Bfing in first 24 hours

[francesrivis]

Hi, I'm 33 wks pg with 2nd DC and would like some advice on bfing in the first 24 hours. A bit of background - my dd had breathing problems when she was born and had to go to special care (thankfully only for 4 hours) so I was not able to feed her immediately after birth. When we were reunited it was past midnight, and I'm ashamed to say I was so exhausted and overwhelmed the idea of feeding her didn't even occur to me. It wasn't until the next morning, some 12 hours after birth, that she had her first feed. I fed her several times that day, but in the evening she began to scream and did so solidly for five hours, despite being put to the breast. Eventually one of the midwives decided she was hungry and gave her a formula top up. Although all the books - and everything I've read on here - say this is wrong, I'm convinced it was the right thing to do as it was the only thing which would settle her. However, I would like to avoid it this time round if possible, so my questions are a) how often should the baby be put to the breast in the first 24 hours? and b) should the baby be woken for feeds even if it doesn't appear to want them? TIA

You'll have the experts along in a minute I'm sure, but just wanted to say I also felt so tired in the first few hours, I didn't feed much. Although my LO slept lots anyway, which I think they are programmed to do so you both have some recovery so don't feel too bad.

I read that getting baby to the breast within the first 20 mins can help establish BF'ing. So I managed to get him straight to the breast in theatre, and again in the recovery room so he had a couple of feeds straight off but after that I was so exhausted it was a few hours later a midwife gave him some SMA whilst I was sleeping and he was crying - he promptly threw this up along with the colostrum he got from me so I felt very disappointed and a bit guilty about that. So just wanted to say check any formula you do allow to be given for it's palatability, or take your own if you think you might need it (hopefully you won't).

Anyway I'm awaiting your replies for more info too, as although later on they let you know very clearly when they want feeding, I'm also unsure how much to let sleeping babies lie in that first 24hrs without letting colostrum go to waste!

frances, the best start to breastfeeding is to hold your baby close for as much of the time as is practicable, skin to skin. This will ensure (in most cases) that the baby has a gentle and physiological intro to feeding. It is entirely possible that the early separation your baby had (necessary as it was for health)interrupted this natural progression and led to her being distressed and unsettled a little later - I seriously doubt she was 'hungry' and BOO to the midwife that gave her formula....yes, it was important for your baby to be settled and calm, but this is not the right way to do it, sorry

It might have been better to help you express a little colostrum by hand, and for this to be given to your baby, and/or for your baby to be tucked up close to you (tucking her up close to you might have been tried, and this may have needed to be tried again, alongside giving some expressed colostrum).

When babies and mothers are kept close together this way, there's normally no question of wondering if the baby needs to be woken for feeds - the baby may sleep a lot in those first 24 hours, but he/she will feed as well. It's the 'normal' practice of putting a baby into a crib next to the bed that disturbs what should happen and which can lead to problems

Hope this helps! Good hospitals know all this, and the better ones actually put it into practice

Aha, that's the lady you need!

Tik Tok, can I just ask for myself (sorry Frances!) the best way to keep LO close after C/S? After my natural birth I could keep him on a pillow on my tummy whilst I slept but wondered if a rugby hold will be better or more bearable, if you know, thanks.

I was in the same boat, dd went to special care for two hours and i was so shattered that it took me a while to click that maybe i should try feeding her! it took a while, she would do tiny bits at a time, then a lovely midwife came in and lay me down on my side and tucked dd into me, and we were off - so was born a wonderful co-sleeping relationship.

I so agree with everything tiktok says. i had been on a bf course that said you should sit upright in a straight backed chair and hold your baby square on to you. well in my case this was bollocks and worse upsetting because it just didn't work. once i was lying down we were fine and then once we were off i could feed any which way.

the thing about being hungry i agree is a bit fishy. i read that babies have plenty of store to last them a good day or two if need be while they get the hang of bfing...

Good luck

With my last 2 babies both had a feed at birth one before the cord was cut. I have put them to the breast at least every 2 hours first 3 days. Yes I would wake them for a feed first day or so. DD1 was very jaundiced at birth and too sleepy to feed and we couldn't wake her it made BFing very hard to start with. DD2 and 3 were different, eager to feed and stuck to me 24/7 at first.

I didn't wake either DS1 or 2 for feeds, but there was no need to. I just fed them every time they whimpered, and did so for the first few months. Neither had jaundice or anything though which might mean that you would wake them for feeds etc.

Loster - after my CS I was able to sleep with my DD on my chest inside my nightie (me propped up on a couple of pillows and I folded a blanket over my tum to protect it in case she kicked). TBH the painkillers were so fab it wasn't until 24 hours were up that I had any pain anyway. I was knackered and felt very ill after she was born so was not that bothered about trying to feed (andshe was sleepy too). I just figured if I left her in there she would help herself, which incredibly after about 12 hours she did!

With DD1 I had to wake for feeds as she was so sleepy she would sleep for 6 hours or more which isn't good in a newborn. My BFing help consisted of a MW or whoever trying to thrust my nipple in a sleeping babies mouth, even nappy changes and baths didn't wake her. I had to express for her and got off to a very shaky start.

Next 2 have been different, I agree skin to skin they will root and feed with very little effort, with very new babies I would offer a breast every 2 hours unless they were asleep.

Mrs Happy, thanks! Will try the same.

Lotster, just to add to the post from MrsHappy - there is no need for a CS baby to miss out on skin to skin immediately after birth. The convention is to wrap the baby up like a parcel and then show him/her to mum who is still flat on her back on the theatre table...no need for this, but you will have to ask in advance for something different. The baby does not need wrapping up; he can be covered in a shawl or blanket and still be skin to skin with you, and you will need help and support to sit up a little so you can offer the breast as you are stitched up.

