Breast feeding a big baby

[H007]

I have a big bouncing baby born Friday morning and I've been encourage to top up with formula pretty much since birth. I avoided it so fat however she has just has her first 30ml of formula as she looks like she is getting jaundice and they are taking about keeping her in extra this had made meal times upsetting and therefore she wasn't feeding as much as she should have been

How can I make going back to breast feeding success or is there a good change it will on it's own?

Its early days, I had this with my first. Has your milk come in? It is fairly common for big babies to get a bit jaundiced, its not related to illness Try gently waking baby every 2 hours during the day, having some skin to skin before feeding. Jaundiced babies can get a bit sleepy. Once your milk is in you could try expressing some and using this instead of formula to top up with. They may offer light therapy, has this been mentioned? This jaundice will resolve, keep offering the breast regularly and there is no reason for the odd top up after a feed while baby is jaundiced to disrupt your supply.

They are saying about light therapy no milk hasn't come in yet as it's only her 2nd day ideally I'd like to go back to just breast feeding but am just worried ive ruined the whole bf thing

Congrats on your new baby

I think introducing formula isn't the best idea if you want to exclusively bf, it will eventually affect your supply. Best way is just keep offering feeds often, your milk will come in very soon. Breast milk is also good for jaundice too so I'd keep going it's still early days for you both but good luck, you'll find good support here on MN

I'm pretty that you are under such pressure to give your daughter formula so young tbh. Do your midwives not understand that colostrum (which you have in your breasts now while waiting for your milk to come in) is very important for colonising the 'good' bacteria (think actimel adverts!) in babies' tummies?

Her tummy is tiny at the moment, literally the size of a marble, so giving her 30ml will probably have her so full she feels uncomfy. Was she sick afterwards?

You talk about mealtimes being upsetting - are you trying to feed your daughter at specific times? or was it your mealtimes when they were talking to you and putting pressure on/upsetting you? Does she latch OK when you put her to your breast - little and often is definitely the way forward at this point

And when you describe her as a big baby, how big?

Congratulations

I dont really get why they would want her to have formula I mean if you exclusively bf till baby iss 6 months shes going to be alot bigger. I would just keep bf her she might lose some weight and find her own centile I know its stresful and you want to listen to the experts aask to see a proper lactation midwife.

I do agree that eventually it would affect your supply, but do be reassured that you can exclusively breast feed after a few bottles early on and you haven't ruined anything. Shame the hospital felt the need to jump down the formula route, are any of the staff more supportive of your decision to bf?

Congratulations on your new baby!

I had a big baby (10lb 15.5oz) back in June who was also jaundice for nearly 3 weeks but not severe enough to merit light therapy.

In the early days she did have one little formula feed of 30ml but only as she wasn't settling after feeding. The midwives were really supportive where I was but did say that until my milk came in I would be constantly feeding her as the colostrum wouldn't be filling her up.

I would say just stick with it and keep feeding her frequently to encourage your
Milk to come in. Once it's arrived you may find its all ok. it did take nearly 3 weeks to get her back up to her birth weight but she had lost over a lb but I just stuck at it.

Good luck x

I had this with my second, he was enormous and had jaundice/low blood sugar. I topped up with formula while we got BFing established, I was devastated about this (feeding issues with DD had been a big factor in PND) but thankfully the MWs were great.

I only topped up after BFing. Always always try boob first. I would BF while DH prepared a little bottle.

The MWs reassured me that if I really wanted to I would be able to drop the FF. I did, on day 14. I knew my milk was in properly and when DH had to go back to work I just thought fuck it, can't be arsed to make a bottle up! I just kept BFing. He was on my boobs pretty much all day, which was difficult, but after that it all worked out in a vague routine and it was fine.

He never had FF after that, he was EBF until just before 6 months, and had his last mummy milk on his 2nd birthday :) so I'm really glad I had the confidence to ditch the formula this time.

Have faith in your body - I know that sounds all Woo but your boobs will figure it out.

