Your midwife will use a universally recognized tool known as the Apgar Score to assess your baby's condition one minute after birth and then again five minutes afterwards. Both these scores will be documented in your notes.
Weighing and measuring your baby
After the Apgar Score, the first assessment is usually to find out what your baby weighs, and this is often one of the questions you will be asked when you tell your friends and family that your baby has been born. A healthy term baby will weigh on average around 3.5kg (7%lb); although a birth weight between 2.5kg (5 1/2lb) and 4.5kg (101b) is generally considered within normal limits. If you and your partner are particularly rail and well built, or short and petite, the size of your baby may reflect this, although this is not automatically the case.
The length of your baby may also be measured at this time, using a tape measure. The average length of a newborn is around 50cm (20in). In some hospitals her head circumference will be recorded as well.
"Midwife's check"
Your midwife will perform a physical check of your baby at the same time as she weighs her. This is a gentle external examination and causes no discomfort to your baby. Your midwife will talk you through what she is looking at and can answer any questions that you may have, but she is primarily checking to exclude any immediate signs that your baby has been born with a congenital abnormality. You may notice, for example, that she explores your baby's head for any unusual swellings and inside her mouth to exclude a cleft palate or tongue-tie. She will also count your baby's fingers and toes, checking for webbed digits, and examine your baby's spine for any dimples or other signs of possible spinal defects. The midwife's check also includes an overall assessment of your baby's general well-being, including her temperature and whether she has passed any urine or stools.
Your baby will be examined again during the next few days, when her eyes, ears, heart, hips, and reflexes will be tested and her internal organs checked. This assessment is often referred to as the "first day check", but is usually performed any time during the first few days, just before you go home from hospital. Increasingly, midwives or advanced neonatal nurse practitioners (ANNPs) may perform this check, as well as pediatricians.
If you have had a home birth, your baby's "first day check” will usually be performed by your GP at around three days. If your GP has not supported your home birth and your care has been backed up by your supervisor of midwives. It is more likely that you will need to take your baby into your local maternity unit or hospital to be checked over by a pediatrician.
Recent Articles
Friday, November 7, 2008
Wednesday, November 5, 2008
How Vitamin K Affects Your Newborn Baby
Vitamin K
Offered routinely to all newborn babies as protection against Vitamin K Deficiency Bleeding (VKDB), vitamin K is administered either by injection or in an oral preparation, depending on the policy of your maternity unit and on you and your partner's preference. The risk of VKDB occurring in a well, full-term baby is estimated at 1 in 10,000, yet the potential seriousness of the condition has led to a supplement of vitamin K being offered to all newborns.
VKDB is a condition whereby your baby can spontaneously suffer from some internal bleeding. There are two categories of VKDB: "early bleeding", which can occur during the first week of life, and "late bleeding", which may occur when your baby is between 1-12 weeks old. Symptoms include unexplained bruising, nosebleeds, and bleeding from around her cord area, through to invisible hemorrhaging within the area of her brain, which can have serious implications. Jaundice that lasts for more than two to three weeks can be a sign of liver disease, which has also been linked to many babies that develop internal bleeding.
Vitamin K is necessary for your baby's blood to clot effectively but she is born with only a minimal supply: the level of vitamin K is lower in babies than in adults but research has not yet discovered the reason for this. Artificial milk is fortified with vitamin K and therefore the risk of internal bleeding is low in babies who are bottle fed. Although research has not yet investigated any possible side effects that might be caused by large doses of vitamin K. However, evidence does suggest that the greater risk of VKDB to breastfed babies is due to Insufficient feeding over the first few days rather than to a deficiency in breast milk. Breastfeeding well "on demand" from birth will encourage your baby's Internal system to begin making vitamin K naturally. If she is not able or keen to feed well from the breast during the first 48 hours it is more likely that she will be at risk of developing VKDB.
