I can't thank you enough for any advice you can offer me. I am a first time mom home just a few days with my DS. I am bound and determined that he will be breastfed, but I am getting very frustrated in my attempts. He was born this past weekend (so is on day 6 now I believe) and was born at 36 weeks and 2 days.
He hasnt fed well from day one. He doesn't want to open wide to latch and when he does latch well he quickly gives up on suckling. By the time we left the hospital this past Monday he was starting to latch a bit better and suckle for a few minutes on one breast (loses interest by the second one.), but I was pumping colostrum and feeding that to him out of a cup to supplement.
When we arrived home he quickly improved, and by Tuesday morning he was suckling at least half-heartedly on both breasts for 10 minutes each. Unfortunately, he regressed precipitously with the onset of jaundice. His level of bilirubin was as high as 16.6 on Wednesday and he became super lethargic. He absolutely would not wake up to breastfeed despite our extreme measures: stripping him naked, bathing him all over with wet washcloth, sitting him up and bouncing him, and moving his arms around. We were still able to feed him out of a little medicine cup, and since my milk came in on Tuesday he is getting increasing amounts of food- all by cup except for maybe one suckle or two from each breast- of around 1-1.5 oz every 2.5 hours or so.
My routine consists of offering each breast to him for 15 minutes - which is laughable because he has next to no interest in it at all- then pumping for 10 minutes per breast and then feeding him out of a cup for the next 45 minutes. Then repeating the whole thing 1 hr 30 minutes or 1 hr 15 minutes later. It is becoming very frustrating that he refuses to suckle on the breast but then he will fuss while I pump because he is hungry! He actually seems to get angry when I offer him the breast if he is fussy- he much prefers the cup!
One thing I have noticed now that his bilirubin levels are dropping is that he doesn't seem to get his tongue underneath the nipple appropriately. When I give him my finger to suckle, his tongue wants to stay at the back of the mouth. I can encourage it to drop to the bottom of his mouth with my finger and when I do, he sucks quite strongly and continuously. It is significantly stronger than I ever feel him do on my breasts.
So, my questions are multiple-
1)Is there any way I can encourage him to put forth the effort necessary to breastfeed- especially to open wide for a good latch and to continuously suckle past just 2 or 3 pulls? He obstinately refuses to open wide for a good latch- and I assume it is because he doesn't feel it is worth the effort to breastfeed.
2) How do I ensure that his tongue is below my nipple to get good suction?
3) Is it possible that he isn't putting forth the effort to breastfeed because he knows he is going to get his feeding out of a cup? We didn't want problems with nipple confusion, but now it seems we have ended up with the same result- a baby that is too lazy to breastfeed. If so, what alternatives do we have to get his nutrition in him without worrying that it is going to interfere with his breastfeeding?
4) Do you think these problems will resolve themselves when his bilirubin levels come down enough that he is no longer lethargic? Because of the jaundice I cannot risk letting him go without food for any length of time, so I can't just wait until he is super hungry before I offer him the breast. And at times it is clear that he is very hungry but that he doesn't understand how to feed himself from the breasts.
Thank you so much for any help you can offer- I feel powerless and incredibly frustrated!
I anxiously await your advice!