Please help a very new mum: latching on, positions, and frequency

[mpops]

Hello. Just back from the hospital with a lovely 2-day-old DD.

She didn't take to the breast until a couple of hours after being born but we managed something on the side-lying position with the help of the midwife. Then had another 'feed' on the same position after that, followed by 24 hours of great upset as she wasn't latching on and getting very frustrated and me very disappointed and stressed out. Then finally she latched on last night (after 24 hours of being born) and it was great. However, she isn't latching on the other breast, finds it very hard. Probably because my nipple is not that pronounced and she can't get her head around how to do it. This is resulting to my 'good' nipple getting quite sore as she's only feeding from there now and she's on for a good 40-mins to an hour.

So, question: does anyone have any good tips to encourage her to latch on the other breast?

Other problem: like I said, she's only been able to latch on on the side-lying position. That's fine for now but obviously I'd like her to bf in the cradle position as well so I can eventually go out and stuff! I've got a C-shaped nursing pillow. Is that a good way to start trying her on that position again? Any other tips?

Final (HA!) problem: right now we're sort of following a 3-hour pattern: say she feeds from 10 to 11, I'll then get her to feed again at 2, then at 6 and so on and so forth. Is that about right to start with? Should it be more often? I'm not sure if every 3 hours means from the start of the feed or from the end.

I know I should have asked these questions at the hospital but I was so stressed about her not feeding at all that I forgot. But now these things seem very important! I'll give the bf helpline a call as well but it'd be great to have some experience from mums here.

Oh, final question: do you change the nappy after each feed?

Thanks for your help!

I'm no great expert but I am awake so that's a start!

Easiest one first- I think most people would change the nappy each feed for one so young as they tend to poo anyway and can be useful way to wake them up if they doze off in the middle of feeding.

I think you are supposed to time from start of one feed to start of the next which would make it more 4hrly which is maybe not quite enough for such early days (my two never made it more than 2 hrly!) Do try not to get too obsessed with clock watching though and just feed whenever she's awake (don't wait for crying).

latch is really hard to advise on remotely. Best thing is to get a good midwife (you should get a visit tomorrow shouldn't you?) or bf counsellor or go to a bf group or even a friend or relative who has bf to watch you. I would just go with whatever works for now even if that is lying down and only one side until you can get some 'live' help.

Three hours is from the start of one feed to the start of the next. But if no concerns over jaundice, weight loss you can go four hours or even a bit longer.

With your not so good side you could try the rugby hold. So if it's your right side you hold her under your right arm with her tummy against your side, head pointing to the left. Express a few drops of colostrum onto the end of your nipple so she smells it. But you have more chance of this all working if she's actually wanting a feed and rooting about instead of her just been woken up as it's three hours from the last feed.

Are you sure the latch is good on the other side as it shouldn't be getting sore really. Nice open mouth, lower lip curled back, plenty of the areola in, chin touching your breast.

Good luck, it does get easier I promise.

PS- Is the breast she's not feeding off engorged and that's making it harder for her to latch. You could try hand expressing first and it might make it easier.

New borns need to feed about 10 - 12 times a day I think so could probably do with a bit more.

Not sure on the non latching side, probably just take a bit more practise. If you can manage it lying down now that's fine. She will get better at feeding & so will you & then you can expand your feeding positions.

Biological nurturing helped me to get DD latched well. Once we had the swing of it we could use other positions.

There is a video on that site and pictures. I really recommend it.

My DD never went 3 hourly until we started introducing solids. At 2 days it was more like every hour. So long as you're not imposing the 3 hour gaps and she's happy & thriving then it's probably not a problem,

Nappies - I can't remember really, changed an awful lot so yes, probably at every feed. Certainly this was the case at night until DD stopped pooing in her sleep.

It's so early on, I wouldn't worry about expanding your range of feeding positions too much right now. Once you've both got the hang of it, then you can try. I also fed DS lying down for 4-5 days but after that the cradle hold started working for us. Lying down also means you get plenty of precious rest in these early days

I also had trouble feeding from one side, so I expressed (hand) from that side & fed with a syringe. I was still in hospital so MW showed me how. You could ask when you see her? Once my milk came in properly (3/4 days) things changed. Initially DS found it hard to latch cos my boobs were so full, but once that settled down, he was fine on both sides. I found it changed a lot over the first week so maybe go with what works for now & see how it goes?

I fed DS when he was hungry. I used an iPhone app to note down frequency & length of feed and there wasn't much of a pattern in those early days. It prob was more like every 2 hours but he wouldn't feed for long each time. He grew well though and eventually settled down.

I had assumed a baby would cry when he needed his nappy changed but he didn't so I wasn't changing it enough at first and his bottom got a bit red. So if you check it at each feed you should avoid that at least.

Hope that helps! Remember, it is still early days & you and your baby are still adjusting to each other & the world. Do get help with your latch but don't panic! My nipples were sore at first (1st few days) and then they got used to a baby sucking on them day in, day out. Not sore at all afterwards. I was surprised how much changed over the first couple of weeks - just as I'd got the hang of it, my milk came in etc.

