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Thread: Preterm infant - supply/latching questions

  1. #1
    Join Date
    Mar 2008
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    Default Preterm infant - supply/latching questions

    It's quite confusing to read one article that states under no circumstances should anything be put in infant's mouth when mine stayed in the NICU for awhile with the haberman bottle supplementing with formula. My milk came in on Day 4-5 and now getting about 600 mL daily (not counting BF attempts). Is there a link somewhere of the amount I should be getting three weeks post partum? Secondly, I was given a nipple shield by three different LC to use. Thirdly, I am battling some sort of thrush infection I believe. I'm really at my wit's end... admire those of you that DO breastfeed, and understand thoroughly why people stop. My baby's due date is coming up. I'm trying to hang on until then or two weeks past.

    Any suggestions? It almost looks like he doesn't open his mouth wide enough. He's interested though.

    As far as the thrush possibility... Nips are on fire with stabbing pains at times. Thought I had it under control last week with a cream I made up - lansinoh, hydrocortisone, polysporin, nystatin/triamcinolone, and miconazole mixed with probiotic powder, but stopped taking it and it came back just as bad. So starting back with that.

    I need so much help!

  2. #2
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    Apr 2008
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    Default Re: Preterm infant - supply/latching questions

    Quote Originally Posted by nicolebf View Post
    Is there a link somewhere of the amount I should be getting three weeks post partum? Secondly, I was given a nipple shield by three different LC to use.

    Any suggestions? It almost looks like he doesn't open his mouth wide enough. He's interested though.
    I know what you are going through. I had a 24wk preemie and I have to say BF was extremely difficult. I also was given a shield and was told it is because she can not open her mouth that wide. It did work a few times. Because I had such a hard time with BF her I kept pumping and kept trying. As for the supply I would say you can read it in a book how much you should be making, but I could be wrong. I think every woman is different. For me they said the first time I would pump it would be 2-3 cc but I can out and handed a few ounces. I could fill a bottle from each breast be the end of the week.

    I have a full term newborn now and also had difficulty the first week but did not give up and now it is easy after just 3 weeks. So don't give up. Also go to the NICU as much as possible to BF. That is the advice I was given from our NICU.

    Don't give up.

    Stacey
    Proud mother to a 24 wk preemie girl, born 9/6/04 and to a full term baby boy, born 4/9/08.

  3. #3
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    Mar 2008
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    Default Re: Preterm infant - supply/latching questions

    We've been home with him for a couple of weeks... I'm not getting that much on pumping. I'm getting 60ml-70ml on right breast and then 30 ml on the left every 2-3 hours...

  4. #4
    Join Date
    Apr 2008
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    Default Re: Preterm infant - supply/latching questions

    How long have you been pumping for (is it three weeks)?
    For the first few weeks of pumping (and I did the same as you, every 3ish hours day and night) I got an ounce or two from each side. My baby was in the NICU for 2.5 weeks, and even when I first brought her home I would think I had a "good" pumping session if I got 3 ounces total.
    My LO is now 7 weeks old (and I'm still pumping, although not quite as often as I was making too much milk - so I slowed down a little to try and match supple and demand) and I get anywhere from 4 to 8/9 ounces per pumping session now - it depends on the time of day, and how long since I last pumped.
    Everyone produces different amounts, but if you keep up with pumping, I think your body will keep up with the needs of your growing baby, and make more as he needs it.
    Are you able to pump enough to give EBM every feeding?

    If you think you have thrush I think you should see your Dr - becasue you and your LO can pass it back and forth between you.
    I also get stabbing pains in one nipple, but I think mine is from a bad latch (strange that my LO can latch on one side with no pain - yet feels like she is latching with a razor blade on the other!!) Does the end of your nipple go white after feeding - and does it hurt your nipple when it's cold? If yes, it could be "blanching" of the nipple. I find that if I get the pain when nursing, if I pump for a few minutes afterwards it actually helps the nipple go back to a normal shape and it stops hurting.

    I'm also hanging on until my LOs due date. I heard that most babies "get it" at about 42 weeks.....the penny drops and they start to BF 'properly'. Lets keep our fingers crossed that that happens

    Good luck!

  5. #5
    Join Date
    Apr 2008
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    Default Re: Preterm infant - supply/latching questions

    Do you have a hospital grade pump? You can rent them from the hospital. They are so strong there should be a warning with them. Maybe this would help?
    Proud mother to a 24 wk preemie girl, born 9/6/04 and to a full term baby boy, born 4/9/08.

  6. #6
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    Mar 2008
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    Default Re: Preterm infant - supply/latching questions

    Thanks for both of those replies. I do have a hospital grade and pump every 3 hours round the clock... I hope the 42 week thing is right! Only two more weeks to go for me! Thanks for answering the supply question as well...

  7. #7
    Join Date
    Jan 2006
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    2,866

    Default Re: Preterm infant - supply/latching questions

    How are things going now? Is the suspected thrush under control?

    Nipple shields can be helpful for breastfeeding a premature baby, but they should really be used under the guidance of an IBCLC. Here's some resources for using nipple shields:
    http://www.medelabreastfeedingus.com...nipple-shields
    http://www.medelabreastfeedingus.com...-nipple-shield

    And here is some information about maximizing milk production with a pump:
    http://newborns.stanford.edu/Breastf...roduction.html

    HTH!

  8. #8
    Join Date
    Feb 2006
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    422

    Default Re: Preterm infant - supply/latching questions

    Quote Originally Posted by nicolebf View Post
    Thanks for both of those replies. I do have a hospital grade and pump every 3 hours round the clock... I hope the 42 week thing is right! Only two more weeks to go for me! Thanks for answering the supply question as well...

    Congrats on the birth of your baby! Glad baby is doing well!

    The 600 ml milk volume obtained in 24 hours is considered a bit more than a borderline amount but less than "ideal" amount to be obtained per 24 hours based on research by P Meier, PhD and associates at NICUs in Chicago and a couple of other cities.

    You've talked about pumping and that you're using a hospital-grade pump, but any manufacturer can call a pump "hospital-grade." Is it a rented pump, e.g. Medela Classic or Symphony or Ameda Elite? Some of the better pumps that are purchased for "personal"/single user vs. rental for "multiple" users are often called "hospital-grade" but they were not really designed to establish milk production or maintain it 24/7. They were designed to be great pumps if using several times a day several days a week after good production is already well established. A rental tends to obtain more milk in less time, because it's designed for the 24/7 job of pumping.

    If you're not using a rented pump designed for the job you need, that may be something to be considered. Another thing may be the amount of pumping -- breastfed babyies often cluster feedings at certain times of day. Throwing in some extra 3-5 minute pumpings here and there are similar and often increase production. (Don't have to clean collection kit pieces each time; many let milk collect until a "big" pumping and then clean. Also, the 8 pumping sessions usually seem OK for "baseline" production, which baby can increase once breastfeeding [transferring milk] well.)

    You mentioned not including baby's breastfeedings in the daily tabulation of milk volume. How do you think baby is breastfeeding? Do some breastfeedings go better than others? (If yes, what makes you think so -- both for better and less so?) Are you using the nipple shield mentioned? (If you used it in the past, have you tried it lately?)

    I'd be careful about "grabbing" onto a number, e.g. the 42 weeks gestational age. Sometimes it takes a bit more and sometimes less for a baby who's had other oral experiences due to early birth. Some of it may depend on infant issues, but sometimes a mom isn't completely ready to let go of more definite measurements, such as oz or ml and rely on baby's behaviors, diaper counts, etc.

    Hang in... It sounds as if you're doing well and baby is about "there"!

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