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To ask if anyone can explain why bf went so tits up for me?

(22 Posts)
PippedAndPopped Wed 28-Oct-15 09:03:56

I'm an experienced breast feeder, no previous issues. Always been told that babies need next to nothing for three days, marble sized bellies, colostrum enough, reserves etc. I had a good amount of early milk.

At two days old while still on postnatal dd had a temperature . It was lucky in a way as blood tests showed severe hypernatremia and high urea in the blood, basically a dangerous level of sodium due to dehydration. They said it was due to insufficient breast milk. She was at risk of seizure it was that high and developed a strange cry.

As I said I'm experienced, nursed frequently yet it still happened. How did she get so dehydrated? Everyone was telling me that babies hardly need anything for days, yet before tubing her neonatal wanted to get a min of 60ml down her (no chance! 15ml was more like it).

Does anyone have an idea to explain to me why this happened? It's bugging me.

She was also on antibiotics for presumed sepsis if that makes a difference.

Was I unlucky? I was laying on the ward listening to midwives tell mother after mother not to worry about baby having tiny amounts in first few days, yet unlike most the worried first time mums I know I had a good latch and I nursed her a lot. I had diabetes so I was particularly keen on nursing to avoid low blood sugar. She lost 6% of her weight and maintained blood sugar so no other sign she was starved!

SweetAdeline Wed 28-Oct-15 09:07:33

I don't know about why your DD was dehydrated but I do remember being shocked at the size of the topups the paediatrician wanted newborn DS to have when he was hypoglycaemic. It made the syringes of pre-expressed colostrum I had bought with me completely pointless.

duckyneedsaclean Wed 28-Oct-15 09:15:30

If she had an infection with temperature she would have had more insensible losses - sweat and so on - as her body fought the infection, and tried to maintain a safe body temperature.

Diggum Wed 28-Oct-15 09:17:02

Is there any chance the severity of her symptoms was more linked to sepsis than milk supply?

You're right in saying they should only need teeny amounts in the first few days- was she on the boob frequently? Maybe there was something else causing trouble for her in actually drawing down the milk apart from supply (tongue tie etc???). Just guessing really.

Has this all only just happened or are you looking back for answers after an interval?

ragged Wed 28-Oct-15 09:18:01

I never really believed that "tiny babies need nothing" type talk. I have heard it but not taken it in as a heavy msg like you seem to have heard. I fed them as much & as often as they would take it.

I don't think you should see breastfeeding as a failure, but some problems were encountered & hopefully will be resolved soon. Problems are there to be fixed. flowers

Crazypetlady Wed 28-Oct-15 09:30:00

Sorry about this O.P flowers
Hopefully you can resolve it, if not don't see formula as a failure.
With my ds I tried and I cried all night because he would just feed and feed and get frustrated because he wasn't getting enough milk.
He went grey from lack of food. I tried my best and feel guilt now but sometimes things just happen.

I hope you can continue to bf, I can't give you any answers just didn't want to read and go

PippedAndPopped Wed 28-Oct-15 09:41:44

Just happened, they were quite heavy on it being a insufficient milk thing.

I fed at least hourly, if not constantly at points. First day amazingly well. Second though she started to be a bit too sleepy. Even on formula to pups it would just dribble out her mouth.

I'm mixed feeding now, formula top ups after bf. taking about 10ml though. Poo looks more like bf poo so I presume she has plenty, I can express easily and squirt her so I know I have a good supply.

Ducky, I was also wondering if the temp was a factor. It was 39.

PippedAndPopped Wed 28-Oct-15 09:43:28

The weird think is her weight loss is very standard, she doesn't look unfed. Even the paed agreed despite the blood results her skin and soft spots appeared to show hydration. Her appreance and electrolyte imbalance did not match

ShowOfBloodyStumps Wed 28-Oct-15 09:51:43

Breastfeeding is a relationship. Sometimes, the other partner in the relationship is unable to fulfill their side of the bargain. There are all sorts of reasons why you might be doing everything 'right' but it still doesn't work. Physical problems such as ongue tie, underlying health problems, poor latch or sucking and on and on. I am sure the fact that she was unwell had a massive impact on not only what she needed from you, but also how well she was able to access it.

You'll never have a definitive answer but I think it's part of a wider picture. She was unwell at birth and it probably affected many things but the breastfeeding is a really tangible one and the one we attach most guilt to in those early days.

The way to look at it is that you did your utmost. You took action when things weren't going wrong, you continued breastfeeding and undoubtedly, it would have helped in all the ways breastfeeding does anyway but when unwell and needing comfort, temperature regulation and an immunity boost, you were still there and doing everything you could.

Your current breastfeeding relationship sounds very positive indeed.

How is she now? Has she recovered?

It must have been a really tough time for all of you. Such a tiny baby being ill is terrifying.

duckyneedsaclean Wed 28-Oct-15 09:55:38

To be honest, I had similar with ds1, he'd lost 12%. No one was concerned until they did bloods though, because he was aware, skin supple etc. Then the results were similar to your dd's. With one night of formula top ups his electrolytes had rebalanced. Managed to stop top ups within a week - so don't worry too much.

As for my point about the temp and infection - even adults who are septic can have impaired kidney function as a result, and often need extra fluids. So it's not surprising a newborn would struggle!

PippedAndPopped Wed 28-Oct-15 10:02:17

It took a tube fed and three days of formula top ups to regulate, they said her baseline was so poor.

