Establishing breastfeeding a preemie?

[HCB]

I always wanted to breast feed, or at least try, and although we've started trying it I'm not sure how we actually go about establishing it with a premature baby. We started trying (just once a day) when Lucas was 33 weeks corrected but he then had a bit of a wobble so we couldn't do it for about a week. He will be 36 weeks corrected tomorrow and I'm starting to think about how do we go about establishing his feeds with the thought of being able to eventually bring him home.

Has anyone had any experience of this or did most people just bottle feed?

I'm concerned that the hospital will introduce a bottle before we've had chance to establish whether or not breastfeeding will work and it will cause problems with trying to breastfeed. Also, do I or will I be able to do feeding on demand or will they just want me to feed him every 3 hours like he currently is? I guess the only way I'll be able to do either way really is if I stay at the hospital even though we're only about 5 minutes or so away. I certainly wouldn't want to be driving over there in the middle of the night!

I know these are all questions I can (and will) ask the hospital but I wanted to hear other people's experiences as well.

 

[katy1310]

I breastfed Sophie. We started with one feed a day when I was visiting her all day, and they topped her up with EBM via her tube. Then we moved to 2 feeds per day and then I stayed at the hospital for 6 nights and the nurse who was looking after her came to get me when she woke in the night. At that stage she was going every 4 hours between feeds.

When I came back home again, I did all the day feeds when I visited and at night they gave her EBM by bottle but they laid her on her side facing them so she didn't get too confused.

I think all this started about 2 weeks before she came home, and when she came home she was feeding on demand but I was told not to BF her for longer than 30 minutes because it would tire her out, and if she was still hungry then I had to top her up by bottle. I used all the EBM that I had in the freezer and expressed when I could as well as BF but I ended up having to top up with formula after a while.

I managed to combination feed till she was 5 months actual, 2 months corrected.

If you make it clear to the hospital that you don't want a bottle introduced, they won't. They tried to cup feed Sophie when I was getting the BF established but she wouldn't take it! They didn't do anything with the feeding without discussing it with us first.

xxxx

 

[Bec L]

Poppy was born at 34 weeks and was tube fed (I expressed every 3 hours). If she was alert and awake enough at feed times I was allowed to take her out of her incubator/cot and try to breastfeed her. She was able to do it, but often tired easily and didn't always get a full feed.
She was in SCBU for 2 weeks and as she got bigger and stronger I was getting her out for most of her feeds, and it was only at night (while I wasn't there as I wasn't allowed to stay) that she had her feeds through her tube or in a cup.

I stayed over with her for 2 nights before she came home and fed her on demand.
Hope that helps and hope you manage to breastfeed your LO. x

 

[HCB]

We had another go today and it went really well. Lucas didn't seem very interested at first but I realised he had hiccups so sat him up and when they went away he was ready. He was sucking properly for ages so we decided not to top his feed up with much, just a bit so that they could administer his drugs. It was the first time that Lucas had really sucked properly and sustained it so I was a happy mummy!

Thank you for letting me know how you did things Katy and Bec. I think we will see how things go over the weekend doing it once a day and then discuss with the nurses what to do going forward.

 

[25weeker]

Glad to hear your lo fed well. When we started to establish breastfeeding we would bf during the day and at night she was either tube fed or cup fed initially but when they got rid off the tube they gave her a bottle. I was using a nipple shield as she couldn't latch so she didn't have any confusion with the bottle. I started weaning her off the shield at home around 6 weeks corrected.

I always demand fed and I was never told not to feed longer than 30 mins even though Katy and I were in the same hospital. For the first 6 weeks being home my lo was an evening cluster feeder which stressed me initially as I thought he wasn't getting enough but it's actually quite common for newborns to do it. I am still bf and my lo is 14 months next week.

Try not to stress too much and enjoy it. It is difficult at the beginning but it gets much easier as they get a little bigger.

Good luck xx

 

[Srrme]

Elias was born at 28 weeks and 6 days -- when he started oral feeds he was given a bottle. I only breastfed him a handful of times in the NICU, and that was only 1 week before he came home - every other time, he was given a bottle. I was afraid to breastfeed him in the NICU because everyone kept telling me he would lose weight at first, and would have to stay longer, so I waited.

