Please help, 3 day old bf concerns

[Smanderson]

I'm so confused, I wasn't really prepared for bf to work as I tried so hard with ds1 and was unable to get him to latch. Ds2 is now 3 days old and latches easily and appears to feed when latched, however he has only had 2 poop nappies and 1 wet nappy since 2:30 this morning!

I've fed him 3 hourly but he seems to want to sleep most of the time, I think he's a bit jaundice so I know it's really important to get fluids into him. I strip him down to wake him and he usually wakes and feeds for around 20 mins. He often falls asleep though...

I'm panicking about the lack of pee and possible jaundice so I've started offering top up feeds after each by session and he takes around 20ml. Why would he take this if he's satisfied with bf enough to take himself off the breast? I'm so confused!

I don't understand how he feeds for so long (I feel him sucking and looks like he's swallowing) but no pee?! My breasts feel sore and full before a feed, after a feed they feel less full but there is still a hard bit at the side that is tender, is this normal? Does it mean he's not drinking enough? I don't understand, I am completely clueless.

Ohh I forgot to say my milk appears to have come in day 2 it looks watery with white ? Is that ok? Also my breasts leak loads, and when he's feeding one side the other side leaks....is that normal?

Edited to add my iron levels are low and the midwife says that may affect the calories in my milk. Maybe this is why it's watery with white?

 

[ja14]

Was your LO born on the 10th? Mine was!
We've been having some BF frustrations as well. I don't have any advice, but I'll be following!
It seems my LO has a great latch, but he won't hold it or if he does doesn't seem to be sucking out all. He jut fights it! I know he wants to suck though because if I give him my finger to suck he's content in about 2 seconds.
Some feeding he does great though, and I don't think I'm doing anything different.
I've been worried about his dirty diapers too. On his first day he had a few, yesterday none, and today one.
I noticed at our last feeding I'm expressing a little milk & he loved that! I was a great feeding so hopefully things improved. His pediatrician appt is Monday, anxious to see his weight. He had already lost 6-7% before we left hospital.

 

[Marumi]

I've fed him 3 hourly but he seems to want to sleep most of the time, I think he's a bit jaundice so I know it's really important to get fluids into him. I strip him down to wake him and he usually wakes and feeds for around 20 mins. He often falls asleep though...

Just a thought, maybe he peed some when he pooped and it was less noticeable? A small amount of pee will get soaked up by a good diaper. Squeeze the diaper to check for liquid. Jaundiced babys are sleepy. What are his levels?

I'm panicking about the lack of pee and possible jaundice so I've started offering top up feeds after each by session and he takes around 20ml. Why would he take this if he's satisfied with bf enough to take himself off the breast? I'm so confused!

He likely falls asleep before he is completely full. I had to feed my jaundiced newborn more often. He is one month old almost and still too sleepy at night to finish a feed with very mild jaundice so he wakes more often.
While in the hospital (we stood longer bc of his jaundice) I nursed on one side, let him nap for 20 mins, woke him again and let him have the other. He gained well this way despite jaundice.

I don't understand how he feeds for so long (I feel him sucking and looks like he's swallowing) but no pee?! My breasts feel sore and full before a feed, after a feed they feel less full but there is still a hard bit at the side that is tender, is this normal? Does it mean he's not drinking enough? I don't understand, I am completely clueless.

Keep an eye on the pee, that is a bit odd. Are you home already? Either have a nurse or pediatrician have a look if the amount of pee does not increase. Though a 3 day old pees smaller amounts too. Your breasts will be hard for a while because your milk is just coming in now. That is normal. You can warm tjem before a feed and cool after for optimal release of breastmilk and to reduce swelling. Works wonders.

Ohh I forgot to say my milk appears to have come in day 2 it looks watery with white ? Is that ok? Also my breasts leak loads, and when he's feeding one side the other side leaks....is that normal?

Oh yeah you get let downs on both sides. Totally normal I am drenched in milk during the first month whenever I only think of breastfeeding. It can be such a pain.
Watery white milk is likely foremilk. It is thinner and more watery for hydration, hindmilk at the end of the feed is more fatty. That why it is important to let your baby finish one breast before offering the other.

Edited to add my iron levels are low and the midwife says that may affect the calories in my milk. Maybe this is why it's watery with white?

Have you pumped a full bottle? When you do that you can see the fat content. Foremilk is always watery, so if you pump a small amount it will be watery. I let my toddler drink off some foremilk if I am too full so my baby gets more of the fatty milk. As an alternative you can pump off 10-20 ml to see if your baby seems more satisfied.

