Success in breastfeeding a preemie?

[sehbub]

My daughter was born 10 weeks early. She is now 6 weeks old.

I started pumping for her about six hours after she was born, and it went fairly well. She was getting enough to survive, and they only had to give her IV fluids in the NICU for a few days, because I had been on magnesium three times, trying to stop my labor, and her mag levels were faily high. Slowly, they kept increasing her milk intake and decreasing her fluids until she was just on my milk. I kept pumping every 2-3 hours to build up the stash in the hospital freezer just in case something happened and I couldn't get to the hospital to see her one day and bring fresh milk.

Fast forward to the beginning of her fourth week in the hospital. I noticed that my supply was dwindling, and instead of being about to pump 3 ounces every 3 hours, like I had been, I could now only get one ounce. This was no longer enough to feed her, because she was eating just over an ounce at every feeding. Luckily, they had that stash in the freezer, so the only formula she was ingesting was a little teaspoon of it that was added in order to increase her calories and bulk her up.

She came home 27 days after she was born. Within four days, my milk stopped completely. I kept pumping around the clock, hoping to get something to give to her, but i got nothing. This entire time, I had been using a manual pump, by the way.

My parents surprised me last saturday and rented a Lactina pump for me, and I am now getting just under an ounce every time I pump. It's less than half of what she eats every feeding, but is enough to feed her milk overnight so that she stays fuller and sleeps longer.

I put her to breast at every feeding, and she is strong enough to suck on the nipple for a while, but not big enough to latch. I have large, flat nipples, so she has to work extra hard.

Has anyone had success in breastfeeding a preemie after they've come home? I so desperately want to end up being able to exclusively breastfeed her, because I missed everything that is "supposed" to happen during pregnancy and after having a baby, and really really want to establish a good strong bf relationship with my darling babe.

Here's my tiny little sweet pea:
http://www.flickr.com/photos/samanthab/153152748

[Moonprysm]

My son was a preemie, although just barely (I was 35 weeks 6 days when I gave birth). He was 4 weeks early and didn't have to stay in the hospital any longer than I did, but I still am having issues bfing and he's now 8 weeks old.

I wish you the best of luck!!

[Lousli]

Hi, I've been following your babe's progress a little (I like to lurk on preemie threads) and she looks great! Congrats on having her home! My daughters both had a hard time learning to nurse, but my second was much worse than my first. I didn't have a supply issue because my older daughter was helping to keep the supply up, but latching was really hard for my baby. She also got tired easily and would fall asleep before the feeding was over. It took nearly three months for her to learn to nurse. I also have large breasts and pretty flat nipples (especially with my first, since she nurse for so long they started "sticking out" a little more).

If your daughter has been taking a bottle, it might help to try nipple shields. It will help her to compress more of your areola and not just the nipple and hopefully get more milk that way. Also since she has been bottlefed in the NICU, the feeling of the nipple will be more familiar with the shield on. You can then slowly wean her off the shield and directly to the breast. I know lots of LC's and books about breastfeeding say not to use nipple shields, but I think things are a bit different with a preemie. I had to use them for both my kids. They were both able to wean off the shield and I nursed my oldest for 4 years and 3months, and my younger daughter is still going strong at 17 months. I wish you the best of luck!

Also, if you have concerns about how much she is getting, remember she is more efficient than a pump. You might try weighing her on a good digital scale (you can usually rent one from the hospital, or buy one from Ebay-ours was only $50 or so). Mine was accurate to 1/2 ounce, so that was pretty good at seeing how much she got from a feeding. There are some even more accurate than that, but they cost more.

I hope I'm not too rambly or incoherant, I'm recovering from a horrible bout of stomach flu. Feel free to PM me.

[sehbub]

We have a good scale, so that's an idea.

Any suggestions on where I can get nipple shields? I'll try anything at this point. I never thought in my wildest dreams that I would spend more time with my breast pump than I do with my husband, but it's the sad truth. :

[Moonprysm]

A lot of medical supply places that carry pumps and parts will carry the shields as well. I have to use one with my son, although yesterday he just suddenly started latching without it. It really is a lifesaver sometimes...when I started using mine, my son was refusing the breast all together. Using the shield was the only way we could get him to nurse again. It's so helpful with a preemie. I would definitely suggest one, but be careful to do things to keep up your milk supply. The down side to a shield is that your body doesn't feel them nurse as much, so it can deplete your supply a bit. But the way I see it, he wasn't nursing at all before the shield, so even with a reduced supply, he was getting more with the shield than without. And hopefully now that he's nursing without it quite often, hopefully I'll see an increase in my milk.