Sorry for long rambling post but hope it helps.

Good luck

Disagree that you can leave a newborn to go 4 hours between feeds - in the early days when you are trying to get things established it's important to both of you to feed frequently, 10-12 times in 24 hours as was mentioned above. Demand feeding doesn't really get going until after the first week or two, in the meantime make sure she's feeding every couple of hours in the day (I'd wake 3 hourly at night at first too).

The 'rugby ball' position can be good at getting reluctant latchers to latch on.
Congratulations

Personally Loopy, at 2 days old (or under 14 days really) I wouldn't risk it - things can change so quickly and you are working hard to get feeding established. I worked on the basis that you can't feed too often, but you can feed too little.

When I was on the postnatal ward the midwives just told us "not to let them go more than 6 hours without a feed" - I assume they meant one 6 hour break in 24 but the girl in the bed next to me ended up only feeding her baby 4 times a day for the first day or two.

After the first couple of weeks once I was confident we both had the hang of things and ds was waking and demanding loads of feeds in the day I did just let him sleep at night, and he was a pretty good sleeper then.

Loopy, I'd say that in a baby so small that feeding in the middle of the night is Very important. I think your not supposed to let them go more then 4hours at night. Your hormone level's are higher at night then anyother time and this is what help's estabish a good milk supply. So even if a baby is feeding well during the day then night feed's are still important. Ovously once baby is a bit older and demanding feeding well then you can stop waking them up.

You can read some more hear about early nursing. www.kellymom.com/bf/normal/newborn-nursing.html

I think you can definetly leave a newborn 4 hours between feeds.

Where I work the only babies we have on a 3 hourly feeding regime are the ones on Transitional Care and even thouse the aim is to normalise them into 4 hourly feeds as quickly as possible. From there to on demand feeding. Infact some of the Transitional Care babies who are borderline whether or not they need to be on Transitional Care are 4 hourly feeds from the beginning.

Do you not think it makes it difficult to establish breastfeeding with only 6 feeds a day?

Most babies will want to feed more than 6x a day but if they don't then I think its harder to get breastfeeding established with a baby that isn't hungry/interested. There's more likely to be a poor latch which will cause problems. Most babies will feed between 6-8 times a day.

It is important to wake baby up at least once in the night. Most people will do a late evening/bed time (adult bedtime) feed, once in the night and then crack of dawn. But I think that aiming for 3 hourly feeds isn't helpful or necessary. Of course if baby wants to feed 3 hourly or more frequently than that then thats fine.

6-8 feeds seems very few for a newborn/young breastfed baby.

viva are they having breastmilk? It digests quite quickly. I recall when my DD was newborn she was feeding sometimes every 15 mins or maybe an hour and probably 2 hourly at night.

I was told it was because bm digested so quickly compared to formula.

Yes breast milk. I know that bm digests quicker than formula and like I said earlier most babies will want to feed more frequently than four hourly and obviously of they do wake hungry then they should be fed. But if a healthy, term infant is sleeping I would not be waking it because it's three hours since the last feed.

Have you not come across babies who are just very sleepy in the first few days and do not wake themselves to be fed often enough? It must be very tough to establish a milk supply on 6 feeds a day unless the mother is pumping as well.

As I understand it "demand feeding" doesn't really come into play until the baby is gaining weight and feeding often (eg. 10-12 times a day).

mpops - best thing for you to do, I think, is to have a good chat with the community midwife, who can see you and see your baby. The midwife will explain about responding to feeding cues and assessing feeding effectiveness.

If you post to a talkboard like this, you will get unusual and conflicting advice that may not apply to you.

Apart from that, you really cannot talk about a feeding 'pattern', even with a 'ha' in brackets :), for a baby who's 2 days old...

Hope things go smoothly!

That's interesting about demand feeding Rita, I'd not heard that before.

I had a sleepy baby Kelly and it was something I read on a few breastfeeding sites linked from Kellymom like this one www.breastfeedingbasics.com/articles/waking-a-sleepy-baby. DS slept 6 hours the first night we were home from the hospital and when I told the community midwife the next day she was

Wow, my DD IS 2.9 and I think she still doesn't go 6 hours between feeds at night!

Thanks all so much for your replies, I really appreciate your interest!

We are still struggling with breastfeeding, both DD and I, despite getting a lot of help from the midwives. She's not latching on properly despite trying every single position there is. Which is an altogether different issue to what I originally posted but there you go.

Motherhood is hard!

Mpops, sorry to hear you are still having a hard time. I know you've had some help from lots of mws but can you see a lactation consultant or breastfeeding councillor? Mws mean well but are not always experienced enough to help. Is there a breastfeeding group you can go to to see if they can help? Has dd been checked for Tongue tie?

Hope you can find someone to help/things improve.

Remember it's just early day though.