To increase calories in milk eat good fats like avocado, real butter (best grassfed), fatty nuts and fish for example.
Iron levels are low for most after giving birth. If you aren't severely anemic I would not worry. Mine were 10.9 after pregnancy and 13.5 before.

 

[Smanderson]

Sorry for delay, kept typing reply and then my ipad would refresh as I was getting distracted with feeds etc. On phone now so there's a chance this reply will make it!

Ja How's everything going? My ds2 was also born on 10th may How's his sucks going now? Ds2 has a tongue tie which is apparently stretchy so hasn't affected things too much but feeds on left are quite painful. He's doing loads of cluster feeding at night now then sleeps for 4 hours which is great timing. Lots more wees happening now I'm wondering if he was just not taking very much and now fills up enough for big wees...

Marumi thank you so much, I did what you suggested offering boob again once he woke from falling asleep on boob and he takes it every time. Think he just gets tired bless him. I don't know his jaundice levels but midwife said it's very mild and was pleased he wakes at night to feed.

I've been put on iron tablets but they decided against an infusion though I passed out several times the first time they mobilised me after c section which they said was iron levels, BP dropping and pain related. no idea what they are like now, I'm pale and tired but no passing out etc so guessing taking tablets and eating cabbage will help.

Are there any foods/drinks I should avoid while bf? I dint drink alcohol but I love my coffee. I also had a curry the first night home and my mum said I shouldn't have?

I haven't pumped yet the midwife suggested I waited though didn't say for how long. When he possets the milk looks quite creamy but I dint know what the stomach does to it or if it's showing the later part if the feed is OK...? Still looks water with white fresh from the breast though. I've started making sure he stays on one side per feed.. how would I know one side was finished to offer the other side?

Thanks again for your advice it's made s massive difference xx

 

[noon_child]

Are there any foods/drinks I should avoid while bf? I dint drink alcohol but I love my coffee. I also had a curry the first night home and my mum said I shouldn't have?

Some people avoid caffeine but I never did - I needed it too much to function. There is no evidence you "should" avoid it, or any other food/drink (except alcohol). Curry is fine! In fact it will flavour your milk a bit so LO might be more likely to enjoy the food he has "tasted" through your milk when it comes to weaning.

I haven't pumped yet the midwife suggested I waited though didn't say for how long.

You don't have to pump at all. How long you wait depends on why you are pumping. If you start to early you can cause oversupply which can cause its own issues (baby struggling to latch or overwhelmed by milk, or blocked ducts etc.) but some people need to form a bit of an oversupply in order to build a freezer stash for returning to work etc. Others need to pump because baby isn't an effective feeder. What are your reasons?

When he possets the milk looks quite creamy but I dint know what the stomach does to it or if it's showing the later part if the feed is OK...? Still looks water with white fresh from the breast though.

Stuff that leaks from the breast is always watery - don't worry about that it is normal. Also I can find absolutely NO evidence to say anaemia causes low calorie milk. There is evidence that uncontrolled anaemia can cause low milk supply but it doesn't sound like you are suffering from that, and you are taking steps to control the anaemia so I would definitely stop stressing about the quality of your milk. Women can produce high quality milk till they are on the brink of malnutrition/starvation. Your milk is perfect!

I've started making sure he stays on one side per feed.. how would I know one side was finished to offer the other side?

If he falls asleep on the boob (rather than taking himself off) then I'd say he hasn't finished and put him back on the same one. However if when you do this he takes a few sucks and pull off or fusses, then he's probably ready for the other side. The more often he feeds the less it matters whether he goes back on the same side or a different side, but the longer there is between feeds, the more important it is that he is allowed to 'finish' one side. This is because longer between feeds gives time for the fat content to get "stuck" inside the breast - this is sometimes referred to as foremilk and hindmilk but the breast only produces one type of milk; milk that is freshly or recently produced has fat mixed through it, milk that was produced a while ago has fat separating from the water and getting stuck to the sides of the ducts.

 

[Marumi]

Sorry for delay, kept typing reply and then my ipad would refresh as I was getting distracted with feeds etc. On phone now so there's a chance this reply will make it!

Ja How's everything going? My ds2 was also born on 10th may How's his sucks going now? Ds2 has a tongue tie which is apparently stretchy so hasn't affected things too much but feeds on left are quite painful. He's doing loads of cluster feeding at night now then sleeps for 4 hours which is great timing. Lots more wees happening now I'm wondering if he was just not taking very much and now fills up enough for big wees...

