Advice for friend who is expecting small baby...

[EdieMcredie]

...She is desperate to breastfeed, is there any advice to give her about this? The baby has been predicted to be born at around 4lbs. She is 31 weeks pregnant. She has just joined MN but is having difficulty posting a message.

Thanks in advance.

The best thing she can do is to get all the numbers of the helplines, make contact with her local bfc etc.
Is the baby going to be born before 40 weeks, or is it just very small ?
If it is predicted that the baby will have to go to SCBU, then it would be worth getting someone to teach her how you manually express ahead of time - I had to go and find someone on the ward and hassle them to teach me.

My baby was born by Emergengy C section and the best thing I did was start to express asap (about 20hrs later) with an electric pump provided by the hopsital. EBM can then be given by cup or NG Tube until baby is strong enough to feed itself...although at 4lb it will probably start feeding from the breast fairly easily and quickly (my baby was only 2lb 1oz so she has only started in the past week or so and she is 3lb 11oz)

Gestation matters to, as the suck swallow and breath skill is usually only there after 36wks BUT there are babies on the unit where my DD is who have done this from 33 weeks ...every baby is different.

Good luck to your friend x

Regardless of whether baby will be in scbu, I found that my DS (born at 5lbs 1oz) simply didnt have the energy to suck off the breast lots. I have the following advice

1. If for any reason the hospital doesnt have her baby in the SCBU...then make sure she demands it, especially if the baby is not latching on etc. Small babies are more prone to tire easily when trying to suck on breast and she may need help getting milk into them. SCBU will keep more of an eye on feeding etc than mw'S on a normal postnatal ward
2. Get her to read up on manual expressing. So she knows how to do this. Perhaps even take in a good book on bfeeding.
3. Also have her start looking into / asking at the hospital about their policies on babies who are born on the smaller side. She needs to know whether they will advise formula top ups - and she needs to know (without being exhausted) what her views are on this.
4. If she is ever worried about the advice she receives, make sure she asks to see a senior paed.
5. Take her own electric breastpump into the hospital (or have one that someone can bring in if she needs it, the hospital may have many on hand)
6. To not be discharged if she can help it until bfeeding is successfully established

My experience was the following:

DS was Straight onto breast in recovery, fed twice. After that would tire easily when on breast. He was borderline SCBU - and they recommended formula top ups until my milk came in, as they couldnt afford for DS to lose too much of his birthweight. I was also to put him to the breast every 2 hours.

So basically, would wake DS, and MW would help put DS to breast and help to get correct position and latch. He would suck until tired.
I would then manually express colustrum into a syringe which was then given to DS. He was then topped up with formula.
This lasted until end of day 2 when my milk came in at which point I started to express my milk and that was given to him in a bottle instead of formula.
By day 5, he hadnt lost any weight, jaundice was fine - didnt need lamp or anything, was feeding off my breast with no issues and we came home - by this point, I had to feed every 3 hours.

For me, the formula top up meant that DS thrived. I didnt want him in SCBU, he didnt suffer any nipple confusion and breastfeeding was fine. But I found it hard - despite wholeheartedly being behind the medical advice given, I would be in tears as I expressed colustrum and DS was given formula - them darned postbirth hormones.
BUT, that was my DS and I had terrific support from the MW's who persevered by putting DS to breast every feed so he would suck before giving him the calories he needed. Other mnetters may come on and say what worked for me didnt work for them - I dont know, I just thought I would share my experience and what worked for me.

I have seen advice on here with mnetters being very much against formula being given (and reading the studies that show why exclusive breastmilk is best), I can understand why. This is why my main advice is for your friend to understand the pros and cons of giving formula when her bub is born - especially when it comes to successfully establishing breastfeeding.

HTH - let me know if you have any questions.

That's really helpful, thanks. They are not going to induce so hopefully will be born at term.

I know she will be on here getting lots of support when baby is here.

I will give her all the numbers...thanks again.

DS1 was born just over 5lbs and his weight fell dramtically after that. He was induced but at full term (eclmapsia / IUGR).

He in fact had plenty of energy for feeding at first and his blood sugars were monitored and fine so he avoided SCBU and could go home BUT that was a mistake I think- when we got home his weight fella nd because were in a bit of a fall out of low stafing (december 1999- Millenium / Christmas etc) we couldnt see anyone.

How was the weight determined? just, scans not that reliable- can be a pound error easily.

Get all the support you can, ABM / NCT etc. A good BF pillow helped somewhat as he felt very small and also needed that extra bit of lift to raise him up- but I am not norkily blessed either.

Little and often with feeds, and making sure Mum takes zare of herself too- sometimes a difficult pg or birth can mean mum struggles a bit at first and doesn't look after herself so well.

Well she will have plenty of people to look after her-good husband, mother, sisters and me.

Yes weight determined by scans and she is aware they can be out. They led me to believe I was have a huuuge baby but she was 8.8.

She is very determined, think she will do well. Will tell her to get a BFing pillow.

DD was 5lb 4oz at term. Was labelled IUGR but I dispute this- she is still on 0.4th centile at 9mo so I think just meant to be small.
My hospital had a policy of doing blood sugars on all babies

Blimey deja vue.....ds1 5lb 4 oz, had blood sugars (but ws OK), is still on 0.4th centile, and is dairy allergic.

Bizarre!

(But I agree with IUGR for him as placenta was deteriorating- the other boys were born mroe average then dropped to a lower centile like their skinny dad)

My friend has just had a tiny baby, 4lb 15oz at full term. He lost about 10% of his birth weight and developed jaundice but the (IMO) very sensible paediatrician said he'd be better off with his mum and getting regular breast feeds than being put into SCBU. In the month since he was born he's gained an amazing 2lbs and is now over 7lbs!