About to give up

[@llli*rdh2378]

I had my DD one month early @ exactly 36 weeks on Monday 4/4. We came home on Wednesday evening 4/6. Friday morning (4/8) at her 1st pediatrician appt., her bilirubin was 18.4. They called us at home around 3PM and told us to get things together for us to prepare to spend the night (at least) at the hospital, and head over to the local Children's Hospital. They said to go to ER/Triage b/c we would be a direct admit to the NICU, but that "we shouldn't freak out" (Yeah, sure, right.....)
We ended up there for 13 grueling days. She was put under triple phototherapy for 2 days and was getting fed my pumped breastmilk via NG tube. Her bili went down after 2 days to 11, and we took her off phototherapy. We began to try bf'ng and bottle feeding breast milk. She was barely able to latch even with the help of a nipple shield. Then, she started having trouble maintaining her core body temp and eating at the same time. Next, she went into an isolette to help her with the temp. issues. Then, she had another bili check and it was going back up, so she went under the lights again for another 3 days. We got the bilirubin down to 9 something. We were discharged to come home. She had gotten better at latching and sucking and had been gaining consistent weight. She's in the 25% for weight and height as of her 2 month check up (which was 6/8). I have been worried, though, because since returning to work on 5/27, her latch seemed to have gotten bad. She was clicking a lot and fussy at the breast several nights in a row. She only gets 3-4 bottles/day at daycare (about 80-90ml each) or with Dad when he watches her during day. Also, she was still yellow. I forced pedi. to run another bilicheck and she was now 9.2 (down from the 14.8 that she had been at previous week). So, the dr.s are not worried b/c she's gaining weight and her bilirubin is coming down, but I am freaking out b/c her wets are far less frequently "heavy", she only had one green, watery poop in my presence yesterday and one yellow poop today (daycare marked she'd bm'd a few times yesterday, but I don't know volume, color nor consistency). Also, she seems content to sleep, and I am waking her every 3-4 hours to nurse at night. Also, her bili is still higher than average, per the Dr. Last night, she and I went to see an LC (we've been to see her 2 times before) and she got 60ml off my one side in about 5 minutes. We then put her on the other side and she got 40ml more in also about 5 minutes. The LC had said she thought my latch was good, and that since when I pump at work in the mornings (around 8:30AM daily) and get 8oz (total) that LO is doing great.... but I just can't shake the feeling that LO is still too jaundiced, and afraid it's because she's not getting enough. Also, BF'ng at home is fine, but I am petrified of trying to BF in public, for fear she won't latch and instead will scream/cry. Any suggestions on making BF'ng in public easier? Also, the pedi said heavy wets don't matter if they are more than 6-8/day and that poopies don't matter either, as long as when they happen they are soft. Does this seem right?

[@llli*mommy2lilah]

I think it sounds like things are going ok. Your pediatrician is right about the diapers. Have you heard of breastmilk jaundice? It doesn't mean that your baby should not be breastfed and it doesn't have anything to do with your milk. Some babies are jaundiced for a little while...

http://www.nbci.ca/index.php?option=...tion&Itemid=17

[@llli*joe.s.mom]

I agree - it sounds like you are on the right track! I see a little light at the end of that tunnel, just around the corner! You have been through some rough times, and you stuck it out like a champ. It seems better now. So don't give up just now!

Most babies do grow out of their jaundice, and it might just be a matter of holding on and letting yourself get used to her being healthy and strong. But I also trust your instincts, if you think she's still jaundiced, definitely keep going back to the doctor and making sure everything is okay, you know?

I hope you'll stick around, because your experiences, harrowing as they were, would be so valuable for a lot of new moms here who are dealing with the jaundice issues.

[@llli*mommal]

Welcome and congratulations on the new baby! It sounds like you have had a rough ride so far, but it also sounds like you have been doing a fabulous job at overcoming all the challenges you and your baby have faced!

Your pediatrician's advice is spot on. As long as baby is gaining weight, having a sufficient number of wets in a 24 hour period, and is passing only soft poops, things are fine. These links on diaper output may be useful:
- http://www.kellymom.com/bf/supply/enough-milk.html
- http://www.kellymom.com/bf/supply/enoughmilk-older.html

The following would not concern me:
-the occasional green poop. Green poop is only an issue if it is consistently green, meaning that the majority of your baby's stools are green.
-the bilirubin level. Your baby's levels are low and are trending down, which is what you want to see. A falling bili level is good, a climbing one is a problem.

The nursing difficulties you're currently having- the altered latch, the fussing, perhaps even the clicking- all sound like things that happen when babies get a lot of bottles early on. Sucking on a bottle is very easy compared to sucking on the breast. It requires less skill andless strength, and sometimes that causes a baby to fuss when they get the breast, because they don't necessarily want to work hard for their meals. Some things that can help can be found here:http://www.kellymom.com/bf/pumping/bottle-feeding.html

Nursing in public is difficult when your baby is small, young, and perhaps sleepy. Newborns take a long time to feed, require mom to support their bodies and heads throughout the nursing session, and are so small that they don't cover mom up very well. But all those things change- the baby will become more efficient when eating, getting meals in only a few minutes, and will get stronger and more physically adept, enabling her to nurse without needing so much help from you, and she'll get bigger, covering more of the things you don't want to expose. Until those things happen, I suggest doing the following:
-invest in some nursing shirts. They allow you to expose the minimum.
-try nursing in front of a mirror to see what you're really showing.
-try a nursing cover.
-put a couple extra blankets in your diaper bag. A well-stuffed bag can double as a nursing pillow.

