What's going wrong?

[little_O]

Some background:

My friend had a baby last night 10pm. Quite a stressful birth and the baby was removed by forceps, was put on antibiotics and placed, after a brief cuddle with dad and mum, in the nursery in an oxygen crib till 5.30am this morning.

The midwives then advise for my friend to try feeding her (this is her first feed since birth). The baby sucked 2-3 times and then stopped. Didn't unattach but just wouldn't start again. They then made her express and then syringe fed her.

Fast forward to 4.30pm and she has only attempted feeding 2 times since all with the same result.

They can't work out why the baby won't suck. Any suggestions?

I told her to try and put the baby on the breast as much as she can and try skin on skin. Anything else??

She has a lactation consultant coming shortly but she doesn't think they'll say much different.

Advice please!!!

[Mumma T]

Does she have flat nipples? My DS1 would do that when i tried feeding and i never did manage to get him to latch without shields.

I do believe though thats its not totally unusual for some babies to not really feed in the first 24 hours. My sister had this happen with her second child, i think it was about 24 hours befors bub had and even semi decent feed.

[Ca Plane Pour Moi]

Baby had a stressful birth too and needs to recover. Keep offering the breast, not expressing and syringing it in, and baby will recover soon, especially if they are allowed plenty of skin to skin and are encouraged to feed often. My DS didn't feed for the first 24 hours at all after a traumatic birth and ended up bfing for 16m, weaning only after I became radioactive for a medical procedure. I was also given no help and awful advice in hospital, despite what the nurses and midwives say, they cannot remove your baby and give formula without parental consent. Don't let them lie to your friend.

Sadly, sounds like what went wrong is the medical system. Again.

[little_O]

MummaT she just said the midwife has said about the shields for tomorrow because she is flat. Also she is very well blessed up top so they think it might be hard for the baby to work the breast.

CPPM: it is a big medical system fail. I feel so angry but I don't want to give her that negativity at the moment. There are so many things they have done wrong with her, I'm sure with good intentions but wrong nonetheless because the baby and her have suffered. Hopefully if she persists it will work. You give me hope.

[Mumma T]

[QUOTE=little_O;3431560]MummaT she just said the midwife has said about the shields for tomorrow because she is flat. Also she is very well blessed up top so they think it might be hard for the baby to work the breast.


If she is flat nippled then it is still possible to feed without shields so like everyone else has said suggest she keeps putting bub to the breast. I managed to feed DS2 without shields it was just through perseverance of trying and trying til he got it.

She could also try baby lead attachment if she's game as i found that worked a treat too.

[OceanPrincess]

Hi little O, it sounds like your friend has had a really rough trot. For most babies, right after they are born, they experience an alert period, where they are ready and open to try feeding. Once they have a big feed, they settle down for a big sleep. Like CPPM said, they are recovering from the birth.

Sometimes, if there are things that don't go according to plan at birth, they might miss the wakeful period after birth and baby will just got into big sleep mode. And that's ok. Not ideal, but ok. They are born with fat stores to get them through.

When DS2 was born, he had a massive session at the boob after he was born, then slept for almost 12 hours. The MWs keeps asking me "has he had another feed ever?" And I'd just say "Nope, I'm not worried" and they'd back off. But it can be tough if you aren't confident that everything's ok.

Everything that the others have said is great. Remove the pressure. Lots of skin to skin, lots of rest for mum and bub. Snoozing together. Lots of time together. Use the LC - make sure she asks for an actual diagnosis as to whether she has flat/inverted nipples or not. It can be hard to tell and if you introduce shields when there isn't an actual need it can be just another hurdle to overcome. Try and keep it simple - one feed at a time, one day at a time.

Remember she can ring the ABA helpline anytime - 1800686268.

[little_O]

She just messaged me that the baby just fed 15 minutes either side whilst she laid down with it skin to skin.

Looks like the 24 hours was about spot on!

I will tell her about shaping her breasts and also to get the diagnosis from her LC.

I think the tough thing is that she has had so many visitors back to back she hasn't been able to just focus on the baby (a cultural things I think). I said to her she may just have to say no visitors until the baby is established.

[Ladylove]

I think babe may be exhausted by a stressful birth? Mama should keep putting her on and constantly trying. They need to just hang out together skin to skin, as you said. Just hang out like that rather than, ok now it's time to try feeding again. Let baby sleep on her (bare) chest, no swaddle etc. Enable the space and opportunity for baby to suckle in a relaxed environment.

