Really sleepy newborn won't latch on--help and/or support please!!

[NoraFlood]

I have a 3-day-old who was put in the special care nursery shortly after birth due to possible sepsis. I wasn't allowed to hold him at all or try to feed him for almost 24 hours. His infection has resolved, but then his bilirubin went up and he got very very sleepy. He is currently under bili lights, but will probably come out pretty soon. We have been trying to nurse, but he either won't wake up at all or just won't open his mouth to latch. Positioning him is also very hard for me because of all the tubes and wires in the way--that at least I think will probably improve once he is unhooked from everything. We have had a total of about 10 minutes of nursing so far, if that. I am pumping every 3 hours after each nursing attempt, but I am not getting very much. The milk is thinning out like it is transitioning, but I still only get maybe 10 mL total per pumping session. He's had three bottles of formula now, because they said that he wasn't going to be able to clear the bilirubin until he started eating something. It is actually hard to even get him to take a bottle because he is so sleepy. I am terrified that he's never going to latch. Does anybody have any advice at all for trying to breastfeed a very sleepy baby who won't open his mouth? Also, has a similar situation happened to anyone else? I am absolutely terrified that the formula supplementation has already ruined his chances for nursing. Of course I could exclusively pump, but pumping is not necessarily going that well so far either. Somebody please reassure me that it's not all over!

[Heba]

Congratulations on the birth of your son!  You are doing a brilliant job to perservere under difficult circumstances, and it *will* be worth the perserverance and patience, and he *will* "wake up" and when he's feeding round the clock you'll be amazed at the difference :).  Jaundice / sleepiness are a bit of a vicious circle - the sleepier they are, the less they feed, the sleepier they are.  IBCLC Paula Yount has some really great tips for waking a sleepy baby and keeping him actively feeding at the breast: http://www.mother-2-mother.com/cc-baby-A.htm#SleepyBabies . 

It is great that you are pumping regularly - a few ml in the first few days is completely normal, and the regular stimulation will help to establish lactation.  While it's true that early breastfeeds help, many many mums and babies who do not get to do this for many different reasons go on to long-lasting, successful breastfeeding relationship.  When he doesn't need to be separated from you any more, lots of skin-to-skin (all the time at first, if you can) will really help to stimulate both him to feed and you to produce milk.

[Heba]

Oh, also Biological Nurturing (laid-back nursing) positions might help - these capitalise on baby's natural latching instincts. See www.biologicalnurturing.com .

[31rubies]

I just went thru a similar situation with my newborn ds, my fourth (and it happened with my first baby who was jaundiced, too).   I know the sadness and fear was overwhelming, he would not open his mouth or latch, or barely even suck, for FIVE days.  No jaundice this time, though.  This was an incredible challenge for me, and I have 7 years of breastfeeding total under my belt!  He lost weight, became weak and sleepy.  Anyway here is how I got him nursing:

1:  Fed him with my milk using a cup or syringe.  I pumped every 2 hours and offered my breast at every feeding, kept him sleeping against it. 

2.  When he seemed stronger, I kept trying to get him to suck on my finger.  I gave him an ounce of my milk in a medela bottle four or five times, when he seemed frantic to get food.  This made my feel like giving up!  He got that ounce in so easily!  It just pours in.  But I do think the bottle helped him get strong a little faster, and he started to get the idea of what sucking was.  I know about nipple confusion and all that, which is why I limited the bottle to few times.   He acted like he didn't know how to suck, or if he did it was about 4 sucks before he pulled his tongue far back and stopped.  The LC at the hospital told me to press DOWN on his tongue with my finger and draw him to my breast.   Didn't work.  He would only suck my finger a few seconds.  The breakthrough came when my mama (God bless her!) suggested I put my finger UP in his mouth so that the pad of my finger tip touched the roof of his mouth.  This stimulated the suck reflex!  A few hours later, he latched on.  After five days!

The main thing is, don't give up!  You are doing everything right with pumping.  Give him YOUR milk in a cup instead of formula in a bottle, even if it is 10 mL.  Just keep giving him tiny sips.  I understand about the bili level, but your milk is about to come, I promise.  Your breastfeeding relationship is NOT ruined, you and your babe are hardwired to nurse.  Have courage, don't listen to fear or doubts. 

[31rubies]

My first dd didn't nurse the whole first week, and when she finally got the hang of it, she nursed for over 3 years!  So, don't worry that you have lost your chance, because you have not!

I forgot to mention, when my ds did latch, he only nursed a few minutes at a time before he fell asleep.  So feedings were like four times an hour.  If your baby does that, just nurse him all the time.  As long as they are pooping and peeing enough, he will get better and better at nursing. 

Congratulations!

[Oliver'sMom]

Originally Posted by 31rubies 

My first dd didn't nurse the whole first week, and when she finally got the hang of it, she nursed for over 3 years!  So, don't worry that you have lost your chance, because you have not!

I forgot to mention, when my ds did latch, he only nursed a few minutes at a time before he fell asleep.  So feedings were like four times an hour.  If your baby does that, just nurse him all the time.  As long as they are pooping and peeing enough, he will get better and better at nursing. 

Congratulations!

This is just what I was going to say!

Both of my sons were jaundice and they both were tongue tied.  With my first, I had little to no support and didn't know what I was doing, so we were not successful in establishing a good breastfeeding relationship.  I nursed him for 6 months, but heavily supplemented with formula.   I didn't even know ds1 was tongue tied until he was 2yo!

But with my second, I learned not to make the same mistakes twice.  His tongue tie wasn't nearly as severe, but he was far more jaundice and sleepy.  With ds2 I just stayed in bed with him and kept him at the breast constantly.  He's almost 5mo and we're still going strong.

Don't worry!  Just keep pumping and nursing as often as possible. 

[NewMaMaZenLovin]

My baby is 12 days old and we had/are having similar problems.He was under the bili light for 3 days (thank god my midwife had one so no hospitals) and we did as much skin to skin as possible. He was SSSOO sleepy and everytime he would break the latch I would burst into tears cause I knew I wouldnt be able to get him back on. Got the pump and the syringe. Used the pad of my puinky on the roof of his mouth. I offer the breast everytime i pump. 1.offer breast. 2. pump the difference out of that one breast of what he at, syringe feed him that. 3.change diaper talk smooch nuzzle make fun sounds and wait upto 10 minutes.4  offer other breast. 5. pump difference of what baby did not eat. then syringe feed.

Can you get your LO into water? I gave mine a bath and he opend up and floated around and was SO alert and happy. took to the breast fo a whole 20 minutes after! water has done wonders.

STOP the formula!!! Just keep pumping! i know its hard believe me!! get some herbs, drink a glass of wine, do you have your placenta by any chance? Dehydrate it and capsule the puppy up! 

Much love to you mama. This has been one of my most trying efforts and I wish you love and joy in yours!!! Time for m,e to go do that booby thing (we call it the booby trap tee hee)

[carrierwright]

You are doing a great job. Don't make things too complicated, Keep it simple. The amt you're receiving in pumping is still normal, and he should be sleepy since both jaundice and bili lights cause sleepiness. Once home keep pumping until he's at the breast regularly and relax with your baby skin to skin. Give yourself and baby the gift of time to start over w/breastfeeding. He very well may be a wonderful latcher as soon as he wakes up!