1 week until large baby number 2 - any advice appreciated

[abbymeg]

Hello!

This is long - sorry!

I'm booked in for a c-section next monday and I really want to BF my baby, so I've done some reading and I'm already boggling at the amount of conflicting information out there. So, I thought I would post (possibly a bit early) on here in anticipation and see if anyone can help with my particular circumstances.

I had DD 10 years ago. I had a 3 day labour that ended in EMCS. Labour included pethidine twice as well as gas and air and a spinal block. When she was born she was a mega baby - 10lbs 12oz. I fed her after a couple of hours as I wasn't given any contact until after I was back on the ward. She was fine to start with, but quickly starving. By about day 2/3 I was feeding for up to 9 hours solid without even a toilet break (the care in the particular hospital was truly crap). I was also not really allowed to eat - I had not eaten for 2 days before the birth, then they had me on restricted food because of c-section. I was only allowed small portions of bland food. I think my milk came in around the end of day 3, not that it made any difference. By day 4 I was bleeding lots, I was in agony and shaking at the start of each feed, and by day 5 the doctor weighed her and told me she'd lost over 10% of her body weight - which was considered to be dangerous - and she had to have some formula. I let them give the bottle; she slept and I gave up instantly. She was bottle fed from that point onwards. That was it, except for a nasty bout of mastitis (sp?) a week later.

I was only young, I thought it would be easy and I was quite ignorant of what to expect. I was also quite shaken by the birth going so wrong compared to my expectations. The MWs, bar one, were all very pro-bottle and I was given very little help.

So, I'm expecting DS (in a different hospital) who is also a large baby and I want to avoid a repeat performance of last time, though I know that it won't be easy and I'm more prepared for that.

Any advice would help, but particularly - if DS becomes hungry after first day and milk isn't in (elective will probably delay this), what do I do? There is so much conflicting advice about whether to top up or not. Any help with how to cope with a larger baby and what is normal weight loss. Also, with regards to positioning, is it worth getting a feeding pillow? Any advice about positioning generally and latching on would be brilliant.

I felt that if I tried to get some advice now, it will help me to establish feeding without making any mistakes that will hinder me after I leave hospital.

Thank you all

I can't give any personal advice but know that you will get some help here - I was advised the kellymom site to help me with my bf issues and found some practical advice there.
Good luck - have you got a lactation consultant / clinci near you maybe they can give you some sound advice?

Hello abbymeg. I had two big babies, too! I'm hoping you'll find things have changed in the last 10 years in terms of encouraging mums to BF, although I found that the hospital staff were pretty busy so if you have time this week before your section it might be worth contacting NCT or La Leche League to arrange some specialised BF support in the first few days when you get home. Also, do you have a friend who has BF who can come to visit you in hospital??

Anyway - a few things that may help. Ask if the baby can come straight to you after the birth - literally the first few seconds after, and stay with you - for skin-to-skin contact, and probably a bit of rooting around and sucking too which should get things off to a good start. Keep your fluid intake up after the birth - and if you're on an IV drip make sure you're getting drinks too. Don't worry about food so much, but if you can eat make sure it's high protein stuff - chicken, eggs, cheese etc. (You may have to get someone kind to bring in supplies!)

Just let the baby suck as much as they want and don't worry about actual 'milk' - it's just colostrum for the first few days, which is good stuff full of antibodies, but the important thing is for you both to get the hang of it so that when the milk comes in (day 5 for me - owwwwww! I bought some of those boob ice packs from Boots) your baby can get at it. Babies do mostly lose weight in the first few days, the 10% rule is a guide, but if everything else looks OK and you make it clear that you are keen to BF then they should support you with that and not 'make' you offer top-ups which (unless baby is unwell) IMO can be the beginning of the end of BF'ing. Large babies are easier in some ways because although they want more food, they tend to want it a bit less often and have more reserves! It might be worth phoning the GP surgery and asking to speak to whoever will be health visiting you in the first few weeks just to let them know about your concerns ahead of time.

