Post by Stingyshark on Dec 27, 2013 8:02:54 GMT -5
I should probably move over to the MMM board, but I'm feeling vulnerable & helpless, and I feel like we've all been together for a while now - LOL.. gawd, i'm so hormonal.
We took Paisley to her first pedi appt yesterday... She has jaundice; which is normal for newborns, but the pedi was pretty concerned. She sent us to the hospital for labs. Her bili came back at 17, which according to our pedi is intermediately high. 20 is the admit level.
We have to take her back for more labs in a few hours to get more labs; if her level is above 20 the Pedi will admit her.
What is killing me is that she wanted me to supplement w/ formula/bottle. I know my milk is in.. I have no idea how much she is getting. She takes forever to eat, and I have a really hard time waking her up. So the pedi wants/wanted me to supplement. I asked if I could pump and feed her a bottle that way, and she said she would rather me use formula for the time being. </3 So I'm pumping & freezing.
I will obviously do anything I can to make sure she is getting enough food/proper nutrition, but my heart & pride are hurt a little... and I'm definitely feeling like I've failed already..and we are only 5 days in.
I'm also feeling frustrated because, yes, they told us to feed her every 2-3hrs, but she doesn't wake up on her own (like I thought she would). So I didn't wake her up and feed her as often as I should have. I feel like maybe the hospital should have reiterated how important those frequent feeds are and why. Maybe this is one of the things that would have been covered in newborn classes, had we gone. I can play the what if game all day, i guess.
**I really like our Pedi. She was super nice & supportive yesterday at our appointment. I busted out crying when she was going over all the jaundice stuff.. She gave me a hug and told me it was normal.. so that was nice that she didn't totally dismiss me.
UPDATE: So, we had our 3rd labs done today. After some miscommunication with between the Dr & the lab we found out her level is down to 15.1 from 17.2, so that is great news! Initially the lab told the pedi her number was 17.2, so the Pedi was concerned that it wasn't going down and was going to have us f/u on Monday... I'll skip the details, but the pedi reconfirmed the number and found out it was lower.
I asked the pedi if it was okay if I fed BM exclusively - she said her only concern was that she wasn't getting enough. I told her I was pumping 2oz and feeding from a bottle to make sure she was getting the recommended amount. She said this was fine. So, yay for that bc I haven't given her formula since friday morning.
She is way more alert today than she has been and she is eating much better. I have BF a few times today when she acted like she was still hungry after the bottle. It takes her a few minutes to latch, but we are doing pretty good.
For now I feel more comfortable pumping & feeding from bottle just so that I can ensure she is getting enough to eat.
I'm feeling much better about all of this. Between this & my gimped up foot my anxiety has been out of this world. THANK YOU for all the kind words & support!
Stingy, you are a fabulous mother and there's no way in hell you have failed. It's so obvious how much you care about P and this shit is totally new to you; you guys are all learning together! P will be great and you are doing a wonderful job. It sounds like your pedi is supportive and will help you through this. If P needs formula right now, give the girl some formula until you are able to go back to EBF if that's what you want. I don't have specific advice since I know absolutely nothing about bf, but it sounds to me like you are doing all the right things by listening to the doctor and loving the heck out of your daughter. Big hugs, mama!
Stingy, you are doing great. You are brand new to this parenting thing so do not be hard on yourself. Did the ped suggest you expose her to natural light at all? That was suggested for DS jaundice and you are so lucky you live in a warm climate so that is possible in the winter. Are they doing a bili blanket?
Post by sporklemotion on Dec 27, 2013 10:10:48 GMT -5
Keep in mind that they monitor jaundice really closely and err on the side of caution, so you are not failing-- what she is going through is concerning but not uncommon. We were borderline for treatment initially, but things turned around once my milk came in. She also just barely missed the 10% of body weight lost cut off-- we turned things around just in time, and she has gained well since. I feel you on the wake ups, and this has been tough for me too. My girl is SLOW to nurse-- often taking an hour, so it's hard not to let 2-3 hours stretch to 4 to give her some rest and me a break. My DH and I don't always agree on when to wake her up, either-- he'd let her go longer, while I get anxious and want to wake her. Now that she is above birth weight, I've lightened up on it, but it's hard to feed her 8 times a day, and I have probably settled for fewer feedings (or counted a long, two staged feeding as two) a couple of times. I will be happy and feel less guilty when we get down to 6 feedings a day. When we left the hospital, the pediatrician told us that one bad eating day will not make a difference long term-- this made me feel better in those first few days when everything panicked me. Five days in, you have NOT irreparably damaged your baby. Supplement if you need to, and you can always try to reduce the ratio of formula to breast milk as your supply increases.
