NICU - Bottled EBM vs. Breastfeeding - Page 2

[tikva18]

I don't know what's with peds:

[Kathi13]

My NICU was extremely Bfing friendly - to the point of Most of DD's Drs told me that their BF'ed babies tended to do much better than the ones who got formula. They had a very helpful LC (who was way over worked for the size NICU we were at) who was there when ever I needed her.

DD was born at 28wks - I pumped and pumped totally spazed about making sure I had a good supply for her. She did not get her first cc of BM until she was 10days old - and it was through her NG tube. Finally around the time she was 32 wks I was able to put her to nipple while they fed her through NG tube - it was only a few days later that we Bf for the first time. By the time we left the NICU (11wks) I was at the NICU from 4:30am until after 10pm at night so I could BF on demand. Her midnight/3am feedings were still done through the NG tube. 3 days before getting out of the hospital they said they had to take the NG tube out - unfortunately their "room-in" room for parents was crowded with 4 babies so we couldn't stay the night with her (well we could have sat next to her crib. DH convinced me that it would be ok to give her those few feedings by Bottle - so he went in for the midnight feedings and the nurses taught him how to give DD a bottle of eBM. The nurses did the 3am feedings.
No formula - but she did get a few bottles of eBM. We were lucky though as we were staying at a RMcDonald house (NICU was 100+ miles from home) and we both had VERY accomidating work situations, and DD was our first so we didn't have to divide our time between older children.

When we got home - our Ped wanted me to BF AT LEAST until DD was 15m - and was totally good with us for BFing longer.

[NZmumof2]

I've not posted before, but my son was born at 28 weeks in New Zealand. In my time as a mum in a NICU and also as a Doctor in a NICU here, the only times we would bottlefeed babies is if that was the parents choice. We steer clear of bottles for any baby when the mother intends to breastfeed. Bede was on TPN for a couple of days then tube fed. He start to breastfeed at 34w and was home fully breastfed at 36 weeks. I would say that it is very unusual for babies in NZ to go home as early as many of yours did. We tell mums to expect to be in hospital till their baby is at their due date (longer for twins). But while I found being a NICU parent really hard and if it happens again I will not be going home at all till my baby does I would choose to stay till term if necessary and be able to fully breastfeed. Bede nursed till he was nearly 4.

Anna, partner to Leah mums to Bede 6 and Emmett 2 in New Zealand

[sehbub]

Our NICU wasn't really bf friendly either, only because there was one full time LC for the entire hospital. So, at any given time, there was one woman doing the job of at least a dozen, and none of the nurses knew anything about bfing a preemie, so we were stuck. I put DD to breast at least once a day from the time she was 2 days old (born at 30 weeks) and she nuzzled immediately. She got her bottle around 33 wks, because she was unable to latch, and we couldn't synch her feeding times up with free time from the LC, so we were pretty much out of luck.

I EPed every 3 hours for 10 weeks, and finally admitted defeat after my milk had dried up for the third time and I was getting just under 1/3 ounce per DAY from the pump. Of course, we know now that it's probably because I got pregnant 4 weeks post partum that my milk dried up.:

Of course now that there's definitely no milk there, and DD is 3 months old (1 month adjusted age) she dives for the boob every time she's hungry. Poor kid knows where she's supposed to go, there's just nothing there! I have let her comfort suckle many times though, and she seems happy. I really hate the formula though. Makes me gag to be honest.

Sorry so off topic!

[Guinevere]

Bfing a preemie w/o involving bottles seems to be VERY dependent on the hospital and frankly, on your baby's medical condition. I've had three preemies in 3 different hospitals in 3 different states and, unfortunately, all 3 were bottle-fed EBM before they were bfed. HOWEVER, I got all 3 of them to nurse exclusively once we got home, at varying ages. So, for me, it wasn't a deal-breaker in terms of bfing.

