BFC Advice please - Newborn low blood sugar

[Hulla]

I'll try to keep this short and would be grateful if anyone has any advice or experience they can share.

My dsis had her baby yesterday, 3 weeks early, 6lb 10oz. She had gestational diabetes and ds was born with low blood sugar. She was taken to theatre for stitching and the midwife gave him a bottle of formula.

When she came out of theatre and was on the ward, ds woke to feed, she used the buzzer because she didn't know how to bf and asked the midwife who snapped at her and took her ds away to ff.

She has been told that they will need to bottle feed him because he needs regular feeds because his blood sugar is low. The will "let [her] try breastfeeding" today.

They also planned to ff him in the night and let her sleep. I haven't yet heard how that went.

I asked if she could suckle him even if he still had to be given formula top ups for his blood sugars but my dmum snapped at me about putting pressure on my dsis.

Is this right? I know that what is best for lo is the most important thing but I thought they might have syringe fed him (I did this with dd when I struggled with her latch, syringe fed ebm). I don't know if there is anything I can do but I feel really sad because I know she wanted to bf.

He was kept in HDU last night because of his blood sugar.

I have to go out now, I can check replies from my phone but I can't post.

Thanks to anyone who reads this.

I can´t see why she can´t express as then the baby could be fed at regular times and the amount given would be known.
But it needs sorting soon!
It disgusts me that she wants to bf but isn´t being allowed.
There´s no medical reason that the baby can´t have bmilk,is there?

If not, is there anyone with her who can stop the baby being ff?

Just had a quickgoogle & it says the best is for the baby to be breast fed as often as they want to stabilize blood sugar!

I won't comment on the reasons for formula being given as I'm not qualified in that area, but my dd needed to be given some formula when she was born and for the first 24 hours or so. We were told about this in advance, we were asked what type of formula we wanted to use. They asked if I wanted to breastfeed and because I did the formula was given in a cup. I was also given a lot of help with the breastfeeding.
I agree that if she intends to breastfeed she needs some help and advice as quickly as possible or breastfeeding will be harder to establish. If she doesn't feel up to asking for this help it might be a good idea for someone to go to the hospital and help her discuss it with a midwife.

Forgot to say, if she wants to breastfeed her baby no one can stop her doing this. The midwife might have said she needed the formula but at the end of the day its her baby and she shouldn't feel that she needs to ask to breastfeed, although I appreciate that its not that straightforward if she needs help with it.

Thanks for posting, I have just got back. She has still had no help bf and so hasn't put baby to her breast at all. I think that might be it. She said the morning midwife had written in her notes for the afternoon midwife to try.

Dsis said that she didn't expect to have a problem starting feeding after 3 days but I expect there will be. She still thinks its possible but has said if she "can't bf" then she will continue with the bottles.

I feel very said but I can't say much to her because I had a huge row with my mum after I left this morning and told me this was a medical issue and I was putting pressure on dsis. I feel sick that she would think that.

I do plan to write to the hospital but I cannot act on behalf of my sister on this. I am so incredibly sad.

Thanks you for your replies.

Here's a link to the Babyfriendly best practice guidelines for hypoglycaemia of the newborn. Maybe hospital should take a look. I'm sad too

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

I'm sure your mum is just trying to look out for your sister but you know what your motives are. Helping her make contact with people that can help her establish BFing is NOT putting pressure on her, it is enabling her choice. It sounds like she isn't receiving the support she needs right now, have you considered contacting the BFC attached to her hospital? Also, the LLL might be worth a call? 0845 120 2918 Might have some advice for you or be able to help your Dsis.

I too hope she has a lovely midwife on her return home (as I did) that will help her establish BFing. It's not too late if that's what she wants to do

Good morning, thanks for these replies.

Dsis text me first thing this morning saying that she accepts that she'll probably only be able to bottle feed now but she is sad that she's not even had a chance to bf.

I asked if sh still wanted to try (in as pressure-free manner as possible) and she said she would. My dmum has still managed to turn this into me applying pressure but I have avoided another row).

I have offered to go into the hospital but she doesn't want me to as she hopes to be discharged today.

bedlambeast biological nurturing was what finally got my dd to latch. It really saved our bf relationship. I have replied to her text saying I'll see her at home but in the meantime to have lots of skin to skin cuddles with the baby. She was with me when I used biological nurturing with dd so I hope she remembers.

Maybe I should call the hospital and ask to speak to the midwife and ask her to help? My mum has got me so paraniod I don't know how much help is enough or too much. Hairymelons thanks for posting the LLL number, I will give them a call when its a more reasonable hour and see what they can suggest.

maygirl thats fantastic, thank you. I fully intend to write to the hospital and enquire about its policy and I will refer to that document. I have just checked and the hospital has stage 2 accreditation.

Thanks hoochie, I hope she can get established. What worries me is that they might recommend no more bottles and I think her dh will object because he enjoys bottle feeding his ds (he was against bf to start with, now he's happy for her to mix feed).