I love my V-shaped pillow - just makes positioning so much easier. Also I love feeding lying down on my side which is good after a section. Try and get as much of the nipple and areola (brown bit) in as possible. Buy some Lansinoh cream for cracked nipples (they will happen, even if the latch is good) and try and get one of the MW's or assistants to watch the baby latch on in hospital. I found that my shoulders used to get very tense, so always make a mental note to relax them at the beginning of each feed.

Good luck - it sounds like you will be great! And there are lots of people on here to support you. Good luck with the birth - I bet you can't wait to meet your new baby!

Hi Abbymeg.

I had DS2 7 months ago, after an elective CS and am still feeding him now, he has never had formula, so it's perfectly possible.

For the first couple of weeks you should expect to feed the baby almost constantly, as this is what establishes your supply.

The baby sucking will release prolactin, which in turn tells your body to make breastmilk. If you top-up instead of letting baby suckle then your body does not get these hormones, so will not make the amount of milk you need and, in short, it's a pretty definitive way to end your chances of exclusive breastfeeding without an awful lot of unnecessary effort and faff.

Skin-to-skin in the first instance is the best thing to do. I'd discuss this on your pre-op appointment with the anaesthetist and your consultant. In a good hospital this will be written on your notes and all care will be taken to ensure that breastfeeding goes well.

Do you know if your hospital has baby friendly status?

A newborn baby's tummy is the size of a small marble, so they need feeding little and often, but as they get bigger, so does their stomach and they can last longer between feeds.

The best thing to do would be to get a breastfeeding counsellor on hand ready to help if you need it, but if your latch is good and you have the right expectations re amount of time feeding then all you'll need is emotional support and a bit of determination.

WRT the diet, I've had 3 CS's, and never had my diet restricted so I don't know why they would have said that. I had a Kebab bought in after my first, a KFC with my second and a MaccyD's with my third!
Good Luck.

Oh, also meant to say, my last DS was 10lb 3oz, size doesn't really come into it too much.

Rosa Thanks - we have a breastfeeding cafe locally that I will visit. I should have gone this week, but I'm a bit immobile now. I had a search for consultants near me (I'm in Leeds) and couldn't find anyone, but I might try some of the national organisations.

smellyeli Thanks for your reply, there's loads of helpful things! My mum will be with me when I come out - she has (exclusively) BF 3 of us and is keen for me to have another go. I've also got a good friend who had a little boy 5 weeks ago and has been through it, but BF is now settling nicely. With regards to 10% - the doctor then didn't give me a choice over the formula; but then I wonder how much of what I was told I could have disputed, but because of my age and inexperience, I just accepted what they told me. I'm going for pre-op today, so I will be asking about feeding and skin-to-skin as quickly after birth as possible; I have also written a mini-essay about BF experience last time and desire to establish it in birth plan.

Thanks again

LilMatchGirl That site is great. Well, new hospital has a certificate of commitment and last hospital has no information. Surprising that! I wondered if post CS advice was outdated - it was 10 years ago, and I've been reading about people eating whatever they want after CS. I was on boiled fish and 3 boiled potatoes for about 3 days! It was odd. I wasn't allowed any fruit or veg because of bloating. The whole experience was shambolic and my consultant apologised to me - though I was never sure why.

Abbeymeg - had emcs in Leeds 3.5yrs ago. Ds had a 20min feed within first 2hrs when I was still in recovery. MW all v. supportive. Ds lost over 10%, but no one was worried - clearly doing OK.

There are some really great NCT bf councillors in Leeds - find their number and get it written down somewhere useful - they will give you advice on the phone and if necessary come and visit you. I recommend getting dp involved to see if the latch looks good for you - so difficult to see yourself!

Also, if you have a local NCT coffee morning group, this is a good option and all very bf friendly (we went when ds was 5 wks and carried on until recently). If you live where I think you might from your name, there is a local group with a Friday morning session that roves around different people's houses.

After cs found that the rugby-ball position was the most comfortable - or lying down, v shaped pillow really helpful.

Good luck!

I think that by going in for an elective will put you in a better starting point than last time as you will have more energy and able to express your wishes better rather than feeling that the advice provided by the hospital is the only option.

I had a EMCS with dd and bf for about a year. DD was 9lbs so just a large baby.

I had skin to skin contact with dd about 30 mins after she was born - mainly because there was waiting around for a trolley to take me to the the post op room.

