It's happening again - please help, really upset

[narmada]

Hi everyone

Sorry long post.
Had a terrible time trying to BF my first daughter. Very traumatised by it at the time. We did relactation at 7 weeks and eventually she was off formula completely.

New DS was born on Tuesday evening, all well with him and the birth, save for me being a GBS carrier and there not having been time for IV antibiotics.

We are now home, I have plenty of help around the house and with my DD, now 2.5, but she is being very demanding, wanting to be in DS's presence all the time, bless her. I have spoken to hospital BF supporter, and recieved I think good advice, but finding it hard to trust myself and my instincts, and trying to establish BF with DS extremely stressful again.

He does not really wake to 'demand' feeds, so I am having to wake him to feed him, struggling to latch and gape wide enough (checked for tongue tie, doesn't appear to be a problem), struggling to get him to stay actively feeding when he is on. He has now not pooed since yesterday morning. And just a couple of wees, dry-ish and cracked lips, so I have been giving him formula supplements and EBM supplements where possible as I do not want him to get dehydrated. I am also trying to do skin-to-skin (I do not want to do bed-sharing) and hand expressing after top-ups but finding it totally exhausting. Milk not come in, but it didn't last time until day 5-6? Amount of colostrum I can express is now significantly less than pre- and immediately after the birth. I am a competent hand-expresser after last time's relactation efforts

Have probably had about 5 hours sleep in total since he was born.

Gotta wake him to try and feed him now, while DP and grandparents wrestle DD in to bed. Can anyone talk me down and tell me what to do succinctly??!!!

Sorry should say I have actually seen and not just spoken t o BF supporter. She is great, but unfortunately has now dropped off the radar because her poor daughter is ill herself .

First of all congrats on the birth. Second hand over care of DD to DP and grandparents. Get them to take her somewhere tomorrow - not all day but at least the morning. Milk is fickle (my supply was always low when ds who was prem was on his poorly days and i was stressed) Time for you to rest. Get the baby and snuggle. Don't worry about feeding but have lots of skin on skin. I had ds under my top (with no bra) on a neo natal ward. Every time i did kangeroo care my milk flow out afterwards. If you are worried of falling asleep get DP to lay next to you. He can read, watch TV or play on internet.

You are brill mother - just remember that whatever happens

I have no doubts that you'll get some great advice from someone more knowledgeable than me really soon, but just wanted to say it sounds like you're doing the right thing with the skin to skin and perseverance. Your milk will be here in the next day or two and things may well turn a corner then. You sound so committed, well done so far!

Congratulations on your new baby boy.

New babies' skin does peel off. Are you sure his lips are dry due to dehydration?

They do sleep quite a lot when they're so new.

Expressing isn't a good indication of what is there.

I would give him lots of skin to skin, let him suck and see how his weight is when MW comes to visit (remembering that they are very likely to lose weight at this stage). With no indication that they are needed (is there?) I would stop formula top up. You need him to suckle to stimulate supply. Formula takes longer to digest, so it also won't help you if he's very sleepy. SBaby at the breast is the best for your milk supply.

Remember the bf helplines are there if you want them.

Trust yourself. You can do it. You did it before.

Poor you, I really feel for you and I can sense you are panicky. Right you know it takes a while for your milk to come in, you have some help with your older one (she won't remember any of this time, I promise, I have that gap between my first 2).

1.as the other poster suggests, babymoon. So on bed, snacks to hand, tv and reading material and just snuggle and feed at every peep. If you can do the weekend there, so much the better. If you don't want to bedshare have moses to hand or ask someone to take him but only once he has had a few decent suckles.

1. Try and use the top-ups wisely and sparingly. So give an ounce to get the edge off his hunger and get his strength up, and then latch him to the breast and then aim for maximum time on the breast. As opposed to taking him off the nipple to top-up - often you limit time on the breast

1. While you may feel your current life is very stimulating and noisy, some babies hate this and will 'shut-off' and sleep. So it can help to go up to a dimly lit and quiet room so all the baby has to do is concentrate on feeding.

