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Breastfeeding in hospital

  1. #1
    happybilly is offline Registered User
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    Talking Breastfeeding in hospital

    Hi everyone,

    My baby is due in 2 weeks' time. I am going for natural delivery at St Teresa's hospital. I've been told that you must go to the baby's ward in order to feed your baby so if you can't get out of bed, you could express your milk and the nurses could feed the baby by bottle.

    Do babies really get "sucking confussion" if they are fed via bottle and breast?

    I have heard that the hospital could feed the baby using cups instead of bottle - is this possible? Would it choke the baby?

    Appreciate your sharing of experience or advice. Thanks!

  2. #2
    LLL_Sarah is offline Registered User
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    Dear HappyBilly,

    The first milk you have in your breasts is called Colostrum. This milk is very important for your baby but it comes in drops not ounces. A normal colostrum feed is only about 2 mls the first day. One of the purposes of the colostrum is to help teach your baby how to breastfeed without the worry of too much liquid to swallow (often formula feed babies throw up or chock a lot the first day). see http://www.lalecheleague.org/FAQ/colostrum.html

    If you are not allowed to feed your baby the first day (although it is easily possible to feed the baby sitting up or lying down in bed if you are not able to get out of bed yet) it is best to hand express your milk rather than pump. The colostrum is sticky, like honey, and so will stick to the sides of the pump and you won’t be able to collect much. In the first few days if the baby isn’t able to suck hand expressing is done eight times a day and the milk collected in a syringe and then fed to the baby.

    As your milk increases and becomes less sticky usually mothers are able to pump and collect milk if the baby isn’t breastfeeding, some mothers still find they get more by hand expressing for the first two weeks.

    It is important that your baby learns to breastfeed directly at the breast before you introduce other things for the baby to suck on. Usually we try to wait 4 to 6 weeks before introducing the bottle or pacifier. This way we know that the breastfeeding is really working. Bottles introduced at 6 weeks have much less effect on the breastfeeding than bottles introduced at 6 days or 6 hours.

    Babies can cope well with cup feeding and in fact in hospitals where they never use bottles the nurses are as quick at cup feeding as they are at bottle feeding. If you want to cup feed ask a nurse to show you how to do it, as they are tips which make it easier.

    Remember that a newborn baby needs to feed between 8 and 14 times in 24 hours. So if you are expressing your milk rather than feeding the baby directly you also need to express between 8 and 14 times in 24 hours (this is a minimum of once every three hours, from start of expressing to the next start of expressing).

    Research has shown that mothers who get special breastfeeding instruction before they have their babies are more likely to success at breastfeeding. If you don’t yet have such education La Leche League in Hong Kong do a Breastfeeding Class, http://www.lllhk.org/Class.html

    Best wishes,
    SARAH
    Last edited by LLL_Sarah; 01-15-2007 at 08:03 AM.

  3. #3
    happybilly is offline Registered User
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    Dear Sarah,

    Thanks so much for your detailed advice!

    As you say there may be only a few drops of colostrum/milk in the first days, will the nurse have to feed formula to the baby as well?

  4. #4
    LLL_Sarah is offline Registered User
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    Colostrum is the first milk we have it is sticky, yellowish in colour and comes in very small quantities but it is a very concentrated nutrition and also easy for your baby to digest.

    The newborn’s stomach at birth is the size of a marble
    . It holds less than a quarter of an ounce of milk. Colostrum comes in small quantities because small quantities are all the baby needs and wants. There is no need to give formula to your baby, indeed giving formula can cause unnecessary problems with your breastfeeding.

    Also giving formula, water, sugar water or anything other than breast milk will stop your baby from being an exclusively breastfed baby. The most benefits for your baby are with exclusive breastfeeding – so only give your baby something else if medical necessary.

    Colostrum comes drop by drop so it can take the baby a long time to get the few millilitres it needs and wants. A normal colostrum feed is between 40 minutes and two hours (using bothe breasts).

    A baby needs to feed 8 – 14 times in 24 hours. When you have colostrum this is usually close to the 8 times in 24 hours (This is an average of once every three hours, measured from the start of one feed to the start of the next. If you have three hours from the end of one feed to the start of the next your baby isn’t feeding enough.)

