NICU - Bottled EBM vs. Breastfeeding

[Mama2RMM]

I have an honest question sparked from several posts here and the Dr. Sears Preemie Baby Book. I don't mean to start flames, so please just share your experience or comment on your NICU's policy.

Our girls were born at 32W. We knew they were going to be premature, so I'd done a ton of research about breastfeeding preemies. Everywhere I read talked about pumping and bottle feeding and then how to transition back to the breast. I also read a lot of stories of Moms that never got their preemies to the breast and had to EP. I was determined not to have that happen. I wanted to suceed and knew that with a toddler and two newborns I wouldn't do well keeping up with pumping and feeding.

We simply requested from Day 1 that our girls never receive bottles. They were fed through their NG tubes up until they went home. I was at the hospital for 2-3 breastfeeding sessions per day and I did one 24-hour rooming in stint and one 48-hour rooming in stint right before they came home. We worked with the LC weekly to ensure proper latches and the girls proved they could gain weight solely breastfeeding over the longer durations that I roomed in.

All of our nurses and doctors readily agreed that learning to nipple from a bottle was no easier or faster than learning to feed from the breast. Yet this isn't presented as an option anywhere that I researched. I honestly thought they were going to tell me flat out no when I made my initial request because I'd not read that it was possible to skip bottle feeding with preemies.

Our girls were born at 32W, started latching on for short bursts at 33W, did well by 36W and came home at 37W.

X-Posted to Breastfeeding to get a broader response.

[twins10705]

My NICU was not bfing friendly at all -- when the NP told me that we could try nippling(around 2 weeks after their birth), I asked about bfing and she told me that they would just have to wait and see how they did with a bottle. I got such a runaround about bfing(and there wasn't any privacy really in our NICU plus it was more a pain for the nurses I guess :( ). My babies were never even put to breast until 35 weeks gestation(6 weeks pp). Of course, they didn't know what to do with it! They were used to super fast flow rubber NICU bottle nipples. Everything has been an uphill battle because of this. Although I pumped religiously every 2 hours, I never got a full supply of milk in(about 12 oz every 24). I know that if I had been putting them to breast from the start of their feedings I would have had enough milk and they would have learned to do it just fine. Stubbornly, I kept eeking out those drops of milk for them month after month until one baby stopped screaming when offered the breast and started nursing 5 months pp. He is a pretty good nurser now -- it is still a constant fight with my other baby however. As long as he nurses at least twice in a day I am happy he is getting some, though I am hoping he will want to nurse more as he gets older.
I wish I could go back and say "no bottles." -- though I really doubt that would have gone over well.

[Mama2RMM]

I admire SO much Mamas that have stories like yours because I know what hard work you've had to put into pumping and getting babies on the breast. It breaks my heart that hospitals are not more supportive and it's rarely addressed in literature.

I just can't fathom why there isn't more out there to inform people that it is possible not to bottle feed in the hospital. I was really shocked to find no info here or in the Sears preemie book. I didn't read KKG's book on feeding multiples, perhaps there is mention of it in there?

I posted here since a good amount of multiples are preterm. I know it has to be a hard subject to discuss, and feelings are sesitive if the breastfeeding relationship isn't established as a Mom wishes. :(

I hope even if one person can take away suggesting no bottles in the hospital and save themselves such a hard journey that posting our story is worth it. I just hope it didn't come across as boastful... I certainly am not trying to be "above" what other people have done.

[cdahlgrd]

Hospitals are coming from the other side. . . at least their alive. They don't see anyting wrong with formula or with pumping for mom (because most of them haven't tried it! Especially with multiples!)

Sooo, just remember where they are coming from when making requests. Also, most NICU's see your babies and "their" babies until they go home. When you try to make the rules or be the dominant figure in these kid's lives, it can get nasty (not always, but can).

That said, I agree that we need to keep at the docs and nurses. Eventually, they will catch on about breastfeeding/kangaroo care etc.

As I tell most people, I wouldn't wish my worst enemy a stint in the NICU with her child, but thank God it is there when we need it.

