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Newborn with jaundice & dehydration

(17 Posts)
Skaffen Mon 10-Aug-09 13:58:07

My wife gave birth to a beautiful boy on Saturday - had a scare during the delivery, with him not breathing and having an erratic heartbeat, however he perked up after some oxygen and stimulation.

Has shown no interest in breastfeeding at all - usually falling asleep as soon as he's near the breast.

He has been diagnosed with jaundice and being dehydrated, so both he and DW are still in hospital. He's having phototherapy and antibiotics (required a cannula to be fitted - I was really upset by this, makes me fill up now thinking about it).

I'm just really worried about how lethargic he is and the amount of stress my wife is under. She seems to be holding up well, but must be shattered as she has to express every 3 hours (hardly anything being produced), cup feed him any breastmilk and then top up with formula, clean him, and sterilise all of the equipment. I doubt she's had more than an hour's sleep in the last 2 days.

Trying to keep it together but broke down yesterday in the hospital and can't help fearing the worst.

LIZS Mon 10-Aug-09 14:12:05

It is very common in a new born to get jaundiced and it does make them very sleepy and hard to feed. ds was like this and eventually he b'fed using a shield which we stopped using at about 10days old but it took trial and error and persistence. Your dw won't seem to be able to express much at the moment because her milk won't have come in yet. What you are feeding is colostrum which is a rich , concentrated fluid. Feeding little and often is th key and hoepfully you'll see a difference in a few days' time.

Is she getting support for her feeding in hospital, formula top ups may or may not help long term if she really wants to b'feed then they should go as soon as is feasible as they may disturb his natural appetite making it harder to establish her milk supply. Also could a mw, you or another visitor, do the nappy changes and sterilising(are the bottles not presterilised though?) while she rests.

good luck

tiktok Mon 10-Aug-09 14:28:48

Skaffen you might get some further help in the breast and bottle feeding folder.

I am a breastfeeding counsellor with NCT.

It's really, really common for babies who have had a rough entry into the world to 'switch off' from feeding and this makes the early days a bit of a struggle.

But it is something that is overcome with the right support and treatment.

No one produces much volume of milk in the early days - your DW will have had that explained to her, and her milk will 'come in' tomorrow or the next day, probably. In the meantime, regular 3-hrly expressing is absolutely the right thing to do a) it gets that wonderful colostrum out so your little boy can have it b)it primes the body to set up the milk production line.

Keeping him at or near to the breast as near as poss to 24/7 is really important - this supports instinctive responses and ensures these early days have comfort and closeness. Someone else can clean and sterilise the gear (surely just the pump bits?).

Sometimes, babies in this situation need formula for a short while - there should be someone around with expert knowledge to ensure he does not get more than he needs, and to discuss the possibility of using a bottle rather than a cup - the bottle gives sucking comfort and there is really very little evidence that the cup is better. No one should be dogmatic about 'confusion' as the evidence is thin to zero that it is an issue, as long as bf is being supported.

Hope things start to look up and feel more normal soon

iMumruly Mon 10-Aug-09 15:07:56

Ive had 3 prem babies, all badly jaundce, all terrible births with lots of difficulties, babies on special care afterward. My last ds had to be tube fed my other 2 were spoon fed and I too had to express 3 hourly.

So long as your wife continues to offer the breast, squeeze some "milk" onto babes lips etc, her milk will come in in a few days and things will get easier then. Once babes sugr levels get back to normal he will "perk" up a bit, once perier he should show an interest in breast feeding.

Like I say my 3 all went through this and are all healthy boys now-wish you the best of luck.

Skaffen Mon 10-Aug-09 15:11:46

Thanks for the messages - reassurance is exactly what I'm after!

Back to the hospital in a minute, will let DW know not to worry too much.