    Some babies want to nurse often for long periods of time, some want to nurse steadily for a couple of hours and then sleep for a couple of hours, some want to breastfeed more often but for shorter periods of time and some babies are not interested in nursing at all or are sleepy (drugged) during their first few days.

    Whatever type of baby you have plan to spend a lot of your time nursing during these early days and weeks.

    The important thing is that your baby is latching on well to the breast. If the baby is moving all his jaw as he feed and you are not in pain then the baby will be getting the colostrum.

    If, however, if your baby is not moving his jaw much as he feeds he will not be getting much milk. Likewise if you have pain when you are feeding the baby will not be getting much milk. Being in pain is an indication that the baby is not latched in a good way and so will not have your breast and nipple in the correct place in his mouth.

    Incorrect position leads to sore nipples and baby not taking much milk. Correct position leads to comfortable breastfeeding and baby taking lots of milk. If it hurts when you feed GET HELP.

    Best wishes,
    SARAH

    LLL Leaders in Hong Kong:
    Maggie 2817-7475
    Margarita 2257-6757
    Rochelle 2947-7147
    Sarah 2548-7636
    [email protected]

  5. #5
    happybilly is offline Registered User
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    Hi Sarah,

    Thanks once again for your detailed advice! It's much clearer to me now and I'm preparing to be a breastfeeding machine when my baby is borned.

    One last question, do you recommend feeding with syringe or cup in the first few days at the hospital?

  6. #6
    LLL_Sarah is offline Registered User
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    Most babies will be able to breastfeed directly without problems when they are born and so only breastfeeding is required. Thus there will be no reason to express your colostrum (or milk) and feed the baby with a syringe or cup.

    Occasionally the baby has problems breastfeeding and can’t manage to feed well. This is more likely if the baby is born either early or small but does sometimes happens to full term large babies.

    If the baby isn’t able to breastfeed well then the mother must help. The usually means stimulating your breasts yourself by hand expressing (and later on by pumping) and feeding the milk to the baby in another way.

    If you have to do this then a syringe or cup is a much better alternative than a bottle. I would try to avoid bottles until your baby has been feeding well for a number of weeks. I personally like the soft cup feeder from Medela. http://www.meridianhk.com.hk/special_feeding_main.html
    I like the way that you have the milk in the feeder but only the amount you want comes out. I find these feeders as easy to use as a bottle.

    Medela take everyday objects like a spoon, a cup and a feeding tube and make then easier to use, e.g. a soft cup feeder, a cup feeder and a supplemental nursing system. After all we wouldn’t buy them if they weren’t easier to use but it is not necessary to spend the extra money if you don’t want to. I usually use the cap of a feeding bottle if I need to cup feed a baby.

    Sometimes a baby doesn’t get off to a good start with breastfeeding and is unable to pass all the meconium before some of the bilirubin had leached back into his body and causes jaundice. The doctors in Hong Kong are very keen to suggest supplements in these cases. If supplements are required then a syringe or cup is a good way to give them. Remember that a supplement of your own expressed milk is much better for the baby than a supplement of formula.

    Best wishes,
    SARAH

  7. #7
    loupou is offline Baby Guru
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    Happy Billy,

    I had a friend who had a baby in St. Theresa's. She had a private room and completely ignored the nurses and insisted that the baby stay with her when *she* wanted it and fed the baby on demand (none of this going to the baby room and sitting in some strange feeding room).

    That said:

    A) It was a vaginal delivery (so no problem getting out of bed)
    B) As I mentioned, she had a private room, so the excuses of "it will bother other people" could be ignored
    C) It was her third baby and she was quite confident and was not intimidated.

    ****
    The biggest surprise for me when I had my 1st baby was how often she nursed. She wanted to be sucking every few hours. When I had my 2nd, I wasn't so surprised.

    I know a lot of HK women will express and try to feed the baby that way. It's almost "mouh yung" and your supply will not become adequate that way.

    I had vaginal deliveries w/ both children and I was ready to be up and about the next morning (both kids born at night). Not ready to run a marathon by any means ;) but able to walk to the toilet and take strolls around the hospital.

    Good luck.

  8. #8
    AndreaY is offline Registered User
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    Sorry to disagree, I pumped milk nearly the entire time and my milk supply was perfectly sufficient for my baby, even with spare for the freezer. A few of my friends also did the same and they had no problems with supply either. Think it depends on the milk supply of the mother whether pumping would work.

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