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Thread: Bottle to breast from NICU

  1. #1

    Default Bottle to breast from NICU

    Had our little girl early at 33 weeks and as we went at home I got to stay with her at the hospital and see her in the NICU whenever I wanted. I started pumping that night but she did get some donor milk from tube until mine really came in. She had no health issues initially and we were able to start syringe feeding her and tried breastfeeding with a nipple shield. They also had us doing a bottle once in a while. She got a fever in the first few days and they for some reason also did an MRI which showed bleeding in the brain and they thought maybe a cyst so she was airlifted to another children's hospital 3 hours away. They since ruled out any real health issues and we worked on getting her to either breastfeed or take a bottle so we could go home. I felt more pressured to use the bottle so we could leave but I did work with lactation a couple times who always told me I was doing everything fine and didn't have many suggestions. We used he nipple shield every time and follow up with a bottle to make sure she got enough. When we were finally discharged at 37 weeks I tried breastfeeding at home with the shield and kept following up with a bottle. She wouldn't take formula so they had us add it to milk. I kept up pumping about 8 times a day and have a freezer full of milk. I went to lactation consultation here at home and she showed off that day. I was only trying to breastfeed a couple times a day then and she suggested doing it every time. We dropped the shield before this and she had been doing ok with latching but I am never sure she's getting enough so always added a bottle fortified with the 22 calorie after breastfeeding for about 10-15 minutes. She will either fall aslee after that much time or pull away and cry
    I had planned on breastfeeding so it's been very frustrating that things haven't gone to plan and I'm trying to stay positive but sometimes she just won't eat or she's latched but I don't hear any swallowing. When I give her the bottle after she often doesn't take much at all. I've had to go back to work part time at 6 weeks old and I bring her one day and my husband is home with her the other two so i need a mixture of breast and bottle feeding but would like to be able to feed her when I am around without having to warm up a bottle. Or feed in bed so I'm not getting up (although I still pump at night -about 6 times per day)

    I know this is long but any recommendations? She's two months old today but really only 2 weeks past her due date. Am I just expecting too much? Should I not try to breastfeed each time to give her a break? I don't want to have her expect a bottle every time when mommy is home

    Thanks in advance!

  2. #2
    Join Date
    Jun 2009

    Default Re: Bottle to breast from NICU

    Wow you have been through quite the ordeal.

    Of course it does not help that you had to go back to work at 6 weeks, which seems particularly hard when you and baby had so much trauma the first few weeks. But assuming you make enough milk and there is no physical barrier to your baby being able to transfer milk normally at the breast, there is no reason you cannot get into a pattern where your baby exclusively nurses when with you.

    I am a little confused on some points. It would help to know:
    Is baby considered entirely healthy at this point?
    How is baby's weight gain?
    Is baby's doctor saying baby needs supplements or fortifier at this point and why? Is baby at this point supplemented only with your expressed milk or formula or fortifier as well?
    What exactly is going on now on the days and nights you are with baby as far as nursing frequency? How many times in 24 hours is baby eating total?
    Is baby getting a bottle after every feeding, some feedings? How much is in the bottles?
    When baby takes a bottle when you are at work, how much does baby take typically? How much do you think she should take?
    Can you explain more about how baby "showed off" at the lactation consult and when that was exactly? Was a before and after nursing weight check done?
    Did you like that consultant? Have you been back in touch with her? Often it takes a follow up appointment or two to get things on track.

    No mother can tell exactly how much her baby is getting at the breast. This is not typically necessary.
    Falling asleep at the breast is usually normal and not a problem.
    Last edited by @llli*maddieb; December 19th, 2016 at 09:45 AM.

