Sleeps all day, few dirty diapers, impossible to wake to eat

[ZeezMom]

The facts:
- Son is 4 days old
- All-natural labor & delivery. No complications.
- Latched pretty well from the start, but latch got very lazy by day 2-3.
- 1-2 wet and/or poopy diapers per day since being home.
- Sleeps now day & night. Won't wake to eat. (The cold, wet cloth to the head/armpits/neck/tickling/stripping down to diaper wake him momentarily crying, but quickly falls asleep again after latching.)

He slept a lot when we brought him home, but he still had a moment or two of alertness in the day. I understand that sleepy babies, for some, are par for the course. However, by day 3 he slept day & night, barely waking to feed. He would latch, fall asleep, lather rinse, repeat. Again, a scenario I know to be very common.

But he's had very few wet/dirty diapers since he came home from the hospital, and yesterday I noticed he was very slightly jaundiced. His weight, however, is so far fine, save for the few lost ounces typical for this time in a newborn's life.

I took him to the doc today, who was, of course, completely ignorant to the nuances of breastfeeding & immediately told me to start supplementing w/formula before ever looking him over. (Even questioned my supply, which further confirmed her ignorance.)

This is my second-born. I'm fairly well-versed in breastfeeding challenges & all that come with newborn nursing. But this one has me really worried & stumped.

I've begun syringe feeding after pumping to get fluids in him b/c we suspect the jaundice might be coming from dehydration.

I'm starting to worry. I don't understand why he's not hungry enough to at least wake long enough to feed, or when he does is almost impossible to latch.

At what point do I start letting ignorant physician start imposing? I could use some comfort by way of similar experiences. The post-natal hormone flux is starting to get the best of me.

(For what it's worth, I'm in close contact with a LLL leader, too, I just hoped for some similar experiences here that would put my mind at ease.)

TIA

[dachshundqueen]

Get a second opinion, ask if someone in your tribe can provide one for a decent pediatrician.

Liz

[jeliphish]

Please get your LO's billirubin levels checked. My oldest DD acted the exact same way you described and she also looked slightly jaundiced but when her blood was drawn at 5 days old her level was 28 and that was very dangerous. Everyone thinks jaundice is a normal thing but "high" levels are considered to be around 18. As it approaches 30 there is considerable risk for hearing loss and brain damage. Sometimes all the feedings in the world whether it be breastmilk or formula do not help and they actually need to be admitted for phototherapy.If he not eating and is dehydrated- which it sounds like he is, something needs to be done. I wouldn't take the wait and see approach with this one - get his bilirubin checked ASAP.

[lizziebits]

I'm not a lactation consultant or anything, but I think I would be concerned about a couple of things:

- number of wet/dirty diapers. According to Kelly Mom, baby should have one very wet diaper and one dirty diaper for every day of life. So by now, 4 very wet and 4 dirty diapers.

- the sleepiness. Yes, newborns are sleepy, but the fact that he is getting more sleepy might be concerning.

Has your milk come in? Are his fontanels sunken? Did he get weighed at the peds office? I wouldn't expect him to be back up to birthweight, but it would be good to know that number.

Oops, I missed the weight and the jaundice. Did he have his bilirubin levels checked?

[Llyra]

I agree with the others who have said to have the bilirubin levels checked, right away. I also agree that getting breastmilk into baby should be your highest priority; in your position I'd be doing syringe or dropper feedings, or feeding from a tube on the finger, every two hours or so, after nursing. If you do get the levels checked, and they recommend phototherapy, be aware that this can be done at home, and it can be done with something I've heard call a bili-blanket, so that baby can still be held to nurse. But often they won't offer those options unless you ask.

My DD1 was one of these happy-to-starve babies, and it's a vicious cycle they get into, where the less they eat the more they sleep and then they eat even less, and the next thing you know your supply has tanked and baby is in trouble.

[Blueone]

My son was having the same problems. He was so orange and the only time it lightened up was when we were supplementing in the hospital. Unfortunately, even when my milk came in he still wasn't doing good and still not producing enough wet or dirty diapers. He was feeding around the clock too, but always falling asleep, waking up to eat, then falling asleep etc.

Supplementing really isn't that bad. What matters more is that your son gets nutrients. I would still check with a doctor obviously.

[hotharmony]

Get some sun on his skin and go see a Lactation Consultant. I would have his billirubin level checked especially if you notice the whites of his eyes a little yellow.

I think your doing a good thing by supplementing with pumped milk!

[mambera]

Sounds a lot like my experience. Baby eventually woke up and started eating, but by that time my supply had tanked and we ended up needing permanent supplementation.

Ditto the advice to get the bili checked, and to keep getting food into the baby. It's such a vicious cycle where they're too weak to wake up to eat so they keep getting weaker.

What do you think about maybe using an SNS? I think it is a little easier for the baby to get milk from that than from the nipple directly.

I think my baby didn't really understand that a boob was for food; she had an instinct to latch but would fall asleep immediately afterward.

On the boob the baby has to wait for the letdown, and in the five or ten seconds that would take he is probably already asleep. If you use a SNS and make sure the supplement (pref your pumped BM obv) is already down to the end of the tube before you latch the baby on, he will start getting the milk immediately. This may give him the idea, and hopefully some incentive to continue sucking.

(I tried to do this by expressing drops of colostrum/milk onto the nipple, but she would literally suck once, swallow the drops, and then fall asleep. I think the SNS would have worked better, though I didn't know enough to try it at the time.)

Smart job on the pumping, I would definitely keep that up too, 8-12x/day if the baby really isn't sucking at all.

Good luck!

[penstamon]

Everyone has given excellent advice and from our experience I agree with the bilirubin levels needing to be checked. DS was jaundiced (16.5 bili) and it made him very sleepy and dehydrated because he wasn't eating enough. We supplemented with pumped bm and got him out in the sun for 5-10 min at a time at least 6-10x day. He bounced back even after the first day of this.

Best of luck! Hope to hear good news soon!

[HoosierDiaperinMama]

I second getting the br levels checked. My first DS did this and we ended up on the biliblanket for 10 days. He was doing pretty much what your LO is doing. My second DS, one month old, had very little jaundice but could still be a lazy baby. We did the dropper feedings with EBM 4x a day for a week to get him over the hump and it worked! The dr. also told me I should be supplementing with formula but I completely ignored him and I am glad I did! However, I am concerned about the number of wet/poopy diapers your LO is having. Definitely get his br levels checked before it gets out of hand. I totally understand the hormone thing. I finally had my first breakdown the other day. Hang in there!

[ZeezMom]

Thanks so much, ladies.

Update:
- Had two poop diapers & about 6 wet ones.
- I have been syringe feeding him for the past few days, but it's still a struggle to get him to wake up to swallow it. He's getting about 9-12oz in a day, however.

The doctor told me that the jaundice was just in his face & to be concerned if it spread. It has not done so.

But your responses have me scared enough. I will be getting him into a doctor's office tomorrow to see if I can get his bili levels checked.