Jaundiced, sleepy newborn weight loss. Conflicting advice.(5 Posts)
DS2 was born on Thurs 19th weighing 8 lbs 8 oz. He got the hang of latching on very quickly and all seemed to be going well with feeding. My milk started coming in on day 3 and I could hear him swallowing it. However, he also developed slight jaundice and is/was very sleepy.
The jaundice has been monitored and isn't at the level that would indicate treatment. On day 4 (yesterday) his weight loss was calculated to be 11.1%. My hospital reckon up to 12% is OK for a bf baby, but as we were very close to this the midwife we saw that day recommended 3 hourly feeding, first with breast, then topping up with 60 ml of ebm, formula or a combination. Although I want to bf, I would much rather take no chances with weight loss so was happy to follow this advice. So there followed a pretty stressful 24 hours of 3 hourly feeds and expressing where he slept pretty much 100% of the time. He was barely interested in breastfeeding and needed much persuasion to take anything from a bottle, although we managed to get 60 ml (barely) into him most feeds, normally half and half ebm and formula.
So I was close to a nervous breakdown today thinking that my baby is dangerously underweight, jaundiced and so weak he is barely awake. However, the midwife who came out today weighed him and apparently he's 180g heavier than yesterday, which makes his weight loss 6.54%. Her explanation for why he is so sleepy is that we were actually feeding him too much over the past day and so he has been in a food coma, not needing to wake up and demand to be fed because his tummy is full. Her advice was to reduce the frequency of feeding to 4 hourly to try to restore his interest in breastfeeding, obviously feeding him sooner if he appears interested, and to continue with the top ups. For the next feed following this visit I took her advice and woke him 4 hours from the previous feed. He fed very well from the breast this time and refused the top up. However, he's still so sleepy - had closed eyes throughout that feed and has slept ever since, which was 3 hours ago.
I am just so confused and can't make sense of it all. I had anticipated bfing a newborn to be little and often, cluster feeding etc and led by baby waking and showing signs of wanting to be fed. Instead, he seems to be sleeping all of the time, and I'm having to wake him up and being told to leave a pretty big interval between feeds. Perhaps he's just a naturally sleepy baby, but the jaundice makes this a little worrying - I know he has to feed lots to help flush it out of his system.
His nappies have been concerning me a little too. He's had tiny spots of urates in most wet nappies since day 2 but he specialises in peeing while his nappy is off so he's never given us a heavy wet nappy. Poos are just about on track I think - just turning pale greeny yellow and numerous small ones.
I would really appreciate any thoughts you have on feeding a sleepy newborn 4 hourly. Believe me if I could be sitting here cluster feeding him I'd be delighted! He is just so difficult to rouse. He screams the place down when on his changing mat and when his clothes are stripped off but he just goes back to sleep again at the drop of a hat.
4 hourly is not enough for a sleepy newborn. It will also not help you establish breastfeeding to feed that little. 60ml is an awful lot of formula to give if you want to persevere with breastfeeding too.
Just feed him at the least cue -fussing, crying etc- and never more than 4 hours apart. It sounds as if he and you are doing well and just need to get it more established. There won't really be a pattern to his behaviour for a while and sleepiness s very common in the early days, especially with jaundice. Congratulations!
kellymom.com/hot-topics/newborn-nursing/ suggests nursing every 2 hours during the day (4 hourly overnight) for sleepy babies
Thanks for the replies. He's been much more alert and breastfeeding loads this evening since my post, which is brilliant. I haven't expressed or given any formula due to this - not sure what's the best thing to do but I seem to have milk in abundance so I assume he's taking what he needs from me.
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