i need some hope here

[liz-hippymom]

i want to bring DD home exclusively breastfeeding. She was born 2 1/2 weeks ago at 31 weeks. my supply is almost twice what she eats right now. she has been getting Gavage feedings every three hours. a few days ago she actually latched and sucked and swallowed. she had two nursing sessions with gulping/swallowing yesterday and one this morning.
the LC here said she has never in 2 years seen a mom/preemie go home exclusivly BF with no bottles.
this news set me into a crying spell. i can be here for every feeding when she is ready to nipple every feeding. Please tell me some positive stories!

[sparklett]

My DS was EBF when I brought him home. He arrived @ 32 weeks and had IUGR and we were 21 days in the NICU. He had nipple confusion and breastfeeding apnea. It took a TON of work and some very angry moments with the NICU staff, but I did it! We went home on nipple shields. In order to do it we had to show our neonatologist that I could EBF him, so DS and I spent an extra 24 hours in the hospital to prove it. Three days before we were ready to leave, I begged the neo. to change our orders to EBF. That really helped the situation.

Once we got home I lost my nerve and tried to offer bottles of expressed milk, but DS wouldn't have it, so we stuck with nursing. During the first few days, nursing at home was actually harder than nursing in the hospital.

You CAN do it. It's tough, but possible. I've recently spent time various NICUs as breastfeeding support and have noticed that going home EBF is very rare, but it does happen. At my NICU, the nurses could not remember the last one to go home EBF.

God luck!

[aikigypsy]

I think we would be cleared to go home EBF, except that we have to give DS his medicine and vitamins in a bottle once a day. I plan to BF as much as possible, and hopefully get down to pumping only once a day (or even less?) in the next few days. We are also using a nipple shield.

I don't really plan to discuss these plans with the people at the nicu -- it's not written in stone, and I'm going to see how the baby reacts and what he seems to need. I'm also not opposed to giving him a bottle or two a day, because with our older daughter my husband felt left out, and not able to take care of her while I was away (even for a few hours) because she wouldn't bottle feed at all. I am kind of looking forward to the flexibility of being able to bottle feed if we want or need to.

[ShanaV]

We came home with a mix of BF and bottles. My boys were 30+5, so pretty similar to your DD, and started eating around 34-ish weeks, I think. It took a LONG TIME to get them to nipple all of their feeds (either from the bottle or a boob). Once they were eating everything orally, I was in the nicu for about 1/2 the feedings, and the other half were from bottles from nurses. Some feedings in our nicu HAD to be by the nurses from a bottle because they occurred during hours that the nicu was closed (7-9 am and pm). We also used nipple shields, and had to keep using them until they were 4 months old (one guy stopped needing it a month ago, the other guy a week ago). So don't be alarmed if this happens to you as well.

But really, the most important thing is that the baby comes home asap, right? Who cares how she's eating! Get her home! You can work on easing off of any bottles and onto the breast once she's home. This was my attitude. And hey, if she can come home without any bottle usage, that's a bonus!

Oh, and I had many crying fits too, you're not alone on that front. See my post in the Bringing baby home thread. Every time they'd have a spell I'd lose it. Plus, when they had spells with the nurses (but not with me) I became LIVID and had some very frank, serious conversations with the neonatologist about who could feed my baby. One time an OT was evaluating them, and the nurses told me that the way she fed one of them, she forced him to drink the last of a bottle that he didn't need/want, and he had a spell as a result. Of course that means "Oh, he's not ready yet, blah blah blah." I was SO PISSED. I straight up told the doctor "Never let her touch my baby when I am not here again."

Sending you good vibes! Hugs!

[MeepyCat]

My daughter was born at 32 weeks and went home on a combination of breast and bottle feeds. We were fortifying breast milk for her, and giving her vitamins once a day, so some bottles were necessary, and she just had a tough time coping with my supply for a while. Further, I didn't find the NICU to be all that helpful in establishing the kind of nursing relationship I'd had with my DS - I just couldn't be there all the time, and her cues were a little lost in the chaos of schedules and shift changes and machines. The NICU is hard on every parent who has a child there, in so many ways.

The NICU staff wasn't exactly skeptical about breastfeeding, it was more like they just came from a different planet about it. They suggested that when I got her home I could maybe nurse her once or twice a day (seriously? that seldom? I thought). I thought they were nuts.

In the end, it took us two and a half months or so to get to exclusive breast feeding. I nursed her three or four times a day, and as much at night as she wanted. We gave her bottles the rest of the time. As fortification became less necessary, we dropped the bottles. It wasn't really planned, the balance just tipped, and then tilted, and then slid in that direction. But we definitely weren't at exclusive breast feeding by the time we went home.

[emilysmama]

The nurse in the NICU didn't say that mothers don't go home exclusively breastfeeding. She just muttered in a very loud voice, "Those doctors don't know what they're talking about. You just need to go home, relax, and then you will be able to resolve your breastfeeding issues in the comfort of your own home."

And you know what? She was right.

