Formula Feeding a Preemie

[aamh0343]

Hello everybody, I've been breast feeding my preemie (born at 25 weeks) for a couple months now. She is now 34 weeks and is still not taking to the bottle very well and this is the major thing keeping her from coming home. My milk supply is starting to diminish and I'm having trouble with whether or not I should continue to breast feed or if my supply starts becoming very low then to just start formula feeding. Please tell me if you have formula fed your preemies when they went home and if they got sick more often or if you think there any real problems with switching to formula...especially for preemies since they are even more immune compromised than a newborn and could use some extra anti-bodies.

Thank you!

[karika]

Did your hospital provide a hospital grade pump? That is SOP where I am from. When I used one, I produced so much milk I donated some. I am confused. Is your baby nursing from your nipple only? Is the hospital giving anything else, like your milk via a feeding tube?

Breastmilk is closely linked with optimal health, in preemies and term babies. I am not much for mainstream media, but since this is related to breastfeeding, it was brought to my attention. http://edition.cnn.com/2010/HEALTH/0...ex.html?hpt=T2 It quotes the WHO recommendation that "infants should be exclusively breastfed for the first six months of life "to achieve optimal growth, development and health." " (In a preemie, you go from due date to calculate age I think), but fails to complete the WHO recommendation that women breastfeed for 2 years or more.

I am not on board with much else the WHO says, but at least they got that part right. I would recommend you ask the hospital if they provide hospital grade pumps for at home use (though it is late in the game for you, when your child comes home, perhaps you can pay rent to keep it for a week or two while you reestablish supply). If not, I would recommend buying one to use until your child comes home especially. But wait, if she has been there and she is breastfed, you already must have a pump? right? Ok I am not sure with info given. Keep breastfeeding your child as often as possible. Like someone else said and I agree, Breastmilk is Magical!

[aamh0343]

Sorry, I was in a hurry when I made the post and forgot a couple of details! My insurance provided me with a breast pump and the hospital gives me a pump to use so I am no way lacking with pumps. Yet for some reason my supply is diminshing. I have been drinking a lot of water and eating well so I don't really know why my supply is becoming low. At first I was like you and I was getting WAY more than she was using...so I do have some in the freezer which I have been giving.

My baby girl is being fed through a bottle only every other feeding and the rest is through a feeding tube.

[liberal_chick]

My milk supply vanished around the 5 month point and I used my freezer stash combined with formula for another month or two and then ds went to all formula.

I'll tell you, I wish I'd have fought to keep my milk supply! I was a new mom (no other kids) and my dh was deployed, so I wasn't in the best mental place. I didn't try any herbs or teas and, looking back, I would've tried Reglan or Domperidone before giving up.

Once my ds went to all formula, he got terrible ezcema and started getting constipated badly enough that we had to give him laxatives. He also started getting sick, namely ear infection after ear infection.

So I would fight to keep and increase your supply. Mother's Milk Tea, oatmeal, and fenugreek are all great places to start. If push comes to shove, I would try the prescription options before giving up and moving to formula.

[RiverandJulie]

I am going to jump in with another opinion. Yes, breastmilk is best, and I agree that if you can keep it up, you should.
But, our 29 weeker has been formula fed since the beginning (we adopted him while he was still in the NICU). He went home at 35 weeks.
He is now just over 6 months old. He is strong, healthy and showing no problems whatsoever. He got a cold at about 4 months, but was able to fight it fine.
There are other factors to how well the baby does, including genetics and parental care.

The preemie formula he was on until a couple of weeks ago is expensive! And there really are no generics, so one more thing to consider.

[aamh0343]

Thank you guys, I'm going to continue to try and keep my milk supply with some of the natural options and then if that doesn't help I will gradually mix in formula with breast milk. I think that if you find the right brand of formula for your baby then if I really don't have any other option then my baby will be fine.

Thank you for all of your input!