I began exclusively breastfeeding him when he came home on the 15th of January, and we're still going strong. I let him demand feed straight from the beginning, and I think that's what helped. He didn't even lose weight like everyone kept telling me he would.

 

[tamarah]

I always wanted to breast feed, or at least try, and although we've started trying it I'm not sure how we actually go about establishing it with a premature baby. We started trying (just once a day) when Lucas was 33 weeks corrected but he then had a bit of a wobble so we couldn't do it for about a week. He will be 36 weeks corrected tomorrow and I'm starting to think about how do we go about establishing his feeds with the thought of being able to eventually bring him home.

Has anyone had any experience of this or did most people just bottle feed?

I'm concerned that the hospital will introduce a bottle before we've had chance to establish whether or not breastfeeding will work and it will cause problems with trying to breastfeed. Also, do I or will I be able to do feeding on demand or will they just want me to feed him every 3 hours like he currently is? I guess the only way I'll be able to do either way really is if I stay at the hospital even though we're only about 5 minutes or so away. I certainly wouldn't want to be driving over there in the middle of the night!

I know these are all questions I can (and will) ask the hospital but I wanted to hear other people's experiences as well.

Hi All,

My DS was born at 33 wks gestation weighing 2 1/2lb. I was adamant that I wished to bf so when lo was 34 wks I begged docs to let me try as up until then I was expressing and he was being tube fed (5ml every 2 hours). They agreed and lo latched straight on and was away. I then insisted that they remove the tube and allow me to bf exclusively 24/7. I slept in a chair at nite and sat with him all day as was so worried that they would bottle feed in my absence. Eventually they gave us a room so we could be together and comfy. My Ds had very bad jaundice and although that cleared up he then got a type of jaundice caused through BM. ( I am O Rhes Neg and baby Pos so think this is what caused a lot of probs). I was very insistent and got to feed him on demand. At 36 weeks I was allowed to take him home for 12 hours. At 39 weeks we was allowed home. After being home for 3 days lo put on 1 1/2 lb's. Good Luck to you all xx

 

[Foogirl]

We started at about 32 weeks and at first she just gave little kitten licks. It took us until about 3 weeks later to get anything meaningful and we had to use a nipple sheild to help her.

Whenever you are there, try for a feed, even if it isnt due - practice makes perfect.

And don't worry about them offering a bottle, Abby was bottle feeding properly before she breastfed and it was great to have her able to do both once we got home. The "nipple confusion" according to staff at my NNUCI is a complete myth, they are well able to switch between the two.

 

[maisiemoo]

My lo was born at 33 weeks and subsequently tube fed. I stayed at the hospital and attempted bf before every feed, night and day. During a bf attempt, my daughters feeding tube came out and due to having surgery on her oesphagus, they were reluctant to put it back thus leaving us in a sink or swim situation. Removing her tube was the best thing to happen as she took to the breast wonderfully and then discharged the next day - olivia was 35 weeks gestation we're still going strong at nearly 10 months x

 

[Minimin]

Thanks for this post- I am following the responses and it is really useful to know others have come across the same problems and continued with trying BF!

My little girl was born 34 + 4 and spent two weeks in scbu. She was nasal drip fed and then bottle. I tried BF a few times but hard being at scbu. I did express and she has been on my milk + special Nutriprem formula. She's been home for almost two weeks and I have continued expressing and giving her that with formula in a bottle. I try the boob but she just doesnt really latch on or falls asleep after a few suckles. She is now around 4.5lb so I wonder if she is too small to get milk from me. I know small preemie teats are not good on the bottle for her as she tires and falls asleep. Her feeds are better using level 2 teats which is a little faster but she has to work less.

After reading this thread I am ordering the medala nipple sheilds in hope they will help.

Thanks ladies

Minimin

 

[HCB]

Thanks to everyone!

We are still trying! I have found the unit is very pro breastfeeding so are now encouraging me to try breastfeeding for 3 feeds a day with top-ups via his nasal feed tube. The amounts he is given depend on how long he has been sucking for but it's obviously a bit hard to tell how much he is getting from me. It's a bit hit and miss and at the moment I feel that we're not even doing as well as we seemed to when we started but I'm persevering. I'm finding that sometimes he falls asleep very quickly (he seems to be comforted by being there and his sats always go high when we breastfeed) but then sometimes he has a good go.