[Nessa's Quiverfull]

My boys were in the NICU for 7 days. I pretty much did whatever I needed to do to get my boys home. I would pump and bring breastmilk to the hospital 3-4 times a day. At first they were being tube fed..and then they were being bottle fed. During the times that I wasn't there to nurse them they would get the bottle. Both of my boys were lazy nursers, so eventually when we got home we switched over to the bottle. I pumped for them for 8 weeks before switching them over to formula. I really wanted to breastfeed them like I had done with my girls..and I was sad when I stopped...I was just to the breaking point and needed some relief.

[Periwinkle]

My twins were 2 mos. early and were tube fed initially, followed by bottle, followed by breast. They could not get enough from the breast to gain weight in the NICU (they barely woke up at all and their sucks were very weak), and did not nurse well until they were about 1 week past their original due date, i.e., when they were supposed to be born anyway. Nursing skills vary a lot and some babies - even barely early, healthy babies who are just born at 35 or 36 weeks - are too sleepy and/or just don't get it togther with nursing until more like 40 or 42 weeks equivalent.

So I guess what I'm trying to say is, if your babies can nurse well enough to thrive then great, but a lot of babies can't that early. So in order to get them the hell out of there (my numero uno priority) you do what you gotta do. :)

After we got home (they came home from the NICU equiv. to 35 weeks gestation!), I worked with an IBCLC who specialized in preemies - she was wonderful and it was due to her knowledge and perserverence that we were finally able to exclusively BF. That happened for us around the time they should have been born anyway.

[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!

[crissei]

:yeah: Sigh... pretty much the same story.

DS was born at 30 weeks. I lived an hour from the hospital and was only able to come in once a day.
The neonatologist actually made me cry, he said I was trying to nurse DS to often.:( I decided that it was best for us to get him out of there by any means neccesary and, then do damage control when we got home.
My only resources were my instincts and this site but, I managed to hold on and DS is still going strong at 18 months.
The ped. was no help either. When I asked for help with getting DS off bottles and to the breast, he flat out said "you won't be able to, I have never heard of a preemie that was exclusively breastfed":irked:

[JoyJoy1975]

My DD was born at 32 weeks and was 3 pounds 12 oz I refused to let them put a tube in her nose. I called a lactation lady up and I BF her from the breast she was out of the hospital in a week. Thats our story she never had a bottle their except at night and it was EBM and the NICU was the easist time to feed her it was when I went home I got bad advice.:dizzy:

[tikva18]

Our hospital wsn't supportive either. I pushed for Gedalya to have the n/g tube instead of bottles, and then they convinced me that if he had bottles it would be faster to go home - and that they had a method which would teach him how to suck/swallow/breathe. So we did that for both babies - gedalya was breastfed solely one week out of nicu and TEhila took a month (until their due date). Our ped was insistent that no one can nurse twins exclusively. HA! She always mentions how shocked she is that they are exclusively nursing.

Oh, and I recently read somewhere (wish I could remember where) that preemies actually do better when they are breastfed rather than bottlefed.

[puffelly]

The hospital and NICU staff were very good.
They tried very hard to accomodate my wishes and we were able to meet half way on all our issues.
Kilian and Bjorgvin were born at 35 weeks.
Kili went to the breast right away and Bjorgvin at two days old.
I requested that the boys had no bottles, although they did receive my pumped milk and formula while they were in the NICU for 6 days.
However, the hospital had an exceptional lactation staff!
When the boys came home, I was diligent about putting them to the breast (using the nipple shields) and pumping afterwords. For the first few weeks they got two bottles of breastmilk and put to the breast, so I could sleep a bit. By four weeks they were getting only the breast and by six weeks we didn't need nipple shields anymore.
I am so proud of them! At seven months they are still bfing like pros.

[tanyaandallie]

My ds was born at 34 weeks. I had given my dh strict orders early on in my pregnancy that if anything happened (premature birth, c-section) that he was to follow the baby around and allow no bottles or formula period. That didn't exactly happen. He started bottles the evening he was born and started bf the next day.

I guess I don't have a huge problem with bottles in general when it comes to preemies. Before my son was born I sort of had the evil-bottle mentality and didn't want my son having one. After he was born I suppose I did some rethinking.