SIDE EFFECTS OF VITAMIN K
A small study in the 1980s suggested that there was a link between babies that had been given vitamin K by Injection and an increased risk of childhood leukemia. Further research did not confirm such a link, but there was a simultaneous rise in the uptake of the oral preparation. Other side effects include the small degree of pain suffered by your baby and, more rarely, bruising, bleeding, or infection at the injection site, and the wrong dose or drug being administered.
Offered routinely to all newborn babies as protection against Vitamin K Deficiency Bleeding (VKDB), vitamin K is administered either by injection or in an oral preparation, depending on the policy of your maternity unit and on you and your partner's preference. The risk of VKDB occurring in a well, full-term baby is estimated at 1 in 10,000, yet the potential seriousness of the condition has led to a supplement of vitamin K being offered to all newborns.
VKDB is a condition whereby your baby can spontaneously suffer from some internal bleeding. There are two categories of VKDB: "early bleeding", which can occur during the first week of life, and "late bleeding", which may occur when your baby is between 1-12 weeks old. Symptoms include unexplained bruising, nosebleeds, and bleeding from around her cord area, through to invisible hemorrhaging within the area of her brain, which can have serious implications. Jaundice that lasts for more than two to three weeks can be a sign of liver disease, which has also been linked to many babies that develop internal bleeding.
Vitamin K is necessary for your baby's blood to clot effectively but she is born with only a minimal supply: the level of vitamin K is lower in babies than in adults but research has not yet discovered the reason for this. Artificial milk is fortified with vitamin K and therefore the risk of internal bleeding is low in babies who are bottle fed. Although research has not yet investigated any possible side effects that might be caused by large doses of vitamin K. However, evidence does suggest that the greater risk of VKDB to breastfed babies is due to Insufficient feeding over the first few days rather than to a deficiency in breast milk. Breastfeeding well "on demand" from birth will encourage your baby's Internal system to begin making vitamin K naturally. If she is not able or keen to feed well from the breast during the first 48 hours it is more likely that she will be at risk of developing VKDB.
SIDE EFFECTS OF VITAMIN K
A small study in the 1980s suggested that there was a link between babies that had been given vitamin K by Injection and an increased risk of childhood leukemia. Further research did not confirm such a link, but there was a simultaneous rise in the uptake of the oral preparation. Other side effects include the small degree of pain suffered by your baby and, more rarely, bruising, bleeding, or infection at the injection site, and the wrong dose or drug being administered.
Tuesday, November 4, 2008
What Are the Proper Postures for Breastfeeding?
How breastfeeding works
Breastfeeding is a natural, biological process governed by your hormones and physiology, as well as your baby's own automatic instincts. However, in our society it is not always easy - some mothers are uncomfortable doing it in public while others may never have seen friends and relatives doing it. Many mothers and babies struggle with breastfeeding as a result, especially in the early weeks. Understanding how it works will help to make it easier.
Many women doubt their ability to sustain their babies purely on breast milk, but in fact your body has nurtured your baby throughout pregnancy amazingly well. After the birth, your breasts are designed to take over the role of the placenta in feeding and protecting your baby.
Your posture
As you will be in one place for quite some time, try to get comfortable before you begin. An upright chair might be useful, one that supports a straight back. If you are leaning back, for instance on a sofa or against bed pillows, your breasts flatten and it is harder for your baby to get a good mouthful (although some babies can manage like this - especially when they are older, stronger, and more used to breastfeeding). Some women can feed sitting cross-legged on a floor cushion.
You can also feed lying down. This is a useful position as you can have a doze during the day while you are feeding or you can feed your baby at night in your bed. (This position is also useful if you have had a caesarean as it ensures that your baby does not lie on your wound.) However, if you are likely to fall asleep when feeding make sure that it's a safe environment for your baby. Don't sleep on a couch or armchair with your baby as there is an increased risk of cot death, and if she is in your bed make sure she can't fall out or get covered by bedding.