1. Try not to panic, you are right to watch for signs of dehydration, but babies are born with fat reserves and are meant to feed little and often with colostrum, so expecting a big 'decent' feed might not be realistic at this stage. He may need lots of little suckles every hour and you close by to provide it. It will be tiring but it will provide your boobs with the stimulation needed.

1. Great article here

1. Finally, you managed to fully relactate, do you know how hard that is? So go easy on yourself, you can stick this out and get there!

Breastfeeding Network supporterline 0300 100 0210. It sounds like you could do with talking things through with an expert.

Thanks everyone, it is great to have such a support network. Please accept my apologies for not replying to everyone individually - minutes here and there to type, you know the score.

Is him not pooing not quite worrying evidence of insufficient intake though? I thought this was something you were supposed to look for? Or is day 3 too early to be jumping in there with the formula? Seems like the overriding feeling here is that it is...

It mightn't come as any surprise that I had PND and crippling anxiety last time after DD birth. So I am prone to panicking and worry etc. Although trying to keep calm and carry on. Like you've said, got through it before and will do again ...

Weeing and pooing are usually a good indication of whether the baby is having enough milk but he is still very tiny.

With no indications that your baby is not getting what he needs apart from your understandable anxiety, the formula will more than likely get in the way of your supply. Your baby will be checked regularly by MW and HV, so any concerns will be picked up. In some cases formula can have its uses, but normally it is a hindrance rather than a help in getting milk supply going.

When is MW coming? Would you feel comfortable with just suckling until then?

MW- we can either leave home and see her at hosp tomoro - dunno why no home visits - don't want to start traipsing around really - or wait till monday for home visits. Re just suckling, not sure i will be able to overcome my anxiety about his intake till then.....

Maybe do what Franup said then. While suckling is the best for your milk supply, you need to take the edge off your anxiety too.

When you weigh him, you know he is likely to have lost weight? Most newborns don't regain birthweight until day 10.

My thoughts on pooing are that if your milk's not in yet, and he's still so tiny, he ain't going to be pooing very much. Is it still meconium? I don't think DD's poo changed to proper poo until at least this stage and I seem to remember it was pretty infrequent at first.

I sympathise with the latching problem. I had exactly the same problem with DD not opening her mouth, and none of the latching advice seems to take that into account. You could possibly try manually lowering his jaw as you latch him (it didn't work for me though). Are you sure you're holding him so that he's physically able to tip his head back enough? Is he making you sore sucking with a shallow latch?

latrucha going to try and make it thru night with just suckling, and maybe one small topup. yep, do expect him to have lost weight. they don't reweigh around here till day 6....

gaelic, thanks for post. i saw your other posts on your own experience. yes,, still meconium but none of even that since yest am. am trying to folliw latch advice like that you give but it is so so hard when you are exhausted and with a toddler pulling your hair!

gotta wake him now. thanks again.

The other thing is how do you know how often he's weeing? I just re-read your OP and you say there have only been a couple of wees since yesterday morning? If that's the case that would be a concern, but are you using disposables? As I'm sure you know they can hide a wee very well.

Also, despite me singing the praises of formula in my particular circumstances, I would say it is probably not a good idea just now in your case. I totally understand your concerns about dehydration, however. I think I would be tempted to make the trip to the hospital tomorrow to hopefully put your mind at rest.

narmada - sorry you are so anxious.

This is day 3. It is very early for supplements of formula or ebm - really, it is. Dry lips are normal in a newborn.

No wonder you are exhausted - expressing colostrum, preparing formula supps, preparing ebm supps, struggling to latch and keep him on - it's all too much and too intense. It makes it hard to see the wood for the trees.

It;s not possible to say from your description whether there are real grounds for concern here or not - lack of poo could be a sign he needs to feed more, but of itself means nothing.

Is it possible for a midwife to come and see you tomorrow and help assess 'the whole baby'?

