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Newborn in neonatal care, can't breastfeed

(36 Posts)
OstrichRunning Mon 21-May-18 05:04:12

I'm hoping someone can help.

My ds was born Sat night. I had gestational diabetes (on metformin) and even though it was well controlled ds had low blood sugar that night and was admitted to neonatal high dependency unit for a glucose drip. They have him on 35 mls formula every the hours and he's off drip for now as bloods stabilised, to see if hopefully they'll stay stable without it (still getting t formula). They encourage hand expressing colostrum here but umfortunately I've never gotten on well with expressing either colostrum or breastmilk (though bf dd for 1.5 years). So only getting miniscule amounts - like 0.1 mls a go. They aren't keen for me to bf as they say the energy he expends doing so could affect his blood sugar which they want to keep high. So they want the colostrum without the feeding : ((

Could anyone tell me, will my actual breast milk supply still come in, even if I've mainly been expressing over past 36 hrs since ds was born, rather than bf ing? Is there anything i can do in this situation? Desperate to breastfeed and really worried it won't happen this time. I've asked to see a lactation consultant today.

TIA

Mrscog Mon 21-May-18 05:10:52

I’m not an expert but I think your milk will come in anyway, and even if not much is coming out the action of the pump will help to stimulate this.

Are you allowed to do lots of skin:skin to get the oxytocin flowing?

Keep well hydrated, and I know it’s hard but I had to be relaxed for expressing to work.

Hopefully someone better than me will be along soon! Congratulations on your new arrival smile

OstrichRunning Mon 21-May-18 05:15:37

Thanks MrsCog. Skin to skin has been tricky because he was in incubator (out for now) but I've been doing as much as possible. I'm only hand expressing, they don't allow machine pump unto 48 hrs after birth.

Mrscog Mon 21-May-18 05:26:11

That seems like a strange rule - my friend who had a 28 weeker in nigh was given a pump immediately to help build her supply. Maybe you could insist on one today? Good luck though, it sounds like a difficult situation but I’m sure you’ll find a way, hopefully the lactation consultant will be able to help.

Mamaryllis Mon 21-May-18 05:30:43

Where are you? They gave me a double machine pump the first night (so less than 12 hours) - no wonder you are not getting anywhere hand pumping. Be very firm and ask for a machine.

Cheeseandwineandgin Mon 21-May-18 05:34:25

My baby was in the neonatal unit and had formula to start with. My milk didn't come in till day 5. Make sure you eat and drink plenty, lots of skin to skin, express every 3 hours even overnight-really important for supply. I am rubbish at expressing but the hospital grade pumps did the trick to get things going. Good luck.

43percentburnt Mon 21-May-18 05:40:49

Ask for a copy of their hypoglycaemia written guidelines. Formula does not help hypoglycaemia however some staff appear to encourage formula feeding as they can count how much baby is feeding. You will find the guidelines say mother should be encouraged to breastfeed.
www.google.co.uk/amp/s/www.unicef.org.uk/babyfriendly/baby-friendly-resources/guidance-for-health-professionals/implementing-the-baby-friendly-standards/further-guidance-on-implementing-the-standards/hypoglycaemia-policy-guidelines/amp/

Speak to pals at 9am ask for the guidelines.

Is the hospital baby friendly? There will be posters around, or google unicef baby friendly iniative.

I had a similar experience and complained once discharged. Staff were found to have ignored hospital policy.

43percentburnt Mon 21-May-18 05:46:51

www.meht.nhs.uk/EasysiteWeb/getresource.axd?AssetID=1719&type=full&servicetype=Attachment

This is likely to be similar to the hospital policy. Are they following it?

Page 10 has a flow chart.

43percentburnt Mon 21-May-18 05:56:25

Ask the staff member who said sucking may tire baby out to write that in his notes and sign it. What is babies blood sugar level? Is baby hypoglycaemic?

sorry For several posts I am currently breastfeeding and typing badly on my phone!

