Help Please, Advise, Experience, Anything

My little man is a week old. We had a few health issues in hospital such as suspected wet lung, concern for infection due to that, and he was very sleepy for the first 3 or so days. This then led to concerns regarding jaundice and we were on 12 hourly checks for this with instructions to keep up his fluid intake. As a result of these compounding issues and a non-interest to attach and feed, he has been syringe fed with EBM. We went home on day 3 with re-admittance hanging over our head if we didn't keep him hydrated enough to fight the jaundice. It's been a hell of a week and I'm certainly feeling the pressure.

My ideal is to BF however I/we are struggling with that. We tried in hospital but everyone had different techniques and advice. One feed I saw 3 different midwifes with no real positive outcome.

We tried to establish BF from yesterday once we had the jaundice all clear however it was not successful over night and we reverted to syringing this morning at the advice of my midwife (from birth centre). She checked him out yesterday and thinks he may have a short tongue, ie not coming fully forward which was one of the attachment cues I was looking for. He seems to just 'tickle' the end of my nipple rather than being able to suck all along it, so my breasts get sore.

We have an appointment tomorrow afternoon with a specialist regarding this possible diagnosis so will hopefully know more then, however I'm just not sure if BF will be possible. I'm really sad, although I know I should be happy that I have enough supply to express. Do we just accept, express and use bottles to feed, do we continue with syringing until he's a little bigger and able to attach more (he was 3 wks early and people have said that may be effecting his ability?), if we express and bottle feed, can we try to re-establish breastfeeding in a month or two (depending on the outcome of the specialist appointment tomorrow)?

Sorry if this doesn't make much sense. I've spent today mostly in tears, so I'm not sure I'm thinking and writing things down straight.

Hi, there,

Just the briefest of replies - because I really need to go to bed. But, you will breastfeed - and sooner rather than later. It's what babies are designed to do! the first rule is *feed the baby* The next is maintain your supply. You will be astonished at how quickly it all comes together when the jaundice passes. I know it seems in many ways like the longest week of your life - you have already encountered many hurdles. But it's only a week - he will change on a daily basis. Let me know what happens tomorrow - there are some very good people in the ACT in regards to tongue/sucking issues. Make sure you express every 3 hours - yes, day and night. The rest will come together. Have you tried a nipple shield?

I'm just weaning a bub that was sent home from hospital mostly on ebm bottles - and is now 2 and a half.

Keep bub hydrated, keep expressing, and keep seeking help. Try attaching whenever you can - but don't get stressed about it or let bub get too upset - give it a few minutes, and if it doesn't work then go for the ebm. In the first weeks we would have 1 suck feed and the rest bottle feeds each day. If you can express enough to be one feed ahead of bub then that makes things much easier - you try and attach, if it doesn't work (or even afterwards as a top up) you grab the EBM, and then express afterwards, once bub is fed and happier. My DS ended up finding the swoosh of a pump quite soothing.....And by the time he was a couple of months old he was back bf-ing full time (to the extent that we had another battle later on to get him to take a bottle or a cup when I went back to work!)

So much will change in the next couple of months - most importantly that little mouth will grow, the jaundice will go away and you will have a much stronger baby.
Hang in there!

:hug: Ce. You are doing brilliantly under tough circumstances. I bet you are tired too after your huge last week. Barb's advice sounds really good. Hang in there if you can. My friend who gave birth 15 weeks ago is still expressing her beautiful BM and feeding by bottle and it is working really well for them. Though with some help you should be able to get attachment going.

I will text you a local lactation consultant details who I know nearby who can help you in your own home if you are interested. She is a local ABA member and I know others that had lots of difficulties in the early days who are now successfully BF after her help.

You are doing so well hun, so proud of you!
xx

A great lactation consultat is a wonderful thing! It can work out with time and the right advice and support :hug:
Well done on your hard work feeding your baby - those early weeks are tough even under the best circumstances

My little lump of lard couldn't quite work out what to do with a nipple at first either. He's still lousy at getting latched on his own, I have to squish my aerola and stick it in his mouth or he just nibbles. But he's got it all worked out now, and is ... a lump of lard. Took less than a week, but then I've done this before. If he was my first baby I think I would have had some major issues. You need someone who knows what they are doing to see you in person and check out what you are currently doing.