[Bokonon]

How much are you pumping in a 24-hour period? Some moms think they are low supply when they are actually producing an average or adequate amount. Babies fed breastmilk take in 19-30 oz./24 hours, for an average of about an ounce an hour. This does not change for weight or age.

I know that I was way overproducing when my son was in the NICU, getting about 70-80 oz./day. No one ever told me that was too much and that he would never, ever consume that much, so a lot of frozen milk went to waste. And having such an oversupply made it difficult to transition him to the breast because it would practically drown him! So I had to scale back on pumping to tame my supply before I could get him on the breast successfully.

TBH, with a 25-weeker, I would do everything in my power to keep her on breastmilk for at least the first year. If you do find that you are running out of milk, you may want to consider getting donor milk through MilkShare.

[haydensmomma7407]

Breastfeeding does ROCK but it CAN be hard for moms of preemies to keep their supply up or to get much of a supply at all. I met with multiple LC's and took all the magical supplements to no avail...after 6 weeks of BM, we had to use Neosure preemie formula. Work as HARD as you can to produce that milk but if you end up stopping, for whatever reason, know you did your best for as long as you could. HUGS! The NICU experience is a stressful one and I believe THAT is the biggest cause of preemie mom's low milk supply. Lots of gentle hugs.

[texmati]

Originally Posted by Bokonon

TBH, with a 25-weeker, I would do everything in my power to keep her on breastmilk for at least the first year. If you do find that you are running out of milk, you may want to consider getting donor milk through MilkShare.

Forum crashing.

I wanted to suggest HMBANA; mama's donate milk there for exactly this reason. The milk is prescribed by the doctor, and hopefully paid for by insurance. Also, you probably have already seen this but the first link when you google 'standford hands on pumping' really helped me increase my pumping yield. (I was pumping as a working mom, but the video is geared towards mom's in a nicu setting).

[justKate]

Originally Posted by haydensmomma7407

Breastfeeding does ROCK but it CAN be hard for moms of preemies to keep their supply up or to get much of a supply at all. I met with multiple LC's and took all the magical supplements to no avail...after 6 weeks of BM, we had to use Neosure preemie formula. Work as HARD as you can to produce that milk but if you end up stopping, for whatever reason, know you did your best for as long as you could. HUGS! The NICU experience is a stressful one and I believe THAT is the biggest cause of preemie mom's low milk supply. Lots of gentle hugs.

Do your best to keep BFing, but don't think the BFing relationship is lost just because you FF to get your LO out of the NICU. When my DD was in the NICU, it seemed like every time we changed her formula or gave her breastmilk, she had a major setback. So we stopped giving it to her; I kept pumping, and she was able to keep down enough food at 43+3 wks to go home. After two days at home with mama, she latched FOR THE FIRST TIME and didn't have another drop of formula. She weaned at 18 mos.

But I can also understand how much trouble you're going through. It's hard to see the benefit of all of that work right now. Either way, your baby will be fine. Give yourself lots of credit for doing so much for her already!

I hope she's released soon.

[aikigypsy]

One of the other moms in our nicu says that when she dropped the 3AM pumping (on an every-3-hours schedule) her milk supply increased dramatically. It's important to get enough sleep or rest one way or another, and so easy to get run down/exhausted/over-stressed. Take care of yourself as well as you can in terms of food, fluids, sleep, and even exercise. Even if it doesn't cure your supply worries, at least it will help you be in better shape for the other challenges of having a new baby.

[Megan73]

FC to suggest two things. First, have you tried domperidone? U.S. moms can buy it online (it's available by prescription in Canada and OTC in many countries) and is effective for many woman to boost supply.
Second, if you still need to supplement, you can use an at-the-breast supplementer such as a Medela SNS or Lact-Aid - no need for bottles.
HTH

[smeep]

Originally Posted by Megan73

FC to suggest two things. First, have you tried domperidone? U.S. moms can buy it online (it's available by prescription in Canada and OTC in many countries) and is effective for many woman to boost supply.
Second, if you still need to supplement, you can use an at-the-breast supplementer such as a Medela SNS or Lact-Aid - no need for bottles.
HTH

Exactly what I was going to say! For a lactation aid, you can do this as often as possible, so baby will still get tube feeding but will be nursing at the same time so it will help your supply and your baby will get used to nursing. drjacknewman.com has videos and a page about the lactation aid (you can buy the special Medela SNS or Lact-Aid or you can just do what Newman recommends on his web site and just use a tube, which you could start doing the next time you go in since your LO is obviously already using them). He also has a page on how to get domperidone in the US and there is a thread on it in the Breastfeeding Challenges forum.

