Baby nephew in SCBU - want to feel useful!

rachnbri

My little sister had her first baby yesterday, a gorgeous baby boy. He is a full term, good birthweight, healthy baby, however was having some trouble breathing and was admitted to SCBU last night. My sister is understandably very distressed. Like any new mummy she had pictured her first few days with her new baby and none of her imaginings involved being separated from him.

Also it is very important to her that she breastfeeds her baby and she hasn't been able to do this yet. Because he was struggling to breathe he couldn't master the suck, swallow, breathe co-ordination and is now nil by mouth. She was told to try to express some milk today for baby to be tube fed. I'm a bit cross about it actually because she wasn't given any support with this (and they wouldn't allow me or my breastfeeding consultant best friend to be with her as it was before visiting hours!) and as her milk hasn't come in yet the whole experience left her feeling a bit inadequate. I'm trying to support her and went to visit this afternoon with a rather good visual aid (a small marble, big marble and ping pong ball) showing the size of baby's stomach at 1, 3 and 10 days (not very high tech but terribly effective) just to reassure her that she doesn't need to produce gallons of milk to nurture her baby.

She has now been told that baby has a chest infection and she is hoping to get him out of SCBU in the next 48 hours all being well. Obviously she is hoping that at that point she will be able to establish breastfeeding properly. First question - any practical tips on how she can make this easier for herself given the shaky start? Second question - I'm a little bit concerned about my sister and the increased risk of PND given the early separation - anything I should be looking out for?

I have had 2 children of my own but was very, very lucky with easy births, easy breastfeeding and no real problems so I'm feeling a little bit clueless as to the best way to help her and keep her feeling positive.

UKTigerlily

I'm sorry I can't help but plenty of people will be along soon who can! Congratulations to your Sister & also to you, you seem really lovely & she's really lucky to have you x

Intastella

I don't know too much about the ins and outs of signs of PND, but i think if your sister and OH are having to spend a lot of time at the hospital, the last thing they'll be thinking of is making sure that they have the staples or a good, homecooked meal when they get home. Anything that you can do in that respect will take a load off i'm sure, as well as making sure that they're eating properly, which most often takes a backseat in times of stress, and often exacerbates it. Sometimes the little things can make all the difference.

All the best to the family, and congratulations Aunty! :T:beer:

spammy29

Ok, the problem with breathing difficulties and chest infections is that you don't want to stress the baby's respiratory system with something that's hard work for them at this stage like sucking. Also, infections use up a lot of energy and calories, so the baby is likely to be sleepy and not feeding well anyway, and if this is mummy's first baby she won't have any milk until around day 3, just colostrum, which is still important, but then baby is running the risk of low blood sugars which can be dangerous, so the alternative is being fed through an naso gastric tube (tube up nose) or via an IV drip of 10% Dextrose until the baby stops recessing (breathing very hard) other wise there is a risk of milk ending up in its lungs if allowed to feed by mouth.

Once the antibiotics kick in, baby will probably be on them for 5-7 days, he will start waking up and screaming the place down. Once he is feeding properly, Mum is espressing lots of milk and feeding from breast and/ or bottle and there is lots of wee and poo from baby, if Mum is still on the ward baby will go back to her until antibiotics are finished then they both go home. If she gets kicked out before baby is well enough to leave unit, usually because of bed pressure, she will have to visit from home, and the baby will only be discharged from the unit after 48 hrs of good feeding. As its a full termer, he will be very soon on 4 hourly feeds x6, Mum needs to visit for at least 3 feeds to establish breastfeeding, boys are pretty good at it though.

The shaky start will be a bit of a knock back for baby, if Mum starts expressing every 4 hours, even if she has nothing much and puts baby to breast it should start flowing by around day 3, if she still hasn't got enough baby will have to be topped up by bottle until Mum make more milk. The post natal midwives should show her how to express, especially hand express, sorry SCBUs are pretty busy, and that's what the post nates midwives are there for. Mum can bring her milk to the unit and it will be used for tube feeds. Encourage her to drink 3 litres of water a day and not get stressed, eat calcium rich food and drink fennel tea. At the moment most maternities/ SCBUs are only allowing partners to visit because of swine flu. Once she goes home she will need decent food and rest because she won't get it on the ward.

The baby blues will hit her soon anyway, but lots of mums blame themselves for their baby being ill, it's very common for this to happen, not everyone gets the perfect birth as much as we want it, I've got three and I never got to full term. In a couple weeks time or less it will all be a bit of a bad memory.

Lots of hugs

Forgot to say, I work on a SCBU!

Tigsteroonie

From my personal experience, the best thing your friend can do is not stress about this.

She should have been encouraged to express early on, as even the colostrum is useful and can be given as a tube-feed, but better late than never - I didn't start until day 4, and was only getting about 20ml a time then. The SCBU should have a specific nurse or sister as a BF advisor, get your friend to ask for a chat with her about how the baby's feeding behaviour will develop.

She is not to worry about starting BF late and whether the baby will take to it - because he was in SCBU on tube-feeds, I didn't start Andrew on the breast until he was about 8 weeks old. We're just home now (at 12 weeks), and we're still learning, we have some good feeds and some unsuccessful; we are bottle-feeding him expressed milk to supplement (and no, bottle-feeding has not hampered his ability to BF).

msb5262

Hi OP,

Congratulations to you and your family - and your sister is very lucky indeed to have you.