Position of you and the baby
You need to hold your baby so that her body is turned towards your body (remember: "tummy to mummy"). Do not hold her in the position you would hold her in if you were bottle feeding. If you do, she will have to turn her head towards your breast and it will be difficult for her to swallow (try it and see). Once your baby is facing towards you her nose needs to be next to your nipple to begin with so that when she opens her mouth she will be reaching out a little to latch on. If you tuck her bottom in close and leave her neck and head relatively clear, you will find this allows her to extend her neck better.® Avoid holding the back of her head as this will force her chin down and most babies don't like it. Also, if her chin is too close to her chest it will be awkward for her to feed and swallow comfortably. The size of your breasts and the position of your nipples will affect how high up or down your body your baby lies.® For example, if you have smaller breasts you will be holding your baby higher up your body than if you have larger breasts.
Lying across the mum's tummy, as described above, is the most common position for a baby to lie in when breastfeeding. In this position you can support your baby's body using the arm on the sane side as the breast (supporting her with your left arm while she feeds from your left breast and vice versa) and support the back of her head somewhere on your forearm (not In the crook of your arm as this will constrict her neck and chin). Alternatively you can hold her with the arm opposite to the breast she's feeding from, supporting her shoulders and neck cradled in your hand. This position gives you quite a lot of freedom to move her body in relation to your breast ready for latching on.
Likely Page Break
Once you have your baby attached to your breast, if you need to support your arm you can tuck a pillow or cushion under if .This then leaves the other hand free to hold a drink, a book, the phone, or television remote contrail You can also hold her under arm - this is a useful position after a caesarean because it keeps the baby away from the scar. Support her lying along your forearm, cradling her shoulders and neck in your hand. Her feet will extend out behind you so you'll need to sit quite far forward with cushions or pillows behind you. This can be a useful position if you are having problems at the beginning, as you can see what is happening. It is also useful for mothers with twins, if you feed both babies at once.
To position her when lying down, lie on your side and support your head and shoulders with pillows. It may help to have a pillow behind your back so that you have something to relax against. Your lower arm can extend out and round the top of your baby's head. Use your upper arm to position your baby and draw her onto your lower breast. Your baby should lie on her side, facing you, again so that she has to reach up for the breast. As is the same when sitting up, if you tuck her bottom in close and leave her neck and head relatively clear you will find this allows her to extend her neck better.
Attachment or "latching on"
The final part of the jigsaw is how your baby takes the breast, it is important that she has a good mouthful, with her chin making contact with your breast first. She will need to open her mouth really wide, which she will usually do instinctively. This is part of the rooting reflex, an automatic response that enables her to turn towards whatever is touching her mouth or cheek and then open her mouth. So when you see her rooting get ready, and as soon as she opens her mouth wide -gaping as if she were about to bite on an apple - draw her onto your breast.
Your nipple needs to go right back to make contact with your baby's soft palate - this is the smooth bit of the roof of the mouth. If your nipple is in contact with the hard palate - the ridge of bones at the front of the mouth - it will chaff and get sore. Stimulating the soft palate triggers the baby's feeding reflex.
Your baby's jaw then uses a chomping action, working with a rolling action of her tongue, to squeeze milk out of the breast. A good mouthful, with her chin in contact with your breast, is important as it allows the baby to reach the milk that lies behind the nipple and areola.
Your baby will show you that she has had enough milk from your breast by coming off it of her own accord, looking satisfied. Now is the time to offer her the second breast. This gives her the opportunity to have more milk if she is still hungry. Some mothers find that their baby often wants the second breast, others that their baby rarely wants it. It doesn't matter as long as your baby has the chance to have more if she wants it. Either way, start with the "second breast" the next time you feed, to balance out the milk supply.
Why breastfeed?
Breast milk is more than just nutrition; it is a living fluid that protects your baby from the world around her. It also stimulates her own immune system, which will take more than a year to fully develop - In the meantime she will receive copies of your own antibodies from your milk. Breast milk is also perfectly digestible, so even her nappies won't smell unpleasant!
