My preemie is coming home soon, and I need help :(

[@llli*envyninja]

Hi, I am sure this has been asked and said many times, but there is something about writing a personal post (almost a vent) with personal answers that just helps.

I gave birth to my preemie at about 31weeks, - He has done amazing ever since being born (breathed solo since birth, gained weight, is now out of incubator, and taking each feeding from the bottle)

I have an amazing supply (almost 40ozs per day) - I think that is mostly due to the fact I was BFing my older toddler throughout my pregnancy so my body just remembered what to do - My boy is only getting BM, gaining weight at a great pace (no fortification in anyway) - And hell I have tons of milk to spare and am even donating the spare milk

My biggest issue, is I can't get him to actually breastfeed- He is almost 35weeks, and I know the lactation consultant at the hospital says "he will get it" but it isn't helping, I feel like a failure, and I hate this goddamned breastpump (I can't wait to drop kick the thing down the stairs) - One time he got it, and nursed and it was amazing, but ever since then he will root, latch, suck for a moment, (literally one or two sucks) and either look confused, or fall asleep right there and then, I have tried skin on skin, keeping him uncovered, playing with his feet, football position, - Yet the moment I give him the whore-y bottle (That horrible little Snappy bottle that just throws milk at him like it is nothing) - he guzzles it down, and is the happiest little chubalub you ever seen - I almost take it personally - I want to breastfeed, my body can and is making tons of milk, but I just can't get him to do it.

the consultant says he will need to transition from bottle to breast and he "wont go straight to breast" when he comes home - but I definitely want a less milk throwing bottle if I have to have one, what do you suggest? How did you get your preemie from bottle to breast - I do have very large breasts (is that an issue for a preemie? I mean my breast is literally BIGGER than he is right now)

I would love some tips, advice to do the swiftest easiest transition from bottle to breast, I can't stand bottles, I loved nursing my other baby, it was just that thing only I could do, and was that special bonding time I want and need and I can't stand the thought of being stuck with bottles, I know it's a selfish thing to want, I should be thanking the gods my milk supply is so good, but I want my cake and to eat it too I want to full time breastfeed again

Any tips on how to begin the transition from bottle to breast? I am willing to spend almost any amount on strange and whacky bottles if it will help I just want my breastfeeding sessions back, and to drop kick that pump down the stairs

[@llli*krystine]

I haven't been in your exact situation. I had a full term baby with a ton of breastfeeding problems who acted like a premature baby according to our LC. We did do lots of skin to skin and offering to nurse all the time, switch nursing (so once he stops nursing give him the other breast). I don't think you're stuck with bottles, I really do think he'll get it as long as you keep working at it. You have a bunch of great things you're already doing and sometimes it just takes time. My LC said most babies get the hang of nursing by 6 weeks so I don't know if by 6 weeks adjusted age things will get easier but I do know it can be easier for them to be alert and remove milk better when they're older and bigger. It took us the whole first year to work out all of our problems but we had a wonderful time nursing after age 1. I really hope things smooth out much sooner than that for you but I do think there's lot of hope.

[@llli*worknpump]

I've not been in your situation (as far as the issues specific to preemies), but the "finish at the breast" method worked for me with DS when he started to prefer bottles after I went back to work. Don't be confused about the put off about the origin of the article (it's from a resource about low milk supply, which you clearly don't have) but it offers one approach to handling issues related to getting a baby off bottles and on the breast.

http://www.lowmilksupply.org/finishatthebreast.shtml

The only other thought I have is to maybe try pumping to trigger your let down then immediately putting him to the breast. He may be more inclined to stay there for a while (allowing you to work on his technique and latch) if the milk is already flowing, as opposed to him having to work for the letdown right off the bat. This is essentially the same theory as the method above - you're giving baby the immediate reward of milk but doing so in a way that he ultimately learns to associate feeding with the breast. Then, as he gets stronger and learns to elicit letdowns on his own, you could phase it out.

Just some thoughts. Keep at it - I'm sure he'll get it and you'll be just fine. Congrats on your baby!

[@llli*mamamia]

SNS? If he's not latching, this might not work, but sometimes can help encourage latching.

Cup or spoon feeding? Messy but can discourage bottle-preference.

Babies sometimes do better nursing when they are just waking up. Will you be able to bed-share? Take your top off, baby down to diaper only for lots of skin-to-skin.

I think it's going to be a gradual process requiring lots of patience. Preemies just have a hard time learning all the coordination that breastfeeding requires. Having small, achievable *written* goals and recognizing the positives (write down two or three great things a day!) might help.