Marumi thank you so much, I did what you suggested offering boob again once he woke from falling asleep on boob and he takes it every time. Think he just gets tired bless him. I don't know his jaundice levels but midwife said it's very mild and was pleased he wakes at night to feed.

I've been put on iron tablets but they decided against an infusion though I passed out several times the first time they mobilised me after c section which they said was iron levels, BP dropping and pain related. no idea what they are like now, I'm pale and tired but no passing out etc so guessing taking tablets and eating cabbage will help.
[\quote]
That is good the jaundice levels are low. Some babys with higher levels still wake to feed (mine did while in phototherapy)

Are there any foods/drinks I should avoid while bf? I dint drink alcohol but I love my coffee. I also had a curry the first night home and my mum said I shouldn't have?

There is no set rule. It depends on your baby. Some aren't affected, some are. Caffeine is said to be limited because it can keep them up. Some babies are sensitive to Gluten or Dairy. I am avoiding it because my lo has gas problems and reflux (I had to take lots of antibiotics in pregnancy and he also had them after birth)

I haven't pumped yet the midwife suggested I waited though didn't say for how long. When he possets the milk looks quite creamy but I dint know what the stomach does to it or if it's showing the later part if the feed is OK...? Still looks water with white fresh from the breast though. I've started making sure he stays on one side per feed.. how would I know one side was finished to offer the other side?

Thanks again for your advice it's made s massive difference xx

You're welcome
I was just asking about the pumping because that way you could see if your milk was very watery and I was wondering if maybe you pumped and saw it was watery or you were judging by letdowns.
Babies will usually pop off once one side is finished because they got full off of hindmilk. With a sleepy baby that is a bit tricky. I tend to offer the same side again to be sure and also judge by how empty it feels.
When baby drinks hindmilk the suckling will also slow down and often you can see thick, very sticky drops of milk near his mouth. Mine is a messy eater

 

[ja14]

Last night I decided to pump and feed from a bottle. I don't think LO was really getting much from the breast because he was usually either fighting it or falling asleep. He was having went diapers, but didn't seem like much. As for dirty diapers he had 1 early yesterday, and none in the last 24 hours.
He was so satisfied after that first bottle!
It was a little disappointing for me to have to do that, but now I can be certain he's getting what he needs.

 

[Marumi]

Last night I decided to pump and feed from a bottle. I don't think LO was really getting much from the breast because he was usually either fighting it or falling asleep. He was having went diapers, but didn't seem like much. As for dirty diapers he had 1 early yesterday, and none in the last 24 hours.
He was so satisfied after that first bottle!
It was a little disappointing for me to have to do that, but now I can be certain he's getting what he needs.

It will take them longer to get the same amount from the breast and for young babies this can be frustrating. Having to work for it works in favor of their jaw and teeth and bone development too though. Some babies also overeat a bit with bottles.
It will get easier with every month. My first was like a new baby after 4 months.

 

[noon_child]

Last night I decided to pump and feed from a bottle. I don't think LO was really getting much from the breast because he was usually either fighting it or falling asleep. He was having went diapers, but didn't seem like much. As for dirty diapers he had 1 early yesterday, and none in the last 24 hours.
He was so satisfied after that first bottle!
It was a little disappointing for me to have to do that, but now I can be certain he's getting what he needs.

It is so normal for them to fight and fall asleep, it doesn't mean he doesn't want to breastfeed or that anything is wrong. ALL babies do this.

Im not saying you can't offer pumped milk (I did as it would take hours to get her to latch, I was in constant pain and her weight was not going up - but people choose to offer pumped milk for a variety of reasons which is fine) I just don't want you to think you HAVE TO offer pumped milk otherwise your baby will not get what he needs.

Yes you need to keep an eye on the poo output, but as long as when he does poo it is changing colour from meconium towards green then orange/yellow then there isn't an immediate cause for panic. Do you have a support group you could go to, or are there any lactation organisations where you live (like La Leche League)? These guys saved my life when I was struggling.

 

[Smanderson]

Noon child thanks that's really interesting about them tasting food through breast milk. I didn't realise they got the flavours, I will be eating broccoli and cabbage etc so he likes his veggies!