As soon as I got in the room I put dd to breast and she started rooting straight away and trying to feed. I basically kept putting her to breast every few hours or so til my milk came in four days later. There are also a few different techniques that you can use to encourage the baby to start sucking/swallowing - such as gently stroking down under the chin to the neck.

I had a really good 'hands on' midwife who really helped me to get a good latch and position. I found that to sit up as straight as possible and then get a pillow to get dd to the same height as my nipple and having her parallel to my body. I also found feeding her in the rugby ball position good as it took the pressure off the scar.

As I was also on painkillers for the first few days dd was also still v sleepy to I kept her in a nappy only when feeding her to try and wake her up a bit.

HTH's?

mistlethrush thanks - I will get the NCT number. I've already met my health visitor (they're very keen around here!) and she's told me about a couple of groups I can try for support. Do you have to be a member of the NCT to go to coffee mornings or can anyone join in?

Missisboot the choice to have an elective was mainly for that reason - I wanted to be in the best position afterwards to feed; I didn't want to chance the same things happening again. Given my vastness now, my MW thinks I've made the right decision as he's going to be big! It all helps - thank you for replying.

One thing, from what missisboot said - what happens when you are feeding solidly for 9 or more hours - is that normal? Do I grin and bear it or is something going wrong? I found with DD that she fed ( probably sucked, possibly not fed) solidly for hours on end and screamed blue murder if I stopped. Other BFers on ward were feeding for an hour and putting their babies down for a couple, then feeding again. Mine was relentless. If this is to be expected, then that's fine, but I still wonder if I was doing something wrong.

It's bizarre writing about DD as a baby given that she starts secondary school in September! So long ago..!

Sorry, should have been clear missisboot - when you said that you put DD to the breast every few hours.

I found I couldn't put DD down. The MW even had a go when DP came to visit and I gave her to him for two minutes whilst I went to the loo (I'd been feeding all day, about 8 hours that time) and MW told him off - she said someone feed that baby - it's starving! She never bothered to help though!

Constant feeding and suckling is normal, infact it will be your lo's favourite past time for a few weeks. In the very early days this is a good thing as it will boost and establish your milk supply. It can be tiring and relentless, but in the long run it is worth it. Just make sure you eat and drink a lot too. It's not essential for your supply, just your grumbling belly and your sanity! Your job is to look after the lo and your dp's job is to look after you and the rest of the household.

The csection won't delay your milk, it's when the placenta leaves the body that a hormone is released to trigger milk production. Regardless of delivery people's milk comes in at different times.

One thing to keep an eye out for is nipple thrush. As you will have routine IV antibiotics after the surgery, you are at a higher risk of nipple thrush. It can be painful, but if caught and treated early it is easy to get rid of and you don't need to stop bf. Read up on the symptoms and keep them in mind, just incase.

If you find out in advance the breast feeding counselors in your area (NCT and Le Leche League) and speak to them before the birth, they will give you some pointers and also it will help if you have started a realtionship with them if you need them once your lo has arrived.

Good luck, you can do it

I think that probably she would have been sucking rather than feeding if she was at the breast for 9 hours constantly. IMO it's not 'normal' but then each baby is different.

DD also sucked for comfort - although that was when she was a few weeks older. I guess you'll have to wait and see. You can look at see if they are actually swallowing or just sucking and then try and get them gently off the breast. If they want to comfort suck then I guess it up to you depending on how comfortable it is or use a dummy.

I too would have an elective if I had another one so that I could be in a better starting position - I felt like I'd been through the mill and back and could barely string a sentence together let alone think about how to feed my baby.

Hi abbymeg

I had an emergency CS with ds1 5 months ago - and he is still only breast fed. am convinced that one of the things that helped get us started was my husband went and dragged in the nice midwife i'd had the day before while i was recovering to get skin to skin contact started and to get ds feeding. - am not sure whether they would have done this otherwise even though i had stated all the way through that i wanted this. perhaps you could let birth partner/support know that they might have to be proactive at stating your wishes.

I hope the cs goes well - for me it wasn't too traumatic - although was too relutanct to ring for a midwife afterward and am sure that i didn't help myself by trying to do everything myself - in hindsight i should have asked for help getting ds from cot/changing nappies etc... that's what they're there for!