Hang in there! I am sure it will get better as you settle into motherhood.
Post by JayhawkGirl on Dec 27, 2013 10:10:52 GMT -5
This will be okay.
DD had jaundice too (as did DS) and we saw numbers ip to 18.5, did light therapy at home for 2 days. I resisted supplementing at first but finally had to do 24 hours of formula while I pumped to keep my milk up.
Once we got her number down I got the ok to nurse again, but had to supplement after w formula or pumped milk. She's not a strong nurser just yet but it's getting better w practice. We are back to all breast milk.
I hated doing formula but she needed it. We went through the same basic thing with DS and in the end he nursed for 22 months. This is a small bump on the road. It feels a lot worse because we are so tired. And jaundiced babies just want to sleep, so it's a vicious cycle.
It will be okay. I promise.
Eta: she dropped from 10# to 8#12oz. Just looked at my notes and she topped at 20.5 on her bili.
Post by speckledfrog on Dec 27, 2013 10:21:45 GMT -5
Do not feel bad about the sleeping thing. The same thing happened to us. When the pedi came to the hospital to check on him she asked when he had last eaten and I said about 6 hours ago (although I tried every two hours). I thought she was going to have a heart attack (she was a bit of an alarmist). I had no idea that babies are not smart enough to wake up and eat. And I took the infant care class!
Our pedi also wanted us to supplement and that made me super sad but our LC was wonderful. For the first week we supplemented with breast milk. I would feed him (this was a two person job, because MH had to squeeze him rather vigorously to keep him awake while I positioned him) and then I would pump. The next time he ate I would nurse him and then finger feed him what I had pumped. For the finger feeding, I would let him suck on my finger and then thread a small tube along my finger. The tube was attached to a syringe filled with BM and I would just slowly squeeze that in there.
If you have a LC I would call her and ask if she can help with your jaundice issue. Jaundice can be serious, so if you do have to supplement with formula, pumping and freezing is perfect. GL, I hope it clears up quickly!
Post by Jalapeñomel on Dec 27, 2013 11:10:19 GMT -5
Does your hospital have an LC or are you close to a La Leche League? You may find comfort in contacting them about supplementing with formula and if it's possible not to do it (if that's what you want to do).
But regardless of what you do, just keep in mind that you are doing what you feel is best for your baby.
And also the MMM women are a fantastic resource and very welcoming to don't be scared..,ask away.
Post by redpenmama on Dec 27, 2013 11:42:27 GMT -5
I'm sorry you're dealing with this. New parenthood is hard enough even without any issues.
Just out of curiosity, why does your pedi want you to supplement? Is she not gaining weight or is the supplementing jaundice related? If you're pumping while supplementing, you shouldn't affect your supply too much, so it shouldn't negatively impact your ability to nurse her long term if that is your goal. If you're concerned about supply as you supplement, is there a lactation consultant or LLL chapter in your area you can speak with? Mamas have to supplement for all sorts of reasons, and I know many people who have done so early on and been able to maintain their milk supply and nurse their babies down the road. You might consider still putting baby on the breast regularly to stimulate your supply -- even if you feel like she isn't getting much, that might encourage milk production as you supplement and pump.
Hang in there! Don't beat yourself up over any of this -- you are doing a great job!
I'm paging jennlin over here. She's wise with the EBF and jaundice.
Hello! My first was ebf and severely jaundice (numbers were in the 20's, 24hr inpatient light box, 48hr outpatient lights). HANG IN THERE. Even the LC gave me the option of formula, but understood I didn't want it. Pump as much as you can and try a SNS. I didn't buy an actual SNS system, but we used a syringe and feeding tube with my hub slowly squeezing the syringe as I held my baby and nursed.
If you're not in the hospital for treatment, get your baby as much natural light as possible- turn up the heat in the house and lay him by the window naked.
Also know that the numbers are all precautionary. You don't see actual damage until the numbers are in the 30's somewhere, and even then, it's acute. So if they don't admit you to the hospital, your baby is healthy.
Hang in there, ebf is very possible with jaundice..I'm still nursing my jaundiced 22mo (while also tandem feeding my 2mo).
(P.s. If you want to talk more, tag/quote/pm me as I'm very bad at checking other boards).
Remember, the most important thing is that your baby eats. It does not truly matter how she eats. She needs to eat. Formula is NOT poison. It is good food, and she will thrive on it. Any amount of breast milk she gets is good. She will get a benefit from even a smaller amount.
