Day 2, won t latch on. Help.

[Gert2a]

Please excuse the briefness of post, am in hospital on phone. Dd2 born friday by elcs. First couple of breast feeds went well within 2 hours of birth whilst in recovery. I know dd2 was latched well and took plenty as she later threw most of it back up. Since then she has failed to latch on despite regular attempts particularly when she s alert and showing signs of hunger. Have fed colostrum with syringe about every 4 to 6 hours. She s Just had blood sugar test and it was low so on advice of midwife have topped up with formula which dd2 hungrily and happily took. Advice from midwife now is to feed every 4 hours with colostrum in syringe and top up with formula, and still keep trying to get her to latch on. Does this sound right? Is there anything else I can try with latching on? I ve tried lots of positions, lots of skin to skin. Dd2 has routed, gets right amount of breast in mouth, gives 2 sucks and spits it out. Its as if she can t be bothered. Any advice and suggestions greatly received. Ps I successfully fed dd1 for 8 months.

No no no! Much more than every four hours will be necessary.

Every two hours at the very least. Try to stay awake or set your phone to alarm.

You will need to make your hand into a C shape with the thumb on top and the fingers curved, holding the hand as if you were showing someone in front of you the letter C, then grasp your boob close to your ribcage and squeeze it quite flat, then try to insert your nipple into the baby's mouth when she roots. This way the nipple isn't flopping around and she doesn't have to do too much work to get it right into her mouth.

www.google.com/imgres?imgurl=www.askamum.co.uk/upload/7281/images/10003159.jpg&imgrefurl=www.askamum.co.uk/Listen-and-watch/Search-Results/Video-tips/Video-Latching-on/&usg=__FQOiiuvbYEpdTlJ-GMvigJzqZuk=&h=304&w=450&sz=24&hl=en&start=8&zoom=1&tbnid=cisqkuNrE4GpUM:&tbnh=107&tbnw=158&prev=/images%3Fq%3Dcorrect%2Blatching%2Bon%2Bfor%2Bbreastfeeding%26hl%3Den%26sa%3DG%26biw%3D1024%26bih%3D564%26gbv%3D2%26tbs%3Disch:10%2C570&itbs=1&iact=hc&vpx=314&vpy=122&dur=122&hovh=184&hovw=273&tx=117&ty=106&ei=ZwGoTOr-LtfhnQeh3MXWDQ&oei=YQGoTN3HDdKlnQf72rDEDA&esq=2&page=2&ndsp=17&ved=1t:429,r:7,s:8&biw=1024&bih=564 This picture gives an idea]] but I would squeeze closer to my chest and point the nipple far more. Don't know if you can see it on your phone though.

I would be inclined to forget about the topping up with formula and the syringe business too. Keep on pushing the breast. Put a little colostrum on your nipples.

<a class="break-all" href="http://www.google.com/imgres?imgurl=www.ask" rel="nofollow" target="_blank">amum.co.uk/upload/7281/images/10003159.jpg&imgrefu rl=www.askamum.co.uk/Listen-and-watch/Searc h-Results/Video-tips/Video-Latching-on/&usg=__FQOi iuvbYEpdTlJ-GMvigJzqZuk=&h=304&w=450&sz=24&hl=en&s tart=8&zoom=1&tbnid=cisqkuNrE4GpUM:&tbnh=107&tbnw= 158&prev=/images%3Fq%3Dcorrect%2Blatching%2Bon%2Bf or%2Bbreastfeeding%26hl%3Den%26sa%3DG%26biw%3D1024 %26bih%3D564%26gbv%3D2%26tbs%3Disch:10%2C570&itbs= 1&iact=hc&vpx=314&vpy=122&dur=122&hovh=184&hovw=27 3&tx=117&ty=106&ei=ZwGoTOr-LtfhnQeh3MXWDQ&oei=YQGo TN3HDdKlnQf72rDEDA&esq=2&page=2&ndsp=17&ved=1t:429 ,r:7,s:8&biw=1024&bih=564 This picture gives an idea YIKES

<a class="break-all" href="http://www.google.com/imgres?imgurl=www.askamum.co.uk/upload/7281/images/10003159.jpg&imgrefurl=www.askamum.co.uk/Listen-and-watch/Search-Results/Video-tips/Video-Latching-on/&usg=__FQOiiuvbYEpdTlJ-GMvigJzqZuk=&h=304&w=450&sz=24&hl=en&start=8&zoom=1&tbnid=cisqkuNrE4GpUM:&tbnh=107&tbnw=158&prev=/images%3Fq%3Dcorrect%2Blatching%2Bon%2Bfor%2Bbreastfeeding%26hl%3Den%26sa%3DG%26biw%3D1024%26bih%3D564%26gbv%3D2%26tbs%3Disch:10%2C570&itbs=1&iact=hc&vpx=314&vpy=122&dur=122&hovh=184&hovw=273&tx=117&ty=106&ei=ZwGoTOr-LtfhnQeh3MXWDQ&oei=YQGoTN3HDdKlnQf72rDEDA&esq=2&page=2&ndsp=17&ved=1t:429,r:7,s:8&biw=1024&bih=564" rel="nofollow" target="_blank">Third time lucky?

