Problems developing with newborn BF baby, any advice? Please?

[hopefully]

If anyone can offer any tips, I'd be eternally grateful!

DS was born last Wednesday, weighing a somewhat less than dainty 9lb 9oz. He fed incredibly well initially, despite me not being able to get near him for 2 hours due to PPH (lost 1.3 litres apparently), tear stitching etc.

He has had no problems latching since then, and fed well for the first 2 days in hospital. However, ever since then he has been getting progressively sleepier and sleepier at every feed. He latches on really well initially, but is falling asleep within a few minutes and dropping off the breast. I am trying everything, blowing on him, tickling feet, nappy changing etc, but few feeds are managing to get beyond the 10 minute mark, whereas before he was feeding happily for up to 40 minutes at a time.

The result appears to be sleeping problems, as he is only really sleeping well for an hour at most after a feed, and often not sleeping at all.

He also appears to be terribly constipated. He is managing to produce the odd dirty nappy, but hasn't produced one since early yesterday morning, and has clearly been in distress about it since about yesterday afternoon, bringing his legs up to his tummy and squeaking quite often. I think this is also stopping him sleeping, as he appears really uncomfortabl . e sleeping on his back, preferring to sleep curled up in a ball on one of us. This is fine, but I am terrified of co-sleeping, as I am still a fairly heavy sleeper, so the result is me and DP sleeping in shifts in the night while the awake one holds him.

Anyone got any thoughts on (a) getting him to feed for longer, in the hopes that he'll be able to survive a bit longer and (b) solving the constipation?

Also, he's coming up for 5 days old, and although my colostrum does slowly seem to be turning into milk, I certainly haven't had major swelling and the feeling that my milk is thoroughly 'in'. Nipples getting really quite sore from constant feeding, but boobs not swelling especially.

Sorry, monster post, and probably left out loads of details..

[hopefully]

He is also doing the classic thing of sleeping happily during the day, and I'm not sure whether to wake him regularly to feed or take the opportunity to sleep when he does?

[BabiesEverywhere]

As he hasn't done a poo since yesterday morning, please call your midwife and get him checked over asap. He should be having several dirty nappies a day at his young age.

Your milk might not have come though yet mine took 5 days and it can take longer but again your midwife can advise on that.

HTH

[idontbelieveit]

Definitely wake him in the day every couple of hours, that should stimulate your milk to come in more quickly. At 5 days old you need to feed him pretty much constantly. Your prolactin levels (hormones that help you make milk) are higher at night so feeding often then maybe his way of getting even more milk to come in. Have a look here for some really good info. I'm sure someone better qualified than me will be along in a minute. Have a search in this topic for some good advice too.
oh and congratulations!

[pushchair]

Am not an expert and I'm sure one will be along soon.
Is he gaining weight yet?
Is he producing wet nappies? I have read other threads that have reported quite late coming in of milk, so that may not be too much to worry about.
Btw congratulations!

[idontbelieveit]

Your PPH may slow down the milk coming in. Have you got iron supplements? After my PPH noone bothered to tell me i should be taking iron tablets for about a week.

[hopefully]

MW is coming at 10:30 anyway to weigh him, so will talk to her then about that.

I know it sounds slightly like I'm just getting concerned about normal newborn behaviour, but I'm just worried that the feeds are getting less and less useful for him, and it's going to mean abandoning breastfeeding if he doesn't feed properly and put on weight.

[idontbelieveit]

I think BabiesEverywhere is right, i would call your midwife just in case but DON'T PANIC! just keep feeding him!

[hopefully]

He is producing wet nappies, not a huge amount, but certainly a few a day.

My iron levels were tested and were ok (10.9 I think), but I have a low dose of iron tablets anyway.

Will check out that link IDBI. I'm trying to wake him every couple of hours, but to be honest he's barely ever asleep long enough for that to be a problem!

[bamboostalks]

A bf baby should definitely not be constipated like that at 5 days old. I would phone your midwife asap or your GP. This does not mean the end of breast feeding at all. Keep going.

