Getting a sleepy bub to attach and keep sucking

I'm after some advice on some strategies to get my sleepy newborn to attach at the breast and keep sucking.

He was born at 36 w weighing 2.6 kg. He lost just shy of 10% of his weight before we left hospital. We are due for another weigh in this Thurs. Wet nappies are ok.

I have to wake him for every feed without fail. We tend to spend around 30 - 45 mins messing around with waking him up, getting him on then falling asleep. I am expressing and topping up with EBM in order to keep him fed and build supply.

I am confident my attachment is good as his lips are flared and there is no pain. He's not jaundice.

Any thoughts? Or is this an issue that will simply improve with time? I'm relaxed with how our feeding is going but thought that wiser heads might have some thoughts.

Also, how often and for how long should I be expresing?

ta,
Fiona

I had the same problem with DD... I dont have any advice but wanted to let you know Im thinking of you coz its really sucks when they keep doing that. I gave up @ 6 weeks.

I had exactly same issues with DD1. She was 2.6kg as well. :) I used to strip her off so she wasn't all warm and snuggly, i would tickle her feet and sometimes use a wet flannel on her to keep her awake. Feeding took 45 mins each side in the beginning and I had to wake her every feed. It was exhausting but it did improve and we got there in the end. It was just slow to begin with.

Tickling bubs ears and along their jaw line can encourage sucking. Good luck with your weigh in.

About 45 minutes after a feed, the breast has made more milk so this is a good time to top-up or express.

I was exactly the same - DS was 36+3 and 2.6kg and for the first few weeks we would have to sometimes wake for feeds. A cool face washer worked with waking him and stripping him down to nappy, once he was awake and on the boob if was all good although sometimes he'd just fall asleep while feeding. It passed after a few weeks and then he was letting us know in no uncertain terns that he wanted a feed on HIS terms.
Hang in there :)

Hi,

Tell me - what have the pooey nappies been like - this is the real "paydirt" for breastfeeding success! She is only 6 days old - but her poo should have transitioned from black to greeny to yellowy and be a couple or more a day. She is exhibiting pretty normal "near term" behaviour. Hospital staff are pretty blase about 36 weekers - they see 27 weekers all the time. But by rights she should still be inside you, being fed constantly, with no effort from her. These guys are on their L plates and they can often look like they are feeding well, but have trouble actually transfering milk on their own. When you pump, how much do you usually get? Do you pump after every feed? Are you feeding her every 3 hours? Is she jaundiced (this makes them very sleepy)Sorry for the questions!
The key to "waking these babies up" is getting more milk into them. It's not the sort of sleepy where they sleep and wake refresshed, it is the sort of sleepy where they just don't have the energy to wake up - but it quickly turns around, and your breastmilk is all she needs.
Have her skin to skin with you - sit up in bed or on the couch and just have her on your chest. That way if she shows signs and wants to feed (wriggling and mouthing) she is right there - in the right environment, so to speak. if a baby is in a basinette, they may briefly show these signs, but if no-one notices they quickly give up and go back to sleep.
Let us know how you are going.

Thanks everyone. I feel a bit like a torture master but I'll give the suggestions a go.

Barb - in response:

Poo - not black but not yellow. I'm saying greeny brown. One a day for the past 2 days.

Pumping - amounts increasing daily. Just now was 17 ml. Yesterday was 5 ml. I am pumping after each feed.

Feeding times - yep 3 hours during the day, 4 overnight.

No jaundice. My first son was jaundice and his skin is quite different. I was paranoid about this in hospital as I wanted to avoid phototherapy.

I do the skin to skin but with an 18 month old around it can be challenging. He in back in childcare this week so I'll have a few days to properly skin to skin.

Fiona




Sent from my iPhone using Tapatalk

I think you are nearly there - things will change dramatically over the next days - he will become much more alert. Does she have both breasts at every feed? (having both breasts will mean he will get more milk overall, rather than spending a really long time on one. What sort of pump do you have?
How did the birth go?

Hi Fiona. Congrats on the safe but early arrival of your LO :)

Firstly I want to say well done on getting on top of all this so quickly! DD, admittedly my first baby, was extremely sleepy and was a lazy sucker but I wasn't aware if this until a weigh in at 2 weeks :redface: DD was born 6lb 8oz at 38+5 and was SUPER sleepy. Her tiny mouth was no match for my massive nipples either, lol.

I expressed after every day and evening feed (but not overnight) until DD was around 16 weeks I think. I probably didn't need to do it for that long though (it kind of became habit) as she improved out of sight around 12 weeks. At around 2 weeks, when I started pumping, I was expressing about 20-30ml a side after a feed.