I don't really want to pump to be honest as I just wasn't sure why or how long the midwife wanted me to wait in case I changed my mind. I'm relieved the stuff that leaks is always watery at least I know it's not a supply issue, so glad to hear my milk quality will be good even under extreme circumstances. You've really put my mind at rest thank you!

How long would you recommend between feeds? We've been trying for 3 hourly but he does seem to cluster feed too. He was doing it at night but he didn't last night and did it this morning instead.

Marumi so far he doesn't seem affected by the caffeine so I guess I should just see how we go.

Ja best of luck with pumping if it helps give you peace of mind hope all goes well xx

 

[noon_child]

How long would you recommend between feeds? We've been trying for 3 hourly but he does seem to cluster feed too. He was doing it at night but he didn't last night and did it this morning instead.

When my LO was still under birth weight I was told 2hrly feeding schedule, then when she got her birthweight it could drop to 3hrly. If LO is doing well on what you are doing now then don't feel you have to change it because someone else did something different.

Really the ideal would be that they would be skin to skin 24hrs a day able to snack and sleep whenever they wanted with no real distinct difference between feeding time and not feeding time, however it's not always the case that we have safe co-sleeping environments or can handle (emotionally) that level of dependance - we're just not programmed to expect it, we want an animal that stays in the nest when what we get is an animal that needs to stay in our arms!

So quick answer - as often as possible. Like pp said, if he falls asleep mid feed and wakes 20mins later, offer a boob. Newborns have very little waking time that isn't about feeding. Baby being constantly hungry isn't a sign that anything is wrong as long as weight gain happens, mum is pain free, poo and wee output is good. They have tiny tummies and a huge amount of growing and learning to do so obviously it requires food all the time. Think of people who do weight training who have to eat protein every 2hrs - and they don't even have tiny tummies!

 

[Smanderson]

When my LO was still under birth weight I was told 2hrly feeding schedule, then when she got her birthweight it could drop to 3hrly. If LO is doing well on what you are doing now then don't feel you have to change it because someone else did something different.

Really the ideal would be that they would be skin to skin 24hrs a day able to snack and sleep whenever they wanted with no real distinct difference between feeding time and not feeding time, however it's not always the case that we have safe co-sleeping environments or can handle (emotionally) that level of dependance - we're just not programmed to expect it, we want an animal that stays in the nest when what we get is an animal that needs to stay in our arms!

So quick answer - as often as possible. Like pp said, if he falls asleep mid feed and wakes 20mins later, offer a boob. Newborns have very little waking time that isn't about feeding. Baby being constantly hungry isn't a sign that anything is wrong as long as weight gain happens, mum is pain free, poo and wee output is good. They have tiny tummies and a huge amount of growing and learning to do so obviously it requires food all the time. Think of people who do weight training who have to eat protein every 2hrs - and they don't even have tiny tummies!

Thanks, that's exactly what I needed to hear, he's been feeding a lot today and was starting to think maybe there was an issue with either supply or comfort feeding but it's good to know it's normal and I can just go with it. He lost 7.8% of his birth weight by day 5 so I'm hoping he will have put that back on when they weigh on day 10. It seemed like a lot to lose in 5 days. Wee and poo output has gone from low to really good, we've had 4 poos and wees today and one of those was nappy change time it was like a fountain huge amount I probably should have been horrified but I felt happy to see so much wee

 

[ja14]

He had his first check up today since leaving the hospital, and he's lost nearly a pound total (birth weight was 6 lbs 14 oz, he's now 5 lbs 15 oz). So I think it's good I went ahead and gave him the milk from a bottle yesterday. I'm still pumping and giving bottles, however I'm also still working with him on the breast. Now that I'm not engorged, he actually seems to be doing a lot better, so he doesn't seem to have nipple confusion.
Now my concern is my supply, it needs to be a little higher. I'm breastfeeding him on each side, at least 5 minutes depending on how it's going, and then pumping for about 15 or so minutes. Hopefully the demand will up my supply!

 

[noon_child]

He had his first check up today since leaving the hospital, and he's lost nearly a pound total (birth weight was 6 lbs 14 oz, he's now 5 lbs 15 oz). So I think it's good I went ahead and gave him the milk from a bottle yesterday. I'm still pumping and giving bottles, however I'm also still working with him on the breast. Now that I'm not engorged, he actually seems to be doing a lot better, so he doesn't seem to have nipple confusion.
Now my concern is my supply, it needs to be a little higher. I'm breastfeeding him on each side, at least 5 minutes depending on how it's going, and then pumping for about 15 or so minutes. Hopefully the demand will up my supply!

