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Thread: NICU Confusion

  1. #1
    Join Date
    Feb 2007
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    3

    Default NICU Confusion

    I don't know if I am looking for advise, or a vent, but here's my situation. My son was born at 33 weeks. On Friday he will be 2 weeks. He never needed oxygen, and he is not having any problem holding his temp, breathing, no A & B's. And he is now in an open crib. He was born 4lbs 8oz. He went down to 4lbs 2 oz., but he is already up to 4lbs 10oz.
    He has been feeding via tube every 3 hrs. I have Nursed a few times, and he is able to latch on, but after a few mins, he just stops, like he is not hungry any more. The NICU is "requireing" that he cannot leave until he is able to take 8 full feedings via breast or bottle for a couple of days in a row. I feel like he is getting fed so much, he is not hungry enough to bottle or breast.
    My first son was full term, and I nursed him for a full year. I can't ever remember him taking 8 full feedings in one day. It is a new hospital, and he is the only baby in NICU. I feel like they are keeping him hostage to keep the insurance money rolling in. Does anyone have any thoughts or suggestions? Has anyone had any luck with cup feeding?

  2. #2
    Join Date
    Jun 2006
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    893

    Default Re: NICU Confusion

    When Madeline was in the NICU, they only allowed me to nurse her 1 time a day until she was released, she was also fed via NG tube for most of her feedings. I know the hospital where she was at would not release her or any other baby until they were over 5 lbs (she was born at 5.8 lbs and dropped down to 4.8 lbs and once she hit 5 lbs, they let her come home (with apnea moniter and many meds., she did have some other problems).

    If you think that they are being unrealistic with this, let them know. Also before nursing, have them check the residual in stomach to see if there is formula/breastmilk still in there not allowing him to have a full feeding. Good Luck!!!

  3. #3
    Join Date
    Jan 2007
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    99

    Default Re: NICU Confusion

    Hi there....

    If your LO is on an IV, you might request that they turn the flow rate down a bit so he/she gets thirsty and therefore will WANT to spend more time at the breast. Of course, your LO will need to be monitored closely to make sure dehydration doesn't happen, etc.

    Our little guy got a LOT better at nursing once they let me room in with him and nurse him on demand. Hang in there, and please let us know what happens!

  4. #4
    Join Date
    Jan 2006
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    18,063

    Default Re: NICU Confusion

    hum...
    are you working with a lc?
    that might help.
    Call your local leader she can help too.

  5. #5
    Join Date
    Feb 2007
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    3

    Default Re: NICU Confusion

    Thank all of you for your replies. Its nice to know that someone is hearing me. In my little one's case, he is not on IV, he is in open air and always holding his temp, no breathing or cardiac issues, already surpassed his birth weight (He is now 4lbs 10oz.). He has not had any issues rooting or latching on, but does not seem to have a lot of motivation to continue sucking after about 5 mins. If we tube feed for less than 50 - 60 mins, he will spit it back up. Is it dangerous to skip a tube feeding and wait an extra hour or so until he gives us the signs that he is hungry? It's just a mommy's feeling I have, that this is what's going on.

  6. #6
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    Jan 2006
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    Default Re: NICU Confusion

    are they trying bottles or just the feeding tube?
    how's pumping going?

  7. #7
    Join Date
    Jan 2007
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    8

    Default Re: NICU Confusion

    Wow, this sounds almost exactly like our situation.

    My daughter (2nd child) was born at 34 weeks 4lbs 3oz, dropped to 3lbs 10oz, and then gained back up. She never had any respiratory or cardiac issues, and kept her temp up on her own just fine.

    They had her on a tube feeding schedule starting feeds every 3 hours.

    She showed an aptitude for nursing even on her first day of life, but they wouldn't let me nurse her more than twice per day, and they wouldn't let her take food orally if she hadn't taken her full amount the previous time.

    It just seemed to unnatural. The wouldn't let me feed her on the occasions when she seemed hungry but it wasn't her feeding time, they wouldn't let her take more than 20 minutes to feed orally (nursing or bottle), and they wouldn't let her wait a while if she wasn't hungry at feeding time.

