When a baby stops feeding - Dehydration

[suedonim]

I've just read this article about a baby feeding inadequately and then becoming dehydrated. I was quite shocked tbh and wondered how common it it. Also, is it really a middle-class phenomenon?

Suedonim, I know two persons whose babies dehidrated during the first week and both were reasured all the week that the baby(s) were fine.

One of my friends rang them to say the baby was sleeping far too long and they told her she should be grateful for it, the day the baby finally went into hospital the doctors kept insisting that he was dehidrated but she needed to continue trying to breastfeed eventhough the baby couldn't latch, she begged them to let her give him a bottle but they made her feel as an iresponsible mother, at the end a friend who was visiting realised that she had so much milk that the only needed wto express some so the baby could latch, he latched immediatly and started recovering.

What she can't yet forgive them is that she had spent so many days in hospital and nobody could have given her such a simple piece of advise. Since then she went to wake up the baby for the feeds rather than feed in demand and she was consistently advised.

Thanks for posting that article, suedonim, which has come very very close to bringing tears to my eyes - ds had a recurrence of jaundice and became slightly dehydrated at two weeks old. We were in hospital for 8 days initially after the birth - DS under the lights for 3 days for jaundice whilst I struggled to establish bfing and DS had regular top ups. He was then readmitted to hospital for 3 days whilst they ran a battery of tests (local protocol is that where jaundice occurs after 2 weeks, they have to run tests to exclude liver or other disorders), and I threw in the towel and switched to bottle feeding. I did receive encouragement to carry on bfing, but I had completely lost confidence by then.

Essentially DS had only been in the clear for about one day, and bfing had only been going well for one day when we were discharged - I do not, in hindsight, think that there was adequate warning to me about the possibility of jaundice recurring, and that I should have received advice about top ups/mixed feeding. I know that for the vast majority of bfers, top ups are bad news for establishing the milk supply, but I think where bfing has gone seriously awry, this advice should be altered. I also remember the humiliation of various midwives examining the contents of DS' nappy to see whether the birth meconium was still happening and/or whether it was formula or breast milk coming thru.

Fortunately I had a fabulous community midwife who came regularly, and overrode my incompetent GPs views and had me get DS checked out at the local paediatric hospital. The GP felt that as DS was lively, kicking and screaming, there wasn't anything wrong with him! In terms of middle-class phenomen - I think that is a lazy way of saying that this is more likely to happen to bfing mums than bottlefeeding mums, and bfing mums are more likely to be middle class than bottlefeeding mums. Also middle class mums are more likely to get their stories published in the broadsheets!!!

bump

I agree with M2S re the middle class bit but also because Bf mums listemn to those around and not to themselves or baby and this can lead to baby missing feeds (my hv recommended a dummy when I was bf adn dd lost weight and was dhydrated tho this well meanmt piece of advice

Gosh, I'm sorry if I upset you, Mummy2S, it wasn't my intention at all. Your experience, and others, is very interesting and sad. It seems to me that a lack of continuity of care must contribute to this sort of thing happening, plus a lack of knowledge about bfing amongst health pros. Ime often one person tells you one thing and then an hour later someone else tells you the opposite. I'm amazed that hospitals don't have protocols as to what they tell patients.

Btw, I see the reason for the middle class comment now, d'oh!

Hi Suedonim - you didn't upset me, just memories of the situation upset me! I think that the duty of NHS staff to promote bfing has gone too far, to be honest. When I was on the postnatal ward, HCAs had to tidy my formula top up bottles into my cupboard to ensure that no formula was visible as the hospital could not give the impression that they were encouraging bottlefeeding - I was absolutely livid at this, given that I was striving tooth and nail to bf! I think where a baby is struggling with bfing due, for example to jaundice, I think midwifery staff should be far more honest - i.e. say that he will shake the jaundice far more quickly if you switch to the bottle, and that although it is possible to establish breastfeeding, it means lots of hard work, and the risk of jaundice recurring, and to establish appropriate aftercare to deal with this. It is such a tiring emotional time when you are in hospital following the birth that you do need things spelt out in very simple terms. My basic "grudge" if you like, is that I feel it was only due to an excellent community midwife that DS's problems were picked up on so quickly - without her, there could have been a far more serious risk to DS's health.

I think this kind is very common, and agree completely with the writer of the article about how it happens mostly to women who appear to be coping. Health professionals in the NHS are so overworked that if they meet anyone who appears confident they just breathe a sigh of relief that they have one less person to worry about and get on with helping somone else. I am still struggling to figure out how and why I failed to make breastfeeding work. A couple of days ago I got hold of my medical notes from my hospital stay following the birth of dd six months ago. They are full of comments about how well dd was feeding, how perfectly positioned she was etc etc. One particular incident stands out. I remember asking a midwife to watch me feeding to make sure I was doing it right. She told me to "get her latched on and I'll come and see if you're OK". She came in a few minutes after I had started feeding and left almost immediately. In my notes she has written "baby latched on easily", even though she didn't bother to watch. I'm sure this kind of thing happens all the time. I blame myself for not asking for more help, but at the time I was so confident I thought that breastfeeding couldn't possible fail as long as I wanted it to work. I'm now anything but confident and still doubt every single decision I make about my lovely little girl.

Suedonim, thanks.

Dehydration happens when - just as in this article - a baby is not feeding well, and it is not spotted. Breastfeeding counsellors see it occasionally, and the pattern is very similar to this poor mother's experience.

The right questions aren't asked, and mothers (who have not grown up seeing babies at the breast and don't really know what to look for) think just because a baby has the nipple in his mouth, he is transferring milk. This doesn't always happen, and it can become quite desperate, quite quickly.

I don't think it's especially middle class.

Babies need skin to skin contact as often and as long as possible in the early days, and a healthy, thriving baby will feed effectively from the start. If he is very sleepy, then this can interfere with the process. He needs to be producing several soft yellow poos from about day 5 and if he isn't, then this can be a danger sign. I think it is very sad that mothers are made to feel inadequate and incompetent when their babies become ill through poor feeding....it is not their fault, but the fault of a poor support system.

It is pointless, and actually quite cruel, to promote breastfeeding without the systems and training to help it succeed.

I had great problems b/f-ing at first, and my ds lost a lot of weight too - and again had 'breast-feeding experts' saying it was going well and just to perservre etc. but my fantastic community midwife (we were getting so worried after ds refusing to feed for 10hrs) gave us a plan - to give ds some formula, as well as express and then give ebm, at least peace of mind that he was getting something and wasn't getting dehydrated - if she hadn't have been confident in our abilites, she said would have had to admit me and ds to hospital. ds was born under 25%, 3 wks after giving formula, I got back onto b/f full time and now at 6.5mths ds is a whooping 91%!! he's still on b/f and is wonderful. so are community midwifes if you are in an area where they are, but one should always ask ask ask everywhere everyone for help.