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Infant feeding

Get advice and support with infant feeding from other users here.

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Original poster

urgent question re. bf after gestational diabetes

21 replies

eclipse · 16/03/2006 20:25

My friend has just rung me from hospital where her baby is about to be delivered by cs and she has gestational diabetes. The docs are determined to give formula immediately after birth and she wants to breastfeed and express if necessary in the first instance. I know I read some views on this. Does she have to give formula or can she express soon enough after the cs? I know I saw a discussion about this, hunkermunker I think, but I can't find it. Any help appreciated.

OP posts:

NotQuiteCockney · 16/03/2006 20:28

The baby should go straight to boob, from what I know. Avoid formula if she can. If they must give formula, maybe try cup, syringe or nose tube, to avoid nipple confusion?

(Ideally, she should have been hand-expressing colostrum in the run up to the birth, but it's a bit late for that!)

pepperrabbit · 16/03/2006 20:37

I think she can insist they let her try to breastfeed the baby immediately she's recovered enough. I think HM was just really (scarily!) assertive and fed and fed and fed her baby till it's sugar levels came up.
After all, it's her baby - she'd need to sign consent forms if they wanted to do anything else to her or the baby, so why not assert your rights - though not the easiest of times for that I know.
As a compromise she needs to fully understand what scores they're after and what the implications are for the baby.
I had GD last time and bf - there was at least a 3 hour delay between giving birth and feeding as I had to go to have the placenta removed in theatre - no-one fed DS in my absence so a short delay shouldn't matter?

Original poster

eclipse · 16/03/2006 20:50

Thanks NQC and pepperrabbit. I'll pass the info on. She's gone into labour early but has to have a cs. Hopefully she'll have a keen-to-feed baby. If not, cup-feeding in the interim may be the best compromise.

OP posts:

NotQuiteCockney · 16/03/2006 20:51

I think some hospitals let you latch the baby on in theatre? My hospital only lets you do it in recovery.

Is her baby being delivered by elective CS, or emergency? How late/early is he?

SoupDragon · 16/03/2006 20:52

She doesn't have to let them give her baby formula at all. Whether she is strong enough to insist that they don't is another matter.

Will try to find hunkermunker's thread about this.

Original poster

eclipse · 16/03/2006 20:55

She's due in 3 weeks so it's elective but essential imminently.

OP posts:

NotQuiteCockney · 16/03/2006 20:57

No, this is an "emergency" section, technically. If it's not pre-booked, it's an emergency, even if it's not a "run, run, hurry, do it now" sort of emergency.

Her going into labour is good, it means the baby might well be fully cooked. The extra hormones etc involved in labour will mean her milk comes in faster.

edam · 16/03/2006 20:59

Have the docs explained why they are so keen to give formula and not encourage b/f? Are the docs obstetricians? Have they consulted the paediatrician? Or the the diabetes specialist?

AFAIK docs are keen to get babies affected by g/d to feed asap to sort their blood sugar out, but I don't see why it has to be formula.

Warning - my sister had GD and was keen to b/f. Hospital claimed to be keen to establish b/f but went about it in entirely the wrong way - I feel they bullied my sister into a situation where breast feeding was never going to work. They had her on a stupid strict timetable of expressing/feeding/nappy changing, a real regimented mess that was so demanding sister never got much time just to cuddle up with her baby - in fact she ended up with swollen feet they kept her so busy. She got no rest at all.

Worth your friend pushing them, demanding to know why they want to do what they want to do, what the effect is likely to be, what their knowledge of GD and breastfeeding actually is.... unfortunately all the battles you really aren't up for immediately after giving birth.

NotQuiteCockney · 16/03/2006 21:01

Yeah, your friend should try to get in touch with the BF specialists at her hospital, to get their support, pump loan etc etc, if possible?

They tend to work 9-5 (helpfully), so she might not see them before tomorrow, but still ...

SoupDragon · 16/03/2006 21:01

\link{http://www.mumsnet.com/Talk?topicid=1364&threadid=139616&rnd=03343700137365291\HM post birth "low sugar" thread}

hoxtonchick · 16/03/2006 21:06

i have diabetes. both my children needed supplementing with formula in their first 24 hours. i bf ds for 6 months & am still bf dd at 8.5 months. they were both cupfed formula, & i made sure i put them to the breast first every time. no nipple confusion at all.

good luck to your friend.

Original poster

eclipse · 16/03/2006 21:06

Thanks so much for all this. The docs have said she can bf straight away, even in theatre, but they'll still give formula in addition to make sure the baby's taken enough. They've told her there is a risk of serious neurological complications if they don't. Don't really know any more details, just had a quick phone call.

OP posts:

hunkermunker · 17/03/2006 22:12

Hi Eclipse, only just seen this thread (and just reread the first post on mine too - had forgotten quite how traumatic it all was!).

I hope your friend is OK and has had supportive health professionals.

I am definitely scarily assertive when it comes to bfeeding - I knew that DS2 was OK, I knew that I could do it and DS2 wasn't symptomatic (that would've been frightening!) so I just hung in there.