I wasn't aware of any restictions on my diet/fluids and only spent 2 nights in hosp after op (my choice).

good luck!

Mississboot, sorry, but you're wrong. It IS perfectly normal to be feeding that long in the first few days/during growth spurts.

The signals your body sends/receives in the first few days wrt milk production is what builds up your supply to create that much milk until the next growth spurt.

Ooh see the advice I got on this thread a month ago! mumsnet.com/Talk?topicid=breast_and_bottle_feeding&threadid=635640-Anyone-got-experience-of-BF-a-lar ge-newborn-98th-centile#12941370

hi!

another big baby grower here

DD1 was 10lb4 and fed no problem straight away until I went back to work at 8months

DD2 was 11lb1 and was a nightmare but that was because I was doing it wrong and thought I would be able to go straight back to it no problem as I'd managed with DD1

DD3 was 9lb14 and after a few weeks feeds fine and she's now 18wks

please just keep asking questions and asking for help and trying all different positions to find one thats best for you - the staff are there to help and will hopefully make it as easy for you as possible

good luck

I did everything myself - staff too busy to be able to do everything.

Ds would want feeding every 1.5hrs ish at that stage - rest of the time he was happy to be cuddled, although he didn't want to be put down.

NCT coffee mornings - anyone can join.

I think the website has some numbers to call for different groups. Headingley group good.

Abbey - My DS was also large (although not as big as yours ) I think the rules have changed now - MW's are actually not allowed to recommend topping up with formula - they are supposed to encourage BF. Having said this, most of the MW's on my ward were great with helping feeding, but one did say 'have you considered topping him up with formula? He's a big boy, your milk might not be enough to sustain him' Thankfully I'd done some research, so I refused this, even though DS screamed that whole night.
I would say expect frequent feeding - As someone has already pointed out, this establishes your supply, and also baby only has a tiny tum so needs to stock up often.
Good luck with bf. I'm sure you'll be fine - attitudes are really changing now, so you should be able to get more support than you did last time.

But to have baby constantly at the breast for 9 hours without a break?

I know that you do feel like you are constantly feeding for the first few weeks - ie an hour long feed every two hours or so, but to feed for 9 hours will be exhausting for a new mum and runs the risk of putting them off feeding. I don't think there is anything wrong in 'managing' breastfeeding so that it works for both the mum and baby iyswim.

There is everything wrong with telling someone to restrict feeding, which is in effect, what you are saying.

No, I'm not telling anyone to restrict feeding - its about recognising when the baby is feeding and when they are comfort sucking and for some mums this may be too exhausting and put them off feeding so why not manage it in a different way that will still have the same outcome?

But, it won't necessarily have the same outcome.
At the beginning you should let baby suckle whenever it wants. It doesn't have to be feeding to stimulate the demand.

MissisBoot - comfort sucking is important to the baby, and to breastfeeding. It is important to the relationship the mother is building with the baby.

There will be times the mother has to put her baby down to do something else, but in the main, especially at first, 'managing' breastfeeding is to undermine it.

The mother needs support and care and help with everything else she needs to do, of course she does...and some understanding of what is normal, what does not last, and the chance to sleep and to share the care of the baby with others. But this false distinction between comfort sucking and feeding is not helpful.

9 hours at the breast will be 9 hours of on-and-off, not continuous, feeding. It is still normal for a new baby to want to be 'there' a lot of the time, and it need not be exhausting.

But the OP said that her baby was feeding constantly for 9 hours not 9 hours on and off which you would expect.

I never said that comfort sucking isn't important to the baby or the mother.

AbbyMeg - I have had two babies by caesarian - the second was planned. You can eat four hours after surgery - toast and tea is traditional. It's bollocks to say 'oooh no food for you' just because the midwives don't want to risk you puking on the bed and them having to change it. My personal recommendation is to take some biscuits with you and put them in your locker or get your DH to bring something in.

Your baby will suck and suck for hours straight for the first couple of days. My DH is now four months and did that for three days and yes it's knackering but once you get your milk supply established it's fine.

I'm feeding a toddler (30lbs) and four month old (22lbs) so it can be done.

Good luck!