Breastfeeding develops your baby's jaw in preparation for chewing and talking. The pauses and eye contact, as well as the interaction that takes place when you are breastfeeding, all prepare her for conversing later. Through your breast milk she will also be able faintly to taste the food you have eaten, thus preparing her to join her family at mealtimes as she will remember those tastes. Breastfed babies' teeth tend to be better aligned than bottle-fed babies', and as their palates are not distorted by anything hard, like a bottle, they may be less likely to snore as adults. Finally, breastfeeding is intimate and enjoyable, a way of bringing you closer together. What more could a baby want?
Breastfeeding is a natural, biological process governed by your hormones and physiology, as well as your baby's own automatic instincts. However, in our society it is not always easy - some mothers are uncomfortable doing it in public while others may never have seen friends and relatives doing it. Many mothers and babies struggle with breastfeeding as a result, especially in the early weeks. Understanding how it works will help to make it easier.
Many women doubt their ability to sustain their babies purely on breast milk, but in fact your body has nurtured your baby throughout pregnancy amazingly well. After the birth, your breasts are designed to take over the role of the placenta in feeding and protecting your baby.
Your posture
As you will be in one place for quite some time, try to get comfortable before you begin. An upright chair might be useful, one that supports a straight back. If you are leaning back, for instance on a sofa or against bed pillows, your breasts flatten and it is harder for your baby to get a good mouthful (although some babies can manage like this - especially when they are older, stronger, and more used to breastfeeding). Some women can feed sitting cross-legged on a floor cushion.
You can also feed lying down. This is a useful position as you can have a doze during the day while you are feeding or you can feed your baby at night in your bed. (This position is also useful if you have had a caesarean as it ensures that your baby does not lie on your wound.) However, if you are likely to fall asleep when feeding make sure that it's a safe environment for your baby. Don't sleep on a couch or armchair with your baby as there is an increased risk of cot death, and if she is in your bed make sure she can't fall out or get covered by bedding.
Position of you and the baby
You need to hold your baby so that her body is turned towards your body (remember: "tummy to mummy"). Do not hold her in the position you would hold her in if you were bottle feeding. If you do, she will have to turn her head towards your breast and it will be difficult for her to swallow (try it and see). Once your baby is facing towards you her nose needs to be next to your nipple to begin with so that when she opens her mouth she will be reaching out a little to latch on. If you tuck her bottom in close and leave her neck and head relatively clear, you will find this allows her to extend her neck better.® Avoid holding the back of her head as this will force her chin down and most babies don't like it. Also, if her chin is too close to her chest it will be awkward for her to feed and swallow comfortably. The size of your breasts and the position of your nipples will affect how high up or down your body your baby lies.® For example, if you have smaller breasts you will be holding your baby higher up your body than if you have larger breasts.
Lying across the mum's tummy, as described above, is the most common position for a baby to lie in when breastfeeding. In this position you can support your baby's body using the arm on the sane side as the breast (supporting her with your left arm while she feeds from your left breast and vice versa) and support the back of her head somewhere on your forearm (not In the crook of your arm as this will constrict her neck and chin). Alternatively you can hold her with the arm opposite to the breast she's feeding from, supporting her shoulders and neck cradled in your hand. This position gives you quite a lot of freedom to move her body in relation to your breast ready for latching on.
Likely Page Break
Once you have your baby attached to your breast, if you need to support your arm you can tuck a pillow or cushion under if .This then leaves the other hand free to hold a drink, a book, the phone, or television remote contrail You can also hold her under arm - this is a useful position after a caesarean because it keeps the baby away from the scar. Support her lying along your forearm, cradling her shoulders and neck in your hand. Her feet will extend out behind you so you'll need to sit quite far forward with cushions or pillows behind you. This can be a useful position if you are having problems at the beginning, as you can see what is happening. It is also useful for mothers with twins, if you feed both babies at once.
To position her when lying down, lie on your side and support your head and shoulders with pillows. It may help to have a pillow behind your back so that you have something to relax against. Your lower arm can extend out and round the top of your baby's head. Use your upper arm to position your baby and draw her onto your lower breast. Your baby should lie on her side, facing you, again so that she has to reach up for the breast. As is the same when sitting up, if you tuck her bottom in close and leave her neck and head relatively clear you will find this allows her to extend her neck better.