I don't prefer to bottle feed my kids but while he was in the nicu I was simply not able to be there for every feed. Plus he just could not take enough milk in from bf alone. He suck was just not strong enough. It was not until he hit 37 or 38ish weeks that he was nursing well enough to take all feeds 100% nursing. For us the bottle caused no problems and for that I am grateful. I knew that tube feeding was an option if I wanted to skip the bottle but I didn't want to push as I was already the pushiest mom in the nicu (or so it seemed like). Plus as crazy as this sounds, I wanted him to get some comfort when he was feeding. Babies need to suck. Sucking is comfort to them. Since I was not able to be with him all the time and bf him all the time like I would if he were home, the bottle and the paci were there to comfort him. I totally understand the fear that the bottle or the paci will disrupt the bf relationship, but I also would not want my baby screaming in his isolette with nothing to comfort him when I could not be there. Plus, even if I was there, they didn't want him out of his isolette for extended periods so I couldn't have just sat there and held and nursed him all day.

I was allowed to bf once or twice a day and I really had to push for it. The nurses were not supportive at all. They did have 2 really amazing nicu lc that worked strictly in the nicu. I am so thankful for their support!

[boscopup]

Oh, and I recently read somewhere (wish I could remember where) that preemies actually do better when they are breastfed rather than bottlefed.

The NICU LC told me that breastfeeding was better for preemies who are having apnea issues! So when I told her that he was having some feeding apnea, she said "Get that baby on the breast!", and she talked to the NICU staff for me. It was great!

But I also agree with PPs about some babies not having the physical ability to get milk out of the breast, even with the help of the nipple shield. I got lucky. My DS took to it right away (with nipple shield) and his belly was full after each feeding. But alot of babies don't have that strong a suck so young.

I'm saddened by the ped's comment about never seeing an exclusively breastfed preemie though. :( I know several of us here have done it! It *is* more difficult, but it certainly can happen. DS was home at 33w3d gestation, 100% at the breast (with nipple shield). 4 weeks later, we were off the nipple shield. He did get bottles during his stay, and a pacifier during tube feedings. I truly think I just got lucky, but I'm proof that it can be done! But in alot of hospitals, the support just isn't there, both in the NICU and in the regular postpartum units. :(

[Lousli]

But I also agree with PPs about some babies not having the physical ability to get milk out of the breast, even with the help of the nipple shield.

This was my dd. We tried in the NICU, weighing her on a scale before and after nursing, and she just wasn't really getting any milk out. She came home after 23 days but wasn't able to nurse without a shield until she was 3 months old.

But she's still nursing now at 19 months! And nursed exclusively until 7 months when we first added in a bit of solid food. It was a ton of work, but it can be done. I was lucky that my older dd was nursing while I was pumping and my supply was kept up!

[ApplePieBaby]

Mia was five weeks early- we requested no bottles & they syringe or finger fed her my pumped milk when I wasn't there to nurse her- which was only like twice a day. They were very good with listening us about it.
Unfortunately, Elora is in a different (higher level) NICU that's much further away and we can only visit once a day... I don't know what I am going to do when she's big enough to start taking feeds by mouth. Right now I'm pumping about 20 ounces a day though for her. I've talked a bit to them about transferring her to the NICU Mia was in when she needs less critical care, and then I'll be able to nurse her. I think at this point though, with her being 15 weeks early, I am just happy she's still doing so well. I will pump for her & if I have to give her EBM in a bottle, so be it. I just want her to grow and come home.

[jkpmomtoboys]

My ds was in the hospital for 2 months and for us, we had to prioritize our issues. We wanted him to get the hell out of there, and the sooner the better. Our hospital, which is EXTREMELY supportive of bf'ing, has as one of the discharge rules that the babies must be able to nipple all their feeds.

Well, I was at the hospital 12 hours a day, but since I couldn't be there 24 hours a day, I had no problem, and even encouraged them to give ds a bottle of EBM when I wasn't there.

He never had any trouble switching back and forth between nipples and in fact started bf'ing like a champ at 32 weeks.

So while I applaud all NICU moms, there is no one right way and those of us who had longer stays and more complications frequently had different priorities.

