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Thread: Preemie Home and Thriving - Transition to EBF?

  1. #1

    Default Preemie Home and Thriving - Transition to EBF?

    Hi everyone! This is my first post, though I have been reading other threads and been reading The Womanly Art of Breastfeeding. My son was born on 12/21/12 at 31 weeks and 3 days, a relatively hefty 4 pounds 4 ounces. I was blessed to give birth at a hospital with a fabulous Level III NICU and that was super supportive of breastfeeding. The first time I talked to his NICU nurse I told her that I wanted to breastfeed, and about 12 hours after his birth, a lactation consultant walked into my room with a Medela Symphony, fitted me for the right size breastshields, and helped me pump for the first time. I was extra blessed with a great supply - that first pump I got about 20 mL of colostrum, and it only went up from there. Nowadays I can usually pump at least 8 oz of milk in a session if I go 6-8 hours between pumps, and 3-4 oz if I go 3-4 hours between pumps.

    DS was in the NICU for 5 weeks, and throughout that time got nothing other than breastmilk (except the IV fluids and fat he got the first few days of life when he couldn't eat by mouth). There was a brief consideration of fortifying my breastmilk when he seemed to be gaining weight slowly, but we decided to focus on giving him hindmilk (I would separate the foremilk out at the beginning of the pump) and he was released from the NICU weighing over 5 pounds.

    I was able to start non-nutritive breastfeeding early on, where I held him to my breast for him to be able to lick and nibble a little, and he did well with that. Once he was able to start eating by mouth, I was able to start nutritive breastfeeding, and he did very well with that also. We did have to use a nipple shield, but he would nurse for extended periods of time.

    He has now been home for just over 3 weeks. He is still doing great gaining weight (was 6 pounds 2 ounces at his weight check last Friday, which was a 15 ounce gain in 11 days). He is so good at switching between the bottle and breast, and eats great either way. He has been able to latch on without the nipple shield a few times, though it is definitely not happening when he is hungry.

    I have to confess that I tend to default to bottle feeding him rather than breast feeding him because I know how much he is getting so I know it will help him gain weight, and I know that he will be OK not to eat for the next 3-4 hours if he takes a bottle (whereas he wants to eat every 1.5-2 hours with the breast). I am somewhat scared to bedshare, and we haven't been able to successfully nurse that way anyway, so DH and I are each getting up once a night to give him a bottle.

    I want to transition to exclusively breastfeeding him, but I am kind of scared to do it, especially for the overnights. Does anyone have any supportive input or helpful tips for me? I keep thinking about going to a local LLL meeting but I am not really supposed to have him around other people because of his immature lungs. His due date is Tuesday!

  2. #2
    Join Date
    May 2006
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    19,887

    Default Re: Preemie Home and Thriving - Transition to EBF?

    When you have a small, young baby who has had a rough start, it's really natural that you're going to have some worries about EBF, since as you said, it can mean not being able to measure how much your baby is eating. And it's also really normal to enjoy the relatively predictable routine that bottles can foster.

    I think it's awesome that you want to transition to nursing your baby rather than bottlefeeding him. You're just going to have to adjust your expectations a bit when it comes to what a normal interval between feedings is, and you're going to have to build your self-confidence as you get away from precisely measured feedings.

    It is entirely normal for newborn babies- and even many older babies- to nurse every 90 minutes or so. Breastmilk digests fast and infant tummies are tiny. In order to create and maintain a good milk supply, most term newborns nurse at least 10-12 times a day. Those feedings are not always evenly spaced. Many babies will take some long naps, resulting in 3-4 hour breaks in between feedings, and will also do some cluster feeding, nursing very frequently (maybe every 15-30 minutes) during other parts of the day. So let go of the idea of feeding every 3-4 hours, and let go of the predictable routine, and you'll be a long way towards the eBF lifestyle.

    When it comes to measured feedings and anxiety over whether or not your child is getting enough, there are a couple of options for tracking intake that don't involve bottles. The simplest- and the only one most moms of healthy term newborns use- is to track diaper output. As long as the baby is producing adequate wet and poopy diapers, you can be pretty sure that he's getting enough to eat. Can't come out if it didn't go in, right? The second, more technological solution is to rent a professional scale and do pre- and post-feeding weight measurements. Subtract the before from the after and you know exactly how much your baby ate while nursing. If the baby eats around 2-3 oz on average, and nurses 10-12 times a day, you know he's getting enough and there's no need to supplement.

    Since your baby is now term, I think I'd talk to your child's doctor and ask whether or not his lungs should still be considered immature. You might be able to take him to the La Leche League meeting after all!
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3

    Default Re: Preemie Home and Thriving - Transition to EBF?

    Thank you so much, mommal! Thanks in large part to your reply to me I decided to spend a couple of days on a "nursing holiday" and not focus so much on routine or trying to get anything done around the house. I posted up on the couch with the Boppy and the baby and just nursed him whenever he got fussy. It took a couple of days, but we're now at the point that he is getting only one bottle a day, usually overnight. I am so happy not to be pumping so often, and we are having great bonding time.

    Preemie moms - it can be done!

  4. #4
    Join Date
    Oct 2009
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    2,584

    Default Re: Preemie Home and Thriving - Transition to EBF?

    Wow! Great work! My daughter's first year all I got done was pump and nurse and bottle feed her milk, pretty much. I just had to really lower my expectations of housework and everything else since feeding her was really my priority.
    Nursed my sweet daughter 3 years, 3 mos.

  5. #5
    Join Date
    May 2006
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    Default Re: Preemie Home and Thriving - Transition to EBF?

    So awesome, mama! Well done!
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  6. #6
    Join Date
    Jun 2006
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    4,893

    Default Re: Preemie Home and Thriving - Transition to EBF?

    Quote Originally Posted by @llli*azjen View Post
    Thank you so much, mommal! Thanks in large part to your reply to me I decided to spend a couple of days on a "nursing holiday" and not focus so much on routine or trying to get anything done around the house. I posted up on the couch with the Boppy and the baby and just nursed him whenever he got fussy. It took a couple of days, but we're now at the point that he is getting only one bottle a day, usually overnight. I am so happy not to be pumping so often, and we are having great bonding time.

    Preemie moms - it can be done!
    This right here. It can be done. We need to be patient with preemies. They aren't meant to be in the world yet. I hope you are keeping at it. It's not easy but it's so worth it!
    If you obey all the rules, you miss all the fun. - Katharine Hepburn

  7. #7

    Default Re: Preemie Home and Thriving - Transition to EBF?

    I just wanted to update on my thread and give thanks again for the help. Baby is now almost 5 months old and a champion nurser! I have been back to work for 5 weeks and have been blessed with a good supply for pumping so that he has gotten exclusively breast milk since birth. We nurse exclusively outside of work hours and weekends and he gets bottles of expressed BM from the nanny during the day. He is now over 14 pounds! (Born at 4 pounds 4 ounces). I am thinking about going to an in-person LLL meeting soon, now that I am feeling more confident about his immune system and since we are out of cold/flu season.

  8. #8
    Join Date
    May 2006
    Posts
    19,887

    Default Re: Preemie Home and Thriving - Transition to EBF?

    Awesome, mama!
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

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