4 day old bf baby- why is this so hard :((((((((

[needaplan]

Firstly thank you for even reading this.

I have a 4 day old dd who I'm trying to bf. I didn't succeed with dd1 who never latched on properly. With help from the mw's, dd2 latched on well (well, she seems to- opens mouth fairly wide, sucks, seems to swallow well, stays on for 15-25 mins) though my nipples are sore so I'm losing confidence with this now. For the 1st 3 days she fed around every 3-4 hrs (weighed 6lb 13oz at birth). She has been hard to settle at night though sleeps well in the day. Last night was horrendous-she had a pretty good feed at 10.30 ish last night and then wouldn't sleep or feed (was screaming) until gone 5am. She eventually pood and had a very brief feed before falling asleep. She has hardly been awake since.

I am worried about her losing too much weight and have stupidly weighed her myself (we have baby scales). She has lost 10oz. She is a bit jaundiced too.

I am just confused- what shall i do? Even though I thought she was feeding well, I can;t really tell if she has wet nappies- they don't seem wet at all. The poo in the night was very dark greenish and loosish (I think that's ok).

I spoke to a bf counsellor who said to put her to the breast every 2-3 hrs and she'll probably suck even though she's asleep (what a joke). Then to express if she won't feed. I gave her some expressed milk at 11am as she latched on but fell straight back to sleep on breast with no sucking. How much ebm should I give though? Or should I give it at all?

I am so upset. I think more so because I thought there was a chance of bf working this time . Any ideas would be much appreciated. A bit at NCT helpline- I pressed the option to say I was in distress etc but still only got option to leave a message and still had no call back.

m/w came and said dd's jaundice was no worse than yesterday and she's not that worried. Said she's not dehydrated but couldn't explain the sleepiness apart from the 5hr screaming marathon in the night.

She advised me to try her at the breast every 3 hrs. Amazingly, she did bf at 5pm so I didn't bother expressing then. I was pleased but am now worrying that she is not feeding efficiently as that breast is now only marginally more comfortable than the one she didn't feed from. Also, after I gave her an oz of ebm earlier, she had obviously weed enough for the nappy to leak! When I feed her, I never know if she's got wet nappies or not . worry, worry, worry...

needaplan - feel for you x
I had such sore nips the 1st time I had to stop, 2nd time I used something the hv recommended called breast shells (Not pads) - like a plastic double skin with a hole in one to let the nipple get air circulating, you look a bit like madonna but hey you prob'ly won't care.
They are also great because the let down reflex stimulates the 'let down' process. I have no idea if these are still sold but will try and find out because they were a god send to me at the time (10-11 yrs ago), I got them from Boots then. You probably know this one too but rubbing a bit of bm into nipple at the end of feeding can help too.
If you can stick with it do, it's worth the long haul x

What a wally I am - the shell stimulates the let down reflex as it pushes slightly on the breast at all times.

if you're using disposable nappies they are really effective at absorbing wee from new borns which makes it hard to tell if all is functioning normally. however, if you weigh the used one in your hand as against a new one it is usually possible to tell - hospital tip which stood me in good stead with a slightly jaundiced baby. the other option is to take the nappy off in a cool room - i found my ds would just wee as soon as the air hit her!
you are doing really well with the bf and i wish the books were a bit more honest about the fact that it does hurt at first even if they are latching on ok. if you can get to 3 weeks you will be over the worst and can start to enjoy it (honestly!). another post recommends lanisoh - it's marvellous, cant rate it highly enough, smother yourself in it and feel the relief!
hope things improve soon

Express after every feed whether she does well or not - that will safeguard your milk supply.

I would feed her the 'previous' batch of ebm after she has had a feed, brief or otherwise. This may discourage her from latching on at all, but will chase out the janudice faster. When she is jaundice free and more awake she will start to latch on better. This, at least, is my experience from 2 babies.

Have you tried nipple shields to make the latch easier for her? These are controversial but many swear by them. And the emotional boost you get from having delivered a successful feed is wonderful.

here

Can I just say that you are all keeping me going today-thank you so much. It's sad but I just wish dd was 2 months old. I hate the newborn stage.

