Bottle to Breast for Difficult to Wake Preemie

[@llli*dmwiecz]

My daughter was born at 35.5 weeks 2 weeks ago. From the beginning, I've been pumping and giving her breastmilk through a bottle with some supplements of formula earlier on when my supply wasn't enough. The lactation consultants in the hospital encouraged me to start out this way because they didn't think she'd have the energy to feed directly from the breast and the priority was on getting her to gain weight. (She's 15th percentile for weight for a 35 weeker.) I've also been told to wake her every 3 hours around the clock for feedings (in the 2 weeks since she's been born, I could count on 1 hand the number of times she woke on her own and seemed hungry - almost always I have to wake her up to eat).

I'd like to transition her to breastfeeding at some point, but I'm not sure how/when to make that transition. The complicating thing is that she's still in that super sleepy preemie phase when it's a huge challenge to wake her enough to feed from a bottle (takes her an hour sometimes to take an ounce despite cold washcloths, being stripped down, etc.). So, I can't imagine that breastfeeding will work for us at this point since it requires even more effort on her part. I have been putting her to my breast for about 10 minutes before feedings and she'll latch on and take about 3 sucks, but that's as far as she'll go. Given that it takes a lot of effort to get her to take more than 3 sucks in a row from a bottle at this point, I'm not surprised that she doesn't last longer.

So, my questions are:
1. Is there anything else I should be doing at this point to increase the chances that she'll eventually successfully transition to breastfeeding?
2. Since feedings from a bottle are time-consuming/challenging enough as it is for us at this point, does it make sense to wait until she's "woken up" (I hear this tends to happen a couple weeks after their due date?) and is a more active eater from a bottle before making an effort to transition her to the breast?
3. Are there any particular bottles/nipples I should use in the meantime to increase the chances of a successful transition?

Thanks in advance for any suggestions/advice! I really appreciate it.

[@llli*mommy2lilah]

Could you latch her on AFTER you feed her a bottle? So she still latches, but you're not worried that she's not getting enough to eat and she gets the warm fuzzies of nursing while her tummy is full?

I think you're doing great mama! I have heard that it often takes preemies until the due date or so to really wake up. I had a super sleepy baby born at 42 weeks though, so have some patience.

Hopefully one of the preemie mamas will stop by.

[@llli*smudge]

Here some thoughts that came to mind as I read your post:
1) spend as much time as you can skin-to-skin. I mean no bra, just a diaper between you two. That may tempt her over time to begin rooting for your breast whether or not she is awake, or to latch whether for comfort, practice, or a feeding. It will also help with your milk supply & just feels lovely. It's the joyous snuggly part of having a newborn :-)

2) we liked the breastflow bottles. My DD had had to work at sucking similar to real breastfeeding. We didn't have any nipple confusion & she still preferred the breast over the bottle when available. But I know every baby prefers different bottles & I don't know if breastflow bottles are useful during the preemie stage. You might want to contact a LLL leader or lactation consultant for their opinion.

3) I wouldn't worry too much about her actually feeding at the breast yet. You are getting her the milk & working with her to feed. Keep working with your lactation consultants to help you both transition. You are doing an AWESOME job! Your DD is a lucky little girl to have such a dedicated mama :-)

Congrats on your little girl. Motherhood is such an amazing journey & breastfeeding is truly a gift- no matter how milk flows. Enjoy these precious memories!

[@llli*sassypants]

I don't have any extra advice, but I wanted to tell you that we went through something similar. DS was born at 36 weeks and was super sleepy at the breast. We made sure he latched at every feed, every 2 hours, and tried to keep him awake as long as possible (with tickling him and taking off clothes to make him cold, etc), then offered a bottle.

After about 2 weeks of this he was awake enough to exclusively breastfeed. Yes, it can happen! Keep pumping to keep up your supply and keep trying to get a good latch at every feed. Alway offer the breast first.

Good Luck!

[@llli*dmwiecz]

Thanks to all for the suggestions. Sounds like patience and persistence is the way to go. I do try to do kangeroo care or carry her around in a sling as much as I can, but I'll admit that when it takes 1.5 hours to feed her and pump myself and I have to feed her every 3 hrs, it doesn't leave a whole lot of time in the day to just snuggle with her - as much as I'd love to do it 24/7! I'll look into the Breastflow bottles, too. Thanks again!

[@llli*kst.7399]

Welcome to the forum and congrats on your baby! My daughter was born at 33 weeks and my LC kept telling me to try, but to not expect any major results until it was her due date. Remember your baby is still supposed to be safe inside your belly, sleeping and eating through you. It's hard work being a newborn and even harder work being a preemie newborn. I know you would love to hear a solution, but like you said time and persistence is your best friend right now. You are doing a great job, most moms would have given up by now. But I promise it's worth it. I agree lots of skin to skin. Just keep trying and try not to get frustrated.

[@llli*dmwiecz]

Welcome to the forum and congrats on your baby! My daughter was born at 33 weeks and my LC kept telling me to try, but to not expect any major results until it was her due date. Remember your baby is still supposed to be safe inside your belly, sleeping and eating through you. It's hard work being a newborn and even harder work being a preemie newborn. I know you would love to hear a solution, but like you said time and persistence is your best friend right now. You are doing a great job, most moms would have given up by now. But I promise it's worth it. I agree lots of skin to skin. Just keep trying and try not to get frustrated.

kst.7399,

Thanks for your reply. Was your daughter eventually able to transition to breastfeeding despite being so used to bottles? If so, how old was she when that happened and did you do anything in particular to make the transition or just keep trying her at the breast regularly?

Thanks! It's definitely good to hear that while it might be awhile, I'm on the right track!

[@llli*kst.7399]

The crazy part is she latched for the very first time ever on her due date. I cried. I won't lie though, it took another month before I could toss the bottles and another two months after that to get it all right. She needed to be big enough, strong enough and for it to click in her brain. My son took 3 weeks to latch - and he was full term - so really time is all what it takes. But for me, knowing that made it easier to deal with. By the time I had my son I had been on these boards for 4 years and knew what to do. Doesn't mean it wasn't frustrating. Of course it was. But there were days that I just didn't have the heart to try and knew it wasn't going to set me back. Keep trying but the more frustrated you get the more she will sense it. Stay calm, be patient and know it will click.

[@llli*dmwiecz]

Thanks kst.7399. Appreciate the support and the info. Good to know that your little one eventually "got it." Hope mine will, too.

[@llli*lynxie.rampant]

I just wanted to say hi because I have sort of the same thing going on.

My little girl was born at 35 weeks on September 14th at a big 8lbs and it took her a good month to regain her birthweight. So she's 7 weeks, technically. I was hoping she'd wake up a little more by her EDD, but alas! We had a couple days here and there of good BFing, but overall I just keep pumping like crazy.

I offer her the breast mostly for comfort sucking (I am thankful that she actually needs it to fall asleep...at least she likes me!) and practice before and after her bottle. I also let her nurse all night as we bedshare. I won't lie, I have wanted to give up almost every day. But I also keep holding on to hope that one day she won't be so lazy and sleepy and it will just click.