I’m sorry to say it but telling you not to feed your low sugar level baby is not policy. They are doing this for staffs convenience. Write it in your notes yourself, what was said and by whom. Ask to speak to the consultant midwife when they come on duty today. Ask them to read the guidelines with you.

Please complain. The manager I spoke to when I complained knew this went on but no-one ever complains about treatment if themselves and baby are fine.

Oh and policy is normally to tell the mother what problems dd may cause and write that clearly in her notes.

43percentburnt Mon 21-May-18 05:56:42

Ff not dd

Worlds0kayestmum Mon 21-May-18 06:00:47

Congratulations on your new baby flowers

My DS was born at 31 weeks and was in the NICU for a month. They encouraged hand expression at first and I produced tiny bits of colostrum. They gave me a pump to use later and milk came in within a few days. I wasn't able to latch him on until he was about 2 weeks old. He's just over a year now and we are still feeding.
I remember the desperation and stress of worrying about it not coming in, drink and eat plenty, express regularly and try not to get too worried about it

Mermaid36 Mon 21-May-18 06:09:37

Congratulations on the birth of your baby!

I had 26 weeker twins and was given a double hospital grade breast pump 24hrs after delivery.

Milk doesn't come in until day 3-5, so all isn't lost. Please ask for a pump and start expressing. I was only getting colostrum and dribbles for 5 days, then bang! Day 5, woke up like Dolly Patton and then some.

Make sure you drink loads of water/juice and try and eat properly.

I expressed for 12 weeks before getting my girls to feed direct from me (whilst still in NICU). We got the girls home at 16 weeks old.
I'm still feeding both girls at 2 years old (though thankfully just down to 2 feeds a day!)

Callmegeoff Mon 21-May-18 06:11:46

www.laleche.org.uk/hand-expression-of-breastmilk/

georgeisadinosaur Mon 21-May-18 06:44:37

My little one was born at 35 weeks and like you they said BF would drain the energy too fast and to express. I hand expressed a little colostrum but only managed tiny amounts, they gave me use of a double pump almost immediatly though and I was told to religiously express every 3/4 hours even if it was tiny amounts. I didn't often manage enough for a full feed so baby was largely formula fed.

Gradually encouraged the latch from about a week old and baby did fine. We are still BF 2 years later! Its totally possible just takes a little extra effort. Congratulations!

ingenvillvetavardukoptdintroja Mon 21-May-18 06:57:59

I had full term baby with unexplained low blood sugars who was in NICU for 4 weeks.
He was given formula for the first couple days. I was hand expressing drops into a syringe! So frustrating but staff encouraged me to keep going. Think milk came in day 3 and I was lent an electric pump once I came home - I pumped round the clock at least 8 times a day and took milk up for him daily.
I kept trying to feed him directly but he wouldn't latch until week 2. When he did, they worried he wasn't getting enough because he only fed 5 minutes - turns out he is just super efficient feeder. He came home at 26 days and fed without issue until 22 months.
Even if he is being tube fed then surely they can use your milk instead of formula?? If he's bottle fed surely that uses same energy as breast?

eurochick Mon 21-May-18 07:15:23

I had a baby in nicu and my milk definitely came in! I hand expressed into a syringe (tiny drops at first) and then used a pump after about three days. My hospital pushed formula and told me my milk couldn't possibly have come in (I'm educated to postgraduate level - bright enough to recognise milk coming out of my own breasts you would think, but super arrogant consultant thought she knew better). I had to push quite hard for them not to use formula, even though the walls were plastered with posters about how good breast milk was for premmies🙄.

OstrichRunning Mon 21-May-18 07:18:09

Thanks so much for the kind messages, I can't say how reassuring all that is.
His blood sugars fell a bit again once off drip so he's back on it for now - it's just a matter of how long it'll take his body to regulate its insulin production. I managed to get a tiny bit more colostrum this am though and bf him there before his formula - he latched on like a pro and I got cramping which I think is a sign something was going right.

That's interesting about the pump and the 'rule' re bf affecting energy - going to stamp my feet a little bit about the pump today for sure.

