Practical questions about ELCS and baby going into neonatal

[Frances79FirstTime]

Hi all

I'm hoping someone can answer a couple of practical questions I have thought about since my last visit to the hospital, when I really should have asked all this stuff but had lots of other stuff going on in my mind!

I have an ELCS for medical reasons booked for the end of December. The one thing I do know is that my baby will be taken away almost immediately for assessment on the neonatal unit (with possible/probable heart problem) and I will be packed off to the post-natal ward for recovery. My (probably obvious) questions are:

1. I know I am going to be pretty immobile in the immediate aftermath of the ELCS but will I be able to be wheeled down to see baby the same day? How soon after? I'm worried that baby is likely to be taken away within 5 minutes and I won't be able to see him for hours and hours while he has tests and is hooked up to machines, which will be horrible.
   

1. Does anyone have any experience of managing to maintain breastfeeding while their baby is on neonatal? I won't be able to get down there every time baby needs feeding, and they have talked about helping to express if that's what I want, or giving baby some formula (I'm not at all against that and if that's what they do for his and my wellbeing then I trust them to do that - if I end up having to bottle feed but my baby's life is saved then clearly that is my priority). BUT if I can express and baby is fed that artificially, how difficult will it be to establish breastfeeding once we are home (which could be 2-3 weeks later after major surgery in the worst case scenario). I just want to be realistic - and also plan to get more bottles etc in at home if that looks likely.
   

Thanks for any help or advice you can give.

[Frances79FirstTime]

Oh and also:

1. I have no idea what / how much to pack for the baby - do I provide a ton of babygros while he is in hospital? Are they generally naked in neonatal or does the hospital dress them? I am envisaging packing all the clothes I have bought!!

[VivaLeBeaver]

Ime you won't get to the neonatal unit until you can move enough to get from the bed into a wheelchair. Which is likely to be 2-3 hours minimum.

If you want to b/f then express. Your baby can be given milk by a cup if they're able to sip, this is better than a bottle as no nipple confusion. Majority of babies can do this but if a baby is too poorly then it will be tube fed. Hopefully you'd be able to be there for some breastfeeds and then just build on this.

[SomeSunnySunday]

I managed to bf a baby in SCBU, although he did have some formula top ups.

Actually I think the SCBU nurses' help was one of the reasons we managed to breastfeed - I was sore and tired after an EMCS, DC1 was ill, feeding hurt, and without the very supportive staff I'd probably have given up.

They helped me both with the feeding itself and with expressing (the hospital grade pump was very good). They mainly called though to the maternity ward if he needed feeding in the night when I wasn't there, and I was wheeled (and later walked) through, so I think there were probably only 4 or 5 feeds where he was completely formula fed (although lots where he was topped up).

Once we got home, after 8 days, I just stopped the top ups because I didn't know what I was doing and didn't really think about it. My milk supply ramped up, and I fed him for 15 months.

[SomeSunnySunday]

Re clothes, mine was mainly just in a nappy. But it wouldn't hurt to put a suitcase of vests etc in the car which can be brought in as needed. The one thing DC1 did need in SCBU was socks - his feet were freezing, and they kept trying to take blood from them, but we always needed to warm them up well first!

[Heels99]

I was wheeled down to the nicu after about 2-3 hours but dh was able to go sooner.
Did express and the nurse took it to the nicu night one and then I was either sat on the nicu ward or expressing in the expressing room in the ward. There was no problem getting the expressed milk to babies. They were tube fed and topped up with formula. They never managed to,latch on even after a month in hospital despite trying non bloody stop so eventually switched to bottles after four unproductive weeks of trying!
They provided clothes and blankets, I provided cotton wool and nappies. Yes at first they don't wear clothes anyway, then have a baby wardrobe, a whole wardrobe full of tiny baby clothes!
Be prepared that you may be discharged before baby, so could go home for a bit without baby.
Electric pump is handy, hospital may lend you one.
In my experience, the nicu were brilliant ,the ward was not.
Good luck!

