Confused on feedings

[Phoenix~Mama]

Okay, DS seems to be working really hard to figure out how to nurse. Tonight he did awesome and nursed for about 10 minutes all together. This is the best he's done by like 5 minutes!

I'm only averaging being able to be there for about 3 cares a day out of the 8 cares in a 24 hour period. So if he wakes and is rooting, the nurses will try to bottle feed him. At first he didn't care about the bottle what so ever... but over the days he started taking some out of the bottle, and now he seems to be doing better with the bottle than with nursing. He took 30 ml from a bottle this morning! Which is almost a full feed. (he is at 48 ml)

The only thing I'm waiting on to bring him home is 48 hours of him taking all his feeds fully by mouth...

Am I delaying his home coming by trying to nurse him, when he seems to struggle with that more now?

I don't know, I'm so confused and frustrated and just want him home...

What have other Mama's done? Should I just go find the patience tree and stick with what I am doing and have faith that he will put it all together soon enough?

[Bmorefarmgirl]

this was one of the most confusing things to me when we were in the nicu with our baby! some people said bottle feeding was easier for them and nursing them made them tired. but then everyone said nursing was great and we should do it as often as possible. then i read something after we had left the hospital that said that nursing is actually easier than bottle feeding for them. the answers depend on who you ask!

i think the most important thing is that your baby just gets nourishment and gets stronger and bigger. as long as that is happening, you should do whatever is working for you. sometimes my baby would nurse for 15 mintues or more. other times he would tire out after less than 5 minutes. when you are home, you will be able to nurse him when he is hungry and more often too, but while you are on a schedule at the nicu, it makes it harder to time it for when he has energy and an appetite. nursing might make him sleepy but you holding him and him being near you will help him grow and get stronger, so just keep on nursing as much as you can! if you are there, him being at your breast is the best place for him!

[justKate]

30 ml is great!

Here's what we did. YMMV.

They wouldn't release DD until she kept down 60 ml per feed for 48 hrs. Every. Single. Time. She had breastmilk, she would throw up. We never could figure out why. Maybe my diet? So we decided to take her off the BM for a few days, keep the formula consistent, just to get her out. Obviously I kept pumping, and as soon as we left the hospital, she was on the boob. Sure enough, it worked, and we were out of there. This was at a point when we were preparing to sign her out AMA, so there was a lot of tension. Basically I didn't understand why a ~7 lb. newborn needed to eat 60 ml/feed if she seemed content at 50 or 55 ml. She would stop eating, they would put the rest down her NG tube, and she would throw up. SHE'S FULL, duh. I digress.

If I were you, I would do whatever would get your DS out of the hospital asap. Good luck with your decision. It's so tough.

[SilverFish]

Originally Posted by justKate

30 ml is great!

Here's what we did. YMMV.

They wouldn't release DD until she kept down 60 ml per feed for 48 hrs. Every. Single. Time. She had breastmilk, she would throw up. We never could figure out why. Maybe my diet? So we decided to take her off the BM for a few days, keep the formula consistent, just to get her out. Obviously I kept pumping, and as soon as we left the hospital, she was on the boob. Sure enough, it worked, and we were out of there. This was at a point when we were preparing to sign her out AMA, so there was a lot of tension. Basically I didn't understand why a ~7 lb. newborn needed to eat 60 ml/feed if she seemed content at 50 or 55 ml. She would stop eating, they would put the rest down her NG tube, and she would throw up. SHE'S FULL, duh. I digress.

If I were you, I would do whatever would get your DS out of the hospital asap. Good luck with your decision. It's so tough.

honestly, we had almost the same problem! they weren't quite so strict on it, but they definitely wanted to see her taking a much larger feed than what she was interested in. so i would be trying so hard to get her to drink that last 20-30 ml when she clearly wasn't interested. as soon as she got home, she drank what she wanted when she wanted, and we were able to really relax and work on breastfeeding with the help of my lovely midwife, in a comfy bed, with as many breaks as we needed.

my personal feeling, if i had to do it over, is that i would do the bottles with maybe one or two shots at breastfeeding a day. the nurses feel more comfortable with bottles, they can do them if i'm not able to be there, and our NICU wasn't the most comfortable or private area to be giving the kind of access that a tiny, sleepy newborn needs to properly learn to nurse. once we got home, we were off bottles and on the breast within a few days and i'd much rather be fighting that battle at home on my own turf than in the NICU.