And congratulations :)

Sorry, to clarify - I did keep FFing until the jaundice was better, and a little bit beyond while my milk built up. It is really important not to let baby get dehydrated so they can recover.

BFing is hard, there's nothing wrong with topping up while you get the hang of it, as long as you do it in the right way (ie topping up after a BF not before).

You have not messed this up, ok? You are doing what your baby needs to get over the jaundice and that's awesome :)

www.nbci.ca/index.php?option=com_content&view=article&id=79:breastfeeding-and-jaundice&catid=5:information&Itemid=17 - Jack ~Newman on newborn jaundice. Worth searching the kellymom website too if you geteh opportunity.

Thanks everyone for your advice and thanks montymython it seems I'm in exactly the same position as you! Things got slightly worse yesterday and she was put on light therapy however after this was ineffective she was admits to scbu :( where she is being hit from every angle to try and get the jaundice under control and to avoid a blood transfusion. The doctor admits he is being over cautious however I am happy with that. I have been visiting scbu every three hours through the night where she comes out of her incubator and we attempt some bf before the tube feed her ff, if the bf doesn't work I go back to the ward and express and then give this to her at her next feed. It's been a difficult night but the whole process seems to be working just waiting on results now. I imagine like you montymythlon I will need to do top ups for a while after until my milk comes in, how much ff did you give?

She was 10lb 6, but I think alot of the concerns cOme from her developing jaundice on day 1 whereas it's normal to develop it between 2 and 5 days.

Everyone is supportive here regarding bf it's purely as she was dehydrated and they needed to flush the bilirubin through with something.

Sorry you're not home yet and having these worries. Glad you're feeing supported, hopefully soon you and your gorgeous girl will be home and well.

Leonie, it is helpful to hear that you bf your big babies, but with the baby in scbu and having problems, there is a case for supplementation until the jaundice is sorted. Tube feeding is less likely to confuse baby and as long as she is still put to the breast regularly supply will build up. expressing is good to replace the ff. I remembered having to express in hospital for a jaundiced baby and it is hard but seeing the colostrum being replaced by milk and being able to provide for my baby was good. Hope you have a good day today H007.

H007, how worrying for you....yes, you can return to fully breastfeeding, and this setback does not have to be permanent.

No one here can tell you what to do or advise you to go against what the medics/SCBU are asking you to do.

But.

You can certainly ask for a good discussion, because topping up from birth, and giving formula for jaundice, may not be the advice of a maternity unit well-versed in breastfeeding support (no matter what they are actually saying to you - support means more than words, it means knowledge and ability to help you sustain bf even in the face of problems).

The doctor may be being 'over cautious' because he simply does not know much about sustaining bf in these circumstances, and he is relying on the 'safety' of what he knows more about.

You could deffo ask to see the infant feeding adviser, you could also ask the doc if he is aware of NICE guidance on the topic of jaundice in the newborn and the importance of breastfeeding continuing, even when the baby is being treated www.nice.org.uk/CG98. Size of baby is normally no good reason for supplementing with formula, and jaundice is usually 'treatable' with ad lib breastfeeding/expressed breastmilk or colostrum. In serious cases, however, formula may be justified. You need to be sure in your case that it is.

Hope things go well for you and your baby.

OP, my DD3 developed severe jaundice 12 hours after birth (but we were sort of expecting it - there was a known medical issue). She was tube-fed with extra formula to top her up - she was in SCBU, lights at all angles and also had a drip in her hand to help with the fluids for a couple of days. I expressed as much as I could (with lots of help and support from the MWs) and my milk was put in the tube first, then formula was added to get it to the right level. She did not feed directly from me until she was 4 days old. Her tube came out on Day 5, and she was exclusively bfed from then on, and we only stopped bfeeding when she was about 18 months!

It can be done - expressing does make you feel like a cow, but it gets the supply going and means your baby gets the necessary colostrum too. I would also make sure you are around to talk to the doctors on their rounds - I was desperate to get DD3 off the tube and bfeed her, but the nurses/MWs were not keen on going against the doctors' notes. So, I made sure I saw the paed when she came into SCBU, asked her if we could drop the formula and get onto bfeeding (at Day 4) and got agreement from the paed when she realised that the milk in the tube was my milk and not formula .