I was far more interested in getting my baby HOME with me than in perfecting nursing while in a stressful NICU situation. And, with preemies #2 and #3, it would have been logistically impossible for me to be at the hospital for every feeding. My 2nd preemie was born at a hospital 1 1/2 hrs. from home, and I also had a 21-month old to care for. I only saw her once every other day or so. It was a nightmare! With Sophia, we lived very close to the hospital, but I still only made it in for about 3-4 feedings a day, b/c of my 4 other children.

In my case, at all 3 hospitals, it was standard policy that in order for your baby to be released, they had to be taking adequate nutrition BY MOUTH for every feeding (and NG didn't count, not a single hospital would have let me take home my baby on an NG tube) and, of course, be gaining weight. The nurses would let ME finger or cup feed my babies, but they simply did not have the time to do it themselves when they were the ones feeding.

Also, in my personal experience, NONE of my preemies latched at all or nursed remotely well until they hit their actual due date (and in Sophia's case, she only finally got the hang of nursing a couple of weeks ago, at 7 wks. adjusted). However, my preemies (except for Sophie, she's my exception to all rules, lol!) were ready to go home before their due dates, but for the feeding issues. My insurance was not going to pay for otherwise healthy babies to stay in the NICU just b/c they couldn't nurse yet, not when they COULD bottlefeed to get their nutrition. And I also wanted them home, with me, whatever it took.

I think my situation is very common; perhaps not ideal, but realistic. I'm very happy for you that you were able to get your twins to nurse before their due dates. From my own experience, and in counselling other women who've bfed preemies, I think it is relatively rare to get your preemies nursing well before their due dates.

Guin

[susienjay]

Originally Posted by Guinevere

Bfing a preemie w/o involving bottles seems to be VERY dependent on the hospital and frankly, on your baby's medical condition. I've had three preemies in 3 different hospitals in 3 different states and, unfortunately, all 3 were bottle-fed EBM before they were bfed. HOWEVER, I got all 3 of them to nurse exclusively once we got home, at varying ages. So, for me, it wasn't a deal-breaker in terms of bfing.

I was far more interested in getting my baby HOME with me than in perfecting nursing while in a stressful NICU situation. And, with preemies #2 and #3, it would have been logistically impossible for me to be at the hospital for every feeding. My 2nd preemie was born at a hospital 1 1/2 hrs. from home, and I also had a 21-month old to care for. I only saw her once every other day or so. It was a nightmare! With Sophia, we lived very close to the hospital, but I still only made it in for about 3-4 feedings a day, b/c of my 4 other children.

In my case, at all 3 hospitals, it was standard policy that in order for your baby to be released, they had to be taking adequate nutrition BY MOUTH for every feeding (and NG didn't count, not a single hospital would have let me take home my baby on an NG tube) and, of course, be gaining weight. The nurses would let ME finger or cup feed my babies, but they simply did not have the time to do it themselves when they were the ones feeding.

Also, in my personal experience, NONE of my preemies latched at all or nursed remotely well until they hit their actual due date (and in Sophia's case, she only finally got the hang of nursing a couple of weeks ago, at 7 wks. adjusted). However, my preemies (except for Sophie, she's my exception to all rules, lol!) were ready to go home before their due dates, but for the feeding issues. My insurance was not going to pay for otherwise healthy babies to stay in the NICU just b/c they couldn't nurse yet, not when they COULD bottlefeed to get their nutrition. And I also wanted them home, with me, whatever it took.

I think my situation is very common; perhaps not ideal, but realistic. I'm very happy for you that you were able to get your twins to nurse before their due dates. From my own experience, and in counselling other women who've bfed preemies, I think it is relatively rare to get your preemies nursing well before their due dates.

Guin

I had a reply typed out but then I realized you said everything I wanted to. I have two 32 week preemies that came home around 37 weeks gestation. I had one nursing for all feeds (except 1 bottle of formula a night) within 3 days of coming home. It took about 2 weeks with the other baby. I never got a LC or anything, they both just seemed to be able to do it around there due date.

