Breastfeeding, Jaundice and Sick Baby

[BonoboBabies]

Hi

My DD is 5 weeks old and has been jaundiced since day or two after birth. Doctors have done blood tests to rule out any rare problems - they think its "breastfeed jaundice". Her liver function tests were a bit out of whack but Dr said that was normal if baby still jaundiced. She has previously been feeding well - 30 mins to 1 hr on both breasts every 3 hrs in day, 2 hrs in evening and 4hrs at night.

Reason I am posting in the feeding section is that she has now picked up a hideous cold & cough and her feeding has dropped off to very low levels, she is very sleepy and has horrid cough that is making her retch a lot.

I have to wake her in the day and night at the moment for feeding - in the day & evening I wake her every 3 hrs, at night she is happy to go upto 5 and I have been leaving her for 4-5. (she is 4.5kgs). Now she will do 10-15 mins max on one breast only - she seems ok with this and is not upset or screaming for more, but I am wondering if she is ok on this level of milk?
I have tried everything to coax her into trying second breast but she won't have it - she wrinkles up her face when I try and get her to latch on and just falls asleep.
My milk supply has definitely decreased and I am worried that when she gets better, I won't be able to cope with her increased demand again. Any advice appreciated...

Hi there

The best way to check she's getting enough milk is to see what's coming out in her nappies. Is she having regular wet nappies? If yes, then you can rest assured she's getting enough.

Poo less reliable measure in BF babies, but she should be producing something anywhere from a few times a day to a few times a week.

The cold is probably affecting her appetite and she'll pick up again when she's feeling better. With a small baby I'd be tempted to take a trip to the GP to get the cough checked out (more for your own peace of mind really), particularly since she was jaundiced.

If you're concerned about your supply, your body will probably respond when she gets hungrier and starts demanding more milk. If you're really worried, you could try pumping a couple of times a day which might help.

Hang in there x

Thanks Crazycatlady - she is doing lots of wet nappies and poos for Britain (she has done since she was born) - every nappy has poo in it and when I am changing her, she always poos more... In fact, she poos so often and its so runny, they are also testing her for milk intolerance.
Went to GP yesterday about cough and thankfully its just upper respiratory, not gone into chest which is good news, its just making her spit up more as she has so much phlegm.
Was hoping that my body would respond when she gets hungrier as you say, but was worried that if this goes on my supply may dwindle to nothing. Have started to pump a little - do you know best times to do it?
It is the combination of jaundice, cold, cough and reduced feeding that is making me uneasy - poor little mite has had a tough start!

Sounds like you're doing all the right things and nappies are good! It's very common for a respiratory infection to make their poo a bit weird too so don't worry too much about the runniness. All the phlegm getting swallowed into their little tummies is quite hard for them to handle.

Perhaps try to pump after feeds if you can, not every feed of course, but a couple of times a day.

My DD had a bad start too - awful birth, jaundice, infection, feeding nightmare, but it did click into place eventually!

I was told to wake dd every 3 hours at night when she was jaundiced.

I suggest you put a call out for TikTok - she will be able to help you.

Yes good call, tiktok will know all about your milk supply concerns and be able to give a proper expert view.

In the meantime have you looked at the kellymom website? Loads of brilliant, practical info and advice on there re supply etc

Littlefish - how do I get hold of Tiktok other than hoping she will read my post?- I have seen her replies to lots of bf questions - am hoping she will see this one!

I'd put an unashamed new post out with 'tiktok help needed' in the subject line, in the feeding forum, with a link to this thread.

Or stalk her via advanced search to see if she's posting on threads right now!

I just had a little look and she was online at about 5.30 this evening, but nothing since.

I suggest you start a new thread with her name in the subject line, linking to this one, so that she sees it as soon as she goes on the "breast and bottle feeding" section.

You can send private messages to other poster's now too.

On the poo front, isn't loads of runny poo normal for a bf baby? My ds's poos are liquid and explosive, and he did 10+ a day for at least the first 6 weeks (2-6 a day now at 17 weeks) and I hadn't thought about milk intolerance

OK - here I am :0

Firstly, wet nappies are a good confirmation of hydration but at 5 weeks, they're not really a sign of the baby getting enough milk to grow , sorry. All babies except quite poorly ones will have 'regular wet nappies' ....crazycatlady, I don't agree at all that this is 'the best way to check' on whether the baby is getting enough. As if when that check is done, all is well? There's more to health and growth and milk supply than that! :)

Secondly, it's good you have checked her out with the GP. This shows she is basically ok.

Thirdly, you might well have a temp issue with milk supply....babies who are off-colour do sometimes feed less, and this might impact on supply. You're doing the right thing in encouraging her to feed more. OTOH, her pattern may be enough for her, though I agree, it's on the infrequent side for a baby of this age.