Thanks again. I feel like this might still work now smile

TheCatFromOuterSpace Mon 21-May-18 07:23:57

I had a similar experience when Dc1 was born. I didn't really have the confidence to argue with the hospital staff as I was shattered and traumatised from her birth. However my milk came in at day 5 and my confidence came back and I did successfully bf her. The other thing the hospital tried to tell me was to only feed her every four hours, that is bad advice as you probably know. Also make sure that you have enough to eat and drink. The best thing for me was getting discharged so that we could get on with it by ourselves and with the support of the community midwives who were pro breastfeeding.

Kannet Mon 21-May-18 07:24:49

I had similar to this three months ago. I insisted on double pumping every few hours. We never breastfed in hospital but it took about a week to get it established once we got home abs he was nearly a month old at that point.

AgedTawnyPort Mon 21-May-18 07:27:26

Congratulations op flowers.

I had a 29 weeker and started pumping 18 hours after the birth, I was in HDU at that point and hadn't even seen her.

I pumped every four hours for six months until she got the hang of bf. It is possible. Make a fuss if you have to.

Roomba Mon 21-May-18 07:35:18

I had a similar scenario with DS1 when he was born. It wasn't just that he didn't have the energy to BF, I physically couldn't get down to him (3 floors away) for a good 48 hours after he was born (and after that only with help) which was awful. I was lucky to be able to use a hospital pump which a very patient midwife showed me how to use for ages at 2am.

My milk certainly arrived in force anyway! Barely a drop of colostrum for days then on day 4 I suddenly looked like Lola Ferrari (ouch!) DS was tube fed for a few days then I just spend every second snuggling him and feeding him until he got the hang of it all. BF him for 2 years in the end so I'm so glad that midwife sat and helped me with pumping and another helped with latching later on.

Is there no available pump you can use? My hospital had a couple on the maternity ward but also a few on the neonatal unit as well. I found it SO much easier than hand expressing, that was a non starter for me.

Roomba Mon 21-May-18 07:42:16

Yes, breastfeeding does use up all their energy when they are so tiny. I had to keep waking DS over and over even when he was bigger and could feed okay - at one pint his tube went back in as they could see he was probably using more energy than he was taking in, which obviously isn't great especially with blood sugar problems.

It's hard to know if you're being fobbed off or if there's a reason for their decisions if they don't explain it all properly. If you're unsure please ask lots of questions as to why they want you to do things in certain ways. I hated DS being tube fed formula and assumed they didn't have the time to help me BF, until they explained why they wanted to do this temporarily.

I forgot to say Congratulations before sorry flowersflowers

Iamnotacerealkiller Mon 21-May-18 07:43:14

Had exactly the same. My son was nicu for first three days and never latched. Hospital gave me a hospital grade pump the second day and by the end of day 3 he was getting 100% breast milk.

When he moved to the ward I was able to do some breast feeding too. It was exhusting as I was feeding him then expressing every 3 hours for over a week. My supply came in like crazy on day4/5 just a milky mess constantly which calmed down after a couple of weeks.

He is 3 months now and still 100% breastmilk fed but some via bottle so I can sleep! !

Ratbagratty Mon 21-May-18 07:55:33

Yes you can still breastfeed,I had a baby too small to have the energy to feed. I pumped for 15min a side every 4 hrs from day 4 (too drugged up from emergency c section to do it earlier). We did mixed feeding until about week 5 then went fully breastfed until 14 months old. Keep handpumping as often as you can and especially at 4am, until your 48 hrs are up, then get on to a pump.

Can you ask for a Breast feeding specialist to visit you? As soon as your out find a lactation specialist at a breastfeeding support group. You Can do, it's hard work but really worth it.

ForkIt Mon 21-May-18 07:59:23

My youngest was in nicu after GD, I was allowed to bf. To be honest she just patched and tended to doze off for 3/4 days, didn’t sickle until tired, it was latch- sleep. Seemed happy though. Milk came in and stopped formula about day 8 completely—still trying to wean off BF now at 2.5–

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