Congratulations on getting so much breastmilk into your LO! This is why nursing during pregnancy can be a huge blessing!

[@llli*krasota]

Finger feeding may help train the latch. SNS is less helpful because you have breastmilk right there, readily available. You don't need to stimulate supply or provide milk. The problem is that baby doesn't latch, not that there's no milk.

Have the latch evaluated. If there are suck issues, keep seeing the IBCLC. If you're still in the NICU, talk to OT and the speech pathologist.

My daughter got up to half her feeds at the breast (around 2m adjusted, 5m actual) when she went on a full bore nursing strike. I still offer daily (six months later), but she refuses. I'd love to kick the pump down the stairs, too. I have large breasts and giant nipples, too, but she latched fine when she was still very wee. Her reflux worsened and she developed oral aversions, so feeding her at all became a challenge.

Try lots of skin to skin, nursing honeymoons (all day in bed, skin to skin), nursing in the bath, etc.

[@llli*lllmeg]

Lots of moms find things get much better very quickly in terms of nursing 'normalcy' once they get baby home. You are an experienced nursing mom, so you know that the early days with a newborn mean nurse nurse nurse. Try to have the same mindset about when you bring baby home-line up lots of help so you can concentrate on baby. You have ridiculous production, so the transition to the breast may be quite quick.

Is it possible you have forceful letdown and that is what is confounding baby-too fast rather than too slow a flow?

If you think it is the fast flow of the bottles vs. normal flow at the breast causing the nursing issues, what about considering bottle alternatives as mamamia suggests? or at least paced bottle feeding?

and keep trying the ideas in this article http://kellymom.com/bf/concerns/child/back-to-breast/

You have the production. Now, once baby nurses at all, weaning from pumping/supplementing will be largely a matter of confidence and trust in yourself and your baby.

[@llli*kevins-mom]

My son was not a preemie, but he was very small at birth and I had the same problems getting him to latch.

My LC had us start using a nipple shield in the hospital. He actually didn't nurse with it until we got home and he was spoon fed and we used SNS (although on our fingers because he still could not latch to my breast). The nipple shield worked for us eventually, although it is definitely not ideal....

For us it took a LOT of patience and practice. Try taking your baby in the bath with you to nurse. It's a relaxing place for both of you. Just keep at it, and it'll get easier and easier!

Congratulations on your new baby

[@llli*kathy.montemauge]

I had two premies and nursed both. My 1st was born at 33 weeks and was Nicu for a month. It's sounds like you are still in hospital. If possible switch from bottle feeding to tube feeding. Here are my tips (that worked on mine) for teaching a premie. First to help your baby stay awake undress him and keep him skin to skin when nursing(great job doing this). Take your nipple and run in a down motion on his lips. This should make him open his mouth. To get a deep latch use your hand to make your breast look like a hamburger. Be careful to move your hand in different positions so you don't get plugged ducts. To get him to swallow run your finger along his check from nose to ear. I know it is so much work but try to think of him as a student and you have to teach him everything about nursing. It is so important especially for a premie. You are not a failure. Every drop of breast milk you give him is priceless. If he is just having trouble because it is easier to bottle feed try nursing him when he is sleepy. Also a nipple shield can help transition. It gets better as he grows.

[@llli*joshuas.mommy]

I don't have personal experience nursing a preemie but from what I've heard, many preemies don't get the hang of nursing until somewhere around their original due date. Your LO is still only 35 weeks and may just not be mature enough to coordinate breathing, sucking, and swallowing. Others have given great advice on getting baby to the breast but one thing to keep in mind is you may just need to give it more time. Keep trying!

[@llli*envyninja]

Hi, and thank you for all the replies! I took a while to get back to this, it was so hectic getting him home and in routine and then snow, ectect

Right now he is great with the shield (we have a preemie sized shield if this makes any difference to my upcomming question)

He CAN latch, and has latched and has breastfed, but it's almost like he forgets, I can't figure out what perfect combination of things I am doing that causes him to latch when he does, - In fact almost every time he latches perfectly, big wide mouth, takes it all in (I do the hamburger pinch and even get the milk flowing a little for instant gratification) - But he'll NORMALLY suck once or twice, and give me a sort of disgusted face - Yet if I put the preemie shield on, he'll nurse the entire session without a hitch

I've tried starting with breast, I've tried starting with shield and doing the ol' bait and switch, but he'll either fuss that I took away his shield, or just fall asleep when I unlatch him for the change.


I was wondering, should I upgrade from preemie shield to normal sized shield to perhaps get him used to a larger nipple for a bit then try breast again?