I don't think it is a good thing to be struggling with no more than internet help till Monday :(

tiktok,

you are right, it is far far too intense.

still no poo. now 48 hours. but def weeing. i am not so worried about dehydration now. i take on board what you say about lack of poo not necessarily meaning anything.

re midwives, it is hosp visit or nothing as far as today goes, apparently. Not sure have it in me to get us both down there...

narmada - I think you and your baby need to be seen, somehow, honestly....you need to call a midwife, you should be able to get a home visit. No poo is not something to be relaxed about - it may mean he is not feeding enough or effectively (or it may not mean that - you're right that it is something to look for).

My feeling is your baby should be weighed today, so a fuller picture of what's happening will help decide how best to support your bf.

But at least call a midwife and talk it over with her. She'll help you see the wood for the trees!

Tiktok, I called the midwife around 11.30 am. There is no reply, ringing out to answerphone. It is so frustrating. I have left a message asking for a call back but nothing so far. What's more, the MW did not call back the other day as promised, now I come to think of it.

I think failing a callback, I will go down to the hospital after we have had a nap just now ( we are all so tired and this is the last day of my parents being here to help - they are off tonight) . I guess we go directly to maternity and ask them to weigh him and have a chat with them.

Does that sound like a plan?

It sounds like a good one to me. How did it go last night?

Tried the MW again, ok, we are going now. WIll report back.

Hi, just back from seeing mw at hospital postnatal clinic.

He has lost approx 9 percent of his birthweight, was 3885 g at birth, is 3550 g now. Different set of scales though, but least he was naked. So that seems like it's toward the upper end of the 'acceptable' weight loss range at this stage (still only day 4 postnatally).

MW advises now feeding 3 hourly at the very least, no longer stretches at all (previously told by BF counsellor that it was ok to let him have one 6 hour sleep in every 24) and some topups in the region of 2 oz if he doesn't feed effectively at each feeding.. advised to maintaining as much expression as I can manage. We discussed the fact that more topups mean less likely demand at the breast, but said it was a very delicate balacing act ensuring DS gets enough (given scant wees, no poos and urates this am - latter of which she said could be entirely normal but combined with other factors indicated a degree of caution).

The good news is that I think my milk has started to come in this afternoon, and that this morning I actually saw DS swallowing some at the breast. It's a tiny step but I am pleased. Oh, and the fact that DS is actually looking pink, alert when awake and still gets very very cross on quite a regular basis. Sounds wierd, but at least him being cross shows he is not getting dangerously lethargic or anything.

I am inclined to stick to this advice. I think it will help me maintain my sanity and reduce my anxiety levels in the short term, which is now a priority also. What do you think?

Milk definitely coming in. I have just managed to latch him and heard him properly, properly drinking for a good while. Not every suck, but still... Using compressions too, managed to keep him interested and doing more than nibbling for about 20 minutes.

Right, i am going to sign off now. I think I just need to get on and concentrate on my DS and on getting some sleep. Thanks for advice everyone.

I was in a sort of similar situation with my ds - milk took 4-5 days to come in, ds was jaundiced and sleepy, lost 8% of birthweight I think (something like 3.8kg at birth, 3.5kg by day 4). It seemed to take a while to get going on the pooing and weeing front and he had urates in his nappy. We were in hospital for several days anyway due to his jaundice but the midwives and paeds didn't seem massively alarmed - no one mentioned top-ups to me, just to feed as often as possible, not to let him go more than 3 hours but aim for 2.

I spent a few days waking him up every 2 hours day and night and trying to persuade him to feed, but it didn't take long to get back to birthweight. After that I let him feed on demand and he started doing one 6 hour stretch in 24.

Narmada - The pattern of good feeding is not necessarily suck, swallow, suck, swallow. It is more usual to have suck, suck, suck, swallow, suck, suck, suck, swallow. Obv. nothing wrong with the first pattern but it is not a typical pattern.

There are some good videos here that show effective breastfeeding so you can compare & contrast

Hopefully you will see your son doing similar things so it will reassure you.

Good luck and definitely spend as much time as you can skin to skin with your new baby.

Glad to hear you're feeling more comfortable.

Glad things are going better for you and hopefully once the milk is in all will be fine.

And yep, I agree it can help to have a bit of an angry baby as at least they actively wake up!