breastfeeding supprt - first few days baby won't latch

[suzi2]

I posted here for advice for a friend a couple of days ago. Story so far is: tricky foreceps delivery, mother had morphine, first feed was short but OK. Wouldn't latch for future feeds and just slept (first 12 hours). Overnight, mother expressed colostrum for him which he took. Next day it was noted that he had breathing troubles so was taken to SCBU. He was then given formula. Both mum and baby have an infection and are on antibiotics. Baby is doing well and is back with mum, 2 feeds have been fairly successful.

However, this morning she has texted me to say that he's refusing to latch on again. Simply licking her nipple. Night staff are threatening formula. I've just called the hospital but she's sleeping (day staff sound nice!).

I'm trying to get in touch with LLL or ABM to see if there is anyone in her area that can help her.

Any suggestions on where she sould go from here? My first thought was that with the amount of trauma since birth, they probably need some snuggly skin to skin time for a start. But after that I'm out of ideas without speaking to her some more.

She could continue to express and feed it to him from a cup if he won't latch. Formula may interfere with her early supply and his need to root but ds was given several formula feeds before he'd latch on and even then we used nipple shields to begin with (which at least meant we could go home). He went on to be fully b'fed until he was weaning so this early blip may not mean the end of it for her .

tbh he may be ok on short feeds and if she keeps him snuggled up to her then she can react to the least rooting. Has she been helped into different feeding positions/holds as she may well find sitting upright in bed uncomfortable for any length of time. Lots of cushions for support behind and under her arms would help, perhaps one with a hole like a swim ring and a v pillow to rest the baby in her arms on either across her or in the rugby hold. If she can bath with him (probably best once home) then the general warmth and relaxation can help stimulate the baby who may well still be pretty sleepy still from his birth.

Also she may find he gets jaundiced, common amongst assisted delivery babies and which often makes them sleepy and hard to feed, so in no way her fault. However it does make it all the more important to feed often, however little, and she may find more pressure to ff as a result.

Hope you manage to get hold of an independent BFC but not sure of the politics of their visiting hospital.

hth

skin to skin is what is usually recommended.

Tell her to request to speak to a senior member of staff. I did and saw the doctor who delivered my baby 2 days later. (Also a traumatic delivery) Tell senior staff member that she wants to see a professionally trained breastfeeding consultant. Tell her that she knows that if they give her baby formula against her will that it is assault and will be filing a formal complaint in the future if her baby is fed this way without her permission. Also make sure that they do not remove her baby from her presence at all. Any treatment baby is given must be in her presence.

She possibly needs to say that she knows that it is possible to express milk and that she wants someone who can show her how to effectively do this either by pump or by hand.

Frankly, i would give her a quick call to let her know. I am skecptical about these hospital policies on banning mobile phones. Mine did but had this outrageously expensive system in place beside the bed.

Your friend sounds like she is in an overwhelming situation. Is there another close relative you can talk to to be there to back her up or do the speaking on her behalf?

Sounds like your friend is having a traumtic time, I found that I couldn't feed DS in bed at all sitting up because it wasn't upright enough for me - tried lying down which sort of worked, but managed better in the chair by the bed. Take all the pillows off the bed then to use for feeding and sitting on I should think (ouch).

There should be a trained BFC available to speak to and help/advise her. You can check the hospitals B/F policy on the web if they have the WHO cert for B/F this will tell you where their policy has got too and what they should be able to provide. I found the ancillary workers idea of helping was shoving DS head against my breast until he took hold - not a very good latch and resulted in lots of blisters and bleeding looking back.

The night staff tend to be shorter on the ground than the day staff and it may be that they didn't have the time to be able to help because they are short staffed so it's easier to give formula than spend the time necessary to help sort out the latching problem your friend is having.

(The mobile phone policy is to prevent the signals causing problem with life support systems.)

i know they say that about the mobile phone use. still don't buy it.

My dd1 was a very sleepy baby - and wouldn't latch ( I also had flat nipples which made the problem worse). The hosp provided me with an electric pump - and dd1 was happy to feed from a cup.

I started to use nipple shields - and these did help with latching - and I 'juggled' to keep dd1 awake. It was a lot easier when my milk came in.