    We finally got so frustrated with the whole situation that somehow we begged and argued to be able to use one of the rooming-in rooms so that I could be in the same room as her 24 hrs (actually only 22hrs as they kicked us out during shift changes), and they let me nurse and bottle feed her on her cues with the caveat that she couldn't go more than 4 hrs without taking in something, and she had to average X amount over a 7 hour period, or she'd have to to a tube feeding.

    The doctor and nurse basically flat out said that this wouldn't work, that she wasn't ready, and that it was to just show us that she had to be on their protocols.

    At the beginning of the period we also had a lactation consultant come in with us to give us tips on how to be most successful in this endeavor. With her tips, we managed to encourage DD to consume more than enough. Sometimes she went 2 hours, sometimes she went 4 hours. Sometimes she ate more than the X amount, sometimes she ate less.

    Here are the things that helped in that room to get us out of the hospital.

    *Keeping her on our skin as much as possible.

    *Not hesitating to use various combinations of normal breast feeding, nipple shield, and bottle feeding. Even using all three within a single feeding.

    *Not getting her too warm and cozy while feeding. i.e. stripping her down to just diaper while nursing, or at least not keeping her hat on and not wrapping her in a blanket.

    *If she got sleepy too quickly, being willing to discomfort her to encourage more feeding. e.g. laying her on her back naked on a hard surface until she starts to wiggle and fuss and want the breast comfort.

    Now this room wasn't an ideal situation by any means. Mom's bed was on the other side of the room from baby's. She still had to wear all of her monitors and keep her nose tube in. She wasn't allowed to sleep with mom or dad (though we fudged this one a little bit).

    After she did fine for that 24 hours the doctor said "well, I guess you proved us wrong. Do you wan't to go home?" Well, duh! He also said that he had no idea that we were anxious to get out of the hospital. Another duh!

    Anyway, once we got HOME she all of a sudden went nursing crazy. Imagine that--when the baby is actually with the mom all of the time, she wants to nurse more. Stunning stuff I know.... In the first week home we probably used 8-10 bottles of EBM, and haven't used one since. The nipple shield was phased out during that week as well. Since being home we haven't had to once wake her, or discomfort her, or in any way encourage her to nurse.

    I read something somewhere about when infants are not near their mother for extended periods all of their body processes kind of slow down. They're not going to want to eat as much, their body temperature goes down a bit, they don't expend as much energy on growing, etc. Now this makes sense as these are reasonable survival mechanisms for a baby away from its mother in a primitive situation--but you'd think they'd be able to take these things in to account in a hospital setting specializing in infants.

    Now, as much as I was frustrated with our own NICU experience, I know that they are really important places. They have saved the lives of so many babies that otherwise wouldn't have had much chance at survival. The thing is, they're set up for sick babies, and not for healthy ones. Babies that are born early and/or small, but with no significant health issues have to follow all of the same very conservative protocols that are meant to save the lives of sick babies. While this might be best for the sick babies, it isn't best for the healthy ones. They need their mommies and they need to nurse when THEY need it right?


    (Sorry, this ended up as much a rant on my own experience as a response to your issues. I hope that some of those tips above can help some though.)

  8. #8
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    Jan 2006
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    Default Re: NICU Confusion

    I think what you said was helpfull!
    How are things today?

  9. #9
    Join Date
    Feb 2007
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    3

    Default Re: NICU Confusion

    Thank you for your responses. I love hearing other similar experiences. You just get that feeling that "mamma knows". Last night he took 32 mls bottle, This morning he took a full 42 mls via bottle (boob juice)! and Just now he took 46mls bottle! Hopefully it's a sign of things to come.

  10. #10
    Join Date
    Jan 2006
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    18,063

    Default Re: NICU Confusion

    thats wonderfull.... and you know once you get him out of the hospital you can cut out the bottles and just nurse..
    their is some light at the end of the tunnel!

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