Newborn and breastfeeding (sorry - long and ranty!)

(37 Posts)
AnythingNotEverything Sun 27-Oct-13 23:17:55

Can I have a good old moan?

I gave birth to a beautiful baby girl 5 days ago. She was big, almost 10lb, but had a standard, untraumatic, quick labour. We had lots of lovely skin to skin in the delivery suite, and she latched just fine. It was a lovely, almost perfect labour.

The subsequent (and continuing hospital stay) has been less than perfect.

I had to consent to give formula via cup when she was 8 hours old due to unstable blood sugars - we'd been on the ward a couple of hours at this point. By the end of the first day she was being tube fed, first continuously, and then on a three to four hourly cycle.

At the end of day three we found she was jaundiced, so she's been strapped to a UV light ever since (48 hours, at least 12 more required). Because she has to be rushed back into the bed, she only gets a quick go at the breast before I have to change her and get as much EBM/formula down her as I can and as quickly as I can to get her back on the lamp.

On day four they removed the tube, and we gave EBM and formula top ups after trying her at the breast.

I've had no support to establish breastfeeding. To be fair, they've enabled me to feed by providing a pump and sterile bottles to collect, but we've had no help with latching or other advice. Today is the first day she's had no formula, but has had EBM from a bottle. We had to stop cup feeding because she spilled too much and the staff couldn't monitor her intake.

Her blood sugar stabilised on day three-four, but we're struggling to get the jaundice down to the right levels.

My frustration is that all the hospital systems are set up to monitor the progress of babies who are ff - ie where you can measure exact volumes and force fluid down a baby like a duck on a fois gras farm.

How is this "breastfeeding friendly"? It feels like when I said I wanted to breastfeed I ended up on the slow path, because they're duty bound to support me, regardless if how inconvenient it is.

I'm sorry. I hope this isn't an incoherent ramble. I've been in hospital nearly a week, and have seen so many babies leave with the same issues as my DD, but allowed home because they're ff.

I have no issue with ff by the way - I just don't see why my DD and I should be stuck in hospital because the systems can't measure and monitor our feeding method!

radiatormesh Sun 27-Oct-13 23:28:03

I had the exact same issue here in the US.

DC#2 was readmitted for jaundice at a week old, and I was told he needed 2oz/hr (I think). Exactly that. No more, no less. If he didn't get that, he wouldn't be discharged. So the consultant pediatrician told me to FF. And I refused. I ended up having a stand-up row with her at 2am and then spending the next 24hrs either nursing or pumping to try to get that amount of milk (my milk had only just come in so my supply wasn't established) (so zero sleep, and I had to rely on DH to bring me food and drink since I didn't get anything (I wasn't the patient), and couldn't leave his bedside to run to the canteen). I remember them putting bottles of formula by his bedside for 'when' I didn't produce enough milk (which hardly helped with the need to relax and let my hormones flow!).

If I hadn't BF DC#1 for 12m there is no way I'd have had enough faith in my ability to produce milk and would have agreed to switch to FF just when my supply was kicking in.

This from a hospital with a poster at the ends to the peds ward about the 'benefits of breastfeeding'.

It's utterly rubbish OP. Good for you to sticking to your guns. It's no surprise that we have such awful BF rates (and the associated health issues in infants) with attitudes like that.

radiatormesh Sun 27-Oct-13 23:28:31

Lots of parentheses there....

tiktok Sun 27-Oct-13 23:37:05

Anything sad sad You have had poor help.

Questions:

* why did they test her blood sugars anyway? Term baby, good weight, feeding well....no need. Unstable blood sugars are normal. If there is a concern, then hand express colostrum and re-check

* why tube feeding?

Plenty of other questionable points in your experience.

Very bad. Hope you can get over it and start to feed as you want to.

(for a paediatrician's view on testing, see this:

www.nbci.ca/index.php?option=com_content&id=71:hypoglycaemia-of-the-newborn-low-blood-sugar&Itemid=17

AnythingNotEverything Sun 27-Oct-13 23:44:56

Thank you both.

I had polyhydramnios with no identified cause, and apparently she looked a little diabetic.

