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Breastfeeding a Late Term Preemie

post #1 of 13
Thread Starter 
My daughter is a late term preemie, born unexpectedly at thirty six weeks, after my membranes ruptured prematurely. Since I wasn't in active labor and the doctors were concerned she or I could develop an infection, they induced me and she came into the world after thirty hours.

She weighed five pounds eight ounces when she was born, and I initially thought she was just petite, and all would be fine. However, she had an episode of apnea shortly after her birth and was taken to the nursery to be observed by the medical staff, who eventually concluded this was due to her prematurity and she just forgot to breathe. I tried breastfeeding her in the nursery that night and once she was able to room with me, we spent hours attempting it there, too.

For whatever reason, maybe my inexperience as a first time mother or her inability to grasp the concept of breathing, swallowing, and suckling, we never really became great at breastfeeding. She had issues latching, and when she did latch successfully she'd fall asleep after a few minutes. We also discovered she had a pretty severe reflux issue, which contributed to her losing a substantial percentage of her weight after birth. The nurses recommended that I supplement her with formula, first through a syringe and then a bottle, or risk having her stay in the hospital after I was discharged, so I did.

At her first pediatricians visit, she was diagnosed with jaundice, which ofcourse made her even more tired and didn't further our breastfeeding cause. It's been two weeks since she was born and even though she's gaining weight, and has almost regained back to her birth weight, I'm really struggling with the breastfeeding issue.

We've attempted breastfeeding again, and even though she's a little more alert and aware now, I just don't think she's latching well enough to get much milk from me. On the rare days she manages to nurse for fifteen minutes or more, she still acts like she's starving when she's done. I've been pumping breastmilk with my manual pump , so she has atleast gotten some of my milk since she was born, but I'm not producing very much and to be honest, I'm just frustrated with the whole thing.

The lactation consultant and her pediatrician do not agree; the consultant told me that it's important I keep breastfeeding her, while her pediatrician said he thought feeding her formula would be fine. (I should mention she's on a special formula for acid reflux, and she keeps this down better than anything else, including my breast milk.)

I know I shouldn't feel this way, but I feel like I'm failing her because I can't provide her with a never ending supply of breastmilk, and I'm pretty disappointed in myself. Does anyone have any suggestions on how to increase my supply, or establish a nursing relationship with her? Is it too late? Did we already miss the boat by feeding her formula. Any thoughts or advice would be appreciated. Thanks!
post #2 of 13
I'm not a preemie parent; but I saw this on new posts and couldn't not reply!

Your baby is still only two weeks old-- so I certainly don't think it's too late! I would try to get my hands on a double electric pump. (You may even be able to rent one) These pumps are more efficient than a manual (and a whole heck of a lot less frustrating!)

I'm sure other mom's will be able to chime in-- but I just want to give you a big hug. It's clear from your post what a thoughtful concerned mama you are.
post #3 of 13
my daughter was 35 weeks. we hadn't even had one successful breastfeeding session by two weeks, so no, hope is definitely not lost. we came home on bottles of pumped breastmilk, and we transitioned off the bottles at home. breastfeeding wasn't easy or pleasant until she was about 10 weeks (but once we hit that point, it really was a breeze and so simple!), and i really didn't see it start to get easier until she'd reached her due date (so over 1 month).

1. rent a double electric pump (ask your LC for info)
2. start pumping every 2-3 hours around the clock and transition off the formula
3. offer the breast to your LO first before every bottle.
4. have your LC show you how to use a supplemental feeder. it only took my LO one or two days on the sns feeder to finally get the POINT of breastfeeding.
5. have your LO evaluated for latch, tongue-tie, etc... watch some videos online of babies feeding to get a better idea of what a good nurser looks and sounds like.
6. spend as much time as possible in bed with your breasts at the ready. you and the baby both need lots of rest and lots of opportunities to try things out.
7. be persistant! babies are smart, and nursing is natural to them, but you do just need to decide that you WILL get this to work and stay firm so that at 2am when you're both frustrated and close to tears, formula is the last thing on your mind.
8. be kind to yourself. like i said before, it was TEN WEEKS before i finally felt comfortable. it may take a while before it works.

for the first few days (depending on how your supply is currently doing) your days will look like this: get sns set up, get bottle set up, offer breast, nurse, offer bottle, pump, sleep, repeat. basically all. day. long.

good luck, mama! the breastfeeding forum will have lots of ideas to address the specific problems you may face. but with a late-term preemie, you just need to wait for them to wake up and things will probably work themselves out.
post #4 of 13
oh, i also forgot, with the reflux, you may need to look into taking certain things out of your diet. dairy and soy are the two big culprits. i'm vegan, so never had to deal with dairy issues, but reflux is compatible with breastfeeding. again, the women in the breastfeeding forum are way more experienced than i am with reflux and so on.
post #5 of 13
You've gotten great responses so I just wanted to say that my 34weeker took 3 months to learn to nurse like a normal baby but nursed successfully until 22months. And my 33 weeker took just about 3-4weeks to learn to nurse normally and nursed until 24months. Keep at it. It's certainly not too late.
post #6 of 13
I, too, couldn't read this without posting. I don't really have any advice for you mama, but I also agree that the breastfeeding forums on here are phenomenal as are the incredibly knowledgeable ladies that post in them. Good luck mama and you can do it!!

a link to some really good videos of babies nursing like one of the PPs mentioned.

s
post #7 of 13
You got great advice from Silverfish, I agree with all of it! You need to rent a hospital grade electric pump so you can get and keep your supply up. I had a Medela Symphony and loved it (as much as one can love a pump, anyway). I almost cried when I gave it back at 13 weeks.

