Breastfeeding after nicu

[MoBaby]

Hey! Baby was born at 36 weeks exactly via c section. He came out screaming but his lungs weren't fully mature so he kept dropping his oxygen so had to go to nicu. He also had low glucose and feeding problems initially. He only spent 8 days there and went from cpap to high flow oxygen and room air. He also had a feeding tube until he could tolerate his bottles. He came home Thursday and I have no idea how to transistion to breastfeeding. I've tried once yesterday and twice today. I tried a couple times in nicu. He gets so tired really fast so doesn't suck. He just lies on my nipple. I tried for a hour today and did all the tricks then tried another feeding for 40 mins. I pumped after and did get les sour and he only took 20 ml expressed breast milk each time after attempting nursing. I should also mention his bilirubin was still elevated at 12.1 day of discharge. Can anyone offer me any tips on how to establish the bfing relationship? Im not a huge or over producer of breastmilk so I need him stimulating my production. I'm afraid the pump will only do so much and I would like to get rid of it at least at bedtime. This was so unexpected and it has really made me sad and upset we weren't able to establish a bfing relationship right away. Thanks for any help or tips!! We do see lactation on Monday.

 

[Mrs W 11]

My baby boy was born at 35 weeks and it took over a week to establish feeding. I was advised to do as much skin to skin with him as possible and it did work. I sat with no top on and him on me as much as was possible, I pumped with him on me which really increased my milk production (although meant I had to do one side at a time not double) and I tried to bfeed him every 3 hours before his tube feed. It did work, eventually he just latched on and we never looked back.

I was in hospital still as he wasn't allowed to leave nicu until feeding was established so I'm sure it's harder at home with a lo around but enlist all the help you can get to give you skin to skin time with baby. Also get your oh to do skin to skin too as it all helps baby develop.

Good luck!

 

[MoBaby]

They wouldn't let me bf in nicu. Just quick sessions 1-2 times per day. They wanted him to get "measurable amounts" which made me so mad because he had a great latch after a few days. I think I need to do more skin to skin and I will try with this next feeding in a couple hours. Today he's been a little better and bf twice but obviously we have a long way to go as he's still sleepy. But he was super alert this morning which helped I'm hoping things improve daily from here on out and I can go to pumping only as needed for freezer stash when I return to work.

 

[Mrs W 11]

Really, gosh that's awful surely the choice to try and bf should be yours. My ds got measurable amounts as he was topped up by ng tube feed every 3 hours. What a shame you couldn't try.

Keep going with it all, you'll get there x

 

[MoBaby]

Yeah I wanted them to just do the scale. Wrote and after but nope. They told me when I left to just try and make sure I supplement my expressed milk after nursing as I needed to make sure he's being fed properly. But supplementing defeats the point since every bottle he takes is time away from the breast. I'm seeing lactation soon this morning so will be curious as to what she says.

 

[Kiwiberry]

First, you can do this Mama. I know it seems tough at first but just hang in there. I had a 27 weeker for my first and a 34 weeker for my newest lil bundle. I did get to breastfeed at the NICU for my first but for obvious reasons she still did get addicted to bottle when I was not around. So what I did when she came home was offer the breast first and if she refused or had a hard time with it I would offer the bottle. I also used a nipple shield to make the transition a lil bit easier on her. After about 2-3 weeks she was completely EBF. She spent a lot of time on the bottle so it took longer than expected to get her to that point. Surprisingly enough, I have not put my 34 weeker to breast yet. My 27 weeker was nipple confused because of all the BF'ing I did which caused her to stay in the NICU longer. With this baby I have decided not to put her to breast until she is home to get her out of this black hole of a NICU quicker. I will most likely face the same challenges, but I know if I am persistent that I will be able to EBF her just like I did with my first preemie.

As for supplementing, I was only able to do it for a couple of days after she came home from the NICU. My daughter absolutely hated formula and would spit it out. So I would use breast milk only bottles with her. I am no doctor so please do not take this as medical advice, but my preemie had no problems gaining weight off of my BM alone. I could not even give her the vitamins. She spit it out, at first I used a syringe, but after she got a little bit older it became harder and harder to get her to take them. I did have frequent Pediatrician appointments. They tested her blood and she was perfectly healthy. This is just my own experience, every baby may tolerate it differently.

Good luck Mama, and I hope you update soon on how its going for you and your LO.

 

[MoBaby]

It has not gone well!! Thanks for reply. I did see LC a few times. I was given the okay to do "tough love@ since he did transfer 1.5 ounces in 25 mins so she knew he could do it. It was supposed to be better than nurse, pump, supplement. Well for a day and half I did that. Just let him nurse and he stayed on my breast almost the entire day, maybe a 2-3 hour rest. I finally was exhausted and fed up so midnight the next night I went back to pumping him a bottle.
But I know he received the proper milk from the weight. So he went from 8lb 14 oz on Tuesday at 4pm. Nursing only started Tuesday at 430pm and went until Wednesday midnight. Thursday 9am he was 9lb 2oz so he gained 4oz in that short time and only received 4-5 breastmilk bottles instead of the 14 or so he would have received in that time frame (if I calculated right, he drinks 9-10 per day 3oz each).
I'm still pumping almost exactly what he needs. He drinks 810-900 ml daily and I pumped 820 ml yesterday and 810 the day before. I'm stuck around 800 ml. Today so far I've pumped a little less than average.
He has to nurse both breasts for at least 20 mins to get his feed. Sometimes longer. My supply didn't increase after the one day marathon nursing session like I was picturing.
So idk what to do- try again and just now it's going to be a long week or keep pumping. I'm going back to work In 6 weeks and will have to pump then. I would love the bond of nursing because I hate sitting here pumping staring at him and not able to offer anything for him since Im hooked up.
It so emotional and I'm not sure what to do.
During the day when my 2 yo is at school I can nurse all day since I don't need to focus on him but when he is home I need to be available and at least when I'm not pumping I have a couple hours between sessions to be with him and can put a bottle in the baby's mouth.
Do you have any advice?

 

[Kiwiberry]

10 minutes per breast is really good. Especially since you pump what he needs too. The pump barely gets all the milk that babies can. Is that what your asking hun?

 

[MoBaby]

No, does it sound like he did good at the breast? I'm worried about my supply with just pumping.
I can only pump what he needs when he is not nursing. When he nurses I don't pump much. maybe an ounce after he eats, maybe less.
This is all so hard! I'm trying to encourage myself to keep going. When I see my work it's encouraging but then when supply seems lower I get discouraged.

 

[Kiwiberry]

You are doing great Mama!! An ounce after he eats is really good. Judging by everything you have told me I would say he is breastfeeding really well. Remember the pump pulls out far less milk than your son can get to from feedoling.

 

[Kiwiberry]

As long as he has at least 8 wet diapers a day then chances are you have nothing to worry about.