Ineffective sucking in 1-week old

Kate622

Mostly looking for thoughts, comments, similar experiences (and how you got past it), and any advice which people are able to give.  I am a second-time mom, and nursed my first son for the entire first year.  Never thought I would have issues, but I am completely discouraged here now.

I have a 1-week old son, born via C-section at 9 lb. 4 oz.  Although it took a while readjusting the latch, it felt like we were getting things down at the hospital the first day. Fast-forward 36 hours later though, they draw his blood and tell me that his blood sugar is dangerously low and we need to supplement what he is getting.  If we couldn't get his blood sugar levels above 50 within the next couple hours, they were going to transfer him to a larger hospital with a full NICU... So we start pumping, and using a nipple shield to be able to put the little injector thing in it and maintain nursing.  We got his blood sugar above 50, and the following time they took it, we were in the 70s.

Lactation consultant said that it would probably just take some time, and that he maybe was a little tongue-tied - which would affect the efficiency of his latch (at least in theory).  She recommended seeing an ENT Dr. to check on the tongue-tie if things didn't improve (we called this morning).

They released us, and we continued nursing with the shield, and supplementing up until Saturday when my milk was in, and my breasts would feel a little softer after I would feed him even with the supplementing.  My feeling was that he must be starting to more effectively nurse.

So 1-day of not supplementing (and still pumping - I have copius supply) - and he was acting hungry every 2-hours, and would nurse for an hour at a time.  In the middle of the night last night I finally got fed up with the zero sleep I was getting, and gave him a bottle of pumped milk.  After that he slept for 4 hours.  So apparently for a day I was starving my little boy without knowing it.

All day today I have just given him pumped milk in bottles - which is doing a number on me emotionally since I never had to do this with my first son, but is keeping my little one full and happy.

Anyone with advice on what to do would be of great help, I realize I am still giving him breastmilk, and that it has only been a week - but I feel like a failure here...

ClaudiaStar21

AmyG*:

ok, first

go see an IBCLC lactation consultant to see how much milk baby is able to transfer at the breast, get latch evaluated, follow up on the ENT tongue tie stuff ASAP.

Depending on how much milk baby can transfer at the breast, that will determine whether you need to continue to supplement. 

Realize that it is NORMAL for a 1 week old newborn to want to nurse every hour and want to nurse for an hour.  They have an instinct to nurse that much, virtually 24/7.  and once your milk comes in, there is a 1 week growth spurt where they are making up for missed time, and will want to nurse non-stop.  it is key at this time to NOT give a bottle and have baby sleep for too long, or the signal from baby to your breasts to make more milk during a growth spurt won't get thru.

during a growth spurt you sit on the couch or in your bed and you nruse and watch tv and play on the internet and hang out and fee baby as much as they want to nurse. 

 It's a bad idea to start pumping and giving bottles exclusively unless you really want to end up exclusively pumping for a year.  baby may quickly learn that the bottle is the way to eat and refuse the breast.  be sure it's what you want to do before deciding to do it.  a lot of women do choose to exclusively pump, but it's not an easy road to go down by any means.

 now if you are soooo worried about baby getting enough to eat, sure you could pump and give bottles until you can see the ent and the LC again tomorrow or ASAP.  If so, at 1 week of age, baby's tummy is still the size of a golf ball or less, so you give 1 oz every hour, or 2 oz every 2 hours for about 25 oz a day.  not more than that, as a breastfed baby takes in about that much a day regardless of how old they are or how big they are. 

 

give the bottle slowly, to take at least 20 minutes, using a premie nipple to slow the flow down and help baby's jaw muscles and tongue strength to increase--rather than a fast flow which doesn't make them get more effective at sucking. tilt the bottle downward so gravity doesn't speed the flow. 

But I really see nothing in your post that says you should be pumping and giving bottles--you weren't starving your baby--unless you saw a drastic decrease in the number of wet and poopy diapers, at 1 week of age you should see 6-8 and may see as many as 10-12.  use # of diapers as a guide to show you if baby is getting enough to eat at the breast.

A lot of breastfed babies will seem to chug a bottle and seem like they were starving and they take in a lot in short amount of time--but that because they don't know how to slow the flow of milk from the bottle in order to swallow, they have to learn to hold their tongue in a different place to stop the milk, and many babies really struggle with this at first, so they drink to keep from drowning and it looks like they are starving.  then they pass out and sleep a long time--and miss a feeding or two. 

If baby has a slow, ineffective or organized suck, the more chances they have to practice nursing the better they will get at it and the stronger they will get.  bottles don't use the same muscles, so they won't get better at nursing unless they practice nursing.

get some in person help.  it will be ok.

This. Definitely see an Ent and ask them to look for a postirior younger tie. They are hard to diagnose but affect bf. we had to see 2 Ent to get an accurate diagnosis but once it was clipped it helped sooooo much! I'm not sure whet you live but Dr Dhal in NYC is great and there is an excellent Ent in Albany. I can get the name if you need   

Good luck