Please help, BF premature baby advice

[~Mands~]

Warning, this might be long...

My son is just over 3 weeks old, and was born 5.5 weeks early. He spent the first 3 weeks in hospital, during which i was expressing breast milk for him. For the first couple of weeks after his birth the milk was given to him via a nasal gastric tube as he wasnt strong enough to suck yet. After this he was having some feeds from a bottle (all breast milk), and i tried bf'ding- he did really well but would tire easily. He needed to be sucking all his feeds before he could come home, so I decided to give all bottles of EBM, as bf'ding was too tiring for him. And I just wanted my baby home. He came home two days ago. I am still expressing all his feeds, and i tried another bf this morning. He was attached for about 30 mins and seemed full, but bout 10 mins later he was grizzly, so i gave him a bottle top up of 50 mls (he is having 85mls per feed every 3.5 hours roughly or when he demands). He obviously didnt get enough from me, as the same thing happened when i breastfed him in hospital. I really want to establish breastfeeding but am not sure where to go from here. I was just wondering if anyone has been in a similar situation, or if anyone has some advice for me? Thankyou in advance.

[Mamaduke]

When I had Jesse (4 weeks prem, 4lb 1oz, 21 days in SCN) my main priority, and the reason he was staying in Special Care, was to put weight on. I also, like you had the problem of him getting extremely tired quickly when he was breastfeeding. I know there'll be some people who will say 'you must persevere, it'll only get better" but from where I was coming from - tiny baby, needs to put weight on...I don't have the luxury of waiting until it happens! I just kept going with the mostly EBM feeds from a bottle and some breastfeeds...that worked best for me and Jesse - we were more comfortable with that - I was stressing that he wasn't getting enough or getting too tired and he wasn't falling asleep in the middle of a feed just to wake up starving 10 minutes after a feed. I spoke to my MCHN about it and she advised, "go with whatever you feel most comfortable with"...and I'd advise you to do the same.
Premmie babies...aren't they just the biggest champions!!!:smiliedance:

[ziggie]

Hi :wave: .
When I had Mitchell, he was nearly 4 weeks early and sounds like he was acting the same as your bubba... and I was doing the same as you do. Expressing every feed is hard, so :thumbsup: that your still doing it!
I ended up going for a day stay at a Lactation Support Unit, organised through my hospital, and that was the best thing ever! She told me exactly what me and Mitch were doing wrong, told me how to fix it, and we haven't looked back since.
Hope all goes well for you :hugs:

[Funkychicken]

It sounds like your doing a fantastic job with the expressing. It can be so tiring, so well done for keeping it up. If you are happy with his weight gain and are happy to continue expressing, maybe just keep doing what you are doing. He will get strong in a little while and in the meantime you can just keep offering the breast as well as EBM so he will keep your supply up. Hang in there. :thumbsup:

[~Emmylou~]

^ I agree.
My daughter was nearly 4 weeks early and we came home when she was only 3 days old.
She was still veerrrry sleepy and I was feeding her mostly ebm in a bottle because she just couldn't stay awake on the boob. We did that for two weeks, while still offering the breast, before she could stay awake long enough to get through a whole feed on the breast. By two weeks old (would have been 38 weeks gest age) she was feeding like a pro.
The only solution is time but until then just keep expressing and offering the breast so it's not foreign to him. If he's doing well when he IS on there he will come good eventually.

[xkwzit]

I would think a Lactation consultant could help you. If you find one with premmie baby experience, she should have heaps of advice for you about a breast / bottle balance and handling nipple confusion etc. You just need to arm yourself with the right advice that works for you both.

Cheers

[~Mands~]

Thankyou all for your advice. Cooper is exactly how you describe your bubs was Mamduke! He is the biggest champion yes :yes: !!

The overnight stay sounds great, I might look into that for a few weeks time. But for now I think I will stick with my expressing, it seems I am doing the right thing and it does feel right for him. I feel I know what he is getting, so it will help him to gain weight as mentioned. And he has been. I will continue offering the breast every couple of feeds too. I know we will get there.

Also a question for funkychicken, you mentioned about making sure i still offer the breast to keep my supply up, if Im only expressing but offering the boob say once a day, could that reduce my supply?

Thankyou all again :)

[MummyCharmzy]

DS was 9 weeks early and spent 6 weeks in SCN, he was tubefed EBM for 5.5 weeks and I was told if I wanted him home it would take 2 weeks to establish breastfeeding or 2 days to establish bottlefeeding so I gave him a bottle and continued expressing for 5 months. I didnt want the stress of trying to teach him to breastfeed when he took 1.5 months to learn to have a bottle anyway!

With DD1 she was 5 weeks early and for 2 days I thought she was bf'ing fine except her weight just kept dropping off and I couldnt get her on properly as she was tongue tied so I started expressing for her. For 10 weeks I tried to breastfeed her with no success so I continued expressing until she was 3.5 months when my milk dried up having already concieved DD2. During this time I had a lactation consulant come to my house numerous times to help teach us how to breastfeed and I did lactation day stay at a local hospital. Both of these were beneficial but neither helped achieve my goal of breastfeeding DD. Im not sure where you are located but if you arein melbourne I can give you the numbers of both of these services.

