1 week infant feeding issues

[Helixus]

Hi - first post so hello all!

We’ve got a 1 week old DS, and we’ve had nothing but issues feeding so need some mental support / would love to hear that we’re over-worried.

We wanted to exclusively breastfeed, but the baby was latching and only sucking few times and then falling asleep. At the hospital (wife had c section) we were told it’s normal (against our gut instinct), then the next day he got jaundice and had urine crystals in pee so decided to do formula not to starve the baby. Clearly had very little food in first 3 days of life (although there were a few decent breastfeed sessions that we didn’t manage ti repeat…).

We were advised (again against our judgment) that bottle with formula would be fine (we wanted to do syringe not to cause nipple confusion) but needless to say DS is refusing the breast now as it’s hard work. Wife stared expressing and we were feeding through bottle tho so all good then for a bit. Then day 6 we got advise from the midwife to try nipple shields and this seemed to work, only for us to realise that he’s been using the sucking for comfort without almost no food intake (pee was still there though, but instead of poop with milky bits we got fart splashes that were tiny). Baby is 10% down from original weight at day 7, still a bit jaundiced but other than that a fairly ‘happy’ baby.

We got super stressed and got back to expressing and feeding through bottle so hopefully out of the woods and will quickly regain weight but 3 questions:

1. is there any risk that we ‘damaged’ the baby with those ‘low food’ episodes? Or should we just move on since he’s feeding again?
2. is there any point trying to breastfeed again? Any advise on how to go about that?
3. Any advice on how to work out how much food to give DS every day? We were advised 60ml expressed milk every 3hrs, and adding 5ml more every day (and obv giving more if baby asks for it, he seemed to down 80ml happily today for example).

Forgive stupid questions but being a new parent we’re totally freaking out (and my OCD doesn’t help, mulling through worries constantly that this will affect him later in life).

1- no
2- yes

On phone hang on

3- offer boob first at every feed
Get baby checked by someone who knows what they are looking at- for tongue tie. Sounds like it to me.
An independent lactaion consultant is who you need to see. You do need to pay but worth it overall if it means less formula

To get rid of jaundice the thing is to feed LOTS
Else baby needs to go back in to a light bed for a day or so. Scary for the parents but totally normal procedure.

Weight loss isn't great but not terrible.
How did the birth go and when exactly after it was baby weighed?

Is he tongue tied? That could explain who he's using boob as comfort but not getting enough milk.
I know the desire to breast feed is huge, and also have two children, but the most important thing is a happy and fed baby and a none stressed Mummy so maybe bottle to get his weight up. Continue to express though as breast milk stored great in the freezer and revisit when the dust ha settled?

The sucking will be stimulating milk supply so that's not wasted.
Breastfeeding is supply and demand - baby extracts milk and more is made. In an increasing manner.
And also the opposite. So whilst you get the proper breastfeeding support I suggest trying expressing.

A wide open latch to help baby get a good attachment at each time attempting a feed.

Persistence and support is what you need. Be her advocate and make the calls to get the help in. Breastfeeding can be really tricky.

It’s early days for breastfeeding, it takes a while for the milk to come in properly. Make sure they check for tongue tie as this hampers the latch. Lots of skin to skin and let baby feed little and often, bed for mummy and baby for several days resting and feeding. The more formula the baby take, the less milk is made, supply and demand. It’s so hard to get going but worth it in the end.

@SleekMamma no as in not to worry I hope 🙏

@Shoemadlady No tongue tie, been checked 3 times, he does latch but he is too lazy to suckle and work for it (it seems). Having said that we know he is capable as there were 3 good feeding sessions, and then the bottle messed us up…

Do you want to breastfeed? If it's important to you as a family, leave the baby in the breast for as long as necessary. Unless there is a specific problem, or will work out. Monitor baby's weight and as long as it's healthy, just keep baby at the breast.

Sorry, no your baby won't be adversely affected by these few weeks

Congratulations on the birth of your baby and for being so supportive and involved. Just off my own experience, the c/s meant my milk didn’t come in for 5
days and too we were re admitted to hospital for weight loss/crystals, also jaundiced baby. No damage done. We had to Formula feed but I kept going with BF and over 3 weeks switched from 90% formula to 100% BF by pumping at the end of each feed/ time baby was being FF to have enough in the fridge to be able to do one breast milk feed in a bottle a day. Whilst my milk supply was building up. I kept trying BF at each feed and built my milk up. Fortunately no nipple confusion. I found the NHS BF cd ( probably on line now) amazing for latch advice. In a couple of weeks as baby grows DS may want to feed the whole time as he grows- fantastic to build up supply, keep baby at the breast as much as he wants ( the whole day is not unusual and exhausting but it really helped my supply). Also when he’s asleep at night just before he wakes for a feed, pick him up asleep and put him to the breast- he may take deep long sucks and feed whilst asleep- he probably won’t burp as so relaxed and simply put back down. That will boost supply and help his latch. Hope this helps, it’s infuriating to hear but there is no set rule, but what your wife is doing sounds fine. What’s more infuriating is to hear that the more she relaxes the easier it will be ( hard in the moment!) good luck

Just wanted to add - breast fed babies do tend to do less poos, or poos with lower substance. This is just because there isn't a lot of waste in breast milk. It's perfectly normal.

Ok if you have seen some good feeds that's great. Just keep feeding!
You are measuring output not input when breastfeeding - wees and poos by baby. As you cannot measure input.