[davidzhang]

we have the same problem with you

[Phoenix~Mama]

The nurses do give bottles whenever he is awake at a care time and I am not there. I am only there for about 3 cares a day. Wish I could do more, but the balance of my DD needing me at home and sleep is hard.

Yesterday he slept through 2 of the care times, but the third one he nursed for 10 minutes again!

But even so, it seems that nursing him isn't going to get us out very fast until he is really doing it consistently and the LC starts doing test weights because they need to know he is taking his full feed, of right now it's up to 48 ml.

Which is annoying, because sometimes it does seem like he is content after 30 ml, but then they have to put the rest down the gavage tube.

It's so frustrating because I know, and even the nurses know a baby will take different amounts at different times, but they don't to open feeding until they show they can feed well by mouth for like 24 hours. Then they will graduate to a min/max feeding amount, and as long as they take at least their min, they are happy.

The other issue that has popped up... when DS does really good at nursing and is sucking away... he forgets to breath and has had two Apnea episodes... and now they say he has to go at least 5 days without one of those to be released home too.

I can't shake feeling discouraged and like I'm doing something wrong and I can't find the right answer of what I should be doing.

And also... I HATE the fortifier. It's so sad to me changing his diapers and him not having lovely BM diapers, instead his poop has turned a nasty gray color and I can see powder in it from the crappy fortifier, because they tell me he needs extra calories and calcium and phosorphous that he missed out on getting in the third tri-mester.

But what I don't understand is right now he gets it mixed in at every feed, but they told me once he goes home I only have to give it to him in two feeds a day. So why does he need so much extra right now? How do I know if he is digesting it well?

I am so against formula and have way more than enough pumped milk to handle his feedings right now. I know I'm likely being silly having an issue with the fortifier if he really needs it... anyone else felt like this?

[heymama1plus1]

Does your unit have cue-based feedings? It's somewhere between scheduled feedings ("you must take 60ml every 3 hours!") and ad lib demand feedings ("take what you want when you want" ie normal newborn).

For example, if a baby was taking 60ml every 3 hours, that would be 240ml in 12 hours. So from 7am to 7pm (and 7pm to 7am) the baby would need to take 240ml (when we switch to cue based we usually go down in the volume a bit to give them a chance at success, so maybe 200ml in the above scenario).

It lets babies feel hungry and develop their own schedule. When it's their idea to eat they always do better. We leave the gavage tube down so that we can top them off now and then if needed. We like to see babies taking 70% of their volume 8 hours into the 12 hour shift, so that you don't have to play catch up and stuff them too full at the end. It's a very individualized way to feed a baby; everyone's pattern is different.

If your baby is taking 30ml bottles and starting to wake between feedings it's worth a try. Even a 24hr trial would be nice. You never know unless you try! And if the gavage tube is down, they'll still get all their calories in, so what's the harm? You can always go back to scheduled feeds.

Good luck!

[aikigypsy]

My experience is that I was worried about setting him back with breastfeeding, because what he took couldn't be measured and counted towards his total, but I really shouldn't have worried about it. He got straightened out on his feedings, and then was kept in for FOUR MORE WEEKS (or was it five) just for apnea. There are so many issues, and also, you will be able to BF after you come home.

The lactation consultants/nurses warned me that it would take many months to transition to full breastfeeding at home. Now that I'm here, I am wondering how on earth they imained it would take that long. It's so different now that we're out of the hospital, so much better, but really, don't worry about holding back his discharge date, because you never know what will keep him in.

[Phoenix~Mama]

I am so ANGRY!!! Right now!

DS had his first day of taking all his feedings by mouth!! He was up to his 10th feeding in a row by mouth, and only needed to take 6 more in a row for the docs to talk about him going home, then the night nurse decided he was eating too slow, which meant to her that he was working too hard and she put his feeding tube back in.

AAAAAAAAAGHHHHHHGGGGHHHHHHH!!!!!

I was THIS close to bringing my baby boy home tomorrow.

What if he just eats slow??

I am so done with this BS scheduled must eat this amount routine!!! It's frustrating and infuriating, becase in my heart I just KNOW that if he was home and able to eat on demand all day/night long if he wanted to, in whatever freakin amount he wanted he'd be fine!!

Most NB's eat FREQUENTLY. Not just 8 times a day. I know my DD nursed ALL DAY and every 2 hours through the night like clock work until she was close to 4 months old. And when I went back to work and she started taking a bottle, she NEVER ate the same amount from it two feedings in a row!!!

Why do they expect this of preemies? I have a good idea it's just for their bloody numbers.