He is now 37 weeks corrected and we still don't know when we will be going home despite not haaving any major problems along the way. I have been told by our doctor that they are now looking to establish his feeding to be able to think about him coming home and weaning him off oxygen is secondary so I am keen to crack it. I'm starting to think that maybe we ought to try bottle as well as breast and reading some of you having done this successfully has eased my mind a bit. If it gives us a better chance of him coming home I will give anything a go!

 

[Foogirl]

He is now 37 weeks corrected and we still don't know when we will be going home despite not haaving any major problems along the way. I have been told by our doctor that they are now looking to establish his feeding to be able to think about him coming home and weaning him off oxygen is secondary so I am keen to crack it. I'm starting to think that maybe we ought to try bottle as well as breast and reading some of you having done this successfully has eased my mind a bit. If it gives us a better chance of him coming home I will give anything a go!

I would be wary of making any decision based on getting your LO home quicker. Certainly Abby was fed ebm through a bottle when I wasn't there and it never caused any problems, but we still made sure breast was the first option. But at no point was it suggested bottle feeding to get her home quicker. It really does surprise me they are suggesting the oxygen reduction is secondary. I would have thought getting off oxygen would be a priority.

I know it is hard at the last stretch when you just want them home but it will happen all in good time. The feeding will come. Did you try the shields?

 

[HCB]

I would be wary of making any decision based on getting your LO home quicker. Certainly Abby was fed ebm through a bottle when I wasn't there and it never caused any problems, but we still made sure breast was the first option. But at no point was it suggested bottle feeding to get her home quicker. It really does surprise me they are suggesting the oxygen reduction is secondary. I would have thought getting off oxygen would be a priority.

I know it is hard at the last stretch when you just want them home but it will happen all in good time. The feeding will come. Did you try the shields?

I probably didn't put it quite right and of course I want him to be OK to come home but we are now at a point where it is mainly the feeds and oxygen that are holding us back. We have been told that his reliance on oxygen will gradually come home but whilst they are establishing his feeds they won't push him on this. It's because of this and because it is possible to be able to come home even if he still has an oxygen requirement (it can be weaned at home) that it is secondary to feeding.

My other concern is that I do not produce enough milk (and also takes forever and a day to express what little I do get) and although I know that breastfeeding is different to expressing I am not convinced that the amount he is getting is and can be hugely better (I am only able to express around 20/25ml on average each time and Lucas is now on 46ml every 3 hours). It is very hard to work out at the moment and the only way we will be able to find out if he does get enough is if he feeds off the breast every time, which is going to be weeks away if he does. It might not ever happen just because he might get frustrated if there isn't much coming out each time.

He is currently fed ebm and formula (more formula than ebm), and I had a bit of a discussion with one of the senior nurses about it and our future breastfeeding. She suggested that he may have a requirement to have some formula even if we are able to breastfeed to a certain extent but I am concerned now how long before we come to that conclusion and HAVE to introduce a bottle as that will then be another thing for him to learn and get to grips with before he will be allowed home.

Sorry, I've just rambled on now! But I'm getting quite confused and frustrated about how I feel about the whole breastfeeding thing now and am wondering what's best for Lucas because of some of what we went through over the weekend. Having a baby crying his head off and pushing you away doesn't make for a relaxing breastfeeding session!

ETA: I haven't tried nipple shields because it hasn't ever been mentioned to me before and I don't really know what they are or how it would help. If it's to help him latch on then that's not really the problem as he latches on fine most of the time. It's just getting him to suck, although he will suck very well on a dummy or a finger.

 

[Sweepea_s Ma]

I am thankful too for this post, I am glad to read that it has been possible for you, although our experiences and circumstances with our babies are different. My Sweetpea was born at 29 1/7 weeks and is going home in a few days - when he was ready we did try to establish latching but i found that offering the breast then bottle then gavage was too complex for both him and me. My little one needs some formula supplementation though for increased caloric yield, so I will check if it would be okay to offer him just the breast during some feeds.