Looking for reassurance bf newborn

[winterbabythistime]

Had my midwife check on the phone this morning.
At that point DS was 42 hours old. He'd done 2 wet nappies and 3 dirty nappies with the last dirty nappy turning greenish instead of black.
On the phone the midwife seemed slightly concerned my milk hadn't started to come in. I didn't think milk came in until around day 3 (that's certainly what happened with my older child)?
She tried to encourage me twice to start expressing to make sure my supply is ok. I expressed with my son as he wouldn't go to the breast and I honestly think the time taken expressing ruined any chance of direct feeding happening. I'd rather top up with formula if I had to.
Baby has a tongue tie so she came out to assess his latch after our phone call. She said his latch seems ok but she couldn't hear him swallowing. Again she mentioned expressing.
He'll be weighed tomorrow afternoon but now I'm of course worrying that I'm starving my baby!

What has baby been fed since being born?

You’re not starving him, don’t worry! The fact that his nappies are changing colour just proves that. You’re doing the right thing, keep feeding and I reckon tomorrow you’ll start to hear him gulping and realise your milk is in.

My milk came in on day 3 both times. First time I woke up with massive engorged boobs but second time I realised when he was feeding that he was swallowing all of a sudden and when I checked I could see milk.

@Welliesandpyjamas he's bf

I got dh to listen closely when I last fed him and he says he can hear him swallowing. I can see his chin moving up and down and the throat moving.
I'm so surprised the midwife thought my milk should have been in at less than 2 days old. Tonight my breasts do feel a bit fuller so I'm sure it's on it's way.

Are his cheeks nice and full when he sucks? Can you see any milk in his mouth after a feed or feel your letdown? Definitely sounds like it’s on the way.

@ClaraLane yes his cheeks look chubby when he's on, don't feel letdown yet but his mouth is wet when he comes off and I've seen colostrum in his mouth definitely. Not milk though.

The most reliable way to assess intake at this stage is what's going out - you want at least 2 dirty nappies the size of a £2 coin, plus a wet one for each day of his life, so one on day one, three on day three etc until six, which stays the same from then on.

You would expect day two nappies (all being well) to be showing a colour change, moving towards green.

Swallowing isn't necessarily an indicator yet, as colostrum comes in dribbles rather than flowing mouthfuls.

Not letting him go longer than three hours between feeds until he's back at birth weight is a generally useful rule of thumb too - sleepy babies can be hungry babies hoarding their reserves.

What's your instinct? Does he have alert periods? How does he compare to your previous babies? Is his latch comfortable?

It sounds fine OP. As you've said, day 3 is normal for milk to come in, and his poo sounds good!

@RockCrushesLizard thanks, my instinct was that he is perfectly fine. He's a lovely colour, wet mouth and bright eyes, seems perfectly alert for a newborn. He's done some cluster feeding but other times has come off the breast perfectly content and slept for 3 hours. Cries when you change his nappy or clothes. Roots when he's hungry. I just feel like whole phone call / visit has dented my confidence.
I can't compare feeding with my older ds as I almost exclusively pumped for him.
His latch isn't always massively comfortable which may be because of his tongue tie but the midwife did say she thought it was actually ok when she observed us feeding. She checked my nipples and they're not worryingly damaged or anything. I said I'd decide about getting his tongue tie snipped tomorrow after he's been weighed and my milks had a chance to come in. They won't advise me either way about getting it done for some reason.

I think that sounds like a really sensible course of action. By day five when he'll be weighed your milk will be in, and you'll have an idea whether he's feeding efficiently or not. If he's alert, peeing and pooing, you've got time.
I only asked about the latch because some babies can have a poor latch that leads to feeding really inefficiently, so it seems like they're feeding well/regularly but not so much (like trying to drink a pint through a thin straw - takes ages!)
You might want to have a look at "exaggerated latch" online - it can compensate for minor tongue ties and get you a bit more comfy.

Thanks.

Just changed another dirty nappy and it was dark browny / green.

There you go then, definite progress. Yay poo!

Remember the National Breastfeeding Helpline is always available 0300 100 0212, and you can get support and accurate information - they're brilliant, don't dictate what to do, but give you knowledge to make your own choices.

Thanks for the phone number @RockCrushesLizard

We defo have milk in my right boob! Suddenly felt letdown and he started gulping and was dribbling down his chin when he came off.
Just going to change his nappy to wake him up enough to work on my left boob now.

My right had more supply than my left with my first too and always leaked more during pregnancies. I've been starting each feed on my left side but obviously hasn't helped yet.

He's only lost 4.3% they'll weigh him again in 2 days time

4.3% is amazing - you're obviously doing a great job!

Brilliant news - well done you!

Well that's everything you needed to know - great job!
This is the problem with phone appointments, the midwife can't see you and the baby, so has to be super cautious, and everyone ends up unnecessarily worried.
Enjoy your babe, you're obviously right in tune with what he needs

He was weighed today, 6 days old and 5oz over his birth weight. He's a wee champ 💪🏻

You absolute star, aren't you just winning at this
I'm so glad there was no need to worry

Lovely :) I miss the newborn days when they are tiny and munchy and a good feed sends them milk drunk. Sounds like you're doing brilliant op. Remember plenty of lansinoh, especially if he has a bit of a tongue tie. And if in doubt, feed. I've bf two now and that was my solution to pretty much everything.