You milk might have come in making it difficult for her to latch on? Can you express a little bit off by hand to make it easier for her?

I remember my DS doing this - couldn't get him on for love nor money at day/night 2. So I started expressing and finger feeding but didn't top up. I was getting wound up and nervous which made it harder. I just tried to stay calm, kept trying and finally he got the hang of it.

Is there a BF counsellor in the hospital? I found the midwives useless TBH!

Hi

I did what math said. Actually for first 5 days I was shoving my boob towards baby as opposed to 'bringing baby to breast'. One midwife said a lot of Southern African women fed this way so to do what worked. Decided to find a way to feed DS first and refine it later. After about 5 days comm. midwife corrected latch and it was more comfortable the 'proper' way.

Good luck

lie quietly side by side with your baby. no top on you or your baby. let your baby take the lead. when she starts to wiggle around and root, let her be. just do what is necessary to keep her safe on the bed. she can self attach.

forget topping up with formula. how can you be syringing colostrum, and topping up and also spending quiet time waiting for your dd to self attach, especially with the pain of a cs scar.

I wish someone gave me a pound for everytime I read 'midwife said top up with formula' on here.

Gert2a - foxytocin's info is the way to go....I find what your midwife said to be extraordinary - complicated and and fiddly and unlikely to support you in your wish to breastfeed.

There should be a low blood sugar policy/guidelines in the maternity unit, and I would be amazed if it included any of the stuff you've been told, in babies who have no symptoms (apart from what the test said)....hope you can seek a better and more informed opinion, and that today goes well for you. No reason why it shouldn't :)

(When the dust settles and all is well, think about making a complaint, too :( )

Just to add - before not doing what the midwife said, do check it out with another midwife.

I am just worried that we don't have the full story and there may be some justification for the syringing and topping up (though at a loss to know what on earth it could be!). The hospital need to know what you have been told, anyway, and to support you in your choice to do skin to skin/self-attachment with your baby.

yes, TT is right. I hated to imply to ignore the MW's advice but unless there are medical good reasons a baby being topped up then they ought to be more supportive of breastfeeding.

Ask them to give you more information about why they have recommended topping up. If it is 'because your milk hasn't come in' or 'baby is big', 'to give you a rest' then you can ask to see an infant feeding coordinator or supervisor of midwifery and explain that you don't see those as medical grounds for topping up.

and when you feel up to it, try to write a letter complaining about the poor information you received on the PN ward.

I just went through this and my midwife said the same thing and that's what I did and glad I did too as dd was starting to become dehydrated. now that my milk is coming in she is sucking for longer, think she just did not want to make the effort before but milk flows easier and faster. hang in there, give the top ups so stays feed and that will make it less stressful on both of you while trying to latch. should get much better once your milk is in but keep expressing so that it comes in fAster.

chillichill - glad all is well with you. Yes, avoiding dehydration in new baby is really important - but feeding every 4 hrs (which is what the OP was advised to do) does not do this. Instead, it actually restricts the amount of fluid getting into the baby.

Yes, if the baby is restricted at the breast to every four hours, he may well need formula top ups, simply to make up for the lack of opportunity to feed direct from the breast.

But the better solution in the OP's case - as far as we can tell from what is described here - is to check with another midwife that feeding unrestrictedly at the breast, with the skin to skin contact and self-attachment opportunities that support this, is, indeed, a more effective way of getting more fluid into the baby without the need for formula supplements.

The OP may need to express as well at this stage (though she may not, if the baby starts to respond well. This is a new baby, just day 2, and keeping things simple with unrestricted access to the breast is often the better solution). Your situation may not have been quite the same.

I'm with tiktok a) because she's the expert and b) because I'd be VERY concerned about accepting advice from a MW who suggests that newborns should only be offered the breast every 4 hours.

Of course, clarify what she's said if you're not totally sure but definately get another opinion. You could ask if there's a breastfeeding nurse in the hospital - ours have specialist ones.

oh no, I offered breast constantly, she just didn't take anything in. having said that, after formula top up she was more alert and latched better. happy to say we only had to use one carton of formula to get over the hump till milk came in and now dd is very much making up for lost time, I haven't put the boobs away all day ;)

Thanks everyone for your replies. Have kept trying skin to skin and helping baby latch and letting her try herself but still no success. Blood sugar readings have continued to be low so have continued with formula and colostrum by syringe. Last reading was ok. I am so stressed and crying lots which is obviously not helping baby and me achieve what we want. And doesnt enable me to be strong to challenge what I m told by the 'trained' staff. (As an aside I was told by a breastfeeding trained member of staff that you could see the colostrum in my aerioles? Have I not been understanding how my breasts work?). I ll be trying to keep an open mind about method of feeding and will review with more expert help when discharged from here hopefully tomorrow.

