Need premature baby breastfeeding info

[nakagain]

My sister is due with her 1st baby and I've had a horrible feeling for awhile now that she might deliver really early. I had no reason to feel this way. Then a few weeks ago she was diagnosed with her 2nd UTI and she still has it. She's now 22 weeks pregnant and has been having lots of cramping and still has her UTI. She's actually going back to her OB's office right now because of lots of cramping and pain.

SO to be proactive and hope she never needs this info, where can I good info on breastfeeding a premie? She plans to breasfeed, sling, co-sleep etc... I remember hearing a long time ago about a really good book to read for premie baby moms.

[jeanine123]

Here's hoping that you don't need it but here's a link to kellymom with a ton of links and info on preemie nursing.

http://www.kellymom.com/babyconcerns...p-preemie.html

[mommyto3girls]

Pamela- Have they tested her urine for GBS? A persistant UTI with Cramping can be a sign of GBS and if it is colonized in the urine it can cross the placenta. I know of a few moms (from a GBS support group) whose babies were actually stillborn because of this. MOst people think GBS is only a concern after your water breaks but in highly colonized people (those who show GBS in the urine) it is a concern at all stages. I hope this isn't it but I would be sure to ask her to have her Midwife or OB send the urine out for a GBS test.

[Pinky Tuscadero]

Dr Sears has a Premature Baby book. I'm sure it is bf friendly, though I haven't actually read it yet.
Suzy

[wende]

I don't have any references, but I do have experience. I nursed 2 preemies myself. Both times I was told they would never nurse or never nurse exclusively and that I'd always have to supplement. My first preemie is now a nursing 2yo (exclusively for almost a year, never given a bottle since learning to nurse...which took 2 weeks after coming home from the NICU) and my second preemie is now 4mo and refused to take a bottle in the NICU so they wouldn't let her come home until I spent 36hours in there with here proving to them that she just wanted to nurse. She came home the next day without ever having a drop of formula!

It can be done. Sometimes it is more difficult than others. Pumping can be a pain. Listening to the doctors and nurses tell you to just give it up can be very hard. Not giving up can be difficult. BUT, in the end it is all worth it. She will have to stay strong and stand up for herself and her baby.

Hopefully it will all be a moot point though, because that baby will stay put for another 18 weeks or so.

[plantmama]

My ds was born at 29 weeks and breastfeeds- now he is 20 months.
The hospital he was born at had a family centered care policy and were very pro breast milk. That said, the doctors and many nurses knew nothing about breastfeeding preemies.
I got so much help and validation from one nurse there though, who recommended Kangaroo Care (skin to skin), NO fake nipples until breastfeeding was introduced and somewhat established.
This is what I had to do: pump (they provided pumps and our insurance paid for rental of one while I was away from the hospital), 8-10 times a day to establish a supply and the milk started going right to ds via gavage tube by day 2 or 3. I also had to get up twice a night to pump.
I tried brestfeeding him when he was a week old and he rooted but couldn't latch. He really couldn't latch for the first 3-4 weeks and went home at 6 weeks fully breastfeeding, no bottles since.
He started getting bottles at night when I wasn't there when they took the gavage out (he started pulling it out) about a week before he came home. They also frequently gave him a passie from day one- he did not have nipple confusion BUT one mama in there was very frustrated because her baby wouldn't nurse after getting several bottles against her wishes.
I think the most important thing is to establish breastfeeding before bottles.
Also let down can be hard when you are away form your baby, but pictures and smells of baby helped me a lot with pumping.
I can't think of anything else, hope your sis doesn't even need this, but if she does tell her it's hard but very worth it- my ds has never needed any extra care and has grown really well etc.. is very attached in spite of a rough first 6 weeks living in an isolette. A lot varies by age too...
Most preemie books have breastfeeding suggestions but the best thing is to just be persistent and gentle and positive about your decision to nurse.
hope everything goes well.

[mom2alicia]

when my baby was born prematurely, i met with the lactation consultant at the hospital frequently. i would have her paged when i arrived to visit my daughter (that was the system at the hospital we were at) and she would come and guide me hands on to try to bf my dd. i would ask her any questions about pumping at that time she would work with me on position and latching. she wasn't able to latch on for quite awhile, but we just kept practicing. i used a hospital grade pump and we gave her bf in a bottle. there are other options like tubing and finger feedings. but what we did was 1) put to breast, give best effort to latch her on, if not latched at least let her suckle a little 2) then give a bottle of previously expressed breastmilk 3) tube feed if she wouldn't take the bottle 4)then burp and put down asleep 5) pump milk. this was our routine. i wasn't able to room at the hospital, they were full. so i wasn't there for every feeding, but i pumped at home and brought my stash with me to the hospital and they stored it and used it when i wasn't there. my daughter was sent home from the intensive care after one week. after that i made appointments to see a lactation consultant at the medical center weekly. then she latched on, right around her due date, six weeks later! and i ditched the pumps and bottles. and just nursed exlusively on demand. forgot about the schedule and everything. now she won't quit she is 2 yrs and 4 months old now! i have another friend whose child never did get the hang of it and she pumped and gave BM in a bottle for a year! although she did later say that she didn't get as much help with latching and positioning and just kind of gave up on getting her to the breast pretty quickly and stopped putting her to the breast. she just pumped and gave it in a bottle. oh and my dd like a lot of preemies had a very difficult time regulating sleeping and eating. so i did have to rouse her to eat, because she wouldn't otherwise during the first 6 weeks. then after that she would get so overstimulated so easily, that she couldn't fall asleep and stay asleep. i used the pregnancy pillow to support me on my side so i could just lie on my side all night comfortably with her tummy to tummy with me and nursing on and off all night. she had to be tummy to tummy. this worked to regulate her and eventually she developed more normal sleep cycles. preemies sleep patterns do not follow full term babies sleep patterns and this was frustrating because i couldn't find this issue addressed anywhere for quite awhile. i found out that preemies spend very little time in deep sleep compared with full term babies (who don't spend that much time in deep sleep either) but preemies spend even less time in deep sleep. it is a survival mechanism. they spend most of their time in light sleep and are very sensitive to stimulus. except in the very beginning when they might be completely shut down and in a very deep sleep as a defense mechanism to shut out all the stimulus.

also i actually found it a bit frustrating to get bf advice from some of the traditional sources of support because bf moms with full term babies just don't understand the extra challenges of bfing a preterm baby. it is important to read books about preemies, not just regular parenting books, and talk with other parents of preemies and talk to the specialists. there are some special issues with preemies. and of course every child is different. so there are individual differences as well.

[nakagain]

Thanks for the info, I will send her the link to this thread. That's interesting about GBS because I had a UTI and when the culture came back at I was GBS ++ and I was only 20 weeks. I went in for contractions and the hospital never tested my urune and the very next day my midwife did and GBS+ with UTI. I never was able to get rid of the GBS...nak