
Mears ... more people need to know what you said about the first 48 hours ... I have a friend who was told when her baby was a few hours old that she would never feed her 'big' baby (9lbs) on her own ... and as a result the baby was fully bottle fed from 3 weeks ......
Sorry about length of post .... typical Ghosty!

[Croak]

Wow Ghosty I'm so impressed
I really hope that I manage to be more assertive in hospital if/when I have another baby. Last time I was really shocked by just how compliant and unquestioning I was as it really isn't how I am normally.

[Croak]

Am back again as unable to write dissertation, should go to bed but do not want to admit defeat
Agree with you totally about the power of mumsnet - knowledge and inspiration in one.
Also just wanted to say congratulations on the birth of your dd, she sounds absolutely lovely.
Finally, good luck to Zerub and everyone else in this position. I spend lots (probably far too much) time thinking about things I'll try to do differently next time and I'm not even really planning another yet. Still exciting though

[toddlerbob]

Wow Ghosty, you are a very determined woman. I can't believe they put that in your notes - you did not ignore the advice they gave you - you actually listened to it properly, unlike the midwife. You should complain, you deserve an apology. You should c.c. your letter to the baby friendly hospital people because Nat. Womens' is probably going for baby friendly status as we type and they probably have a little further to go yet.

[Ghosty]

Croak thanks
toddlerbob and croak ... yes, I was determined. I hadn't spent 4 years telling myself, "Next time it will be different" only to fall at the first hurdle when DD was born.
I never researched any breastfeeding stuff when I was pg with DS ... just assumed all would be ok ... and have regretted my giving up b/fing so early with him ever since - it still breaks my heart.
Just reading threads on breastfeeding since I joined mumsnet just made it all clear to me that it needn't have happened that way 4 years ago and that NEXT time I was going to give it a really good effort.
DS was mixed fed from 5 weeks and fully bottle fed from 6 weeks DD, however, is still thriving on the old boobie at 8 weeks and although has had a couple of expressed bottles there is no way she is going to have bottles of formula for a good long while ... I believe much of this is down to mumsnet ...

[Ghosty]

Toddlerbob ... I have thought about complaining ... but just haven't got round to doing anything about it.
They do have signs all over National Women's Hospital in Auckland saying breast is best etc and I do think they are a baby friendly hospital. It was just this one midwife ... every other one I came in contact with was fab ... (apart from the insistence on heel prick tests .... )

[robinw]

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[hoxtonchick]

When ds was born he was high risk as I have diabetes (though he weighed 7lbs10). They did a heel prick test & though I can't remember the value it was definitely above 2.6. I had made a big fuss previously about breastfeeding. The paediatrician insisted that he needed formula to keep him going (I remember the midwives asking me what brand I wanted. Answer not repeatable...), but 'cos I was intent on breastfeeding, he was fed from a cup & literally lapped it up, like a cat. Also, they made sure that I put him to the boob before he was cup-fed every few hours, so he was sucking lots too. They wanted to keep us in for 48 hours but we discharged ourselves after 24 & my milk came in the day after that. ds didn't have a bottle 'til 6 months when I went back to work, though we did very occasionally cup-feed him if I was too exhausted.

This is a big long-winded, but I just wanted to talk about my experience to show that even if hospitals do insist on formula (with decent reasons) it doesn't have to mean the end of breastfeeding.

[GeorginaA]

Mears - is there some sort of recognised "official" guidelines version of what you've posted that we can print out and take into hospital so we can have an added bonus of saying "look, read that" when we get hassled to give formula? Anything to make the fight a little easier!