Breastfeeding refusal and jaundice

[BrokenRainbow]

Hi,
I desperately need advice, I had a baby 4 days ago via VB. Day 2 baby was going to have high bilirubin levels and was put on phototherapy, baby was very very sleepy and would breastfeed up to 20 minutes and have top ups. During therapy dc had to have a feeding tube which I would expresss for. I was expressing between 30-50mls.

She's now off the lights and bring encouraged to breastfeed but she keeps falling asleep after suckling for 5minutes! I have to top her up with expressed milk through feeding tube.

As we are on a strict time and measured feeding monitoring( 37mls every 3 hours) it's proving really hard to breastfeeed as I don't know how much she's having.

I really don't want to use bottles but it's looking likely if I go home and she's still slow at feeding.

Is there anything I can go? She's been feeding on and off for 1 1/2 justniwand they still tube fed her 20 MLS (although she was bringing some up the midwife stopped at 15ml)

*just now

Bump

I'm sorry your baby is unwell. The most important thing is that the jaundice is treated and cleared. I have no experience of a feeding tube so perhaps others can advise there. However both my babies were seriously jaundiced very soon after birth and I instantly threw any desire to breastfeed exclusively right out of the window. Did anyone explain to you that the excess bilirubin which causes jaundice is remove from the bod through bowel movements? So it is really important to get enough food into the baby so he produces lots of stools and excretes it that way. Unfortunately, the sleepiness is a consequence of the jaundice and so the feed for a moderate duration on each breast, then top up is the solution to that.

Using bottles to clear the jaundice isn't a catastrophe. If you wish to breastfeed exclusively after the jaundice resolves, then there will be lots of support for you. A less sleepy baby will be far better at feeding and while it didn't work for me, I know lots of people who needed to supplement in the early days and who moved to breastfeeding only after initial problems were resolved.

In my experience, the advice was to offer as much of a top-up as the baby would take. If the baby is spitting back up after a certain amount, that's probably a good sign that he is getting more from the breastfeeding already and so may need a lower supplement. Do you feel as though your milk is coming in?

Best wishes, it is very stressful to be worrying about your baby taking enough. But by far and away the absolute priority must be consuming enough milk - whether direct breast milk, expressed milk, formula or any combination - very regularly to treat the immediate health problem. Ask lots of questions of your doctors - in my experience midwives or nurses are less useful when it comes to specific medical problems like jaundice - and keep asking until you are satisfied.

Finally, if you do need to continue to top up when you are discharged, make sure someone has shown you the correct way to make up a bottle in case formula is needed. Ready-to-feed formula is also a good option and although expensive, it may be worthwhile for the small amount you would be supplementing.

Congratulations and best wishes.

I assume that you're expressing milk for the feeding tube? Has your milk come in? Sorry to start with more questions.

I also had to express for a feeding tube at this point, but not because of jaundice - because my son had wet lungs and was in NICU on oxygen and didn't have enough energy to feed. I syringe fed when he was too sleepy to breastfeed properly, and that seemed to provide an extra burst of energy to breastfeed.

It IS anxiety-provoking that you can't know how much milk a baby is getting from breastfeeding, but there are other ways of seeing whether it's enough - for you it will be reduction in bilirubin levels, but also number of wet and dirty nappies.

I agree that needing to supplement at this stage is not a calamity. My son was formula fed into tube, and we phased out formula within about two weeks. It's great that you are feeding already, that's definitely in your favour for establishing feeding.

Is there an infant feeding consultant in the hospital you can see? They may help to check feeding in real time and help you to work out how things are going. Good luck. This bit is hard work, but you're doing brilliantly.

Mine were both jaundice too - have you tried skin to skin and squeezing their door a little to keep them awake ?

Are they taking bloods every day to see when the bilirubin levels start to decrease? With both of mine it took 5 days before I left hospital post birth before bilirubin was declining in circulating blood

*squeezing their foot - not door

We were discharged as the bilirubin levels were well below the treatment line.

Now that we're home she's still sleepy but constantly cluster feeding during the night. I'm up 10pm to 7am just breastfeeding. She still falls asleep but has longer feeds.

I've just resorted to topping up with a bit of formula as sheaves had my expressed milk and hours of boobs and still not falling into deep sleep. She wakes 10minutes after putting her down.

That night-time cluster feeding is a ruinous isn't it? Rest as much as you can - it won't last long, or it'll shift to a slightly more civilised time slot (we're currently 6-10pm).

Short naps are ok at this point. It's REM sleep that's important for brain development in babies. Congrats on getting home, and good luck!