Many thanks for the responses. Hopefully all will be well this time round.

thanks TikTok.

Good luck Frances.

anyone had big baby with section am due in 6 weeks with third elec c section desperate to breast feed properly anyone with advice or similar experience?

I am far from being an expert but have just gone through a relevant experience. My son was born 12 days ago by planned CS; however, the CS was moved forward for medical reasons so he was 3 weeks early. I had been told feeding in theatre wasn't possible, but I did feed him in the recovery room, with the help of the midwives present (to the extent of them actually shoving the nipple in - I know some people find this intrusive but TBH I was willing to do anything to get feeding going). This was lucky because I was then told his blood sugar was low and he would have to go to special care for extra feeding. He went off to special care that afternoon and I didn't get him back till the next morning I only got him back when I did because I pestered endlessly till someone took me round to special care and I got him discharged - basically, he was fine but they were (perhaps understandably) busy dealing with really ill babies and hadn't got around to discharging him. I then set about feeding again ASAP, and was again lucky enough to grab the attention of a breastfeeding support worker who was with another mum on the ward - I kind of flagged her down like a taxi and she came over and helped me do skin-to-skin. DS really liked that and also seemed to know what he was doing, unlike me, so was able to feed after that, and despite being told that he might still need more top-ups, he never did and carried on BFing.

The advice I'd extract from this for you is:

• ask/push to be able to feed DC2 in recovery
• ask for whatever breastfeeding support people there are to come and see you ASAP
• if DC2 needs to go to special care, insist on them being cup fed not bottle fed

For all this, the squeaky wheel gets the oil so keep asking for all this stuff till you have made a thorough nuisance of yourself, or make sure you have partner or someone else there with you who will do this if you are too tired. Also try to give the impression that you will wreak vengeance/complain soundly if your wishes are not followed. The midwives on my ward were largely lovely but I did get the impression that they would often take the route of least resistance, so you need to project the image that it will be less trouble for them in the long run to do it your way. Personally I'm convinced it was BFing in recovery that enabled DS to feed so well when he came back from special care, so it's well worth pushing for help with that. Hopefully it will all be more straightforward for you this time round! Good luck.

Ticklytum: I had ECMS with an epidural for a rather big baby, after 24 hrs failed induction. Despite APGARS of 9 and 9 DS had to go to special care for antibiotics while I was stitched etc. About 4 hrs after the section one of the midwives came to say that the baby unit was asking if they could give DS a bottle as he was ravenous.
I told them i was very keen to breast feed and could they arrange it somehow? As DS was not needing any care but iv abx they brought him to me on the ward each time he seemed hungry and a lovely midwife helped me latch him on for the first 2-3 feeds, before he was discharged from the special care unit. I didnt really manage to get skin to skin and had to have a lot of help at first but hes still 98th centile and exclusively BF (barring meds) 3 months on.

My advice for BF after CS - make sure staff know in advance that you want to BF, try and get some skin to skin contact as soon as you feel well enough - on operating table or in recovery if possible, try lying down or rugby ball positions, take pain meds regularly so you are as mobile/comfy as possible for the first few days, take good care of your wound and make completely shameless use of any midwives, breastfeeding advisors and helpers around to help you position yourself and the baby while you are still uncomfortable.

And dont stress at any stage that it's not perfect - take each feed and problem as it comes, despite less than ideal starts its still possible to build up a good breastfeeding relationship, and even if you dont suceed in breastfeeding for as long as you want every feed you get into your baby helps.

Good luck with the new arrival!

A girl in our LLL group had a planned cs with her 3rd and asked for skin to skin contact immediately and was given it. Baby was never taken away from her - obviously a different story if there are any problems but I think if you ask in advance and make sure they know you want to bf they will do their best to facilitate it. Also, not sure if anyone else has seen/heard of these but I came across them the other day - caesarian belts.
here They look like a good idea - anyone tried one before?

With my dd i had a retained placenta that wouldn't budge, i wasn't even passed her until she was half an hour old which was when i first tried to feed her to help maybe deliver the placenta, but she wouldn't feed. I was then taken to theatre to have it removed after an hour and a half.. another hour and a half i was out of theatre minus the placenta thankgod and reunited with my dd who still didn't feed. Luckily for me a fantastic mw tried to help me get her latched on but my dd was trying but just wouldn't. This mw told me it didn't matter if she didn't feed atall in the first 24 hours. Thankgod she told me that as over night when she went off shift a mw kept telling me 'if she doesn't feed soon we'll have to give her some formula' it took all my knackered willpower to stick to my guns overnight to wait till the morning. The 'pro-breastfeeding mw with the correct information' came back on duty in the morning helped me try and feed her over and over until suddenly my dd brought up a load of mucus. She then fed beautifully and i carried on breastfeeding her until she was nearly 13 months old. One thing that i did do was keep her in bed with me all night, maybe that helped that i kept her close. She fed every couple of hours when she started to feed. So it doesn't matter if a baby doesn't feed in the first 24 hours my dd never even lost any of her birth weight.

My advice would be stick to your guns about breastfeeding and ask for as much help as you need, request to see a breastfeeding counsellor too. In my area they were actually going to transfer us from the main hospital to a birthing centre where they had more time to support breastfeeding mothers than in the main hospital. This was offered to me the morning after i had my dd, i was told i could stay there until we had breastfeeding well established. It sounded great, we were going to have a double room where my df could stay aswell. (Although my dd then had to then go under light therapy so we never went) so the support is out there if you push for it.