Establishing BF to a bottle fed Preemie and Routine change

[Minimin]

Hey,
Just looking for advice. My lil girl was born at 34+5 days on Feb the 6th. She is 38w this week. She spent two weeks in SCBU where she started off feeding through a tube and then eventually a bottle. I was encouraged to express and this was given to her as 'half and half' with special formula to help her gain weight. I am giving her this at home now too.

I have not managed to establish BF- I want to know if anyone has had the same situation arise where their little one has had the bottle first. Also do Preemie's take longer to latch on? Or is she so used to the bottle she is unable to get milk fast enough from me. I have hand expressed to start the flow and have tried giving her my breast when she is really hungry and when she has had a little from the bottle.

Also I am sooooo tired and fed up of expressing!!! I am ready to give up. I spend my days feeding, getting her nappy changed and then hooked to a bleeding machine for 30-40 minutes. I am trying to keep up with 7-8 times a day but am averaging 5-6 as I am not expressing at night. She is up every 90 mins at night atm and I am too shattered to express. I spend the rest of my time, sterilising, cleaning, cooking tea/lunch for myself and then trying to catch a nap if I can. ATM- at most an hour!

Sorry the last part is just a rant!

So just to ask again, Do preemie's take longer to latch on? Will she be stronger and therefore better at it when she hits around 40w? ATM she is only around 4lb so working milk from me is probably tiring? ALso how much milk should I be getting from expressing. I am averaging about 250mls which wouldnt cover her if I didnt have the formula as well. I am wondering if it is worth continuing. how does this level increase if she isnt latching to instigate it. I am expressing way past them producing milk but that hasnt increase my supply. I am trying more expressions per hr to increase levels today

Finally, she seems to be reversed in her night and day pattern. More awake and more feeds at night. Can I change this so this is in the day time. She tends to sleep for 3-4hr at a time during the day- which would be welcomed at night

Thanks for reading and hope someone can shed some light.

Minimin

 

[25weeker]

well done expressing and looking after lo as I don't think I could have done it.

You could maybe start with a nipple shield as that is similar to a bottle and it would get lo used to having to suck harder than they do with a bottle. Once she is happy on that you could start weaning her off it. I had to use a shield in the beginning as my lo was too small to latch. I started weaning her off the shield when she was closer to 7lb.

I found the medela ones really good. A baby will get more milk from you than a machine and they are good at increasing your supply when they need more.

Sorry can't advise on the sleep. My lo is still a rubbish sleeper at nearly 14 months!

 

[Minimin]

Thanks 25weeker. I think I will try the shields. I have some nipple protectors which I am not sure do the same things.

Thanks for taking the time to reply and I hope you and your lil one are well.

Minimin

 

[Foogirl]

Abby was bottle fed ebm in NNICU whenever I wasn't there to feed. It took us a while to get BFing established but with the shields we managed fine.

I wouldn't judge your supply by how much you express. It isn't very accurate, you'll generally produce what your LO needs and the more they are on there the more you will make. Just keep trying with it. If you think you have problems with latch / position etc, ask your HV for advice or see if there is a local BFing group with a specialist who can help.

Make sure you offer the breast before using the bottle if possible, it will make sure your supply has the best chance of increasing and your LO is more likely to have a good go at feeding.

 

[Minimin]

Thanks FoogirlI just need to perservere and seem to lose motivation. I need constant reminding that it is ok to take a while and she is only 4 weeks this weekend so we havent really been trying too long. Also she has only been home just over a week.

Which sheilds did you use- I have some nipple protectors that are meant to help feeding when your nipples are cracked and sore. She didnt like the teat on that when I tried last night. (also- do you sterilise them before use like the bottles etc?)

Thanks for taking the time to reply and well done on establishing feeding! I will try and speak to a counsellor and take her to BF group next week.

Minimin

 

[Foogirl]

Thanks FoogirlI just need to perservere and seem to lose motivation. I need constant reminding that it is ok to take a while and she is only 4 weeks this weekend so we havent really been trying too long. Also she has only been home just over a week.

Which sheilds did you use- I have some nipple protectors that are meant to help feeding when your nipples are cracked and sore. She didnt like the teat on that when I tried last night. (also- do you sterilise them before use like the bottles etc?)

Thanks for taking the time to reply and well done on establishing feeding! I will try and speak to a counsellor and take her to BF group next week.

Minimin

I used the avent shields. https://www.toysrus.co.uk/Babies-R-...ories/Philips-AVENT-Nipple-Protectors(0028039)

They are nice and sturdy. Everything else she just sucked right off! They do need to be properly washed with hot soapy water to get rid of any milk residue then sterilised, just as you would with a bottle teat.

How long is she feeding for? Any more than 20 minutes and she will be using more calories than she is taking at this stage so try to avoid keeping trying for ages and ages. After about an hour she will pretty much need to be put back down for a nap as her stamina won't be up to much at the moment.

The most important thing is not to put too much pressure on yourself. Relax and your LO will too. Give it time and it really should establish itself fine, but remember it isn't the end of the world if it doesn't work. You can still feed EBM or Formula or a mix of the two and your LO will not suffer because of it. Breast may be best, but that doesn't mean you are failing your LO if you can't do it.

We've got quite enough on our plates as preemie mums, we can't always do everything!

For switching day or night there are a couple of wee tricks you can use. We always used to change her clothes in the morning -usually just into another sleepsuit, but a change nonetheless. You could also use a bedtime routine at around 7pm to signal the end of her day. Have a bath, read a story and put her to bed. All feeds after that would be done with minimum fuss, in a low lit room, and put back down afterwards. Does she self settle ok? You could also consider cluster feeding. This is basically where you allow her to suckle in the evenings for as long as she wants to. It will vary between big sucks and little sucks, she may drop off to sleep and wake up etc, but doing this for a couple of hours will definitely help the supply and may give her a wee bit extra in her tummy to help her through the night. And, I have to say, was one of the most wonderful things I did! Mr Foo kept the tea and biscuits coming and I watched trashy movies for a couple of hours!