My DS was born at 34.5 weeks and stayed 6 weeks in the NICU for apnea and bradycardia. I attempted to breastfeed him about 3 times a day in the NICU but he always had a chaser bottle of EBM afterwards. When he finally made it home, he had a distinct preference for the bottle. Transitioning him back to the breast is one of the hardest things I have ever done, the only advice I have is to hang in there, keep your supply up/increase your supply via the pump, and if it doesn't work at one nursing session, just start over again the next time--wipe your mind, it's a clean slate. Also, sometimes if he was super hungry it helped to give him a tiny bit in a bottle first to take the edge off the hunger, then he was more willing to work at the breast (it was work for him).

Also, has anyone mentioned fenugreek yet to increase supply? You have to take a pretty big dose, but it worked for me.
post #8 of 13
Late preterm babies can have a surprising number of issues, and trouble breastfeeding is definitely one of them. Late pretermers don't always have enough strength or stamina to breastfeed well, and therefore they don't always bring in a good milk supply for mama.

I spoke with one of the lactation consultants in the NICU where I work last night about a similar issue, and she very highly recommended this Stanford.edu site. You can also check out my list of tricks for breastfeeding a preemie, although *hangs head* the Stanford site is much more thorough :-)
post #9 of 13
I know you posted this a few weeks ago, so I hope things are going better now.
Your experience sounds very similar to mine. My DS was born at almost 36 weeks. He couldn't latch on either and it was heartbreaking. We were able to successfully get him to latch with a nipple shield, but he still have trouble with breath/suck/swallow for quite a while and would fall asleep too. I ended up feeding him with the nipple shield, them pumping. At the next feeding, I would feed with an SNS with the milk I had pumped after the last feed. It was quite grueling for several weeks. I felt like half of my day was spent trying to get him to eat!
By the time he was 4 weeks we started weaning off the nipple shield and by 6 weeks, he didn't need it at all! He's a great nurser now. It's amazing to look back and see how far he's come! I was lucky to have great health care providers who never even mentioned formula and did everything they could to help me with breastfeeding.
post #10 of 13
Quote:
Originally Posted by justmama View Post
You've gotten great responses so I just wanted to say that my 34weeker took 3 months to learn to nurse like a normal baby but nursed successfully until 22months. And my 33 weeker took just about 3-4weeks to learn to nurse normally and nursed until 24months. Keep at it. It's certainly not too late.
my 34wkr (33+6) also took 3mths to latch and nurse at the breast and self-weaned at 27mths. had to comment since our preemies were the same "age"
post #11 of 13
would love to read an update - you received excellent advice - my 34wkr took 3 long months before he finally latched and supply was a huge struggle until then. my 36wkr had a very weak latch (but at least he latched) and could take 10-15 min to get him latched - but finally improved around the 3mth mark as well.

it's not too late mama! be gentle and loving with yourself and know that sometimes our early arrivals take a lot more time to learn things that should be "natural"
post #12 of 13
I'm late to this thread, but wanted to add for any lurkers that I got my 32-weeker exclusively breastfeeding after 6 weeks in the NICU on EBM, then 2 months at home trying to get him on the breast. He nursed to 22 months.

My DD was a 34-weeker and is still nursing at almost 15 months, with no end in sight. It's certainly not easy to breastfeed a preemie of any age, especially without proper support, but it is possible!
post #13 of 13

My daughter was born at 37 weeks (5lbs) and my son was born at 36 weeks (7lbs).  Both have struggled with breastfeeding.  With my daughter, I tried to nurse her, bottle-fed breast milk and then pumped every 2 hours around the clock for 5 1/2 weeks.  It was exhausting and a bit humiliating.  I felt inadequate.  I became very depressed.  At 5 1/2 weeks I decided that I could no longer do both.  My daughter had reached 8 lbs.  We made the switch to exclusive breast feeding.  It wasn't easy for either of us.  She refused to eat for more than 1 minute for 32 hours.  Finally she conceded.  I breastfed her exclusively after that for over 2 years.  It was worth it.  My son has also struggled.  I pumped and supplemented with a medicine dropper - I refused to introduce the bottle as my daughter rejected my breast once she drank from it.  We did this for about 4 days to offset his wieght loss.  He is now gaining and we have stopped supplementing.  I know this must be very difficult.  I have been there and come out on the other side.  It can be done.  It is beyond difficult, but it can be done and it is completely worth it.  I loved  breastfeeding my daughter.  My lazy sucker became so efficient that she could drain my breast in 8-10 minutes.  My son still needs to be undressed.  We change his diaper.  We use wet wash cloths to wake him.  It takes about 1 hour to feed him.  He sleeps for 1 hour.  Then I wake him and do it all over again.  It's a lot of work. but he's gaining weight.  This too shall pass and there will come a time when breastfeeding will be a pleasure for us, just like it eventually was with my daughter.       

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