PROM @ 33w4d, breech presentation, currently home AMA--support please - Page 11

[courtenay_e]

SS...as an aside, do you have LLL in your area? I'm seeing some kind of borderline inaccurate info from your LC about premies...and I'd love to see if your LLL Leader might have a different perspective that may help Oscar latch sooner. If you pm me I might be able to help you find a group in your area, if you're interested, and willing to try a different method of feeding until he gets a good latch down...

Oh, and you may see increased input and still not a ton of gain, as bililights tend to make the baby dehydrated (personal experience with that...), but it sounds like he's doing fine!

Looking forward to hearing that he's come home!

[sanguine_speed]

Thanks so much! I will have to look into the LLL. I've never had an easy time breastfeeding, and this preemie business is just way beyond anything I was prepared for. It's going well right now in terms of pumping, and just last night he latched for the first time and suckled a wee tiny bit. He should be coming home this morning and I think having him home will make all the difference. It's sort of tricky while he's in NICU because if they don't take their supplement then you risk them not coming home. It's really discouraging to breastfeeding mothers.

[*jeanine*]

Hoping he's home!

My friend's baby had to spend a few days in a NICU - also not at all supportive of breastfeeding. But once home she was able to give him 24 hour access to a bare breast. He usually ignored it, and was getting bm from a bottle. But when he was 3 weeks old, he latched on and hasn't had a bottle since!!! Don't give up!!!

[courtenay_e]

What I would suggest to to continue to pump, but to use a Supplemental Nursing System to give him any supplemental breastmilk you may need to give him. This will allow him to get the "extra" he mght need, and still cause him to latch on YOU rather than a bottle nipple, which uses completely different muscles. In essence, in order to breathe, a baby MUST swallow when a bottle nipple is in it's mouth. The function of a nipple is such that it automatically puts milk in the baby's mouth, therefore causing the baby to swallow in order to breathe. With the breast, however, the baby must suckel, using completely different muscles, in order to "milk" the breast. This is why some babies who are started on a bottle have a MUCH more difficult time nursing at the breast later...they are simply taught to "get" their sustenance in a manner that won't get results on a breast, and then they can get frustrated when you put them to the breast to nurse.

Statistically, it's actually a LOT less stressful for most babies to suckel at the breast than it is to do the "hurry up and swallow" that they have to do with a bottle. If you would prefer, however, NOT to use the SNS, you could also consider using a syringe or using the tubing from the SNS and finger feed, which is much closer muscle-wise for the baby to become accustomed to "nursing" than bottle feeding is.

Just some thoughts...I know that you've been really focused on the birth and now on getting the baby home from the hospital. Now, if you want to focus on breastfeeding, it would be a GREAT idea to call a Leader tonight and see if they can give you some help. I'm a leader, and could probably find out for you where the nearest Leader in your area is.

You're doing GREAT mama. I hope I"m not overwhelming you with this info, but you've been working so hard, I'd hate for misinformation to sabotage your breastfeeding relationship.

Check out drjacknewman.com he has a LOT of great information, is more than willing to anwser emails with questions, and is all around a great guy, from the experiences I've had with him.

TAKE CARE, and I look forward to reading more updates! :

[Blucactus]

congrats on your little guy! I looked at his pics and read your story on your blog, he is beautiful and holy cow BIG for so early! yay for a strong lil guy!!

[mommyminer]

I second what courtenay_e posts. Babies learn to breastfeed by breastfeeding and moms learn how to breastfeed by breastfeeding. I encourage you to supplement your breastfeeding education you are receiving from the LC with Dr. Newman's information. According to him, there should be no problems with a 32 weeker exclusively breastfeeding and spending most of babies time skin to skin with mom (no reason baby can't be monitored skin to skin). Anyway, I just finished reading his book "The Latch" and there was a great chapter about breastfeeding and prematurity. The rest of the book was great too. I'd highly recommend it. Otherwise, he has a lot of really good information online.

You were strong and wise in your birthing choices - you showed a lot strength through your education and conviction in the path you choose. There is also another path to breastfeeding success than the path you are on now. There is a whole nother school of thought on bfing and prematurity that I encourage you to educate yourself on.

[sanguine_speed]

Originally Posted by courtenay_e

You're doing GREAT mama. I hope I"m not overwhelming you with this info, but you've been working so hard, I'd hate for misinformation to sabotage your breastfeeding relationship.

Check out drjacknewman.com he has a LOT of great information, is more than willing to anwser emails with questions, and is all around a great guy, from the experiences I've had with him.

TAKE CARE, and I look forward to reading more updates! :

No, you aren't overwhelming me at all. I really appreciate the help. There are so many things i've learned on MDC from generous mamas like yourself who have taken the time to help. I will definitely be looking into the SNS.
What do you think about nipple shields to help "latch"? I have flattish and biggish nipples and this really seems to be part of the problem. He does try, but his little mouth is just so...little.

[sanguine_speed]

Well, I've just gotten in touch with LLL who suggested I try a SNS but that I buy from a LC because I'll get a mini consultation along with it. I called the LC and signed up for a 2-hour consultation! I hope that she can come this afternoon...it might be tomorrow morning. I hope this helps. My pocket book is already hurting from all the expenses associated with this...the doula ($650), the parking at the hospital ($100), the bottles and pump (a lot), and formula to top up his feeds. I'm so grateful and fortunate for a 'free' midwife through public health insurance. At least I didn't have to pay for my birth nor hospital care (at least not directly).

[flapjack]

Hang in there. Kangaroo care has worked really well for some of the early babies I know, and they've had strong breastfeeding relationships further down the line.