My dd did not go home express breastfeeding. She went home with a Haberman feeder, an SNS, and two different types of breast shields. But she eventually became an extremely strong nurser, and she weaned herself at the age of 3 years old.

You CAN and will succeed. I think it's fabulous that you can now pump double of what your dc needs. It took me two weeks of solid pumping with the baby at home before I was able to even get to the point of pumping enough to keep up. If you are able to pump that much with your child in the NICU, then you are one very determined lady. You will certainly succeed.

Plus, in my book, two years experience is very little experience for a lactation consultant. So I'd just assume that you will be the first in a long line that your lactation consultant is going to see in her career.

[liz-hippymom]

ok, so here is where we are at now-
after MANY long talks with many nurses and a few docs i got an order written that i can nurse her every feeding she will wake for (yesterday it was 6 out of 8), and i can estimate the amount i think she got and they will deduct that from her gavage feeding.
as long as she continues to gain wieght they will be satisified. i also started using an SNS at some of the feedings to try to get more into her from the breast.

the nurse who got the doc to write the order was very excited and said she really hoped this works because it would change the way they do patient centered care and would open up this avenue for more moms.

SOOO lets hope it works!!!

[justKate]

Originally Posted by ShanaV

But really, the most important thing is that the baby comes home asap, right? Who cares how she's eating! Get her home! You can work on easing off of any bottles and onto the breast once she's home. This was my attitude. And hey, if she can come home without any bottle usage, that's a bonus!

Definitely. They wouldn't let DD come home until she kept down 60 mL for 6 consecutive feeds. She couldn't do it with mama milk. So we let her have formula until they released her, and when we got home we put the bottles away.

Originally Posted by liz-hippymom

ok, so here is where we are at now-
after MANY long talks with many nurses and a few docs i got an order written that i can nurse her every feeding she will wake for (yesterday it was 6 out of 8), and i can estimate the amount i think she got and they will deduct that from her gavage feeding.
as long as she continues to gain wieght they will be satisified. i also started using an SNS at some of the feedings to try to get more into her from the breast.

That is AMAZING. Go Willow!

[sparklett]

Originally Posted by liz-hippymom

the nurse who got the doc to write the order was very excited and said she really hoped this works because it would change the way they do patient centered care and would open up this avenue for more moms.

That is REALLY fantastic!

[aikigypsy]

Originally Posted by liz-hippymom

ok, so here is where we are at now-
after MANY long talks with many nurses and a few docs i got an order written that i can nurse her every feeding she will wake for (yesterday it was 6 out of 8), and i can estimate the amount i think she got and they will deduct that from her gavage feeding.
as long as she continues to gain wieght they will be satisified. i also started using an SNS at some of the feedings to try to get more into her from the breast.

This sounds good. We're fresh out of the nicu, so I know how important it is to have A Plan in communication with the doctors.

My DS had been off "calories" for a couple of weeks when he came home on Monday. We bottle fed him once or twice on Monday night, about twice on Tuesday, once Wednesday morning, and then yesterday and today I've only given him the bottle with his vitamins and medications in it. So, if all goes well with his weight check next week, we'll have been 2.5 days from nicu to near-exclusive BF. But I am a bit anxious about the weigh check.

[loveneverfails]

Wonderful news!!! And yes, a friend had a placental abruption around the 32 week mark and she DID go home with an exclusively breastfeeding infant around 35 or 36 weeks gestational age.



And

You can do it, Mom!!

[smeep]

Originally Posted by liz-hippymom

ok, so here is where we are at now-
after MANY long talks with many nurses and a few docs i got an order written that i can nurse her every feeding she will wake for (yesterday it was 6 out of 8), and i can estimate the amount i think she got and they will deduct that from her gavage feeding.
as long as she continues to gain wieght they will be satisified. i also started using an SNS at some of the feedings to try to get more into her from the breast.

the nurse who got the doc to write the order was very excited and said she really hoped this works because it would change the way they do patient centered care and would open up this avenue for more moms.

SOOO lets hope it works!!!

Yayyy!!!!

I do have one suggestion, you say you can "estimate" what you "think" she got? This isn't a very good road to go down...there's no way to just guess what a baby gets. It depends on their efficiency, energy level and hunger level at each session...and so sometimes they can nurse for 45 minutes and get half of what they get in a later feeding that only lasts 25 minutes. You really have no way of knowing. Obviously, this is generally pretty irrelevant because breastfed babies don't NEED their intake measured, but clearly you're in an exceptional situation. Therefore, I recommend that you weigh your baby before and after each feeding, and keep a log (something along the lines of, "feeding #3 at breast, lasted X minutes, X weight before, X weight after = approx X ounces, plus an additional X ounces via gavage"). Make sure baby has a dry diaper on before you nurse and do make a note if she has a wet or dirty diaper after the feeding, so you know to not hang TOO much on those feedings as that can make a difference in the weighing. I would make sure you get a VERY good accurate scale for this, though I can only assume a NICU would have a proper scale.

And keep up with the SNS! Great idea!