help needed for a friend..

[STARRYSKY]

Hi guys, Im hoping some of you lovely ladies can give me some advice and help to support a friend of mine who really wants to Bfeed her 5 d/o son.
He was born by Csection 5 days ago at 38 wks due to GD, spent a little time in scn due to low blood sugar and was given formula for a bit.
they have been out of hospital for 2 days, was kept in an extra day as little J had lost more than 10% of birthweight.
so My friend was discharged having not seen a LC as she requested , and feeding witha nipple shield on one breast.
I spoke to her today quickly, she is really relying on me to support her with this, she feels she failed miserably with her daughter and really wants to do it right this time (her words, not mine)
so firstly, she tells me that she spoke to a LC on the phone, yesterday, was told to feed 4 hourly (!) she is also worried about weather he is getting enough as only seems to feed for 5 mins from one breast (with shield) but will latch excellently and suck for aaages on the other.
I have told her that IME new borns were fed every 2 hrs or do what I did and chuck him on when ever he wakes and before a sleep, every time he cries or makes a sound.
I have no experience with nipple shields, why are they used? how do you stop using?
I also told her that as long as J was having plenty of wet nappies he would be getting enough and not to stress about it.
I have encoraged her to ring The ABA and speak to someone, but I dont think she will, I have also told her about BB and the wonderful support here but shes just not into it.
So I would realy like to help her as much as I can, TIA .

[Miss H]

In my experience, feed as much as possible to establish BF in the beginning. My babies seemed to never stop feeding. Why is she using a nipple shield on the one side? He obviously doesn't like it if he is not drinking too much from that side. I'd tell her to feed whenever he will take it and to get rid of the nipple shield if she can.

[BabyQ]

For starters good on you for being there to support your friend! Ok, I had to use a nipple shield for a while until mine healed..and one of the reasons the baby might not take to that side is because it takes a bit longer for the milk to come out. Baby might also have a favoured side-my ds liked the left better. ...feed feed feed as others have suggested. I think my ds fed for about an hour and a half in the beginning..and stuff the 4 hourly rule...especially if baby needs to gain more weight.
Another idea- If the baby isn't taking more than 5 minutes on the one side have your friend express afterwards..until she doesn't need the shield anymore...
when i didn't need the shield anymore i just took it off..there's no weaning process...just make sure she's putting it on properly...i had LC's and midwives watch me use it improperly without saying a word!!!...it should not just be placed over the nipple (like i'd been doing)..invert the shield, so nipple pointing to nipple, then close the rest of the shield over the areola holding it in place with one hand, then carefully, pull the nipple part of the shield out. it should make a suction and pull out the nipple for better attachment (sorry if that's obvious to anyone else..it wasn't to me).

for you and your friend. hope that helps...if i can think of anything else i'll come back.

[Fleur]

Ok, first of all - not sure how it works in SA, but in QLD there are LCs attached to the hospital in clinics that you can see even after being discharged. If they have the same thing there, her MCHN might be able to put her onto one, or otherwise contact the hospital. It might be good for her to see someone in person?

I can't understand why she was told to feed 4 hourly?... that advice seems kind of out-dated? just me but I would say feed whenever bub seems to need it.
Especially if she is using shields, and he is so little, her supply isn't really established yet.

Babies usually have one side they prefer, so the shield might just help him along a bit until he is older. My DS was just a bit lazy & needed the help for a little bit - I just kept trying him without it until he eventually 'got it'. I think it was about 4 weeks or so before we stopped using them but I have heard of mothers who have BF for months with shields.

A lot of LC's don't like shields, but they worked fine for us. I'm pretty sure the current advice when using shields is to make sure that the breast is being emptied - sometimes milk supply can drop a bit , so it's a good idea to express a little bit off afterwards.

If he is feeding well from one side, and having plenty of wet & dirty nappies, then he is getting enough. Some babies will have a permanent preference for one side - her body will adjust to suit how bub is feeding.

Sounds like she is doing a great job & just needs a bit of support - she's lucky to have a friend like you

[Shades]

I'll second the 'feed whenever s/he'll take it' advice - CJ was almost permanently on the boob it seemed the first couple of months - and my supply has been great.
Also query the use of the shield, get rid of it if she can as bub does seem to dislike it, or if not then make sure to express after the feed so the supply doesn't drop in that breast. Personally, unless it's for inverted nipples or something I'd be thinking shields just prolong the 'getting used to it' part for the nipple and would mean it would stop hurting later rather than sooner.

[onthefly]

How's your friend going?
Calling the ABA would be a great idea, if she's up for it. It is so hard to go and get help, isn't it? It's one of my greatest regrets from early motherhood - not seeking out more help. It's out there if you'll just go and find it.
Would she go to a local meeting of the ABA if a good friend went along with her perhaps...? Once she's met her local counsellors she might find it a lot easier to seek help.

4-hourly feeds for a newborn sounds very wrong to me.... 2-hourly would be closer to the mark at that age - and especially if weight gains are a worry.
I'm not sure what the go is with the shield - you'll have to ask about that. Was the nipple damaged? Or maybe they told her to use it as it's flat/inverted or something...?

Hope she and her baby are doing well.

[Jennifer13]

Let us know if there's anything further you need to help your friend out, hun. She'd probably appreciate some assistance with her other child so she can focus on getting things established with the new baby, if you're in a position to help. Good on you for being there for her!

[~clover~]

My DS fed 2 hourly for alot of months during the day. On off days even hourly. But didn't spread any feeds out til 3 hourly til he was 8 months old.
All babies are different, but 2 hourly is the average for a BFed NB. I would suggest to her to just feed him when ever he needs comfort. Be it 30 minutes ago, or an hour ago.
DS used to cluster feed at night as well, so from about 5 ish he would basically feed for 3 hours straight.

I used shields when I was cracked. They gave my nipples a break while healed. I just gave it 2 days, then would be fine to feed without them.

I would be trying to get her to another LC. They are worth their weight in gold

Your a great friend. Goodluck.

[STARRYSKY]

Thankyou for all your replies!

I was shocked that she was told to feed 4 hourly!

I will be ringing her today to see how she is going, her DD is in CC 3 days a week, so she has a bit of a break.
I didnt even ask why she was using the shield will find out today.
I know she was expressing a bit in the hospital, I am going to lend her my pump so she can continue to pump if she wants, might help to up the supply in the other boob.
Thanks again ladies, youre all fantastic!