I think they tube fed because the cup feeding wasn't going well, and I refused to let them use a bottle at a first resort.

I feel let down. I'm not sure the consequences of any of these decisions were explained, and the regular crying is starting to taint these early days!

AnythingNotEverything Sun 27-Oct-13 23:46:55

I was never advised to hand express colostrum for her - once the tube went in I asked someone to help me as I knew I needed to get my supply going. This feels like it was the wrong way around now!

I'm quite tempted to complain when I get home. I suspect the jaundice wouldn't have been treated if it had been spotted by the community midwife rather than a consultant.

Kayshields Mon 28-Oct-13 01:34:07

Sounds exactly the same as my experience except my baby was 7.1lbs

tiktok Mon 28-Oct-13 08:31:35

Anything, none of what you had done to you was protective of your choice to breastfeed. If there needed to be any clinical interventions, then all of them should have been discussed in the light of protecting this

AnythingNotEverything Mon 28-Oct-13 08:35:40

Thank you tiktok- it's lovely to hear someone else say that, as I think this has all been harder than necessary.

tiktok Mon 28-Oct-13 08:48:43

When the dust settles, complain. Take a copy of your post to mumsnet (I mean.....how bad is it that a mother of a 5 day old has to seek support from the internet because she feels she has none in hospital?).

Please don't worry about bottles - there is no good evidence at all that bottle teats stop a bf baby learning to suck, and they can be easier to use than cups, and there is no concern that your baby will not return to full, direct bf when this crisis is over.

callamia Mon 28-Oct-13 08:54:45

I've had a very similar experience, and I really know how you're feeling.
My full term baby had to spend some time in NICU after birth. He recovered quickly, and was being NGtube and bottle fed. We HAD to get him to drink a huge amount of formula every three hours, but then when we were discharged it was assumed that we'd move straight to breast feeding. It felt like a hoop he had to jump through, and after that no one would check on how much fluid he was taking. It just didn't make sense to me.

I had been expressing, but nowhere near the amount he'd been bottle fed. I had no idea what I was doing, and I panicked and cried my way through feeding for the first week. Breast feeding cafés have really saved my sanity and my ability to continue breast feeding. He's now nearly three weeks old, and I've stopped using formula to top up. I do feel disappointed that we weren't better supported.

I admire you for sticking to EBM, and I hope you get out of hospital soon. I've been advised to talk to PALS about this experience, and I think I will. Maybe you'll have the energy to do the same when you get home. I wish you all the best.

glorious Mon 28-Oct-13 13:54:41

Oh anything you've been having such a tough time. Congratulations on your DD and well done for standing up for her, you must be exhausted.

We had a similarly bad experience with jaundice treatment. It is totally exhausting to cycle between breastfeeding, cup feeding and expressing, and I found I got absolutely no sleep. I just wanted to say it will end and you can go home breastfeeding. My DD had no formula after she came out of the incubator and no expressed milk after 24hrs at home. She's 9mo now and breastfeeding has been totally problem free since.

I did complain to the hospital and they took it extremely seriously. Three members of staff were disciplined. If you are still in hospital you can ask for someone from their PALS department to contact you. They have a role in advocating for patients. Alternatively ask if they have an infant feeding coordinator. The one who dealt with my complaint was excellent, and as clinical staff they have some authority. They don't always have weekend cover so today's a good day to ask.

Congratulations again and good luck thanks

AnythingNotEverything Mon 28-Oct-13 15:37:25

Thanks glorious - it's lovely to know it's not just me. And yes, the cycle of feeding and pumping while trying to get some sleep (and eat enough - bf induces serious hunger!) is tough.

I'm really hopeful we can go home tomorrow and just sit around topless letting her feed on demand. I think her latch needs some work but we have baby cafés and a bf counsellor attached to the community midwifery team.

She's had no formula since sometime during the night between Saturday and Sunday, so we're on the right track.

Thanks so much for your support.

AnythingNotEverything Mon 28-Oct-13 18:01:59

Being recommended for discharge tomorrow!

