Urates, dry nappies in 4 day old DD

[BabCNesbitt]

DD2 was born Sunday evening at 37+5 and we were discharged Monday afternoon. I thought BF was going ok as she seemed to be latching on ok and showing full cheeks etc. But she's still got tarry meconium poo today, and we've only had urates so far - no wet nappies (although she did pee all over the changing mat this morning). She was sent back up to the hospital by the community MW yesterday (she's slightly jaundiced) and they found she hadn't yet lost 10% but I need to take her back in for checking with the community MW tomorrow.

I've spent the day in bed with her doing what I was advised - feeding on demand but every two-three hours minimum, stripping her down to her nappy to keep her awake for feeding - and she's feeding lots, but it doesn't seem to be making a difference.

Other points:

• latch seems a bit rubbish now but I can't seem to fix it. Blistered nipples.
  

• I've had a hideous cold for a week (it was the cough that helped to break my waters, it seems!) and I'm still full of snot, chest death rattle, and (since last night) a hugely swollen lymph glands on one side of my neck. I'm wondering if I'm just too dehydrated to feed her properly?
  

Any advice?

[NewIdeasToday]

This does sound worrying for you. Can you phone your maternity ward this evening and go back to get advice? Or is there an out of hours community midwife?

A sign that babies are dehydrated is if their fontanelle starts to dip. How does it look?

[BabCNesbitt]

She has a lot of hair so I can't see, but it doesn't feel like it's dipping, though I'll keep checking. I have a number for the hospital but no OOH midwife number, I don't think?

[CaravanOnCraggyIsland]

Where abouts are you OP? Have you looked at the national breast feeding helpline?

Or Dr Jack Newman videos on YouTube, the Milk Meg, breastfeeding uncovered, Kellymom?

I would suggest if you're concerned about urine then pop a cotton ball in her nappy and see if it's wet. Disposables are stupidly absorbant and babies don't really wet as much as we think they do.

[CaravanOnCraggyIsland]

Also is it Greeny black rather than full black and has your milk come in?

[BabCNesbitt]

I'm in Yorkshire. I do remember calling them when I was having issues with tongue tied DD1, and tbh it didn't feel terribly helpful over the phone; I couldn't translate the spoken advice into practical action. Had a look for a biological nurturing video last night (as this was suggested by the breastfeeding support person at the children's centre) but what I saw, again, didn't work in practice - DD2 just kept rolling off my huge post-birth belly!

Will give the cotton ball thing a try.

[BabCNesbitt]

It looks like milk rather than colostrum, but my breasts don't feel "full" like they did at this point with DD1. The poo was maybe slightly green?

[Mungobungo]

I suggest. Cotton wool ball in the nappy to keep an eye on utine output.

Keep putting baby to breast 2-3 hourly, if latch doesn't feel right then either go for biological nurturing (skin to skin, baby in your chest and let them bob around to find nipple - don't be tempted to move them, let them do their thing)
Or go back to basics - tum to mum, spine in a line, nose to nipple, wait for gape etc.
If latch doesn't feel right: i.e. Tie curling feeling lasts more than 30 seconds, take baby off by sliding little finger down the side of nipples into baby's mouth to break the seal, then start again.

If baby doesn't latch or doesn't feed well or your breasts feel full post feed, express some milk off and give it to baby on a sterile spoon (put spoon to baby's mouth and let baby lap at it like a kitten).

[BabCNesbitt]

Thanks, mungo. I forgot to mention that they recommended hand expressing after a feed then cup feeding it to her, but I got barely 5ml out and most of it dribbled down her chin.

[Meffy]

If you've got electronic kitchen scales ... weigh a dry nappy and then weigh all the wet ones!!! This will help give a good idea of output.
Have you tried different ways of holding her.... some are much better if you are well endowed.
If she's still jaundiced then put her Moses in front if the window.
Use some great nipple cream and RELAX!!! It doesn't sound like your milk has come in yet..... fingers crossed for tomorrow ... i always find it stops you stressing as you can feel the emptying!

Enjoy her !

[BabCNesbitt]

Thanks, Meffy - not much light in Yorks at the moment! DH put 3tbsp of water in a nappy (saw this amount mentioned on Kellymom or somewhere like that) and it was noticeably heavier than any of her nappies have been.

Positions: have tried bio nurturing (she rolled off, I got backache); various cradle holds; her resting on a My Brest Friend pillow (most successful).