If you're finding expressing difficult, ask if you can express where you can see her - the MWs at my hospital volunteered to put up screens at DD3's cot so I could sit and look at her while using the pump, to try and get my milk down.

Oh, and DD3 was 8lb 11oz at birth, so not exactly tiny! Good luck - you can get there.

Oh, sorry to read baby's in scbu :( I hope you are all ok.

I can't remember how much formula I gave TBH - I let him feed as long as he wanted, although actually latching on was difficult. The combination of huge boobs and flat nipples made for a tricky start, until I was shown how to shape my own nipple to bring it forward a bit. If that makes sense. Basically he needed a lot of help to latch on.

Anyway after he'd had enough - or rather, he'd got tired due to jaundice/blood sugar/after effects of pethidine - I just offered him formula in a syringe. He hardly took any; don't forget a newborn tummy is like a marble in size! :)

I hated myself for topping up when I was so determined to EBF. But his blood sugar was dropping and jaundice worsening. I was really worried it'd be the end of BFing or that I would have to mix feed, but it really isn't the end if you don't want it to be.

It is up to you to decide what to do but please try to be assertive - and get your visitors/partner etc to be assertive too! It can be bloody hard work getting enough help in hospital.

Well an update for you all my baby girl was discharged from scbu this morning :) I spent the whole night with her and tempted her to bf prior to her formula each feed she was only interested the first time so after that I expressed and syringed it prior to her formula. Today we've been breast feeding every 2/3 hours and adding a formula top up on every other feed. It's been a tough day as she'd forgotten how to suckle anything and was being really lazy... But now things have improved greatly and she's latching like a pro.

poledra that's exactly what happened with her... So scary but thanks for the support :)

Thank you everyone for your support!!! It really did help that Theravada light at the end of the tunnel... Especially when shavers refusing to eat anything earlier.

leonie I didn't find your comments very helpful at all!! I have MSc in nutrition and am fully aware of the importance of colostrum, however i am also fully aware of the importance of my babies health and I would not risk having to put my baby through a blood transfusion, liver or brain damage because I wanted to breast feed! Also if my baby was 3 days old and developed jaundice it wouldn't be an issue as that is normal for any size baby the issue was that she developed it within 24hours due to dehydration (although could still be a live or kidney problem find out tomorrow). I find it judgemental that at I time I was seeking advice you were making those sorts of comments after all you are not me, you do not know how much colostrum I produce and your babies were smaller than mine!

Really pleased to hear that baby has been discharged from scbu and is latching like a pro. Sounds like you are doing well :)

There is a big emotional element to this. I was really upset that my ds had to have formula in the first few days because I thought it meant that I wouldn't be able to bf but it all worked out. When my second was due I had no such hang up and bought a tin of formula just in case (it wasn't needed).

Congratulations! So glad little (not so little!) one has been discharged. Keep letting her latch on whenever she wants and you'll be back to full BF in no time, the more she gets from you the less she will want the top-ups anyway. Every other feed sounds good, I think we did that and then reduced it to twice a day or something

Keep an eye out for returning jaundice though as it can come back if they get dehydrated again. I waited 2 weeks for this reason, although DS and I took that long to master the latch due to my awkward boobs.

Glad to see a happy ending - though do keep us posted. Look after yourself too, your milk won't suffer if you're undernourished, but you will, so eat and drink plenty and stick your feet up while others do your bidding.

Did she have to wear those funny fabric goggles when she was under the light? DS looked like a fly in his. Or Biggles :o

Haha yes and I kept them for her box, although scbu's biggest size was too small for her head so we had to do some improvising :)

Great news! It all sounds very promising, H007 - you'll be bfeeding till she's a toddler now

Ohhhh, the little fabric goggles! And the bright orange rings round their eyes when you took them off, like some type of colourful panda