[Raupe]

I struggled the first few days too due to big breasts. She has to make sure she shapes the breast with her hand and guide it into babies mouth. Also with big breasts you have to keep holding and shaping the breast as you feed. The weight of the breast pulls downwards and if you don't hold it the nipple will slip and destroys the latch. Also get her to stimulate the nipples as much as possible and squeeze a bit of milk out to get the taste of the milk on baby's tongue.
That's all I can think of right now... will update when I think of more!

[Ladylove]

Little O you are a great friend.

[Mumma T]

Little O you are a great friend.

I fully agree with this. I wish I knew you IRL

[justjen74]

So glad hub has now had a decent feed. It will get easier from here. My experience was quite the same. Bub had no problems latching, but when on would only have a couple of sucks, then fall asleep and let go. They tried all the techniques to keep her awake, even wet cloth etc, but all it did was make her upset and in turn make it harder to get her on the breast. In terms of expressing and syringing into the mouth, I was advised to do this too. Was explained that sometimes after traumatic births (or even normal births) that bub lacks energy, especially if they don't get that first good initial feed. This then makes them too tired to drink or want to suck properly. So feeding them a small amount (we only did about 5-10ml) is getting some energy into them which hopefully will give them the pick me up and energy that they need to start feeding properly. It took around 48 hours before I was confident my dd was feeding well.

[little_O]

Aw thanks LL and MummaT I wish I lived near you guys then we could catch up.

On a sad note, I feel so angry.

So my friend has been trying all day to feed the baby but with little success. Apparently the have told her now not to feed the baby for 24-48 hours on her breast and they will just give her formula. The reason: the midwives have been manually expressing her nipples...hand expressing and have severely damaged her nipples so now it's too painful for her to feed.

They have instructed her to get a pump and keep pumping so her milk comes in. They are feeding the baby with a cup at least... But seriously!!!!! Now the baby stops getting colustrum because they've damaged her?????

This has all been decided with the LC as well. I'm at a loss. What do I even say?

The LC has told her to do skin to skin but no feeding for that time period so that the baby still feels comfortable.

I don't know how much to say to my friend because I'm not the professional here, but it sounds so wrong. Or am I just wrong?

So angry and frustrated and sad that this has all been mucked up for her. What's the chances of the baby taking the breast now?

[Mumma T]

I didn't feed DS1 for the first 3 days for different reasons and I still managed to get him over to fully breastfed, so definitely possible.

How on earth they managed to damage her nipples by expressing I can't even begin to understand.

[wysiwyg]

I didn't feed DS1 for the first 3 days for different reasons and I still managed to get him over to fully breastfed, so definitely possible.

How on earth they managed to damage her nipples by expressing I can't even begin to understand.

Agreed - nipples can quite easily get damaged using a pump, but hand expressing is hard to understand as is so different.

[onthefly]

It's still early days. Her baby will feed once baby has the chance.
I wonder why are they giving formula if she's pumping? A baby this young would typically only have a very small volume of colostrum and be fine.
You can help by passing on info on normal baby stuff: so before milk comes in, 1 wet nappy per day of life, poos changing from black through to mustard after milk comes in, then 2-3 poos per day, 4-5 wet ones. This is the easiest indicator for mums to track.
Also would suggest mentioning laid-back nursing, which is a great way to harness baby's natural instincts to latch and feed, and relaxing for mum, too.

[myturn]

Sometimes all you can do is watch and wait and see. Unfortunately. I agree it's the medical system. I was convinced to formula top up in hospital too. Even though it didn't feel right, I still did it. There felt like there was no option. As long as she's do tuning to pump and maybe even hand express herself it will happen. Just continuing to encourage her and let her know that you have full confidence that's she can make this happen.

I don't understand how they managed to damage her either. I resent that the nurses expressed for me, when I was completely capable of doing it myself. Just because I wasn't as quick as they would have been.

You are a great friend. Just continuing to be there and support her without adding the pressure is important. Even if I'd been given different advice from friends, and I did I would have still done what they told me to. Cause it felt like I HAD to do what the professionals said. The only other thing I would suggest is to get her to call try ABA or MCH Line (if she's in Victoria) and tell the hospital staff the advice she is given from them. If she is not satisfied she could ask for the nurse manager. But it's hard to stick up for yourself when you have just given birth.

[Ladylove]

Laid back nursing has been amazing with both my girls when they were new and still sorting out attachment.

Poor mama she must feel so overwhelmed and even a little violated.