[Nan0second]

5ml is tons!
Can you use a syringe (e.g. Calpol)? Much easier then trying to use a cup!
Agree re cotton wool in nappy.
She may need checking out though

[CaravanOnCraggyIsland]

Ok, how about breast compression?

You didn't have a large blood loss did you? Bit of a shock of a labour?

Have you tried the flipple technique?

[BabCNesbitt]

Good idea about a Calpol syringe (is that what they use when people talk about syringe feeding?)

Caravan, sorry, I must seem like I'm being deliberately obstructive! Is breast compression just squeezing while the baby feeds? I watched that video but couldn't make out what he was doing and what the "theres" related to. DD still likes to curl her knees up at all times so the flipple technique is a bit awkward!

She's just peed all over the changing mat twice (and over DH) and managed a wet greenish-brown poo, so could that be a sign that it's picking up for her?

[Nan0second]

That sounds good.
Yes that is what they mean by syringe feeding.
Poke the syringe right to the back of the cheek - much better for making them swallow it :)

[CaravanOnCraggyIsland]

You've just had a baby mate, I think you can be forgiven for being a bit all over the shop . Ok, breast compression is a rhythmic squeezing similar to what you would do in hand expressing. So in the video, the woman squeezes the breast to encourage milk flow. The 'theres' relate to the pauses that baby does in the suckling where you can see babies mouth filling with milk, so baby sucks, pause as milk flows into mouth, then swallows. See what I mean?

Anyway, browny green is amazing. That shows you right there that milk is getting into her. Her poo wouldn't change colour otherwise, nor would she have peed over the mat.

Both my babies got urates for the first few days. The midwife didn't seem to bat an eyelid over it. Seriously, the best thing you can do is relax, get your oxytocin flowing and just shove a boob in your babies mouth as much as you can. A good mantra is always 'if in doubt, boob.' It's such a good cure all.

Even if she comfort suckles for a few minutes here and there as well as her regular feeds (which will be all over the place at the moment). She'll be helping your body lay down all the milk receptors that you need to feed your baby long term. This is all done within the first two weeks of breastfeeding, it's like she's ordering in for a long winter in the spring.

Take heart, you're doing a fab job.

[BabCNesbitt]

Thank you! That's made me a bit tearful now, effing hormones...

I couldn't really see the pauses as it just looked to me like the baby was sucking and swallowing constantly with no pause, but I was also slightly terrified of the twisted up shape that he'd contorted her breast into - I'm not sure mine would do that, even if there were the space to fit a hand in!

"If in doubt, boob". I'll do that.

[NewIdeasToday]

Glad to hear your evening is improving. Hope you get some sleep tonight and lots of wet nappies tomorrow!

[CaravanOnCraggyIsland]

It was very very slight in the videos, there are better ones out there to be fair. You'll probably see it in your own baby, there'll be rapid sucks as she stimulates your let down, which will eventually settle down into a suck suck pause swallow, suck, suck, suck pause swallow type of pattern. You may hear her swallowing and see signs of milk round her mouth as well. Hope Ms Madam lets you sleep a bit tonight.

[Poosnu]

Tongue tie does run in families and if DD1 was TT then perhaps this may be an issue? Might be worth getting a tt practitioner to the house to check if you are not completely happy about feeding.

My DC2 and DC3 both had TT. It is apparently a recessive gene which causes it.

[Bex134]

Sounds similar to how my little one was at 3 days (he's now 18 days) - he was sleepy feeding and I felt he was just going through the motions rather than swallowing and feeding. We gave a little formula which then gave him an energy boost to keep feeding and he fed all night. Interestingly around an hour after formula my milk came in - whether it was because I'd relaxed I'm not sure. Keep calling for advice from the breastfeeding support I really had to push mine as it sounded like DS was feeding but I knew he wasn't.

[CaravanOnCraggyIsland]

How are you today OP?

[Bobbybobbins]

It took a few days with both of mine for my milk to come in properly - don't know if having 2 emcs affected it! We used small amounts of formula for the first few days to give baby a bit of energy also then stopped it on day 5 or 6 once my milk was fully in. Kept having baby on me to get my milk in but .inwas bleeding after 3 days of dry sucking.

[pileoflaundry]

Just in case, as you DD1 had TT, have you checked DD2 for tongue tie?

[CaravanOnCraggyIsland]

Bobby That's actually fairly standard for those having a c-section to have delayed milk coming in, I'm surprised no one mentioned it to you.