BF-ing update.. - Mothering Forums
NICU & Preemie Parenting > BF-ing update..
keilonwy's Avatar keilonwy 08:28 AM 12-24-2008
Thank you so much for all the kind responses and encouragement and suggestions in my previous post about successful breastfeeding! Today (yesterday? Yes, yesterday, I guess...it's 5 a.m. here ) I saw a good friend of mine - we were pregnant together, and her daughter was born at term the day before Gwyn. She had some trouble with nursing at the beginning, and we were talking about it. What she did was just stop giving bottles and nursed around the clock, and while we were discussing it, I realized that we could probably do that. He definitely gets SOME milk from me (I hear him swallow it, he'll have it in his mouth if he suddenly delatches), so he definitely wouldn't starve, and we'd figure out our latch kind of by necessity. What I also realized, though, is that I'm terrified of doing that. I've come to associate his weight gain with real, tangible proof that he is healthy. I think there is a bit of my brain somewhere that is scared he will stop gaining weight if I stop giving him the bottle. Like, forever. I feel like my wanting him to nurse is a selfish decision, even though I know it's not...he loves nursing, and often spends his awake time just bopping his head around my boob, latching on a little, sucking a little, and talk talk talking .

Does anyone else have experience with something like this? I feel bad because we could probably be exclusively nursing if I weren't so nervous. Granted, the last time he was not gaining weight was when he got an overdose of vancomycin in the hospital and they told me he could die, so the idea of him plateauing has some pretty awful associations for me.

Thank you so much, mommas!! It's been so, so helpful to be able to read everyone's responses and try stuff out...I think that Gwyn's latch has been helped merely by the fact that we're paying more attention to it now! I love this community and I'm so glad I found it (albeit late...but better late than never?) :.

henriksmom's Avatar henriksmom 03:40 PM 12-24-2008
My assosiation of not gaining weight is not as scary as yours. But when I roomed in the hospital with him, before he was discharged, He lost weight because I was trying to exclusively breastfeed. We were supposed to stay one night and it ended up three. In the Special Care Nursery he never once got a whole feed from br-ing. Also, we associate weight gain with success and when we have to go to the specialist so often we do not want to show failure. It is if we are being monitered for progress. We feel guilty that our bodies failed us in having a premature baby and now we must be "successful".
1momct's Avatar 1momct 05:17 PM 12-24-2008
nak.


I'm not sure you should go "cold turkey" on the bottles. I would maybe do every other one or every third one. or cut back on the amt you top him off with.

I don't know if you are giving any formula supplements (we are giving a 28 kcal formula 2-3x a day 80 mL)

how much are you topping him off with. I personally never gave him more than 80 mL ebm post BF once we got home.

a couple of weeks ago, we got the okay to stop topping him off except he still has to get his 3 formula feeds

You need to remember that our babies aren't blessed with the reserve that term babies have. mine is still playing catch up on his ht/wt, though his head is caught up finally.

but your lo has 3 weeks on mine (25 weeker) so ymmv.
irangel's Avatar irangel 05:53 PM 12-24-2008
I thought I posted on your last thread but I must not have. Cutting bottles out is exactly what we did in order to get my son to start nursing successfully. I didn't have the problem of needing to see weight gain since it had been ingrained in me that plenty of pee equals plenty of food. I knew that he'd plateau/lose weight when we switched over and was prepared for it. It didn't take long though before he was growing again.
BetsyNY 11:38 PM 12-24-2008
You could rent a hospital scale and weigh him before and after feedings...I know some people who have done this.
mommylovesra's Avatar mommylovesra 11:39 PM 12-24-2008
I would ditch the bottles too. Babies don't need "topped off" preemie or not and it will hurt your supply. Give it a try and watch for wet diapers and check weight every few days. Nursing around the clock has worked for me. I have never supplemented my preemies.
1momct's Avatar 1momct 03:39 AM 12-25-2008
Well I know for a fact my son NEEDED to be topped off. He didn't have the physical capability to nurse enough to take in enough calories to cover what he ate, let alone enough to make up the deficit of being pushed to develop for the months in the the nicu vs the womb.

Trust me, if I could have done it, I would have. There's nothing more fun than putting him to breast, giving him a bottle, then pumping, no more than every 3 hours. That was a 2-3 hour adventure every feeding. Plus taking care of a 3 year old.

He left the hospital taking a MAX of 8 mL at a feeding. He was taking 100-110 mL per bottle. That's just not even close. Even if he'd stayed attached to the breast, he wasn't going to do it, and he needed to rest too.

My first didn't have a single bottle for the entire time he was a nursling (self weaned at 2yrs), so I was dedicated and motivated to nurse.


I gave up topping him off as soon as he was even close to capable. I am glad for it.