  3. #3

    Default Re: Bottle to breast from NICU

    Thanks for your reply. It's definitely not making me happy to have to work when I really need to focus on her. I guess I feel obligated to. I was originally going to take three months but it's a small company and when two people leave unexpected it makes more of a strain on things so I'm at least not full time but that doesn't mean it has been easy or ideal

    As far as health is concerned she's been a "normal" preemie since we went home early November
    She's gaining on the same curve as a term baby but our pediatrician wants her to jump up to that curve. I'm not sure that's realistic but she is growing and over the last week it seems like she's growing a lot
    We have another appointment this week but they want us adding 22 cal neosure formula powder to all breast milk bottles and she gets multivitamin supplement with iron once per day in a bottle as well

    I try to breastfeed every time she wants to eat, excepting the two days my husband has her while I am working and for one feeding that he does in the middle of the night. She usually eats 6-7 times a day and when it's a bottle anywhere from 2-3 oz at a time

    The showing off for the LC was mainly that she latched no problem and was consistent in her sucking and according to the before and after weight, took 1 oz. lately she will sometimes have trouble getting a good latch and waves her head side to side or does the baby bird pecking and after less than 10 minutes she starts to freak out and scream. It's hard after that to calm her down enough to latch again on either side. I think I have a squirt if I don't pump often enough and it's too fast for her but that's a guess. When I pump every 3-4 hours I don't see it squirting as much as if I go 5-6 hours between pumping even if we breastfeed. I was supposed to see a different consultant this week but she got sick. It's a small town and my options are very limited but I've seen the one gal a couple times now.

    Since I first posted I've been working on side lying with her in bed and she's gotten better at that. But I still end up having to give her a bottle after as she's still hungry and won't latch anymore after getting upset. I'm definitely not giving up on her. There are some days we do great and others that it's just super hard to stay positive. If I stay home all day and don't go anywhere we do better. If I run any errands with her it throws things off. The town we go to for groceries and such is a half hour drive so it's at lest an hour to driving instead of hanging out together which I know isn't helping.

  4. #4
    Join Date
    Jun 2009

    Default Re: Bottle to breast from NICU

    She's gaining on the same curve as a term baby but our pediatrician wants her to jump up to that curve.
    Huh? Why? Is this why they continue to want baby getting formula?
    Vitamins, if needed, can be given in droppers, that is how non-bottle fed babies get vitamins.

    2 month old babies normally nurse a minimum of 8-12 times in 24 hours. If your baby is eating less frequently than that, it may be that baby is being asked to consume more than would be normal at each feeding, and that in turn will create a situation where baby asks to nurse less and less, and so a situation can snowball. Have you tried offering to nurse- just nurse- more frequently? Also I would suggest reconsider any bottles given when you are physically there to nurse.

    It is important that baby nurse with high frequency for a few reasons-because this is good for milk production, reduces issues of fast letdown if that is happening, and perhaps most importantly in your case, because this way, baby has a chance to fulfill her needs at the breast so you can start reducing the supplements. That would be difficult for many 2 month olds to do nursing 6 or 7 times a day.

    when it's a bottle anywhere from 2-3 oz at a time
    This amount for a bottle given instead of nursing session sounds fine.

    I think it would help to 1) clarify if your doctor's expectations for gain are appropriate. Overfeeding with supplements is a surefire way to undermine breastfeeding. A resource you may find helpful is the book My Child Won't Eat. He explains weight charting and how charts are often misunderstood and misused.

    2) see if baby will nurse more often if offered. Every feeding session does not have to result in a ton of milk transfer. It is normal for per session intake to vary considerably and you want to encourage your baby to nurse "for comfort" as well as food. Also when baby seems fussy right after nursing, consider keep offering to nurse or try comforting another way. Assuming normal gain, it is entirely possible baby is just fussy, not hungry.

    3) keep working with whatever breastfeeding help is available.

    If you planned to take a 3 month leave and are being prevented from doing that because other people are out, I am not sure how that is your responsibility. Your baby's health concerns early on if anything would warrant a longer leave, not a shorter one. (I mean logically, not legally.) Maybe there is a way you can assist your employer if they are in a tight spot, but not be separated from baby as much. This might not be necessary to get baby nursing exclusively when with you, but it would probably help.

    Also, Kelllymom.com has an article about weaning baby off formula supplements you might find helpful.
    Last edited by @llli*maddieb; December 20th, 2016 at 03:00 PM.

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