The second woman I saw was 23 years old. American. Her first pregnancy and delivery.
Delivered at 39+6
On June 21 at noon.
A baby boy
I went in to see her around the time it was turning into the second day for the baby.
Baby weighed about 3.2 kg
Came in with contractions. Fast delivery. Unmedicated.
Skin to skin in delivery room and nursed (or so she thought)
Baby had 3 dirty diapers overnight and 2 wet diapers. Around 6am nurses forced her to give materna because the baby was screaming a lot all night long. She kept trying to nurse.
I went in the first time around 11am. She complained of nipple pain.
The baby was extremely sleepy. Was very hard to wake him up. I tried checking his mouth and could barely get my finger in he was just not waking up or interested. Nurses had said nothing to be aware of. I said do skin to skin while I check her milk. She had colostrum and on one side she had a hickey
So obviously the baby wasn’t getting milk. I showed her how to express milk into a syringe and or a spoon. We tried to give some to the baby to wake him. Not really working.
I tried latching him. It looked like he had a very shallow latch because he only wanted
the nipple and wouldn’t open his mouth much.
Levana suggested a nipple shield. We tried it. He sucked a little but gave up.
I left her to do some skin to skin and to express every two hours. Explaining that first day he should normally have about 5-7cc and by day two 10-15cc per feed.
I came back around 2pm. Baby was still extremely sleepy. We tried to latch him when he woke up and still couldn’t get a good latch. He cried but then was sleepy. I tried checking his mouth again. It was hard to see but may have been a tongue tie. Levana came in to see what was happening and saw how hard I was trying. She tried to latch as well. No success. Mom was in a lot of pain. We tried also different positions. Nothing was helping her or the latch. She then went to get some sugar water and gave him some on top of a silicone nipple shield. The shield was hard for him to adjust to but he drank the sugar water and sucked on the nipple shield and milk came out. His latch seemed fine on the shield but Levana said it could be a lip tie and to get it checked out. I explained the breastfeeding management to her and her mother who was there helping. And explained that this baby really needs to wake up and eat. Can’t just let him sleep through hunger.
There was really nothing else to try because. We had spent so long trying to wake up the baby throughout the day and Levana had to go. I suggested to see a lactation consultant when she gets home. And possibly a tongue tie specialist.