I tried really hard to breastfeed my daughter in the hospital when she was around 34.5 weeks gestation. I spent an entire day nursing her and thought she did great. That night she was so worn out the nurses couldn't wake her up to feed her and had to pump milk into her and her temperature dropped so low they had to put her back in an isolette. She had been getting ready for discharge up to that point. I don't know that it was all because of the breastfeeding but it just seemed like more work than her little body could handle at the time. At that point I just decided to go with the bottles because I just wanted my babies HOME and I knew we could figure out the breastfeeding later. It wasn't easy when we got home but it wasn't impossible and I would have called a LC if I had to. They were both breastfed until they were 19 months old.

[americastamps]

I hadn't realized that not allowing breast feeding was so common in the NICU's

Originally Posted by 2QTs

We also did not have a BF friendly staff at the NICU. My boys were born at 30 weeks, so of course we started with the tube and then at 33 weeks they wanted them to nipple. BF was out of the question they said at that gestational age and they needed to measure the amounts they were getting. I wish I would have stood up for myself better in there, but like others, I just wanted to get out of there! As soon as they were able to get the nippling down and gain weight they could be released. We were relased 7 weeks later. I immediately got with a LC who came to the house everyday to help us get back on track. It was not easy as the babies were very confused but after a couple weeks we got ot down and we are still going strong today. I'm sorry for anyone that has to go thru the nicu experience!

I'm so shocked that they wouldn't even let you try! What the harm could be in trying is amazing to me. I had a discussion with a friend about NICU's and we were so surprised at how many things just don't make sense in various NICU's. In mine, a NICU in Japan in 2002, there was a smoking room downstairs IN the hospital where you could smell the smoke leading all the way up to the hallway to the NICU but not once inside the 2nd door to the nursery NICU. (Thank God or I would have hired a translator to express my outrage on that one!!)
Then, I was allowed to visit once a day, for an hour.
Then, they only provided a stool with no back for me to sit on the whole time, or i stood. (i had just had a c-section)

thankfully, after the first week when the iv feeding was removed, they introduced a bottle of my pumped breastmilk, and I believe it was two days later they allowed me to breastfeed during my daily visit.
thankfully he took very well to it and I think the poor guy was just starving.

However, my son was not preemie--he was postterm so I don't know what their protocol was with the preterm babes.
They would have me weigh him before the feeding and then weigh him after to see how much he had eaten. It seemed like the perfect system to me to see how much they had taken in. Why couldn't your NICU try that?

Grr, it makes me mad for your situation. I'm so sorry they did that to you. HUGS
Erica

[mimid]

We specified that I was going to bf. By the time we got to the NICU they already had pacis and were bottlefed. I was told that I wasn't going to be able to ebf. I was also told that they couldn't go home until they took all of their feedings in a 24 hour period by bottle in a specific amount of time for a specific amount of formula. They would mix my bm with formula. Whe we were starting to talk about discharge is when I was allowed to try to bf. It only happened twice and they would feed the girls before my appointment so they were basically asleep the whole time.

[redwolf2]

My boys were 34 weekers and were in the NICU for 2 weeks. They were tired little guys and would not stay awke for feedings, which is most preemies. We pumped and bottlefed EBM. My NICU was very proBF though they did tell me to try x amount of times a day. I had a hard time accepting that but the times I did try they really didn't latch and got tired very quickly. They had NG tubes to feed them what they wouldn't take.
We struggled to BF, and I really got paniced there for awhile thinking they would never BF. Wetried a few times a day and afterward gave them a bottle. I hated pumping, fixing bottles and all that, I would cry and cry. So many people think that if they do not nurse from the breast right away they never will. I know it depends on each individual baby. right around there actual due dat (6 weeks) thay started nursing like they have always been doing. They are 8 months now and are still nursing like champs.

