Wanting to Breastfeed my preemie

[Jrene]

My little man was born 5 1/2 weeks early weighing 4lb 7oz and 17 inches. We were verrrry blessed to not have to have had spend anytime in the NICU. We got to go home after 3 days.

His feeding while in the hospital was 15 ml then to 30 ml by bottle and he got 30mins to eat. They said anything after that he'd burn to many caleries and it would defeat the purpose.

So now that we're home, I pump into a bottle and also feed him special preemie formula. They said to breastfeed would pretty much do the same.He'd burn too much energy. But he is eating so much better. He's went from 15 ml to 30 ml and now 40 to 50 ml.

Whats really discouraged me is the nurse said once they've been bottle fed for so long, trying them to take the breast is a hard. Which I guess is fine if he's getting breastmilk through the bottle. But I guess its the bonding Im missing.

Whats your advice or suggestions?

[MeepyCat]

I found NICU nurses to be kind of apathetic about breast feeding, not terribly helpful and sometimes misinformed. They're all about feeding the baby, but they are also all about reporting EXACTLY what was done. And I have no idea how much the baby nursed, there are no gauges on my breasts.

Some babies do have strong preferences for bottle vs. breast or vice versa. Others don't. So how hard this will be is hard to guess.

I would say to you that if you put your son to your breast, and he latches on and swallows, that's a sign that you can do this. You may not get to all breast right away (and fortifying breast milk is worth the effort until he's more solidly on the growth charts, IMO), but you can get there.

If he doesn't latch and swallow, you need a lactation consultant with experience dealing with preemies. You can still get there.


And I really think the 30 minute time limit for a feeding session is pretty silly.
- Both of my kids (the preemie and the full-term guy) have lazed on the breast some, done some fast nursing and some slow, and both have gained weight just fine. I don't like to gulp my food down in a hurry either.
- Breast milk, straight from the breast, is not a perfectly homogenous substance. Hindmilk is richer and fattier than foremilk, but that stuff doesn't come out first. A babe who nurses longer is likely to get more hindmilk.

[MaryMarg]

Go for it! Our 33 week DD weighed in at 4-12 and didn't take anything by mouth for four days. With a lactation consultant's help, we started nursing and I nursed her for the month she was in the NICU while pumping after each feeding and at 2 hour intervals in between. DD had breathing and heartrate issues and was on supplemental oxygen the entire month she was in the NICU. Thus, the feedings were tiring for her, but she was fed exclusively breastmilk (from the bottle during the hours the NI was closed) and she grew and grew! I had lots of milk and there was some concern she wasn't getting enough hindmilk b/c of green poops (there are differing opinions on if the foremilk/hindmilk issue is accurate or not) but we kept on keeping on. Took her home weighing about 5-7 and she kept growing, breastmilk only. Now, we weren't even on the growth chart at the pedi's office for a few months, but she followed her own growth curve (more important!) and even jumped up in the percentiles in time.

Based on professional experience, I agree that a child begins to burn calories if they are actively feeding for 30 minutes or more. That said, I just nursed our little one a little more frequently and worked to keep her alert during her feeds. Consider continuing to pump at least a few times a day until your son is taking the breast successfully at each feeding. Also, our lactation center offered free weight checks and I took advantage of this for the first few weeks to avoid the doctor's office and make me feel better about weight gain. Congrats and best wishes!

[Mrs-Mama]

DS was born at 32 weeks, weighing 4 lbs 8 oz. He was bottle fed from Day 2 (or 3) until Day 20 when he came home. They let me nurse him on days 18-20 but it was only a couple of times and I know he didn't get much. Once home, however, I made it my mission to breastfeed him. So, I would offer the breast first and let him nurse until he was done (or fell asleep). If he still acted hungry, I would give him a bottle of expressed breast milk, and then after all of that, I would pump to keep up my supply. Sometimes he nursed every hour. Sometimes I would sense that he was frustrated and hungry and go straight to the bottle. In fact, I always bottle fed at night (and pumped). But, I didn't want to have to nurse for 20-40 minutes, bottle feed, and then pump for another 20 minutes, so that's why I skipped the nursing in the middle of the night. I don't remember how long it took to get off most bottles, but I do remember that he was off all bottles by 6 weeks (3 weeks after we brought him home).

It can be done! I highly recommend finding a lactation consultant who can help you. Sometimes they can even be helpful over the phone. Good luck! And, way to go with the pumping and providing breast milk for your little one!

[elus0814]

I'm wondering why the baby was ever given a bottle in the first place. Was there some other issue? Why was formula started? Why the random 30 minute limit? Why put breastmilk in a bottle when the breast is right there?

I had a 34 week premie who never once had a bottle (even through a week long nicu stay). I stayed all the time and nursed. The baby gained weight just fine, the gains we measured in weight on the scale and not lines on a bottle. There was never a time limit, not that I would have followed one.