God what bad advice from the MW! No wonder they're suggesting formula top-ups -- 4-hourly = not feeding baby enough! With a newborn you should go no longer than 3 hours maximum before a feed. Keep expressing the colostrum and feeding by syringe AT LEAST 3-hourly, but more importantly keep trying to get the baby to latch on before using the syringe.

I had HUGE problems getting my baby to latch on properly, and it was only when I got to see a proper lactation consultant that we sorted it out. See if you can insist on seeing a lactation consultant at the hospital before going home.

BTW "some justification for the syringing and topping up" yes there is. In my case, we were both drugged out to begin with from the long labour/EMCS and baby really couldn't work out how to latch himself on. It was the hottest week of the year, and if we hadn't used the syringe, we would have ended up formula feeding due to the risk of dehydration. Breastfeeding is now really easy and fantastic, but the first 6 weeks were hell.

It's far far better to express and syringe than to give up on breastfeeding, and if that's what keeps you going, don't tell her to stop!!!

Sorry should have clarified there is NO justification for topping up with formula unless the baby is really poorly. But there IS justification to express and syringe if the baby has trouble latching on.

In the end we worked out that my baby was naturally a bit of a panicker got so excited by the sight of a nipple he couldn't keep his head still and mouth on the task PLUS my breasts are a weird shape (enormous, and nipples that point sideways and towards the back; hard to explain).

One more thing -- it really helped a) watching myself feed in the mirror so I could work out how far across I had to place the baby (miles further than any photo I've ever seen due to weird boobs) and b) singing to the baby while I latched him on, mainly to calm myself down so that I would let down more quickly. It really really worked.

(and much, much love to you -- I know exactly how distressing it is when you can't get the baby to latch on and you feel like s/he will die if you can't work it out. Horrible. Noone ever tells you it could be like that, and all I'd ever heard were immediate success stories from friends and family. Keep persevering; you WILL get there. I did.)

Gert2a - it is still early days. I'd be asking someone to watch when your baby tries to latch. What exactly happens when she comes to the breast?

I absolutely understand the difficulties in challenging trained staff - when you feel tearful, the necessary assertiveness just doesn't come :( Is your partner around to 'translate' your words for you, I wonder?

It is possible to see milk/colostrum exiting the nipple - I cannot imagine and have never heard of being able to see the colostrum in the areolae. I don't know what she means by this. Perhaps she is SuperMidwife and has X-ray vision?

Incidentally, the threshhold for diagnosis of low blood sugar differs from unit to unit. There are plenty of units which would not even test infants with no symptoms, and of the places that do test, they may not diagnose it, and of the places that diagnose it, they may not actually treat with anything except watchfulness and encouragement to breastfeed often, as well as effectively. It may be your baby is not transferring colostrum at all at the breast, but someone needs to be investigating why :(

beanlet - yes, if the baby is unable to access breastmilk/colostrum, then that is indeed 100 per cent justification for getting it into the baby by expressing and then using a sryinge/spoon. The baby has to get it somehow.

But there is no justification for this if the baby is on a 'feed four hourly' regime.

tiktok I'm with you -- I can hardly believe that in this day and age a MW is recommending 4-hourly feeds with a newborn!!!

Gert2a - Don't give up!

Poor you :( Where is the BF councillor??
I struggled SO much - DS was Tongue-tied and latch was a nightmare. I think this is one of the most stressful times of my life until it was fixed!!!
I managed to go to my local BF group day 5 - do you have one?

We got a latch last night! My milk came in yesterday too. However latch hasnt been repeated since, as at the time I was on my own on the ward and very calm, but ward is now back up to capacity and I m easily stressed! Will be discharged this morning and will hopefully have visit from breastfeeding counsellor this afternoon at home. I think I will be giving feedback about the 'support' I ve received on the ward. Thanks again everyone for your help and advice. I ve been a fan of mumsnet for ages but this has been my first real need for specific help, so good to feel like I ve been virtually looked after!

Great you are making progress, Gert2a, and I bet you are right you need to have the calm of being at home to continue this.

Keep in touch with mumsnet :)

yippee!

Get home, go to bed, lots of skin to skin and stay calm!

deffo give feedback - it's the only way maternity services will get better.

gert2 well done you on making progress, all the advice here is great as ever. I had v similar with my DD2, she didn't feed for about 10 hours on day2 and I was beside myself. lots and lots of skin to skin, plus refining my hold back to tummy to tummy etc seemed to help (i was thinking I was feeding an older baby I think, forgot she was newborn!). I hope the BF cllr helps you this afternoon - please continue to seek help, it's very very easy in the first couple of weeks to doubt yourself.
and it does get easier
and congratulations on DD2!!!! Get thee to bed with your baby and enjoy