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Breastfeeding after c-section at Baptist Hospital - tips wanted

  1. #1
    charade is offline Registered User
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    Breastfeeding after c-section at Baptist Hospital - tips wanted

    So, unless my baby turns in the next couple of weeks (still hoping for that), I may end up with a c-section at Baptist Hospital. I'm looking for some advice on the best way to go about breastfeeding, given the constraints at the hospital. As I understand it, the situation is:
    1. I have written exclusive breastfeeding in my birth plan, but I know that with c-section I will not be able to get off the bed till the next morning and because I am going to be in a ward, they will not bring the baby to me. Therefore, I can start breastfeeding the baby when I am capable of going to the nursery myself.
    2. In the interim, I'm assuming they will supplement her in some way. I heard some hospitals use glucose water. I wrote 'no glucose water' on my birth plan but if my choice is between glucose water and formula, which is better? (i am aware that neither is ideal).
    3. I will request cupfeeding to avoid nipple confusion but realistically, I don't know if they will comply. Therefore, I was wondering if I could bring my own bottles/nipples that are closest to the mother's breast. Any thoughts on this?
    4. To avoid engorgement, what should I be doing? I can carry a pump but I heard pumping might not be the best idea...Should I be handexpressing? With handexpressing how does one collect the collustrum...in a cup/bottle/something else? How soon after the c-sec should one start this and at what intervals should I be handexpressing?

    Other than that, any tips for successful breastfeeding given the many constraints I have to deal with? Once I am able to get to the nursery, is there anything I should be doing to make up for the fact that baby will probably have been fed formula from a bottle?

  2. #2
    miran is offline Registered User
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    Charade,

    I delivered at Sanatorium, not Baptist; so I dodnt know if this is relevant But they did bring the baby to me for feeding. In C-sec milk flow takes more time to set in than normal delivery. So for the first couple of days even though my baby sucked for long hours - the milk flow set in properly by the fifth day only. In the meantime they gave baby formula a 3 or 4 times. And glucose water a couple of times. There was no nipple confusion thankfully. But this meant that my breasts were very very sore and bleeding. I had to wear nipple gaurd for a few days - which caused more nipple confusion.

    I was engorged pretty much the first six months. Pumping did work for me but I used it in real distress. For normal engorgment it was simply hand pressing (not even pump) till pain subsided. Do carry breast pads - I wore them constantly and they used to be soaked.

  3. #3
    Gracey is offline Registered User
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    I delivered at Baptist.
    * They seem to give give formula instead of glucose water. In fact, when you check in, they ask for your formula preference (even if you say you want to BF)
    * When I asked about BFing policy beforehand, they seemed awfully strict. But when I was actually there, it seemed like there was some flexibility.
    My advice is to make your preferences known to everyone. The grand majority of their patients are mainland moms who want to formula feed, so they cater to them. If you say nothing, they will just go with their default behavior. But if you make it loud and clear what you want, they can be helpful.
    Ask if you can be wheeled into the nursery for your feeding times.
    Ask if they have a pump you can use.
    Ask if they can cup feed, if that's what you prefer.
    Talk to your ob/gyn in advance. See if you can choose who your ped will be in advance, and talk to him, too. I find that their peds are pretty pro-BFing.

    Of course, BFing from the beginning is best. But it's not a do-or-die situation.
    My baby was fed formula from a bottle in a hospital -- plus she had to stay a couple extra days. And we still managed to segue into exclusive BFing as soon as we got home. It's not like they touch a bottle and they're doomed forever.
    I don't think many moms suffer from engorgement that early on -- it takes 3-5 days for your real milk to come in. If anything, people are pumping to encourage more milk flow.
    I think the main issue is whether you can get your baby to take colostrum.

    Good luck!

  4. #4
    Gracey is offline Registered User
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    Oh, also, when my baby had to go back for a few days, the ped encouraged me to pump and home and bring EBM in for her. So that can be done.

  5. #5
    lesliefu is offline Registered User
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    I wouldn't worry too much. It's only colostrum the first few days, the actual milk flow didnt come for me till the4/5th day and at the hospital they did bottle feed to supplement but it didnt cause my baby any confusion...you're out of the hospital within the week. Also good thing about them supplementing is that you can get some much needed rest before you head home...

  6. #6
    JennyLLLHK is offline Registered User
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    Hi charade,

    I hope your baby has been able to turn since you last wrote, but if not, I can give you some tips on breastfeeding after c-section in a hospital that may not be ideal for breastfeeding.

    If you are separated from your baby, the best thing you can do is hand express some colostrum into whatever sterile container the hospital can provide, and ask them to feed this to your baby using a medicine syringe. You can still request that your baby be given no formula, but you will have to be quite diligent in expressing colostrum at least 8 times per 24 hours, and no guarantee the staff will respect your wishes.

    You probably won't have engorgement problems in the hospital - the idea behind expressing your milk is to stimulate your milk supply. To get a full milk supply we recommend 8 to 12 breastfeeds per 24 hours (starting within 6 hours of birth is ideal) and if any of those are missed, to replicate the breast stimulation by pumping or hand expressing.

    Don't be discouraged if you don't get much quantity at first. Colostrum only comes in small quantities because it delivers concentrated nutrition and antibodies, when the baby's stomach is too small to hold much volume. It's sticky and that's why hand expression is more useful for collecting the milk, because it just coats the sides of the pump parts. It can still be useful to pump too, to encourage your milk supply.

    When you are able to breastfeed directly, I would recommend to hold your baby skin-to-skin as much as possible, and to breastfeed as many times as your baby is interested, to catch up. Once your baby is breastfeeding well, you can then settle into a pattern that suits you both. Not everyone is as lucky as the previous posters whose babies have no nipple confusion after receiving bottles in hospital. I spend time every week helping women whose babies can't suck well at the breast because they are more used to the bottle, and it is quite a different sucking action for babies to get used to.

    If you are lucky enough to have your baby sucking for long periods of time, this should not by itself damage your nipples. If a baby has a good, deep latch, it should not be painful for the mother. Pain is a signal that something is wrong - usually the nipple can go more deeply into the baby's mouth, so that it's not rubbing on the hard palate near the front of baby's mouth, but instead reaches the 'comfort zone' towards the rear.

    I would also recommend that you get in personal contact with a La Leche League Leader (such as myself) and ask for individual advice if you have difficulties. We give free telephone and email help - email [email protected], or phone one of the numbers listed on the www.LLLHK.org home page. It's possible to give more detailed help via those channels than here - for instance, we can send you diagrams of breastfeeding positions that are most comfortable to use after c-section.

    Best wishes,
    Jenny
    LLLHK

  7. #7
    charade is offline Registered User
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    Thanks all for your replies. Sorry didn't reply earlier but my baby decided to put an end to my vacillations between private and public by coming earlier than expected at 37 weeks +4. An emergency c-section in Baptist would have been too expensive for me so I ended up delivering at United Christian (public hospital). She was in special care overnight where she was fed formula but they cupfed her I think. And then they got me started breastfeeding on the afternoon of Day 2 as soon as she was brought up to the regular nursery. My milk hadn't come in yet so we ended up supplementing a bit more but through a supplementary nursing device. My milk came in on Day 3 and after that we were on our way. My only complaint is the four-hour feeding schedule. On the one hand, I was grateful for it because it was really hard hobbling off the bed with a c-section. But my baby ended up with weight loss and jaundice and not enough stools/urine and I think I should have been feeding her more. When I got home, that's what I did and she has been improving.

    Thanks again for the tips!

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