OK, I've got expressing stuff, bottles, teats in the steriliser and will express off both sides if dd doesn't bf this next feed. I doubt she will. Before mw got here, I thought it would probably be better to use bottles for the ebm instead of a syringe as at least she would be getting sucking practise. Mw suggested the same. Do you think this is right? I don't want to give up on bf yet!

needaplan, this sounds just like my dd - can't suck won't suck, asleep as soon as she got cozy on my chest before i even got chance to whip boob out.

a few tips that helped us tremendously on days 4-5 (she only really had one colostrum feed until then and had lost over 10% of birthweight too)

1)feeding ebm helps - takes edge off their hunger, helps with the jaundice, prevents you getting engorged. ime 10ml is a good start, 15ml is heaps - remember her tummy is abt the size of a malteser at this stage.

2. esp if boobs get stone heavy when milk comes in she will find it tricky to latch on - express a bit (by hand probably easier than pump at this stage) and feed by bottle / cup (we used the pre-sterilised single use bottles, nothing fancy, still worked). then try putting her on the boob straight after as your nipples are softer after expressing. (on day 4, she is only beginning to learn what being hungry feels like, once she gets a good taste of your milk she won't look back)

3. call community mw from the hospital you delivered in and ask them to come and see you - they are required to do so by law anyhow but insist. if you are lucky as we were, they will stay until your dd has had a good feed and you will be in much better spirits.

4. sorry, but boobs / nipples will stay sore for a while yet even with textbook latch. warm baths for you, expressing to relieve engorgement and lansinoh / avent nipple cream will help, but just have to accept the discomfort early on. it WILL get bettter with time.

5. pls don't shoot me everyone get a carton of ready-made formula as backup. dd took about 20ml in hospital from a cup, it got her gut going and woke her up from her lethargic state. once she got interested in feeding she took the boob much faster. 5 1/2 months later she is still exclusively bf so despite my massive fears it has not mucked up the bf. you may never have to use it, but just knowing you have it as backup when your dd is screaming at 3am will help sorry, but she will continue to scream at night and sleep all day for a while yet

6. esp if you are still sore from birth, don't forget to take your pain medication. Remember to take it BEFORE you find yourself unable to stand up! I recall thinking at the same stage "I could probably do this if only I wasn't recovering from the birth AT THE SAME TIME".

HTH and hang in there. I am sure your dd will take to the boob like a duck to water. Good luck and keep us posted.

I can't add much to the wonderful advice the last few gals gave. Only thing I can offer up is that I never felt full, never felt empty and didn't feel the let down reflex for months. Just because things aren't "text book" doesn't mean its not working.
Totally agree with comparing unsed nappy to used one - it really helps to tell if they have weed. Bear in mind, its only going to be a tiny quantity. Have to differ with advice with them weeing once nappy is off - think this applies more to boys than girls.
Another thought - if a baby is dehydrated there's a spot on their head which becomes sunken...I hope someone can explain it better than I can, but it would help to reassure you that things are better than you realise.
Don't worry about wasting mw/HVs time if you have any concerns, its their job and they expect it, you have genuine concerns. You'll be feeling alot better in a few days time and they'll know this too.

Just a quick update- I think a)either my milk still hasn't come in properly (doubtful at day 5) or b) I have a rubbish milk supply. I have expressed every 3-4hrs overnight and only get between 1-2oz total. Last time by day 5 I leaked everywhere and was expressing about 8oz by now.

I had to resort to formula overnight and have a very happy contented baby and it's nice to see her not worn out by sucking fruitlessly at my boob. Feel sad though- don't know why I don't have the milk but am going to keep expressing regularly to try and build it up. I am really eating and drinking well and have been since Friday so that's definitely not the issue. Maybe dd has never really fed properly and the milk has come and gone. God, this is a horrible rollercoaster. I am also putting dd to the breast at the beginning of each feed but beginning to lose hope... She is usually too ravenous by the time she wakes and screams when she gets nothing from me.

oh needaplan can hear how upset you are but you just said you have a happy contented baby. Try not to be too upset if it doesn't work out with the bf. (Please don't shoot me everyone)because being stressed out about it will make it far harder to bf and be added stress to what is already a difficult time for you. It is entirely possible that your milk hasn't come in properly yet btw, it's different every time.
Why not carry on as you are doing just to check, but don't beat yourself up if you need to resort to formula, having the happy contented baby and enjoying this precious time is the important bit.

needaplan - the amount you are expressing is perfectly respectable on day 4-5 I don't know why it was more last time - not really relevant, though. I can so uderstand why this is so very stressful for you

Expressing 3-4 hours is prob not often enough, sorry...while you are in this difficult time, think of at least 8 times in 24 hours. It is hard to express to establish and maintain a supply

It sounds to me as if the midwife did not observe you feeding - and this is a crucial.

