4 day old after c-section and not really sure what I'm doing!

[MrsArchchancellorRidcully]

Just arrived home after crash section on Tues (& general anaesthetic) with DS.
He's my 2nd and I never bf DD at all and it really affected my bond.

Hospital were great and DS had his first suckle in recovery room. Over the first 3 days DS would latch on but didn't seem to know what to do and didn't suck. Then, as his body recovered from section, he started to want more colostrum. He would then get furious latching on and get too distressed to suck and he was so so angry.
We got lots of skin to skin and mw kept saying newborns don't need much colostrum, don't worry. But he still didn't have the patience to suck

On day 2 his blood sugar was 2.4 and he was jittery and dehydrated. He had nappies that weren't dry but not wet either.

Mws suggested using nipple shields and bingo - he latched on no problem and sucked. But as my milk is only just coming in I have no idea whether he is getting enough milk or not. He latches on easier (though sometimes gets angry) and sucks but yesterday he sucked on and off for 4 hrs but the docs thought he was dehydrated so I gave him a cup top up of ff 20mls.

Today I have only given him the breast using nipple shields but before we went home he was weighed and had lost 10% of his body weight (9lb 3 to 8lb3).
Midwives were concerned and said I need to keep feeding him but get him off the nipple shields (HOW??!) and to occasionally give formula as a top up. This I have done (20mls here and there) but he is very sleepy and I don't know if this is from ff or he is just a chilled baby or he is ill?

So, here's my concerns:

How do I know he is getting enough from my bm and isn;'t just showing signs of sleepiness cos he's dehydrated.
How do i get him off the shields

and, off topic, if you have a newborn who wants/needs to constantly feed, how do you find time for an older child. DD is 3 and atm I can't even see a time when I'll be able to bath her at night. And as for leaving the house...how do you do it?!

Sorry, rambling post and I'm only 4 days since a general but I'm desperate to feed DS and need some tips and support on getting it right but I really dn't know what I'm doing. I am scared DS is/will become dehydrated too.

When my ds was little he'd feed constantly, often fall asleep whilst feeding, it does eventually get easier. My dh would bath my other ds (4) and get him ready for bed etc. I would by foods I could make quick. I'd pump after each feed to try and increase my milk supply, if you want to then you could always top up with breast milk. I'm sure you know giving formula will mean you don't produce as much milk as your ds needs. Could you perhaps not use the shields half way through feeding? Them
Your baby isn't desperate for a feed, good luck

OP, what a frustrating start for you :(

You have not had great support so far at all, you've already had a panic about weight loss and now you're at home without the confidence to know what the best way forward is :(

The formula top ups will affect your milk supply if they're not stopped soon, but at the moment please don't stop them as they may be required - it's just not possible to tell without being with you. You do have time to deal with this and for things to be absolutely fine so it's not urgent that they stop, but ideally they need to be reduced soon.

Can I suggest that you get through tonight by feeding as much as your baby asks for and getting as much sleep as you can. You asked how to know whether he's sleepy because he's not eating enough, or whether it's because he's just sleepy? Well it's tough, so because of the difficult start I'd probably not go more than 3 hours tonight, and 2 hours during the day if you can. Maybe try to work out how to feed lying down. Are you set up for safe co-sleeping or at a minimum do you have a partner who can bring your baby to you to feed and them put him down again?

Then tomorrow, please contact your midwife and ask her to come to visit you tomorrow urgently so you can work through your questions. If you don't feel that she's helping you to breastfeed (some don't know enough about weaning off nipple shields and top ups) then another option is to call one of the helplines and maybe see if there's a local NCT or LLL breastfeeding counsellor who is willing to pop over and see you?

Please don't worry about your older child right now. Honestly, it will all be fine and things will settle down soon and then you'll have time for her. Is there anyone who can help with her while you focus on yourself and your son for a few days?

Keep an eye on nappy output as that's a good indicator of hydration. Has he passed his meconium - ie are his poos now yellowy rather than blacky/tar colour? I'd be looking for 4+ poos a day and 6 or more wet nappies a day. If you use disposables you can put a sheet of kitchen towel in the nappy to check for wetting.

I hope tonight goes ok for you. Try to relax as much as you can, keep feeding and see what RL support you can get tomorrow. I'll be looking out tomorrow to see how you are. xxx

Exactly what pinkyp says. Feed feed feed! Your supply will become established and your baby will settle into his own routine. As for your older child, this is what your dh was invented for!

