Was it a transition from bottle to breast? (x-posted in BFing)

[momtoafireteam]

HI Everyone,

My DD3 was born on the 14th at 35 weeks. She had double pneumonia and was unable to breathe on her own and spent 8 days in the NICU. For 6 of those days she was fed through IV since she was on CPAP, the other 2 days she drank EBM from a bottle. She did BF when I could get to the hospital, but 75% of feedings were from a bottle.

I am trying desperately to transition her solely to the breast, but its quite hard. She has a very lazy suck and either gives up when it isnt pouring down her throat or goes to sleep. When she is asleep, she is ASLEEP. No amount of undressing, tickling, waking up works. She does latch great and knows what to do...

Since I am so scared she isnt eating enough from the breast (she clearly isnt, she maybe sucks about 10 times total before quitting) I end up giving her a bottle of EBM after which still takes her a good 45 minutes between naps and her lazy suck.

She still has bad jaundice and is only 36wks 2 days GA today. Will her suck improve over time to make it easier for her on the breast? Am I doing something wrong or should I keep offering the breast but giving EBM from a bottle til she picks up strength?

[Lousli]

Premature and preterm babies are often very difficult to establish nursing with, and bottles can sometimes complicate this as well. Often, preemies don't really "wake up" and nurse vigorously until around their due date or slightly thereafter. Different mamas here have had success with a few different things. Personally, both my 36 weeker and my 33 weeker did better at the breast (at first) with a preemie sized nipple shield. I know others here have used a SNS to help with this issue.

Some thoughts:
Set up an appointment with a good lactation consultant
Contact your local LLL and see if they have any resources
Check out Kellymom.com for her section on nursing a preemie
I think there are some books out there as well, you might want to look into a book about preemies, like the Dr. Sears book or Preemies: An Essential Guide or you might find some LLL publications that would be helpful.

Best of luck! It was a long struggle for us, to be honest, but I ended up nursing my oldest for 4 years and my youngest is 3 now with no signs of stopping. I hope this helps somewhat.

[beth144]

i'll take a minute to share my experience. my 28 weeker was also very sleepy and difficult to bf when we brought her home at 36 weeks GA. she was only nursing 3x a day followed by supplemental bottles of bm. i tried several things including an SNS, but the nipple shield really worked for us. things got a lot better around her due date and she also weaned herself from the nipple shield at that time also. keep trying to add nursing sessions based on you little ones cues and alertness. definately get in touch with a lactation consultant with preemie experience. even a phone conversasion could be helpful. good luck!

[bitobsessive]

My 30 weeker also had issues with being too sleepy to nurse. We used a preemie sized nipple shield (16mm) until right around his due date. I offered the bare breast first, and if he didn't take it, I put the shield on. We also had problems for awhile with a shallow latch, but that corrected as he grew.

[averymybaby]

What type of bottles are you using? Are you using something with a nipple shape that is comparable to yours? Try getting as close to the size and shape of YOUR nipples as you can and she'll have an easier time going back and forth. A good place to start is Playtex Natural Latch.

We tried nipple shields, etc. but in the end, as she was getting closer to "getting it," I got a scale from a lac consultant and made her wing it. That way I could weigh what she was getting at the breast. If she didn't get enough over the course of a few feedings we topped off with a bottle as needed. Following her lead for a few days, literally glued to her in my house, we figured it out together and she figured out she could nurse as much as she wanted, whenever she wanted. No more waiting for a bottle and being forced to finish 4 oz. or whatever, she loved it eventually! That'd be my biggest advice... nurse her on demand as much as possible. If she even looks hungry, give her a boob! You say she latches great and knows what to do - let her do it! If she falls asleep, it's ok - she's big enough now, she will wake up when she's hungry again. If it's in 10 minutes, fine! Put her back on. I see you have older kids and it can be hard to juggle - but if you can even get someone to help out with them for a couple of days, and let you just focus on getting the rhythm with your DD, you can be 100% successful.

