Newborn latching

[CosmicMouse]

I'm 26 weeks with DD2.

I attempted to BF DD1, but never really got off the ground. Despite having lots more support around me this time, I cannot shake the feeling I'm going to have the same difficulties this time around. Logic tells me that all babies are different, I'm more experienced, I've got lots of lovely BF mummies to turn to for help...yadda yadda yadda. But I feel I have to prepare for history to repeat itself, and then if it doesn't it's a bonus. Neurotic much?

Anyway. DD1 was born naturally and had excellent Apgars. No issues there. I offered her the breast straight away, but she wasn't interested. I then unfortunately had to be taken to theatre for repair of a bad tear. I was reunited with her approximately 2.5hrs later. She had skin to skin with DH in this time.

Once back on the ward, I tried and tried to get her to latch. She would open her mouth and accept the boob, but then made absolutely no attempt to suckle. This carried on for 48hrs. She got more and more upset, as did I. We were recommended to try all sorts of different positions. I had midwives trying to shove her on. I had midwives telling me she was latching (because they'd stick their head round the curtain and see a baby with a boob in her mouth) when she obviously wasn't. They recommended I try and express some colostrum, but I couldn't get anything out. We ended up giving some formula in hospital, via syringe and then cup. And then discharging ourselves on the 3rd day because I couldn't hack being in the place for a minute longer.

I fully intended to start pumping at home. But when it came down to it, I was physically and mentally exhausted and just couldn't bring myself to start.

We fully formula fed from then on.

I've never understood what went wrong. I've never really had a proper explanation as to why she wouldn't latch.

I guess what I want to know is what should I have done last time? What do you do with a baby who doesn't latch for the first few days of life? I'm considering antenatal expressing so we have something "in stock" and also to take a breast pump with me to the hospital. To complicate matters, I'm having an ELCS this time so I'll be in hospital for 3 days-ish.

Can anyone make any suggestions?

My DD wasn't great at latching for the first 24 hours or so. I definitely had colostrum though so I hand expressed it and let her suck it off my fingers. That's what the midwives had me do in hospital.

I laid her on my chest with free access to my boobs for the first few days and let her kind of get used to me and then slowly she kind of got the idea. She has never done the wide gape mouth thing that everyone goes on about though. She kind of nuzzles up to the nipple and then kind of "hoovers" it into her mouth until it's deep enough. I know this isn't what is "usual" but it works for her and it's not painful for me so I let her get on with it.

DD is now 8 weeks old and has on average been putting on about half a pound a week from her start weight of 6lb 9oz (after regaining first week 4.5% weight loss.)

First things first...try not to stress!:) babies have to "learn" too as well as mum.

Please don't express ante natally, and please don't think that because your first wouldn't latch, your second won't either. I have just had DS 4 and he spent the first three days of his life barely touching the nipple. He would hold my boob in his mouth,use me as a it of a dummy but barely took any colostrum. (although he must have had some!) my view was that he had been inside me for nine months anther few days until milk comes in wont make that much difference.

Try to be kind to yourself and not worry overly about it, every baby is different and hopefully a wiser mumsnetter will be along soon with some wiser words :)

Did you have pain relief when in labour with your first? Some drugs pass through the placenta and is known to make newborn drowsy. Maybe that's why she didn't suckle at all?

And what the midwives do wasn't helpful at all. I think bf counsellors are not supposed to push a babies head onto the boob!

Theres no need to worry at all. Your 2nd might have a very strong suckle reflex. Mine did. She just latched herself on and feed away with no help from me when we had our skin to skin. I was in a stir up getting repaired

Also it might help to find out if there are bf clinics or groups running in your area. You can visit them before your LO arrives. Them you will know where to get help. Midwives are not trained in bf so the advice you get from them can vary.

Did she ever get checked for Tongue tie? DS went straight on the boob and made a half-hearted attempt to suck but couldn't do it properly. After 36 hours of syringe expressing and worry I asked the paed to check him when she was doing the newborn check and he had tongue tie.

Got it snipped and it took another 36 hours but then he did begin to feed.

Some babies don't want to feed as soon as they are born but become more interested in the first hour, after that 'golden hour' they can become a bit 'switched off' and less responsive to bfing.

The more hands on the 'help' the more switched off a baby can become (if every time you were given a plate of food rather than letting you pick up your cutlery someone pushed your head in the plate, you'd soon not want to see a plate ever again).

None of this is your fault or anything that you could have done differently at the time but it can help you this time round.

Having skin to skin in recovery (if clinically safe), trying biological nurturing (letting baby's own reflexes get them to the breast and start feeding - easier on the stitches than sitting upright but perhaps have a cushion or pillow over the wound in case baby kicks it) and adopting a 'no hands on the back of baby's head' rule (supporting head by cradling the neck with your thumb/forefinger in a C shape) can all help bfing get off to a good start. No guarantees though as I'm not Mystic Meg

Good luck with the delivery and the rest of your pg.

