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#1 of 6 Old 02-19-2013, 10:14 PM - Thread Starter
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My third child was born at 34 weeks weighing 5lbs 2oz 17.25in.

She is now after three days in the regular NICU in the "progressive care nursery" portion of the NICU.

Day one they were concerned about her blood sugar but that quickly corrected itself.

She has had no jaundice. Didn't need to be under the heat lamps for any significant period of time. No breathing problems. No blood pressure problems. She has not been on any monitors since day five at which point we found out her O2 monitor was only left on for the nurse not because they were worried about anything for the previous two days.

She has a gavage tube because she won't stay awake long enough to eat.

I have no experience with NICUs even though my first child was born (albeit 12 year ago at a different hospital) at 35 weeks - 5lbs 10oz. 17in. An hour under the heat lamps. A little jaundice on day two that was cured by doctor prescribed sitting in the sunny window - he was never in the NICU.

I am being told that she doesn't have the strength to suck hard enough to nurse. I am pumping enough for two days now that she is fed all breastmilk but they are mixing it with HMF.

Today she nursed for a bit and actually got 10 ML we think (used the gavage tube to see what was in her tummy).

She is fed 41 ML every three hours. They try and bottle feed as much of it as possible until she tuckers out. The rest is given via gavage.

She was born on 2/13. They tell us she will be here for a couple weeks.

I have no idea if this is normal, necessary, etc. I wonder if she was at home if I couldn't just nurse her more frequently.

I don't know who to ask for unbiased advice.

I want her to come home but I want her to be healthy of course.
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#2 of 6 Old 02-20-2013, 06:45 AM
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Generally, they want the baby to take all feed by mouth before they send them home - if they don't have sensors on her, that's probably what they're holding on to her for (assuming she's maintaining body temp okay - is she?). 


As a former NICU mom (DD born at 32w4d, 4lbs., 3oz.), I'd want a plan.  What are they doing to move towards the goal of feeds by mouth?  How many calories does she need?  Would more frequent feeding help?  What does the neonatalogist say?


It's not always possible to address the question of sleepy feeding by just feeding more often, and nursing from the breast takes more energy then bottle feeding, and a lot more then gavage feeding.

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#3 of 6 Old 02-20-2013, 01:59 PM
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Another former NICU mom here, and I'm sorry you're both going thru this.

If you took her home and just nursed her 24/7 she might be just fine. But they don't know that. I think the NICU can be like a purgatory- just waiting and waiting... Sometimes the babies need it, sometimes I honestly think the place is just trying to avoid liability by playing it very very very safe. greensad.gif

I would talk to the head neonatologist (not just whoever is on call) and find out the bare minimum for your baby to come home. For example, taking all food by mouth for 24 hours. (Your baby sounds pretty good otherwise, from what you said!)

Then stay with your baby as much as possible, do skin-to-skin, and try to enjoy them despite the circumstances.
Move in if you can. smile.gif

Get good nurses. Don't be afraid to request certain ones, and refuse to allow others. Do all the care you can- baths, diapers, weighing... Jump in and take care of your baby. Be really nice, but firm when you need to be.

Maybe lactation could set you up with an SNS and they would let you go home that way..? Worth a try.

Soon, it will be over. It is so hard though. (((Hugs)))
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#4 of 6 Old 02-21-2013, 05:03 AM
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It can be hard to offer advice, because every NICU operates a little differently.  Everything you are describing sounds normal to me-my daughter spent a couple extra weeks in the NICU because she had trouble learning/getting strong enough to feed.


Like the pps, I would suggest talking directly to your baby's doc.  Even better, if you can sit down with the whole team involved in your daughter's care, including a hospital LC.  Make sure that you are very clear about your goals: breastfeeding and getting baby home.  Unfortunately, at first, these goals may be at odds with each other, but the NICU team should be able to support you in breastfeeding as often as your baby can tolerate it, while also making sure baby is feeding enough to get home.


Is a hospital LC coming to work with you in the NICU.  That is something I would definitely suggest.  For my daughter, the LC helped give the docs a better sense of where my daughter was with breastfeeding, which made them more comfortable that she could safely go home.


My baby was primarily bottle fed in the NICU, with two or three bf sessions a day, but she was able to transition to primarily bf when she got home.


Good luck to you both, I know it is a hard time.

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#5 of 6 Old 02-25-2013, 09:07 PM
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Previous posters are all right on.


My DD was a 27 weeker, in the NICU for 80 days (discharged 1 week before her due date).  I am not a NICU nurse, but am a healthcare professional, and am maybe as close as you can get without actually having specialized knowledge in the NICU field.  Knowing a lot, having experience, etc doesn't really help much.  Let people know your goals and concerns, and ask what the next step is.  But beyond that- I think it's important to realize that you are an expert in skin to skin care, providing breastmilk, and being a haven of mother-loving to your baby.  It isn't your job to become an expert or to supervise what the staff does (yes, ask questions if something feels wrong, but also have some faith that they have your best interest in mind, until/ unless proven otherwise).  I know I'm biased.  I've "drank the koolaid" of the health care world.  I trust that even though the NICU staff made my life miserable in some ways, that they did their job well.  Very little about the NICU world is "normal newborn stuff."  If this was all about being natural, your baby wouldn't survive.  It will all feel sort of wrong.


To be specific about some stuff- my DD actually went home with an NG tube.  My husband is a stay at home dad so he had to learn how to place one.  We were able to stop using it after a few days at home, and feeding her hourly was the only way to get enough into her, and it was about 1 month before she was eating like normal, and she never was willing/able to breastfeed (due to an oral aversion) so I pumped for a year.  But it was only once she was a giant, healthy baby, and we had been doing the NG tube feeding ourselves,and they had tried everything to get her eating, and everything else was totally fine, that we were allowed to go home with the NG tube.  Feeding more often is more tiresome for a baby.  There isn't an easy answer.  34-35 week babies are not supposed to know how to do this functionally yet.


I don't know exactly what went wrong, or right, or whatever, with my experience.  You make the best decisions you can at the time, with the information you have.  Maybe some of the NICU practices caused her oral aversion and her inability to breastfeed.  But without the NICU she would have died.  Having a child in general seems to be a game of doing your best and knowing that mistakes will be made.


It is not wrong to go with the flow.  Find the balance between your mothering instincts and questions etc, and the fact that these are all professionals who have done this a million times and know what it takes to get a baby home.  Win the war- get your baby home- and don't get too caught up in every battle.  Or, maybe this is all wrong, but it's one viewpoint.  


Babies are smart and resilient.  She'll be great in the end.  

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#6 of 6 Old 03-01-2013, 10:12 AM
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I am a NICU nurse for years and have worked in many units. The one I am in now is my favorite by far because its soooo holistic and promotes breastfeeding (not just pumping) which is a rarity. In our place, I've helped create all new policies: if you want to breastfeed exclusively, your baby will literally never get a bottle. You must be there to nurse at least half the feeds in 24 hrs and then 100% if the feeds the last few days. It's called "tube to breast". If baby sucks vigorously 0-5min they get a full gavage/tube. 5-10min=2/3
Feeding, 10-15min=1/3 feeding and 15"+ is no supplement. They will get the fortified milk in the tube and sometimes go home without needing bottles but occ get 2 bottles a day of fortified milk. I can totally pm anyone who wants to learn more about this!!
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