Did you have any pain meds during the birth? Some of those can make your baby very snoozy for several days, which makes you feel like a failure (not helped by nurses prodding you to BF) but it really just sets things back by several days.

Thank you Barb. DS had a posterior tongue tie snipped yesterday which has allowed him to cup his tongue and bring it forward. We also have an appointment with an osteo on Friday afternoon as the specialist recommended it due to noticing his jaw was slightly misaligned - his chin is further back than it should be. Feeding has improved however it seems to take forever and even then he's not satisified. The last feed we did until he seemed almost content was just over an hour and then I topped him up with 6mls EBM to settle. My midwife said whilst not ideal, this is good enough until he establishes better?

We tried a nipple shield several times before the snip yesterday but to no positive effect. He still would not really suck or stay attached.

KMN - I've been advised to use breast for feeds and settling, however I'm still expressing after the feeds so I keep up supply and have stores on hand for topping up etc. Thankfully after a few good expressing sessions I do have enough to have a feed ready when needed. Thank you for your reassurance.

Dusty - Thank you. I almost called the lady today. I think I'll ask the midwife tomorrow if it's not going to be counter-productive. Whilst in hospital every shift change I got different advice etc and I think that's added to my confusion and troubles, so I don't want to compound that.

Marcellus - thank you also for your support and understanding.

RumpledElf - I only had a little gas during labour. One of my reasons for no other meds was for an alert and ready to feed baby which hasn't worked out to plan for other reasons. I think that's one of the things I'm battling to come to terms with.

So, my next questions is... my DS seems to like to suck to settle and this includes our fingers, his thumb etc, after a feed. It doesn't have to be long but he obviously finds it comforting and doesn't always need it for long. My midwife has told me not to use any fingers, dummies etc until BF is established to avoid confusion. This at times leaves me with a rather upset little DS. Is this advice a general rule, or is it just her stance? It doesn't necessarily sit comfortably with me, but at the same time I want to establish BF. I know I need to do what is best for DS and I but at the same time don't want to go against advise if it will help.

Will he suck at the breat to settle, or is that not working? It's a tough one given your situation - the midwife's advice is correct in general terms, but your situation is a bit trickier maybe? Barb will know :)
Call Dusty's contact hon, she sounds good. The more advice and people you have on side the better. You may feel you're already getting advice from your midwife, which is good, but nothing can compare to a really good LC when it comes to feeding. :hug:

I'd just use a finger/dummy if he's unsettled. Believe me, they can tell the difference between boobies and dummies. Food comes out of one and not the other, a hungry baby (in my experience anyway) will NOT take a dummy.

But they're all different ...

Hi, You might not be able to see it as clearly as we are - but you are making amazing progress already. It's never simple in these cases, but you are ironing them out one at a time, and you will both go on to breastfeed fine.
Sucking is everything for a baby. They suck to feed, to settle, when bored, when tired, whenever. It's great to use the breast whenever you can to comfort. Avoid using other things if you can. Often they will settle just being with your or their dad. As long as your not drunk or drugged and you have a safe sleeping environment - not too many pillows it's fine to put them in bed with us - it's how most of us get by. Otherwise, a finger to suck is OK. Try to avoid the dummy for a while if you can. I'd call that LC - you are doing great but it's important to get all the support you need

CeCe I just wanted to offer you a hug, my support & loads of encouragement! You are doing a great job. I experienced similar issues with my son and I know how stressful it can all be. The expressing is very frustrating I know but do try to keep your supply going, because your little boy will soon grow & get better at attaching and be feeding like a champ soon. Hard to imagine when you're in the thick of it all with a hungry unsettled bub I know, but you will succeed. I would get on the phone to the LC - having a consistent support person who knows what they're talking about is gold in these situations.

We also had exactly the same sucking issue. We used fingers a lot as well as a dummy too.

Good luck!

We saw the osteo today and DS seems to be able to open his mouth wider now and has had a few good sucks but doesnt last very long. He is also still favouring the right breast.

I called the LC this afternoon but havent received a call back yet. I'm now worrying about my supply. Today has been a real struggle to express. I use to get about 50ish mls per expressing session (20mins) but i've struggled to reach 30mls in the sessions today. I may need to top up with formula tonight :(

I've been resting, drinking water and have increased cuddles this afternoon all in the hope of getting supply back on track.

I read in another of your posts Barb that stress doesnt dry up supply, but that is my concern atm.