[hopefully]

Oh, and as an example, from 6am sat to 6am sun, he fed 12 times (think he fed about 10 in the previous 24 hours), with a couple of sleeps of 2-3 hours and lots of shorter ones, and from 6am sun to 6am this morning he fed about 18 times, with lots of screaming in between feeds and only 1 sleep of 2 hours.

[BabiesEverywhere]

hopefully, Please try not to worry, it is early days yet and I'm sure your midwife will be able to answer questions and reassure you.

Re. Feeding properly and putting on weight.
It is normal for a breastfed baby to lose up to 10% of their birth weight in the first few days and the midwife will want him to regain his birthweight by around the two week mark.

'Feeding properly' will vary a lot for a breastfed baby. Feeds length and number of 'sides' will vary from month to month and increase a lot when the baby has 'growth spurts'.

The only thing which needs checking out at the moment is the lack of poo which is whilst likely to be nothing (just a big poo brewing) does needs proper medical checkup to be on the safe side.

[idontbelieveit]

hopefully, I'm sure he's just "waking up" after getting over the birth and trying to stimulate your milk supply. If he loses weight in the first few days it's nothing to worry about. Please don't think this means the end of feeding. My dd dropped about 15% of her bodyweight (she was fairly big at 8lb15) but regained it all within about 20 days.
My milk didn't come in for about 6 days (after traumatic c section and PPH). I'd ring your midwife just to make sure she treats you as a priority this morning (they often don't make it when they say they will due to short staffing etc).

[tiktok]

It's good your midwife is coming today...and I would agree with the posts here that what's happening does deserve a proper look at the way feeding is going.

He is not constipated - unless there is some very rare problem. Lack of poo in a baby of this age can mean feeding is not yet effective, and he has not had enough in at the 'top end', and this needs to be fixed as soon as poss.

Getting 'sleepier and sleepier' is the opposite of what most babies do now, as well.

None of this means you need to panic - it is easily fixable, and the fact you are seeing the midwife today is really good, as he will be weighed and this weighing will add to the info and help assess the way forward.

Skin to skin contact for as much of the day and night as you can means you can respond quickly to feeding cues, before he drops off to sleep again. Your midwife might suggest you start hand expressing.

However, all may be well - he does not need to feed longer than 10 minutes if 10 minutes is enough for him. These feeds should be frequent - frequency is more important than length of feeds.

Post back and let us know what's happened!

[cockles]

Just wanted to add, don't get too worried about length of feeds - I had one who only fed for 5-10 mins froom about this age , he was just an efficient feeder. Frequency is more important as tiktok says. Hope things get clearer soon.

[hopefully]

thanks so much for all the advice, making me feel a little better after a night of tears at all my failings. think i'm feeling particularly sensitive as i've been trying to think positively about fairly awful birth by consoling myself that DS was born using only G&A, giving him best chance of establishing BF.

Will let you know what MW says. Also, any thoughts on changing sides a few times during a feed? MWs at hospital were keen to keep him to one side per feed, have been swapping him over a bit mid feed this morning and think he's staying more awake. Am I doing more harm than good?

[tiktok]

Hospital midwives were wrong and should not be telling mothers to try to only feed on one side

It is fine to feed on one side only if the baby wants it that way but mostly, babies should at least be offered the second side, unless they are clearly satisfied and content after one.

Frequent stimulation of the breasts is what drives the milk supply, and deliberately only using one breast per feed halves the stimulation, which isn't good.

The stricture to use only one breast per feed is a misunderstanding of how breastfeeding works. Mothers used to be told they had to feed the same length of time on each breast every time, and to take babies off the first one in order to 'use' the second one. This is equally misleading - and it was good midwives stopped saying this. But some have swapped one daft rule for another one

[idontbelieveit]

Always offer the second side when he finishes the first. Then start the next feed from the side that you offered second. If he doesn't want the second side, offer that first at the next feed.

eg. first feed: Left, Right
second feed: Right, Left
third feed: Right only
fourth feed Left, Right
Does that make sense? It can be useful to wear a bracelet and swap sides when you swap breasts so you remember where you're at, especially when you're sleep deprived!

[hopefully]

MW has left. She was supremely unconcerned about his lack of pooing, which I was surprised about after everyone's comments.