Attachment or "latching on"
The final part of the jigsaw is how your baby takes the breast, it is important that she has a good mouthful, with her chin making contact with your breast first. She will need to open her mouth really wide, which she will usually do instinctively. This is part of the rooting reflex, an automatic response that enables her to turn towards whatever is touching her mouth or cheek and then open her mouth. So when you see her rooting get ready, and as soon as she opens her mouth wide -gaping as if she were about to bite on an apple - draw her onto your breast.
Your nipple needs to go right back to make contact with your baby's soft palate - this is the smooth bit of the roof of the mouth. If your nipple is in contact with the hard palate - the ridge of bones at the front of the mouth - it will chaff and get sore. Stimulating the soft palate triggers the baby's feeding reflex.
Your baby's jaw then uses a chomping action, working with a rolling action of her tongue, to squeeze milk out of the breast. A good mouthful, with her chin in contact with your breast, is important as it allows the baby to reach the milk that lies behind the nipple and areola.
Your baby will show you that she has had enough milk from your breast by coming off it of her own accord, looking satisfied. Now is the time to offer her the second breast. This gives her the opportunity to have more milk if she is still hungry. Some mothers find that their baby often wants the second breast, others that their baby rarely wants it. It doesn't matter as long as your baby has the chance to have more if she wants it. Either way, start with the "second breast" the next time you feed, to balance out the milk supply.
Why breastfeed?
Breast milk is more than just nutrition; it is a living fluid that protects your baby from the world around her. It also stimulates her own immune system, which will take more than a year to fully develop - In the meantime she will receive copies of your own antibodies from your milk. Breast milk is also perfectly digestible, so even her nappies won't smell unpleasant!
Breastfeeding develops your baby's jaw in preparation for chewing and talking. The pauses and eye contact, as well as the interaction that takes place when you are breastfeeding, all prepare her for conversing later. Through your breast milk she will also be able faintly to taste the food you have eaten, thus preparing her to join her family at mealtimes as she will remember those tastes. Breastfed babies' teeth tend to be better aligned than bottle-fed babies', and as their palates are not distorted by anything hard, like a bottle, they may be less likely to snore as adults. Finally, breastfeeding is intimate and enjoyable, a way of bringing you closer together. What more could a baby want?
The Mechanics of Breastfeeding
As with pregnancy, breastfeeding is controlled by hormones, these work to keep the volume of milk at the right level to nourish your baby, and to let the milk out when your baby wants it. Prolactin is the hormone responsible for producing milk. During pregnancy it stimulates your breasts to develop milk-producing cells and to produce a small amount of milk. Levels are kept low by the hormone progesterone.® This initial, low-volume milk is called colostrum and is there ready for your baby at birth. After her birth progesterone levels fall, which allows the milk levels to rise - referred to as milk "coming in". Your milk then gradually changes from colostrum to mature milk.
Whenever your baby stimulates your nipples prolactin is released to create more milk, so the volume of milk you produce is decided by your baby's feeding pattern. This is why putting your baby to your breast whenever she wants to feed is particularly important initially, to get your milk supply established. Prolactin levels are higher at night, so it is vital that you allow your baby to breastfeed at night in order to fully establish your milk supply. If milk is not removed from the breasts, prolactin levels fall and milk production will eventually cease.
Oxytocin is the other main hormone involved in breastfeeding, and is responsible for ejecting milk from the breasts - the "let-down" reflex. Muscles high up in your breasts contract, squeezing milk down towards your nipples where your baby can get it. Some women are unaware of this; others find it a strange, almost tickly feeling. A few find it slightly painful. Oxytocin also helps your uterus contract, so when you feed your baby in the early days you may feel "afterpains". These are usually stronger for second or subsequent babies.
Oxytocin can be switched on by different stimuli. Feeding your baby raises oxytocin levels, but Just holding your baby also works - as does thinking about her when she's not there. That's why it's possible to express breast milk without your baby present. This hormone is also produced when you make love so you may find you leak milk during sex especially at orgasm. It's best to feed your baby just beforehand if possible and have a towel handy.
