Breastfeeding advice - 9 days in after having to top up with expressed breast milk to flush out jaundice

[croft85]

Hello

After some advice with breastfeeding please as I am desperate to solely breastfeed if I can. In a nutshell:

• we were in hospital for 5 nights after birth as baby DCT positive and was just below jaundice treatment line for days (then dropped down and we were discharged!)

• husband not allowed on ward so didn’t see baby and it was so stressful and horrid.

• every midwife on different shift told me different thing. I was expressing early to give milk in bottle to help flush jaundice and it’s caused real problems with my breastfeeding now I am home.

• she is still sleepy and I spend so long trying to wake her and then her latch isn’t great. Sometimes I get a good 25 min feed in and it feels great but all the more they are 10 mins. If I have a few hours of bad feeding I tend to give 20mls bottle of expressed as I would hate to not give her enough. Lots of wet nappies so I know she is ok.

Can anyone suggest anything? I am compressing as I feed which does help, but she just doesn’t stay on for long. I strip her back to nappy and try and do lots of skin to skin.

Also as I have expressed my boobs are crazy hard and uncomfortable so I am in a cycle of expressing after breastfeeding!

Anyone else had to bottle (with breastfeeding) early and managed to breastfeed well after?

Thanks so much xxxxx

Firstly, congratulations on your new LO 

Are you in the UK @croft85? If so, I'd give one of the BFing Helplines a call. All of the BFCs are fully trained and have BF.

It might also be worth asking @MNHQ to move this over to the Infant Feeding section as you are more likely to get someone with experience in there.

Congratulations OP! You sound like you are already doing a wonderful job and yes, you will absolutely be able to get to just feeding at the breast and no pumping. As your baby get bigger, stronger, less sleepy and more alert, she will become more and more effective at feeding at the breast. It's hard work for them in the beginning and babies in the early days often get too sleepy to finish a feed. They tend to be pretty sleepy in the first couple of weeks and then have more awake and alert time as they get a bit older. I'm just going to go away and double check how much breastmilk per feed, on average a 5 day old baby will take and I'll be back (just want to remind myself, as a top up of 20 mls early on is quite a lot I think, and so I wonder if she's not quite as hungry for the next feed as you might expect her to be?).

Just had a look and by about 7 days old, a baby's stomach can hold about 45-60 ml per feed. Your baby is only 5 days old. Perhaps try giving her slightly less of a top up after the feed, or even alternating... One feed with a top up, one without. But continue to monitor her wet and dirty nappies to make sure she's still taking plenty of milk?

I would also suggest going skin to skin for each feed and using the laid back breastfeeding position as the combination of these helps to trigger babies' inherent newborn nipple-seeking reflexes and hopefully keep your baby more alert for longer.

And to answer your question, yes, with my 4th baby, who has a tongue tie revision at 7 days, I was able to revert back to full breastfeeding from using expressed milk and bottles for the full feed, every feed.

Lastly, have you heard of a supplementary nursing system? As that could be something to consider for the short-term?

P. S. The laid back position (biological nurturing) is also great for improving a baby's latch. It encourages baby to seek, find and latch on themselves and, in my experience, is the absolute best for a really effective and deep latch (helped by gravity too!)

@Somethingsnappy wow that is incredibly helpful thank you for taking the time to respond!
Interesting about the mls per feed, that’s something I was confused over with different midwives on different shifts in hospital telling me different volumes!
The laid back position I haven’t tried but going to now... will up my skin to skin definitely.
So reassuring to hear you reverted back to full BF after giving bottles.
And I must remember that she is still days old and it will take a while to establish feeding together and her getting stronger will make things easier.
Thank you again! Xx

@BunnyRuddington thank you so much for the advice! I am going to ring the helplines and get a plan together. X

Absolutely, your baby is still brand new and even without initial challenges in the early days, it can often take mothers a few weeks to establish breastfeeding! You're doing brilliantly. Many women struggle with trying to get a sleepy baby to latch in the early days so you are not alone.

You could try giving your baby the top up milk from a cup, rather than a bottle too, if possible? This is better for breastfed babies as they still need to use their tongue to lap it up. Bottles can sometimes be too easy for them and they get used to it. But if you'd rather stick to the bottles, then use paced feeding, with a newborn teat, so she has to work harder to get to the milk and is closer to breastfeeding.

Just keep persevering with the skin to skin and laid back BF position. You will probably notice your baby getting a little stronger day by day. And the breast compressions are a great idea too! As soon as you notice she has stopped sucking actively, compress your breast and hold until it triggers her to start sucking again and then release. Move your hand around your breast to compress different areas with each go, if possible

The tiredness and hormones of the early days, together with a brand new baby, make every hurdle seem almost insurmountable, but I think you'll be surprised how quickly things can improve. You won't have done any harm to future BF by giving your baby top ups. She could still be just as sleepy and struggling to latch at this stage anyway. You just both need lots of practise! Another tip, is to keep your baby with you skin to skin after she falls asleep, so that you can catch her just as she's beginning to stir and wake up for the next feed. The hormones from the skin to skin will help you both and babies often latch well just as they're waking.

thank you for link, I had a good look and it does sound like him. Showed the Dr too so thankfully it's not been ruled out completely.

Hope you find them useful