URGENT - 5 day baby not breastfeeding - ADVICE?

[miranda2]

My sister has just rung me in tears because her 5 day old dd isn't feeding today - I promised I'd come on here and ask your advice, please don't let me down!
She sleeps a lot - has done 2 lots of 5 hours plus shorter sleeps all through so far, and today has basically slept for 8 hours. When my sister woke her after about 6 hours she cried at the breast and wouldn't latch on - she ended up tipping some milk from the breast shell down her throat, and has cup fed her again a bit an hour ago.
She woke up crying while we were talking and sis is now trying again. I've advised her to get the pump sterilised so she can pump if my neice still won't feed, to keep the supply going - and not to feed her by cup for at least a couple of hours so she isn't too full to bother sucking. I also said I thought she was probably OK so long as having wet nappies and not particularly unresponsive etc.
Any other advice/corrections to my advice??
Thanks very much,
M.

Oh, how upsetting for her - and you.
Is she engorged and it's making it hard for dd to latch on? (express first)
Is DD getting floppy and drowsy? (call MW - blood sugar could be dropping)
What sort of delivery did she have? If prolonged pushing / ventouse, she could try cranial thingy - ds was quite fractious after birth, I think he had a headache / sore head
Does her health service / hospital have a breastfeeding counsellor?
Is she in S London - in which case call Clare Keskedeves breastfeeding help department for the best help in the world!

this is probably not the case- is there any chance that she has a soft cleft palate? Look into her mouth and if she has an abnormally large entrance to her throat she may be having trouble keeping the suction when she's feeding. Has she been BF with no problem up until now?
DS2 has this - he would try to latch on, not succeed, get upset then sleep again. He hadn't fed in over two days before we figured it out, scary times.
Expressing and cup feeds are the best way at the moment. Don't let her go too long without food as she will have less energy for sucking later on.

My best advice would be to get your sister on the phone to one of the breastfeeding helplines - I don't have the number to hand, but try the NCT.

At this age I would wake the baby during the day if she sleeps longer than 3-4 hours, and try to feed her.

If she's failing to latch on, or not wanting to feed, definitely try cup feeding, or even dipping her finger in the milk and putting it in the baby's mouth just to give her the taste and give her the idea of sucking. Then try her on the breast again.

I'm sure you'll get lots more useful comments from others here.

Also your sister should know that lots of people go through a really stressful time at the start - weeping over the baby is not uncommon, but it does get better, and if it isn't getting better of it's own accord she should definitely shout for help.

Yoyr advice sounds great Miranda well done, it must be good for her that you are there for her and so supportive. Remember babies untill about a months old tend to sleep alot anyway(mine did anyway)especially in the day, and there bellys are very tiny and dont take much to fill. If shes content then i wouldnt worry. And if she really is worried then ask the midwife to come round, its expected so early on. Wish her luck for me.

Miranda, have you seen Gomez's 'Urgent B/fing' thread? She had some v interesting advice from the NCT helpline about the way she was holding the baby...who is 6 days old.

another though- is she engorged? Maybe that's why the baby can't latch on - perhaps she could try expressing off a little then latching on DD.

thanks, will ring her and tell her. She's had the midwife out and she doesn't seem worried. Babe has been bf fine up til now. The funny thing is my sis is a trainee midwife so knows it all (and was a bit sarky about my giving up bfing quite early - v. apologetic on phone just now!!!). Thanks for all your advice and support, you are all lovely.
xxx

i had probs feeding dd initially - it's important if she's sleeping a lot to wake her up. we had to wake dd every 3 hours and feed her 20 mls of formula through a syringe for 48 hours to get her strength up. Also, need to keep an eye out for wet nappies - if they stop being wet and the little one is sleeping a lot that's a definite time to get the midwife out. Don't wait - they get dehydrated really quickly.

Sounds similar to my experiences with DD. She may be engorged, the advice given to me was to express although I found this very difficult at first and used nipple shields to create a nipple for her to latch onto (I know that many of you don't agree with the use of these but it saved me!!!) I would wake the baby to feed as they can get a bit jaundiced if you don't keep the fluids up. Try to alter the position too. Holding under your arm and feeding off the same sided breast (Rugby ball style) is a good position to try for them at this age. I would recommend advice asap from a BFcounsellor - she must have been given numbers from the hospital when she left? Hope this has been some help? - it all sounds so similar.....

la leche bf counsellors excellent on this too, will try and find number for you

0845 120 2918 is la leche league's helpline number

0870 444 8708 is line for NCT.

Good that she has seen the midwife.

I think she and you are right to be concerned. This is not normal behaviour for a five day old, and if the baby continues doing this (sleeping a lot, not being responsive) she needs to see the midwife again...or even take the baby to A&E, seriously. Babies of this age dehydrate (and it is warm today....) quite quickly. She needs to get some EBM into her somehow, give her lots of skin to skin contact so she doesn't sleep and sleep and sleep (this is not being 'content', this is conserving energy because something is wrong) and get hold of professional advice if she is at all concerned.

She may well perk up - I hope so. She should be having several yellow poos a day by now (day 5-6) and if she is, that's reassuring.

This happened to me too at exactly 5 days old. Ds refused the breast and went for 11 hours without milk.

WHat I did was express every 3 hours and syringe or cup feed him. No-one ever knew exactly why it happened, it could be he was too small, distressed by my let down or objected to having his head handled.

Offer the breast each feed. I would actually say to cup feed a little first and even drip some milk down her breast to encourage her. A frantically hungry baby may not feed well. LOTS of skin to skin contact, to try and turn it into a positive experience. One thing she could try is taking the baby into the bath (re-birthing). If she or the baby gets distressed at all, stop and cup feed.

Is the baby jaundiced? It can become a vicious circle of sleepiness increasing the jaundice increasing the sleepiness.

The MOST important thing is to get milk into the baby. EBM is preferable and a cup is preferable to a bottle. When this sort of thing happens there is a tendancy to feel like you have stumped all the experts and you wonder whether the baby will ever feed. Dh certainly said to me that I must face facts that ds was not going to feed.

Does she have enough cups/access to them? I could send some if need be.

Lastly, she CAN get through this. It will be tough depending on how long it lasts (in my case just over 4 weeks and she will need incredible support.

I am only half way through my peer support training, but if she wants to talk on a mum to mum basis to someone who has been through this then feel free to contact me julief @ netmums dot com