[mommajb]

It does add up doesn't it? Think in terms of avoiding even more medical care down the road with a happy, healthy breastfed baby. It is less expensive than all formula and doctor visits and medications that you might encounter if not breastfeeding. The SNS is a great way to get your baby the nutrition he needs while stimulating your breasts to produce milk and teaching him to latch well.

and hang in there

[forestrymom]

Sanguine--I just posted on your thread about getting a preemie from the bottle to the breast. I also posted a link to the LLL preemie info...there is some great reading there. If you need more specifics, because you are limited on websurfing time, let me know and I can dig it up. I am certain I have more time than you right now .

Here are some more LLL links...
Nipple Problems
Nipple Shield...Friend or Foe?

Nipple Pain: Causes, Treatments, and Remedies

While the information out there on nipple shields is generally negative, there may be some situations where it can save a breastfeeding relationship. Also, be sure that the LC you are seeing is IBCLC if at all possible. I had bad information from a LC that was not, and I didn't know any different. Thank goodness I found LLL...or we would be bottle feeding for certain!

[sanguine_speed]

Thanks mamas

Yes, I just had a 2 hour consultation with an IBCLC today and it was so useful. You always (or I always) heard that nipple shields are "bad" but she evaluated his suck and palate and said he really does need one to be able to feed at breast right now. Latch will come next. Off the bottle comes first. So, we did a great feed, and she did a pre and post weight, and he took almost 30mL from breast at his first feed! So we're off...

The only downside is it actually seems that pumping and bottling takes half the time. This feed took a good hour, and by the time I got dressed, got him changed and cleaned up he was fussing again. the LC said "oh, yup, it's been a couple of hours; might be time to feed again" : . I'm imagining this tonight. Dear heavens. I have a hard time falling asleep again after waking and always have. Sounds almost like sleepless nights altogether. It does get easier, right?

[mommajb]

Yes it does get easier and he will get better at nursing.

Who is helping you with your daughters and other things? Is your dp home or back at work?

[artgirl]

Yay! Congratulations on a good feeding!! That is great news.
FWIW, I had to use a nipple shield to feed my dd. I never could wean her off of it but I think I'm the exception to the rule in that department. We nursed for 16 months anyway and I was thrilled to have done so.
You are working so hard for this baby. I hope you have lots of help at home.

[forestrymom]

Great news on the LC! I have generally agreed with that theory...breast first, then latch. Remember to work on correct latch even with the shield though...don't let him get sloppy. It will help your supply to make sure he is latched on correctly even with the shield, but since he's used to an artificial nipple, it won't feel as foreign to him. As for the length of time, many newborns who are not preemies need that much time for nursing, so its not just a preemie thing.

We used a shield in the beginning to get dd back to the breast. We had given her a bottle because I was so engorged and the LC I talked to said it couldn't be mastitis and it was, and I was sick, and weak...and gave her bottles for an entire weekend. Of course, she liked those better as it was easy to get milk and she didn't have to wait for a letdown. So we had to trick her with a filled up shield . She was off the shield at 2.5 months, but it took a lot of work. My sil fed her 32 weeker with a shield for 6 months and then gave up bfing altogether for reasons not associated with the shield.

Great job Mama!

[sanguine_speed]

Originally Posted by mommajb

Yes it does get easier and he will get better at nursing.

Who is helping you with your daughters and other things? Is your dp home or back at work?

Well, I was working full time (and planning to finish in a few weeks) when this babe came early, so the kids still have ft daycare (a godsend right now). DP can be home another couple of weeks. We are in a fortunate position right now given the circumstances.

[courtenay_e]

The upshot with breastfeeding is that once the baby is a little older and you get the sidelying "hold" down, you can sleep while he nurses at night...no bottles, tubes, mixing or warming anything, you can just take the breast out and go back to sleep. Look forward to those days...they're what kept me going when my kids were itty bitty and couldn't latch on their own yet at night. But, yes, it SHOULD come easier as time goes on! Oh, Get thee a sling, if you don't already have one. It makes it seem a lot less constricting to have a baby whose nursing style is leisurely (and actually, that's a pretty normal pattern, even for a non-premie!)...too, it makes allllll the skin to skin time that you should be taking right now easier on your arms and on your other kids.

[MOMGOTSPUNK]

Thank you so much for sharing your story, it is an encouragement to other mama out there! Thank you for your strength! : Congratulations!

[sanguine_speed]

Originally Posted by courtenay_e

TOh, Get thee a sling, if you don't already have one. It makes it seem a lot less constricting to have a baby whose nursing style is leisurely (and actually, that's a pretty normal pattern, even for a non-premie!)...too, it makes allllll the skin to skin time that you should be taking right now easier on your arms and on your other kids.

They actually told us not to use any kind of baby carrier at the NICU. But, I think with some good sense, and considering he's equiv of 36 weeks now, I think it's a good idea. We do have a Maya lightly padded ring sling and a Moby wrap. Good thinking and thank you thank you thank you!

He's actually having a good break right now..i.e. sleeping for 2 hours. I spoke with the LC and she's suggested limiting his nursing sessions only in the sense that he's not actually nursing the whole time he's at breast. So, if he's there for 30+ minutes, I do recognize that he's not eating that whole time (Not because of the time, but because of his sucking motion and his not swallowing). I don't mind non-nutritive sucking, but I do when it goes on for hours and I'm exhausted and not able to lie down to nurse.

[junamoss]

I don't have much to offer but support! Take care and good luck with the breech. A provider who can manage a breech delivery makes the difference, and there are so few out there!