It still hurts me every time I have to give him fake milk. My pedi knows that I want to get him off it as soon as he is able to do so. But right now he needs those extra calories.

I will be even more glad when I don't have to live by the scale and the growth charts.
irangel's Avatar irangel 05:02 AM 12-25-2008
Quote:
Originally Posted by 1momct View Post
Well I know for a fact my son NEEDED to be topped off. He didn't have the physical capability to nurse enough to take in enough calories to cover what he ate, let alone enough to make up the deficit of being pushed to develop for the months in the the nicu vs the womb.

Trust me, if I could have done it, I would have. There's nothing more fun than putting him to breast, giving him a bottle, then pumping, no more than every 3 hours. That was a 2-3 hour adventure every feeding. Plus taking care of a 3 year old.
I totally know what you're saying. There's a big difference between a micro preemie (I think you said yours was a 25wkr) and a 28-30wkr (I don't remember exactly her baby's gestation). And you're right it's very likely that your son couldn't fully nurse even if you did cut out bottles. An older preemie however is likely to have success with this. My son was a 29wkr and we were able to cut out bottles and he did catch on to nursing. With my 25wkr no matter how hard I tried that was never a possibility. She is still tube fed at almost 3yrs. You run into many more feeding problems with babies born 23-26wks. I don't think anyone said anything to make you feel bad but I thought I would point out the big difference that even those 3 short weeks can make. It's amazing!
1momct's Avatar 1momct 09:59 PM 12-25-2008
Quote:
Originally Posted by irangel View Post
I totally know what you're saying. There's a big difference between a micro preemie (I think you said yours was a 25wkr) and a 28-30wkr (I don't remember exactly her baby's gestation). And you're right it's very likely that your son couldn't fully nurse even if you did cut out bottles. An older preemie however is likely to have success with this. My son was a 29wkr and we were able to cut out bottles and he did catch on to nursing. With my 25wkr no matter how hard I tried that was never a possibility. She is still tube fed at almost 3yrs. You run into many more feeding problems with babies born 23-26wks. I don't think anyone said anything to make you feel bad but I thought I would point out the big difference that even those 3 short weeks can make. It's amazing!
No, I didn't feel bad. I did state that her LO had 3 weeks on mine, so essentially, her experience could very well be different.

It just worries me when people make blanket statements like babies don't need topped off, since preemies can be so very different.

That's why I felt that I needed to be so vehement about how we HAD to, so she needed to do what her baby needs, especially as some babies do need it.
keilonwy's Avatar keilonwy 01:42 AM 12-26-2008
nak!!! :

We are lucky enough to have a visiting nurse who is studying to be a midwife (loooooove her!), who is committed to getting Gwyn breastfeeding exclusively by January and is very very supportive of our goals! Yesterday at our visit (where he weighed 6 pounds, 15.5 oz ), she said that she saw no harm in going ahead and nursing all the time. We're watching diapers, and so far in the past 24 hours there have been ten wet ones!! We've also gotten quite a few poopy diapers which resemble breastmilk poo much more than they used to. I never thought I'd be so excited about what is in a baby's diaper...I must be a Momma now.

Thank you so much for sharing your stories and experience!
1momct's Avatar 1momct 09:11 AM 12-26-2008
:

keep us updated!

nak here too
~bookcase~'s Avatar ~bookcase~ 03:11 PM 12-26-2008
Congrats mama to nak

I had to wait until my daughter was almost 6lbs before we stopped top ups completely; and I was terrified. Actually, 3/4 weeks later I still am. LOL.
Her brother had stopped top ups only 4 weeks after birth (they were 36 weeks gestation by then) but I had to keep tube feeds going in my girl until past her due date ( I've deliberately not remembered dates and figures as far as possible out of defiance to all those wretched charts I had to keep )

Anyway, this is why you really need pro b'feeding, professional support to get things sorted for each individual baby.
mommylovesra's Avatar mommylovesra 03:35 AM 12-28-2008
Quote:
It just worries me when people make blanket statements like babies don't need topped off, since preemies can be so very different.
Sorry I did not realize that your baby was born at such an early gestation and what I said was not directed toward you ((hugs)) I do agree that every preemie is an individual with different feeding needs but I stand by my belief that the majority of preemies once they are strong enough to nurse effectively do not need topped off. Neonatologists will tell every preemie mom to supplement whether it is necessary or not and that can be detrimental to the breastfeeding relationship. A mother's milk will adjust and become richer to add extra calories for her baby. I was told to supplement twice and it was bad advice that I did not follow with no regrets. I would just hate for someone reading and getting an ideal of how to care for a preemie to automatically assume that just because a baby is born prematurely that they have to be supplemented when that is often not the case and they are told otherwise. The majority of doctors including neonatalogist have little to no training in lactation.


To the OP great news! I hope things continue to go well.
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