Yes, I had to offer expressed milk because we knew we had a problem. In my previous reply about feeding expressed milk I was confused and thought I was replying to the mum whose baby had good weight gain.

If your baby has lost that much weight, how much support are you getting to identify the cause?
There are a few things that can cause low supply like large blood loss during labour and lack of breast tissue or breast malformations (which is very rare) but by far the biggest cause is a baby who is unable to effectively suck or latch properly or too infrequent feeds.

So on that basis, when he feeds for 5 minutes is he actively and strongly sucking and swallowing?
How often does he feed in 24hrs?
Does he ever take himself off the breast himself, or fall does he fall asleep with it in his mouth?
If you can get him to suck your finger, can you feel his tongue cupping your finger underneath or can you feel his bottom gums doing some of the work? (he could be tongue tied if he uses his gums rather than tongue to suck which is why I ask - although babies who can stick out their tongue can still be tongue tied).
Do you have any nipple damage or pain?

Sorry for the barrage of questions. It is hard to sound supportive on a forum rather than like I'm questioning what you are doing, but really I want to identify ways to help you. Everyone is in the same boat with not knowing what to do for the best. Breastfeeding nearly broke me till finally we "got it" and it was so great! I want everyone to heal the way I managed to.

 

[Zephram]

There is some great advice here on this thread. I just wanted to give my two cents about frequency. I bf both my boys every 1-2 hours as newborns. 3 hours sounds too long to me in the first couple of weeks. I would bf your baby at least every two hours.

Ja14 - breastfeed your baby longer than five minutes each side! The general rule is to let them finish the first breast - keep going until baby stops swallowing or falls asleep - then wake him up if you need to and put him on the other side until he's finished. 15 minutes each side is kind of a minimum rule midwives bandy about. It can take longer, my DS1 used to feed for 40 mins at a time. My DS2 was mega efficient and took 10 mins all up as my supply was massive second time around.

If you want to increase your supply I would put baby to your breast every 1-2 hours and leave him as long as he wants on each boob. They get more out by sucking than you do by pumping.

 

[ja14]

Thanks for the advice!
I would reply to sections of your comments, but currently doing this one handed on my phone

The reason I just nurse him on 5 minutes on each side is so he stays familiar with the breast & possibly help with letdown when I pump. If he's doing well, I leave him there, but he usually isn't. I've only been able to hear him swallow a couple times at breast. It comforts him at times, but he's not eating.

We have been feeding him at least every 3 others or more. Through out the day, typically more because it seems he's likes drinking smaller amounts more frequently. Night time is hard though, because he sleeps through the night. Who would have thought that would be annoying. I set an alarm on my phone, but being sleep deprived I sleep through it.
That also means I go longer without pumping which is no help to my supply.
I am pumping right now though and I've pumped for twice the time getting twice the amount. Another frustration is that my husband offered to clean my pump parts last night and tore a duckbill valve do I can only single pump until my replacement parts come in.

 

[noon_child]

The reason I just nurse him on 5 minutes on each side is so he stays familiar with the breast & possibly help with letdown when I pump. If he's doing well, I leave him there, but he usually isn't. I've only been able to hear him swallow a couple times at breast. It comforts him at times, but he's not eating.

And are you happy with nearly exclusively pumping or do you need support to get your LO to feed directly from you? I know all the support routes for the UK but the US confuses me as different states work differently and insurance comes in to play etc. Do you have access to La Leche League there?

 

[campn]

Ladies I had such a struggle with DS too. I had to exclusively pump for 6 weeks every 2 hours day and night cause he wasn't latching.

I recommend getting a lactation consultant right at your home. I was going to the hospital for a lactation consultant but it didn't work until I brought one consultant home so she can help right on my bed or wherever I nursed. It's like something clicked then and I breastfed DS for 19 months. It was the happiest feeling ever to get him to latch and not scream and cry at me.

Best of luck to all of you mamas you are wonderful!

 

[ja14]

Exclusively pumping was getting terribly depressing, so today I bought a nipple shield and he has been nursing like a champ!!
I never really considered a nipple shield before, because I've heard so many bad things, but it is such a better alternative!

 

[noon_child]

Exclusively pumping was getting terribly depressing, so today I bought a nipple shield and he has been nursing like a champ!!
I never really considered a nipple shield before, because I've heard so many bad things, but it is such a better alternative!

Brilliant!