Hun, you are doing such a great job. Expressing is not a good indicator of your milk supply, so please try not to worry (I know it's hard!). Stress doesn't dry up your milk but it does make it harder to have a let down with a breast pump. Some things that can help you to get more when you pump are to relax - could you DP give you a shoulder massage first?, a warm compress on your breast before expressing, gentle breast compression while expressing and for some mums totally distracting themselves while they pump by watching TV or reading.

As Barb has said, you are continuing to make progress which is fantastic. Short feeds are definitely a step forward. Hopefully you will hear back from the LC tomorrow. Getting some face to face support and help will really make a difference. Hang in there hun, you are getting there :hug:

We are still persevering. DS is sucking on breasts but prefers the R to L. He doesn't seem content afterwards so he's being topped up with EBM after each feed (formula if not enough EBM). After being told he wasn't hydrated enough on me in hosp and them insisting on formula top ups I'm really worried about this, particularly as he's still a little yellow.

I'm reall not sure I'm prducing enough milk to sustain him. Should my breasts be feeling full towards the next feed as they are not? Or the fact he sucks and I can then express indicate there is enough to go round? I'm so confused and concerned.

Have you heard back from the LC yet? I think getting some help in person is probably your best bet. What about your local ABA group?
What were the reasons for saying he wasn't hydrated enough when you were in hospital?

Don't worry about your breasts so much - how many wet and dirty nappies is he having? How often do you get him to the breast?
I know this is extra stress for you at an already difficult time :hug: I hope you can get some help very soon.

Hi Cece, I am a BF novice as my little girl is only 11 weeks old but I couldn't read and not share my experiences to date. But disclaimer - I am seriously just learning as I go!

I think if you are feeding and then still able to express this means that your DS isn't emptying your breasts and there is still plenty of milk. I find that after most feeds I am unable to express and my breasts feel really empty and the breast she has fed from is obviously smaller. I don't really notice that my breasts are hard and full except in the mornings or if my DD has missed a feed or I am due to express and am running late. It took me ages to get to this stage though - before that sometimes my breasts were hard like rocks after 3 hours and sometimes they looked totally empty after 3 hours. But even when they looked empty I still fed my DD and she seemed okay with this. If you are worried about your supply, you could google lactogenic foods and I am pretty sure there is a biscuit recipe available on this site that is supposed to help you with supply as well.

I think you are doing an amazing job of continuing to feed/express and offer formula. If you are really worried, go and see the midwife or health nurse as soon as you can or call the LC again. Don't feel like you are overreacting or overly worried, any questions are good questions if they help you and put your mind at ease.

Cece, as Marcellus has said, not feeling full between feeds is not an indicator of supply. Feeling full between feeds is a sign of oversupply, not feeling full is normal. The fact that you getting some out when you express after a feed suggests that you have enough milk.

Worrying about supply is the most common thing mums worry about - even mums who have had an easy start with bfing. I can imagine that it must be even more worrying for you after your difficult start. Luckily there are some signs to help you figure it. The best way to tell that your baby is getting enough milk is from the nappies - 5 or more heavily wet disposable nappies (or 6 - 8 pale wet cloth nappies) in 24 hours, and 2 or more soft or runny poos in 24 hours are the best signs of enough milk. Some weight gain over 3 - 4 weeks and good skin tone with bright eyes are also good indicators. Jaundice can make babies sleepy and breastmilk is particularly important as this helps to remove the bilirubin. However if the jaundice is not clearing you might need to see a medical professional for a check up. Have you been given a follow up appointment at all?

Cece hun, it really does sound like you are making fantastic progress. It is normal for babies to prefer one breast to the other and the sucking sounds like it's going better. I agree that seeing someone face to face would be reassuring for you - either an LC or perhaps you could go to a local ABA group meeting and talk to a counsellor. I think you are doing such a great job, I really hope that everything is easier soon for you :hug:

:hug: honey. I agree that an LC in person would be a great idea for both you and Bradley. If I could give you some adivce about BFing, I would... but considering we only made it to 6 weeks and I was comping with formula from day dot... I have nothing. But my issue was definatley supply. I wish I'd gone and seen my GP early to get some help from him or booked in at the local Private Hospital because they have a brilliant LC feeding program where you stay there as long as you need to establish good feeding.

:hug: honey. I am so proud of you and everything you're doing.

MG