I had to express for my daughter when she got very jaundiced very quickly at 1 day old; it was a pretty stressful experience and of course produced very little to start with. I did find it helped to try to focus on my daughter and think about the milk flowing...but anyone using a breast pump needs to go carefully and not overstimulate their breasts (easily done with giant hospital breast pump). A little and often approach will probably work best. When your sister is allowed to hold the baby, that will help her to produce milk. Even looking at him will help her body to recognise that it's time to lactate - honest!

Give your sister a huge hug and reassure her that it's all in hand. As your friend is a breastfeeding consultant, she will no doubt be able to tell your sister that she'll be feeding her baby herself before long. Your sister's determination to do it is a vital factor, and as she is well supported by family and friends, she will succeed.

Best wishes,

MsB

tiamai_d

All 3 of my babies have been in SCBU and I expressed for all 3. This time was much more difficult as they suddenly decided that I couldn't use the pump for 48 hours and had to sit and hand express and suck up the colostrum with a syringe. So I didn't express till I could use the pump. Then they limited my time on the pump and I ended up with mastitis! :mad:

My advice would be get a comforter blankie or the like to put in the cot/incubator with baby to get his smell on it, then if she holds and smells this while expressing, it will make things easier. A used vest or sleepsuit will do the same (so long as it's not covered in poo!). Oh and of course baby NEEDS an incubator buddy, a small cuddly toy that usually ends up with a name band

The first few days you are in numb shock, the next few days you get used to the routine and then at some point she will hit a crisis point where everything will get on top of her and she will crack. For me, I wanted home, I NEEDED to get out of there and did get home for a night each time. It helped getting away from that surreal world of non stop back and forth. You feel that you can't do anything for your baby and you don't get the time to spend alone and everyone is watching you. All you can do at the crisis point is to listen. Do not suggest anything as no matter what you say it will be wrong. We don't want suggestions, we want a cuddle and to be told that it is all going to be ok. Chocolate helps too.

Practical help right now is to keep the house clean and tidy, make sure there is milk and bread and that when they do finally come home, the house is tidy and they can just relax. I came home this time to an inch of dust, hubby tired and I was like 'argh!', luckily it didn;t bother me as much as it would have with number 1.

Best of luck for them both and I hope they do get home soon!

Redcedar

Massive hugs to you and your sister. My 1st was born a month early and was in SCBU for 2 weeks. He was very very ill to begin with, now at 19 months he is fit and healthy and we had no issues with PND or breast feeding. We stayed in a hospital 2.5 hours away from my home and family, so was a lonely experiance.

My top tips would be:

once baby is well enough to try, then cup feeding mimics the natural way to suckle more than a bottle teat. If mum misses feeds then the nurses will be able to feed via this method and help with the breast feeding.

Help her get involved - if she is well enough / has been sent home then making sure she is there with baby and asking questions to the nurses . doc will help. They are there to look after baby 1st and sometimes can push mum and dad back alittle.

Bring her food, books and clean clothes! make sure home is running ok with out, pets looked after, washing, cooking etc

Expressing is hard and painful and you feel like a right idiot the 1st few times!! i kept going by comparing how much i was expressing each time, as it whent up a little each time i felt like it was worth being stuck to "Daisy" for what seemed like hours lol!!


It is hard but she will bond with baby and as long as he is getting better then all the rest can be worked out when he is home with his mummy!

Hope all is going well (( hugs ))

Pipling

Really hope that your sister and nephew are OK and that he gets better soon. Just want to add a little about PND. The baby blues will most likely kick in soon and your sister may start to feel like she can't cope, the stress it too much etc. If this doesn't pass in a week or so, do keep an eye on her. PND can manifest itself in many ways, I had the "Hit by a truck" varient that kicked in pretty soon after the birth of my DD. I had a rough time and when she was born, I didn't get to see/hold her for 2 hours which was horrible. Something my sister did for me was bring me a small teddy that I cuddled, then the nurses gave to my baby. I just made me feel a little bit closer to her. Signs of PND include loss of interest in food, insomnia (incase having a baby didn't screw your sleep up in itself!), loss of interest in daily activities, not wanting to go out or see anyone - the list goes on. If she doesn't seem to be herself, just reassure her and try and support her in any practical way you can. Maybe offer to come round and watch baby so that she can have a sleep?

Really hope things pick up soon.

ailuro2

I'd suggest you try not worry too much about them, he's full term and is just having a little hiccup -he'll be fine in a few days. Yes, it's distressing but if you go in all guns blazing then you're just going to transfer your worries to your sister and make her more stressed. If you act calmly, give her a big hug, a shoulder to cry on if she needs one, and ear to listen, and then remind her he's full term and that these first few days will soon seem like a haze, then she might feel better about it all.
Take her a flask of soup and a nice sandwich, get her a magazine, print off a picture of her little boy so she has something to look at while she expresses if she's not allowed to be with him all the time.

I doubt she's beyond imagining what a marble and a ping pong ball look like, I don't think you really need the props.;) Good information is good when not overdone.



So, in short, calm down, give her a hug and don't pass on your worries.

rachnbri

Thanks everyone. I'm feeling an awful lot calmer now and, more importantly, so is my sister. Baby is still in SCBU, although we're hoping not for too much longer. They've taken him off sedation this morning and are hoping to try him without the ventilator this afternoon.:j

My sister has managed to express a good quantity of colustrum and this is being stored ready to feed to baby when he's ready - he's currently being fed a dextrose solution- she feels a lot better now that she knows her body is doing what it should!!