DD2 was basically fullterm, she was my first to actually braestfeed relatively well despite attachment issues but then he too kept losing weight and just had big problems gaining it so I had to start expressing for her too. She then started to completely refuse the breast so once again I had a LC out to my house trying to help me and then last week went and did lactation day stay again. If anything I feel this made it worse as I went from bf both sides, then expressing and topping up to only being able to bf from one side because they kept telling me she wasnt on the left side right and taking her off and trying to reattach her which damaged my nipple so bad i couldnt put her on and now its healed she still refuses that side. Im currently bf'ing from te right side, expressing from the left side and bottlefeeding her that and thne topping her up with formula as my supply isntso great!!

Sorry for rambling on here but thought it might be beneficial to share my experiences!

There are many avenues of support, another avenue I have used this time is the ABA 24 hour line, I got some very good practical advice from a lady there too. The aba website is full of useful information to and im sure there is a section on feeding premmie babies on there just do a google search and you'll find the site and then the 24 hour line.

If you are in melbourne pm me and ill give you the details of my lactation consultant and where I did day stay.

Other avenues that could help are: the hospital you had your bub at, they should have a lactation consultant you can see. Your MCHN should be able to help, or point you in a direction to help. Or you local GP should be able to refer youon to someone helpful.

Some of the mums from the ABA will come to your house to help you or let you go to there house also if you're really stuck, they're all lovely and all very passionate about bfing so that might be a good supportive and encouraging avenue!


Finally before I really give you an essay to read, with my DD I find that if she doesnt have the breast for one feed, the next feed is a LOT harder to get her on. So perhaps offering the braest every time might be an idea, I know it can be stressful when they dont just latch on and drink away so give yourself a time limit to get him on and then stop. and if he goes ons traight away let him drink as much as he wants and thne top him up, it will only be beneficial to have him on as much as possibe.

hope that helps a little!

[Goosie22]

Hi,
Congratulations on the birth of your baby, and Im sorry you have had a rought trip so far. I am one of the people that will say "hang in there" its only going to get better.

Here (http://www.lalecheleague.org/NB/NBpremature.html) an LLL page with a few links that you might find helpful.

Someone has already mentions offering the breast as much as posible and seeking out an Lactation Consultant (http://www.alca.asn.au/find.php) with experience with preterm babies and I would strongly agree with those suggestions.

Just to add to the suggestions though you could give extra EBM while your breastfeeding through a SNS (http://www.medela.com/NewFiles/specialtyfdg.html#sns) (supplemental nursing system) once you get the hang of it will cut out bottles all together, usually you would offer 1/4 to 1/2 a feed in the SNS and the baby will get the rest of the feed from the breast.

kellymom on (http://www.kellymom.com/bf/preemie/index.html) Premies you might find something that helps there also.

[Funkychicken]

Hi again. Hopefully you have found the answers about supply at one of the sites that has been recommended. :)

[Mischief]

Hey Mandy - Congratulations on the birth of your beautiful baby.

My son was full term (4 days late actually) but I have had alot of problems trying to breast feed.

Ive been expressing for almost 2 months now, and am giving Oliver all EBM except for his middle night feed, I give him breast at that time (my CHN has said that is probably why my supply is going well still).

Best tips would be:

Express when your baby goes down for a nap....grab a bottle of water, and a snack and sit yourself down somewhere (I usually express while I use the computer now...but originally i sat and watched TV with the subtitles turned on...:D) relax, and express....if you are tense your let down is much harder to get.

Express every 2 hours if you can, until your supply is established....both breasts....now most days I can get away with 5 sessions and the one BF...some days I have to express every couple of hours though, just to boost my supply, but once it is back up again....she's apples!

Massage your breast before, during, and after.....I hold my breasts and gently rub my thumb down over it, smoothing any lumps out, down towards the nipple. Pay special attention to the underarm side and below the breast, as that is where the lumps tend to form the most (in the milk ducts)....once your milk stops flowing so much, gently sandwich your breast between your palms....it helps drain it out.

Pump for an extra 5 minutes at least, even after your milk has stopped flowing....sometimes you get a second "wind" but even if you dont, your body will provide extra milk for next time!

Let your bub suckle even if he isnt "feeding", because your body will pick up on any infections he is fighting and help you to produce the antibodies to fight them....it also helps your supply. :)

Gravity helps....if you are having trouble emptying your breast, lean forward and massage....helps release the milk...

Oh, and if you dont have one...GET AN ELECTRIC PUMP!

Any milk that you have left over, stick it in the freezer, sometimes no matter what you do you supply may get low for a few days, esp if you are sick....if you have some in the freezer you can suppliment with that before formula! :D

Goodluck, you are doing a GREAT job. If you have any questions or just want to chat, feel free to PM me anytime!!!!

:)

Cheers,
Kat and the happily EBM baby Oliver!

[~Mands~]

Thanks Charmzy for sharing your experiences, it really made me want to keep going! And thankyou everyone else, I have had a look at the websites, and they have been very useful.

I am still expressing most feeds, and offering breast once-twice a day. I am hoping to start offering the breast more very soon. We are taking it one day at a time... he is a little star so hopefully we will get there, but for now at least he is getting the best milk there is- even if its not directly from the source!

[Mischief]

but for now at least he is getting the best milk there is- even if its not directly from the source!

Yes he is, you are doing an amazing job, and giving him the best start possible!