We're pretty good with bf now, I'm offering top ups to be sure though. She's doing well, though she never appeared as sick as she should have been. Neonatal even let me take her back to the wars most the time with just four visits a day back to them over the corridor which was a huge blessing. I sobbed when they first came to collect her

tobysmum77 Wed 28-Oct-15 10:15:01

I think she was ill op and that's what went wrong. Having failed dismally to feed 2 myself they don't get to that stage usually in 48 hours and her weight maintained well (6% is nothing, believe me sad).

But once she became dehydrated then the obvious answer is tube feeding formula to sort that out, the same may well have happened if she'd been ff.

TaliZorah Wed 28-Oct-15 10:19:39

Something similar happened to DS. He didn't get that dehydrated but he just wouldn't nurse properly. He would have a good latch and then just come off and scream, try to relatch and be unable to do it. I had loads of milk, could express 150ml and he still screamed and wouldn't take it properly. I ended up cut to pieces.

DS was also on antibiotics for suspected sepsis and had been in NICU. They told me it was important to feed every 3 hours and to wake him up if he wasn't waking due to the antibiotics. I wonder if it's connected?

Pandora97 Wed 28-Oct-15 12:36:48

SweetAdeline your colostrum syringes wouldn't have been pointless at all. To start with, you'll only produce colostrum in small amounts but it's extremely concentrated antibody and nutrition wise in comparison to formula which is why formula is needed in much larger amounts.

It does sound like because of your daughter's temperature her reserves weren't as high as normal. It does take a while to get the milk supply going well so maybe it just wasn't coming in quickly enough for her. Well babies don't need a huge amount of breast milk in the early days but it is a different matter for sick babies unfortunately. Like another poster said, the fact she was unwell means she might have not been feeding as much as she could due to low energy. But it sounds like you've done very well, it's not easy feeding a sick baby.

Elledouble Wed 28-Oct-15 12:43:32

I had a similar confusion - I didn't manage to BF my son til the second night and I kept being reassured that the 1ml syringes I kept trying to give him were enough, that his stomach was the size of a marble, etc etc. But that second night he screamed and screamed and the midwife went off and got him a bottle of formula - about 45ml! He swallowed it down like lightning and actually, once he wasn't so hungry and frantic we managed to get him latched on. But the mixed messages!

SweetAdeline Wed 28-Oct-15 13:47:45

Thanks Pandora. I had expressed the colostrum to avoid giving any formula. But I needed to give huge formula top ups in addition to breastfeeding directly and giving the expressed top-ups. It was pointless in the sense of avoiding formula because what they don't tell you antenatally is the size of top-ups that will be required if your baby is hypoglycaemic. I was told to only bring a few ml in with me, well his first top up was supposed to be 30ml.

Despite the top-ups I managed to bf him to over 1yr but if I manage to stay pregnant again I won't waste hours of my time expressing antenatally.

Claireshh Wed 28-Oct-15 14:09:03

Similar situation happened with my son. He ended up in SCBU the day after he was born. He had an infection (again presumed sepsis) and had very low blood sugar and was dehydrated. He fed immediately after birth and did feed at other times but was sleepy.

I think he was using lots of energy trying to fight the infection and also wasn't able to feed as well as he was really tired due to being poorly. He received top up formula feeds in SCBU (24hrs) as well as breastfeed and was in hospital for a total of seven days. He lost a pound of weight in that time but then continued to be breastfed for a year.

Claireshh Wed 28-Oct-15 14:10:13

I also hand expressed colostrum. It wasn't enough!

PippedAndPopped Thu 29-Oct-15 07:50:16

Thank you for the replies.

Dd is now completely rejecting bottles which makes me nervous after discharge advice on top ups. However judging from her impressiive nappies and weeing on me she's not milk starved. Next weighing is Tuesday, so we'll find out. Not much midwife contact as we were in hospital early days.

I didn't express antenatally as I know I produce so little pre birth.

Some of these replies make me feel les guilty. I'd feed dd whatever is best for her, if I had any idea shed had problems I'd happily give foula.

tobysmum77 Thu 29-Oct-15 08:09:46

Obviously there is nothing to feel guilty about but it's easy from here.

I don't know how old she is now but once they start feeding properly 10ml is nothing. I remember all these stories about mn 'tiny bellies' but by 3 weeks dd2 could take up to 120ml in one go , by the time I was discharged from the mw I had to use proper size bottles so was offering 150ml.

It must be hard though as quite obviously this has shaken your confidence which is understandable. She is well now, weeing well etc but if you are worried then ask for the mw to come out again sooner.

SweetAdeline Thu 29-Oct-15 10:09:01

If she still needs top-ups after next weighing you could ask the midwifed to show you how to cup feed. I gave DS most of his top ups that way because I was worried about messing up his good latch (Dd had a terrible latch so I didn't want to risk it).

Skiptonlass Thu 29-Oct-15 10:13:48

When they are born there's a big physiological change which sees fluid go from inside the cells to the extra cellular space. This fluid is dealt with with the kidneys and excreted- in a nutshell that's why they lose weight.

If something goes wrong with this, you can end up with too much or too little fluid in the baby, which can be very dangerous.

To remedy it you need to rebalance the electrolyte/fluid situation- by preventing fluid loss or increasing sodium intake for example. I wonder if they've just not explained this well to you? If they were needing to get more sodium in to the baby for example, your milk would be insufficient even if it was normal and perfect...

I think if this is continuing to bother you, you need to have a mini debrief. Sometimes in the hurry to get things fixed, things aren't always explained well.

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