One week old latching issues with jaundice and always sleepy

[@llli*courtneyallen]

Today my 2nd daughter is one week old. With my first one she never latched and I had to pump for six months and it was very wearing on me. I am really trying to avoid it with this one. My daughter has jaundice and is constantly sleeping. I am trying to get her latch on ever two hours but she won't wake up half of the time. I usually try the breast for 5-10 mins and then if she doesn't latch or even wake up I give her the expressed milk in a bottle. I can usually force that in and get her to have maybe one oz every two hours. When she had her appt the other day she was down to 6 lbs 15 oz and was born at 7 lbs 5 oz at 39 weeks. So I need to know if I am getting her enough food to help with the jaundice and weight. I would also love ideas of how to get her awake to eat and latch on. Also if I cannot always get her to latch on now, am I doomed for her to latch in the future??? I try all things like undressing her, tickling her feet, making her uncomfy, etc to get her to wake up but she really could care less to wake up or eat. I am getting very discouraged since I am already pumping a couple times a day when she doesn't latch on! Any advice would be great! Thanks so much!!

[@llli*maddieb]

Hi, welcome!

Have you tried keeping baby on your chest most of the time, skin to skin if that is comfortable for you, or lightly dressed, and offering the breast at her early cues? A Baby will often cue, latch and nurse right in her sleep. Have you tried leaning your body back on some pillows or on the couch so you are nice and supported, with baby on top? When baby starts to root, simply slide baby down to just below your nipple, so her nose/mouth are at nipple, she may just latch, of course, help her as you like or need. It may take the two of you fiddling around a bit to figure out how you fit together.

'nurse every two hours' is a nursing frequency minimum that actually means, nurse at least 12 times in a 24 hour day. She may instead (for example) prefer to nurse every 30 minutes for a couple hours and then sleep for three. Or some other more irregular pattern. This is fine and normal and may fit with her natural sleep rhythm better than waking her every two hours. Of course, sometimes waking baby is needed as well. It all depends.

So I need to know if I am getting her enough food to help with the jaundice and weight.

This is a medical question. What did the doctor say?

Also if I cannot always get her to latch on now, am I doomed for her to latch in the future???

NO! you are certainly not doomed. Many babies take weeks to latch and nurse effectively. You are doing really well because baby is nursing a bit plus you are pumping as needed when she does not. Very good.

Remember the rule of three for the non-latching baby.
1) feed the baby. If baby is not able to nurse, nor bottle feed well, what about a syringe? Of course, nursing at the breast is preferred, but you must do what works.
2) protect your milk production if baby is not nursing or not nursing well, it is important to express milk frequently-8-10 times a day, (or once for every time baby does not nurse and is supplemented instead) preferably with a hospital/rental grade pump (a pump you rent because it costs 1500 dollars or more.)
3) Get breastfeeding Help Have you seen an IBCLC? Is that possible for you? Any local LLL near you ? in person help can make a huge difference. And phone help is also good.

Her apparent weight loss of only 6 ounces after birth does not sound unusual to me. It's like 5% of her birth weight, right? That is not bad at all.

Was she blood tested for actual bilirubin levels? Or is the jaundice diagnoses from appearance?

[@llli*mommal]

with the excellent advice above. I'd just add 2 more things you might want to do:
1. Keep the lights low in the house, and the places where you nurse. Newborns tend to close their eyes in response to bright light, and once their eyes are closing sleep often isn't far behind.
2. Take baby outside with no sunblock and no hat and put her in the full sun for at least 15 minutes per day. UV light is great for breaking down bilirubin. You can also put baby in a sunny window, but the glass will block a certain fraction of the UV light.

[@llli*courtneyallen]

Thanks so much for all the advice! This has been very helpful!

[@llli*MaeganAlberta]

I sympathize with what you're going through! My twins were so very sleepy and jaundiced in the beginning. They were still below their birth weight at three weeks. Fortunately, my doctor encouraged me to keep trying with the breastfeeding and it completely clicked between three and four weeks. Now they stay on the breast for the majority of time that we're together! Tickling them under their chin and on their neck was much more effective than their feet for me. And I changed their diapers before very feeding attempt, too. You're probably already doing these things, so I just wanted to lend my support. Jaundice is such a difficult challenge, especially when exclusively breastfeeding, but the minute it starts to go away, they become so much more alert and it snowballs and picks up speed very quickly.

[@llli*laohurose]

Oh my goodness, thank you for this post and all the replies! Similar sitn for me- my 2nd daughter was just born on May 24th, treating for jaundice, very sleepy (although prob not as sleepy as @llli*courtneyallen's).... Most difficult for me is the latching, ESP after my milk came in. She will latch/unlatch 4-5 times, chomping up my nipple until it hurts and still not eat or eat very little and gets frustrated... but when I use the bottle (Avent) she has no prob with its nipple and eating right away. Now I'm experimenting with pumping a bit more than before so I'm less engorged, but think the nipple scabs or plugged ducts might be making it difficult. It has become painful each time putting her on either breast now. Feeding her from bottle every time now is very tempting, although i would really like to get more comfortable again feeding straight from breast without the nipple pains.

Anyone have advice for how I can ensure baby tongue is positioned between nipple and her lower gum during latch? This seems very difficult, but I keep reading I should try to do this for proper latch.

Also, I am fortunate to have an oversupply of milk, but told I should avoid completely emptying breast (via pump of course since she is eating so little right now) to more effectively control my milk supply needs and help make pumping less time consuming. Do I really need to worry about losing my milk supply if I don't empty every time??

[@llli*mommal]

Welcome to the forum!

When the baby opens her mouth, does her tongue cover her gum line? Is she able to stick her tongue out past her gums? And has anyone checked her for tongue tie? If the answers to those questions are all yes, then the key to getting her tongue in the proper position is probably just to wait for her to open very, very wide and to aim the nipple for the roof of her mouth. (Google "asymmetrical latch" and you'll see what I mean.). If the answers are no, then it is probably necessary to have a professional take a look at baby's mouth and make sure everything is as it should be.

Generally a mom will make only as much milk as her baby takes. This is usually not a problem when baby is nursing well- supply will adjust to meet demand. But if the baby isn't nursing well, and can't take the milk she needs, then you need to pump. Not to emptiness every time, but you want to pump when your child gets a bottle and also pump everything she takes by bottle.

You might want to start a new thread about your situation- it will get more attention than if you post the question on someone else's thread.