In hindsight I should have tried to get off the nipple shields as bf eventually went pearshaped and dd1 was ff from 10 weeks.

I was determined to bf longer with dd2, so contacted La Leche before the birth and after they helped with the latch etc - dd2 is still bf at 27 weeks.

I would wholeheartedly recommend getting a bf counsellor involved - if not at the hosp - then at home. IME - midwives and HVs don't have the expertise.

Even if it has gone a bit pearshaped in hosp - all is not lost if your friend wants to bf - it is still early days and a bf counsellor should be able to help. HTH

Where abouts is your friend?

I've jsut spoken to her. She says that the problem isn't actually latching - he seems to do that. But he's pulling off and fussing. She's sore and tired. They're both on an antibiotic drip so she is going to be in there a while longer.

I'm seeing her this afternoon so hopefully might be able to help a bit. I'm struggling to find anyone in her area - West Lothian - and struggling to get through on most of the helpline numbers.

It is still very early days for both of them and even if he comes off he may yet be getting something. It may all change again once her milk comes in. Another thing to watch out for is thrush in his mouth which may make him find it uncomfortable to feed.

Thankyou everyone. I wrote down all the different ideas you posted. I saw her and baby this afternoon and he is showing lots of interest, latching for a few moments and then losing the latch and getting frustrated. But it would seem that he can latch and she is comfortable when he does. So I think it'll just take a bit of practice. He's not demanding feeds so the mw said to wake him every 4-6 hours... which seems insane! I've told her every 2-3 and that she can't overfeed and to keep at it as long as she isn't forcing him. I'm hoping that things will get going for them both soon. But she definately seems on the right general track.

Thanks again. Sus, x

2/3 hours is defintiely more like it Glad things are looking up and at least you can give her some advice until she sees someone trained to do so.

Skin to skin... lots of it.....
She can express (by syringe if she still on colostrum) if already on milk then hand express or hospital may have a pump. She can give that milk by cup - I'd avoid using a bottle !
Don't forget that baby may be very bruised from forceps birth!
Good luck to her!

My son was forceps delivery and I also took allot of drugs during the labour. We had feeding problems at the start and this is what we did that cracked it after a few days..

• Don't let baby go more than 4 hours without a feed.
• Express at about 2 hours,aiming for around 40 ml minimum.
• Try baby on the breast for no more than 15 mins (to avoid the baby getting stressed and forming negative associations with the breast.)
• If the baby doesn't feed, cup feed the expressed breast milk.

My baby was fed formula at one or two feeds only via a cup to give him a booster after not manging to feed for two days. A midwife would cup feed him milk that I had expressed earlier, while I expressed some more and as my milk came in, it took over from the formula.

The hospital should not be threatening formula, unless your friend is having serious supply problems. It is cruicial that even if the baby wont latch on, she is expressing all or as much of the milk that her baby needs, otherwise her milk supply may not build up properly. It is also cruicial that they avoid giving the baby a bottle. There is no reason why the baby can't feed out of a cup and that would prevent nipple confusion.

Unfortunately, allot of her future success with breastfeeding is going to dependon the support she gets at hosital and at home. Most hositals have a breast feeding counciller, if you can get one of those involved, they will usually fight off formula-happy midwives with a stick and make sure she and her baby are being given proper advice and support.

I know how stressful and upsetting feeding problems can be at the start. You are so tired and overwelmed by it all and all you want is for your baby to start feeding well so you can go home and stop worrying about it. It can be done. I am still breastfeeding my DS and he is now 15 months old. It's great that she has a friend there like you who is trying to help. Tell her she CAN do it!!!

Lots of skin on skin is important too.

Good luck.

Sorry suzi2

Didn't really read this thread properly. V. glad your friend is getting there. SOunds to me like they just need to a bit more practice.

Sorry, my 1st post was no good!

thanks anyway tigertum - it's good to know others experiences (and successes).

how are they doing now ?

Sorry - a VERY late response to the last question! I just spotted it when searching for another thread.

Well, just a couple of days ago I got a lovely card in the post from my friend saying thankyou for my breastfeeding advice/support and also for a rather 'gritty' email I sent her about 8 wks giving her a kick up the backside (which she has promised to send back to me when I have the same doubts with baby2!)! She has been exclusively breastfeeding her DS since about a week old and he's now almost 4 months. She's looking to continue when she goes back to work at 6 months and is thoroughly proud of herself (as she should be) and is now loving it.