I also had a 32 week premie who never had anything except breastmilk. Never formula or fortifier. He was tiny, under 4lbs., but still no need for formula or time limits. He did, however, receive pumped milk in a bottle at night. He was in the nicu for three weeks and with another baby at home I wasn't able to stay there 24 hours a day. He was able to nurse without a problem from two days old (before that his breathing equipment prevented nursing but he received colostrum via a nasal tube). The calories burned through nursing were never brought up, that just seems silly.

If there is a real concern over how much milk is being consumed why not take the baby to the doctor (or a lc office or purchase your own scale that measures in very small increments) and weigh the baby before and after nursing, it might be enough piece of mind for everyone to get rid of the bottles, formula, and time limits. I would be very wary of all three of these things as they can all cause lots of problems while trying to establish breastfeeding.

Good luck!

[shelbean91]

Mine were all early, 35.5 weeks, 35 weeks, 34.5 weeks. All around 6 lbs. My middle child was the hardest - I pumped and fingerfed him - he didn't latch properly until 4 months old. If you want to get back to the breast FT - try an SNS or finger feeder to reduce nipple confusion. See an IBCLC. My ds had a latch so bad, the IBCLC couldn't get him to latch - the first in her 16 years of experience - so we went with the finger feeder. He couldn't latch to a bottle correctly. Sucking on my finger used more energy, I'd assume.

Good luck!

[aikigypsy]

I also just had a baby, in the wee hours of Monday morning, the same size and gestational age as Jrene's, but he is in the NICU and they say he will be there for a few weeks. I wonder if it's overkill, if he really needs to be there as much as they say, but at the moment I'm willing to go with it.

It was a real shock to me to have a baby at 34 weeks. My daughter was born at almost 43 weeks, and I fully expected to go to 41 weeks with this guy, but then I had placenta previa and it bled, and my waters broke. The placenta was wrapped around the lower part of the uterus in such a way that they had to do a vertical incision (the top, non-uterine layers were cut horizontally, but then they had to change strategies when they saw the uterus). Anyway, the cut was done such that I will never be able to have a vaginal birth, which bums me out, but DH wanted to stop with this one and I'm 40, so maybe it doesn't matter anyway.

About the feeding: My little guy is getting IV feeding, formula, and colostrum. I heard that he had a couple of bottle feeds and he went to breast once yesterday and gave a few sucks, but he's getting most of it through a nose-stomach tube. The NICU nurses say he's having a hard time breathing -- he's on room air, but it takes a lot of effort, and he got an air pocket around his lungs. He's not really comfortable. He should really still be on the inside.

Anyway, the NICU nurses vary a lot in their approach, but many of them are also lactation consultants, which is encouraging. I am bummed out about pumping, not being able to hold and be with the baby much, etc., but I do think it's very important for him to gain weight at this point. My DD lost tons of weight in the first week or so. With a starting point of 8 lb. 11 oz., losing 11 oz. didn't send me into a panic, but I don't want this little guy to lose any more than he absolutely has to.

This morning I pumped 10 ml., which is what he gets in a feed now, so I'm optimistic that in the next few days he'll be able to go to 100% breast milk. I doubt I'll be able to directly feed him much until he's in the next step down in the NICU, out of the incubator and fully off the feeding tube. I may use the nipple shield with him -- I did with DD, and we relied on it for about 5-6 weeks, but by 8 weeks I had her off it completely.

Anyway, I know I'll have to wait until he's home to be able to exclusively breastfeed, but I'm OK with that for now.

[aramat]

My 3rd daughter was born at 32 weeks & weighed 4.2 lbs, and my very-bf-friendly pedi let me start nursing her within her first week I think. After nursing, we'd supplement with a cup, not a bottle.

I did make a serious mistake which was to stop pumping entirely when she stopped wanting supplements after nursing sessions (~4 wks old); in spite of constant nursing, her little mouth wasn't giving my breasts enough stimulation to keep up production, and my supply nearly tanked. Mentioning b/c I wish someone had told me to keep pumping--have been on a galactogogue & supplementing w/formula for 7 months now bc of it.

[Jrene]

Brayden has really improved the last few days. He's went from eating 30 ml to 50 ml or more at every feeding. So I think I'll try to introduce the breast to him instead of pumping that feeding.

I think the biggest challenge will be latching on. But he takes the round pacifier (nipple like) very well. So we're gonna give it a try!

I so look forward to the bonding time with him. He is just the most precious thing I've ever seen and I want whats the best for him.

[MeepyCat]

Jrene - that's awesome that he's doing so well! I want to say, though, you ARE bonded with your baby! It is certainly possible to fall more in love (and deeper and deeper), but breast feeding isn't going to catapult you to a different level of emotional experience than the one you're on.

It is, however, a much cuddlier experience than the breast pump. Enjoy it!

Aikigypsy - OMG, you had the baby! Going to check your other posts, probably PMing.

[ewe+lamb]

Great to hear that things are going so well for you, I was sent this article by an LLL friend of mine and thought you guys may like to read this and certainly you'll be able to relate to it - it really is a miracle story.
http://uk.news.yahoo.com/5/20100827/...c-3fd0ae9.html