I'm just so upset today and want to scream at everyone.

[MamaFern]

Originally Posted by Phoenix~Mama

I am so ANGRY!!! Right now!

DS had his first day of taking all his feedings by mouth!! He was up to his 10th feeding in a row by mouth, and only needed to take 6 more in a row for the docs to talk about him going home, then the night nurse decided he was eating too slow, which meant to her that he was working too hard and she put his feeding tube back in.

AAAAAAAAAGHHHHHHGGGGHHHHHHH!!!!!

I was THIS close to bringing my baby boy home tomorrow.

What if he just eats slow??

I am so done with this BS scheduled must eat this amount routine!!! It's frustrating and infuriating, becase in my heart I just KNOW that if he was home and able to eat on demand all day/night long if he wanted to, in whatever freakin amount he wanted he'd be fine!!

Most NB's eat FREQUENTLY. Not just 8 times a day. I know my DD nursed ALL DAY and every 2 hours through the night like clock work until she was close to 4 months old. And when I went back to work and she started taking a bottle, she NEVER ate the same amount from it two feedings in a row!!!

Why do they expect this of preemies? I have a good idea it's just for their bloody numbers.

I'm just so upset today and want to scream at everyone.

im checking in from the nov DDC and im so sorry things are not going the way you need them to go. i agree with you. newborn babies do not nurse consistently at all. they nurse when they are hungry, comfort suck, some nurse a LOT at night others not so much. i think following your intuition is the best thing a mother can do for her baby. is it a legal thing? you literally cannot leave till they decide its okay? i think you are doing amazingly well considering. i know i would feel very similar to you in a situation like this.
but im sorry that you are frustrated.

[heymama1plus1]

Originally Posted by Phoenix~Mama

I am so ANGRY!!! Right now!

DS had his first day of taking all his feedings by mouth!! He was up to his 10th feeding in a row by mouth, and only needed to take 6 more in a row for the docs to talk about him going home, then the night nurse decided he was eating too slow, which meant to her that he was working too hard and she put his feeding tube back in.

AAAAAAAAAGHHHHHHGGGGHHHHHHH!!!!!

I was THIS close to bringing my baby boy home tomorrow.

What if he just eats slow??

I am so done with this BS scheduled must eat this amount routine!!! It's frustrating and infuriating, becase in my heart I just KNOW that if he was home and able to eat on demand all day/night long if he wanted to, in whatever freakin amount he wanted he'd be fine!!

Most NB's eat FREQUENTLY. Not just 8 times a day. I know my DD nursed ALL DAY and every 2 hours through the night like clock work until she was close to 4 months old. And when I went back to work and she started taking a bottle, she NEVER ate the same amount from it two feedings in a row!!!

Why do they expect this of preemies? I have a good idea it's just for their bloody numbers.

I'm just so upset today and want to scream at everyone.

Are you still on an every 3 hour schedule? If he ate all his feedings by mouth for over 24 hours, it's reasonable to try the cue based. In fact, I'd demand it. He may be an every 1-2 hour kind of kid. And, yes, it is all about the "bloody numbers" So if he can eat when he wants, gain weight and gets the calories in, then a 3 hour schedule may set him back if that's not his style.

Feel free to PM me (I'm a NICU nurse) if you want to give me particulars about his weight, feeding volumes, calories, etc, and I can see if it's reasonable. I work at a very large, progressive university hospital (not trying to knock the place you're at, but it sounds like they're not really listening to you! Putting a gavage tube in after 1 "failed" feeding sounds drastic).

[Phoenix~Mama]

I'm still agitated and confused. So today DS has taken his feed by mouth again for another 24 hours. (though this time I can't get excited, thank you for that NICU). Anyway... the nurse had to tell me though that they do have to work with him to keep him awake to finish his feeds but he is doing it, but he's slow about it, that babies should take bottles in 20 minutes or less, or else you'd be doing nothing but feeding them.

Um, WTF? I said to her that it usually took my DD longer than that to take a bottle when she was a baby. And she said again that I should know that that is a long time.

So now I'm wondering if there was something wrong with my DD? She seems normal now and she has always met her milestones. Is it really odd or wrong for a baby to not chug down a bottle in minutes?

And!!!! GRR!!! Freakin yesterday he woke up at 4:00 pm rooting around like crazy and getting really upset. But no... he couldn't eat because his care time is 5. I was so PISSED because I knew he was going to wear himself out and not want to wake at 5, and I was right. So he wouldn't BF at 5, but I was able to coax him to take his bottle while sleeping, because I just want him out of this place.