And don't forget that when her jaundice is under control you can totally pursue breast feeding again with a lactation consultant if you want. You are wise to keep pumping to keep your supply up.
You are feeling something totally normal, but remember that you are a good mother, no matter how she eats.
Eta: I have had to wake my baby up as well to eat. Now that she is over her birth weight I can let her go longer at night, but during the day, it is still sometimes me waking her up every 2-3 hours. In the day now, she wakes herself up/is awake more. P will get there!!
Ditto all of this. Supplementing is okay and does not mean the end of breastfeeding.
I would get a second opinion on the supplementing with formula.....it's normal for babies to lose weight the first week after they are born. Can you speak with a lactation consultant or someone in LLL about the need for supplementing ?
She didn't lose weight, the pedi was concerned she's not eating enough to produce enough pee/poop to get ride if the extra bilirubin.
There is no LLL nearby. I meant to get info for an LC yesterday but I was way overwhelmed and forgot.
I would get a second opinion on the supplementing with formula.....it's normal for babies to lose weight the first week after they are born. Can you speak with a lactation consultant or someone in LLL about the need for supplementing ?
She didn't lose weight, the pedi was concerned she's not eating enough to produce enough pee/poop to get ride if the extra bilirubin.
There is no LLL nearby. I meant to get info for an LC yesterday but I was way overwhelmed and forgot.
Does your hospital have one? If so, you can usually just call them up. You can also page frkls (poster on ML). I'm not sure if she is a certified LC, but she is our resident boob expert and has definitely taken courses towards being a lactation specialist.
Post by disappointedkittens on Dec 27, 2013 12:31:27 GMT -5
I don't have any experience with this, but I just want to say that you are already doing everything you can to do what's best for her. Formula is still a way to feed her, and that's what is the most important thing. You are doing a great job and I hope that things work out for the best for you.
You got some great advice. I'll just add that the majority of babies get jaundice. The liver in a newborn is not fully functioning at birth and is not ready to take on the full load of the baby's needs yet. In utero, the mother's body takes care of both. So its natural babies have a "back up" of bilirubin temporarily. Babies excrete bilirubin in their poop, and if they get light therapy they can excrete it in their urine too.
Also breastmilk is very sweet compared to formula, so don't worry about a temporary use of formula to help the baby poop more. Often times the milk wins out for taste! GL!
I would get a second opinion on the supplementing with formula.....it's normal for babies to lose weight the first week after they are born. Can you speak with a lactation consultant or someone in LLL about the need for supplementing ?
She didn't lose weight, the pedi was concerned she's not eating enough to produce enough pee/poop to get ride if the extra bilirubin.
There is no LLL nearby. I meant to get info for an LC yesterday but I was way overwhelmed and forgot.
She didn't lose weight? That's great! That means she IS getting enough. How old is she? Like a week? Her stomach is only the size of a walnut! How much more can she possibly eat? Pedis are rarely well versed in breastfeeding and seem quick to suggest supplementing, which can really fuck up nursing. I would try light therapy way before supplementing with formula.
We nursed around the clock with DD1 and her bilirubin still went high. (I had the opposite problem from you - instead of being under informed, I think DH was a little over informed as a Dr. He would start flipping out about how I was going to cause brain damage if I didn't nurse right away! Don't pee! Nurse now!) The hospitalization and UV light guidelines are set conservatively to protect your kid. If you are close but not there, it will be okay. If you can, nurse a session every now and then too. She is more efficient than a pump at getting / keeping your supply up. Or breast first like merida said.
I would get a second opinion on the supplementing with formula.....it's normal for babies to lose weight the first week after they are born. Can you speak with a lactation consultant or someone in LLL about the need for supplementing ?
The supplementing recommendation is to keep bilirubin down, not weight up. Jaundice, while normal, can be very dangerous if too high. LLL are not medical professionals and not in a position to judge what will and won't prevent brain damage. I agree that she should be able to get there with a plan that includes breast feeding, but that plan should be arranged with someone medically trained to understand the risks.
We nursed around the clock with DD1 and her bilirubin still went high. (I had the opposite problem from you - instead of being under informed, I think DH was a little over informed as a Dr. He would start flipping out about how I was going to cause brain damage if I didn't nurse right away! Don't pee! Nurse now!) The hospitalization and UV light guidelines are set conservatively to protect your kid. If you are close but not there, it will be okay. If you can, nurse a session every now and then too. She is more efficient than a pump at getting / keeping your supply up. Or breast first like merida said,
((hugs))
We have done a mix of bottle/breast today. She's a lot more alert and eating 2oz from the bottle easily.
