Breastfeeding.. is this ok?!

[llaethmam]

My newborn (6 days) is jaundice and very sleepy, HV aware and he didn't need treatment but I'm struggling a bit with whether he's feeding enough and engorgement pain. He feeds roughly every 3/4 hours, sometimes more often but only like a little 'snack' not a full feed. He's notorious for falling asleep after a few sucks and pulling off when let down starts and missing all of it (I collected it in a bowl and it's a lot!) this happens most feeds. I have to jostle him awake constantly. I'm finding myself feeling permanently engorged, the relief after a feed doesn't last long and my boobs never feel empty. Im trying to encourage him to feed more when I'm particularly in pain and he'll usually latch on but will fall asleep and stay asleep. If he wakes on his own accord for a feed it's usually a better one, and if I change his nappy first he goes demented and will really cry and wake himself up so we'll get a better feed then. I keep worrying he isn't taking enough but he is pooping very regularly and had some bigguns so I just don't know?!

When did you last see you HV? If he is still very sleepy I would call her in the morning and they should be able to pop out and check his bilirubin levels are heading in the right direction, and if not, suggest some other ways of feeding or using formula to make sure he’s staying hydrated. It is really common and that’s what they are there for but you do need to get it sorted 👍

The pump is your friend here! Breastfeeding is effort for jaundiced sleepy babies but it’s self fulfilling; the less they drink the more jaundiced they become.

Unfortunately you need to be feeding him more. As PP said it's a cycle - feeding him will be what gets rid of the jaundice and makes him more awake. Keep feeds to every two hours. Strip him of his clothes, or change his nappy, or tickle his feet to get him to wake. It's not fun but it only lasts a few days. You need to get that milk in him!

Have you tried doing some breast compressions while he's latched on? That can sometimes keep the milk flowing while he's sucking and keep him awake and feeding for a bit longer?

Is he your first baby? Congrats either way. I agree , your milk in baby bottle then you can see how much he's drinking. I always worried the first few weeks of feeding. Keep expressing at least you wont feel engorged and so uncomfortable. Yes health visitor for any worries. My first one was like a bilge pump,never could get enough! The midwife used to say stroke their face to try and keep them awake enough.

Please get seen for the jaundice. I know it's common but it can be extremely dangerous if not sorted x

Unfortunately you have to make him as uncomfortable as you can to keep him awake and feed at least every 2 hours - strip him down so he's a bit cold, tickle feet, stroke face, bright room etc.

Yes definitely get him retested. I requested they retest my daughter at 10 days and it turned out she was very jaundiced and we got readmitted for UV.

I really don't want to introduce a bottle if I can avoid it he was tested for his jaundice and it was below the levels for treatment

Yes but the levels can creep back up! My daughter was in neonatal and her levels were okay at birth then they went up and she was under light therapy being monitored until they safely went down. Please check! Also you don't need to introduce a bottle if you don't want to. Just feed feed feed xx

And just to add we were put on a two hourly feeding schedule (breast only) and as the commenter above said, we had to simply wake her up. Not nice but had to be done x

3-4 hours at that age doesn’t sound like often enough to me.

I had this for about 10 days with DC2 and it was only later that I worked out the post section pain killers were likely making both of us sleepy. I had to really make an effort to keep them awake during feeding.

You might not have any choice OP, baby’s wellbeing has to come before your ideal feeding scenario, hard as that is - please do get him tested then if he is jaundiced do what you need to do to clear it. It might not come to that but the priority has to be making sure he is well and thriving x

My baby was jaundiced, luckily he didn't require treatment. I was advised to feed him every two hours, counting the next feed from the start of the previous feed.

I think you should be feeding a little more regularly, every 2 hours or so. And at this stage, if you’re engorged feeding will help.

Give the NCT infant feeding helpline a ring - they are open now.

They can talk through how to keep him away (stripping him to a nappy can help) and how to check latch etc is ok.

You can also find out where your local breastfeeding support group is. Get down there as soon as possible to get some qualified support.

I wake him more regularly for feeds but if it's much sooner than 3 hours he just isn't interested and will fall asleep within a few sucks. I was feeling really engorged earlier so woke him around 2 hours after his last feed and kept jostling him and tickling him and he fed for longer then dribbled it all back up! He poos almost every time he feeds and I'm having to change his nappy constantly, we got through a pack of 24 in less than 2 days and he seems content, just sleepy, so it's hard to know as there are signs he's getting enough. They're coming back out Monday to weigh him again just wasn't sure if I needed to seek help sooner.

He's my second! My firstborn breastfed for over a year but was born full term and was a lot more chunky and alert from the get go, with this one being early and so much sleepier and smaller its hard to compare. I'm confident his latch is good you can really hear him gulping and my boobs are softer after although can still feel big lumps but I do make a lot of milk

Every 3-4 hours really isn’t enough at that age, with or without jaundice, and he may be too sleepy to feed well because he’s not feeding enough and his blood sugar is low. I would hand express a bit of milk (this will help your engorgement too) to syringe feed. This will get a bit more in and help him wake
to feed. How the latch? Could he struggling because he’s not able to feed effectively? (This was the case with my son who had a tongue tie)

What gestation was he born at and what was his birth weight? Has he regained any of the initial weight loss? The thing is if he’s very tired and sleepy, constant breastfeeding is going to exhaust him and it will become a vicious cycle. I had this with DD, the way I saw it was I would get as much milk into her in the lowest effort way possible (pumping and bottle feeding the expressed milk). She gained really quickly this way, ‘woke up’ then had the energy to breastfeed. She then breastfed for 8 months.

Waiting for support groups etc is all very well but your baby is 6 days old, sleepy and possibly jaundiced, the answer is milk - you don’t really have days and days to try different breastfeeding techniques. If you express and use a bottle it is by no means the end of your breastfeeding journey, despite the scare stories on here.

I had my first baby abroad and the midwives there were very pro breastfeeding. They told me to tickle the feet of the baby or pinch a little to make sure they are awake. Also to change nappy before feed (which was very annoying as the baby always pooped after feed).
I would expect such a young baby to feed more often (2 hour intervals) and maybe for like 10 to 15 min at a time. But babies are all different.
If you are concerned definitely call the midwife or maybe go to a weigh in clinic if you have one locally.

Ah, I thought he was early! He sounded like an early/small/jaundiced baby to me, just like mine was (37+0 and 6lb).

He was born at 36+5 weighing 6lbs 4 and he had dropped to 5lbs 7 when he was discharged from SCBU. He was tube fed the first couple of days while we were there but breastfed since. It was the nurses in SCBU who told me to wake him to feed every 3 or 4 hours!

Ah sorry just saw your recent posts. So you know what you're doing as it's your 2nd. The fact that he poos is good and it might be you just produce more milk than he needs. But to be sure could you ask the midwife to come earlier? It's worth a check if you're concerned.
And good luck!

I was told every 3 hours until they regained their birth weight. 3 hours is timed from the start of one feed until the start of the next feed. So if you start a feed a 7 and they finish feeding at 8.30, the next feed starts at 10.