KiwiPanda Mon 10-Aug-09 20:21:06

Skaffen I know it's incredibly easy to say and very hard to do but try not to worry. My DD was very similar - not with jaundice but had renal failure (unknown cause but presumed to be some form of dehydration) and also wouldn't feed, I too was expressing every 3 hours and existing on almost no sleep. So this is just to say that after about 5 days of expressed milk she finally latched on, started improving and has been absolutely fine ever since. She's now nearly 8 months and still breastfeeding.

As Tiktok says, skin-to-skin as much as possible is great. Don't worry about the cannula - DD also had one and I too still well up when I think about it but once it's in I don't think it bothers them at all.

Hope it all goes well, keep us posted.

TheWolf Mon 10-Aug-09 22:45:32

Congratulations on the birth of your son, and sorry to hear that you're all having a rough time of it.

My dd was born with an infection and jaundice which led to dehydration. We spent 8 days in the hospital in a very similar situation to your wifes - expressing every three hours, feeding via cup (to measure fluid intake), sterilising the equipment, changing nappies and recording their contents, antibiotics down at NICU twice a day and numerous pin prick tests to check her billirubin levels.

From my experience, I'd suggest considering the following to help your dw during this period;

Making full use of visiting hours, either yourself or family. This was the only time that I had the opportunity to snatch some sleep for an hour whilst someone else held the baby. It made all the difference.

Taking in any toiletries/clothes/magazines etc she might like - it may sound daft but I really hadn't anticipated such a long stay in the hospital and a few creature comforts would have been appreciated.

Taking in snacks - hospital food is appalling, and the gruelling pumping sessions and general lack of sleep means that she'll need to keep her energy levels up.

More than anything I think that it's important to be there to support her. A couple of days post partum it's completely normal to get the baby blues, but I remember being stuck on a ward amongst a high turnover of women with 'healthy' babies who were all going home the same day. There I was with a baby that wasn't well and wouldn't feed and I felt awful.

When dd was ill she slept a lot for the first couple of days, but as her condition improved she became more alert and the feeding situation got a lot easier. The decision to push to continue breastfeeding was actually quite difficult as there was a lot of resistance by drs who wanted to know exactly how much (in mls) fluid she was taking in. I kept a diary instead of feeding times/nappies/weight gain.

DD is now 2.10, perfectly healthy and was fully breastfed after leaving the hospital until after her second birthday.

Best of luck to you all

JetLi Mon 10-Aug-09 22:57:07

tiktok is right - the pumping will really help to bring in the milk. Pumping is exhausting though so any help you can give with cleaning/sterilising the kit etc. is invaluable, just so your wife can get some sleep whilst you're there - it will help with the nights when you're not. Rest and plenty of water were key for me, plus the folks here gave me the advice to pump both breasts at the same time which really helps. Sadly the hormone shift when the milk comes in may make your wife feel very weepy (it did for me) - as I understand it, it's perfectly normal, and I felt much better after 24 hours or so - it didn't last much more than that but it's unpleasant at the time.
Let us know how things are smile
We're thinking of you

deepdarkwood Mon 10-Aug-09 23:05:59

You've had lots of fabulous advice from tiktok et all (as always smile) but just to add more personal memories.
Ds was (slightly) prem and very sleepy and jaundiced - and one thing that helped encourage him to bf was stripping him off a bit and even giving him a gentle wipe with some warm water - just kept him awake for a little bit longer, and allowed me to keep the nurses off my back by telling them he'd been feeding for longer! (I bow to tiktok if this was actually not helping - but made me feel like I was doing something...)

Ds also had a canula, and I found that upsetting - it looked so big and painful. But I must say, it never seemed to bother him, and I hung onto that fact.

He's now 5 1/2 and wonderful smile

Hope you had a good visit with your dw and ds, and that things settle down soon for you and the family smile

TotalChaos Mon 10-Aug-09 23:19:30

me and DS went through similar - it's gruelling at the time - but this period will be a distant memory sooner than you think, and as you will have seen from the replies here, this sort of experience with jaundice is not that unusual, particularly with breastfed babies.

tiktok - I was actually told off for spending too long bfing DS, they felt he should be under the lights in his incubator as much as possible sad.

agree with other posters. in particular re:food - when you are on this strict routine of feeding/pumping etc, it can sometimes clash with mealtimes - so it's useful to have a plentiful supply of non-perishable food and drink. also take in more babygrows/nappies/cotton wool as well.

