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Infant won't wake up to nurse and jaundice

post #1 of 19
3/14/09 at 6:28pm
Thread Starter 
So my friend just had her first baby two days ago. The baby has been sleeping so much that they can't even get her to wake up to nurse. She had a good start the first night but now she's sleeping so much. They took her to the hospital this morning because she hasn't soiled a dipe yet since they brought her home yesterday and she's starting to get a little jaundice. They kept her in their bed last night and I suggested she keep her next to her without a covering to see if she'd root for the nipple in her sleep. Yes, they've been trying to wake her up nurse with no luck.
She did have a epidural. Could this be affecting the babe 48 hours later and would it make her drowsy?
Any advise would be appreciated. My milk came in ASAP and my babe was an all nighter so I don't really have any experience to share with my friend. Do you the babe isn't getting a good latch and gives up?
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post #2 of 19
3/14/09 at 6:39pm
I don't know, but she should definitely be a) consulting with a doctor, b) pumping to maintain supply and perhaps c) syringe feeding to help the baby be a little stronger. Wow. Can she get in touch with LLL or an IBCLC?
post #3 of 19
3/14/09 at 6:44pm
like the baby will not ever wake up? i remember ds being really difficult to wake when he was sleeping, but he was not really jaundiced.

i would recommend waking the baby every 2 hr to try to feed, any way possible - strip the baby down to no clothes, tickle feet, light, sound, whatever it takes.

good luck.
post #4 of 19
3/14/09 at 7:00pm
Thread Starter 
They were able to keep her up for a couple of hours last night and maybe an hour this morning. I'll see what they've tried to keep her up.
Would a pump be helpful if all she has is colostrum right now? I'm not sure if she has a pump, but I'll suggest it.
post #5 of 19
3/14/09 at 7:21pm
Hand expressing is important if baby isn't nursing. Plus it is easier to catch the colostrum that way than with a pump, and to refeed it to baby by spoon or cup.
post #6 of 19
3/14/09 at 7:35pm
Quote:
Originally Posted by Burnindinner View Post
like the baby will not ever wake up? i remember ds being really difficult to wake when he was sleeping, but he was not really jaundiced.

i would recommend waking the baby every 2 hr to try to feed, any way possible - strip the baby down to no clothes, tickle feet, light, sound, whatever it takes.

good luck.
would like to add: a wet cloth to the back.. DD was hard to wake also, no jaundice but the cloth did it for us.
post #7 of 19
3/14/09 at 7:46pm
Yes, pumping is still important, even if her milk isn't in. As my lac. consultant put it, "it's like placing orders." It will tell her breasts to get going on making the milk, if baby isn't doing that herself.

I think it's fairly normal for newborns to be really sleepy in the first couple days, especially with a medicated birth. She should do as much skin-to-skin as she can, like you suggested. Baby on her chest skin-to-skin will help boost her milk supply, as well.

Good luck! Way to support her.
post #8 of 19
3/14/09 at 7:52pm
Jaundice would be the most likely suspect. DD's jaundice level had reached 28 by her 5th day and was admitted to the hospital. (This was very close to brain damage level). I could barely keep her awake to feed. I would tell her just to keep check on her jaundice. In the mean time strip baby down and use cool wash cloth to keep her awake to feed. Sunlight and food is what is going to keep the jaundice at bay I hope. Your friend should pump as much as possible it wouldn't be out of the ordinary for it to take 3 to 4 days for her milk to come in if this is her first baby and if the baby isn't suckling as much as she should.
post #9 of 19
3/14/09 at 8:18pm
Thread Starter 
Well I just talked to her mom and they are all sleeping right now. The dr recommended supplementing with formula. I'm going to talk to her later and give her some of the above suggestions. Her mom didn't bf and I don't think my friend is getting much good information on getting her milk in quicker. She doesn't have a pump right now. I think she was going to borrow a friends, so maybe she can get it sooner than planned. I'll find out later what they've done to try and keep the baby awake.
Thanks for all the great suggestions. My friend is not so set on breastfeeding that I think a tough start with misinformation could really derail her. So I really want to help her become confident about it and get things rolling.
post #10 of 19
3/14/09 at 10:51pm
ITA with Jeliphish. Both of mine went through jaundice-- it is actually very common, but it makes the first days rough. It does make babies very sleepy, and they need to be more or less forced to wake up for feedings. Your friend can pump every couple of hours. Using a SNS for supplemental feedings will provide some stimulation to the breast and help avoid nipple confusion. Colostrum is MUCH better at helping the LO excrete bilirubin than formula is. Formula should be a last resort, because you want the baby at the breast absolutely as much as possible.

Sunlight is good, and if sunlight is not available due to weather, a doctor can set them up with a bili-blanket for phototherapy.

I don't know the specifics of her situation, but I really hate to hear docs pushing formula for jaundice as a matter of course.

