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Breastfeed after C-section?

  1. #9
    LLL_Sarah is offline Registered User
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    First I don’t think you should lump together all the private hospitals but look at them on a case by case basis. I know of at least one private hospital in Hong Kong that has both a breastfeeding policy and a skin-to-skin policy and actively encourages babies to breastfeed as soon as possible after birth, no matter what sort of birth you have.

    I would recommend that you discuss this with your doctor and see if you can get it written in your notes that you are to breastfeed as soon as possible after birth. Even hospitals that have policies that limit mother and baby contact will bow down to instructions from doctors.

    If you are unable to breastfeed your baby then hand expressing is recommended rather than pumping. 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.

    Because the amount you get when you express is a few millilitres it is usually easier to feed the baby from a syringe than from a cup. (Even when the mother manages to express about 20 mls I find it easier to keep filling up the syringe than to try cup feeding with new born babies.)

    If because of the hospital policies it turns out that you have to supplement your baby with formula remember that when your milk supply increases you can stop all formula are start fully breastfeeding. If this is your case and you are worried about being able to satisfy your baby on your milk alone a call to one of the LLL Leaders might give you the confidence you need.

    Best wishes,
    SARAH

    For help and information about Breastfeeding
    SARAH 2548-7636
    MAGGIE 2817-7475
    ROCHELLE 2947-7147
    MARGARITA 2257-6757
    余婉玲 9048-1701
    E-mail: [email protected]
    Web site: www.lllhk.org

  2. #10
    Chinchilla is offline Registered User
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    Sarah,

    You said, “Delaying the first feed and giving formula in the hospital are the two biggest predictors of breastfeeding failure.”

    It that just your opinion or do the doctors and nurses agree with you?

    Chinchilla

  3. #11
    LLL_Sarah is offline Registered User
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    As a Lactation Consultant all the information and advice I give is evidence based. It is one of the things that we pride ourselves on; our knowledge is up-to-date and supported by recent medical research.

    The knowledge about what causes problems for breastfeeding comes from,
    Evidence of the ten steps to successful breastfeeding

    http://www.who.int/child-adolescent-...O_CHD_98.9.pdf

    The Ten Steps to Successful Breastfeeding
    are the criteria for hospitals to become baby friendly. (So far we have no Baby Friendly Hospitals in Hong Kong although China has a lot.)

    If you are wanting to see whether or not a particular hospital is breastfeeding friendly ask them if the following ten points happen in their establishment.

    Ten Steps to Successful Breastfeeding

    Every facility providing maternity services and care for newborn infants should:
    1. Have a written breastfeeding policy that is routinely communicated to all health care staff.
    2. Train all health care staff in skills necessary to implement this policy.
    3. Inform all pregnant women about the benefits and management of breastfeeding.
    4. Help mothers initiate breastfeeding within half an hour of birth.
    5. Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants.
    6. Give newborn infants no food or drink other than breast milk, unless medically indicated.
    7. Practise rooming-in - that is, allow mothers and infants to remain together - 24 hours a day.
    8. Encourage breastfeeding on demand.
    9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.
    10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

    Source: Protecting, Promoting and Supporting Breastfeeding: The Special Role of Maternity Services, a joint WHO/UNICEF statement published by the World Health Organization.
    http://www.unicef.org/newsline/tenstps.htm

    Best wishes,
    SARAH

  4. #12
    LLL_Sarah is offline Registered User
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    Current research also indicated the need to modify Step Four:
    Help mothers initiate breastfeeding within one half hour of birth.

    It is now cautioned against taking this step too literally, since recent evidence suggests that a newborn at her mother's breast will take, on average, 55 minutes to begin suckling. So some organizations have increased the recommended time for breastfeeding initiation to one hour.

    Others believe that "initiating breastfeeding" should be interpreted more broadly to include the skin-to-skin contact, smells and soft conversation that culminates in the infant's taking of milk from her mother's breast.

    So it is worth asking about the hospital's skin-to-skin policy and also their bathing policy. As it is advised that babies not be removed for their first bath until after they have breastfeed successfully.

  5. #13
    bekyboo44 is offline Registered User
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    I had a c-section at a private hospital in Hong Kong and they helped me put my baby to my breast in the operating theatre, minutes after he was born. We were then both taken up to our room where I was helped to start breastfeeding.

  6. #14
    cyberyoda is offline Registered User
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    Dear all,

    You may not understand how DISAPPOINTING of most of the private hospitals in HK about breastfeed and baby policy. Due to teh influx of millions of mainland chinese women, most of teh hospitals changed their policy starting in Dec 2006. Only Matilda, Advantis, Sanatorium those a few hospitals at the mid level are the exception. I have talked to most of the private hospitals, apart from teh above exception, they all said that CANNOT breastfeed teh 1st day after C-section; CANNOT room-in baby; even the husband are NOT ALLOW to enter the baby room to see the baby while I am in hospital as it is too crowded. I absolutely agree that we pay for private hospital and should receive good services. Unfortunately, because of the mess of mainland chinese women, we now have to pay more (nearly all private hospitals increase price to both HK or Non-hk people) but we are facing more restrictions.

