Wanting to breastfeed but need to help flush Jaundice with expressed milk in bottle

[croft85]

Sure this question has been asked on here a million times.

I’m a first time Mum with a 5 day old and we’re still on the ward. Past few days she has been tracking as if she’ll need light therapy for jaundice. It’s been pretty difficult as my husband isn’t even allowed in for visiting hours so hasn’t seen her since birth. Hospital covid policy (which I think is totally inhumane by the way) - so I have been doing everything in my ward cubicle and it’s been tough.

Breastfeeding has been ok and thought it was going well but the classic jaundice sleepiness has kicked in and it’s not certain she’s getting enough.

Midwives here wanting me to top up with formula and bottle feed expressed milk aswell as breast feeding.

I’m really upset as I wanted to exclusively breastfeed (for the bond but also for medical reasons for the both of us)

Is it possible to give a bottle of expressed milk and still have the baby as interested in the boob?

I feel sad and like already she is losing interest :(

Any tips for breast and bottle so early?

Thank you xx

Why are they keeping you in at day 5? Is it medical reasons for you or baby?
If baby doesn't require treatment for jaundice you can go home. The SBR's must be below treatment line if they are not treating?
What are the indications for top ups? Unless there are clinical reasons such as weight loss out of normal range there's no indication to top up?
If you don't want to top up with formula and there's no indication then don't do it. Alternatively if there are clinical reasons for topping up then you can get pumping.

First of all, congratulations!

I would say: it depends on the baby and how long you will have to use bottles. The bottle has a more regular flow than a breast. Is easier to drink from. In some cases you can have a 'lazy' baby who prefers the bottle, breastfeeding starts with a (quick) let down and then the baby has to work.

However, our story: preterm (almost 5 weeks) and wasn't strong enough to breastfeed. She only had the strength to do so once or twice a day. We struggled a lot. I also expressed milk but it wasn't enough and we had to top up. Strangely enough she also cluster fed while bottle feeding and didn't drink as was indicated on the packaging . I felt awful that I couldn't produce enough. After over 5 months we found the right position and I could stop expressing... she breastfed untill we stopped just passed her second birthday and till about 18 months she also had formula. When looking back, I shouldn't have stressed about the top ups with formula at all. We bonded perfectly, she is happy, healthy and develops just as a child born at term. She loved breastfeeding.

In your case: I would top up, breastfeed a couple of times a day and also express a few times a day. Get rid of the jaundice and see if you can get rid of the bottle afterwards. Also, your production increases when you are relaxed, better rested and well fed. So going home may help breastfeeding a lot!

@Secretsoutis she is DCT positive as we have different blood types so I have been told she is likely going to need treatment. She’s been tracking as if she’s going to go above the line for days - now she is one box below. It just wasn’t explained to me properly in the early days if I’m honest so I presumed it’s the done thing to keep someone in!?

She lost weight but has put some on past couple of days so now 4% below birth weight. She was born at 38 weeks but don’t think that makes a difference in all this.

Waiting on today’s result now.

Just completely desperate to go home to my husband. It’s been so horrid not seeing him.

Also feel like I’ve been talked into expressing and giving bottle as well as breast - but they keep stressing how much I need to flush the jaundice out of her system!

@StarsandStones thank you so much - makes me feel better! You’re right I would be a lot more relaxed for breastfeeding at home X

I was in a week with a prem baby who had jaundice.
He was under a lamp for a few days.
Ff never mentioned.

Flushing it out was never mentioned
Older ds they realised he had it in the first week at home. Mw told me to put his basket in the window!

croft85 it sounds like you're having a pretty shit time.

Day 6 (counting day of birth as day 1) is usually the peak day for jaundice.

If baby is 4% below BW that is absolutely normal. Where I work we don't keep mums and baby's in who are DAT positive, we send them home and observe jaundice in community and repeat SBR's as required if clinically indicated (worsening jaundice and symptomatic). Your baby bloods are normal - regardless of how close to the treatment line they are.

From the info you've given I can't see a reason to supplement.

Are you in the UK? I can't believe that your partner has not seen you or your baby since birth. That's utterly ridiculous and unacceptable.

@Secretsout yes in the UK. It’s something I don’t think I’ll ever get my head round. Horrendous rule and time we can never get back. He’s also used up his paternity leave which couldn’t be changed.

I have no idea why they have kept me in if that’s the case.
I had a slightly problematic delivery so would have stayed in couple days for that reason but why I’m being kept in for this jaundice I’m not sure!!

I was in the exact same situation. I think I kept trying to have her latch and then offering a bottle a few minutes later, and then after a couple of weeks her bilirubin levels were down and her latch was good enough we could just feed. She had formula in the first few days in hospital but never really needed it beyond that, pumped milk was fine.

Jaundice can be serious btw, we got discharged after 3 days, but then her bilirubin levels shot up overnight and we got rushed back into hospital the next day after the pediatrician (we were in the US) measured them at her next day check up.