Babies take as much milk as they need, same as with giving a bottle only you can't see how much they are taking. This may mean you feed him every hour or more to start with but your DS won't starve himself, honestly!

Congratulations on your new arrival, you're still in the fog so just hang on in there and make use of your DH :)

cross post, excellent advice. Wish I'd known about MN with my DD.... BTW feeding lying down is a fabulous skill to acquire and I fully recommend persevering with it.

Some newborns are just very sleepy, all you can really do is try to feed at every opportunity, and try to wake him up a bit by making sure he's not too warm. Removing clothes always worked for my DS, as well as tickling feet.

Agreed about the formula, the less you feed him, the less milk you make and the bottle might be confusing him. The best way to increase your supply is just to feed feed feed, and unfortunately those first couple weeks especially you might find yourself trapped under a baby for hours at a time. All I can suggest is before you sit down, get some activities set up for your DD, make sure you've got snacks and drinks for both you and DD, and be ready to stay in the same room for a while.

What are his nappies like now, are you getting wet ones? I'm sure I just read something tonight that said 6-8 wet nappies expected as a minimum.

As for the older child, I'll be going through that myself this summer so I can imagine it's hard! Relax your rules on telly, and possibly invest in a sling so you can carry your DS everywhere with you and still have your hands free. You can still wear them even with having a CS (I did!).

I second co-sleeping! If possible.

Congratulations!

FWIW has his latch been checked?
Are you using the shields because he isn't latching properly or because your nips are in rag order?

Your breastmilk should be enough for him completly, but if you are worried that he's not getting enough maybe you could pump it and feed it to him with a bottle?
Regarding how to keep your other child in the loop, there's not much you can do except involve her with your feeds somehow: maybe she could pass you a linen square? do a puzzle / colour a picture / have a drink of water herself every time you need to feed?

I'm sure you'll bond very well even if you express and feed that way, or mix feed or FF. Maker sure you get skin on skin and that your DD can have some of your time exclusively (30 mins a day is fine just you and her)

If you're still struggling with the bf in a few days then you may need to have his latch checked by a lactation consultant.
In the meantime, be easy on yourself, you're only 4 days in, and congratulations again on the birth of your newest family member. Snuggle up on the sofa with them both. It's cold outside in Ankh Morpork!

"Snuggle up on the sofa with them both." but not to sleep as sofa-sleeping with a baby is not safe :)

Making a safe bedsharing space or having someone to bring babe to you in bed would be a safe and cosy option. Sofa snuggling awake during the day is, of course, essential :)

Hello, I'm a first time poster on Mumsnet so bear with me, but I wanted to respond as I could have written your message three months ago. I'm now happily breastfeeding my son, but had exactly the problems you describe as he wouldn't latch or suck properly - he was bottlefed breast milk for the first week, then we used nipple shields.

After a lot of conflicting advice and hurtful unhelpful comments from health visitors the following worked for me: I was pumping to keep up my supply and eventually worked out that if I pumped on max setting to pull the nipple into a shape more similar to nipple shields he could then latch on, this also helped with let down so he didn't have to work so hard. Midwives had suggested taking the shield off mid-feed and this occasionally worked but the pumping trick worked best. I set aside a day to spend in bed, lots of skin to skin and decided to go cold turkey on the shields. Hope this helps.

Ta for comments. On phone so excuse poor spelling etc.

Hanging on in there. DS 6 days old and not really much better and I'm getting conflicting asdvice. Nipple shieldss work okish - it seems even if he's chilled when brought to breast he screams ands stresses as soon as I try to latch him on. It takes a good 10mns to get him to suck with the shield and when he does he'll come off every few mins as the milk isn't flowing fast enough. He is having wet nappies but not as manay as DD (though she was ff only so I'm struggling to feel confident) It feels like he's not getting enough cos he's always hungry and sometimes his mouth feeld dry :(

I am expressing a bit but only getting 20mls a time. In hospital he feds for 4 hrs once but they just said he couldn't be getting enough. They also are concerned cos he's lost 10% of his birth weigt and are talking about special measure is he doesn't gain! This is stressing me out and not helping supply. My right boob is huge ands constantly flowing lots of milk but he hates latching on. Left boob nowhere nr as big but he prefers this one, despite the bleeding nipple.

Argghh. Just so confused. Mw coming today and I'm going to bf drop in tomorrow but I just want him to 'get' that if he sucks, there's plenty of milk. If it doesn't come in floods he just gets cross and dscreams. I'm worried about using the nipple shields but he simply will not latch or suck without, desppite me having sticky out nipples.

