Severely jaundiced newborn, trying to salvage BF, please help.

[wolfhound]

DD, now 9 days old. Born 3.5 weeks early, and got very severe jaundice so had to go back into hospital at 5 days for UV light therapy. Jaundice came right down, and we were allowed out 2 days ago. She's getting sleepy again. When we were in hospital, she had formula top-ups as they said she needed more fluids to flush out jaundice and i couldn't express enough.

Feel like I have enough milk now, but she is a gentle/sleepy sucker (poss because slightly premature) so don't think she's getting enough. I have BF twice before (till 1 yr each time) so didn't expect problems this time!

Anyone got any advice?

There will be others with more experience, however if shes actually feeding then thats a great sign! Might take a few days for her to pick herself up but I think if you keep going as on demand as you can it will sort itself out. If shes starting to put on weight too then its working.

Chin up. As she gets stronger she will feed better. Your doing fab to have kept it up. Big hugs to you both :0)

You're not the first person to deal with this, help and advice must be out there. If you haven't got this in progress already I'd ask to see the hospital infant feeding experts (not sure of their exact title.) Also, the national helplines and local BF groups may be able to give good advice and one to one help.

In the meantime, I'd be tempted to try whatever helps to get a good feed, e.g. offer the boob, change nappy or whatever to keep her awake then offer again (same or other one depending on time taken to feed so far.) Also while feeding, try blowing gently on her face or neck when she seems to be dropping off to sleep.

Have you tried a (clean) finger in her mouth to test her suck reflex?

That's exactly my story and my DD is EBF at 13wo now. She was not prem but back in hospital at day 5 for 2 days for jaundice. She was given tube top ups because she couldn't be taken out of the bilibed. Since they didnt give her bottles she didn't have any nipple confusion.

Honestly I don't know how I did it! I just trust she's getting enough and never went for the ff or express route. I probably got lucky coz she got back to her birth weight before we were admitted to SCBU. So no HV harassing me. Also easier to have faith in the feeding.

She was also very sleepy for the first month. None of the normal tricks can wake her up. Not even a nappy change.

Annoying iPhone.

Anyway I know my post probably isn't much help since I can't remember how I got DD to feed. (maybe just stuff a boob in her face at every squeak)! But hang in there it is possible esp since you are already experienced with bf.

hiya all 3 of mine were 4 weeks early in hosp with jaundice.

With ds1
I was expressing and syringe feeding-when he was a little stronger once the jaundice subsided I striped him down and feed him walking aorund. Also I wouldnt wait for any of mine to wkae for a feed-I just feed them every 90 mins regardless-they picked up very quickly, but remianed 90 min feeders for a good 3 months then slowly slowly went longer between feeds.

She will be 2 wks soon so you can see how her weight is getting on.

Are you getting 3 mustard coloured poos a day?
Do your breasts feel softer after feeding?
Can you see / hear gulping and swallowing?
Does she have some content periods?

If these sound ok, do you think it might be that your confidence has been a little shot by the hospital admission? Give it some time, keep an eye on her and see how things go.

The syringe feeding sounds like a good idea and reminded me of something I did in the early days to persuade DS to feed while sleepy and not having a powerful suck. Just a thought but it might be handy until you can get syringes. Could you try to express some milk from your breast and once the nipple is milky then offer it to DD. If she's keen and awake but the sucking is poor you could perhaps (and carefully of course) try to get a few drops at a time into her mouth then let her swallow. I did this in hospital on advice from a MW and she said that even wiping the milky nipple against a baby's gums will wet their mouth, get them intersted and give them some hydration. This was during the colostrum-to-milk days for me so I didn't have a lot of milk coming out, this may not be safe or easy if you've a lot of milk coming out.

thank you all! Lilham - sounds very similar - DD also had tube top ups so she could stay on the bilibed thing.

Midwife just been and DD has put on 20g in the 2 days we've been out of hospital - which is about half the 'normal' weight gain but encouraging given our circumstances - I was afraid she'd have lost weight.

LaCicc - we saw the infant feeding coordinator in the hospital and she said everything was right about the way she was feeding. The main problem is simply her often being too sleepy to latch on or to suck for long. iMum - I try the stripping down but often doesn't work!

Albrecht - yes, now getting several yellow poos a day (all very small but there, nevertheless) and also some weight to the nappies which shows she's weeing. She is content most of the time, which is partly the sleepiness I think. I think you are absolutely right about my confidence being knocked. I need to keep having faith and keep on pushing her to feed, poor little thing!

really appreciate you all giving time. orchidee will try the drops in mouth thing. Am also going to try expressing one feed a day and cup feeding to give her a 'no-effort' feed.

The 20g weight gain is brilliant. The UV light could have dehydrated her even with topups, so hopefully this is the start of things to come, things are moving in the right direction.

Now you two can get on with enjoying your early days together.

thanks orchidee :)

Hi Wolfhound, I had a very similar sitaution with DD, she was 6 weeks premature and had terrible jaundice and needed triple phototherapy for 8 days and she was incredibly close to the transfusion level. When she was under the lights I was told that this as well as the jaundice made them extra sleepy, I found that after about a week of no lights she was much more alert and started to feed like a trooper and is still going strong with her breast feeding at 6 months. I offered the breast every time she stirred and spent a good few days just lay in bed with her and this also seemed to help as I didn't miss any feeding cues. Best of luck x