Newborn woes...UPDATE 4/2/11 :-)

mommylove

So Sebastian was diagnosed as jaundice while still in the hospital at 2 days old. His score at that time was in the high risk range at 14.1. He spent 12 hrs under a phototherapy light and the next day his score had dropped 1 point to 13.1. We were then discharged from the hospital but instructed to visit the Pediatrician the very next morning for a check up. The Pedi ordered a biliruben blood test the next morning and unfortunately Sebastian's score was up to 17.4. He had also lost about 1 pound from the time he was born (6lb12oz to 5lb14oz). We were instructed to go home and feed him every 2hrs even if we had to wake him, not only that but the Pedi recommended we supplement the breastfeeding with unlimited formula (as much as the baby would eat)...I was admittedly heartbroken, since to me breastfeeding my son currently means the world. DP was so sad watching me struggle with that. To make matters worse once I began the formula Sebastian stopped latching, the Pedi said it was because he had become so dehydrated due to the weight loss and didn't have the energy/will tto feed. He has breastfed about 5 times in the last two days and I did begin pumping and bottle feeding him a combination of breast milk and formula. Sebastian has gained back 5.5oz (YAY!), however his biliruben score has still increased. We have yet another blood test tomorrow and the Pedi said we will then decide what step to take next. They are talking so far of just using a "bill-blanket" that gives off the same light as was used in the hospital for the phototherapy. He would use this for 2-3 days. The Pedi did also say that he believe Sebastian's scores are actually starting to top out as when an infant hits about 6 days of age they begin to have far better liver function to clean out the red blood cells. I do know IF he Keeps getting worse he will be admitted hospital...we don't want that.

Couple of questions for anyone that has any advice...
1. I am Determined to breastfed Sebastian...for now Im continuing the bottle feeding per doc instruction but I do breastfed once in the morning when we all wake up, once during the day, and then at bedtime. He gets frustrated sometimes when I try to get him to latch and I don't know why. Do you think its possible to breastfeed and bottle feed, especially considering how early the bottle was introduced? How often should I pump, how much?
2. Anyone deal with the jaundice thing? Any advice?

Best wishes to all of you... :-)


********UPDATE*********

We had another Biliruben blood test this morning and Sebastian's score went down from 19.1 to 18...we are so happy!!!
His Pedi said no longer a need to supplement with formula as long as milk supply is good and baby is feeding well. We've had three feeding sessions already today and Sebastian is latching without problem and eating super well...my supply is definitely all in as I can't even stand over the sink naked to brush my teeth without milk dripping continuously from my breasts. When I was pumping still last night, I was pumping about 3-4 oz every 2-3hrs. Wow! :-)
The journey continues...but for now Mommies are just so happy with our healthy baby boy and his breastfeeding skills. We have our next check up at 2wks with the Pedi and as long as nothing else worrisome arises in the meantime we are free and clear. He also gained another ounce and is now up to 6lbs 4.5oz. In other words our son just simply ROCKS! :-)

Thanks for all the well wishes and advice...it's so great to have you all here as a resource.
Happy weekend to all!!!

babybaby

how frustrating! i'm so sorry you're having these troubles. i know it was necessary, but sometimes it seems like doctors/hospitals try to sabotage breastfeeding. that's how they were with me. they kept insisting it was, "okay to supplement her breastmilk with formula" during my entire hospital stay, and i kept seeing her come back from the nursery with dried milk (formula) by her mouth when they'd take her for weighings/measurements, in spite of the fact that breastfeeding was going well, in my case. anyway, i was just wanting to say that it makes total sense that he's getting frustrated, because it's harder to get milk from the breast than it is to get it from the bottle, or so i've read. i would just really try to push the breastfeeding on him, and gradually cut back on the formula (but that's my untrained opinion, for what it's worth). again, so sorry.