From what you say, I think it will help to have her skin to skin with you as much of the time as you can - that way you gain a little extra time, so she is not ravenous when she comes to the breast, and desperate! S2S means you cn respond as soon as you see the early feeding cues.

Hope you can get someone to watch you feed.

Did the NCT helpline phone back?

finsburymama thanks for your post- very helpful

tiktok- No, the NCT helpline never phoned back! I'm not sure if I'll manage to express any more than 4 hourly. Also what happens if I end up expressing and then dd needs feeding 30 mins later? Won't there be very limited milk there?

When mw came yesterday, she did get me to put dd to the breast but she was zonked out and so could not really observe much!

I will try the skin to skin more- it is a good point. Really though, she is not waking up herself for feeds. She will maybe wake once for a feed in a 24hr period. I wake her for the rest, aiming for 4 hourly. When the jaundice is gone (it is no worse), I can maybe leave her longer?

I am going to keep persevering. How does this sound?
At feed time, I put her to the breast first. If she is too sleepy or too hungry/ distressed I give her 20mls of ebm. This seems to calm/wake her enough to either latch onto the breast directly or with a nipple shield. I then express off both sides! I just don't think she has enough energy to bf full-time yet. mw thinks my milk supply is ok enough and says it's a good sign if there is milk in the nipple shield after a feed. Dd has lost 8oz of birthweight. mw said she was expecting worse and that dd must have been getting something from me if I'd only been topping up for around 20hrs before the weigh in. I don't know how things are going to pan out really! Feel very up and down- the success of a feed determining my mood.

needaplan, sounds like you HAVE a plan. i think it is a good one. one more tip - try to express some milk onto the nipple (a few generous droplets) before you put dd on, so she can smell and get a taste. keep an eye on the nappies. if poo is getting lighter in colour (more mustard yellow) compared to previous ones means things are ok.

insist that your mw does not discharge you until you are confident with the feeding. if the person you are getting is not quite what you wish her to be, phone the hospital and ask them to send someone else.

needaplan,
I had a caesaren and my milk did not come in for 6 days.

I also had a very sleep baby (due to all the drugs i took no doubt) but i didn't have the extra concerns of jaundice.

please please please try to take heart from what your midwife is saying. she doesn't sound too concerned but you don't seem to want to believe her . I know that when you bottlefed before you had the reassurance of being able to keep a track of what baby had but you simply aren't going to get this with a bf baby. Try to stop comparing and just go with it.
breast pumps aren't as efficient as babies - they will always get more milk even after you've expressed.
i really feel for you and don't blame you for trying the bottle but if you do want to perservere with the breast then try to hang on in for another day or two. that really truely, honestly could be all it takes.

oh and warm flannels on your breast to relax the blood vessels / milk ducts and get the milk flowing.

popeye- do you think I shouldn't use a bottle at all? So much conflicting advice on this, pro= at least they're sucking, con= breast/teat confusion? Yes, you're right I'm finding it hard not knowing how much dd is taking but she plainly was not getting enough by day 3 that I had to help her out in some way or other. Screaming/not feeding all night and sleeping/not feeding all day was hideous

thanks for the thumbs up finsburymama. I do do the squeezing a drop onto my nipple trick first. Sometimes it works, other times not. Poo may be getting a bit lighter I think

you're doing brilliantly well, needaplan, i've just read through your thread and I'm so impressed by how you are dealing with all this on top of recovering from a c section,
ds1 was also c section at 37 weeks plus jaundice and soooo sleepy, it was really incredibly hard work for the first few days but improving daily after that. I think you need to try to wake your dd more than every 4 hours tbh, I know it's a pain, but could you try every 2.5-3? i think it would help your milk and her responsiveness in the long run. i used to do an entire baby strip including nappy, then wash his bum in quite cold water, then feed, then take nappy off again and clean his bum again then try another feed. throughout the whole feed I was annoying him, tickling toes and rubbing behind ear esp, to keep him going and not fall asleep too soon.
hth

personally, I'd ditch the bottle, not just for nipple confusion but also cos I found it very dispiriting seeing how ds1 could neck down an entire bottle no trouble at all but struggled with bf. he soon got into the swing of things, and I'm sure your dd will too, esp as your milk should be coming in more pretty soon

needaplan - when people don't get a call back, something has gone wrong. Very occasionally, the technology messes up (or mothers speak too quietly), and you can't hear the number on the message. I promise you - we never ignore calls. A couple of years ago we were overwhelmed one August and people waited a few days, But since then, nothing has happened like that, and callbacks only fail to happen when we can't call back for some reason.

