# Sleepy newborn -- epidural related?



## msmiranda (Apr 22, 2009)

If a baby is born at 36 weeks, with pitocin and an epidural, and is too sleepy to breastfeed effectively for the entire first week of his life (to the point where he becomes dehydrated, doesn't poop, and almost always has to be awakened for feedings), is it more likely related to him being slightly preterm, the epidural, or a combination of the two? I'm just curious because I'd heard that epidurals can cause this type of problem, but also that preterm can cause extreme sleepiness.


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## jeliphish (Jul 18, 2007)

Is he yellow? Sounds like jaundice to me. DD1 was born right at 36 weeks and was so jaundiced at her 5 day appt that they had to admit her to the hospital.


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## notjustmamie (Mar 7, 2007)

While epidural meds can cause sleepyness in newborns, I'm pretty sure everything would be out of his system after a day or so. If my babe had to be awakened to feed after a week, I would be calling my doctor. There are a lot of reasons babes may be sleepy. It could be nothing, but I would get it checked out to rule out anything serious (like a heart problem).


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## AlexisT (May 6, 2007)

That sounds a lot more like jaundice or just being 36 weeks, to me. Epidural sleepiness wears off quicker than that.


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## Bluegoat (Nov 30, 2008)

Well, the half-life of the epidural drugs in a baby is actually rather longer than a few days. I don't remember the number, but it seems to me that it is closer to 10 days. And a late pre-term baby is often sleepy. Also, pitocin can tend to case issues with milk coming in, so that could also be related.

I would be inclined to think the baby was not getting enough to eat. Perhaps things got off to a bad start due to the other factors, and now baby is just not strong enough to eat well. I would see a lactation consultant ASAP to see if baby is actually getting any milk.


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## MsBlack (Apr 10, 2007)

I agree with Bluegoat.

It could be that your baby being a bit early is contributing to sleepiness--I had a 36wk 3days baby once, and she did indeed sleep quite a bit. But she woke regularly to nurse, and grew well--and around the time I would have been about 40-41 wks pregnant, she seemed to come more into herself, have longer alert periods and such. But my girl was already 6lb 9oz at birth, and ready to breathe and nurse--labor started naturally and was fairly short and easy. Some babies born that early are smaller and/or a bit less ready for life on the outside.

I'm wondering why a baby was born at 36wks--only because the reasons for that could be part of the reasons for her sleepiness (even apart from earliness itself, or the epidural). That is, if a mom were induced for a medical reason, perhaps the baby is still impacted by whatever that reason was....if that makes sense!

In any event, seeing La Leche League or a lactation consultant is probably a good idea just to be sure that such a baby is getting enough to eat, and to figure out if the sleepiness is 'just normal for her' or is caused by hunger/low blood sugar or another 'problem'. This is something I would want to know for sure if it were my baby.


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## DocsNemesis (Dec 10, 2005)

I agree, it sounds like the baby isn't getting enough milk, but what the reason is, I don't know.

As others have said, is baby jaundice at all? A little jaundice is ok; when their limbs, especially their lower limbs/hands/feet are yellowing, its bad. Of course getting bili levels checked involves a little poke, but its not too bad and a lot of hospitals have a non invasive instrument that they just put on the baby's skin, which then somehow figures out the levels (no idea how exactly, haha).

I had a newborn stay mildly jaundice for over 12 weeks. She was fine, levels wise (well below the danger zone) but still very sleepy and had to be woken up to eat-but also ate well and had no problems. Just very very sleepy.

I also had a preterm babe, though he was a 33 weeker. However, even at a few weeks old, all the way to when he should've been born (and actually a few weeks after that) he was very sleepy and hard to keep awake for a whole meal. I just woke him up more often to make up for his smaller meals and as he got nearer his due date, he started waking up on his own more frequently and wanting food.

However, in both cases, I had to make sure I was waking them up frequently, every hour or less, depending on how long they ate last, to make sure they were getting enough to eat. Its hard to wake a sleeping baby, I know, but get 'em down to a diaper, get them awake, and then get them to eat. If they fall asleep, put their clothes back on (which usually wakes them back up) and then feed them some more. Let baby have a rest for a bit again and then do it all over. I know I had to set an alarm at night too to make sure I woke up several times at night to feed them. (This could be part of the problem as well, if supply is an issue-night time feeds are so important for breastmilk production)

I second going to a lactation consultant too. Weigh baby before and after a feed. Figure out how much they are getting. Go from there. If all else fails, supplementing may be needed at least temporarily-though I'd ask about a SNS or something similar, rather than bottles if you can. The extra nursing stimulation will help with milk production as well (if thats the problem).

Good luck!!


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## msmiranda (Apr 22, 2009)

Thanks all, for the responses. This is a friend's baby I'm asking about; he was not jaundiced when he left the hospital, not sure about now. My friend was induced because her water broke and she did not go into labor on her own within 5 hours (time that she asked the doctor for, they tried orgasm and nipple stimulation but it didn't work). She had gone into preterm labor at 31 weeks and had been on modified bed rest. He was 6 lb. 14 oz. at birth and did not have any lung or blood sugar issues at the hospital.

