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Why won't my NICU baby take his bottle?

post #1 of 11
Thread Starter 
My son was born when I was 6 month & 1 week pregnant. He had the typical NICU things to resolve, but has done pretty good. He weighed 2 lb. 4 oz. and now weighs 5 lb. 2 oz. Due to his being so early & other factors, I was not able to pump, so when he was ready, he went on formula via a g-tube. He is now almost 2 months old, and still in the NICU but in the special care nursery. For the past two weeks they have been trying the bottle. It has been a struggle. Also, for the past 2-3 weeks, he has been very gassy with some stomach cramps and some constipation. He will take some of his bottle and stop, and they have to pour the rest down his tube. I talked to the doctor about him being so 'uncomfortable' with his stomach problems, and he agreed to switched my son to his 'going home' formula. The first formula was high in extra nutrients, which he needed during his first couple of months. He definitely seems more comfortable. But last night he just lost interest in his bottle, after taking a little bit. Has anyone dealt with this before? He is about 36 weeks gestational age right now, and I've heard that it could take him up to his due date of Nov. 8th, to really catch on......Or would anyone know of any other reason he doesn't like his bottle.....has the stomach cramps and gas and constipation? He doesn't always have the constipation.....some days he really fills his diaper with no assistance. He has to be able to take all his feeds by bottle before he can go home. Any helpful tips? It is always something to worry about with a baby in the NICU. Surely we can overcome this too?????
Sandy
post #2 of 11
What kind of formula is being used? You might want to try a different formula if he is getting crampy and constipated. Maybe something really elemental like Alimentum or Nutramigen. Or Elecare if he is dairy/soy allergic. Has he been tested for allergies? Reflux? Motility issues?

Is he tiring out? Has he been seen by a speech therapist to evaluate his suck, coordination, and stamina? Those are other things that could contribute to his not wanting the bottle.

If he has a G-tube, why can't he go home with that? Tons of kids do...it's no big deal at all.

Sorry to ask so many questions...I hope you get this sorted out. (((hug)))
post #3 of 11
Thread Starter 

Why won't my NICU baby take his bottle?

Thanks Susan for the tips. I wrote down the names of the formula....and no we haven't had a speech therapist look at him, which is a great idea. He does take some of the bottle, but sometimes he just seems to tire out :. He has had two blood transfusions during his 7 weeks in the NICU, along with many a's & b's (was on caffeine for these); has had a lot of desats, IVH grade I - resolved on its own; Reflux (was on Reglan); Jaundice X2; Was on the CPAP, then the nasal cannula and now is off all oxygen; On the upside, so far he has had no infections :, his eye exam checked out o.k., He is gaining weight, and has had no residues in his stomach from his previous feeding (bottle or tube). They check before they do each one. So he is digesting. We are so thankful that he has come this far with no 'major happenings' because a lot of his little 'roommates' have had some rough days. Thanks again for your advise. It helps to have someone to listen who has been through some of this. We lost a little boy last year due to being stillborn. I was exactly 8 months pregnant. A very devastating time for us. So this time, we are sooooo anxious about everything, but trying to remain optimistic and positive. We have no other children.
Sandy
post #4 of 11
Welcome Sandy and congrats on your new baby boy!

I remember my dd Maggie had issues taking the bottle as well as having As and Bs while doing so. Right around her duedate (we took her home 2 1/2 weeks before that) she just sort of picked it up and it was much easier as the weeks went on.
post #5 of 11
Hi,

post #6 of 11
Quote:
Originally Posted by twins10705 View Post
Is there any reason why the hospital did not put him on banked human milk for at least the first couple weeks of feeds?? I believe all insurances cover that milk for micropreemie NICU babies. It is really irksome to me that they just put the babies straight on formula like that.
Unfortunately, alot of areas of the country don't have access to a milk bank. I had looked into it when DS was in the NICU, as I had more than enough milk for him and would have loved to donate some. But even if I'd been able to find someone personally to donate to, the NICU won't take it if it's not the baby's mother's milk, since we have no milk bank here.
post #7 of 11
Sandy,

I hope he starts doing better with the bottle. Overall, it sounds like he is doing awesome!

I second the breastmilk idea...we are actually thinking of going that route with my NICU-grad (she's now 3) because right now she is 100% dependent on TPN (IV). If you can try to relactate or try a milk bank that might make things easier for your baby's tummy.
post #8 of 11
My baby also was not very interested in bottle feeding until very late in her NICU stay. She was not finishing bottles up until they sent her home (with an NG tube). We started bottle feeding at 33 weeks and she went home at 39+ weeks. She would often take too long to take a bottle and then nurses would tube feed her if she went ove the "time limit." She had the tube until about 3 weeks after she came home.

The anemia and the a/b's might have something to do with it. They tire out so easily. Also, some babies are just not developmentally able to handle the suck/swallow/breathe until later (closer to their due date).

You can try to relactate, if that is something you're interested in. In which case, I would recommend getting some help from an LC, nurse, or someone from LLL. I had tremendous issues with pumping in the NICU as well, and almost quit many times (I had two lactation consultants even tell me that I wouldn't be able to pump enough to matter, so I should just quit.) The breastmilk may help with the consitipation/gassiness issues, which may in turn make him more interested in bottle feeding. But if the problems are developmental, they'll resolve in time. 36 weeks is still pretty young, especially to a baby that was born as early as yours. I know it's hard, but it will get better in time.

Good luck, and hope this helps!
post #9 of 11
Welcome! Your little boy sounds like he's doing great.

I second (third?) the recommendation for talking to a speech therapist. They may be able to give you suggestions or exercises to do with him that might help.

And re: the banked milk thing - our NICU does not do that either.
post #10 of 11
my son also had what seemed like a slow start with getting with bottle thing. He also had reflux . As far as formula goes he was on neocate for a while. I did some research and switched him to a different bottle instead of using what the hospital provided. We switched to Dr. Browns bottles and he seemed to do much better. With the hospital bottles he seemed to go really slow then of course would get tired and/or run out of time. He was also spitting great amounts back at times. I wondered if he would go slow because it was uncomfortable? Anyway I dont have any hard prove but he absolutely took his bottles better after switching. I bought the wide neck because I was also planning on nursing. The bottles are a bit expensive and harder to clean. I left the brushes at nicu and would wsh bottles myself and also bring them home. The nurse were also really nice about it would wash them as well...I didnt want them to something else to do so i would try and do it my self. I hope you find something to work for you I know how feels to want to do ANYTHING to get your little one home!
post #11 of 11

slow to nippling

Sandy,

try not to worry just yet. Some babies are slow at first, and possibly just not quite ready yet. The corrected age is important, but remember that neurodevelopmental delay is very common in preemies especially depending on how sick they are at the start etc. Even 3-4 days can make a big difference in feeding readiness and ability. For your preemie baby to be able to tolerate nipple feeds they have to be able to handle a lot of stimulation from vital signs, diaper change, checking tube placement with cold stethoscope, change of environment if they are still in isolette/incubator etc. This is a lot of work for a premature brain that should only be dealing with a warm, dark, baby womb and a dampened mothers voice. Don't get discouraged yet! Sometimes partial feedings by mouth/some by tube go on for several weeks, there is no need to push and let the baby set the pace.
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