Then we can get on with breastfeeding proper at home. Phew.

glorious Mon 28-Oct-13 19:57:06

I'm so pleased for you, it sounds like DD is doing so well. Make sure everyone knows you're hoping to be discharged tomorrow and keep hassling, otherwise they can be too slow. And prepare yourself for a long day (we were finally discharged after 8pm on the second day after we were told we were going hmm ).

Keep us updated, I still remember going home and it was one of the best moments of my life. You will be just fine and your skin to skin plan sounds great. I bet you just don't want to let her go now you don't have to smile

stickysausages Mon 28-Oct-13 20:05:13

Our hospital have the cheek to flaunt their UNICEF approved breastfeeding plaque, when the reality was little support until hubby kicked up a stink with the unit sister in charge.

Hope you're home soon, take it easy & I'm sure feeding will establish soon x

Judybluey Mon 28-Oct-13 20:20:16

Your story sounds quite similar to mine...DD1 born in Scotland in a midwife-led unit all the help I could ever ask for relating to bf no probs there...DD2 born on labour ward in north east low(ish) birth weight low blood sugar on SCBU for three days..if it hadn't been for 1 very determined very well trained midwife I don't know what me and DD would have done...DD was in special care and while she was being tube fed ff I was frantically expressing colostrum ('liquid gold' love that phrase) into syringes and little egg cup things..it was so frustrating doing all this on a ward where new mums were demanding bottles every 20 mins and I just wanted some reassurance and encouragement....but practically had to beg for it...anyhow lots of skin to skin and liquid gold later I went on to bf DD2 as I had DD1 for a whole 12 months and loved every minute of it. Congratulations and well done you thanks

elfycat Mon 28-Oct-13 21:03:28

I had a tough start to BF with DD1. She was a bit prem and I had to do expressing/BF/top up with donor then FF for 4 days until her blood sugars stabilised. Then at 10 days she had toxic jaundice and was a bit critical, didn't feed for 24 hours and I had to express anything I could and FF while she was under as much UV as they could get (I particularly liked the gel-glow pad under her). I had a great BF advisor, but also witnessed mothers willing to BF encouraged to FF to have a bit of a rest. Pissed me off and I did write in and comment.

I took a couple of non-consecutive days to do nothing but sit, topless, in bed with her. If she slept I did the same and the rest of the time we snuggled under the covers and she fed as she wanted. DH ran drinks and snacks to me.

I then handed over the next few weeks to her and we basically sat snuggled on the sofa allowing her to cluster feed (had the laptop handy for FB games etc). I figured that was what the maternity pay and leave was for and I did boost my milk and establish easier feeding. The main boost happened in week 2 after all her hiccups and despite a lip tie so I know that feeding can be established after a poor start.

My personal belief if the best milk is made with the power of chocolate and cake wink. I normally am not bothered by either, but absolutely CRAVED them while BF. Maybe sweet carbs will not be your thing but eat well and indulge any long-lasting cravings.

Congratulations and good luck!

AnythingNotEverything Tue 29-Oct-13 08:24:29

Oh it's so sad that so many of us have similar stories. We should all be very proud of ourselves.

We've had a good night here - no bottle top ups since 8pm, so we're on our third fully direct feed. She's also waking four hourly for feeds so I'm getting some rest too. I'm sure this won't last!

We've just got to jump through some final hoops but hopefully home today. Whoop

tiktok Tue 29-Oct-13 08:58:02

OP - glad you're going home!

You are right about four-hourly feeds.....it's not something that should last and hopefully feeding will become much more frequent soon. This level of frequency is not usually enough in the newborn period to build up and maintain a good supply, so when the feeds become more often, give a cheer smile

JimbosJetSet Tue 29-Oct-13 09:08:43

When my two both had jaundice at birth I was also coerced into giving them formula top ups, completely against my wishes. It made me feel very guilty, as if my selfish choice of wanting to BF had somehow let them down hmm

On the positive side, the second they were out from under the blue lights and the billie ruben (sp?) had stabilised, we ditched the bottles and never looked back.

You have my every sympathy. Before too long though, you will be home with your lovely daughter and this will all seem like a distant nightmare thanks

AnythingNotEverything Tue 29-Oct-13 09:50:48

Tiktok - once we're home I intend to push as much boob at her as I can ... But the break at night is a relief at the moment.

