Going from EPing to nursing

[Justmee]

Last week I had a baby boy who, in a complete shock to us, was born with a heart defect. He's now Thank G/d gone through open heart surgery and is on the mend :)

Because his fluids were restricted in the beginning, and now he's still hooked up to a few wires, we have not really been able to nurse (I did nurse him a few times right after I pumped when he couldn't get much, and he did seem to take right to it so I am hoping there won't be a huge learning curve). I have been EPing for him and he's been taking only my milk from a bottle, which he is doing great with (no feeding tube, great suck, etc.)

My question is how did you go back to nursing? He's going to the regular ward in the next few days so he will be wireless and we can start. Should I keep pumping? Gradually cut it out? Pump after he nurses?

Supply isn't an issue thankfully, there is plenty of milk to go around, I just want to get him nursing!

Thanks for any tips you might have!

[jocelyndale]

Does your hospital have any IBCLCs on staff?  Do you have a local LLL leader you can call?  

I put DD to breast often.  She was an early preemie and has some latch/feeding issues, but I offer her the breast frequently.  I don't force it on her (oral aversion), but I do lots of skin to skin and lots of reminding her of the boobs.  Some days are better than others.  If I feel she got a decent feed, I don't offer a bottle of EBM afterward.  If I think she was playing too much, I offer EBM.  

Have you asked to speak to a lactation nurse in the NICU?  Firmly state your wish to nurse and practice feeding at the breast.  I put DD to breast often once she was off the ventilator and had an NG tube rather than OG.  

[Justmee]

Yes a little update from my phone. We have been in the ward since Sunday. He is still nursing and taking bottles, and thankfully has a great latch and suck (although I think he has a slight tongue tie like two of my others). The doctors here don't want to clip it so I'll take him to the specialist when we get out of here. I am allowed to nurse all I want, but I haven't made the total switch yet because juggling him with the O2 is not easy, and mostly I don't want any reason to keep us here. We have a great well baby nurse at home so if he drops a but from the switch I'm not worried, but I want him continuing to gain now so we can get home.

Good luck to you and your preemie!

[skycheattraffic]

Since he is nursing nicely when offered, I would just keep pumping for now until he comes home and seize every opportunity to nurse. Once he is at home, I would just offer to nurse for every feed and (as pp said) only offer the bottle if he really seems to need it. I would at that point only pump after a feeding where he needed a bottle. I EPd for ten weeks (healthy term baby who wouldn't latch at first) and even then the switch wasn't too bad going from 100% bottle to 100% breast. Really the worst part was the juggling pumping, offering the breast to a baby who wasn't used to it at all, giving a bottle when she was resistant and cleaning the pumping stuff. We also needed a nipple shield because she was very used to the silicone bottle nipples by then. Now she is over 16 months old and loves to nurse.
Anyways, if he latches well and nurses when given the opportunity then you're really technically supplementing his nursing with EBM rather than strictly bottle feeding - a HUGE head start. I'd just give him a ton of opportunities (as circumstances permit of course) and would dial back the pumping to match his need for a bottle. Once he is well, he will probably only need a few weeks or less to make the transition to the breast and you can try putting the tough early weeks behind you. Congratulations and good luck!

[Justmee]

Yes, I think we have now progressed to nursing and supplementing. Pretty much I am giving him the bottle first, then pumping, then nursing him the next time he wants to eat. He's getting more hindmilk that way, and keeping up his weight gain (still in hospital so he's weighed every day and I do not want to be stuck here any longer than I need to be). I probably would have switched totally, but he had to have another procedure done yesterday where he needed to fast so he dropped a bit of weight today. I hope we will be home next week and we can switch to only nursing, and me just pumping if I need to while the supply adjusts. He's been nursing more & more and thankfully nurses like a champ!!!

[Justmee]

Just wanted to update. We came home 2 days after the last update and thankfully he's 100% nursing great, gaining, no problems at all. Haven't clipped his tongue yet (we'll see the specialist in the next 2 weeks or so), but he's gaining a ton and really doing well. I can't believe a kid right after major surgery can bounce back so fast, but thank goodness he did!

[skycheattraffic]

That is wonderful to hear!! Congratulations and good luck

[clairebear3]

Great to hear your LO is doing so well!