what would cause excessive sleepiness/ failure to feed in a newborn?

[belcantavinissima]

my df had her gorgeous longed for ds on sunday morning. but, he will not feed, she is beside herself, he doesnt wake up hardly at all even with prodding and tickling etc. she is having to hand express into a cup and feed him with a syringe but he is literally having 1ml which she has to kind of force on him then he is back to sleep again. aparently the midwives are getting worried about him now. she is in a small community hospital so if it carries on much longer she will have to return to the city hospital for tests. just feel so worried and for her. she had a stillborn ds last yr (her first) at 36 weeks so everyone is so desperate for this baby to be perfect and everything to go smoothly for her. any advice welcomed

pethidine, low blood sugar can cause this- and some babies just are sleepy

is she trying him undressed? that can help, esp. in warm weather

sorry to hear this

my dd1 was like this and lost a lot of weight

we weerent allowed to go home for a week but eventually we went regardless

she had to try to have a small amount of expressed milk every two hours but it was a night mare as she wouldnt take it

but there was actually no medical reason

by 6 weeks i changed enturely to formula as she wouldnt breastfeed

She just needs to keep continuing to offer feeds.

Keep him skin-to-skin as long as possible

Express colostrum if he won't latch

Have patience

When he is at the breast she should run her fingers gently up his back to stimulate him. She can also wipe his hands gently with a wet cloth. The midwives will have guidelines for 'reluctant feeders'

If she had pain relief in labour such as pethidine/morphine it can take a number of days to get out of the baby's system and will make him sleepy.

Hopefully he will wake up soon. Then she needs to be prepared for him feeding very frequently to make up for lost time

Have they done a blood test for jaundice ? Its not always apparent in their skin (apparently, when DS was in SCBU a baby was brought in who, by its blood test, should have been orange, but looked fine) and the light treatment sorts it out very quickly

she had a drug free labour, normal delivery (tho he had been breech/transverse and they had turned him twice during the week preceding delivery). he was born at just under 38 weeks, quite little- 6lb 11oz. she has him wrapped up quite well now as the other day he was freezing to touch and sleepy as well so they swaddled him. i think the worrying thing is that he just doesnt wake for feeds at all. he literally sleeps all the time. (she will be wising for this in a few months!!!) when he is 'offered' the breast he makes a face turns away if poss then goes back to sleep. she has to force his mouth open to squeeze syringe in instead.

blimey it took me so long to post there were loads of replies! thank you all. she so wants to breastfeed this baby and i know she will be sad if the little amount she has hand expressed doesnt keep her supply up. milk started to come in yesterday.

starlight- good idea. will do.

If there is nothing medically wrong with him, he might be caught in a cycle.

The baby is too tired to feed so doesn't feed. The body then goes into like a hibernation mode to preserve the little calories that it has. The only way out of that cycle is to constantly feed. If he has more calories he will have the energy to be awake and feed better - hope this makes sense.

After last year I can understand her worry. However, sleepy babies are not uncommon and sounds like the hospital is monitoring it. I had a sleepy pethidine baby which worried me with lack of feeding/ended up on the bottle (for a variety of reasons incl sleepy baby with low weight worries). She is fine now. DD2 was the opposite and had a baby so awake that it worried me she didn?t sleep enough and was putting on weight too quickly! I guess there is always something to worry about with a new baby and even more understandable after your friend?s terrible loss last year. No advice to give unfortunately other than sympathy and understanding at how stressful it is to have a sleepy non feeding child. Keep going, be there to listen and comfort her and carry on being a great friend.
Agree about the undressing - I used to have to strip off DD1, nappy change first regardless of need or not and then feed next to the cool fan going round hoping that the gentle breeze, lots of talking and stimulation first to "Wake her up" helped with the feeding.
Hopefully next week he will be so wide awake that he is keeping her up at night yelling for food

jaundice sounds likely. feeding as much as poss is best way to help.

He needs unswaddled immediately!

He needs to be skin-to-skin with his mother and then covered with a blanket. A hat on his head will prevent heat loss.

