If the jaundice is mild enough, simply getting baby to start pooping out all that meconium faster is enough - IIRC, some of the jaundice is from re-absorbing bilirubin from the stuff that’s settled into the colon during pregnancy. So that reduces resorption, and of course the sunshine is the natural version of the bili lights and helps break down the nasty chemicals.
If it’s bad enough, of course, just sunshine / breastmilk won’t be enough and they have to trot out the bili lights (Moon Unit was under them for a couple of days while in the NICU, but of course at that point I don’t think she was taking much by mouth anyway; she wasn’t fully nourished by mouth until she was at least a week and a half).
I’d like to find out why the lactation consultant is advising against mixing breastmilk and formula. To me, the idea of mixing, then reducing the amount of formula until it’s pure breastmilk is very good. Maybe the LC thinks she’s making the formula with breastmilk?
If the baby doesn’t like the taste of breastmilk, I suspect that she’s not going to take to the breast, regardless of how many times your sister tries. Most breastfeeding problems are ones of technique, on the part of baby and mother, not a problem with rejecting the milk itself. One thought, the flavor of breastmilk does change based on your eating habits, if your sister is big into strong flavored foods like garlic, onion and cabbage, maybe she should try a more bland diet. If she is already a bland eater, get her some good garlic bread and see if the kid likes it.
Your sister is also suffering from Bridezilla Syndrome. That’s when people develop expectations for their upcoming Momentous Event, and when those expectations are not met, feel as though everything is Ruined. It’s not ruined. She needs to realize that if she puts a healthy baby to bed at night, she’s been a good parent. It doesn’t matter what trials and tribulations happened during the day, if the kid is healthy at bedtime, you are a good parent. With brides, this Syndrome needs a swift kick in the ass, with a post-partum mother, I’d suggest a delicate, supportive touch.
Breastfeeding is also not easy. My wife and I had a few troubles early on (Cheesestick is now just over 1 month old) it’s REALLY hard to know your child is hungry and you have trouble feeding him. Breastfeeding is not the type of skill you are actually supposed to just pick up on your own. It’s something you learn from your mom, older siblings, aunts, cousins. Our society today puts a value on separating ourselves, so these people are not right there with us to help out, we have to depend on consultants that take days to show up, then give you 2 hours of their time and go away.
Nursing is hard, it really is and I tend to agree that after 6 weeks things start to get easier. It does suck, literally until things start clicking.
We took the classes before baby, and were determined to make things work. I was having some problems when we got home and my nipples were so sore and things just didn’t seem to be working right - in our minds.
We went out and bought some books, and the one I liked the best is: ‘So That’s what they’re for!, by Janet Tamaro.’ The book doesn’t read like an encyclopedia and really does seem to cover a lot of common issues. I also picked up ‘The Girlfriends’ Guide to Surviving the First Year of Motherhood, by Vicki Iovine’ to read while I was nursing (funny view and real world examples from other girlfriends.’
As I stated, my hubby and I were determined to make this work. The times I’d be crying cause my chest hurt, or our daughter wasn’t feeding he’d come in and rub my feet, turn on my favorite tv show, make me a cup of tea or read to the baby just to take my mind off things, which helped a lot.
Some hospitals have weekly meetings of nursing moms, maybe take a look into the hospital she delivered at and see if there’s something like that.
Just be there, however it is and you’re doing a great job. Beautiful baby!
There are two types of jaundice associated with breastfeeding, and then there is just plain old neonatal jaundice. Most babies have some level of jaundice that goes away over time on its own. Some babies have dangerous levels of bilirubin.
My daughter and my nephew both suffered from breastfeeding jaundice. This is most common when the milk doesn’t come in for a long time and the baby basically gets dehydrated. In both our cases, the lactation consultant told us not to even give water for risk of “nipple confusion.” You need to poop to get rid of the bilirubin - don’t eat, don’t poop. Its more common in babies born by C-Section (neither my daughter or my nephew were though, we just come from a family that has delayed milk production). In both cases the lactation consultant assured us that the baby was getting enough colostrum so there wasn’t any issue, even without breastmilk in. In both cases, the lactation consultant endangered our babies. My sister is an RN, gave birth AFTER I did, and didn’t see what was happening until it involved an ambulance ride to a hospital with an NICU.
The second type is breast milk jaundice. A small number of babies do not process breast milk - or sometimes the woman’s breast milk itself is an issue, which contributes to jaundice.
Neonatal jaundice is normal - most babies have some of it and bililevels are seldom high enough to cause concern - even when its breastfeeding related. But SOMETIMES bililevels are high enough to cause kernicterus http://www.kernicterus.org/
In addition to the lactation consultant, check and see if there is a La Leche League group in her area. They typically have scheduled meetings, but leaders might be available for telephone or in-person consultation. Or, there’s 1-877-452-5324, their 24 hour hotline. You can find a list of LLL meetings in North Carolina on this page Local Groups - La Leche League of North Carolina.
It really does sound like she’s suffering from post partum depression, or at least the “baby blues.” It’s very common to experience mood swings, sadness, and irritability after a baby is born, especially the first time. You just don’t know what to do! My only recommendation for your sister is to spend as much happy time with Elizabeth as she can. When she’s awake and alert and quiet, mom should hold her, rock her, sing to her, play with her, look in her eyes - it really helps with bonding, which is important when you’re breastfeeding. It really sounds like your sister needs to relax a little bit as well. Babies can sense tension and moods, and if your sister is dreading the idea of trying and failing, that can have an effect on her physiologically.