allthingslucky

I'm not an expert or professional by any means, but generally baby doesn't have to work to get the milk from the bottle so I think when the bottle is introduced this early they learn they don't have to work for it and stop wanting the source they have to work at it to get. I know you want everything to be okay with your son, but I would do some research and trust your instinct. Something to help the jaundice is to lay him in a diaper in front of a window with direct sunlight. He wont get burnt because the glass provides UV protection. Leave him in the sun for as long as you can, all day I'm talking. I wouldn't bottle feed him either, that is just me though. Breastfeeding is so beyond important to me and he is only a week old, if he gets too comfortable with the bottle he wont want the breast. I think making sure you stay hydrated as much as possible and you eating well, should be sufficiant. One thing I have learned is don't take all the advice from Drs as the end all be all. It ultimately is their opinion on what is best. I am sure if you asked 10 different doctors, each of them would have a similar, but different opinion as to what they thought was best. Yes, his jaundice level needs to come down, but I don't understand the why you would need to bottle feed if he was being satisifed by the breast and you were doing it every two hours, maybe your pedi is more pro-bottle, I know mine is pro-breast so a lot of the info I got from her was heavily geared towards bf-ing. IMO he perfers the bottle because like I said, there is virtually no work in eating, he has to get the milk to drop at your breast and that isn't instantly gratifitying. If you haven't already try kellymom.com it is an awesome website with tons of breastfeeding advice and articles. If you type janudice in the search tab it will pull up articles about breastfeeding and jaundice. Do you have a lacation consultant? Sorry if this is all over the place, I just wish I would have known half of what I know know about breastfeeding when I was actually doing it. There are many factors that can lead to unsuccessful breastfeeding and a lot of it is avoidable. Oh, as far as how much you should be pumping.. I would pump as if you were feeding him if he wont latch. Depending on what pump you have and how your body works you might not even get an ounce out. I could not get my milk to drop from the pump so pumping for me was useless. But I would ALWAYS offer the breast first and don't get discouraged if it takes time to latch. Try different positions, the other breast, I heard that massaging the breast prior to offering it "primes" the breast.. idk, it breaks my heart when women that want to breastfeed cant. I know in no time your little man will be just fine, I know its scary, but perfectly normal.

lovelymswolf

I am SO sorry . I have felt the dissapointment from not breastfeeding like I wanted. In my case, I was so overwhelmed that I didn't have time to bf enough and my milk never really came in much. I pump only about half oz when I pump, and I bf about 3-4 times a day. I try to bf both boys twice. But it honestly is hard to find the time to do it more to increase my supply. So I totally get it . I had planned for exclusively breastfeeding and so anything less was disapointing. But I had to tell myself that the health of the boys is the most important thing and since I know I can't produce enough now to feed both of them, we have to supplement. We just do.

I know your situAtion is different, but I wanted to explain that I get how hard it can be. I am also sorry that S is having some troubles with Jaundice.:( I know LK's(Paibec, LKPB) son Beckham had some trouble with jaundice so she might be a good reference. I wish u all the very best and I just know he will get through this just fine. Thinking of you !!!

Trishlettes

I would absolutely follow the doctors orders. Sorry, Im a nurse and excessive bilirubin can have devastating effects on babys brain. Cerebral Palsy and developemental delays. Dehydration only adds to the problem and can cause levels to elevate even further. Baby gets rid of bili by having BMs. Excessive bili can also cause baby to be listless and not feed well. So its a double edge sword when it comes to BF-ing.
The american academy of pediatrics does not reccomend putting baby in sunlight at home or outside. Baby has to be undressed and newborns can not self regulate temperature. They can easily be too cold if its cold in your house or overheat in a window.
Most docs will institute more aggressive treatment at a level of 20. Lights at home or potentially readmission to the hospital depending on baby's overall health.
I am very pro breast and pro natural remedies over modern medicne EXCEPT when it comes to something like this that could potentially have devastating effects and is preventable!

A&J

I am sorry to hear this. Olivia did come home and when taken to the pedi on day 2 was tested and determined to be slightly jaundiced. I do not remember her score, but we were told to take her home and to let in and expose her to as much light as we could ( which is no small feat in Western Wa during the winter) and to breastfeed non-stop. I did not supplement with formula. I swear I didn't sleep that first week and all Olivia did was eat and poop...which was needed to off-set her lower birth weight of 5 lbs. 15 oz (5.8 at the first pedi appt.) and to help with the jaundice. Fortunately in our situation by that Friday, day 5, we were out of the woods and Olivia's tests cleared her from any issues with jaundice. However, we were still feeding on-demand to raise her weight. I am happy to say she has gained an average of 1 oz. per day and 4 days ago weighed in at 9 lbs. 9 oz!!! While I realize our situations are different, and I do not have specific advice I do want to offer support and encouragement in your continued efforts to breastfeed. I know you will be able to get this! It is important to you so please don't give up. I realize how stressful those first few weeks are especially when trying to feed so frequently and with so little sleep...I know the lack of sleep was terribly overwhelming for me. Just keep at it and know that somehow, someway it will all get better. Again, since you so badly want to bf, do not give up and continue to reach out for support. I am wishing the best for you all and hoping those biliruben scores come down!

Kari

Sorry you're going through this. Been there, done that. We had an extended visit in the hospital for an extra 3 days beyond when we should have been discharged.

