Very urgent help needed - nb in intensive care

[zgaze]

My sister had her son Saturday morning, v long back to back labour ending in ventouse, but all seemed well and they were discharged and went home Sunday. The baby was very sleepy and did not feed much - would sit with the nipple in his mouth and not do anything with it. Finally seemed to get the hang of it yesterday morning and fed a few times but short feeds, then fed on and off pretty constantly through last night. I saw her Sunday and said that the baby looked very jaundiced, apparently on Monday looked even yellower...midwife finally turned up this afternoon (we'd rung and chased from Sunday!) and sent them straight to A&E.

He's now in intensive care under the lights, they want to put a tube into his stomach and feed him formula while running a battery of other tests. My other sister and I are both breastfeeding and have offered to express instead of the formula but told 'we don't do that in this country'(!) But this isn't really my question, I'm presuming they will do what they need to to get the baby well. Its really that my sister is desperate to breastfeed once this is all over so I've told her to ask for a hospital pump and get expressing. How often should she express to try and get and maintain her supply? bearing in mind her milk has only just started to come in.

Sorry this is long - no mental energy to try and edit. Any help welcome. Thankyou.

princesslina - thankyou so much, you gave me a lump in my throat reading that!

Better news this morning, the baby's levels have dropped so that they are 'within normal parameters for jaundice' - they were way off the scale last night. He is still in intensive care and likely to be there for the rest of the day and overnight. She is successfully expressing almost enough milk to keep him going which is fantastic.

Thankyou so much everyone for your help. I love Mumsnet! glad my 3rd sister has found it now too

Gosh you are wonderful sisters.

I expressed for 4 m and 6 w respectively for my NICU babies - every 3 hrs at first. It took a little bit of time to get them to transfer to the nipple - nipple shields helped, just phased them out later. Hopefully the tube feeding will make the transfer back much easier though.

Good luck to mum and baby.

morning twofalls.. Baby Gaze's bilirubin levels are dropping and our sister is expressing almost enough milk for each of his feeds. Not sure about if it is anything more serious yet as some tests take longer- the one concerning her Rhesus blood especially, but his bilirubin levels dropping indicate that this isn't too likely. Will know more later.
Does anyone know if baby can suckle when he has a tube going in his nose?

Yes, they can suckle with a ng tube.

At some point it should be encouraged that he suckles while being given his tube feed so that he associates suckling with getting a full tummy. That's the first step to breastfeeding and stopping NG feeds. It doesn't matter if he isn't getting any milk from the suckling to begin with. It is important however that he doesn't get too tired from doing it.

Please excuse poor grammar as I'm BFing DS atm.

I was thinking about this last night.

My sister expressed an ounce of breastmilk for me while I was in having orthopaedic surgery whilst heavily pg. This was just in case something went wrong and they had to deliver the baby (which didn't happen).

I run it past the infant feeding team (the head is a LLL leader so I know her) and was told that it would be fine because my sister's notes would be on the system and they could look up to see that she had been screened during pregnancy.

Wonder if the same would apply at your hospital if you and your sis had babies in the same region?

Fantastic news, lazygaze. Wanted to add that expressing every two hours, possibly a bit less at night is the best practice for expressing for a newborn.

It's interesting what the peadiatirican said re donor milk. THere is evidence that suggests that donor milk does have a negative impact on development of premature babies (contrary to my intuition and wishes!), but conversely there is also evidence that shows that babies fed exclusively on human milk for the first six months (or at l;east 4 months) enjoy better health than those formula-fed. There is also evidence that shows that infants fed formula in hospital are likely to be breast fed for a shorter duration than those not given formula.

Oh and yes, a baby can suckly with a ng tube in place

Thanks for the update lazygaze and zgaze. Baby gaze in NICU was the first thing I thought about this morning. Brilliant news that his levels are dropping, that is the key thing. DD2 was out of NICU in 48 hours because she responded so well but we had to stay in hospital 8 days in the end because they were treating her for some kind of infection too (which may or may not have been the cause of the jaundice). Just to warn you!

At the point she left NICU, I started feeding her as long as I kept her biliblanket on her back when I did so and I had to put her straight back under the lights. This went on for another couple of days. During this time I expressed and fed her - by day 5 in hospital I was soley breastfeeding.

The crucial time will be when they stop the light treatment. They will probably monitor him to make sure the levels don't go back up again without the lights.

Really hope all the tests are OK and there was no underlying cause. If they are anything like the team at the JR, they will not let him go before they have done every test under the sun and deemed him fit and healthy so they could be in for a while.

Just read this thread and glad to near things are going a bit better. My baby was in NICU too and I expressed. I found listening to music really helped take my mind off the hours of boring expressing - espwcially in the middle of the night. Plug ipod in, switch on pump. DS vomited first couple of feeds from breast but then became a great feeder. Good luck to all of you!

How are things with baby gaze?

Ahhhh hi Twofalls and thanks for thinking of us. Baby Gaze came out of NICU 36 hours ago and has been happily skin to skin feeding on demand. They are still in hospital as he is on penicillin but should be out tomorrow!
I can't tell you how happy it made us to see our sister successfully feeding her (much less yellow!) baby, he is latched on perfectly and getting stronger every hour..beautiful! Thank you NHS and mother nature! and Mumsnet xxx

Wonderful news...

Bet they can't wait to get him home.

Hi, late to the thread but wanted to wish you all the best, and I'm so glad BabyGaze is getting better.

Btw excellent photos on your profile, zgaze!

Lovely news. Really pleased for you all. I remember the time in hospital (out of nicu) actually aided bf-ing because there was nothing else to do so hopefully your sister has found the same.

lazygaze I've just come across this thread and wanted to say I'm glad things are really improving.

I was shocked by the hospital's attitude to your donating milk, and the HV's reaction to your nursing your nephew.

I do a lot with milk banking. Preemie and sick babies are prone to a devastating bowel disease which when they are fed breastmilk is very rare, and when they are fed formula milk is much more common. The protection against this disease is the same even if the milk is pasteurised donor milk as opposed to raw mother's own milk.

notanexcitingname please can you point me in the direction of research that says that babies don't develop so well on donor milk?

Pasturised donor milk loses some of the protection against general infection properties of raw mother's own milk but it still retains properties which are not replicable in converted cow's milk - formula - hardly a surprise that another animal's milk simply cannot be as good for a baby as its own species'.

For you to provide raw milk of your own to your sister's baby would be the best of all worlds (second to her providing it all herself of course) as long as you know that you are not infected with HIV/AIDS, syphilis, HTLV or Hepatitis, which are in theory transmittable via breastmilk, and which donor mums are screened for.

This hospital has a lot to answer for. Which is it that they're at?