Maybe given the fact the GP is basically happy with her and your bf has been going well, you could have a word with the HV and ask about weighing in a week or two? No need to worry about milk supply not being 'rechargable' when she is well again :)

Frequent, soft and runny poo is normal for a bf baby...maybe nothing to do with intolerance.

thanks Tik tok - that was a speedy reply!
Her latch seems to have gone to pot and i am wondering if its down to the cold - she is basically nipple feeding and gulping in lots of air.

Have had same feeding patterns this morning - managed to get her to feed for 15 mins at 7, 15 mins at 10 and despite changing nappy, talking to her she will not go back on - she literally wrinkles her nose up when i put my nipple in her mouth and pulls away and then goes to sleep.

I will take her to see HV this week and check on weight.

I expressed some milk last night after she fed - got 20 mls out of the boob she had just fed from and 80 out of the one she wouldn't take - does that sound enough? - my thinking is that she maybe got 60 out of the feed?

She fed last night at 11pm, 2:30am and 7am and again just now at 10, but relatively short feeds every time. I gave her the 100mls of expressed milk at 11pm in a bottle for first time and she took it all, although did vomit up quite a bit.

I bet you have seen on mumsnet how expressing is the world's poorest guide to milk supply. It is so misleading. Expressing can produce more, or less, than a baby...and is in any case only a snapshot in time.

It's even less good at allowing you to calculate how much your baby had at any particular time by doing the maths for breast 1 and 2.

Honestly, what you are describing does not sound too terrible - you are bound to be more sensitive and anxious because of the jaundice thing. When she is better she may well feed more (if she needs to - she may not) and your body will be just fine at producing more for her, 'cos that is how the whole flippin thing works :)

sorry should have said she vomited a lot because she had a coughing fit.

Just expressed again and got 25 ml out of boob she fed from and 75mls out of other.

ok thanks tik tok,cross posts re the expressing thing but i didn't know actually it was bad guide to how much your baby takes. Good to know.
I think it is the jaundice making me more anxious than I would normally be . Thanks for putting my mind at rest

OK well I was wrong then... when I was worried about DD's feeding I got a million and one responses on here, from MWs and HVs too saying 'if she's having wet nappies she's fine'. Oh well, I'll know for next time. Sorry to have misled you OP.

In fact, we should probably get rid of this forum altogether then as there is so much misleading advice that is clearly wrong. It would be great if we could have an 'ask the expert' forum instead where only qualified people could respond. Might suggest it.

crazycatlady - I think other people's experiences are really valuable, and I don't think bf help should 'belong' to any group rather than another.

You clearly only wanted to help! I don't want to sound bossy to you :)

Problem is what is called in bfc training 'boundaries' - so I would never give medical advice to anyone here, or assume I knew everything about someone's situation, or tell them not to do what their HV/GP has said (except when it sounds totally stupid)....but I'd suggest questions to ask the HV/GP or areas to explore with them.

Similarly, if someone is offering their experience of what they have been told, then they should say 'this is my experience' and not assume they can generalise out from it, or assume that what was told to them applies to someone else. You said 'you can rest assured....' and 'the best way to check she is getting enough....' and it was a bit too strong and sure!

It also does depend on the circumstances. My DS who is nearly 9 months and therefore much older has a horrible cold/cough which turned in bronchiolitus earlier this week. I know he is not feeding very well and guessed that he was having maybe half the volume of milk he was having last week. I've been into the local hospital twice (once referred by my gp, once as an emergency as I was concerned) and they were looking at 2 things to decide if he needed hospitalisation. One of which was dehydration, and for a baby of his age the paeds said more than 2 wet nappies a day was probably enough to be sure he was not yet dehydrated. But did want me to keep an eye on that.

Also for what its worth he is feeling a bit better today, and is definitely trying to cath up with the milk. I have so far fed him at 5 am, 9am, 10 am, midday, 2pm and 3pm! when on a normal pre brochi day it would have been 7, 10.30 ish and 2.30 ish.

I hope your lo gets better soon. Its horrid when they are ill, and just another thing to worry about

hilda - the point is that hydration is not the same thing as 'is this baby getting enough to stay well and grow well?' - and you're right about circumstances. A 5 week old baby (as in the OP) is different from a 9 mth old - the younger the baby, the more vulnerable, really, I think.

Tiktok, that's what I was trying to say, although obviously less clearly than I had intended.

You're so right tiktok!

I just thought, oh no, I've said something to someone who's worried about their baby that isn't strictly correct. I should have thought about it and worded it better and that's what suddenly worried me - that people (like I did) come on here looking for the right thing to do and then get told nonsense (by people like me!)

Just a quick update to thank you all for your posts, baby is much better now, cold is on it's way out and jaundice seems to be going too. Feeds are lasting for longer and she is now back to two breasts! Looks like she is on the mend!

That's great news Bono.