I have 3 Yo dd was BF til the age of 2. I knew we could do it, I was very determined. I think that b/c I had BF before made it more reassuring to me that it could be done. After the twins I can understand how first time moms without support of other BF moms can give up, especially when confronted with the challenge of preemie BFing.

Hats off to all of you preemie moms!

namaste

[chiro_kristin]

I am so proud of you mamas who have committed yourselves to having a wonderful breastfeeding relationship with your dc. Even if ultimately it didn't work to actually BF but you continued to use EBM in whatever manner worked. I just wanted to say that.

I'm getting a little sniffly. :

[tanyaandallie]

Dana, I think that b/c my preemie was no. 2 for me really helped bf him as well. I bf my first for 20 mos and was dead set on bf this one as well. It was frustrating at times but I knew I could do and I knew he could do. I just had to give him the time he needed to learn to do it. I think if he were my first I would not have had the determination to do it. It wasn't until after I started bf my first that I realized what a wonderful experience it was. If I hadn't had that experience with her, I wouldn't have really understood the goal I was working to with my preemie.

[GatorNNP]

In my experience the best predictor of BF success in NICU moms, is sheer perserverance. Not all babies will be affected by bottle nipples, but you don't know if that is your baby until it is too late so if you decide the risk isn't worth it, then good for you.

Some of my success stories: term baby on vent over a month, went home breastfeeding with corn oil for extra calories due to medical need and healing from surgery

29 weeker went home and threw out the bottles is cosleeping and just starting solids at 9 months old, looking great

Mom of 26 weeker breastfeeding until 4 months old and discharge when she decided to wean for other reasons...

The only babies I am very strict on the initial intake are kids born with gastroschisis and after repair, they get about 7 days of very small feeds before going to breast. Usually they are so hungry they will nurse anything that walks by though.

[intorainbowz]

Hi there. I'm new.

My Nicu was fairly pumping friendly, not BF friendly at all. I was introduced to the Lactina about 3 hours after my c/s so at least I got that started very quickly. We had a very hard time getting her to eat. She would barely eat from a bottle, and screamed when I tried with my nipple.

As she got closer to going home, she FINALLY started to eat. I decided I did not have the energy in the begining to fight the breast feeding fight. She also did need the HMF. For weeks, she was nearly completely tube fed.

Anyway, we discovered that when she ate her bottle at my breast, the desats stopped and she ate more. We then discovered that if I even attempted to BF, she did even better. I attempted to BF there, but a bottle nearly always was offered. Thankfully, once I got her home, BF clicked. She BF when she is with me, is bottle fed when I am at work.

She was given formula and colstrum until my milk came in. After that, she was Breast Milk only. One of my biggest temper tantrums was when I came in, and there was formula on her table. The nurse said she had been told I had stopped pumping. HUH???? I had brought in SEVERAL ounces the night before. They were in the Freezer. My baby had been fed formula when there was breast milk in the freezer had the nurse cared to look. I had the doc remove the order allowing formula to be fed to her. I mean, I seriously have a deep freeze half full. There was no need for formula. But this is the nurse who tried to tell me of the "value" of formula.

My Nicu did not allow finger feeding. A wonderful nurse did this, and got reprimanded. No supplemental nursers either, as this would have helped greatly. Once I got her home, off the easy to drink hospital nipple and onto a more BF friendly nipple, nursing got loads easier.

[Periwinkle]

Originally Posted by GatorNNP

In my experience the best predictor of BF success in NICU moms, is sheer perserverance.

and to that I'd add knowing your s*it when it comes to breastfeeding -- reading Newman and others and coming armed and dangerous with research about what your baby needs and why (e.g., ranging from kangaroo care to nursing). As an aside, this can be REALLY hard for NICU moms of preemies, who probably landed there in such a sudden rush of preterm labor or something wrong with mama/baby etc. that they hadn't read any BFing books yet or been able to do any research. It's times like this when it would be nice for your mom or sister or good friend to do the legwork for you (e.g., photocopying articles, etc.)