[dynamicdoula]

Hi mamas,

I gave birth to my daughter yesterday via cesarean after she was not handling my contractions well and obviously needed to come out another way. As a result, my 35.6 weeker is in the NICU. She so far is doing fabulous and they've shortened the initial 24 hour NPO and are allowing me to nurse her and encouraging me to pump as well.

They say that there are many things that must happen before we can take her home; she's oxygenating well, not desating at all, no apnea, nursing and no respiratory problems at birth.

I'd love any comments/suggestions on things I might face trying to nurse a premature babe, and also what 'milestones' we're looking for before seh comes home.

Thanks!

 

[Mrs-Mama]

I'll write more later, but here are the things we were told had to happen before DS could come home:

1. All feeds by mouth
2. Maintain own body temperature
3. Gain weight steadily over several days while maintaining body temp.

Also, the rule of thumb is that the LO will stay until she would have been full-term. Of course this isn't always the case. My DS came home at a gestational age of 35w3d.

I'm back

Pumping/BFing:
Wow, I think it's great that you are able to BF already! I was not able to BF my DS until he was nearly 3 weeks old, though he was receiving EBM until then. As for pumping, it'll be a little different for you since you're able to BF as well. My DS was on a 3-hour feeding schedule. I double-pumped 9 times a day which allowed me to "stay ahead" of what he needed and still to get one 4-hour stretch of sleep overnight.

Here is another thread from someone else who recently had a near-term baby. Hopefully that will help as well.

Congratulations on the birth of your precious little one. Hoping for a quick homecoming!

 

[Amys1st]

Congrats on your baby! I know things didnt work out the way you wanted and its a nightmare to have to visit the nicu, but things should go well for you! I nursed Maggie when she started to hit the 32 plus week mark. She still got fed thru the tube until about 36 weeks but mainly had nursing and bottle feeds. Its good to know she isnt having much or any apnea and if she is it should go away after she is full term at 37-38 weeks or even her due date.

Pump pump pump. Also if you get some rest and sleep for 8 hours or more since you are still recovering, divide up that first thing milk because its been sitting in your breasts for hours and she dosent need to get that all day or label it boldly. Please let yourself recover too, so you can be rested when you do get to take that beautiful babe home. I wish you the best and pm me if you have any questions or post to vent her too, we understand!

 

[Sheal]

I second the rules of thumb:

1. All feeds have to be oral, at least 24 hrs off of NG tube (nasal gastric tube, the one they put in their nose to their bellies - tube feedings)
2. Maintain body temp
3. They used to say they had to be (for smaller prems) at least 5 lbs or heavier to leave but now that rule of thumb is maintain weight without a significant loss of weight (this means their 10% rule, some bf babies will lose up to 15%).
4. If they are on any meds, or have any underlying problems like bradycardia, or prem apnea (which you said she does not have) they must be resolved and off the meds for (caffeine for bradies\prem apnea) the issues associated with being a prem.
5. O2 sats must be 95% or higher (at least at our NICU that was the case, this goes hand in hand with the bradies and apnea).
6. IF she is in an isolette (incubator) she must be able to be in a criblette (open top plastic prison if you ask me) and be able to maintain body temp as well.

It's very encouraging that they are helping to encourage you to pump and BF, it seems (from experience of almost 7 yrs ago in NICU and 6 months ago in NICU) that NICU nurses are being encouraged to take lactation consultant courses (in fact most of the nurses this time around for me were LC's or had more than LC courses). I'm impressed that they are pushing the bf'ing and trying to encourage it!

Keep your chin up mama, she's sounds like she's doing well! How are YOU feeling? I noticed you said you had a c\s (I've had two, both emergency ones)...how's that healing up? How are you feeling emotionally? Don't forget to take care of yourself and be kind to yourself. You need to care about yourself too. If you need to talk or just hang about (although virtual hanging out) PM me.

BTW my prems were 29 weeks and 33 weeks.

Your doing great mama, keep it up strong mama! You can and will BF that baby! You are doing the most wonderful and selfless thing you could ever do for your baby!

Sheal

 

[momtoalexsarah]

my youngest was a 35.5 weeker and they tend to do very well and have short stays in the nicu.
As others have said temp control, blood sugars, apnea and oral feeding(be it breast, bottle, SNS or combination of any)
My DD had some temp, blood sugar and feeding issues was in nicu 3 days and we roomed in for 2 additional days because we where having some aspiration issues. My DD came home drinking EBM from a bottle and we finally reached 100% BFing at 10 weeks (although there where other things causing feeding issues)
Hang in there mama, she will be just fine and I hope that you are recovering well - c/s is a hard thing to get through, even when they are medically needed(all of mine where as well)

 

[dynamicdoula]

Eidie's situation today (she's 3 days old):

She's doing 'remarkably well' according to the peds who see her. She has been on all oral feeds (no NG tubes), and is being weaned off of her IV since her blood sugar is holding up well and she's maintaining her temps. They won't keep her just for weight if she's doing everything else the way she needs to do, which is a relief, she's starting out so small!

She's jaundiced right now but we anticipated that. The ped feels that we're 'ahead' of the game because she is nursing/cup feeding every three hours at least. I'm making sure to tell every shift of nurses that if she wakes up, even if she's just fed an hour ago, to call me so I can nurse her. She feeds beautifully at the breast when she's awake. When she's asleep, I try latching her on on both breasts a couple of times and then go for the cup- I don't want to tire her out by trying to force the breast on her when she's just too tired to do it anyway. The nurses/docs feel like I'm going about this the right way to ensure she is getting regular feedings.

I have to say I hate pumping. I am sick of it already and I don't know how people do it for months. *sigh* I know I'll feel better about it once my milk comes in, and I'm seeing an improvement in my colostrum supply just from the few days of pumping, but it's frustrating nonetheless. I'm getting around 20ml of colostrum per session which is really exciting but we then go right through it at the next feed if she's too tired to latch.

I'm doing okay, I feel really good about the decision to have the cesarean but now I just have to adjust to it all, yk? I'm trying to take the best care of myself I can so that I can make milk for her and nurse her when she's willing. I have a lot of processing to do.

 

[Sheal]

20ml at day three is AWESOME! WTG mama!

Good job hun, I know what you mean about the processing to do. I'm still processing my prem births at 7 yrs later and 6 mo later (the little guy in the family is 6 mo now and the 29 weeker is now almost 7 yrs old!)

Be proud mama, you are doing exceptionally awesome. You deserve a standing ovation for what you are doing.

*stands*

 

[Jilian]

Congrats on your new baby! It sounds like she's doing really well. Nursing at the breast is a big hurdle to overcome and it sounds like she's almost there. Take good care of yourself mama and I hope she's able to come home soon.