Sleep or Feed? What's more important for a preemie?

[Marleysgirl]

I've also posted this in the babyclub, as it's a rant about my OH ....

Andrew's 22/11 weeks. He put on only 3 ounces over the last 10-day weighing period, last weight 7lb 3oz.

The Paediatrician wasn't happy with his weight gains, asked how much EBM he was getting, threatened putting him onto formula to help his weight. I said he was getting 6 x 100ml feeds a day.

Now Andrew is sleeping through, he'd go from 7pm to 7am some nights if I let him. It means he misses two feeds, so he's only getting two-thirds of the feed. I didn't tell the Paediatrician that, as I knew she'd have a go!

So we've gone onto faster bottle teats, and he's taking a bit more milk now.

[rant]
I'm also trying to feed him around Midnight, dream-feeds don't work as he wakes up. OH thinks this is "stupid", he disagrees with waking a sleeping baby just to feed. But I think it's important to get more milk into him.
[/rant]

So what's more important? If we can't get Andrew to increase his milk intake during the day, should I let him sleep or should I make the effort to feed him?

Don't suggest getting him to listen to the Paediatrician, OH's one of those men who always know better, he wouldn't listen (even if he did bother going to the meeting).

 

[AP]

Personally, when Alex was that weight and wasn't gaining an awful lot, I woke her up for a feed.

Some people will say to let sleep but for a preemie its important they have their feeds and put the weight on quickly.

It wasnt long before Alex started taking more milk comfortably during the day that I stopped waking her up. She only goes from about 10pm to 9am.

Do you just offer 100mls, or more? Having the extra milk available each feed will help Andrew take more eventually. I think you done the right thing about changing the teats, that certainly worked for us in terms of getting Alex to take more.

As for not using formula, is it just a personal choice? (dont mean to sound rude or anything there! ) For a bit we used half formula and half ebm mixed in a bottle, and it did really help change things, we got out of hospital quicker, as she had put on weight much faster than she did before.

I just thought I'd let you know our experiences xxxxx

 

[bumpsmum]

Oh hun I know how you feel last, visit to the Paed he was not happy with Matthew's weight and wanted him weaned early, we were hoping to wait til his corrected 6 months but took the advice and weaned him. Matthew has never been a milky baby at all, took only 4oz (sorry dont know how much that is in mls ) 4 times a day but very slowly over time got him to take 6-7oz. Initially we tried to wake him during night, that didnt work, then we tried dream feeding and that didnt work either.....

We let him sleep thru and offered more milk in each bottle sometimes he would take it sometimes he would not, you can always let it cool (if he takes it warmed) put it in fridge for a bit and mix it back with other EBM you have towards the next feed so no wastage.

Also, remember BF babies gain weight a tad slower than formula babies, HV and Dr's NEVER seem to take this into consideration, to busy going by the formula fed baby charts!! I was at my wits end and too stressed to continue BF so switched to formula at 10 weeks but didnt honestly see a great difference. Some babies are just meant to be a bit smaller than average

Personally, I would let him sleep right through say for a week, try and offer extra milk at each feed and get him weighed at HV clinic and see if it hindering his weight gain, then maybe think about either waking him for feeds or topping his feeds of with formula, that way your OH may see it as a compromise? xx

 

[nkbapbt]

When Lakai came home he was 5 weeks corrected and taking 80mls every six hours via his gtube. I know that g-tube feeding is much different than BF'ing or FF'ing because we do not need to wake him up to feed him. But Lakai is a slow gainer too, he is 11 months old corrected and only weighs 19lbs (which is normal but I still wonder if its not enough).

Some babibes, especially preemies can be slow gainers. I think that as long as Andrew is gaining weight and not loosing it, that such be considered a GOOD thing.

I would work on increasing the volume of each bottle say twice a week, so go from 80mls to 85mls on Monday and then again on Friday increase it by a small amout. I say that because it can be hard on preemies tummys to do too much, too soon.

Also its very common for preemies to have a weaker suck than full term babies...does it take Andrew a while to eat? If so this might be the case and I would have said to try the different teats but since you are already doing that....=)

If all else fails for some reason and he is still not gaining enough weight for your liking and your dr's. Ask if you could try breast milk fortifiers to add to your milk, its a powder that they used in the NICU to give the babies extra calories.