If they’d got much higher it would have been blood transfusion and potential brain damage territory.

If top ups are indicated they can be given by cup- there are special baby feeding cups with a little lip so baby can lap at the milk. It means there won't be any test confusion going between breast and ebm/formula. You just tip the cup enough for baby to lap like a kitten at the milk, it's not like tipping it into baby's mouth.

I really hope you and baby get home soon! I really do feel for you

Congratulations. It's absolutely horrendous that your husband can't come to visit!

We had this issue. Almost readmitted for jaundice (borderline score). I had midwife appointments every other day and each with a different person who gave me differing advice, which was scary and frustrating. One wanted me feeding her every 2 hours and expressing between, but with 40-min feeds due to jaundice sleepiness and rubbish pumping results it was absolutely non-stop and horrendous. The final midwife we had said that was ridiculous and recommended feeding every 3 hours with a small top up of formula after (10ml/kg of baby's bodyweight). Of course if she was cluster feeding just go with it. That really worked for us.

I was really stressed by it all so can only imagine how you're feeling in hospital without family support.

Ask them what it will take for you both to be discharged because you need a set plan in place. Otherwise different people will have different opinions and you might be messed about.

Oh and btw, we gave the formula top ups from a Tommee Tippee closer to nature bottle and she took both bottle and breast fine. We stopped formula top ups at 6 or 8 weeks and have had a happy BF journey since then.

Hi OP, both my two had early jaundice (from birth) and so feeding them up was very important. With my first i was very determined to breastfeed (fed under the blue light at one point) and i had a breakdown on day nine because of the lack of sleep and the constant rebounds. With second baby i said not again and simply expressed and bottle fed so i could get out of the hospital asap. Yes it was a pain to get her onto the boob again afterwards but this is much easier in the comfort of your own home. Alternatively do a bit of both?

Pump milk after breastfeeding (the hospital pumps are the shiz!) this will stimulate your supply too then after a breast feed try to get them to take more in a bottle. this is what i was told once i was producing enough.

Both of mine were in the NICU for a few days and fed with formula while i was frantically pumping to get enough to supply their demand. It isn't the worst thing in the world if it comes down to it. Oldest i exclusively breastfed until 1 year and second until 10months. Both never been ill at 3 and 1 dispite all the antibiotics in the NICU and basically no colostrum/milk for the first 2 days.

Hi
Congratulations and hope you get home soon. I just wanted to echo previous posters- it is ok to top up with formula if required, you just need to keep pumping in the meantime to keep up supply. Night pumping with those hospital pumps really helped my milk supply. I used the ready made formula or expressed milk and fed every 2 hours and did feel like it flushed the jaundice out of the system quicker (as I was advised to do so). I then reverted to exclusive breastfeeding when I was back home. I did this for all 3 of mine ( firstborn - trial and error and then I got the hang of it for the next two. By the time I had my third, I was a pro). My children did not have any trouble switching from breast to bottle so do what is good for your sanity and baby's health at this point.

Hi, not sure if you’re still in but wanted to say you’re not alone.

I had our little boy early Feb and he was over the blood transfusion line soon after he was born so was whisked away to the lights a few hours after I had him. He was tube fed in intensive care for two days with formula as my milk hadn’t come in. When he came out of intensive care we stayed on a ward together and after two days he came off the lights and I was feeding him from the breast (although milk still hadn’t come in). Nobody really explained the flushing out jaundice thing to me and one day I told the (pretty useless) nurse that he hadn’t had a wet nappy for a while. She unhelpfully suggested we just have skin-to-skin. Needless to say, that night I had a very lethargic baby who had to go back on the light therapy.

Anyway that night I broke down as thought I really wasn’t supplying enough for my baby but the nurse was lovely and suggested we top him up with formula and I pump every few hours to encourage my milk to come in. I wish I topped him up sooner as we would have been out at least a day earlier.

I too felt very alone with husband unable to visit at all..not even for 5 minutes. It was horrible being stuck in the stuffy ward in a cubicle of about 9ft x 9ft trying to get my baby better and heal after having a c-section. My husband also felt totally useless and when we got home after 5 days felt like we had a bond that he wasn’t a part of.

Anyway a long story short, I wish I had topped him up with formula sooner to flush out the jaundice. He’s 8 weeks now and exclusively breastfed. ❤️

@BeaKind thank you so much for taking the time to write that. I’m so pleased to hear you’re exclusively breastfeeding after that challenging start. I can’t imagine having to do everything whilst healing from a c section. I had forceps and epi and that was enough, you poor thing. Have to say it’s been quite traumatic, both the no partners allowed (don’t think I will ever get over the injustice of it), the being stuck in the cubicle doing everything alone, and the jaundice and feeding journey. Every nurse or midwife on shift told me a different thing and gave me a different plan.
Thanks for the topping up advice. I will persist!
Hope you’re enjoying your 8 week bubble xxxxx