Breastfeeding in hospital

S

Saisaiii

New member
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!
 
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
 
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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?
 
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]
 
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. :banana:

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

You've had some fantastic information from Sarah and loupou which I hope will help you have a good breastfeeding experience at the hospital. The only advice I would add is do everything you can (in birth plans and in person) to underline to the staff that you don't want any bottles, or formula, given to your baby unless your consent has been obtained. Repeat this mantra often, to every change of staff, if you want to get breastfeeding off to the best possible start.

Also, get advice on all the things you can do to promote natural delivery and minimise the pitfalls that sometimes lead to unnessesary ceasareans. You could have a consultation with a pro-natural midwife such as from Annerley, they are great. They will tell you things like the BRAN checklist (to refer to every time the hospital suggests a medical intervention). I forget exactly what it stands for but I think it is: B - is the Baby OK? R - what are the Risks? A - what are the Alternatives? N - do we have to do it Now?
 
Thanks all of you for your kind advice! I gave birth to a healthy baby girl last week! I only stayed at the hospital for 3.5 days and unfortunately i didn't have enough milk to feed my baby so a few times a day, I'd let her suck for 20-45 min and then cupfeed her with formula. The rest of the day, the nurse would cupfeed her with formula.

i've having problem breastfeeding my baby since we got home from hospital:
1. as soon as we got home, the baby somehow refuses to breastfeed and prefers formula (i've switched to bottlefeed after two days). However, once in while she would be ok to breastfeed but we'd always have to give her formula as she seems to be still hungry.

2. i dont have enough breastmilk, and it's already Day 9! I express my milk since she wouldnt take it directly from me but i could only manage to pump 0.5-1oz each time. I've tried massaging and hot pack and drinking lots of water but nothing works!

It's really worrying. Please help!
 
There is a breastfeeding clinic at the Matilda Hospital on a Monday afternoon. You don't need to have given birth there to attend the clinic.

The sort of problems you have need a face-to-face meeting with a trained lactation consultant. Don't wait longer make an appointment and go as soon as possible.

Tel: 2849-1500 for an appointment - do go the sort of problems you have need solutions this week not next week.
 
Dear Happy Billy,

Is your baby able to latch on and feed at the breast?
If you can latch the baby at the breast is she drinking?
How long is she actively drinking for?

If you don’t understand what I’m asking then you will find a face-to-face consultation with a lactation consultant very helpful.

If you contact me at [email protected] or on 2548-7636 I can send you some photos and diagrams which may help explain how to improve your latch.

The NHS in England has a pamphlet, summarised at, http://www.breastfeeding.nhs.uk/in_howtobf.asp, which shows in pictures how to latch your baby to the breast.

Dr. Jack Newman explains how to latch a baby on his web site, http://www.drjacknewman.com/

When Latching, http://www.drjacknewman.com/index.php?option=com_content&task=view&id=63&Itemid=92

He also has video clips on his web site which can be useful. I think that a picture saves a 1,000 words and a video saves a 1,000 pictures.
Go to http://www.drjacknewman.com/index.php?option=com_content&task=view&id=18&Itemid=42
and click on First Latch
This video shows how to achieve the "asymmetrical" latch, which reduces pain and allows the baby to get more milk.

Kellymom.com has information about weaning from supplements to the breast and a useful form to fill in which helps you know exactly where you are and what the next stage is.

Weaning from Supplements Instructions
http://www.kellymom.com/store/handouts/concerns/wean-supplements.pdf

Weaning from Supplements Log
http://www.kellymom.com/store/freehandouts/wean-supplements-log-sample.pdf

Two more techniques that may be helpful are Breast Compression and Switch Nursing.

Dr. Jack Newman also explains how to do Breast Compression on his web site, http://www.drjacknewman.com/

Breast Compression at http://www.drjacknewman.com/index.php?option=com_content&task=view&id=70&itemid=98

He also has video clips on his web site which can be useful
Go to http://www.drjacknewman.com/index.php?option=com_content&task=view&id=18&Itemid=42
and click on Second Latch, Some Compression and Compression
and show the Breast Compression technique.

Another good technique is Switch Nursing. Switch nursing is changing to the other side when the baby no longer seems interested. Usually when we start feeding the baby is very interested to suck, as the baby slows down we start the breast compression and when the baby slows down with the breast compression we change and get the baby to have the other side. On the other side after the baby starts to slow down we again use the breast compression and when he slows down again swap back to the first side again. We can continue swapping sides as much as we like and for as long as the baby is willing to continue to suck. It is fine to swap sides 8, 9 or 10 times in one feed.