Original poster

eclipse · 17/03/2006 22:35

Hi hunkermunker,
I loved your thread and had an image of doctors cowering around you. I don't know anything about gestational diabetes so cannot really advise my friend but it's great to be able to pass on others' experiences.
The news from the hospital is that the contractions stopped during the night so they're going to try to wait a week for the c-section. In the meantime, as others have advised, she'll try to express a bit in preparation. That can bring on labour though, can't it? She's happy to have a bit of breathing space to find out more about her options.

OP posts:

Original poster

eclipse · 26/03/2006 20:10

Just a quick update (based on garbled excited message from the hospital). Baby arrived safely yesterday and was successfully taking formula from a cup but as soon as the docs/nurses turned their backs, my friend tried breastfeeding and he took to it straight away. He has barely stopped since and thankfully the medics were able to see there was little sense in stopping him breastfeeding to give him formula. His sugar levels are still a bit wobbly but they're sticking with the breastfeeding for now. A very happy result.

OP posts:

hunkermunker · 27/03/2006 09:00

Brilliant, brilliant, brilliant! I'm really pleased to hear it. So happy for them - really hope it all continues well. Thank you for updating

Rach69 · 27/03/2006 09:21

Hunker, I didn't see your threads on this before, having had Finn on the same day as you by ECS. I didn't have GD but he was 10lb 4 and hospital 'policy' was to tube feed big babies with formula to up their blood sugars. I tried to argue whilst still on the operating table but it was implied that such awful things could happen I was a dreadful mother to even contemplating refusal. Talk about informed consent... I have bf 3 other big babies perfectly well and am very assertive but I was a little traumatised to say the least after the birth fiasco. I was incandesent with rage afterwards that I allowed them to sensitise him with formula after battling to express the previous 3 times. Now I have your academic references I intend to add them as evidence to my growing list of complaints. Interestingly the midwife who was such a bitch to me and dp about everything - much of it bf/bonding (also whilst flat on my back with my legs apart preparing to push, she declared 'I'll have to get someone else to help here, I'm only little and you really have some meat on you, don't you'? silly me forgot to go on a diet before I went into labour!) has left the hosptial to work as a rep for SMA...

milward · 27/03/2006 09:26

What a difficult experience rach69.

My ds4 was big & had to have his blood sugar done but I was able to bf no probs or agro from staff. My dh had to stop them giving sugar water when he was having some test, to help calm him (while I was still being sorted after giving birth) - what a load of rubbish but impressed that dh told them no & stop his ground. Write & complain.

hunkermunker · 27/03/2006 10:37

Rach, am aghast. I know you'd had a rough time, but that midwife...words fail me Look forward to hearing how you get on with the hospital - they really shouldn't just routinely give formula. I'm going to suggest that they give the option to hand express and freeze colostrum antenatally (as I meant to, but never got round to - but had they offered me the equipment (sterile syringes), I'd have done it). Paed had no idea this was possible...

Will have to contact my hospital re the way I was treated over DS2's blood sugars (plus the other stuff I overheard to do with bfeeding - let me put it this way, I think there's more than one midwife in the country who could work for SMA...).

ghosty · 27/03/2006 11:02

Rach69 ... what a cow of a midwife !

Hunker, I missed your original post about your DS blood sugars and reading it just now made me gasp at how similar my experience was with DD.

I didn't have GD but I had a very large baby (10lbs 10oz) and she was routinely heel pricked (cruel thing to do to a newborn IMHO) after a couple of hours and her sugars were low 2.0. I was told that if she had 3 more tests in a row (at intervals, can't remember how long) of being under 2.5 she would need formula. First test was 2.6 (yay) ... BUT second test was 2.2 ... after the second test the midwife went off and came back with a bottle of formula. As she approached the cot I stopped her and told her not to give it to the baby. I couldn't get out of bed because I had had a c/s. She said the Paed had told her to. I reminded her that DD hadn't had the 3rd test yet and if they actually fed ME (policy was not to feed mother until she had broken wind LOL ROFL WTF is that all about?????) then I might have the energy to produce some good quality colostrum ...
Anyway, she kept going for the cot. So I told her if she that milk went near my baby I would call someone. She went to pick DD up ... so I pressed the call button ... twice (so 2 midwives came running ). I complained about midwife A and midwife B and C had a chat and agreed that they had to agree with me as DD hadn't had the 3rd test yet. Midwife A marched to the sink and poured the milk down the sink then swept out and refused to deal with me again . I fed DD continuously for the next couple of hours and by the time she had her next test she was 2.6 again (double yay!).
This was all at 3am and the next morning my own (independent) midwife came to see me and was as mad as a box of frogs ... she made a formal complaint to the hospital on my behalf. She showed me the notes they had made ... "Mother refuses to top up baby with formula despite low glucose levels"
Anyway ... I won and what worries me is that had DD been my first child I would have gone with that stupid cow of a midwife ...

BTW ... I did eventually eat ... after I lied about breaking wind

ghosty · 27/03/2006 11:04

ps ... eclipse ... good news about your friend

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