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Thread: 5 days old and not sure what else to do...

  1. #1
    Join Date
    May 2012
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    10

    Default 5 days old and not sure what else to do...

    I had my baby on Tuesday; he did well in the hospital breastfeeding. He had the right amount of urines and stools and I received great help from the lactation specialist. By the time we left, I thought we'd be good to go.

    Saw the Ped on Friday; he had lost weight, nothing too alarming, but of course that freaked me out. He was also started to become inconsolable after feedings. I'd sit there with him, assuming I had a good latch for 60 minutes, sometimes 90 to 120 minutes; but he'd still root and want to eat. During this time, there is a lot of waking him up and once he's up; he fights my breast - pushing away and screaming. I continue to relatch and shove (I'm not above being forceful).

    There was no pain initially, so I again, assumed that something had to be right. Now his urines and stools have dropped off significantly. The only time he urinated in the past 24 hours was when I supplemented with some newborn formula (no stools). Now my breasts are in pain, bloody and cracked (which I know means improper latch), but it's the weekend and I'm sure I can't get a hold of anyone. My milk is not in and I started to pump. This morning, I was only able to pump 3 ml of colostrum. I have to believe that's not enough, right? I also have hypothryodism (which was controlled during the pregnancy), but I've read that it affects milk production.

    I know that I shouldn't supplement, but at this point, I don't want to starve him and I feel like I need a little break from the breast until it's bearable to try again.

    Any and all suggestions would be greatly appreciated; I'm tired, frustrated and just want to help make sure my baby is healthy.

  2. #2
    Join Date
    Feb 2012
    Location
    middle of IA
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    1,885

    Default Re: 5 days old and not sure what else to do...

    mama, congratulations on your new baby, and happy first mother's day!!

    it sounds like you're having a rough day. but you will get through this. my milk also didn't come in until saturday morning and DS was born tuesday morning. so your milk will be in imminently!

    please please try to find an IBCLC right now. they take calls on sunday, even on mother's day, and even if you can get someone to talk to on the phone right now, you should. your nipples shouldn't be bloody and cracked and you need one-on-one help. we are here for you too but i just wanted to try to call someone right now.
    DS1 6/7/11
    DS2 10/29/13

    Nursing, pumping, cloth-diapering, babywearing, working professor mama with the awesomest SAHD ever.

  3. #3
    Join Date
    Dec 2011
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    The Armpit of the Universe
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    Default Re: 5 days old and not sure what else to do...

    pp has good advice, it sounds like you'd really benefit from hands-on help from an LC.
    Would it be possible for you to have your doctor order your TSH levels drawn and speak with your endocrinologist about your levothyroxine dosage? Sometimes after delivery they may want to adjust your dosage, mine did.

  4. #4
    Join Date
    Jun 2009
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    5,472

    Default Re: 5 days old and not sure what else to do...

    There is no need to supplement IF baby is getting enough at the breast. If baby is not getting enough, it is of course appropriate to supplement, while figuring out what is going on, gettign help, and protecting your milk supply. If you do need to supplement, supplement with your own pumped or hand expressed milk as much as possible.

    How much to supplement: A baby this age would need to eat very frequently (10-12 times minimum) and take in a very small amount (maybe 1-2 ounces) of breastmilk each feeding. After day 4, a breastfed baby needs 1-2 oz per feeding for a total of 10-20 oz per day of BREASTMILK. In week 2-3, this increases to 2-3 ounces per feeding for a total of 15-25 oz per day. (if baby nurses more often, then each feeding can be less, the important numer is the total.) At about 4-5 weeks of age, breastfed babies reach their peak intake volume of 25-35 ounces of breastmilk per day, and that is all they need per day from then on. I do not know how any of that changes with formula.

    How do you tell baby is getting enough? Behavior is one sign, but not a very reliable one at this age. Poop volume and frequency is a very reliable sign. If baby is pooping enough, you are almost surely fine. If he is not, you will need to look at pees and weight gain to make sure baby is getting enough.

    It is normal and expected for a hospital born baby to lose up to 7% (some say up to 10%) of birth weight in the first several days after being born.

    A "drop off" in poops could be normal, I would need to know what numbers you are talking about. Pees are notoriously hard to see esp. if using disposable diapers. Try putting a bit of tp in the diaper to help you see pees. Also are the poops transitioning from dark black tar to runny yellow? (in between they may look brown, green, etc.) what the poops look like is a clue as well. See links below for what is expected re: poops, pees.

    Do not judge milk supply by how much you can pump. Maybe you have a supply issue, or maybe baby is having difficulty extracting the milk due to latch issues. You do not know at this point. (and even if you have low supply, you may have many remedies and options-the imporatant thing right this moment is to fix that painful latch, & keep baby nursing while making sure baby gets enough and your milk supply is protected.) No pump is as effective at milk removal as a well nursing baby. And in the early days pumps are even less reliable a predictor. You may need more to supplement, fine. Give baby what you are able to pump and supplement as needed. But pump output tells you nothing about milk supply at this point. NOTHING. If baby nurses, no need to pump. If baby does not nurse, pump to make up for that feeding, and pump a bit for every time you supplement.