I actually sometimes add pure coconut oil to Lakai's feeds, its packed with huge health benefits. And it also is a healthy fat and helps to aid in weight gain. A ton of my preemie moms on the other preemie forum Im a part of do this to put some weight on their preemies.

 

[Marleysgirl]

Thanks for all the advice.

EBM Fortifiers - Andrew was discharged with two boxes of sachets, but they're not available outside of NICU (i.e. not on prescription) so that's stopped now.

EBM vs. Formula - It's just personal choice, pride if you will! I'm proud that he's EBM fed and that given his inability to latch, he's still receiving the natural goodness. But I have started giving him formula once a day now to get the extra calories, I've swallowed my pride

Bottle amount - we've always had about 20% more in the bottle than he's taken, so that he can increase his intake over time. But I got him to take 135ml this morning - woohoo! - so the new teat size is definitely working. If I can get him to take 4 daytime feeds of around 130ml, I'll be happy for him to currently miss both night feeds as he'll stil be getting over 500ml for the day.

I guess I just needed a rant!

Andrew will be weighed at the clinic this week, and I reckon he'll have put on a load - I do believe he's grown in the last week, as his "tiny baby 6lb" rompers are now way too short! Oh dear, another box of outgrown clothes ....

P.S. Saw the HV for the first time this morning, and she's read something about it benefitting premmies to wean them early, even in relation to actual age (4-5m) due to the extra nutrients. So she was pleased that I'd started!

 

[AP]

I think you're doing all that you can do then, hunny, I wouldnt worry! And its good you have a supportive HV - mines is a bint

 

[Foogirl]

I understand the pride thing. I resisted any attempts to give Abby formula and just as well I did as it turns out she has a dairy intolerance (which will be why she was sick the only two times she ever had it in NNICU!) I saw no reason why she couldn't grow on breastmilk alone as my supply is great and there is always plenty fat in it and I was finding breastfeeding no problem at all. To my mind, if she wasn't growing with that then formula wasn't going to help!

Abby sleeps 7-7 so getting the required 500-600 mls a day into her is a challenge, but remember, now that you are weaning it all counts. So, baby rice with 40 mls of milk, is still 40 mls of milk. You can also add milk to purees. I have one full feed a day in the fridge and make sure she gets it in her food, starting with porridge in the morning. If you manage to get one feeds worth in his purees, thats one less feed you need to give through the bottle.

I'm kind of with your OH on this one though. The thought of waking Abby in the middle of the night to give her a feed is an alien concept. We're always told never to wake a sleeping baby and it is something I hate doing.

The peads seem to be obsessed with hitting a certain line. And remember, the current charts are for FF babies, not breastfed ones and weight gain in BF babies isn't the same. Abby went through a stage of not gaining as much and no-one seemed that fussed. She dropped through 2 centiles at one point. Our consultant pointed out that there is always an element or normalisation where they go from whacking on weight to finding their "genetic norm" if you and OH are smaller people, Andrew will be too. But even the GP and HV were very much "we shall wait and see" let's check in a month rather than immediately talking about night feeds or formula.

If he isn't hungry, why feed him? And think about all the mums on here of babies who are much much older than Andrew pleading for a full night's sleep.....now that Andrew is in that pattern, I would be loathe to risk getting him out of that pattern.

Sorry to agree with him when you clearly need to rant!! And I fully understand that much of the rant is actually at the fact that the docs have given you advice and he wasn't there but has made up his own mind. Give him a slap for that! But I do think the advice you've been given is really just one way to go. Leaving him to sleep and continuing to try to get milk into him other ways, is another. Sleep is just as important, for both him and you! Last thing you want is a cranky baby in the morning because you've woken him to feed him.

 

[Marleysgirl]

Well yesterday, Andrew took 4 daytime feeds of around 130ml plus a dribble in his food, so I figured he'd had enough and decided to let him sleep ... He woke around 2am looking for another feed!

But (sneaky me) I left the monitor downstairs with OH as he was playing PS2 games late, so he had to do the feed and not me! I woke when Andrew was shouting because he'd been put back into bed after the feed, so I got the fun cuddly part (which I could do half-asleep).

 

[Foogirl]

But (sneaky me) I left the monitor downstairs with OH as he was playing PS2 games late, so he had to do the feed and not me! I woke when Andrew was shouting because he'd been put back into bed after the feed, so I got the fun cuddly part (which I could do half-asleep).