[lilgsmommy]

I prolly cant help too much, because I am still having issues, but one thing did help with me was the LC showed me how to sandwich my nipple between my fingers so that it was easier for my babies to get it in thier mouths without having to open up very wide, because they had such small mouths. I dont know if this would work for you or not, but might be worth a shot, to get her to get more in her mouth and suck a little harder. She had me start out holding that way for the whole feeding then slowly decreasing the amount of time I held it.

[wende]

YES! I was told that my 31weeker would never nurse and even if he learned to latch on he would never nurse exclusively. I gave in while he was in the hospital but worked like crazy once he was home. I got nipple sheilds at Target and within a week he was nursing around the clock and refused bottles ever since. He will be 3 this month and I am tandem nursing him and my 32weeker, who turned a year old in May! It can be done!!!

[Lousli]

Here is some info about shields:
http://www.medela.com/NewFiles/nipshield.html
and a couple of linksto purchase:
http://www.addalittlelove.com/nipple_shields.html
http://www.mommybabysite.com/nurse_p...da_shields.htm

[GatorNNP]

you can do it! keep putting baby to breast and pumping some after to help increase your supply and get an LC to evaluate your baby at the sheild. Sheilds are useful for preemies. I have had 26 weekers go home and exclusively breastfeed, and it is usually dependant on the determination of the mother and trust in the baby. You may not get her only on the breast initially but it will come with time.

[flminivanmama]

my twins were 11 weeks early and spent 2 months in the NICU. it took 3 weeks with the nipple sheild till they were finally able to nurse.

it's a lot of work but sooo worth it!

[sehbub]

Sounds like the nipple shields are the way to go. She can't latch at all now, so theoretically the nipple shields will help. If I had three hands, I could hold my boob with one, her body with the other, and push her chin down to open her mouth really wide with the third, but since that's not possible, any suggestions on getting her to open up really wide? It's tricky getting her mouth open wide enough.

[Lousli]

If you have a boppy pillow, you can use it to help hold up her body, especially if you have a stool to prop your feet on. She might open wider if you tickle her cheek with a finger or a nipple, and you can also gently pull on her chin to encourage her to open up wider. But the shields will definitely help!

[flminivanmama]

my dh had to help a lot LOL and my mom...

I would say "OPEN" and open my mouth wide stick out my tounge and say ah and hope that they imitated me LOL

I used the football hold too which made a difference

[sehbub]

We'll try the boppy. I forgot all about it, actually. I've bene using it mainly to tuck her in to for naps when we're downstairs in the living room.

[wende]

Yeah, the Boppy became a lifesaver when I was trying to get my ds to learn to nurse!

[BabyGow]

I was just lurking and thought I would also pop in to offer support! My DS was born at 35 weeks and had to be in NICU as well. BF was a no go in the hospital because the nurses were not very supportive and he just would NOT latch, but I was determined. I pumped and pumped and pumped until we both got out of the hospital. I finally had a good milk supply going and spent lots of skin to skin contact with him. I finally took the bottle nipple(he would not even take a nipple shield at the time) and placed it over my own nipple. Then after a few weeks(agonizing: ) of that, I bought a nipple shield and after a few weeks of that, I started to slip the shield off when he was sleepy. Right before he turned 3 months old, he finally latched for the first time!! He has been a nursing champ ever since and has not had one bottle since then either! He is now 10 months old and nursing strong. It took a lot of time and effort and crying and stress. I was told by everyone, my mother, WIC, LC's, Dr's etc. that I was doing everything right and maybe I would just have to pump forever, but I was very determined and held strong to the hope that he would nurse and he did finally! Even after being on a bottle for awhile. So it can be done. Just stay strong, lots of skin to skin contact, lots of pumping and lots of love and hope! Good luck!