Confusion and discouragement

[@llli*haunani]

My brain is just all over the place and I know I need to get some help with my little man.

Background: He was born 7.5 weeks early and spent nearly 6 weeks in NICU. He had recurrent issues with jaundice, anemia, and apnea. He had tube feedings for most of his stay there, only going to all bottle feedings about 5 days before he came home. We tried introducing the breast when he was about 1-2 weeks old, but then his issues started up again and he went NPO for a little while. After that, I made the decision to not attempt breastfeeding again until he came home, as I wanted to concentrate on GETTING him home... which meant finishing his bottles and showing weight gain. I didn't want to risk any issues that may have prolonged his stay. I now know this was a bad decision and is likely playing a HUGE role in our current issues.

He came home last Monday, 10/29. His DD was 11/10, so this coming Saturday.

I have extremely large breasts (36Q) with flat/inverted nipples. My left breast is larger than the right, with a flatter nipple.

Current: I started introducing the breast again intermittently when we came home last week. I ended up exhausted with the pumping, bottle, breast routine and went back to full bottle for 1-2 days. At the suggestion of a friend, I tried going 100% breast on Saturday. He seemed to do well during the day, with hubby giving him a bottle at night so I could get some sleep (I still got up to pump). Then last night (Sunday), he started demonstrating some latching issues.

He'll latch on, wait, then pop off, scream, latch on, wait, pop off, and scream. Repeat. His latch has also changed and is now very shallow, even with the use of a nipple shield (no latching at all without one).

This morning (Monday), he won't even latch on. As soon as I get him in position (football hold on right), he just immediately starts screaming and won't stop until he has a bottle in his mouth.

We've been using the Dr Brown bottles with the Preemie nipple, at the recommendation of the hospital's LC. I also have some Avent, Similac and Momma bottles on hand if it matters.

I've sent an e-mail to the local LLL Leader (meeting isn't until next week) and I can't afford a LC. Heck, we can barely afford our own food right now since I've taken off 4 weeks FMLA (without pay) and I'm the only income right now.

I go back to work November 30 and would like to have at least something established, as I don't expect him to be anywhere close to good by then.

[@llli*djs.mom]

It souds like you have OALD. And a sensitive child. Try beginning by pumping and letting your initial letdown spray into a towel so it doesn't overwhelm him. Or feeding him in a position that is slightly more upright so that he doesn't get overwhelmed with your milk.

[@llli*djs.mom]

Hopefully he will outgrow being frustrated by it as he becomes full term. I had OALD and my baby both popped off and clicked. Which in an effect of the shallow latch you are seeing. They latch lower so that they can control the milk spray with their tongue. It never bothered my son though. He was very focused on eating and he didn't know that there was a such thing as a bottle. So he would pop off wait, go in for a few more sucks and repeat. Without the screaming. So I would stay skin to skin, emptying the breast as often as possible (like have a nurse in. Where you and the baby stay in bed all day with only the goal of feedings.) You want him to to forget that there is an easier way to get food. So have a nurse in and hopefully the combination of less full breasts and you letting down before giving him the breast will convince him to come back to the breast.

[@llli*haunani]

Thank you for the suggestions. I'll have to wait until Friday to try the nurse-in, as I would be up and down the stairs with baby and monitor (apnea) to clean the pump stuff every time.

Any suggestions for dealing with a sleepy baby? It's been over 3hours since he last ate. He was awake and upset during his diaper change, but passed back out when I swaddled him (to help stop him from clawing/grasping me and himself).

[@llli*djs.mom]

Well....for the nurse in I encourage you to let the pump go. If you need to pump at night to relive engorgement do that but other wise it would be you and the baby skin to skin and nursing on demand all day. And I don't suggest you wake a sleeping baby. BUT especially in the circumstances you are describing I highly suggest you try to breast feed your baby NOW. In that protesting at the breast is something AWAKE babies do. Sleeping or sleepy babies not so much! So I encourage you to drop your breast in your babies mouth NOW and see if you can get him to suck. Because most babies, even babies that are actively striking will suck in their sleep. It's instinct to suck in their sleep.

[@llli*elizabeth.johnson.2]

Another thing you might want to try along with a nurse-in is nursing on one breast for a block of say... 2 to 3 hours, and express the other breast just to comfort. The 2-3 hours is an approx, it's until you feel like he's ready to move to the next breast. That way, if he does latch on, just keep him latched on or if he falls off to sleep then maybe begins to stir, you can keep him in the same position he was just nursing in to encourage more happy-at-breast feelings

I had premie twin girls at 32 weeks 4 days and we had a very difficult time getting to nursing! Hang in there, this is just a phase and one day he will latch on and you can begin a really good bf relationship from there

Elizabeth

Isaac - 3 years
and Abby and Carrie - 1 1/2 yrs and still nursing!

[@llli*haunani]

Any recommendations for dealing with a weak rooting reflex? He's not opening his mouth super wide anymore. Actually, it's barely wide enough to even get the shield in. If I try to use a finger to help push down on his chin (which is fun when trying to wrangle the monstrous boob and support his head), he just clamps his mouth shut. If I try to wait for him to be hungrier (talking seconds-minutes here, so not long), he just starts crying and won't even try to latch.

I was talking to the local LLL leader, but she stopped responding to my emails a few days ago.

My new worry... He's losing weight. I don't have a number, but I can see it in how his diapers are fitting, his legs are getting skinnier, and he's losing his cheek chub. I truly worry if I only give him boob, he'll keep losing.

[@llli*djs.mom]

So have you been supplementing since Sat? Or are you still EBF?

[@llli*haunani]

Supplementing every feed except for 2.

He'll nurse for 2-5 minutes, then spit out my nipple and sleep. He'll wake up crying, suck 2-3 times, then pull off and cry. Wash, rinse, repeat.

Right now he's sound asleep next to my breast. It's been 3.5 hours since he last ate. I changed his diaper, which woke him up, but as soon as I laid him down (football hold on right) he was out.

[@llli*djs.mom]

How much are you supplementing?