[tikva18]

I'm saddened by the ped's comment about never seeing an exclusively breastfed preemie though. :( I know several of us here have done it! It *is* more difficult, but it certainly can happen. DS was home at 33w3d gestation, 100% at the breast (with nipple shield). 4 weeks later, we were off the nipple shield. He did get bottles during his stay, and a pacifier during tube feedings. I truly think I just got lucky, but I'm proof that it can be done! But in alot of hospitals, the support just isn't there, both in the NICU and in the regular postpartum units. :(

You misunderstood my post; the ped wasn't saying that she was surprised about successfully nursing preemies, she was surprised that I was successfully nursing TWINS.

[Happypants]

the first nicu we were at told us we would have to bottle feed first to have ds' latch evalutated, and then we could start bfing normally. luckily, we came back to our local nicu before he was ready to start, and the very day we got back the neonatologist asked me if i'd started putting him to the breast yet. i almost broke down just at the question. anyway, my ds was either tube fed or breastfed his entire time in the nicu, never once received a bottle, and came home bfing with a nipple shield. a week later, he had transitioned to not needing the shield. i am so thankful that the second nicu was as supportive as it was.

eta: ds was born at 26 weeks and was moved back to the local nicu at about 32 weeks. we did a lot of practice nursing where whatever milk he got didn't "count" and he'd get a full meal through his tube. it wasn't until much later, maybe 37 weeks, that he actually started getting full meals bfing. and it wasn't until they quit giving him so much through the tube that he woke up and got hungry enough to get serious about eating! he came home at 38 weeks 2 days.

[CallMeMommy]

Tube or breast 100%, never once got a bottle (or formula for that matter - did get the HMF in his tubed milk, though). I did actually have to lie to the nurses to get DS home, he was nursing fairly well but not good enough for them, so I lied and said he was doing better than he was because I KNEW he'd do fine once he was off their stupid 3-hour schedule (and he did!). If it wasn't for Nurse Judy switching to an old nursing guideline that they weren't using anymore but fit my son better, we would have been in there a lot longer. I read somewhere, and I wish I could find it, that premature babies (as opposed to preterm babies) don't learn to breathe-swallow-suck any faster on bottles than they do breast, and bottling their feeds won't get them home any faster. The nurses at our hospital were more concerned with the quality of the nursing sessions rather than the exact amount of intake he was getting, and as long as he was gaining every day they were happy.

[boscopup]

You misunderstood my post; the ped wasn't saying that she was surprised about successfully nursing preemies, she was surprised that I was successfully nursing TWINS.

Sorry, I was commenting on crissei's post... should have quoted her...

When I asked for help with getting DS off bottles and to the breast, he flat out said "you won't be able to, I have never heard of a preemie that was exclusively breastfed"

That was what I was referring to - a ped that hadn't ever seen a singleton preemie exclusively breastfed.

[tikva18]

I don't know what's with peds:irked:

[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.:dizzy:

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]

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]

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.

[Cyneburh]

we just made an informed parent decision to allow bottles. But it's only part time.

We made that decision because my son was simply not swallowing his milk when I let down in his mouth. He was totally ignoring it and letting it dribble out of his mouth. I called the LC and we talked it over and I decided that a bottle would help teach him to swallow his foods since he was otherwise feeling very full from the NG tube without any work at all. 2 bottles later and he latched on and nursed like a champ.

It was hard for me to approve the bottles because I had a bad experience with my full term dd giving up on nursing after bottle feeding a single bottle. But... in this case it worked.

I will say that our NICU was very good about not giving bottles until I approved it and they didn't even push the issue. I asked about it, they didn't even bring it up.

However... the not bottle feeding all his feeds is causing the neonatologist some concern since he won't finish the full bottle at a feeding. So even though he's gaining 3-4 ounces a day right now, they are concerned that he won't gain if I take him home. (grrr!!!) But they aren't even bothering to weigh him before and after nursing sessions... they're just assumin he's getting enough. So that's all good.

I'm able to get up there for 4 of his 8 feeding times even with two other kids so I feel very confident that if I get him home he'll do great. Now to just get him home!

[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. :happyt:

[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]

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

:nod 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.)