[LittlePeasMummy1]

Hello, my daugher was in SCBU for a month and I established my milk supply with a pump and expressed all that time- milk supply quite low so she needed formula top ups After a couple of weeks, she started to feed directly from me for some feeds but i carried on expressing too. When we got home we took it slowly and I did mixed feeding for a while and gradually built up to exclusive breastfeeding over the course of a couple of months. In the end, I fed her til she was 16 months. Just take it slowly and be good to yourself, don't beat yourself up about feeding and remember to enjoy your baby. Hope all goes well

[Frances79FirstTime]

Thank you all - that's all really helpful!

[Thurlow]

DP went straight with DD to NICU. I didn't see her for about 11 hours, but that was more due to me being taken to the ward and generally being so out of it after a long labour I didn't stop and ask them to take me to NICU. Hopefully with an ELCS you'll be in a lot better place physically.

Take clothes, they might need to wear them. Take quite big sizes though as your baby might have a drip in its hand, and they put this sort of boxers glove around the drip to protect it, which is awkward getting clothes over.

I can't help with the bf issue as we opted to go straight to formula, but I can say that the NICU/SCBU nurses were absolutely amazing and we got so much care and attention down there, and that was with a baby who wasn't really very poorly at all. They also had the time to show us little things like how to change, wash and dress the baby, which are frazzled first time parents we really appreciated.

Good luck.

[JammyGeorge]

It may depend what hospital you are in but I was wheeled into scbu on my bed, it was about 7 hours after he was born though .

They kept saying I could see him when they discharged me from labour ward but there was a delay so I presume if all was well it would have been 2/3 hours.

That night he was unsettled so the nurses hauled me into a wheelchair and took me over, it was lovely, I sat and fed him for over an hour.

After the first night the nurses were fab they took me over whenever I wanted to go day or night. If I was having a little cry it was like right up in the chair we're going to see him!

It's only those first few hours after the elcs that are hard logistically, I still had a catheter in etc.

[bonzo77]

I went to see ds2 on nICU as soon as I could transfer from bed to wheel chair. Not sure how long that was after he was born, but he was born at 1030, and it was still light out side, and it was this time of year, so certainly less than 6 hours. I also managed to walk there myself a bit later the same day once the catheter was out. I got a good sleep that first night but after that I was in and out of NiCU doing as much of his care as possible including ngt feeds. I do think that all the slow but regular walking short distances made my recovery much faster.

He was naked in the incubator, and provided with a special hat with Velcro loops to support his tubes and wires. They had some clothes and nappies, but you were expected to provide your own asap.

I was not on the post natal ward, nor were any of the other women whose babies were on NiCU. We were on the antenatal ward and got much better care than I did after my first CS when I went to post natal.

I had no intention of bf, though I did express while I was in hospital. I was certain encouraged to. I was discharged before DS and they leant me a hospital grade double pump to take home with me.

[Thurlow]

And also to say, while there clearly doesn't feel like there is anything positive about having a poorly baby, if you do force yourself to find a tiny positive - you do tend to get more sleep. No other babies in your part of the ward, baby being cared for by its own personal nurse - I actually slept on the postnatal ward, which was a minor miracle. And I felt a lot better for it.

A PP has said that she was on the antenatal ward, whereas in my hospital all women with NICU/SCBU babies were still on the postnatal ward. I would ask about that before you go in, so you can prepare yourself a little for whether there are going to be other babies around you.

[Frances79FirstTime]

Thanks all.

They have told me I will be on the postnatal ward, but there are side rooms for people whose babies are in NICU (I guess so as not to rub it in!) so hopefully I will be in one of those. The good night's sleep certainly looks like a bonus I will be thankful for!

We had a tour of the neonatal unit last week and are confident that all the staff are terrific and I am confident baby will be in safe hands - will just be odd to be separated from him so quickly, but thanks to everyone for putting my mind at rest that hopefully it will be a matter of hours that I can get wheeled down there. And as for clothes for baby, I'll just pack everything we've got and leave it in the car I think!

[Thurlow]

Pack ear plugs/iPod and a sleeping mask just in case you aren't on the side ward. There's always that tiny chance that there have been a few more babies in SCBU than they planned for and you may have to be on a main ward for a night.

