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Infant feeding

Get advice and support with infant feeding from other users here.

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Original poster

Newborns and formula

32 replies

plantsitter · 24/01/2009 12:43

I'm 38+5 weeks pregnant and have got gestational diabetes which is pretty much completely under control with diet. I'm planning a home birth with approval from my diabetic midwife.

However, one of the things she told me to do once the baby is born is put her straight on the breast and then feed her every 2 hours for 24hrs. Obviously this is fine in theory as I am extremely keen to breastfeed.

The only thing I'm slightly concerned about is if it doesn't work as smoothly as that - if I find it difficult to breast feed for example. I was planning to have some formula in the house as its important the baby's blood sugar does not fall too low but will this have long term implications on breast feeding assuming I am able to eventually?

The alternative is to go to hospital for 24h after the birth so she can be monitored every 2 hours. I'd rather not do this but it's preferable to not being able to breastfeed at all (or obviously the baby getting into trouble, but that goes without saying).

I know the advice is not to give breastfed babies any formula but what can the consequences be?

OP posts:

kidcreoleandthecoconuts · 24/01/2009 12:51

Personally I would have formula in the house to be used as a last resort ie. if babies BM drops and bf takes time to master.
Like you say the alternative is a hospital stay which you do not want. If you end up going to hospital there is more chance of having other interventions like drips etc.

Hopefully someone will advise you how a bottle could effect bf. prob not good for supply but as long as you try to put babe to breast regularly I cant see a problem.

Grendle · 24/01/2009 12:51

Sorry this won't answer your question directly, but have you thought about the option of hand expressing? Colostrum can easily be hand expressed, if necessary directly into a baby's mouth. The quantities newborns need in the first couple of days are tiny, as their stomach is the size of a small marble initially.

Some mums with diabetes prepare in advance by hand expressing directly into sterile syringes in the last few weeks of pregnancy and freezing them, so that they have some available if needed.

Have you chatted it all over with a bf expert? It might be a good idea to call the national bf helpline on 0844 20 909 20 to talk your plans through in advance.

Hope you have a great homebirth .

Original poster

plantsitter · 24/01/2009 12:56

Fabulous advice thank you - don't know why I didn't think of expressing. I will call that number right now (and I think I will get some formula just in case as well, kidcreole).

OP posts:

StarlightMcKenzie · 24/01/2009 13:00

This reply has been deleted

Message withdrawn

Original poster

plantsitter · 24/01/2009 13:09

Starlight thanks for your message. I'd welcome advice from experts on here but in any case I think I've decided to call the helpline for a chat. It's stories such as yours (where your newborn just didn't feel like eating) that make me a bit worried about the 'clockwork' nature of the advice.

I suppose that, as usual, not panicking about this and getting as much info in advance instead is the way to go.

OP posts:

idontbelieveit · 24/01/2009 13:18

Hi plantsitter, have you thought about trying to express some milk now before baby arrives? you can freeze it for up to 3 months and offer it by cup, syringe or spoon if you're worried that she's not getting enough or her latch isn't as good as it could be, you can also keep expressing between her feeds and top her up with breast milk. She will literally only need a few ml per feed in the first couple of days. Good luck, hope you get your HB.

TheProvincialLady · 24/01/2009 15:42

If you conyact the LLL they have a leaflet on expressing and storing colostrum during pregnancy.

HeathersMummy · 24/01/2009 17:17

Hi plantsitter. My DS1 was born last month at 38 weeks - I was induced due to gestational diabetes. I chose to FF, so a bit different from yourself, but the hospital stressed that the baby HAD to be fed every 3 hours. Unfortunately, my baby wasn't really up for that - he wanted to feed every 4 hours - so it meant force feeding him. A former SCBU nurse who was now the charge midwife showed me how to force feed him and I had to do this for the first 24 hours in order that his BMs stayed stable.
I can't help you with your BF question, but I just wanted to prepare you for perhaps having to force feed your baby - it's not pleasant for the baby, and if you're anything like me you'll get really upset at it, but in the long run it's best for their health I guess.

Original poster

plantsitter · 24/01/2009 17:30

Hi Heathersmummy. Sorry to hear about having to forcefeed the baby. I'm hoping it won't come to that, but after I'd posted here I had a chat with my sister who lives close by. She suggested feeding the baby with a spoon if she won't take the breast so I suppose that's similar. I think it pretty much depends on the first BM reading - if it is bad we will be in hospital.

I hope you don't mind me asking but did you use insulin for your GD? And what were your BMs during labour? Am trying to prepare myself for all eventualities since the midwife did not mention force feeding (though she was quite clear about waking the baby to feed).

OP posts:

foxytocin · 24/01/2009 17:32

With the best intentions in the world, HM, i don't think your hospital got it right. The instructions you were given sound like a one size fits all method which will stress some mothers and babies without good reason.

It would be better if mums and babies were treated like individuals as many babies born to mums with gest diabetes get on fine without 'force feeding'.