I gave Justin formula & breast milk that I'd pumped for the first two weeks or so. It doesn't mean he won't be able to breastfeed later. At 20 months, he's still breastfeeding. We did, however, have to schedule a lactation consultant visit at 3 weeks and got some great advice (same person as who visited us in the hospital, but once problems set in, they can give more specific advice). Mine recommended the Playtex VentAire Advanced bottles with the brown nipples because those are the closest feel to a real breast. And she recommended a nipple shield (Target sells them) because they reached the tip of his palate and triggered him to suck like the bottle did. Have your pediatrician refer you so insurance will cover the lactation consultant. I thought my doctor would be responsible for the referral, but it's actually your child's doctor who does it because the service is for your child.

Sorry if I'm duplicating anyone else's response. I didn't have time this morning to read all the comments first.

TxMoms2B

Although C's jaundice was not as bad as sebastian's, his first week sounds very similar to C's. He didn't latch well after the pedi suggested supplementing formula. He lost nearly a pound (from 7.2 to 6.4) in four days. I would say put him to the breast no matter how frustrating it is for both of you, as often as possible and before any bottle. Pump as often as you can and try using fenugreek if your supply is being affected. I didn't have much in the way of supply, but what little I had started to dwindle. I struggled with breastfeeding for 6 weeks, and by that tine I was making less than half an oz per pumping session. Emotionally I had to deal with the loss of breastfeeding, and it was hard. Please don't give up though.

K&H

Oh, this was so us! Only we stayed in the hospital for Esther's entire first week, I think. It seemed like forever, that's for sure. I think her highest levels were around 19.5. She also was excessively sleepy and didn't want to breastfeed and lost more than a pound. We were able to supplement her with milk that I had made for her before her arrival, but that ran out around 10 days old. We were adamant that she would breastfeed, however.. and I mention this only to say that concerns about her weight stuck around after the jaundice was gone. She was only 9lbs at 4 months and didn't really start to pick up weight until 5 1/2 months.

Is he pooping the little yellow grainy seed things? That's the billi getting out of his system and you want to see that. E had that for, I swear, three weeks (probably not really, but that's how I remember it).

For the breastfeeding, I would suggest wearing him in a wrap (like a Moby) without any shirts on (or a wrap around your arms if it's cold). The skin to skin contact will help your milk supply. Additionally, I would put him to the breast every two hours as the first choice. You might start to see that some feeds he'll perk up a tiny bit and try the breast, others he'll be too tired. It's a hard balance for sure. I remember those days!
Another thing you can do is to get a medicine syringe, maybe a 5cc size and give him the formula from the syringe rather than from a bottle. Just because you're giving him formula doesn't mean he has to be getting it from a fake nipple. By dripping it slowly into his mouth you're not teaching him to associate the feed with the nipple and he won't get attached to the bottle. Oh, and you can also look at the Lact-Aid or SNS system, which is a little tube (think straw) that you attach to your breast so that when he tries to latch he gets formula out of the tube. This can be how you give him all of his formula and that way he's stimulating your nipple which will help your supply and he's also learning to associate food with breast rather than bottle.
Oh, and we also took her into the bath with us. Pretty much any chance we had to have her skin pressed up against ours we went for.
The every two hour feeds won't last forever, although it feels like it right now.

charcoaleyes

Poor S. I hope he starts feeling better.

When my sister had problems with latching, her lactation consultent suggested she use a medicine cup to feed instead of going for the bottle. I was surprised to watch my niece lap milk up like a dog. She got all the food she needed, but they didn't have to introduce the bottle.

Good luck!

smartycat92

K&H, I agree with your whole post! I was going to say... try the breast first every 2hrs and when giving formula, don't use a bottle. Ray was a little jaundiced and we used one of these tiny cups that the hospital gave us (it looked like a teeny tiny pyrex measuring cup with a lip on it for the baby to suck the formula off of) or a syringe is another great idea. The SNS (supplemental nurser) is also an awesome idea KH!

The one other thing I was going to ask was if there was any issues with tongue tie? Ray was tongue tied but everyone kept telling us it wasn't bad and that it didn't need to be fixed. I think it was THE reason breastfeeding was hard for us at first and part of the reason he was jaundiced.

Also, Trishlettes has a good point... while these are all great ideas to help with the breastfeeding, in the end you need to follow drs orders... this is serious business.

Hope things are looking up soon. So sorry that you and Sebastian are going through this

Zen

I wish Shanny or one of our resident nurses were here because my info is all second hand. My niece and nephew both had jaundice issues. With my niece it was mild and we just undressed her and placed her in indirect sunlight. My nephew was another story. First we had the bili blanket. Then this fish tank contraption with lights above and below. Had to bandage his eyes in that and only take him out for feeding and changing. And go daily to the doctor's for heel pricks.

I don't remember how nursing was handled but I do remember that in the beginning I wasn't giving him bottles. He needed to be fed very often to work the bilirubin out of his system. I remember reading (not sure if here or somewhere else online) that nursing can actually raise bili levels. Moms wanting to BF were encouraged to pump to keep up supply but only give formula to the baby. Then when bilirubin levels came down they could go back to breast feeding. I don't know if the pumped milk was stored or had to be discarded though. I do know that it's hard to get a bottle-fed baby back onto the breast and many give up in frustration and exhaustion.