Don't worry too much, mama. It sounds like you're doing a great job!

[@llli*kst.7399]

It's so hard for us, as women, to trust our bodies but you must. The numbers don't lie. You are doing an amazing job and this is just the first of many worries you will have. It's called being a mom. But trust yourself.

When you say she's in 25% is that corrected? Do not forget that she was a preemie and might take a little time to "catch up".

[@llli*rdh2378]

She's in the 25% for chronological, I believe... I don't think they gave me figures for adjusted. As I said, I know that she CAN get enough in a short time (1st visit to LC she had gotten 1.5 ounces in 5 minutes, then an additional ounce in 5 more minutes after being weighed/burped.) Also, last night in about 5 minutes she got 100ml (about 3.3oz) in only 5 minutes on each side, also. I just am soooo paranoid about the jaundice b/c it actually went back up from the time we left the nicu, and I didn't realize that until just yesterday. She'd been at 9.2 when we left the hospital, and at her 2 month appt she was 14.8. The pedi still is calling it breast milk jaundice, but I am so afraid that it's breastFEEDING jaundice. I have a scale at home that weighs in pounds and ounces, but I haven't weighed her in several days. I am going to try tonight before her bath. If she seems to still be gaining weight, I will be happy.

I do have a few nursing tops and did manage to nurse her when I picked her up from daycare yesterday for 5 minutes. I guess I was just sooo naive about bf'ng.. thought that because it was natural, it came naturally, ya know. I have been to a LL meeting, and had a leader come to my house and think I am going to try to attend the meeting next week. I really enjoy Bf'ng when I KNOW it's going well, and hope to keep it up. Thanks to all for your support and suggestions! I do have a nursing cover, too, and just need to figure out how to get proficient at unhooking my bra, lifting my shirt and getting the nursing cover on. Just because I am protected by law to BF anywhere, doesn't mean I am comfortable enough to do so, especially when I am by myself!

[@llli*sam.c]

I completely understand about assuming breastfeeding would come naturally. I had the same feeling. Ditto re: nursing in public. Personally, I find a secluded place to get my 7-week-old latched on and then resume/rejoin my activity.

[@llli*bumble.bee]

I admire your determination. You must have worked so hard in the past weeks to keep breastfeeding. You are an inspiration to many mothers.

Are you frightened of your baby crying when you breastfeed in public? Is it because you feel it will bring attention to you? Do you want to get out of the house with your baby?

It has been my experience that once me and my baby have a breastfeeding relationship and I am confident with my body, I feel so much more comfortable breastfeeding in public.

Some moms use a cover.
Some moms wear a nursing clothing (and the styles have come a long way - you can actually find "regular" looking nursing tops these days). I have invested in a couple nursing shirts that I will wear when I know I will nurse my baby away from home and around strangers.

[@llli*rdh2378]

I think it sounds like things are going ok. Your pediatrician is right about the diapers. Have you heard of breastmilk jaundice? It doesn't mean that your baby should not be breastfed and it doesn't have anything to do with your milk. Some babies are jaundiced for a little while...

http://www.nbci.ca/index.php?option=...tion&Itemid=17

I know the Pedi says it's breastmilk jaundice, and she said that she called the NICU and that levels of 14.8 at around 2 months aren't anything to be concerned about. When they were at 9.2 last week, the other Pedi I saw said it was higher than average, but still coming down, so ultimately not a big concern. I just wonder... how do you know if it's breastMILK jaundice vs. breastFEEDING jaundice? I am worried specifically because her levels did go back up as I said when we left the NICU. The research I've seen says 15 is worrisome when it's within the first 168 hours of life, but I can't find much about beyond that. The only thing I found was this:

A total bilirubin level below 1.9 mg/dL is normal, though many symptoms, such as jaundice, do not begin to appear until it reaches about 2.5 mg/dL. Direct bilirubin, which is the name for bilirubin that has been processed through the liver, is considered elevated once it passes 0.3 mg/dL.

Bilirubin is found naturally in the body; however excessive amounts can be an indication of a serious medical condition. A total bilirubin level below 1.9 mg/dL is normal, though many symptoms, such as jaundice, do not begin to appear until it reaches about 2.5 mg/dL. Direct bilirubin, which is the name for bilirubin that has been processed through the liver, is considered elevated once it passes 0.3 mg/dL.


Read more: http://www.livestrong.com/article/22...#ixzz1PYKePmzQ

That said, they told me her level was 9.2 total and 0.8 direct, so it's MUCH higher than average, if you ask me. I know that in older infants/children/adults there is no fear of brain damage because of the blood brain barrier, but I don't know if a premature 1.5 month old infant has a blood brain barrier sufficient enough that I shouldn't be concerned about brain damage from kernicterus!

[@llli*mek]

I guess I was just sooo naive about bf'ng.. thought that because it was natural, it came naturally, ya know.

I know!! I wish that when I was pregnant, someone would have warned me that it was going to be hard work. It was so difficult for me in the beginning, because I wasn't prepared for it. I think if I had known that it was not going to come naturally and that I was going to really have to work for it, I would have been more prepared and would have handled it all much better. Now that my DS is almost 4 months old though, BFing has become so much more natural and so much easier. It definitely does get better!