Your baby can get quite a lot of milk from what is released by oxytocin. However, she also needs to play an active part in removing the milk, thus stimulating prolactin to produce enough milk for the next feed. Milk left in the breasts contains an inhibiting factor that stops further milk being produced, so even if your baby feeds often, if she cannot get the milk out effectively then your milk supply will fall.
The first, thirst-quenching milk is often referred to as "foremilk", which means "the milk that comes before". If this is all your baby drinks then she will need to feed more frequently as she will not be getting the levels of fat that she needs to grow. She may also get colicky If she is drinking mostly foremilk, as this passes through the gut quickly and may reach the lower intestine before all the lactose is absorbed. If this happens it will ferment and cause discomfort - as well as green, explosive nappies!
Holding your baby so that she can get at the milk effectively is very important, not only in building and maintaining the milk supply but also in extracting the fat-rich hind milk. There are three things to consider: your posture - how you are sitting or lying; your position - how you hold your baby's body so she can reach your breast and attachment - the relationship between your baby's mouth and your breast.
Whenever your baby stimulates your nipples prolactin is released to create more milk, so the volume of milk you produce is decided by your baby's feeding pattern. This is why putting your baby to your breast whenever she wants to feed is particularly important initially, to get your milk supply established. Prolactin levels are higher at night, so it is vital that you allow your baby to breastfeed at night in order to fully establish your milk supply. If milk is not removed from the breasts, prolactin levels fall and milk production will eventually cease.
Oxytocin is the other main hormone involved in breastfeeding, and is responsible for ejecting milk from the breasts - the "let-down" reflex. Muscles high up in your breasts contract, squeezing milk down towards your nipples where your baby can get it. Some women are unaware of this; others find it a strange, almost tickly feeling. A few find it slightly painful. Oxytocin also helps your uterus contract, so when you feed your baby in the early days you may feel "afterpains". These are usually stronger for second or subsequent babies.
Oxytocin can be switched on by different stimuli. Feeding your baby raises oxytocin levels, but Just holding your baby also works - as does thinking about her when she's not there. That's why it's possible to express breast milk without your baby present. This hormone is also produced when you make love so you may find you leak milk during sex especially at orgasm. It's best to feed your baby just beforehand if possible and have a towel handy.
Your baby can get quite a lot of milk from what is released by oxytocin. However, she also needs to play an active part in removing the milk, thus stimulating prolactin to produce enough milk for the next feed. Milk left in the breasts contains an inhibiting factor that stops further milk being produced, so even if your baby feeds often, if she cannot get the milk out effectively then your milk supply will fall.
The first, thirst-quenching milk is often referred to as "foremilk", which means "the milk that comes before". If this is all your baby drinks then she will need to feed more frequently as she will not be getting the levels of fat that she needs to grow. She may also get colicky If she is drinking mostly foremilk, as this passes through the gut quickly and may reach the lower intestine before all the lactose is absorbed. If this happens it will ferment and cause discomfort - as well as green, explosive nappies!
Holding your baby so that she can get at the milk effectively is very important, not only in building and maintaining the milk supply but also in extracting the fat-rich hind milk. There are three things to consider: your posture - how you are sitting or lying; your position - how you hold your baby's body so she can reach your breast and attachment - the relationship between your baby's mouth and your breast.
Breastfeeding a Baby with Special Needs
Having a baby with special needs can seriously dent your image of yourself as a mother and as a woman, and to know that you are able to feed your baby from your breast is an enormously affirming and reassuring experience. Emotion aside, the health benefits of breastfeeding are magnified for your baby, who will generally be more vulnerable due to her condition. Even so, it is essential that you seek advice as, although breastfeeding is usually less stressful for babies than bottle feeding, for some babies it takes an immense amount of effort -especially at the beginning. If you want to feed her yourself you may need to engage in some lateral thinking.