So yeah, no, not on cue based/demand feedings. They don't seem to do that there for the preemie babies. If a term baby ends up there for some reason, they seem okay with them being on cue based, but the preemies tend to stay on their 3 hour schedule.

They likely won't swith him to cue based either because they feel he should be showing signs of strong eating before they do that, meaning chugging a bottle down in less than 20 minutes I guess. *sighs*

I will be talking to the LC today, maybe she can help shed some light on things. She fought for me last time because in the begining the nurses/docs were only going to let me try to BF every other care so as not to tire him out. And they had it changed to I can try everytime I'm there. (though that hasn't been going well because most times he's been sleepy. )

[MeepyCat]

Do you eat all your meals in 20 minutes or less? I don't.

So no, I don't think there's anything wrong with your DD, or with your NICU babe either.

The NICU staff has a bunch of babies to feed. *They* can't always take 20 minutes or more to feed a babe, because there's another hungry babe in the next crib. The answer to this problem is that, when you are home with your baby, you have no problem taking more than 20 minutes for a feeding, and that time frame does not concern you.

If you're in the NICU, is there anything stopping you from simply picking your baby up and putting him to breast? Unless there's some specific issue with picking him up, don't ask them about it - easier to get forgiveness than permission.

[Super~Single~Mama]

(I'm stalking so that I can get updates on your new babe )

[justKate]

Originally Posted by Phoenix~Mama

I'm still agitated and confused. So today DS has taken his feed by mouth again for another 24 hours. (though this time I can't get excited, thank you for that NICU). Anyway... the nurse had to tell me though that they do have to work with him to keep him awake to finish his feeds but he is doing it, but he's slow about it, that babies should take bottles in 20 minutes or less, or else you'd be doing nothing but feeding them.

Um, WTF? I said to her that it usually took my DD longer than that to take a bottle when she was a baby. And she said again that I should know that that is a long time.

So now I'm wondering if there was something wrong with my DD? She seems normal now and she has always met her milestones. Is it really odd or wrong for a baby to not chug down a bottle in minutes?

And!!!! GRR!!! Freakin yesterday he woke up at 4:00 pm rooting around like crazy and getting really upset. But no... he couldn't eat because his care time is 5. I was so PISSED because I knew he was going to wear himself out and not want to wake at 5, and I was right. So he wouldn't BF at 5, but I was able to coax him to take his bottle while sleeping, because I just want him out of this place.

So yeah, no, not on cue based/demand feedings. They don't seem to do that there for the preemie babies. If a term baby ends up there for some reason, they seem okay with them being on cue based, but the preemies tend to stay on their 3 hour schedule.

They likely won't swith him to cue based either because they feel he should be showing signs of strong eating before they do that, meaning chugging a bottle down in less than 20 minutes I guess. *sighs*

I will be talking to the LC today, maybe she can help shed some light on things. She fought for me last time because in the begining the nurses/docs were only going to let me try to BF every other care so as not to tire him out. And they had it changed to I can try everytime I'm there. (though that hasn't been going well because most times he's been sleepy. )

This is EXACTLY what kept my (full term, mind you) DD in Miami Children's Prison for three weeks FOR NO REASON. If this is the only thing keeping your DC in the NICU, I would be LIVID. I don't know why it is this way, but it is common. Huz and I were considering signing DD out AMA when she finally kept down the required 60ml for 16 bazillion feeds. Not suggesting you do that, but.... It's so hard when you're SO CLOSE. Hang in there mama.

[ssh]

Wow, my DD, who was born at 37 weeks at 8lbs. 12 oz. sometimes nursed for 40 minutes and did nurse every two hours around the clock. Every 3 hours seems cruel especially when your DS was rooting and upset at not getting milk. That just doesn't make any sense at all when AAP recommends nursing on demand. When my DD finally did do bottles at 6 weeks when home with DH she still didn't down them in 20 minutes. Maybe some people just eat slower, my DD (almost 5) still eats slow.

[Phoenix~Mama]

Well they upped his max to take his feed to 45 minutes. And they are okay enough with his pokiness, but wish he was doing better, but luckily they are still counting it as a passed feed! They are talking about him possibly coming home tomorrow if he continues to finish his feeds over the next 24 hours!!!!

Now I'm a mess wondering how he will do!!!

[Super~Single~Mama]

You're an amazing mama!!! I hope you can take him home tomorrow!!!!!!!