    What is not normal is for it to hurt so much when nursing.
    OK, so what to do if baby cannot get enough at the breast? 1) feed the baby and 2) protect milk supply and 3) get help. Start making calls today. Since you liked your hospital LC you can start with her. Call local LC's, LLL Leaders ,etc. Do not feel funny about calling. If folks do not want to be bothered today they will not pick up the phone and you can leave a message.

    diaper log: http://www.llli.org/docs/00000000000...diaper_log.pdf
    what to expect early days: http://kellymom.com/bf/normal/newborn-nursing/

    feeding the non latching baby: http://www.llli.org/docs/00000000000...ching_baby.pdf

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

    try different positions and latch techniques for the nipple pain-some ideas: http://www.llli.org/docs/00000000000...astfeeding.pdf and www.biologicalnurturing.com

  5. #5
    Join Date
    May 2012
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    10

    Default Re: 5 days old and not sure what else to do...

    Thanks for the advice. I talked with one of the lactation consultants at the hospital and will hopefully have a one on one appointment tomorrow (Monday) with specialists at a local hospital. I've had to supplement the past coupld of feedings because he isn't latching well at all, therefore not getting what he needs and I'll pump after a bad session. What I'm pumping is not nearly enough to use alone; I'm averaging only a few ml of milk per pump (and that's even if he received almost nothing from our attempt). The proof is in his urine though; day 5 when he should have had 5 wet diapers, he had 3. Day 4 he had only 2 pees (3 poos). Day 5 was only 1 poo. The poo is brown. I'm concerned that he is or will be dehydrated. We have a ped appt Tuesday so hopefully we will understand weight gain or loss. I really like to think I'm doing the best I can with what we have to work with but I guess we can find out more tomorrow and I'm not giving up...just frustrated.

  6. #6
    Join Date
    Feb 2012
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    middle of IA
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    Default Re: 5 days old and not sure what else to do...

    hang in there mama! let us know how the LC goes.
    DS1 6/7/11
    DS2 10/29/13

    Nursing, pumping, cloth-diapering, babywearing, working professor mama with the awesomest SAHD ever.

  7. #7
    Join Date
    May 2006
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    20,999

    Default Re: 5 days old and not sure what else to do...

    And while you are at it, schedule a visit to your doc to check your thyroid levels. Postpartum thyroid issues are very common even in women who have generally normal thyroid function.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  8. #8
    Join Date
    May 2012
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    Talking Re: 5 days old and not sure what else to do...

    Thanks for the words of encouragement! I went to the LC Monday and she made me feel a lot better. She took a look at my nipples and the latch. She also weighed him before I fed him and afterwards. The good news is that he is getting something when I breastfeed. She gave me a recommendation for jack Newman nipple cream (bc my nipples were bloody and cracked to the extreme (even said my pain tolerance seemed very high)). And while my nipples repair, she said pump for the following 24 hours. After that, pump 30 minutes after I feed each time. If my nips continue to be a prob or bleed again, I should pump and feed from a bottle for that feeding. So, my nips are almost healed and I didn't wait 24 hours, I still brought him to the breast at least half of the time. The main dilemma now is that i still produce very little when I pump. We are on day 8 and my milk has not "come in." I'm taking an herb as well to stimulate milk production, but I think it's crazy that it's still not here. Has anyone heard of milk coming in this late? I read that it could be up to 14 days. I'm going to keep at it, but when is it too crazy to keep up with this type of schedule??? I will also schedule a thyroid screen to check my levels.

  9. #9
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    May 2006
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    Default Re: 5 days old and not sure what else to do...

    When you say your milk has not come in, what do you mean exactly? If you express, what do you see: transparent, golden colostrum, or translucent cream-whitish milk? The reason I ask is that sometimes moms who are not experiencing engorgement or not suddenly producing a large volume of milk think that their milk must not have come in. In fact, milk "comes in" simply when the production of milk starts- volume and engorgement are separate issues. If you are still seeing only colostrum, that is worrisome because your baby is now a week old. Milk production generally starts within 2-5 days of birth. If it does not, you really should see your midwife or obstetrician and discuss what might be causing your milk production to be delayed. One possibility is that you have a fragment of retained placenta- as long as the body has a bit of placenta in it, it acts as if it is still pregnant and milk production is inhibited.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  10. #10
    Join Date
    May 2012
    Posts
    10

    Default Re: 5 days old and not sure what else to do...

    I assume it's still colostrum because when I pump it's a golden yellowish color. It hasn't really changed color or consistency since I started expressing it either by hand or pump. I will give my OB a call today. Thanks.

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