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Thread: 25-weeker.......extremely high palette....please help

  1. #1
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    Dec 2006
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    Question 25-weeker.......extremely high palette....please help

    Hello......I'm the mom of a 25-weeker who JUST came home, after 125 days in NICU, Tuesday night.

    She's not strong enough to BF right now so I'm pumping and we're nippling her. I know this isn't a strictly BFing question but I am feeding EBM so I'm hoping someone can/will help.

    She's been pretty iffy with her feeds so the staff taught my DH and I how to insert an NG tube to gavage the left-over BM so that's how we've been getting the rest of her feeds down.

    Yesterday, as I was feeding her, I started thinking about how it seemed she was doing a LOT of work with very little end-results. She's just not getting down the amount of BM she should with as much as she's trying. She's got an extremely high palette because of being on the vent for so long. I started thinking that it only makes sense that we need to try some different things to help her be more productive.

    Instead of letting her take in as much as the nipple as she wants/can I have been pulling back and letting her have only part of it. This really seems to have helped her with the stream of suction. Also, just now, I started playing with angles of the nipple. I don't know if she suddenly got more energy or if it's because of what I did but she finally completed an entire feed, on her own, without the need of gavage!! And she did it with a good amount of energy!

    I'm hoping this is all doing the trick but am hoping that maybe there's a special nipple made to help babies with extremely high palette's? I don't want her to wear herself out with these feeds. She needs all of her energy to get stronger and grow.

  2. #2
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    Jan 2006
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    Default Re: 25 weeker......extremely high palette....please help!

    maybe there will be somebody else here that could answer you questions about the bottle and high palette. I just wanted to tell your doing a great job! Are you working with a lc? They might be able to help.

  3. #3
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    Jun 2006
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    Default Re: Mom of 25-weeker....just home from NICU...please help!

    I really can't answer your question, but have you asked the NICU drs or nurses? It does seem like such a nipple would exist. Good luck to you-my DS had feeding troubles when we first brought him home and I know how scary that can be. My thoughts are with you!

  4. #4
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    Default Re: Mom of 25-weeker....just home from NICU...please help!

    I have never dealt with a situation like this but you may try to contact your local LLL leader. http://www.lalecheleague.org/Webindex.html You might ask about feeding with a dropper or syringe. We do it because our baby won't take a bottle. I don't know if that's ok for all the time feeding or not. I am glad you have baby home. Congratulations and great job working so hard on expressing breast milk. It will make a huge difference. I know pumping is exhausting. Happy Holidays.

  5. #5
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    Default Re: 25 weeker......extremely high palette....please help!

    http://www.leron-line.com/updates/Bottle_Feeding.htm

    heres something that I found online.

  6. #6
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    Default Re: 25 weeker......extremely high palette....please help!


  7. #7
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    Default Re: 25 weeker......extremely high palette....please help!

    Wow - I read your thread and just wanted to say that you are doing an AMAZING job. I'm so impressed with your dedication, and hope that you and your LO continue to have success breast feeding. Sorry I can't help with the 'high palette' question.

    Rochelle

  8. #8
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    Nov 2006
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    Default Re: 25-weeker.......extremely high palette....please help

    We are using both the Avent nipples (with thickened feedings), which the feeding clinic likes best and the Haberman because we can get more into my little guy with it. The Avent nipples are longer and fairly firm while still soft. The Haberman lets us squeeze milk in when AC isn't sucking well.

    The Avent nipples don't colapse when AC finally sucks. LOL That was terrible with the hospital's preemie nipples which is what he came home on. When he finally did suck some we had to release his suck to get air into the bottle.

    We are almost ready to go back to the NG tube though.

    Feeding is still very frustrating.

    I hope you find something that works!!

    Liba

  9. #9
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    Dec 2006
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    Default Re: Mom of 25-weeker....just home from NICU....please help!

    Congratulations on passing the big milestone of coming home! Let the worries now completely change!

    Gentle sarcasm aside, I don't have any specific tips or techniques to share, but just reassurance. Feeding a baby with any technique, whether it be at the breast, with a bottle, cup, spoon, etc., takes experimentation and trial and error to discover what works best for your unique baby. If this new nipple trick seemed to work, keep trying it. Don't be afraid to try less-common techniques too. There are people out there who never give their babies a bottle but start right away with a cup. As I don't know much about how this would work with a premie, I'm not sure if this is a viable option, but if nothing else it is an example of a less-common feeding approach that might be explored.

    Ask your pediatrician and other health care providers, like a lactation consultant, OB nurses, and anyone else who works with infants if they know any tips of if they know anyone who might. I know there are special feeding techniques for babies with cleft pallate, so there just might be special ones for babies with high pallates too. An unusual source for this information might possibly be an occupational therapist.

    Keep up the good work!

    ~Toni

  10. #10
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    Default Re: 25-weeker.......extremely high palette....please help

    Quote Originally Posted by ruddergrl View Post
    Hello......I'm the mom of a 25-weeker who JUST came home, after 125 days in NICU, Tuesday night.
    Congratulations and welcome to the boards! I merged all your posts together, so you could see the responses in one location.

    Quote Originally Posted by ruddergrl View Post
    She's not strong enough to BF right now so I'm pumping and we're nippling her. I know this isn't a strictly BFing question but I am feeding EBM so I'm hoping someone can/will help.
    Of course!

    Quote Originally Posted by ruddergrl View Post
    She's been pretty iffy with her feeds so the staff taught my DH and I how to insert an NG tube to gavage the left-over BM so that's how we've been getting the rest of her feeds down.
    How is that going?

    Any recent updates?

    Quote Originally Posted by ruddergrl View Post
    Yesterday, as I was feeding her, I started thinking about how it seemed she was doing a LOT of work with very little end-results. She's just not getting down the amount of BM she should with as much as she's trying. She's got an extremely high palette because of being on the vent for so long. I started thinking that it only makes sense that we need to try some different things to help her be more productive.
    Nods. High palate due to being on a vent seems to be fairly common. I have read that in preemies, this often resolves with time. Perhaps your doctor will have more information for you on that topic.

    Quote Originally Posted by ruddergrl View Post
    Instead of letting her take in as much as the nipple as she wants/can I have been pulling back and letting her have only part of it. This really seems to have helped her with the stream of suction. Also, just now, I started playing with angles of the nipple. I don't know if she suddenly got more energy or if it's because of what I did but she finally completed an entire feed, on her own, without the need of gavage!! And she did it with a good amount of energy!
    Did your IBCLC or doctor discuss using a Haberman feeder? It's a special bottle that allows you to control the flow. It also has a wide base, so it reminds baby to open wide. Here's a picture:
    http://www.medela.com/NewFiles/speci....html#haberman

    Quote Originally Posted by ruddergrl View Post
    I'm hoping this is all doing the trick but am hoping that maybe there's a special nipple made to help babies with extremely high palette's? I don't want her to wear herself out with these feeds. She needs all of her energy to get stronger and grow.
    Again, I'm curious as to how things are going now? Things change so fast with preemies as they grow bigger and stronger. Do keep us updated!!

    Here's some info on bottlefeeding in a way that preserves the breastfeeding relationship:
    http://www.bfar.org/bottles.shtml
    http://www.kellymom.com/bf/pumping/bottle-feeding.html

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