She’s managed to get an appointment with a lactation specialist scheduled for 2:30 today. I’ll be driving her and our mom will be coming as well. My BIL has to stay in and catch up on work. I don’t know if she’ll let my mom or myself sit in on the appointment, but I will suggest it so she has an extra ear around. She’s alternated with being alright with me around for appointments that involve her girl parts and not being okay with it, so we’ll see what sort of mood she’s in today. I imagine that if part of the appointment is just discussion based, I’ll be able to sit in on that. It would be great to be able to say, “Don’t worry. Remember that the lactation specialist said…”
The baby has an appointment with their family doctor either tomorrow or Friday. I forget which day. Both my sister and my BIL are going to that one and I’m going to suggest that my BIL asks about post-partum depression. Before my sister gave birth, I asked her what she would do if she had it and she said she wouldn’t do anything. She’d just deal with it. She used to have a really horrible psychiatrist who, literally, almost killed her with the drugs he was prescribing her. The guy refused to talk to my sister’s GP and she ended up in the hospital because of drugs that didn’t play well together. Luckily, they have a great pharmacist who caught the problem. Needless to say, she’s hesitant about taking certain types of drugs. She trusts her GP though, so hopefully if he suggests something for post-partum depression she will listen.
Thank you to all of you who have said that I’m being a good sister. That’s nice to read. The thing is though, by being a good sister I get to have extra time with my niece. She’s pretty much the cutest baby ever born, so I’m definitely getting the good end of the deal by helping out.
Some non-medical ways of helping with PPD include fish oil pills, sunshine, and excercise. A great way to get the last two at the same time is to carry baby in a wrap or sling and go on a walk around the neighborhood. Or she can go out by herself and take 15 or 30 minutes for some alone time. Does she have an MP3 player or something? Sometimes it helps to remind yourself that “mother” isn’t the sum total of your identity just because you had a baby.
Just a note about PPD–it’s technically not considered PPD until it lasts for >2 weeks post-partum. A two-week period of transient “baby blues” is normal. However, previous depression is a risk factor for true PPD, so it’s a good idea to mention it to the doctor, even though she could come out of it just fine in a week or so.
I’m finding this thread fascinating, as I’m finishing up my RN program and hoping to go into L&D and possibly become a Certified Nurse Midwife. (Not the home-birth type, the kind that works in a hospital.) Managing to give birth to a healthy baby is a huge accomplishment in and of itself, so remind your sister that she’s been through some of the hardest parts already. She’s done a great job just by caring enough to keep trying at this, and whatever happens in the end, she’s still a good mommy. Best of luck!
The appointment with the lactation specialist went well. She didn’t want me in the room with her, which was okay. She came out with a written breast feeding plan that involves skin to skin tummy time before breast feeding (she had been doing it afterwards at the hospital nurse’s suggestion), not trying to get a latch for more than ten minutes but feeding as long as the baby wants if they are able to get going, trying to bottle feed breast milk first but stopping after a set amount of time if it isn’t working, and bottle feeding formula as a last result.
She pumped 1.57oz during the appointment, which was the most she has ever pumped at one time, so it looks like her milk still isn’t completely in. The lactation specialist said that the lack of milk combined with the baby getting a taste for formula is probably where the problems are coming from, but my sister seems reassured that it isn’t her fault. They have another appointment scheduled in one week. Hopefully things will have worked themselves out by then and it will be a quick checkup. The big things, for right now, are that the baby is healthy and happy and my sister is the same. We may not be totally there with y sister being happy, but we’re closer than we were when I started this thread.
Glad to hear things are getting easier. Like everyone else said, being a new mom and learning to breastfeed are HARD. It’s great your sister met with a lactation consultant. I second the suggestion that she find her local La Leche League chapter and give the leader a call. It can’t hurt to have another supportive person helping. LLL meeting are great, too. They’re where I met my closest mom friends.
Also, regarding the amount of milk she was able to pump – that’s not necessarily tied to her milk being in, or to the amount of milk the baby will be able to get directly from the breast. I was never able to pump more than a few drops, despite the fact that I had a serious oversupply and I leaked milk like CRAZY. When my son was tiny, I couldn’t take a shower without cascades of milk dripping (and sometimes spraying :eek: ) out of each breast.
Just a word of warning on the LLL - I’m sure some are great - I found the worst group of women I’ve ever met at the one I went to - I went for information on adoptive breastfeeding and got a bunch of pity, judgment and discussion about how I wasn’t a ‘real mom.’
I wouldn’t recommend someone having issues go unless there is a native guide to the group willing to vouch for them that you trust.
My experience was similar to yours, vix. The first 2 weeks for me were the worst, and I remember worrying about whether my baby was getting enough to eat-- even once my milk supply was established. The first few days, I was sure that he was starving.
A few women I know tried breastfeeding for the first few weeks, but then quit, saying it was too frustrating and painful. I would have liked to see them in time to tell them that the worst part was over.
La Leche League helped me a lot at the time, but I get the impression that they’re more militant nowadays and I don’t like the thought of women being browbeaten or made to feel guilty if they choose to bottlefeed.
Once it’s established, it’s the easiest thing in the world.
MissMossie, I’d like to add my support to the statements of those who recommended that your sister have snacks and drinks often during the day. It does help with the milk supply. I used to have a snack close at hand while I was nursing. Not chocolate in my case, though, it really upset his stomach. Even with the snacking, after 6 weeks I weighed less than when I got pregnant.