    This is my first child and I only get back to HK when I was 5 months pregnant (I was transferred by my company to Shanghai for 3 years now). Not until January, I heard about the bad news of all those restrictions. Now that I am due in 4 weeks and it is too late to change hospital. All my friends told me, a few years ago when they deliver in HK, there are not much restrictions and there are not many people in the hospital too. So if we are comparing the services a few years ago to the services they offer now. There is No way you will be satisfied!!! For those who have chosen those private hospitals without much restrictions, congratulations then. For me, I just have to do the best I can....

  7. #15
    LLL_Sarah is offline Registered User
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    It is true that sometimes the hospital policies make getting breastfeeding off to a good start difficult. If you find that your breastfeeding isn’t going well then please consider getting extra help.

    I think it is helpful to understand what normal breastfeeding behaviour and patterns are like so that at least you understand that the practices in the hospital aren’t what you are trying for once home.

    Many hospitals in Hong Kong have timetables for breastfeeding which mothers try to continue once back home. This seems reasonable if you don’t know that in hospital you weren’t feeding the baby enough.

    A new born baby needs to feed between 8 and 14 times in 24 hours. We phase this like that and not every x hours because babies are not regular in their eating habits.

    Other behaviours which are very common but worry mothers because medical staff don’t talk about them are what I call the ‘Chocolate cake syndrome’ and the ‘Chinese banquet syndrome’.

    Chocolate cake syndrome

    Imagine that my husband and I are eating dinner. I tell him that we have a chocolate cake for dessert. However, when he finishes his main course he tell me that he is full and doesn’t want any cake. At this point I suggest watching TV! When the first adverts come on he says, “You know maybe I’ll have a piece of that cake after all.”

    This behaviour is very common in babies (as well as husbands). The ‘chocolate cake’ feed is usually just 5 to 10 minutes but sometimes the baby doesn’t just want one slice of cake but the whole thing and you end up feeding for another hour.

    This doesn’t mean that you don’t have enough milk. Just like I had enough food for my husband (after all I had a whole cake when he said he was full) you also have enough milk. It was the baby who changed his mind.

    This analogy is actually very good. Just as chocolate cake is a high fat snack after your meal, any milk that the baby takes after a feed will be higher in fat than the original feed – just like a piece of chocolate cake!

    Chinese banquet syndrome

    Rather than having big feeds with big gaps some babies like to have lots of small feeds. Mothers often worry about this because they seem to be spending all the time feeding because they aren’t able to do anything during the breaks.

    I like to think of this as a Chinese banquet. At banquets each dish you are given is quite small but you are given lots and lots of them and at the end of the evening you are fuller than if you’d had a meal at home.

    Some babies like to eat like this, often wanting to be at, or near, the breast for two to three hours or more. It is so common it has a name, cluster feeding. But it is a behaviour that I know many new mothers worry about. But it doesn’t mean you don’t have enough milk – rather that your baby wants to feed this way. When the baby eventually stops and goes to sleep he usually sleeps for quite along time, maybe even four or five hours.

    There is a nice information sheet called Cluster Feeding and Fussy Evenings, http://www.kellymom.com/babyconcerns/fussy-evening.html

    Our hospitals make us believe that babies should have large feeds and large gaps between those feeds. This seems to work well for bottle fed babies (where the caregiver decides how much milk the baby drinks at each meal) but it doesn’t work well for all breastfed babies.

    So no matter how good or bad start you get with breastfeeding in the hospital try to fully breastfeed once you are home. And if you have soreness or are worried that the baby isn’t putting on enough weight – GET HELP.

    Best wishes,
    SARAH

  8. #16
    carang's Avatar
    carang is offline Registered User
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    i had a baby 9 days ago by c-section under general anesthesia. i was unable to see my baby until the next day as she was in the special care unit and i was unable to move.

    i bf her as soon as i was able to sit up. i did allow them to give her formula a few times as i was sooooooo tired.

    however, it has NOT in any way impeded bf (for us).... as a matter of fact, i think that i make too much milk for her to possibly keep up with.

    i'm having a hard time feeding her for more than about 10 minutes at a go. i'm not too worried though as from my understanding pumping is not nearly as efficient as direct suckling. after i feed her directly, i end up having to pump as i'm still so full... when i pump, even after a feed, i'm still getting around 3-4 oz!!!

    i'm not freezing the milk, although, i'm now thinking that i should as i'm throwing out so much of it!

    not to worry it is still possible to successfully breast feed, even if the baby isn't with you immediately after the birth!

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