TruthSweet that's interesting about the golden hour. I was left on the stirrup with DD on my chest for hours. I cant remember whether she fed straightaway. But it sounded like we were given a great start by being left alone with DD latching with biological nurturing.

This is one article on the golden hour. There is lots out there though on it.

Cosmic I had quite a similar experience. My DS did feed in the hours straight after he was born (although I also spent almost an hour being stitched while DS had skin to skin with DH) but then would not feed, no matter what the various MWs tried!

I did manage to hand express colostrum but DS was formula fed through a tube and we left hospital after a couple of nights without resolving the situation.

I kept expressing tiny amounts by hand at home and feeding formula but then on day 5 my MW visited and without really doing anything different to what we had been trying he latched on and started feeding! He's 8 weeks now and I haven't had to go back to the formula since that day.

Anyway, if you do have problems again, persevere I suppose is my advice. I have no idea why DS suddenly decided to feed but if you just keep trying they might go for it eventually. Very best of luck.

Thanks everyone for the thoughts and suggestions.

I'm sure it will all work out fine this time, and I know where to go for the proper advice. Although I am concerned that I'm definitely going to be stuck in a hospital for a few days. I'm hoping the Infant Feeding lady will be able to help whilst I'm there though.

I'm friends with 2 local LLL leaders, as well as a couple of peer-supporters. There is a BF support group in my little town, although this is NHS so I don't know what it's like.

We had a lot stacked up against us last time. And it's only going through it with friends and people in the know that I've realised I totally underestimated just how much stress and anxiety played a part in that. On both sides. The poor little lamb just had no idea what was going on, and I was getting frustrated and stressed out. It was a case of too many cooks, with umpteen different people coming in and out of the bay to "help" over the course of 48-72hrs. That combined with the fact we were separated for so long, and before she'd fed, were the main contributing factors I think.

Although having a c-section isn't ideal. I'm hoping that I will be able to get a little skin-to-skin in the operating theatre, and I will make sure she comes with me to recovery so separation is kept to an absolute minimum.

Then, think trying to relax and let our new lady take her time over the whole thing will be key.

In answer to some questions - she was checked for tongue tie by the paed on discharge and nothing came up. I've not noticed any tell tale signs as she's grown. I only had G&A during labour, so she wasn't affected by pain relief.

Sounds like you have an excellent support network lined up Cosmic and a good plan for lots of skin to skin. Perhaps you can do a 'breastfeeding plan' and state in that about no head touching. I think there's one on the Australian Breastfeeding Association website.

Although Witch seems fairly against it, I don't see anything wrong with ante- natal expression. Why not ask your mw about it the next time you have an appt.?

Hope all goes well for you.

Just so you're aware - after an elective c section it can take a little while longer for your milk to come in as you haven't had the hormones of labour to start things off. So when you do get a lovely baby who attaches and feeds like a dream :-) you might then get a longer than usual period of frequent feeding day 3-5 or so as your body catches up with milk demand. Please don't let this make you think things aren't working. Plenty of skin to skin and free boob access will let things happen.

Crikey - hadn't thought of doing a plan which extends to BF, will check it out.

UpYaKilt - is that definitely correct? I've read a lot of people saying ELCS delays milk production. But all the "official" stuff I've read says that it's actually the removal of the placenta that kicks things off, which obviously happens either way?

My newborn is 9 days old today. Went into labour at 36wks, but ended up having an emcs. Same problems as you here, no problems latching, but he won't suck. Had various people, including breast feeding buddies, that they send round to you in hospital. All trying different positions etc with no luck. I keep trying skin to skin, but he just holds nipple in his mouth. Even when i've expressed some first and there is milk on my nipple. I am using a pump now to express into a bottle for him. But as he was 36wks born, i will just keep trying with my breast.
Sorry no advice, but just thought I would say, you're not alone.
Good luck.

Here is the link to the breastfeeding plan Cosmic.

Hope things improve for you soon hippysair.

Hi there CosmicMouse, sorry been away from the computer all day. Milk production is inhibited until the placenta is removed, but the production of hormones during labour with contractions rises to a peak at delivery so they are there as soon as the placenta is removed to start the ball rolling. Your body produces oxytocin and prolactin when the baby suckles, so early and frequent feeding in the first few days will do the same thing, just a little bit more slowly. I googled and found this link, which is a bit 'yoghurt knitty' for me but has some good references. I've worked on PN wards and IME there was definitely an effect from coming from a standing start of EL LUSCS. However tiredness from a long labour, stress and pain from a traumatic delivery, large blood loss, separation from baby etc etc can all affect things too.
Sorry, wasn't trying to worry you, more to say that if there seems to be a delay in the milk arriving it doesn't mean that things aren't working properly.