Just goes to show that a bad start and a bit of a rocky first couple of months (thrush etc!) that it is possible to continue and love breastfeeding.

So thanks to everyone on these threads for MY support when trying to help her.

Hey, that's great

I still haven't managed to make my baby latch once, and we're coming up to 2 weeks old. My milk came in day sixish, and I started giving her formula with the bottle about the same time, she was very jaundiced. I don't know how I could have kept her alive without the formula. I seem to pump (hospital loan) all the time I'm not feeding her/sterilising bottles/changing her and her clothes/eating myself to try to keep supply up, and I'm really exhausted. But i don't pump at night. i got in touch with a prof. breastfeeding consultant and she just told me off for not pumping at night and said I would endanger my supply, wouldn't talk to me about the latch at all and said I was training her to never latch by giving her the bottle. This is probably all true, but I'm so tired, and by the time of my midnight pump, there is almost nothing there. When I do skin to skin she roots and screams for food, and the nipple just vanishes. I've tried when she's fed a little and that doesn't change anything. I've tried nipple shields and she just takes the end of the nipple and won't latch on, and still gets frustrated, I think because the nipple is so far from the end. I'm so scared I'll never be able to breastfeed, and I know what the professionals advise, so know it's partly my fault for not following the advice, but I already feel like i do nothing but breastfeed and prepare to breastfeed. She had all the things that suggest breastfeeding problems - small, early, had to have the black pumpy thing to start breathing, epidural. Then on top of that my nipples don't stay out. I hate hearing her scream because she can't latch onto my breast, and even when i bottle feed she roots constantly and looks around, she even does it when my husband bottle feeds. Also, everyone is telling me to take motillium to increase my milk supply - I can only pump 20-30 mls every 3 hours - and I've looked at the side effects and it's linked to breast cancer, and I have a relatively high risk of breast cancer because of lots of X rays as a child, family history, late baby etc. I want to give up.

Oh MacNeil, I'm sorry your still having such a hard time.

I know the nursing, pumping, cleaning & bottle feeding seems like all you do. Things will get better, whichever way you chose to feed your baby. If breastfeeding is making 1 or both of you miserable then don't feel you have to. Breast is best, but if that doesn't work out, formula is ok. I know its an awful decision to have to make.

I'm sure the last thing you want is more advice but, just in case:

medela nipple shields

I found their website quite helpful

You probably have these instructions for the nipple shield, but make sure you are putting it on correctly. You have to turn it almost halfway inside out. When you put it on, it sticks to you and causes the nipple to stick out a bit. When the baby sucks, the nipple won't be at the end of the shield - the sucking draws the milk out anyway. If the shield you have used didn't work, you could try another brand or a different size. I used medela but Avent ones were recommended for more skin contact.

more help

FWIW, the skin to skin thing never worked with my DS, he just got really agitated, so it's not just you who's finding it isn;t helping much.

Hav you contacted La Leche League? I know lots of people who say they hae been really helpful

Hey, thanks. I will try new nipple shields - I have the Avent. The Medela web site is really helpful. I didn't set off being quite so miserable and then just writing set me off being completely mopey and pathetic, and I think it's just because I talked to the lactation consultant today and felt more of a failure. (I just typoed 'more of a formula' - I think I have become a little one track and obsessed). I'm sure I'll be more stable tomorrow, and ready to try again.

Oh, sorry, i did contact LLL, they put me onto the lactation consultant. I'm looking into going to their meetings, but I might also try the lactation unit at the hospital where she was born again.

Definitely try the lactation people at the hospital again. I don't know where you are but I'm in the US and the lactation consultant saw me after I bombarded her with phone calls! She was really helpful. I think she knew she had to be so she could get rid of me! LLL meetings may help too. I really hope so. I feel for you - I remember how hard it was. I think you're doing brilliantly to still be so determined to try breastfeeding. It's very easy to give up when you feel so disheartened and have a hungry and poorly baby to worry about. Good luck. Keep us posted. Hope your dd is doing well now. x

And lol at formula obsession leading to typos. Poor you!