Having duvet day in bed today to see if that helps. He is askeep on my chest atm but has fed almost constantly since 7am. DP says he wouldn't sleep if he was hungry byt I have zero confidence in my ability/ supply atm. Help appreciated!

Sorry for rushed post( boy in arms) but I would suggest-

1. ask mw to check for tongue tie (or ask who can check?)
2. if you are engorged he may find it harder to latch so you could try hand expressing a little bit first just to relieve the pressure.
3. If he's getting frustrated by slow flow, you could try breast compressions. Google Dr Jack Newman for explanation.
4. Duvet day is a great plan - have a look at biological nurturing (laid back breastfeeding too). Keep him close, skin to skin, don't force him to feed, just look for those subtle clues.

Hope you get some help from the mw- they really need to give you some suggestions rather than just stressing you out with threats of 'special meaures'

Rushed in too but as for the toddler, cbeebies. It won't hurt. No bath for a few days won't hurt.

How are things going now MrsA?

Also coming in for an update...

I second the advive to express off your right breast then try to latch him on - i couldn't bfeed at first because I was over supplying and my nipple was too hard to latch on to

hello m'lovely

just wanted to pop by and say i think you're doing an amazing with a toddler and crash section too. heres my thoughts: was ds bashed about during the birth? If he has a sore head it may hurt to suck - cranial osteopathy? The breast pump trick mentioned below sounds v useful. Ditto hand epressing just before jnr latches for instant gratification. also massage your boobs prior to a feed, a feather touch from your chest to your nipple gets the oytocin flowing, and twiddling your nipples like radio dials triggers prolactin. finally have you heard of breast compression? while jnr is feeding hold your boob in your hands and squeeze and draw your hand towards the nipple to power more milk in.
I feel for you -DS was a 9lb6oz milk monster - eventually - but he too was v v sleepy to begin with after an emcs and sore after he got wedged, and he too lost over his 10 percent. all you can do is keep trying. good luck.

Thanks for all the messages. Sadly,looks like we're mainly formula with some expressed now DS is 3 weeks old.
Just hasn't worked for us. I have tried everything but we ended up back in hospital at 7 days due to DS loosing over 13% of his birth weight and we were being threatened with a drip/being admitted if i didn't top up with formula.He had no poo nappies and maybe one wet nappy, so he was suffering.
Bf was then affecting my DD as to try to bf S properly I would have to ignore her for days. the day we went into hospital, she came with us as we had been told it would just be a routine check to make sure all was oK. We ended up there for hours, till past 10pm. DD is 3 and is in bed at 7 every night and she had her nursery nativity play the next day. The nurses managed to find her a piece of toast at 7 for her tea.
I caved in as I could not put bf DS above DD's needs too - right or wrong I don't know but I am still upset at that night.

We went home and woke DS every hour to feed and top up (later found out we had been marked down as 'discharged against medical advice', but had not been informed of this!) and he is now thriving. Not surprisingly he prefers the bottle to the breast and I am not good at expressing but giving him as much as I can. I can see us 100% ff soon though.
I had a lactation consultant come to the house and called several helplines but they all said the same - I was doing everything i could, my latch was good and there was nothing more I could do. DS just does not want to suck and is a very hungry baby. He feeds like a bf baby - cluster feeding in the evening, and we are feeding him on demand, albeit formula.

I can do no more. Sad but when it came to him being ill and DD being badly affected, bf was less important than the health of my kids.

Never mind, you did your best and the decision was taken from you. Your DD is perfect and was FF, so DS should be too. And you know what, he got some breastmilk, which is better than none, no harm has resulted. I had similar problems as you, and DS was on the bottle by the time we left hospital on day 3. You've done great. Now you can all enjoy each other's company.

Thank you sprinkles that means a lot and helps.

Well done, I also ended up FF after mixed feeding and BF went wrong, as sprinkles says, you did your best - I have been beating myself up about my BF fiasco but I did my best and that is the main thing. That and lots of love and cuddles. DD is now 4 months and thriving. I adore her! but wish she didnt wake up at 5am
Congratulations and Happy New Year!
Hope you get some sleep!

www.breastfeedingnetwork.org.uk/

Just read the whole thread (and seen one or two of your posts elsewhere).

Tbh, bfing can be tough when you're not juggling a 3yr old behaviour, recovering from an exhausting crash section, the Christmas period, winter etc etc.

Do have a look at the link I posted and perhaps call them. That site was set up by a very grounded mner and can help you sort out your feelings and offer practical solutions even if not bfing.