4 days old and sleeping for hours

[suis]

... this is a question for a friend who is a bit concerned....

Her DD is just 4 days old, but keeps on sleeping for hours, despite attempts to get her to wake up and feed. She does startle at times when they try and wake her, but just nods off again. She does seem to be awake and crying at night and can eventually be persuaded to take a few 30-45 min feeds during the night, but in the day time she's refusing to feed and just sleeping.

My friend's MW told her that she is "concerned" about the baby and that she's got to wake her every 3 hours to feed, although without giving any ideas for how to achieive this, other than saying not to give formula or a bottle. My friend is now armed with a syringe and sterilised water for if her DD starts to look dehydrated.

Any ideas ?

is your friend attempting to bf or ff?

here is a leaflet with tips to wake a sleepy baby.

the MW is right. her baby needs to feed at least every 3 hrs (between 8 and 12 times in 24 hrs)

is the baby jaundiced at all....yellow tinge to skin and/or whites of the eyes. This can make babies really sleepy. Sunlight and frequent feeding are the best things. If she can't get out then put baby's pram/carrycot in the window.

HTH

Sorry, meant to say she's bfing..

No jaundice that I know of. I'll pass the advice on though.

When a baby has drunk some milk from the first breast and teh flow is slowing down, she may try breast compession to get more milk into her baby and stimulate her to wake up and drink some more. After compressions, swap breasts and try the same.

videos with compression and knowing when a baby is actually getting milk following a letdown

suis, this is concerning, and the midwife is right to be worried....but she should have given more help.

Your friend should think about skin to skin contact, safe co-sleeping, and she should watch for poos changing to yellow.

suis - I don't know if water is such a good idea at this age. She really needs all the fluid she gets to be milk surely. Can she express some milk to feed by syringe/cup if she's worried about dehydration?

(Just re-read op and realise her milk may not be in yet. Has she been shown how to hand express? I fed ds colostrum with a little cup for some feeds during the first few days although we didn't have this particular problem).

Bookthief - She's been trying to hand express but not getting very far with it yet. Her milk does seem to be in now, she's becoming full, but not much luck with expressing.

Tiktok - the MW was also concerned that the poos were still brown, although the consistency has changed.

She's had a lot of conflicting information, one mw told her not to express as it would mess up her supply, another told she needed to do it.

Has she tried expressing lying in the bath? Obviously not much use for collecting milk but it's a good place to learn how as the warm water seems to make it easier to get a letdown etc.

I hope she gets some decent help soon. Has she tried the helplines etc?

I'll suggest the bath.. and I am just in the process of sending her a list of the phone numbers.

Is there a local breastfeeding group or a breastfeeding counsellor she might be able to get to see? ASAP too - this was something I failed to pick up on as a warning sign at c 5 days and at 7 days my baby was taken into hospital. I think your friend's midwife has picked up on things early enough that your friend has a chance to establish and maintain breastfeeding but she does need to find the right help quite quickly, as after an 8 day hospital I found it impossible to reestablish breastfeeding and generally had my confidence as a new mum severely damaged.

Hope your friend gets the support she needs.

yes she needs to wake the baby every 3 hours and really persist with trying to get the milk in - my ds was just like this. I ended up having to strip him right down to his nappy to kind of shock him awake - and this was november in a chilly house, i felt very cruel! I think this was a battle for at least the first few weeks i am afraid, but it is important that he doesn't dehydrate. Hope its improving for her.

The issue about expressing is not really a question of messing up her supply - the baby needs to get breastmilk inside him, and if he is not feeding effectvely or often enough, then it will have to be expressed breastmilk. But she shouldn't express instead of breastfeeding him direct.

She should see the midwife today and get it all sorted - it may turn out to be fine. But I can't stress the importance of skin to skin enough. The baby is unlikely to turn things around without it.