[WorrisomeHeart]

It's great that you'll have a separate room - I was on a ward with 5 other ladies and babies when DS was taken to NNU - he wasn't taken straight from birth, but when he was about 4 hours old so maybe that made the difference. Either way, despite asking for a private room I was on the ward until discharge. I went to see him as soon as I could get in a wheelchair which wasn't until about 10 hours after he was taken (another grr point as we were waiting for staff rather than me being ready). I was encouraged to hand express but not shown the hosp pump until just before going home. He was dressed while in there but was 2 weeks overdue so wasn't in an incubator, just a fishtank cot with drips and tubes. And yes, the NNU staff were absolutely incredible, much much better than the totally over stretched PN staff who, although lovely, just didn't have the time. Hope all goes well for you.

[vichill]

I found the staff (alder hey) very eager to support bfing. There was a pumping room (with an ace machine) full of brand new bottles and each bfing mum had a tupperware box in a locked fridge where her milk would be kept. I was on a side room off the neonatal ward. As soon as he is well enough to be lifted out of the incubator they will even knock on your door when they wake in the night for feeds! Only if you want to mind

I found the preoccupation of expressing really positive. You feel part of the team making them better and the staff at every level really value the benefit of breast milk. You may even be lucky enough to be offered donor milk if it takes a day or two to get going.

[cavkc]

I had an emergency section and it was around 12 hours before I was well enough to go see him.

My DH could see him but I told everyone that I didn't want any one else to visit him before I had seen him

[sunflowered]

I wasn't able to go to nicu for 24 hours after dd was born because I was hooked up to an exciting selection of drips and machines that couldn't be moved. It wasn't as bad as I'd thought it would be, but the one thing I regret is that all of our family went to see dd before I could, which upset me a little but I felt powerless to do anything about at the time as there were so many of them milling around.

I was supported to express and borrowed a double pump while I was on postnatal. Nicu also had a little expressing room so you didn't have to leave the unit to express. Dd was tube fed initially and came home mainly taking ebm from a bottle as she took a while to get the hang of bf (I think that would have been the case even if we wouldn't have had the nicu stay). There were nurses on scbu who I think specialised in helping to establish bf and they were fantastic. I was completely clueless (dd was early so my only bf education was sending dh to the nct bf class while I was in hospital ) and they couldn't have done more to help.

I hope everything goes as smoothly as it can for you. Good luck!

[Frances79FirstTime]

Thank you everyone - very helpful tips and advice. x

[slightlyinsane]

With regards to all of the questions you have the advice will vary depending on how many wks your lo will be delivered at. Typically before 35ish wks babies don't have the suck reflex to bf but nicu will support you with expressing ready to establish bf when you can. Some hospitals offer donated breastmilk if you wanted to consider that. Formula top ups does not mean you can't establish bf later on.
Clothing wise again it depends on gestation often the smaller they are the fewer clothes they will put on them as they will be in an incubator rather than cot. I would pack a wks worth of clothes in a separate bag for the car for when it's needed and just have a couple of vests and sleepsuits in labour bag. You may find that nicu will not dress them until all the immediate tests have been done as they get in the way.
Good luck x

[Tricycletops]

DD was born at 4pm and I wasn't able to see her until the following morning, although DH was able to go and see her after an hour or so. I hope it's sooner for you! The room on the labour ward where I'd been prepped for surgery was still free so I went back in there straight from theatre rather than going into recovery (I think because there were other women with babies in there) and spent the night there too. The midwives were great about helping me express very soon after coming back from theatre, but I did ask - worth doing that if nobody mentions it. The support with expressing and breastfeeding from the staff in the NICU was pretty amazing as well.

I hope everything goes as well as possible for you. I know everybody says this, but it's true - take the painkillers when they're offered even if you don't think you need them!

[Tricycletops]

Oh - I've just remembered that the reason I couldn't go to NICU was that I was on two or three 24 hour drips which didn't finish till the next day. Otherwise they would have taken me down which the spinal wore off.