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  1. #1
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    Default Prem has nipple confusion... what can I do?

    After having got the hang of breastfeeding and doing really well, today dd2 started refusing the breast after a few sucks but would happily take the bottle. I knew there was a good chance this could happen as she is having ebm bottles (alternated with tube feeds) while I'm not there to breastfeed.

    She's not due home for a few weeks yet so cutting out bottles isn't an option. What can I do for now and then once she gets home?

    My supply isn't an issue and I have a strong letdown almost immediately after she attaches. She has a good latch and is usually finished within 20-30 minutes.

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    My fella was only just prem (36 weeks) and couldn't latch because he was just too sleepy. I would just always try the breast first and then give EBM in a bottle. Then pump, then try again every 3 hours (so was exhausting) and after a week or so he eventually got the hang of it, just took time.

    Maybe just try bub every time you can at the breast and if she won't latch, give her the bottle. She might just need to get a little stronger to be able to latch properly every feed?

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    atomicmama  (18-01-2014)

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    She's wide awake while I'm trying and til after she has finished the bottle, but I will definitely keep offering the breast first... I'm determined to breastfeed.

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    There are teats from medula called Calma (I think) that are supposed to make baby work for it a bit more to help avoid confusion.... Not sure if they are appropriate in a premmie but maybe worth a look.

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    atomicmama  (18-01-2014)

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    Unfortunately my prem never got it and we were exclusively on EBM for 9.5 months! BUT it wasn't for lack of trying so I know every trick the lactation consultants tried with us!! Don't let that discourage you though (although it sounds as though you'd be hard to discourage!) I was the only one I knew, DD's other roomies, all <30 weeks made it on to exclusive BF.

    There was one mum who had a prem previous and was very experienced in it all, she insisted the nurses use the medela calma teat while she wasn't there, and would partially undress her bub when he was being fussy at the breast, to try and keep him alert.

    Are you working with the hospital's lactation consultant?

    Do you notice when you express that you get a lot of watery milk at the start? I did and the LC suggested I pump for about 90 seconds before putting DD on the breast, so that the thin watery milk is avoided. It might be deterring her a little?

    As a positive it's great that she's sucking down bottles weeks from her due date! Does she still have NGT?

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    atomicmama  (18-01-2014)

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    Quote Originally Posted by GM01 View Post
    Unfortunately my prem never got it and we were exclusively on EBM for 9.5 months! BUT it wasn't for lack of trying so I know every trick the lactation consultants tried with us!! Don't let that discourage you though (although it sounds as though you'd be hard to discourage!) I was the only one I knew, DD's other roomies, all <30 weeks made it on to exclusive BF.

    There was one mum who had a prem previous and was very experienced in it all, she insisted the nurses use the medela calma teat while she wasn't there, and would partially undress her bub when he was being fussy at the breast, to try and keep him alert.

    Are you working with the hospital's lactation consultant?

    Do you notice when you express that you get a lot of watery milk at the start? I did and the LC suggested I pump for about 90 seconds before putting DD on the breast, so that the thin watery milk is avoided. It might be deterring her a little?

    As a positive it's great that she's sucking down bottles weeks from her due date! Does she still have NGT?
    I already partially undress her if she starts to get too comfy to suck.

    I'll have a look for those teats and try pumping beforehand.

    Unfortunately, I had a really negative experience with the LC with dd1 so, when booking into the hospital this pregnancy, I asked for them to note that she not come near me. The scn nurses are really helpful though and know how much I want to breastfeed so I'm sure they will have suggestions, just thought I'd ask you ladies too

    It was so disheartening today watching milk pouring out of my breasts while she was refusing.

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    I agree with the calma teat and also with expressing for a bit prior to attaching bub, DS2 (31 weeker) took ages to get the hang of breastfeeding and initially my letdown was just too much for him and he would pull off and refuse to try again. With a lot of time he eventually go the hang of it.

    You sound like you're doing an amazing job - it's such a rough journey

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    Could you try the medela supplemental nursing system? Bub still breastfeed a from you with a tiny little tube in his mouth with is connected to a bottle hanging from your neck with ebm or formula.

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    Sounds like you are doing an amazing job in a very tough and stressful situation.
    Could it be that a forceful let down might be too much for your bub? I had massive supply and a forceful let down particularly if very full and due/overdue to express, and my little prems sometimes struggled with this. I would express off a little bit before putting them on the breast, partly so it was easier to latch, and also so they weren't getting overloaded so fast.
    How many feeds are you able to be there for? And how many weeks is your baby?
    My twins were born at 25+6 and I found the whole breast/bottle/tube so hard! I didn't let the nurses give them bottles in SCN until around 37 weeks, and before that it was either tube or breast, then at that point they started bottle overnight when I wasn't there. Had bottle or tube top ups after each breastfeed though I think, as I was just not confident in what they were getting from the breast.
    Keep persevering (if you want to!!) with breastfeeding before the bottle, and hopefully as your baby gets bigger and stronger they will come to prefer the breast.
    (FWIW we had the endless express/BF/topup cycle continue on and off for almost 6 months BUT once we overcame the initial obstacles i managed to continue happily breastfeeding my twins for 2.5years!)
    All the best, I hope you have your baby home with you sooner than you think xxx

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    How you and bub getting on @redlipsandpearls ? I've been thinking of you.


 

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