I saw her at the hospital last night was feeding dd and my sis looked at me and said "oh imagine when we're at mums and you're feeding babyhulla and I'm feeding ds, how lovely will that be?". I felt so sad that the hospital have given her the impression that its fine to wait 3 days before putting baby to the breast and to give him a bottle instead of a cup or syringe. I am really angry but I can only say this on here and to my dh. Everyone else just keeps saying it doesn't matter. The fact that she's text me this morning saying she feels sad tells me it does matter!

She's asked me not to come in. The midwife is going to help her express later and told her not to worry as her milk doesn't come in until tomorrow.

I will definately complain, I am appalled at the crap advice from the midwives - left 3 dys before nyone shows her how to express?? 4 days before putting baby anywhere near her breasts?

Dsis has just text saying she's happy to bottle feed if she can't bf. I told her she hasn't been given the chance, its not that she can't. I think she's given up already.

Thanks to everyone for posting replies, I will update the post when I get a response from the hospital?

don't know what the ? is about, sorry.

I´m really confused about this.
Unless there is a medical reason,why are the midwives not just giving your sister her baby to feed?
Are they in seperate areas so that your sister cannot get easy access to her baby?
If nothing else,she should be given the opportunity to express.
My baby was born before 30weeks & I expressed the first day to feed.

It sounds like twaddle to me, but then we don't know all the issues. However, it only takes 5ml of breastmilk to raise and stabilise bloodsugar, but 20ml of formula, because formula is harder to digest and not as "accessible" to the neonatal digestive system.

I refer you to a Diabetes link; http://www.homebirth.org.uk/diabetesdebbie.htmhere.

Oh the shame, my link is all wonky, I'll try again!

Another update, I was visiting relatives in another city yesterday so this is all from my mum last night.
my sister managed to express at the hospital yesterday afternoon and give it to ds by syringe. My mum then told me that she doesn't actually want to bf just give ds her milk by bottle so mum has bought her a pump.

I didn't say anything because I can't face another row with my mum and it seemed the decision had been made. I was due to travel home this morning but my sister has called and said that she thought I was going to help her feed ds. She has tried to latch him on and he has sucked a bit but she doesn't know what she's doing.

I don't know what to do. I am going to go round and show her the biological nurturing positions and I'll have to call LLL for advice on the bottle feeding. I don't know if my sister will see a bfc face to face but I am out of my depth with actually helping her.

GreenMonkies thanks so much for that link, I'll definately use it in my letter. I can't believe that she could have used less bm to achieve to stabilise his blood sugar. The more I find out the more angry I feel. I have found out that he didn't go to special care because he needed special care but because it was easier to keep an eye on him from there.

diddl the only time they have been separated is when dsis was in theatre for an hour and a half being stitched and when they decided to move her ds into special care for bottle feeding and monitoring of his blood sugar. He was born at 37 weeks so nowhere near as early as your dc.

Dsis seems to think that the midwives have just been too busy.

although her midwife did admitt that she shouldn't have given her ds a bottle because she wanted to bf, they should have used a cup.

This is good news Hulla, with your support she may manage it even after this terrible start. Try not to talk to your mum about it (I am guessing your mum didn't bf?) and that way you'll avoid further arguments.

Usually expressed milk is given by cup to avoid "nipple" confusion.
But if your sil doesn´t want to bf, then I can´t see tha that would be too much of a problem that the baby has had a bottle.
But if she wants to give breast milk-why not bfeed-no sterilising!!
But, glad things seem to be turning around.
She´s probably very overwhelmed & getting different advice from everyone.

A baby in special care can be overwhelming & it can sometimes seem almost impossible to think for yourself, let alone make a decision or make your wishes known!

I have just visited and he latched on himself after lying him on dsis bare chest with him just in a nappy. He didn't stay on long, her breasts are really engorged.

She has told me that when she asked to bf at the hospital the midwife replied "well he's bottle fed for now" and so she feels she got no choice. They didn't show her how to hand-express so she had to wait 2 hours to use the breast pump. She had 45 mins with it and when she asked for it again later they never brought it. They never helped her try to latch her ds on.

Her midwife has visited this morning and told her that she will help her latch him on tomorrow (he was asleep today) and that she can mix feed.

Dsis is realistic, she was thrilled that he latched on himself (it was amazing to watch in such a tiny baby ) but if it doesn't work she isn't going to feel guilty. She hasn't exactly had the best start.

I suggested we find a bfc tomorrow and see if they can help but she doesn't want to. She has said that she will call LLL today but if they tell her to cut out all bottles in order to bf then she'll have to give up because she doesn't have enough confidence in her ability to bf to stop giving him bottles.

My mum is not talking to me because dsis asked me to help bf and I went round. So argument avoided! I am heading back home today and won't see them for at least a week.

My mum did bf my youngest brother and ff 3 of us (because we were preemie and she couldn't bf). She actually hated bf in the end I think. She thinks it made db a clingy baby and it was tiring. She fed him until he was 10 months. And besides which, its made no difference to his health v the health of the 3 of us who had formula so theres no point in bf anyway.

I actually emailed my mum a copy of the leaflet that was linked on here a few weeks ago - BF for Grandparents (or words to that effect) because I didn't want her giving my sister incorrect information and undermining her bf. Looks like she didn't read it.

So thank you so much everyone. Like I said, I will update with my complaint to the hospital and let you know how dsis gets on. I don't think there is much else I can do.