He was weighed, and has lost less than 10% of his birth weight - think it was about 8% loss, but will check notes later - which might account for her lack of concern.

Tiktok thanks for the reassurance about feeding from both sides - it didn't seem right to me, but I was in no state to argue with anyone at the time!

He's a little traumatised after weighing and heel prick today, so my plan for the rest of the day is:
a) get as much skin to skin as possible for the rest of the day - any thoughts on how long I should leave him before waking him for a feed if he goes down to sleep for a long time?
b) offer the second side when he pulls off the first one - if he pulls off through falling asleep, do we think I should wake him with a nappy change and offer the second side, or leave it until he wakes again?
c) phone a BF helpline later this afternoon if he doesn't poo, as it will mean he's gone 36 hours without doing so.

I'm hoping that this will mean frequent enough feeding that we might simultaneously solve the pooing problem - perhaps he's just not been getting enough going in the top, as you say tiktok Idontbelieveit thanks for the bracelet tip - I always thought it was an odd idea, not realising that sleep deprivation would mean that I actually no longer have a brain. Will definitely do that, as have really been struggling to remember which side I last fed from.

If anyone's got any more thoughts or tips, keep them coming!

[foxytocin]

hopefully, i've posted on the post-natal thread.

[tiktok]

hopefully - lack of poo is only a sign to check things are okay, not something that's a problem in itself. Good that the midwife has seen him and weighed him, and if the weight was done accurately (baby naked, calibrated scales, not a spring balance thingy) then the loss you describe is absolutely within normal limits

If you do skin to skin you will not need to wake him - he will make movements in a lighter sleep which are, in fact, feeding cues. If you need specific timing guidance, then you could start offering about 3 hours from the start of the last feed (which is not the same as 3 hrs sleep, of course ).

If he doesn't want the offered second side, then no need to wake him to make him take it - just put him on the second side next time he indicates a feeding cue.

[hopefully]

tiktok weighing was done properly, glad you agree weightloss is ok!

will keep an eye on feeding cues as we're doing skin to skin, and keep an eye on the time as well.

Will update later on with any progress/more problems!!

[treehugga]

My book talks about newborns not pooing for days at a time, and this being normal. Don't worry if MW not worried. Reckon poos will come, but you might find baby complains a lot getting it out - v stressful! Sounds just like my DD (now 3 weeks old) who still needs poos to be coaxed out with relaxation (tummy massage starting to work at last, but first she screamed at that so instead just tried diff tummy2tummy positions til she eventually quietened). Re sleep, book says let baby sleep up to 3 hours in day, 4 at night and then wake her. This worked for me. I had no idea when baby ate or slept and ended up writing down start and end of each short feed (often 5 mins, 8 mins, 3 mins etc). Tried to get them to add up to 20 mins each side before swopping, and that did make me feel less confused and happier she got mix of fore/hind milk.

[noonki]

if you feel he has a tummy ache (pulling his legs up to his tummy and crying is a good sign)

try 'cycling'his legs as that can help with wind/constipation

weightloss totally normal.

i would try changing nappy midfeed as may stop him dropping off,

I used to stroke my ds1's face to keep him awake (strangely now puts him to sleep)

and on the pooing front, my ds2 didn't poo for about two/three days when he was around 10 days nothing to worry about I'm sure, but iron tablets can make adults constipated so maybe babies too?

[tiktok]

treehugga - which book is this? No poo in newborbs can be ok, but it should always be taken as a sign to check all is well. Also the timing sounds a poor guide, sorry....three hours sleeping may be too much for a newborn, because it could easily mean a long time between feeds (depending on how long the feed took). 20 mins before swapping is not really necessary - some babies need more, some less and the foremilk/hindmilk thing sorts itself out Lots of misunderstanding about foremilk/hindmilk - baby doesn't have to 'drill through' to get to the creamier milk There's a good explanation of what happens on www.kellymom.com if you click through to how milk production works.

[treehugga]

Can't remember which book/site, have looked at a lot and lots of contradictions between them all. It's advice mayhem out there! At hosp different MWs would say diff things every 5 mins. Could this be perverse NHS policy to get mums to firm up on own instincts and ignore all incoming advice?? Like the kellymom site.