Lots of nice food and drink for mum, cozy up in bed, put baby on the boob at every squeak.
Look up feeding cues, moving head is one. Don't wait til baby is crying.

And if you need to wake up baby - undo babygro & gently put a damp facecloth on legs to wake up and prompt to root and latch on.

See how you get on with all that tomorrow

Also jaundice makes baby sleepy, he's not lazy. You really need to wake a jaundiced baby to feed. In the day every 2 hours or more often if they can.

In relation to weight loss my daughter lost a lot of weight cos my milk never came through despite trying loads and was already premi and tiny and bar being very petite she's besutuful and healthy and smart.

If yiu want to get the best feeding back then reccomend keeping baby on breast as much as possible. If you can afford it then a hospital grade pump can be hired from medela which will help stimulate it further.

And if you can't please don't drive yourself insane like I did. I never thought I'd be the type of mother so desperate to do it but I found myself really distressed by the whole thing. But you know what? My daughter is absolutely thriving and well ahead of her peers. So who cares in the long run. As for how much formula it should be around 150-200ml per kilo per day. So if your baby is 3 kilos should be about 600ml per day over usually around 8 feeds which is 75ml per feed. Never heard of this upping 5ml per day thing.

Thanks for the amazing support guys - wife had a bit of baby blues (tbh I did too, who knew!) as she though we’ve done something wrong that would affect development - will follow the advice and try to relax and keep trying 🤞🏻

As to the feeds we’re expressing (we got medela swing which is great) so want some some advise on how much to feed the collected milk as hearing different opinions (as above with the 5ml rule…). There are plenty of ways to figure out formula quantities but not expressed (at least I haven’t found…)

Volume-wise, the guidelines for formula are a good starting point for how much to offer, and then you can offer more if baby is still hungry.

As others have said, I think seeing a lactation consultant if you can afford to would be super helpful to properly assess the latch and milk transfer. I haven't seen one myself but my friend found them worth their weight in gold. I also found the La Leche League website incredibly helpful for checking attachment/positioning.

If your partner is expressing/offering the breast at least 8 times a day, including once overnight, this should be stimulating her milk to come in - and we were recommended to offer the breast before every feed. Sometimes babies can get frustrated by the slower flow from a nipple compared to a bottle - have a read of "paced feeding" to try and make them more comparable.

Little one won't have been affected long term by those first few days. Congratulations!

You definitely didn’t damage your baby 10% of babies have significant weight loss in the first week of life and almost all of them go on to do fine.

if you want to breastfeed again, seek in person advice, your midwifery or health visiting service may have a great specialist team if you ask, there’s charity support and if you can pay, an IBCLC is really worth it.

Do lots of skin to skin, look up co-bathing, lay back and snuggle your baby on the breast, offer the breast whenever interested, may work better when hungry or when not. Just experiment. sometimes a sandwich approach; bottle, breast, bottle works for babies who prefer bottle flow when hungry. Some babies are tempted with lots of milk on the nipple, expressed or formula

Nipple shields are wonderful tools but need support from a specialist. With good supply they should work with the right support.

In terms of milk volumes, in healthy babies it’s not a science, give what he wants to drink, so offer a little more than he usually drinks. If he drains it offer a bit more. 150mls/kg/day is a guide to minimum volumes but it varies especially with expressed milk

Yes, breastfeeding can be established. All sucking will promote lactation.

Feeding should be spaced at most every two hours, including the feedings between 12 midnight and 4 am which are extremely important for milk production.
DO NOT leave a gap of three hours between feedings. That is too long.

Baby needs to be woken and stimulated to feed (stroke his cheek gently to start sucking) and blow gently in his face if he seems to be dozing off. Change sides, change nappy, little drop of cold water to his head - do what it takes to keep him sucking a bit more.

You can offer 2 ounces of formula after he has breastfed. Use a bottle, not a syringe. The important thing is to cure the jaundice and start weight gain, not worry about nipple confusion. Your wife can pump too.

Make sure nipple plus areola goes into his mouth - look up squeezing the breast with a hand shaped into a C to produce a nipple that can be shoved right in.

Bring baby back to be seen if he remains jaundiced another day. 10% of body weight lost is a concern.

Make sure your wife gets plenty of protein as she recovers from childbirth, and plenty of rest.

You mentioned the c section. Did your wife have proper pain killers like liquid morphine or just para and ibu? And does she know when her milk came in (as in switched from the thick yellow colostrum to the more milky slightly yellow tinted milk (transitional milk), and then around day 10-14 fully white watery milk comes in.

I ask because I do know some peers who had trouble with their milk coming in when not taking the liquid morphine. Oromorph promotes lactation and is gold standard for breastfeeding mums post c. Some hospitals are cheap skates or want everyone to suffer, or think we are too irresponsible to self administer - I have no idea why it’s different in different trusts.

Milk production requires lots of rest, low stress, lots of food and water. When your bodies been through a major operation it can throw it all out.

So don’t panic just yet. Feed boob always first and then offer bottle to top up until full.

And I am not suggesting she starts necking morphine now 🤣

It’s usually taken in the first 7 days only so a bit late.

More as an explanation to why things may have gotten off to a slow start.

With the nipple shields ask your wife to do breast compressions constantly, and tickle LO under the chin or side of the jaw to stimulate sucking reflex. Mine did this and the first 2-3 months were hard but we caught up with supply and he latched like a pro by week 16 with no shields (his mouth was just tiny) and fed till 2 here's.