I love Mumsnet. You are all so lovely.

glorious Tue 29-Oct-13 16:38:11

Brilliant stuff. How's the escape plan? wink

AnythingNotEverything Tue 29-Oct-13 20:54:21

We're home!

DD refused breast at the last two feeds though so we've had to top up and pump. She'd latch on (ie do the sore bit!) but then just sit with nipple in mouth. I'm hoping she's better during the night, but we have EBM on hand just in case.

Hopefully just a blip. Despite this being my second child I'm full of first night nerves! I think the constant temperature checking and questions about everything has made me a little scared of her! I'm totally institutionalised, but now out of the institution.

tiktok Wed 30-Oct-13 07:16:09

Hope it all goes well from now on, OP smile

glorious Wed 30-Oct-13 07:38:43

I'm so glad you're home smile thanks It must be wonderful, especially with another DC.

Did the night feeds go better?

AnythingNotEverything Wed 30-Oct-13 23:27:53

Wowsers. What a rollercoaster. We went home for 15 hours, then we're called back to a clinic to discuss likely congenital hypothyroidism, and ended up being re admitted for jaundice.

On the plus side, the breastfeeding is back with a vengeance! Fed on demand at 3, 6, 9 and now at 11. I think she's cracked it, despite the lethargy from the jaundice and CH.

It's only due to the boards here and you lovely folk that I knew I should persevere.

A consultant paediatrician congratulated me today on her fluid levels. I could've cried with joy!

glorious Thu 31-Oct-13 03:43:54

oh anything what a tough time. Do you have any idea how long you might be in? Great that she's feeding well, consultants aren't often known for their compliments so you must be doing brilliantly.

I'm glad we're helping a bit, keep posting smile

AnythingNotEverything Thu 31-Oct-13 08:16:29

I was hoping just overnight. They have taken bloods this morning, and if they are clear we then need another clear reading after a few hours off the lamp. It's a slow process.

I think we discovered cluster feeding last night - she fed from 11pm-4am pretty much non stop. She's therefore not spent as much time under the lamp as she could've done, which I hope doesn't hold us back.

elfycat Thu 31-Oct-13 10:05:18

It's grim being readmitted... just when you think it's safe to go home!

Sounds like cluster feeding so be prepared for your boobs to swell up a notch in a day or two. Get her under lamps as much as you can, but nutrition is also important. DD1's recovery was quite swift once she got a dose of UV.

I still can't stand to see her in the colour yellow 4.5 years on, but that seems to have been the only long-term side effect.

glorious Thu 31-Oct-13 17:52:05

Yes I remember how long the wait between blood tests was, it felt like forever.

Cluster feeding is a brilliant sign and the milk will also be helping flush the bilirubin out, though obviously the lamp is very important too.

How are you feeling?

AnythingNotEverything Thu 31-Oct-13 18:43:47

Tired, emotional ... Finding being alone in the middle of the night really hard.

glorious Fri 01-Nov-13 07:40:09

Yes, the nights are very lonely aren't they, especially when you can't cuddle your baby. How are the bloods? brew for you this morning.

readysteady Fri 01-Nov-13 07:57:09

Anyway you can position the light so you can feed baby at same time? That's what they did with me in hospital co slept with UV over both of us. Not sure how good that is but it was a lifesaver for me and my daughter. Xxx

AnythingNotEverything Fri 01-Nov-13 12:38:11

We've been discharged grin

Feeding going well - 2-3 hourly during the day and slightly longer at night, but I know it's too early for a pattern.

So glad we persevered with fb.

glorious Fri 01-Nov-13 14:25:33

Yay fantastic news!

I wish we'd been able to feed with her under the light but no that wasn't possible (it was fixed to the incubator). So probably not for anything either. Good that you could smile

readysteady Fri 01-Nov-13 17:57:17

Thanks. It was the midwifes idea, she wasn't sure if it was possible but between us we fiddled with the attachment thing and managed to spin it round so it faced the other way no not over the cot any more. So was a bit of a bodge it method.

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