Great idea to speak to a bfc. Also to keep your baby skin to skin day and night, know hunger cues and possibly keep a feed log.

when you speak to the bfc, ensure you talk about what constitutes a 'feed' as this can be confusing with a first time mum.

foxytocin · 24/01/2009 17:39

feed log

skin to skin

Original poster

plantsitter · 24/01/2009 17:48

Feed Log is a great idea - thanks for that. The midwife mentioned the skin to skin to thing yesterday and I'm definitely planning to do that. couldn't get through to the NCT today but I will try later - in the meantime my sister (mum of 2) has said fairly similar things to you. I suppose the fear is that she does have low blood sugar and I don't recognise the symptoms.

OP posts:

foxytocin · 24/01/2009 17:54

i think with low blood sugar a baby will sleep more and be harder to rouse so the importance of feeding often and having it verified that your baby is feeding effectively straight after birth. by planning a home birth you are already making that more likely to occur.

if you go here you will find another helpline to call.

Original poster

plantsitter · 24/01/2009 17:56

Thank you Foxy this is v helpful.

OP posts:

christiana · 24/01/2009 17:57

Message withdrawn

foxytocin · 24/01/2009 18:01

hand expressing colostrum

chloejessmeg · 24/01/2009 18:02

Sorry, no advice but I would say if you are going to have some formula, just get one of those little cartons, which would be more than enough for an emergency feed. If you get a whole tub of powder you have to use it within weeks and might end up using it more than you need, to save it going in the bin. And also a carton is about 50p so not as much to spend out on if BF does work perfectly and you don't need it.

Really hope it goes well for you. I agree about expressing some now, before baby is born, so you have a bit of a supply (also might help pass some time and help you feel like you are doing something).

Original poster

plantsitter · 24/01/2009 18:10

I do take your point Christiana and it's something I've thought about loads. I'm prepared to go to hospital straight away if we need to, but I honestly don't think it's the best place for her to be born. Hospitals stress me out and I'm worried about the intervention spiralling as they do tend to treat everyone with a certain label in the same way. I was 1 point over on my GTT results and I have kept my BMs in the target range since and the midwives seem happy to let me have a home birth. Stress levels have an effect on blood sugar levels too.

That's not to say I don't think hospitals do great things or that I won't be the first one there if things start to go wrong!

Thanks for all the advice on this thread.

OP posts:

Pannacotta · 24/01/2009 18:24

One thing I would say is that it seems that it's often easier to establish breastfeeding after a home birth.
I had both DSs at home and had no problems at all feeding them from the start, whereas all my friends has hospital births and many of them found it quite hard to establish breestfeeding.
I don't know anything about diabetes but if you are worried about feeding in the early days, lots of skin to skin and co-sleeping with your newborn will both help, nicer than stressing over a strict schedule too (though I appreciate you need to keep a careful eye on your baby).

CantSleepWontSleep · 24/01/2009 18:32

Try hand expressing and freezing some colostrum beforehand. This was my plan as I also had gd, but I'm a rubbish expresser, so a friend donated some of her bm to me, just in case I needed it. Happily I didn't, and in fact no-one in the hospital was very bothered about the gd afterwards, and ds only got his blood sugar tested at all because I kept reminding them that he was supposed to!

tittybangbang · 24/01/2009 18:38

I had gd and gave birth to a 10lbs 12oz baby at home. BF from the start - no problems at all. I never needed to use formula.

I know some bf counsellors advise you can express colostrum while you are pregnant (towards the end of the pregnancy) to supplement with if necessary in the hours after birth.

Also agree that you are more likely to estalish bf after a homebirth, but keep all the numbers of local bf counsellors to hand and call them straight away if you run into problems.

Good luck!

NotQuiteCockney · 24/01/2009 18:50

Don't think anyone else has covered this - but learn to cup feed. Won't help with forcefeeding, if it comes to that, but new babies can be cup fed, which avoids (reduces the risk of?) nipple confusion, which is a common (not inevitable) problem if you introduce a bottle in the first days/weeks.

Sachertorte · 24/01/2009 20:20

Just a note o caution re cup feeding.. take it very very slowly... I was told to cup feed (basically force feed) very fast and baby never really took to bf after, partly, I´m sure because cup feeding was faster and easier..

maygirl · 25/01/2009 23:40

Here's a link to the Babyfriendly best practice guidelines for hypoglycaemia of the newborn.

www.babyfriendly.org.uk/pdfs/hypo_policy.pdf

It mentions that a blood glucose measurement taken within the first 3 hours of birth are not informative, as are indicative of mums blood glucose level at time of birth.

Has useful advice I think on what to do if there is an issue with low blood glucose, in a way that best supports BF.

Hope everything goes well

Qally · 26/01/2009 10:14

Hand expressing colostrom is easy, easy easy. You just collect with a syringe, then gently express with a finger in the baby's mouth so they associate sucking & food. Every suck gets rewarded with a little colostrom. (If only milk expression were that easy...)

Two hourly is important with a newborn anyway, in my experience. Demand feeding, with a baby with problems, can easily escalate into their being too weak to wake up hungry.

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