What kind of pumps are you using? As in, what's the names? There's a difference between your typical double electric (most common brands are Medela Pump In Style and Ameda Purely Yours) and an actual hospital grade pump (Medela Symphony, Lactina, etc.).

Here is another link that may be helpful:
http://www.kellymom.com/bf/pumping/p..._decrease.html

On the note of formula...there are serious risks to not breastfeeding (i.e., using formula). While it's a GREAT option for babies who can't get get breastmilk exclusively or at all, it does come with risks (breastmilk doesn't have "benefits" or decreases diseases, etc., it's that not breastfeeding has risks and increases diseases, etc.). Not to give you a hard time, because as I said, it's wonderful when needed, but it's not a decision that should be made lightly, IMO. I supplemented my son (unnecessarily but I didn't know better at the time) and now that I know the real risks associated with it I will never give any of my LOs any formula unless it's absolutely necessary and a complete last resort, and if that happens I will be very thankful to have that option in such a dire circumstance. KWIM? I only mean this with love, so I hope it doesn't offend you, mama.

[BookGoddess]

Breastfeeding is amazing, but it can be hard for mothers of preemies to breastfeed with the frequency one would like. It's a very hard emotional roller coaster being the mom of a child that was born early. Please don't, under any circumstances, feel bad about not being able to breastfeed your baby the way you imagined, not everyone can. I am thankful that we live in an age where formula is available and your baby can thrive if nursing isn't an option. I've given formula to my former preemie and she was hardly ever sick the first two years of life.

[Phoenix~Mama]

Originally Posted by aikigypsy

One of the other moms in our nicu says that when she dropped the 3AM pumping (on an every-3-hours schedule) her milk supply increased dramatically. It's important to get enough sleep or rest one way or another, and so easy to get run down/exhausted/over-stressed. Take care of yourself as well as you can in terms of food, fluids, sleep, and even exercise. Even if it doesn't cure your supply worries, at least it will help you be in better shape for the other challenges of having a new baby.

I know this happened to me too. I was being all diligent and pumping every 3 hours round the clock and my supply wasn't that great. I talked to the LC and she told me to drop one of the night sessions and get at least one 4 hour block of sleep, and it has made a huge difference and I'm around 19 oz a day now.

I also agree with what others have said about knowing you have done the best you could and to be gentle with yourself. Good luck!

[~bookcase~]

it's normal to have a dip in supply, often 5-6 weeks after birth. domperidone will generally be recommended by a lactation consultant, lots and lots of skin to skin contact, letting baby nuzzle at breast, keep regular with expressing (i only did it full time for 4 weeks and know it takes a lot) and just keep at it mama

you've done a super mama job to get this far

one other thing - don't underestimate how much difference b'milk makes there is a study that showed just 40ml a day made a significant difference. i'm sure even less that that will too. so never be discouraged

[Amys1st]

Originally Posted by BookGoddess

Breastfeeding is amazing, but it can be hard for mothers of preemies to breastfeed with the frequency one would like. It's a very hard emotional roller coaster being the mom of a child that was born early. Please don't, under any circumstances, feel bad about not being able to breastfeed your baby the way you imagined, not everyone can. I am thankful that we live in an age where formula is available and your baby can thrive if nursing isn't an option. I've given formula to my former preemie and she was hardly ever sick the first two years of life.

Amen to that! I BF my former preemie that first year, but we had to supplement esp after pumping for 3 mos, your supply does go down considerblyy. Do the best you can!