Being wrapped in blankets will not encourage him to feed at all.

Mears is definitely right, this alone could make him too sleepy.

Please tell her that her milk supply is saveable, even if it did drop there are ways of getting it back up, she should be able to BF.

Has she spoken to a good BF Counsellor, eg La Leche / NCT ? ABM?

Definitely she should maximise the skin to skin time, and keep up expressing even ewhen it is not taken in- I presume put him to breast very regularly, then if he doesn't feed express would be best solution?

Your poor friend

they had skin-to-skin all night sunday night with him in her bed, just laying on her chest. he didnt feed. i dont think he even woke up .

but ds2 did that (exactly same weight) on night 1, they often do, they're tored. She really does need to continue it until feeding is established- indeed I have a 4 weeker now who is slow growing bf and i still sleep with him in skin to skin to support continuing bf.

14 weeker

Ds had this - it was a nightmare. Turned out (we found out MUCH later) that he had reflux so bad that he had burns in his oesophagus.

The lovely ped ge told us that when newborns are in extreme pain they often 'shut down' to conserve energy

I had a very similar experience with my DD. We were readmitted to hospital when she was 4 days old as she had lost a lot of weight, was jaundiced and too sleepy to feed. It seems that she was feeding less and less, causing her to have no energy, which meant she couldn't feed - a vicious circle.

I had a doctor who was supportive of my wish to breastfeed and I was put on a strict 3 hour cycle. We would turn the lights on brightly, strip DD to her nappy and pop a cold flannel on her face to wake her as much as possible. She would then be put to my breast and encouraged to suckle and once she lost interest was given EBM and formula through a nasal tube while I expressed and emptied my breasts of all milk. In between feeds she was skin-to-skin with me and we both dozed and I ate. In 3 hours time we then did it all again...

It was exhausting and, at times, depressing but it worked. She gradually got more energy as she was taking more milk and began to breastfeed for longer and then have a small bottle of EBM. We were discharged after 4 days and after 2 weeks we were exclusively breastfeeding and she has gone from strength to strength. She is now a bouncy 9 month old, still breastfed and on solids.

I was distraught in the hospital when they told me they were going to give her formula but, in retrospect, it was the right thing to do for us. She had a couple of bottles of it and it seemed to give her the energy to start breastfeeding. I know that this goes against the grain of some breastfeeding wisdom, but it worked for us....

I hope your friend and her baby work through this - go and give her a hug

This sounds exactly the same behaviour as my DS who was born at 37 weeks. he basically slept till his due date and had to be woken for feeds.
Like Hollygo I was put on a strict 3 hr cycle, and it was very very depressing at times when he would turn away and scream when I tried to put him to the breast.
The MWs were worried as he was jaundiced and wasn't getting much down him as he wasn't even rooting so i had no chance of getting him to latch. In the end they advised formula which he took happily.
I was very depressed at my failure to breastfeed, but when i took him to be weighed at 10 days he was nearly back to his birth weight so i wish i had persevered with the breastfeeding for longer.
as it was i kept expressing so he had EBM instead. I figure so long as he gets the stuff it dosn't matter if its breast or bottle!
good luck to you and your friend.

This happened with both of my DCs. Had to keep waking for feeds as they were v sleepy and not waking themselves. Had to really persevere and do allsorts to get them to wake. I didn't need to FF as it turned out, just had to constantly encourage the BFing and did a bit of expressing too. After 1 week my 1st DC was waking up himself and feeding. Regained birthweight within 2 weeks (even though he'd lost more than 10% initially). DC2 was a bit slower. Had to keep up with the constant waking routine for at least 2 weeks before she took to waking herself (this was v tiring and involved setting my alarm in the night) - and didn't regain birthweight until nearly a month. Both BF for 18 months or so, so did not affect their BFing longterm.

Am due soon (well overdue actually) with no 3 and really hoping that it is not a mega sleepy one like my other 2.

Hope all goes well with your friend.

Any news on the LO?