Your baby may find it hard to coordinate the actions of sucking, swallowing, and breathing all at the same time. Some are simply too weak to breastfeed successfully and fall asleep before they come to the richer, more nutritious hind-milk. It is possible to express some of the foremilk before you start to feed, stimulating the let-down reflex so that your baby reaches the hind milk straight away. You can store your milk in the fridge. Expressing has the added advantage of stimulating your milk supply to an extent that your baby may not yet be able to do. Don't wait until your baby is ravenous before feeding her, as by this time she may already be weak with hunger. Look out for other signs that she is starting to get hungry (smacking her lips or rooting are dead giveaways), and feed her while she is alert when possible.
Exercises to encourage the sucking reflex are useful, such as rubbing your baby's gums with a clean finger or popping your finger in and out of her mouth. Drawing your finger firmly over her top lip in the direction you want her to turn helps her to latch on. Having your baby in a good position and keeping her well supported means that she does not have to work too hard, and will make sure that you don't get sore. You will need to be prepared to spend longer feeding your baby, especially at first. Undressing your baby and placing her next to your skin, tickling her feet, or gently rubbing her ear will help to keep her awake while she feeds.
If your baby has medical problems that make breastfeeding impossible, then expressing your milk so that you can still feed her yourself (even if she is being tube-fed) is certainly a viable option. Seek medical advice and work out a regime that works for you and your baby.
Remember, your baby will not always be as weak as she is in the first few weeks, or even months. Do not despair; all your hard work will be repaid in terms of the health benefits for your baby, the confidence it gives you, and the close bond that will be forged between the two of you through your shared experience.
Breastfeeding counselors are excellent in providing Information and support for you when you are breastfeeding. Books and the Internet can also be good sources of information, but the most important person in supporting you is your partner. If the going gets tough it can be very easy to throw in the towel, so to have two of you believing you are doing the right thing, working together, and supporting each other is invaluable. It is possible to breastfeed a baby with special needs and, when everything else feels as if it is upside down; it can be a welcome injection of normality into a crazy world.
Your baby may find it hard to coordinate the actions of sucking, swallowing, and breathing all at the same time. Some are simply too weak to breastfeed successfully and fall asleep before they come to the richer, more nutritious hind-milk. It is possible to express some of the foremilk before you start to feed, stimulating the let-down reflex so that your baby reaches the hind milk straight away. You can store your milk in the fridge. Expressing has the added advantage of stimulating your milk supply to an extent that your baby may not yet be able to do. Don't wait until your baby is ravenous before feeding her, as by this time she may already be weak with hunger. Look out for other signs that she is starting to get hungry (smacking her lips or rooting are dead giveaways), and feed her while she is alert when possible.
Exercises to encourage the sucking reflex are useful, such as rubbing your baby's gums with a clean finger or popping your finger in and out of her mouth. Drawing your finger firmly over her top lip in the direction you want her to turn helps her to latch on. Having your baby in a good position and keeping her well supported means that she does not have to work too hard, and will make sure that you don't get sore. You will need to be prepared to spend longer feeding your baby, especially at first. Undressing your baby and placing her next to your skin, tickling her feet, or gently rubbing her ear will help to keep her awake while she feeds.
If your baby has medical problems that make breastfeeding impossible, then expressing your milk so that you can still feed her yourself (even if she is being tube-fed) is certainly a viable option. Seek medical advice and work out a regime that works for you and your baby.
Remember, your baby will not always be as weak as she is in the first few weeks, or even months. Do not despair; all your hard work will be repaid in terms of the health benefits for your baby, the confidence it gives you, and the close bond that will be forged between the two of you through your shared experience.
Breastfeeding counselors are excellent in providing Information and support for you when you are breastfeeding. Books and the Internet can also be good sources of information, but the most important person in supporting you is your partner. If the going gets tough it can be very easy to throw in the towel, so to have two of you believing you are doing the right thing, working together, and supporting each other is invaluable. It is possible to breastfeed a baby with special needs and, when everything else feels as if it is upside down; it can be a welcome injection of normality into a crazy world.
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