Please phone again

I'm not going to confuse the issue more by giving out more suggestions - stick to what the midwife has told you as she has seen your baby and no one else has !
I'd just hadd that no, it would not be good to feed any less often than 4 hrly until you are 100 per cent sure all is well, and even then a long gap shd only be happening once or so in 24 hours. Most babies feed more often than 6 times in 24 hours, after all...

Good luck

hadd=add

Just wanted to say, don't give up - you're doing great to be still bf after all your worry so far. I had terribly sore nipples to begin, with dd1 and dd2, they healed and stopped hurting by magic at week 5.
Have you tried laying on your side to feed - it might help you to relax and let down easier - it was the only way I could feed for the first 10 days or so.

Good luck, it will be worth it.

needaplan,
i understand completely why you are doing what you are doing - but personally, it does sound like you are making hard work for yourself.
the basic principles of breast feeding are...the more you feed...the more milk you produce. thats feeding baby - expressing isn't the same. it doesn't get all the milk ducts opened up, doesn't empty you completley. under normal circumstances people are advised not to start expressing regularly until their supply is establised - yours isn't. unlikely to be for 4-6 weeks.

you sound like a dog chasing its tail but its so hard to say what you should or shouldn't do without being there. i personally think you need to ditch the bottle, even with ebm and make a concerted effort to bf - if that is really what you want.

is the jaundice still a concern? that obviously has some bearing on what you should do. you need to talk this through with midwife because she can take into account the health of your baby.

i remember clearly sitting down one day and saying "right, todays the day", and i sat in the same room all day just DH, DD and me. I just held DD while she slept and as soon as she stirred I just kept trying to feed her. Yes, i'd wake up it she went too long. We got there in the end, all of us.

4 hours between feeds sounds right for a bottlefed baby but it can be every 2 hours with a bf one. the milk isn't as dense so its absorbed quicker...but thats a good thing. think of it as a power shake rather than burger and chips . If she only has a very short feed and trys to drop off to sleep again, wind up to see if you can stir her awake - then put her back on the SAME breast. she needs to get the hindmilk (the real good stuff) and if she has short feeds and/or gets switched between breasts too often she might miss out on this. be reassured that if she doesn't feed often but has a really good one you are making progress. always try both sides before you give up completely and let her sleep again.

You might have to forget about night and day for now - try to sleep when she does - yes, easy for me to say.

if tomorrows your day to crack it....
take a deep breath and try to remind yourself why you want to breastfeed. keep telling yourself you can and will do this. when you sit down to feed, make sure you relax - really really relax - make sure your shoulders aren't round your ears and that your arms aren't like 2 steel girders. baby WILL pick up on this! gently talk to her, reassure her, tell her what you are doing etc etc.

you are really are doing so so so well to still be hanging on in there. breast feeding is mad - its never easy.

you go girl!

Needaplan,

put a cotton wool bal in each new nappy this way you will know for sure if your dd is passing urine.

Feed,feed, feed. if she falls asleep strip her down wash her face with warm water and let it dry naturally. change her nappy then try again. If she falls aslepp on the breast after a feed i would do breast compressions to make your milk flow into her mouth - she will still swallow this even though she is asleep.

Definately contact a BFing councellor, i have attached the numbers.

Also silverette are fantastic for rapidly healing sore nipples.

Hang in there your doing a fantastic job.

The Breastfeeding Network (BFN) - Supporter Line 0870 900 8787 - The service operates from 9.30am to 9.30pm every day of the year.

La Leche League Great Britain - 0845 120 2918

National Childbirth Trust - 0870 444 8708 - 9am to 6pm, seven days a week.

Association of Breastfeeding Mothers' - 0870 401 7711 - Open every day from 9.30am to 10.30pm