Feeding a newborn after neonatal care

[Sunshine142]

Sorry in advance for the long post, but seeking reassurance!

My baby girl was born on Sunday afternoon, and after a bit of a tricky delivery had a little trouble with her breathing. After some skin to skin she was taken to neonatal care, and as a result I wasn't able to attempt to feed her until the next day (she was on oxygen for the first day through a mask which made it impossible). The next day I was given the first opportunity to feed, but she was so sleepy we only managed a few short lived feeds. Min the meantime neonatal gave her top up feeds and a dummy, which I wasn't sure whether would be negative for feeding. Today we managed better feeds and this evening she was let out of neonatal to come and stay with me.

So here she is, and I have no idea what to do. About 4 hours ago I started feeding, I'm reasonably sure she has a good latch, but it's still sore for me, and milk is yet to come though know there's time for that. Every time I tried to put her down she started rooting and crying and will only settle when feeding where she seems very calm and content. She finally de-latched of her own accord a little while ago, but is still rooting a bit so I think will want to feed again soon.

I have no idea what's normal, so a few questions:

• is it ok for me to let her feed as long as she wants (neonatal advised half hour then a top up bottle feed...) - or should I try putting her down and hope she settles...?
• will feeding this long cause problems down track, my nipples are already so sore!
• should top up feeds and bottles be avoided this early (she's only 2.5 days old)

Sorry for all the questions, just want to try and do best by her to get us off to a good start!

Feed, feed, feed, feed! Might not be what you want to hear but is definitely what your baby needs to do. I would definitely try to avoid top ups etc as this early stage is vital to establishing a decent supply.

It's a supply and demand system so you shouldn't interfere with baby demanding what she needs unless there are serious medical reasons to supplement. I'm very surprised at neonatal giving the advice they have to be honest.

Your baby is putting in her order - even if your milk's not in yet - she's just making sure there's enough when it arrives

This next 6 weeks or so will set you and your baby up for the rest of your feeding journey so if you can, let everything else take a back seat. You need to drink gallons of water and eat copious amounts of delicious food.

And feed, feed, feed.

Sorry - you should also get a fully qualified breastfeeding specialist to check your latch. Varies across the country but La Leche League are usually available and do home or hospital visits.

It will hurt at first but definitely make sure you've got it right before you both learn any bad habits.

And congratulations

Thank you so much! That is so reassuring, I'm tired but v. Happy to keep feeding to help avoid problems down track. So much conflicting advice being given at the hospital, have arranged for a Breastfeeding specialist to visit very soon, but needed reassurance that I'm doing vaguely the right thing in the meantime, thanks again!

She might be taking so long to feed because it is tiring for her? My son couldn't feed on the breast because although his laching technique was fine it was hard to get the right amount of milk he wanted without sucking quite hard. He did also have other factors which stopped him from being able to breath properly. In the end I chose to formula feed (found this very upsetting but I felt it was best for him). He was then given high calorie milk so mine would have been pretty much no good for his needs any way. It's not the end of the world if you have to top up, if she needs milk and you arent producing enough I would say top up but express aswel to help yours come through.

Since she already got some top ups, she may need more until your milk comes. Research shows that when babies get formula, they stop using fat reserves (cannot switch between different types of metabolism) and therefore blood glucose levels may fall. Therefore blood glucose level may need to be monitored in such cases.
I wouldn't ignore advice from NICU. Formula top ups doesn't mean you won't be able to breastfeed exclusively later on - they just help vulnerable babies when needed. Both of mine had top up (DS1 was in NICU for a week), and both got back on breast exclusively in about a weeks time.
But if you give top ups, you need to express to stimulate supply - manually to start, hospital grade pump after 3 days (15 min after each feed was the best for me).
If you still in the hospital, I suggest to discuss the plan with pediatrician and breastfeeding support staff.
And congratulations!

And I know exactly what you mean about conflicting advice in hospital - with both of mine I had a feeling that everyone has a different opinion.
To be honest, if you are concerned, I'd ask to check her glucose levels ~2 hours after feed. If they are OK, no top ups needed.

It sounds like you're doing really well - it's great that she's wanting to feed as this is just what you need to get your supply up.

Basically, what fusion said - feed, feed, fed. Was it just the breathing issue and she's otherwise all good? (Ie full term, good weight etc). Obviously take medical advice but sounds like it's perfectly normal for this stage.

My DD was in SCBU for her first 12 hours with a chest infection and I was asking wise mnetters the same sort of questions just 4 weeks ago. She had a top up of formula while in special care - which they cup fed, so you could ask if this is an option if you really do need to top up. Then once I had her back we did loads of skin to skin and I let her feed as much as she wanted. It worked and BF is going well.

Good luck and congratulations!

Thanks everyone, today was a completely different experience... She is now so sleepy she won't feed at all.

But im feeling much better about feeding generally after a great morning with the breastfeeding nurse. She has jaundice now which explains the lethargy and is having light therapy now, But until she's a bit more perky I am still attempting to feed (mostly ending in failure as she resolutely refuses to wake from her slumber to latch) then when this does fail pumping for 20 minutes on both sides every 3-4 hours. I've been relieved as the supply is increasing a teeny bit each time. I'm then feeding her this with a small top up of formula rather than the bigger amounts previously, and giving this with a little finger and syringe in the mouth which she seems to like and be able to manage in her sleepy state. Hopefully tomorrow she'll be a bit more perky again and by then there'll be a bit more supply to meet her demand and we'll keep on trying.

Thanks again for all the tips and advice, it's been really helpful!

Sorry flightffancy just realised I didn't reply to your question! She had a bit of difficulty breathing due to an infection and is on antibiotics for 5 days but now completely normal (temp etc all fine!)...well apart from the jaundice!

Full term and a healthy 8lb 6...the size meant a bit of a long time pushing though which led to a bit of distress on her part and possibly the infection (breathing in some fluid from the water bath...). But she's doing far better now!

Sounds like you are doing all the right things. It will get easier when your milk comes in - it may take a bit longer, but for me it was definitely worth the effort.
Hope you can go home soon!