They have seen an LC and their ped several times. The LC says his latch is fine and suck is effective so it is just the sleepiness that keeps him from getting enough milk. She is supplementing with formula with a SNS, after he had lost 15% of his birth weight and was nearly dehydrated. Apparently he falls asleep after feeding for a few minutes a lot of the time (though sometimes will feed for 15-20 minutes), so he is just not getting enough. He is now 8 days old, and I am still worried about them and was just wondering why he would be so sleepy for this long. I'm worried this will sabotage their breastfeeding relationship if he doesn't become a more vigorous nurser very soon.


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## MsBlack (Apr 10, 2007)

Great that she is getting needed help!

This does not have to sabotage their nursing relationship or anything. That is a very good size for one so early, implying that he is a vigorous kid all in all. And the fact that his breathing and suck are fine, are very good signs. I've seen a few neonates take 2-3 wks to 'get it all together' with nursing, sleeping, etc--losing more than usual amt of birthweight, very slow to gain it back, until finally they take off like little rockets.

Just give your friend a ton of affirmation--the more she feels supported, and encouraged to believe that she is doing the right things, and believes her baby is most likely going to be ultimately ok, the easier a time they will have as they get through this time. More stress....even that stress arising from loved ones' heartfelt concern!...is not a help. Make your concern take the form of affirmative support--positive comments and compliments (sincere ones), helping her with food and around the house, whatever little things you can do to help her feel loved, supported, affirmed. These things make much more difference to moms and babies both than you might think







Think of it as your way of feeding up that baby with your caring.

Know--and help her to know as well--that babies are pretty relisient (even as they are also vulnerable in some ways), and that so far there is every reason for optimism about her baby's health.


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## felix23 (Nov 7, 2006)

DD2 was born at 37 weeks and she was sooo sleepy the first couple of weeks. It was very difficult to keep her awake long enough to eat. She also had jaundice, which made it worse. I would take off all of her clothes and jiggle her around a lot every time she started acting sleepy, so she wouldn't get all warm and cozy. After about two weeks, she finally woke up and started eating better.


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## Bluegoat (Nov 30, 2008)

Quote:


Originally Posted by *msmiranda* 
Thanks all, for the responses. This is a friend's baby I'm asking about; he was not jaundiced when he left the hospital, not sure about now. My friend was induced because her water broke and she did not go into labor on her own within 5 hours (time that she asked the doctor for, they tried orgasm and nipple stimulation but it didn't work). She had gone into preterm labor at 31 weeks and had been on modified bed rest. He was 6 lb. 14 oz. at birth and did not have any lung or blood sugar issues at the hospital.

They have seen an LC and their ped several times. The LC says his latch is fine and suck is effective so it is just the sleepiness that keeps him from getting enough milk. She is supplementing with formula with a SNS, after he had lost 15% of his birth weight and was nearly dehydrated. Apparently he falls asleep after feeding for a few minutes a lot of the time (though sometimes will feed for 15-20 minutes), so he is just not getting enough. He is now 8 days old, and I am still worried about them and was just wondering why he would be so sleepy for this long. I'm worried this will sabotage their breastfeeding relationship if he doesn't become a more vigorous nurser very soon.

Does your friend know how to do breast compressions? It might help with getting him to nurse longer at each session. The Dr Newman website has video on how to do it. Also just using every possible opportunity to nurse, like wearing him in a sling through the day and offering the breast every hour.


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## BugMacGee (Aug 18, 2006)

I'm inclined to pin this one on the prematurity. Late pre-termers are notorious for having feeding issues.


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## Lousli (Nov 4, 2003)

My 36 weeker was really sleepy for her first few weeks (almost until her due date) and nursing was an issue for us for a while. I did have an epidural for about 4 hours with her, but it seems unlikely that the effects would have lasted nearly 4 weeks. She was small, her mouth was small, my breasts were huge and she was tired, so all in all, we really needed to work at the nursing thing (I ended up using a shield to get her to nurse properly, and was able to wean her off it after a few weeks.)

Has your friend talked with an LC about ways to stimulate the baby and keep him awake through a feeding? We tickled her feet, undressed her a little, sometimes places a cool washcloth on her feet or hands, lots of little things to keep her from passing out after just 5 minutes.


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## katelove (Apr 28, 2009)

There is some evidence that an epidural can cause behavioural changes in the newborn for more than a week after birth. This can affect their alertness and feeding. Sarah J Buckley discusses it in her book Gentle Birth Gentle Mothering and there is an adaptation of the chapter here... http://www.sarahjbuckley.com/article...ural-risks.htm


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## ShwarmaQueen (Mar 28, 2008)

DD was full term (39 wks), had pit, epi, c/s, and then jaundiced. She was so hard to nurse. I would have to totally undress her, use wet rags, mess with her so she would rouse...so I think it's definitely a combination of the circumstances, not just age related.


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