Nursing a NICU baby?

[Lousli]

Hi,
I'm wondering if anyone has experiences with this? My first was 36 weeks, and came home with us right away. She had a bit of trouble latching at first, then got the hang of it, and is still nursing now.

I just had my second 12 days ago (7 weeks early). She is latching a little, but gets tired very quickly, and doesn't seem to be getting much milk from me. She is still on tube feedings most of the time, with a few breast or bottle feeds (expressed breast milk) during the day.

So, I have some questions. First of all, I usually pump about an hour or 90 minutes before going in to the nursery. Am I leaving enough milk there for the baby to get some, or should I try to feed her when my breats are more "full"?

Secondly, one of the nurses (who I admit I think is full of it) told me that when she stops nursing "recreationally" and is better at taking a bottle, that we should introduce a nipple shield so that she can compress more of my nipple and get more milk. She says the baby's mouth is too small right now to compress enough of my nipple to get milk. But it seems like she's latching to me, she just gets tired out quickly. It seems that by the time she is better at taking a bottle, she will also get stronger and more alert and better at taking the breast. I don't want to get her used to the feeling of plastic in her mouth at every feeding! I can't go to the hospital for every feeding because I need to be able to take care of dd#1 as well, but I really want her to learn to nurse.

And finally, any tips in general for nursing a NICU baby? I know that some people feel that she should never get a bottle. That isn't really an option for us. If she isn't nipple fed exclusively, she can't come home. While she still isn't ready to breat or bottle feed exclusively at this point, when she is, I want to be able to bring her home. As I mentioned already, I can't be at the hospital for every feeding, so I'm okay with her getting some bottle feedings (it's better than a tube) while she learns.

Thanks!

[DaryLLL]

Congratulations on your birth!!

You must be feeling very overwhelmed. I hope your dd is in good health.

It is fine for a premie to have a bottle. Once she is stronger, she should be able to nurse right at the breast. I don't see why a nipple shield would be neccessary. Assess as you get to it.

Actually, I highly recommend you be seen by a bd certified LC (IBCLC). The nurse who mentioned she is nursing "recreationally," is, as you say, full of it. Your baby is nursing and getting vital practice!

With an LC's help, using a SNS might work for you, as she is latching on. That way she can get a supplement (your EBM) while she nurses.

It should be fine to pump an hour or so before a nursing session.

Good luck. Keep updating! :hug

[flminivanmama]

:hola:

IMO most important is that you get the baby home. also IMO any initial problems can be overcome later. so you understand where I'm coming from ;)

Since every feed needs to be by mouth before they'll let her come home don't stress about how she's doing. Just let her practice and do plenty of Kangaroo Care.

You may need a nipple sheild or you may not. I did but we were off it and nursing exclusively within three weeks of them coming home.

she is not nursing recreationally - she's nursing. period.

you always have milk - especially with a newborn - so don't worry about being empty. plus if you recently pumped she's probably getting more hindmilk anyway, which is good :) Besides a very full breast may overwhelm her or tire her out more... depending on your let down.

try a nipple sandwich and breast compression to get more breast and more milk in her while you are nursing.

are you seeing the hospital's IBCLC? Mine met me at the NICU at 2 pm everyday. If you can that was a great arangement....

:thumb

[DaryLLL]

flmini,

You speak from exp. I forget, do you have twins or triplets?

I looked at yr profile and I see yr b-day is Aug 5. Mine is Aug 6! :D


BTW, here is another current thread on going from pumping to nursing:

http://www.mothering.com/discussions/showthread.php?t=231898

[sg784]

dont have any advice really except to say congrats and Good for you for sticking with this, and trying so hard to give your baby the best. :thumb
I second the ibclc advice. They are really helpfull.

[flminivanmama]

Darylll I have twins who were 29 weekers :) they are almost FIVE

:hola: fellow Leo :D

[khrisday]

I have experience :)

My dd spent her first three weeks in the nICU, the first week on a heart/lung bypass machine. She wasn't a preemie, but she was very sick.
I would also recommend seeing a good lactation consultant who is familiar with preemies.
I would think if she's latching, a nipple shield woudl not be necessary. But of course, if that becomes necessary you can always try one. I woudl also maybe hold off a bit on the pumping before nursing her. But that's just me, and I have a pretty powerful letdown which woudl maybe create it's own problems. I was just thinking she may not get so tired if you are letting down more while nursing.
Lastly, I just want to commend you for your efforst during this trying time for your family. You will work things out, and soon you will have that precious baby home. :love

[schatz]

Got to chime in here as my 34-weeker just turned TWO on Saturday :carrot She also nursed to 22.5 months!

As you have said, the nurse is full of it. Set up an appointment with an IBCLC ASAP to come when you plan to try to nurse. When my dd was in the NICU, I would try to nurse her first for a feeding per day. The previous pumping would have been 2-3 hours before that (but I don't have a fast let down and wasn't ever really engorged at that point). The nurse would weigh dd, we would spend some time nursing, they would re-weigh her and we would finish the feeding with tube or bottle. I would then pump. Don't worry about nipple shields now. And, as long as your dd is getting the breast sometimes and also other skin to skin contact, she'll learn to solely nurse later. You need to get her home.

My dd was in the NICU 10 days, off the NG tube at 4 days. She had numerous bottle feedings. I continued doing 1-2 feedings starting at the breast with the rest bottle after we got home. When dd was three weeks, a nurse friend who runs a moms and babes group asked me if I wanted a bfed baby who had a bottle sometimes or a bottle baby who bfed sometimes. I was a little wishy washy at that point but I said "bfed baby". She said, "well, your dd is 7 pounds now, put that kid to your breast" (in a very nice way with other advice). So that weekend, I just hung out on the couch and in bed with dd in my arms and nursed all the time and she got it.

After you're sure your dd is latching well (my dd had a small mouth too) and she's a little stronger, then you can worry about keeping her awake for feedings. I used to partially undress dd and move her arms around to keep her awake. It took her 45 min for each feeding for many weeks.

Hang in there! You're doing a great job. Attitude and determination can overcome many obstacles. :thumb