You ask -will her suck improve? YES - if you give her ample practice at it. Letting her laze it out with a bottle most of the time won't improve her breastfeeding of course. We had to learn that too. But this is where getting a bottle nipple that's closer to YOUR anatomy can also help. That way there is less difference in how she has to "work" the 2. And something that is closer to you, like the Natural Latch, will be a little harder for her to work anyway - which is the practice she needs to eventually transfer full time to you.

You ask - are you doing something wrong, NO! Should you keep offering the breast - YES, if she knows how to latch, for every feeding offer her the breast first. No bottles first! Seriously look into getting a scale so you can weigh her before and after feeding so that *you* can be assured of what she's taking in from the breast. Most of the time your insurance WILL cover the cost of a scale.

It took my 30 weeker 3 months to learn to nurse exclusively. Now, she was in the NICU the first month, but still, 2 months after we were home. It was a long road but very worth it. Keep sticking it out - it CAN work! Perserverence is the key here. If your goal is exclusive breastfeeding, then it can 100% be done - just keep your goal in mind at all times and think about how you're going about things. You know your baby best and what she can and can't do right this minute, but I promise you, you can get to the point where you are exclusively nursing her. If I did it, anyone can.

[crazycat]

My 34-weeker (now 6 months, 17 pounds) spent 3 weeks in the NICU and didn't really wake up enough to nurse effectively until his last several days there. I was advised we would need to supplement at home, but honestly once he was awake enough it all just clicked for him and I never did have to supplement. He would have been around 37 weeks GA at that point. In the NICU he would latch beautifully but fall asleep after taking only 4-5 cc. Trying to wake him up to force any more into him just caused him to brady so we stopped pushing him and stuck with the NG for just over two weeks. He also had a good week to 10 days of jaundice, which made him all the sleepier. We did not have to use a nipple shield at all, but I would have in a heart beat if needed. In fact, my 3-year-old FT son who spent four days in the NICU and developed a terrible nipple aversion (would scream bloody murder at the SIGHT of my boob ...) finally switched to exclusively breastfeeding at about three months after we started using a nipple shield ... sure wish I would have tried that sooner with him! So if you think it would help, don't be afraid to try the shield, but either way exclusive breastfeeding is definitely possible!

[mousebandit]

Wow - this thread is exactly what I was looking for! We're in the middle of the same thing right now. I just got off the phone leaving a message for a LLL leader! I can see that I need some help! Hubby also had me order a scale - it should be here tomorrow. It's probably in my LLL book - but what does the nipple shield do? THey had me trying one in the NICU with the SNS tube, but I thought it was just a way to hold the SNS tube in place. How does it help otherwise? I'll try finding some of those playtex bottles - they gave us a gerber bottle in the NICU and suggested we only use those (they're some different kind of nipple, I guess). I'll be watching this thread - thanks for starting it, and for all the replies!

Tracey Mouse

[justmama]

It's hard. Really it is. They take so long to wake, and they take forever to nurse. My 33weeker is now nearly 5 months and her latch is still horrible. But I console myself with the fact that she's HUGE(14.2lbs) and obviously getting what she needs. My 34weeker took probably 2 months to really start to figure it out and gain weight well. She was so sleepy that I had to put her in the sling and literally NEVER take her off(but for a shower) and walk around shirtless letting her nurse for less than 5 minutes every 20minutes to half hour. It was SO stressful and ridiculous but around 2- 2 1/2 months she started spacing out her feedings and staying awake longer to nurse. It took incredible willpower not to pop her on a bottle of formula but it was worth it. She nursed until 22months successfully.

[mama2karli]

My 31 weeker took about 3 months to learn to nurse. She would barely drink anything even by bottle; it turned out she had pyloric stenosis but it went undiagnosed for months as she grew smaller and smaller (and NICU nurses were force feeding her at night, ugh)

I found a nipple shield helped a lot with her latch, what eventually worked was going to my parents one night and forgetting to bring any EBM or pump etc - it was a last second thing - and i was forced to nurse her all night and she got it pretty well then.

And now she is almost 4 and no sign of giving it up yet