Jaundice and bf

[Mamamia321]

So in hospital with 3 day old. She was born by emergency c section. First night my milk was not in she was starving and eventually gave her formula 25 ml and then resumed breast. Ok for couple of days. Then last night she only woke once to feed an b this benign she had spent most of the day sleeping and was unrousable and not eating, no wet nappies etc.
So came to a & e who said jaundice an have me expressing and feeding every 3 hrs.
She has taken the bottle and perked up and now bf too.
Just wondering what I should do next presuming they. Happy and she is discharged, feel like failed at bf but thn my body was not read as had ec. Such a worry that sh became so I'll so fast and had zero interest in feedin.
Should. Now mix feed bottle and breast or try return to bread? So I wake to feed or hope sh will?

[TheJunctionBaby]

My dc's have all had jaundice. Personally I would try to persevere with the breastfeeding and wake to feed every 3 hours. If baby is not staying awake to feed properly try undressing her and rubbing her body, or take a break to change nappy. Also try to expose her to sunlight to help break down the bilirubin. If you do decide to formula feed then don't feel a failure! As long as baby is fed and healthy you are doing your best x

[sallysparrow157]

There's no reason why you can't do a bit of both whilst getting feeding established. Wake and put to the breast every 3 hours at least to encourage your milk to come in properly but if you think she's not taken much offer a bit of formula as a top up.
The trouble with jaundice is it makes the baby a bit sleepy so less interested in feeding so more dehydrated so less liquid to flush the jaundice out so more jaundiced so more sleepy and so on! So it gets into a vicious circle. So even if you need to give a fair bit of formula just to get through this period, as long as you keep offering the breast there's no reason why you can't go back to just breastfeeding once the jaundice has settled. Or keep mixed feeding. Or give just formula. Whatever works for you and baby. You've already helped build a healthy gut flora for her by giving her the breast milk you have so far and she's had all the immune goodness from the colostrum so even if you just give formula from now you've done her the world of good already

[AnythingNotEverything]

As others have suggested, wakes feed every 2-3 hours. Expressing so you can top up by bottle is great, but don't worry about giving some formula if you need to - it's important to give bough fluids to flush out the bilirubin.

DD1 had jaundice and we were readmitted for more nights under a bili lamp. We fed until 14 months. Despite a rocky start, it is possible.

[Mamamia321]

Ok thank you. Been expressing all night as required at hospital but between that and bf have had two hours sleep. And two dcs at home that need me. So will see how daytime expressing goes or get formula.
Anything she is under threshold fo lamp apparently but was totally zonked out so started with this or was going to. Nb tube. Luckily sh has taken to bottle. Neither of m boys would go near on.

[AnythingNotEverything]

Don't panic OP - if she's under the threshold for the lamp levels can't be too high, but do be vigilant about waking her and pushing the milk through her system. She literally has to poo and wee the bilirubin out.

In a few days you can go back to feeding on demand.

Congratulations on your lovely newborn though.

[NickyEds]

My ds was jaundice when he was born. Between that and the fact I'd had some diamorphine during labour made him a seriously sleepy feeder for several days. I was told to feed every two hours (measuring from the start of the feed) and strip him off to feed. It still took nearly three weeks and f top ups to fully clear it and get him gaining weight. I didn't express though- just put him to the boob and gave f top up from day 11. You must be exhausted. Don't worry about giving some f (or switching altogether), feeding sleepy babies is hard.

[ShadowFire]

Agree with the recommendations to persevere with the breastfeeding and waking to feed every 2-3 hours. And plenty of sunshine to help break down the bilirubin.

DS2 developed jaundice soon after he was born - he wouldn't feed properly at first so we were still on the post-natal ward when the jaundice was picked up - and he ended up on a bili-bed for the sunbed treatment by the time he was 48 hrs old.

He'd got into a kind of vicious circle where he needed to feed to flush out the jaundice, but the jaundice was making him too sleepy to breastfeed, and the lack of milk was making the jaundice worse, and so on... He had to have regular cup feeds of expressed milk / formula to help flush the jaundice out of his system.

But, once the jaundice started to clear up and DS2 had a bit more energy, he started breastfeeding and took to it really well. He's 22 months old now and still breastfeeding.

[ChickenMe]

We had this too. Forceps delivery and a 37-weeker who was induced. She couldn't work out how to latch on.
I was expressing pretty much hourly at first and we had to mix feed as I couldn't express enough colostrum to fill her. We were kept in and we had the light plus a three hourly feeding plan. I had to cram what I could down her neck which involved waking her up at 3am and tickling her feet to force her to eat. It is quite a ruthless process.
Keep expressing and put the baby to the breast as much as possible. As much nipple stimulation as you can. Unfortunately this means waking her. It's aka a good idea to get her some sunlight to help get rid of the jaundice.
My milk came in and I used a nipple shield to latch DD on. I was able to ditch the formula and top her up with ebm after that.
It is hard but after a week we were elusively BF and still are at four months. Good luck. You may have to dig deep now but long term it should work out fine.

[Mamamia321]

I am back from hospital now. So tired. The hospital pump was amazing could do both boobs in ten mins. I only have a manual at home. Which is the most powerful affordable electric?
Yes it does feel relentless and I am so tired. Was so happy to see my dcs. Unsure how to keep up this demanding regime but I will. Dh has always been utterly useless in the night. He makes up for it in the day with housework and wearing out other two but still nights are tough.
Been told to keep 3 hrly feeds up for a week and see. Will also take into sun thanks for tip.

[PenguinPoser]

Sorry not sure about electric pumps but anything by medela is normally good. I had similar problems to yourself as well- jaundiced sleepy baby not wanting to latch. Every 2 hours during the day and every 3 at night I put her to boob. When she refused I topped her up with ebm or formula as per midwife instructions. She only needed topping up for 2-3 days and gradually got used to the boob. Jaundice took 3 weeks to clear up properly though.
You're doing great. This sounds normal. You're not doing anything wrong. It is really hard but you can do it if you want to bf. But mixed is fine too!
Get as much bf support as you can. Do you have a local la leche league group?

[ShadowFire]

One of my friends hired a Medela hospital grade pump to use at home. I don't know how much that was, but she said it was hired (and charged) monthly, so that might turn out to be a cheaper option if you're only going to express short term.

[NickyEds]

The nct rent out hospital grade pumps-have a look on their website. For ones to buy I used a Lansinoh double electric and it was good.