I'll keep her in my prayers.
post #11 of 19
3/15/09 at 1:54am
All three of my boys were jaundice and I never supplemented with formula, in fact, ds3 was in nicu and tube feed and still made sure to just get mama milk in him Breast milk is best for jaundice as it is easily digested so produces lots of soiled diapers (which is obviously needed to help jaundice). There is information on kellymom.com about the benefits of bm to help jaundice, maybe you could print some articles for your friend and her mom. Pumping is so important too!!! Sending good nursing vibes!!!!
post #12 of 19
3/15/09 at 2:20pm
Quote:
Originally Posted by beebalmmama View Post
The dr recommended supplementing with formula.
ARRRGH. That frustrates me to no end.
post #13 of 19
3/15/09 at 2:29pm
Jaudice is very common and there are studies that show it could even be benificial for babies. Also the best thing for helping baby to reduce her billirubin levels in breastmilk.

Mumma should be putting babe to breast every two hours around the clock. If babe is sleepy and hard to wake they should try stripping babe down to diaper for nursing sessions. Also if they are able to get babe latched on to nurse and then she falls asleep breast compressions during nursing should help to keep baby nursing.
post #14 of 19
3/15/09 at 2:35pm
she needs a pump asap....IF the jaundice is still looming and if it's on the higher level. breast feed, pump like a mad woman, breastfeed, then feed pumped milk....Or at least that's how I did it.
When DD was in the hospital we did one helping of formula (because I didn't know better) and then the pedi encouraged me to pump pump pump...and he didn't feel the need to use formula anymore.
post #15 of 19
3/15/09 at 5:40pm
Thread Starter 
I talked to her today and got a better idea of what my friend has been trying. She's been trying to wake the babe up by keeping her cool, tickling her feet etc. I mentioned the wet rag and she said she'd try that. Apparently the babe is falling asleep at the breast but not long enough to nurse for any length of time. I suggested she make sure she tries nursing before giving any formula and she has been doing the opposite.: Makes me so mad at the doc who reccomended it without giving any bfing support! They are getting a pump today and I reccomended she give the baby the colostrum that she expresses as well. I'm also taking over to her house today, some nursing support stuff, soothies, la leche league breastfeeding book and the phone # of the local la leche leauge contact person, plus phone # for lactation consultant at the hospital. Just want to make it as easy as possible to get her the best info.
post #16 of 19
3/15/09 at 5:41pm
Thread Starter 
Quote:
Originally Posted by BabyBearsMummy View Post
Jaudice is very common and there are studies that show it could even be benificial for babies. Also the best thing for helping baby to reduce her billirubin levels in breastmilk.

Mumma should be putting babe to breast every two hours around the clock. If babe is sleepy and hard to wake they should try stripping babe down to diaper for nursing sessions. Also if they are able to get babe latched on to nurse and then she falls asleep breast compressions during nursing should help to keep baby nursing.
What do you mean by breast compressions? Thanks.
post #17 of 19
3/15/09 at 6:01pm
Another thing... and I always recommend this so forgive me if I'm being repetitive...

Ask her if she'd be comfortable with the LLL leader calling HER. Because some people are like me... calling a stranger at home and asking for help is my idea of personal hell. Awkward at best. Then YOU make the call and have the leader call her. Or you call from her house.
post #18 of 19
3/16/09 at 1:06pm
Quote:
Originally Posted by beebalmmama View Post
What do you mean by breast compressions? Thanks.
Breast compressions are just like they sound; when the let down reflex is finished, some babies lose interest and fall asleep. Doing compressions on the breast when the baby stops drinking will often get them drinking again. There are some examples of this here. http://www.drjacknewman.com/video-clips.asp

Formula is not a good idea for jaundice, it does not help the baby excrete like BM does. Some moms who who still have colostrum find hand expression much easier than a pump - it's not uncommon for a pump to be next to useless. But the best solution would be to keep nursing.
post #19 of 19
3/17/09 at 6:48pm
Thread Starter 
Just wanted to update.
I saw my friend on Sunday and gave her some extra support and helped her figure out the pumping. Baby looks like she's latching well and her milk had come in.
Today breastfeeding is going well still. She saw her ped yesterday and they said they saw no need to continue to give formula past maybe one more day. She is gaining weight fine.
So I've just been dishing out as much confidence boosting as I can to my friend that she has enough milk to feed her baby. i got a bit frank at this point and told her to shove that formula in the back of a cupboard and trust her body. I also explained to her how her body will produce milk the more she is nursing and will regulate itself. And that she won't know what her body can do unless she gives it some time, sooooo........ she sounds more confident and hopefully it continues to go well.

Thanks so much for all the suggestions and support!!

Bluegoat, thanks for the link I forwarded it on to my friend.
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