DD took about 40 minutes a breast and I always offered both sides with a nappy change in between. I nearly always fed her in the lounge with the TV on to keep us both a bit awake. I stripped her off where possible, even if it was just her legs or chest bare.

My LC gave me some brilliant tips which really helped although I was unsure about them at the time. After weighing DD after each breast a couple of times, we found there was a limit to how much she'd drink before she gave up then comfort sucked so I was to limit her to 20 minutes a side then express while DH (or who ever was handy!) offered her a top up of EBM. I also had to wake her during the day every 3 hours and every 4 overnight. She really needed to be feeding by the three hour mark and I was surprised how quickly she found her groove and started waking on her own around 3 hours.

The top ups of EBM really helped give her the weight she needed to gain strength to tackle my breasts :lol: Doing all these things she gained close to 300g in a week as opposed to her 60g (I think it was, will double check shortly) in the first 2 weeks of being born.

We also did a few skin on skin days in bed where I literally just hung out with her all day, semi naked, feeding her as much as I could. I noticed a significant difference with her feeding after those days. Every little bit helped.

You're already doing a great job to get on top of things. Hopefully you're little man will have a couple of great weight gains and find the strength he needs to find his BF groove soon.

Good luck :D

There are also exercises where you touch your finger to the 4 points around his mouth - cupid's bow, side of the mouth, under the lips, and other side - hold the pressure for a count of 2 each time. Then stroke his moustache twice on the left, twice on the right, twice on the left under the lip, and twice under the lip on the right. This will get him ready to suckle - I still use this when my little man is wrought up and won't attach, works a treat.

Good luck :hug:

Good luck!
Hopefully you'll get a bit more milk into him and he'll wake up.... and then it's on!

My husband and I find it very funny. Our 18 month old is a crap sleeper - always has been. After our experiences with DS1, waking him up goes against everything we know. Ah babies, they are odd little creatures.

Barb - I do offer both breasts as I find switching sides tends to help wake him after his attachment drops. I have a Medela Swing. The birth was hard and fast. Briefly, I was induced due to pre-eclampsia. One dose of the synth drip and I dilated 8 cm in one hour. No drugs or tearing. I feel pretty back to normal now.

Taurean - Thanks for the feedback. I stopped BFing my first son for a whole range of reasons. Hindsight is a wonderful thing and I learnt so many lessons from last time. This time I think I've got a good plan to succeed and I'm so much more relaxed. I'm also used to functioning on little sleep so think that will be my secret weapon.

You have a good point about feeding BY the three hour mark rather than starting to wake at 3 hours. Sometimes it takes so long to get him up that I lose half an hour to 45 minutes. When you have to fit in an express and enough time for your supply to rebuild before the next feed that time is precious. I'll start to wake him a little earlier now.

My MIL has seen my boobs enough not to be embarrassed so I think we might take to bed tomorrow when DS1 is in childcare and she comes over to help put the house in order.

Thanks again for your advice. I might pop back in a week or so to take stock of how things have improved!!!

Cheers,
Fiona

Glad some of my info might help :) I totally agree with waking your DS in time for a feed at 3 hours, not waking at 3 hours. DD took forever to wake some times too so a head start really helped.

I just checked her records and her weight gain (or lack of) leaving hospital was worse than I thought! She'd only gained 35g in the 12 days of leaving hospital :o Scary stuff! With all the expressing and top ups of EBM and waking her for frequent feeds, she gained 370g in the following 10 days :D We had issues until about the 12 week mark though as I kept thinking one decent weight gain meant our problems were sorted :rolleyes: and slacked off, so to speak, only to be shocked by a crappy weight gain when I next saw my LC. I finally realised I had to stick with the 'plan' until DD had consistently good weight gains and started showing signs of taking the lead ie waking for feeds instead of me waking her, improved attachment and better intake at the breast (my LC weighed her many times before and after each breast to check her intake).

We would have definitely gotten over our hurdles sooner had I stuck with the plan all along but I have to admit, I found expressing all the time very, VERY time consuming and stressful. It's a hard slog but it was so worth it in the end. I BF DD until a couple of weeks before her 1st birthday. We did do some FF along the way as to be perfectly honest, I got so sick of expressing, to the point where seeing a breast pump made me feel physically ill and so stressed. I did become comfortable with it again eventually so I expressed with a Swing when 'I' wanted to.

Definitely keep us posted on how you go. I think you'll do really well. You seem to be in the right head space and have a great plan to get things happening.

We ended up using mostly EBM bottles for the first 6 weeks or so, since bub wouldn't drink enough before falling asleep.
Bad singing helped keep him awake, but I also used water drips, ice-cubes, no clothes (but this was in March, not June!). It did improve hugely as he got a bit bigger and stronger.