Can anyone help me with breastfeeding after a section? Baby on neonatal unit

[daisygirlmac]

Hi, I had my lovely boy very early Monday morning and he got whisked straight down to neonatal from theatre after an emergency section. He was term plus 5 and almost 10 pounds so absolutely not premature but he's very sleepy and unresponsive, oxygen etc wasn't great and he was struggling to breathe. He's still not woken up properly and is quite sicky even though he's just on clear IV fluids at the moment.

The doctor is really keen for me to express some milk but I've got nothing - any tips?? I know it can take time after a section and I know I need to keep persevering so I'm trying every 3 hours. Skin to skin is very limited so that's not an option for the moment to help me. I have a breast pump and I'm still in hospital - the midwives are being v supportive but also quite laid back so I thought I would see if the power of MN could help. Also if anyone knows why he is so sleepy and sicky please feel free to let me know!

Congratulations on your baby boy.

My milk took until day 5 to come in after both sections. Have you got access to a double electric pump on your ward? Try to pump every few hours if you can manage it. Even if nothing comes out, you are telling your boobs that a baby wants some milk! Have you got photos of your lovely boy on your phone? Look at them while pumping, it may help trigger the let down.

Eats oats and quinoa and drink buckets of water. I had PPH with both kids and had to get my fluids up.

All the best!

I can't help with what's wrong with your baby boy but could you have a photo of him to look at while you're trying to express? And also do just keep trying even if it doesn't happen for a while because it takes time. It's so hard to relax in those circumstances but if you can it will help. Are you eating and drinking properly? Sending you these and lots of good wishes for you and your baby

Snap!

Second time, oats and (if possible) being next to baby when you express.

I expressed after a section when baby was away from me too. Just used a very small syringe and squeezed out a few MLS st a time and sucked up in the syringe for baby. No way would a breast pump have got anything at that point. You cN Google expressing colostrum for tips, and hospital should have syringes. They printed out a picture of my baby for me to look at while doing this which helped.

Hello! Congratulations on your baby and I'm sorry it's been a stressful start.

Fellow NICU expresser here! Top tips for starting out would be:

• prioritise your expressing as you would feeding a hungry baby. Visitors can wait. It's important and you are justified in giving yourself the time / space to do it.

• definitely hand express until your milk comes in fully, which can take a few days

• ask for a syringe rather than a cup at first. Literally the first few times it may be 2 or 3 drops but it's all beneficial so don't let it go waste!

• make sure you're using a good hand technique; you can look on YouTube to check.

• Use heat (hot water bottle / hot flannel on your boobs before expressing

• stimulate your nipples as much as you possibly can, like, all the time.

• get something that smells of your baby and look at photos or videos, or ideally do it by the side of the incubator

Good luck! I'm sure you know what an absolute gift it is to try to give a poorly baby some breast milk. Have a very un-MN hug and high five from me.

Echoing what others have said, if you can express whilst sat next to your baby that will help or look at a photo.

I've had to express like this for both my DSs who were in a similar situation to your baby. One of the midwives told me to really try and relax my shoulders when expressing as being too tense really inhibits milk production. Hard to do when you're tired, in pain and your baby is in SCBU, but it can help.

If there's a newborn program on the pump then make sure you're using that. Don't turn up the suction too high as it won't necessarily help and might hurt your nipples.

Did anyone show you how to hand express and have you had any colostrum yet?

Had similar with PFB.

Listlessness could be jaundice. Check the skin tone. Get docs to get a bilirubin score. That will tell definatively if your baby is jaundiced.

EBF is not easy. Anyone who tells you it is, is a liar. It gets easier, but at the start it is very hard.

Go with your instinct, it is stronger than you know.

Any food is better thsn no food. Happy mum equals happy baby.

Well done you for trying

As above, photo of baby, I was also told to express around midnight or early hours - not sure why but it might have been just to make sure I didn't leave a long gap between 'feeds' to keep up the demand. We had a two blanket system where I would keep one with me while expressing then leave it with baby and take hers. It's not easy op, take care and I hope your baby is soon back with you.

Expressing in the early hours is because the hormones that help milk production are highest at that time overnight.

Hi OP, it's tricky getting the knack of hand expressing at first. Using electric pump prior to milk coming in isn't the best idea as any bit of colostrum (as it's often only a few drops at first) doesn't even make it though the valve. If u could ask a midwife to actually hand express for you for a couple of minutes you will see the correct technique. Even with correct technique it can take a few minutes for the colostrum to make an appearance but then it starts to come easier.

I'm sure you have been shown the technique...it's important to press in on the milk ducts so make a 'c' shape with thumb and forefinger, place at edge of areola and push down on ducts (pushing towards your spine) then sort of squeeze fingers together towards nipple (if that makes sense!).
Agree being near baby or looking at pics will help. Try to do this every 3 hours as regular stimulation is key. If you are not seeing any colostrum at all don't beat yourself up. If you had long labour or large blood loss it will take longer for milk to come in.
Using the syringes is a good idea if you are able to. Every little drop is precious.
If hand expressing isn't getting anything then a pump is no harm as it will be doing the stimulating that's needed and eventually something will come. Try to get as much sleep as possible, eat healthy and often and drink at least 3litres fluid a day ( the body won't function otherwise).
Best of luck and please God your baby will be well soon.

Assassinated, that's interesting, I wasn't sure why the neonatal nurses were so keen for me to express during the night but it makes sense now. Thank you.

Thank you so much everyone, I tried every two hours through the night so will carry on like that and see if I can try next to his cot. Good excuse to eat flapjack I think I will also ask for another hand expressing lesson to see if I can get the hang of it

I just wanted to come back and thank you all as I've managed to hand express a small amount of colostrum and I can actually feel my boobs getting harder as my milk seems to be coming in. He's had a few formula feeds because he had to have something but I'm so pleased that everything I am trying seems to be working and I just wanted to thank you all for your advice

Ask the nurse to show you how to hand express. It's easier if you massage and someone else collects in the syringe. Try and remain relaxed. Photograph of baby and deep yoga style breathing. I had colostrum 2hours post c section and milk came in within 36 hours - however I had fed before.

I had to express for premature DD who didn't have to go to NICU but did have a feeding tube for the first 13 days of her life.

Agree what others have said - it's too early to use the pump. Hand express, I'd try every 3 hours minimum.

Most important - be demanding of help from the midwives, HCAs etc. Be specific. Say 'could you sit and watch and advise me for 10 mins?' or whatever you need. Be demanding if you need help keeping up with the sterilising of equipment, putting milk in the hospital fridge, etc. - it's really hard to find any time to sleep, especially when every movement hurts after a section. If things don't improve - ask if there's a midwife with special expertise you can speak to.

(I've no experience of babies in NICU but have had two long postnatal stays due to baby feeding issues, including one post EMCS. My experience the first time round taught me to be much more proactive in asking for the help I needed to get expressing and eventually BFing working for DD this time).

Hope your little boy is on the mend and you can spend more time with him soon.