All this information is difficult to take in and talking to someone or better a face-to-face meeting will help.

Best wishes,
SARAH
 
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or you can try calling mrs chee (lactation consultant) she can come to your home & help you in person. (sometimes new mothers are reluctant to go out, so she can be really helpful) she's very kind & helped me with all my bfeeding problems (which a had them all). her no. 93176366. leave her a message she'll call you back. the only thing is, she's always late cos she doesn't know how long helping each mothertake , so she's a little messed up with her time management.
 
Hey all, I'll be delivering my first baby in St. Teresa this May. I learned that the hospital has a fixed feeding timetable(4 times per day). So if I intend to breastfeed my baby right from the beginning, this time table cannot meet the need of normal feed times(every 2 hours) and I'm afraid the hospital will give formula in between the 4 times breastfeeding sessions. Anyone can share their experience and advice on this?
 
I give birth at the HK Sanatorium hospital and I just wanted to share my breastfeeding experience and the frustration at the staff. I had to book a private room for the expressed purpose of being able to room in with the baby and feed him around the clock. If you stayed in the ward or a semi-private room you could NOT room in with the baby although they did allow around the clock access to the baby in the nursing room.

I gave birth at 1:21am. I was not given time to try breastfeeding right after birth. (I had a vacuum assisted birth). The baby was taken to be weight and changed and brought back to my room so I could try breastfeeding around 3am. ( I requested BF only when I first checked in). However, after 1/2 hour or so the nurses wanted to take him back to the nursery because they insisted I would not be able to take care of him on the 1st night. I slept for about an hour and was miserable and missing my baby (since I was used to him being inside me for 9 months!) so I had to insist they bring the baby back to my room so I could feed him. I kept him in the room and the nurses contently checked me and asked if they could bring the baby back to the nursery. I refused.

I was only in hospital after the birth for 42hrs since I was so miserable and frustrated at the treatment. The lactation consultant were helpful with latching the baby onto me (mostly by somehow squeezing my nipple into the baby's mouth when he cried) but I was unable to replicate their eagle like grip on my nipple myself. Every time I requested help with latching, they kept trying to wipe my nipples with the fragranced sanitized wet wipe. I think the smell definitely turned the baby off the breast and had to refuse their attempts to wipe my nipples after the first time.

The worst thing I experience during my short stay at the hospital was they kept telling me my baby was dehydrated!!! Since my milk had not come him, he was sucking just a little colostrum. They said he was not having enough wet diapers! But since the was not drinking much liquid OF COURSE he had no wet nappies! He did poop 6-7 times after birth so I knew he was doing fine. After ignoring the nurses the pediatrician came the next day and give me a stern looking and telling me my baby would suffer seriously from dehydration of I did not allow them to feed my baby water! I had read up A LOT on breastfeeding but never came across feeding newborns water. I fought off the nurses but when the pediatrician told me this I was scared and ultimately allowed them to feed 1 once of water to my baby twice. Now that I KNOW YOU DON"T NEED to feed babies water, I feel bad for letting them do it. HOW CAN they be so ignorant and threathening?

After I got home, my milk came in the next day and now my baby is a little over 1 month old I am very successfully breastfeeding. He was 11.5lbs and 58cm at one month!
In the hospital, I tried to breastfeed him every hour or two. He was not interested most of the time but I tried very hard to feed him around the clock. He latched on very successfully only a couple of time a day but after my milk came in he was feeding every 2 hours around the clock.
I was very well prepared to fight the "local" thinking at the hospital and I think I mostly succeeded. But it was a daunting task for a new mother and I don't think most women would be prepared for it. I still feel bad that I was intimidated into letting them bottlefeed my baby water. Fortunately, it seems to not have sabotaged my breastfeedin attemps.

I think it's a challenge to breastfeed with the hospital system but if you are set on it everyone can do it! Sorry for the long ramble but I hope it helps prepare new mothers who want to breastfeed. It takes a lot of determination and work! Engorgement was also very painful for a day. But the experience and benefits are truly rewarding.
 
My wife had completely the opposite experience at the PWH hospital. There they encourage bf, leave the babies with the mothers in the bed to do so and help if there are initial problems. We'll certainly be back there for the next one.
 
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