Hi wise ones!
 I think this is my first time posting here and I have PTP. 

Just visited 2nd time mum, fed 15 months 1st baby. Current baby 37 weeks, BW 7lbs exactly, day 3, traumatic delivery  (sounds like rotational forceps in theatre; first baby same but progressed to section). Baby initially ‘latched and fed fairly well’. Mum keen to come home for sibling (aged 6) so home day 2. Mum has Hb83 and managed to persuade them not to transfuse. As you might expect baby has become jaundiced (no blood test yet as midwife happy not outside parameters today) and is very sleepy last night and today. Usual tactics were employed to get him awake to feed but surprise surprise they don’t work! Mum had been hand expressing and giving drops of colostrum by syringe. Midwife visited today and declared she’d weigh him tomorrow and threatened admission if not doing better. So...I visited this evening, observed a sleepy baby who would latch and feed but not persevering. Reasonable tone but perhaps a little floppy in the arms. Nappies today have been less wet, ?evidence of urates (seen by midwife.) No BO today, yesterday was still mec black. 

I would appreciate feedback on the appropriateness of my actions and plan, so here it is:

1. Having observed feeding attempt with baby cross cradle and persuaded to latch, I initiated laid back position and baby demonstrated expected behaviour (bobbing, licking and self latched with minimal guidance) and it was actually his better attempt but not adequate. 
2. Got mum hand expressing and she got about 2tsps colostrum in total onto a spoon which baby took well. The consistency was thinning. 

So my plan for next 12 hours or so overnight:

1. Explained golden rules Feed the baby/Protect supply/Feed the baby! Reassured mum baby will BF once he has more calories inside him but meanwhile need to do whatever necessary for his good health even if that turns out to be re-admission. (Not the end of the world if needs medically-indicated formula in the absence of her milk but that she is going to do everything she can overnight to get her supply going so that she can provide his food.) 
2. Express 1-2 hourly and give baby the results each time (explained 7 stages alert to deep sleep and that he could take it in any of the five middle stages) Continue this through the night to give him the best chance to perk up and to stimulate milk production. (Dad had been out to buy electric pump and they will also try this, reverting to hand expression if that is more effective.)
3. Lots of S2S. 
4. Stressed that this is a short term plan pending visit to breastfeeding clinic in the morning. (Apart from the S2S;))
5. I will visit around lunchtime tomorrow to re-assess (and support any plans from BF clinic!) 

I explained my thinking all the way through, involved supportive dad and grandma. 


Did I do enough? Would you have done anything else?

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