You have to do what's best both for you and the baby. I hope levels come down soon so you can just enjoy being a mommy without so much stress!

SPJ&E

My boys both had jaundice (so I just expect this one too as well, ugh). P's was pretty high to begin with but the dr. said to feed him as often as he would eat (I was breastfeeding) and put him in indirect sunlight as much as possible. I cranked the heat up in the house and put his bassinet near the window. His level went down pretty quickly.

J's was worse. That boy stayed in just a diaper near the window (with the heat up of course) a lot and I breastfed him as much as he would allow it. Despite that, it was still going up...slowly, but still up none-the-less. They checked him and said that if the next draw (the following day) hadn't gone down, they would have to put him in the hospital. They gave me some formula, which I reluctantly gave him...not that he drank much of it (seriously, maybe 1-2 oz. total out of the pack of either 4 or 6 bottles). I cried too, of course. I was so upset that he might have to be back in the hospital (let me clarify, the boy's birth was a total nightmare...we had already been through a lot). Thankfully, at that draw, his level had started to go down a little bit and I just continued what I was doing at home (minus the formula).

The formula, I don't think it's what's "so" important. What's important is that he's eating a lot and going #2 a lot to get rid of the bilirubin. Indirect sunlight might not help, but I don't think it hurts. My boys never got cold because of the lack of clothing. I put a warm, fuzzy blanket under them and checked on them often. We had also put the couch near the window with J and I would lay on the couch with him on my chest, so he still had my warmth but also the indirect sunlight.

Hopefully Sebastian's levels will start going down soon!

mel

I haven't read all the responses but if you are worried about him rejecting the breast, it may be an option to try a Supplemental Nursing System: http://www.medelabreastfeedingus.com/products/breastfeeding-devices/51/supplemental-nursing-system-sns

That way he will get the hydration he needs, if he needs extra formula, but it will be at the breast so that your supply doesn't suffer and he doesn't develop a preference for the bottle.

First Hope

I am no expert so please double check what I am saying. Xander was jaundice and we were told the reason we had to use formula is because breast feeding can cause the jaundice to get worse. I am only going from memory and one pedi's advice. I hope things get easier and his numbers start to drop. Thinking of ask of you. Again please check what I am saying, I don't want to give incorrect information.

lolabel

My little one was jaundiced when she came home from the hospital. The formula supplimentation was to make sure she was fully nourished, which takes longer with breastfed babies because of the delay in milk coming in, and then the baby eating less at each session than with a bottle. I had to take her out for walks in the sunlight (it was early summer) and to feed her every two hours. The formula isn't magic - it's keeping the bub fully nourished that makes all the difference. If you can pump, pump, pump and make a lot of breast milk and feed that, as well as breast feeding, you wouldn't need formula at all, but most of us can't produce that much at the beginning (or even further along.) Lapping out of the medicine cup is a great idea, as long as the baby is getting enough, but don't worry - as the jaundice goes away, you can just start to withdraw the bottle any way. Most babies switch back if the breast is then the only supply available. Getting him through the danger period is the main thing, and getting your supply up so that when he does go to only breast, he can get everything he needs.
Best of luck to you - it's pretty scary at the beginning when contending with this. You can do it!

GaBeekeeper

so happy to hear the good news!!

K&H

yay!

ncmomstobe

What a wonderful update! Yay for an awesome milk supply, improving bilirubin numbers, and an eating, growing boy.

texas4

Way to go baby S! Our guys were jaundiced too, but since they were in the NICU for 17 days, they were under the 'lights' in their isolettes. No issues by the time they came home. The weight loss is scary, even thought everyone tells you it will happen-Grey dropped to 3 lbs, and Levi to 2lbs 15oz (from 3lb 6). But hurray for the breastfeeding! Lori never got more than 4 oz total each pump and that had to be split for both, so supplementing was not an option. By the time we got them home, they were so used to a bottle (Lori spent 15 hours a day at the hospital trying to get them to latch, and pumping, pumping, pumping), she stopped struggling to bf.

So going through all this when you are more tired than you have EVER been in your life is stressful beyond anything. But you're right, your son ROCKS!

Zen

Happy to hear a positive update! Way to go moms!

smartycat92

Great update!! Sebastian, you are a superstar!

PtownMoms

I've been MIA because we were busy moving. UGH. Moving with a baby was not the most fun thing I've ever done!

BUT, I'm happy to hear about a positive update!!! I hope he's doing even better!!!

A&J

Glad to hear the positive update!!!