How do you measure how much she's getting from the breast?
I had to supplement with a little bit of formula due to jaundice as well, but just after each breastfeeding session. My baby is still EBF at 5 months, so this is likely just a temporary setback and you will be back to BF in no time. My guy was also admitted for jaundice, it was terrifying but after 24 hours under the lights he was so much more alert and awake. Hang in there, you are doing a great job!
We nursed around the clock with DD1 and her bilirubin still went high. (I had the opposite problem from you - instead of being under informed, I think DH was a little over informed as a Dr. He would start flipping out about how I was going to cause brain damage if I didn't nurse right away! Don't pee! Nurse now!) The hospitalization and UV light guidelines are set conservatively to protect your kid. If you are close but not there, it will be okay. If you can, nurse a session every now and then too. She is more efficient than a pump at getting / keeping your supply up. Or breast first like merida said,
((hugs))
We have done a mix of bottle/breast today. She's a lot more alert and eating 2oz from the bottle easily.
How do you measure how much she's getting from the breast?
We did weighed feedings with the lactation consultant. Naked weight plus a clean diaper before. Then nurse and weigh after (with diaper on and any contents). The difference is what she drank.
Post by dulcemariamar on Dec 28, 2013 16:49:55 GMT -5
I am just a lurker here but my DD had to stay an extra week or so in the hospital because of the jaundice. I am sorry that you are going through this. It is common but can be scary. Dont feel guilty about having to supplement. My LO was almost EFF the first two weeks and I was able to switch to BF as soon as her levels went down.
Post by AlpineSlide on Dec 28, 2013 18:31:52 GMT -5
big hugs! i haven't had time to reply but have been following this. I'm so glad things improved!
We had a very similar situation with regards to feeding but it wasn't jaundice related, he just lost a good bit of weight and was a lazy nurser (they think due to tubes down his throat in NICU). I was pumping a min. of 8 times a day, nursing as desired, and following up nursing (or feeding every 2-3 hours) with a 2 oz bottle of BM. My emotions were all over - i accepted that i would pump and feed, then wanted to get back to only nursing, felt chained to the pump, but liked knowing how much he was eating, etc. It was a difficult time, let me know if you want to talk. We managed to transition back to all breast and no bottles unless i'm away for a feeding. Good luck!!
Hugs stingy! I can't speak to jaundice, but had our nurse not walked in the night we were in the hospital when we were going to give up on waking HJ up to eat because she wasn't interested and told us how to wake her up and that we really did have to get her to eat, we would've never known. I'm thankful she told us, and we only had to do it for about 3 weeks. She never lost weight from birth and was up a few ounces at her 10 day appointment, but we kept going for a bit because I didn't know when to stop. Even with knowing she gets enough, she cluster fed so much during a growth spurt that we had to get formula and supplement. I had a HUGE meltdown over it, but it was what was best for her at the time. Now we're back to BFing pretty exclusively, but sometimes I still feel unhappy about the idea we might have to supplement again if it happens again. However, it was what was best for her at the time, and as a mom that's all you can hope for is that whatever you're doing that it's the best for your LO. Don't beat yourself up about any of this! You didn't know, now you do, and you've fixed the problem!
The supplementing recommendation is to keep bilirubin down, not weight up. Jaundice, while normal, can be very dangerous if too high. LLL are not medical professionals and not in a position to judge what will and won't prevent brain damage. I agree that she should be able to get there with a plan that includes breast feeding, but that plan should be arranged with someone medically trained to understand the risks.
Thanks for the info on supplementing, I did not know that formula could help with bilirubin levels.
From what I remember of the explanation my nurse gave me after AJ was born, the baby peeing/pooping helps flush out excess bilirubin so when bili levels are elevated the first thing the docs look to is how many wet/dirty diapers the baby had since they were born. If they feel like that number isn't high enough they might suggest supplementing with formula, at least temporarily until mom's milk comes in, to get baby peeing and pooping more and thus flushing out the excess bilirubin. I could have part of that mixed up though, since it was explained to me in the hospital after i asked why we were tracking wet/dirty diapers so closely anyway...and that whole time is pretty hazy. especially the post birth part
Stingy, I'm so glad her levels have continued to drop and things are going well with pumping and bottle feeding (and getting miss Paisley to latch after). Hang in there, kiddo!