Skaffen Tue 11-Aug-09 00:04:11

Again, thanks to all - these experiences really help put things into perspective.

Having been the more emotional half of the couple, I've now swapped to being the supportive half, as I think DW is hitting the baby blues phase.

Not that it has been helped by some awful night-staff at the hospital.

We've had some absolutely wonderful staff assisting us (especially an infant feeding midwife who has been an absolute angel - spending hours assisting us with feeds) and thanks to them DS is now on the healthy part of the jaundice graph and blood tests show he's now well hydrated - our entire focus is on getting him healthy.

....and then we have some complete numpty from the night staff come and berate my wife for not deciding on either breast or bottle and telling her she needs to decide in order to go home. I've just spent half an hour reassuring her that the most important thing is to get food/fluid into our son by any means, get him well and continue to offer the breast and express regularly to encourage the milk.

I'm absolutely seething that someone could be so callous when she's hardly slept since Friday last week! Anyway, I've hopefully calmed her down, our lovely son is on the mend, you have all provided me with lots of reassurance (thank you!) and once he has the all clear we'll decide how to feed in future and all head home together

TotalChaos Tue 11-Aug-09 00:08:50

glad your boy and wife are doing better now.

btw I had pretty much the same treatment from a night shift numpty - was told I wouldn't be allowed to go home if I was mix feeding, and I couldn't cup feed at home hmm. she was an old bag of an HCA that the mws seemed to think was a bfing guru for no apparent reason.

tiktok Tue 11-Aug-09 00:10:55

Good progress, from the sound of things, Skaffen.

You might want to think about putting a complaint in writing about the night staff.

JetLi Tue 11-Aug-09 08:49:48

Ditto with the night shift numpty - only I had two of them coming back and forth, one doing one thing to the poor child and then the other coming 20 minutes later to tell me off for doing whatever the first one had told me to do (e.g. feeding/notfeeding/swaddling/cuddling/changing etc) - bloody nightmare angry

Complain if you can - I honestly wish that I had

foxinsocks Tue 11-Aug-09 08:55:55

yes I wish I had complained too and didn't. Half the problem is that you are so knackered and emotional, you have many other things that take priority .

Hope she will be home soon. Poor little ds had extended jaundice for around 6 weeks and I had to try and pinch/rub (gently) his ears to keep him awake while he was feeding! And undress him so he didn't get too warm and snuggly! I had completely forgotten about those times but those are two tips to keep them awake if they take one suck and then doze off wink.

Believe it or not, this early stage goes so fast, in a few weeks time you'll barely remember it!

KiwiPanda Tue 11-Aug-09 09:00:53

Brilliant to hear there's progress!

Ditto on night staff from my experience (though only on normal post-natal ward, not SCBU where they were lovely). I remember one awful Russan midwife who tried to get DD to latch on through sheer force. DD threw up on her, clever girl..

Someone has I think already suggested this below but my DH fetched a list of creature comforts for me from home. Also, once DD was properly bf as well as feeding EBM from a bottle and on the mend, the night team in SCBU told me they would do one feed in the night so that I could get a bit of sleep - after all you don't get that offer at home! Of course some people worry about nipple confusion but since DD took a bottle before she'd take breast I don't think it was an issue!

KiwiPanda Tue 11-Aug-09 09:08:41

Oh and tiktok has of course already mentioned NCT for help, but also just to say that we ended up in touch with my local La Leche league person and she was absolutely wonderful. We must have been calling her 8 times a day at one point, she was looking after her 4 kids but dropped everything to help. This has reminded me I must get back in touch to thank her again. But anyway, La Leche as well as NCT may be able to help with any breastfeeding questions

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