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Thread: Transition from NICU schedule to more of a demand schedule - HOW?

  1. #1
    Join Date
    Dec 2008
    Location
    Grand Rapids, MI
    Posts
    35

    Default Transition from NICU schedule to more of a demand schedule - HOW?

    Hi everyone! Things are going well with my little 31-week DS - now home for 2 weeks and at 37 weeks. The noisy sleeping the first few days? He was cold. Oops. Reflux has been less of an issue - we just burp him often.

    He still roots after we give him a bottle w/ HMF supplement (2-3x daily), but maybe that's just because it comes in so fast.

    I'd like some feedback from other mommies who have navigated the transition from a NICU feeding schedule (mine was every 3 hours) to a baby-based schedule. I'm really confused about what to do. Everything I read applies to full-term newborns, not preemie babies who have been eating orally for several weeks before their due date.

    Pretty much every diaper is wet and poopy, so I know he's eating well. But these are some questions I have:

    Am I still supposed to wake him if he sleeps longer than 4 hours - like you would with a newborn?

    If he's used to feeding every 3 hours and then wakes up less than 2 hours after his last full feeding, does it mean he's hungry?

    What constitutes "waking" with a need to feed?

    Should I try nursing every time he roots? Or if a pacifier sedates him, is that okay?

    How often do you change their diaper overnight if you're not on a 3-hr schedule (from the NICU)?

    How long should he be nursing/session? Right now I try to make sure he's on the breast for at least 20 minutes. Occasionally he goes longer. Sometimes it seems he wants to be there for nearly an hour, but isn't really sucking much. What do I do then?

    I know there will be different opinions, but I'd really REALLY appreciate some feedback from those of you who have been there.


  2. #2
    Join Date
    Jan 2008
    Posts
    1,081

    Default Re: Transition from NICU schedule to more of a demand schedule - HOW?

    I don't know but am interested in responses as I will be in this situation with my little man (born at 30 weeks, 16 days ago). He is also in the NICU and will be on an every 3 hour schedule.

    Your little guy is adorable!
    Mommy to:

    Emmalynn Marie
    Born at 37 weeks on 12/22/06
    5lbs 1oz 19 1/2in

    Owen Charles
    Born at 29 wks 6 days on 01/17/09
    2lbs 14oz 15in
    In NICU for 2 months


  3. #3
    Join Date
    Jan 2008
    Location
    Ontario, Canada
    Posts
    247

    Default Re: Transition from NICU schedule to more of a demand schedule - HOW?

    1st off - what a cutie!

    My DS was only in the NICU for a week. When we were finally allowed to take him home I treated him like a newborn, following all the instructions they give the mamas with full term babies.

    Our feed schedule was every 3 hours in the NICU, but towards the end there were times they'd allow me to nurse on demand because DS wanted it! (FWIW, I spent most of the time in the NICU, around the clock so this was possible)

    I think a good thing to do is to not watch the clock, but watch your baby. I personally felt this was important because I felt cheated from the whole preterm birth/NICU expereince and wanted to just be with my son whether he wanted to nurse, sleep or anything else.

    My answers are in red.

    Quote Originally Posted by @llli*finally-a-mommy View Post
    Hi everyone! Things are going well with my little 31-week DS - now home for 2 weeks and at 37 weeks. The noisy sleeping the first few days? He was cold. Oops. Reflux has been less of an issue - we just burp him often.

    He still roots after we give him a bottle w/ HMF supplement (2-3x daily), but maybe that's just because it comes in so fast.

    I'd like some feedback from other mommies who have navigated the transition from a NICU feeding schedule (mine was every 3 hours) to a baby-based schedule. I'm really confused about what to do. Everything I read applies to full-term newborns, not preemie babies who have been eating orally for several weeks before their due date.

    Pretty much every diaper is wet and poopy, so I know he's eating well. But these are some questions I have:

    Am I still supposed to wake him if he sleeps longer than 4 hours - like you would with a newborn? I treated DS like a newborn and made sure he didn't go longer than 4 hours, unless it was night (but he never went longer than 4 hours until he was 4 mo!)

    If he's used to feeding every 3 hours and then wakes up less than 2 hours after his last full feeding, does it mean he's hungry? He might be, but he also might be looking for comfort. I'd offer to nurse just cuz you never know.

    What constitutes "waking" with a need to feed? DS would get fussy and start rooting.

    Should I try nursing every time he roots? Or if a pacifier sedates him, is that okay? We didn't really use a pacifier but DS really only rooted when he was hungry

    How often do you change their diaper overnight if you're not on a 3-hr schedule (from the NICU)? Since DS had a bowl movement with almost every nursing, I'd change him when I switched sides. That way he'd nurse back to sleep.

    How long should he be nursing/session? Right now I try to make sure he's on the breast for at least 20 minutes. Occasionally he goes longer. Sometimes it seems he wants to be there for nearly an hour, but isn't really sucking much. What do I do then? Length of time for us was between 15 and 40 minutes in the beginning when I kept track. If DS was falling asleep on the breast I'd do everything to keep him awake. At first I did time him, but eventually I learned to not look at the clock, it only added to the stress.
    Mellie
    mama to
    DS June 2007
    DD1 April 2009
    DD2 April 2011

  4. #4
    Join Date
    Sep 2007
    Posts
    1,090

    Default Re: Transition from NICU schedule to more of a demand schedule - HOW?

    Things are going well with my little 31-week DS - now home for 2 weeks and at 37 weeks. The noisy sleeping the first few days? He was cold. Oops. Reflux has been less of an issue - we just burp him often.
    Yeap, I usually would had burp her after 10-15min nursing then swicht breast

    He still roots after we give him a bottle w/ HMF supplement (2-3x daily), but maybe that's just because it comes in so fast.
    agreed 100%.. Nurse him after the bottle... if he not longer hungry he will get confort at your breast.... or if you are afraid he might be too full after all that meals pump while you are giving him the bottle to empty a bit your breast, and give him the fatty milk.

    I'd like some feedback from other mommies who have navigated the transition from a NICU feeding schedule (mine was every 3 hours) to a baby-based schedule. I'm really confused about what to do. Everything I read applies to full-term newborns, not preemie babies who have been eating orally for several weeks before their due date.
    The transition will be slow but it will happen... The most important is too fallow all the recomendations you received from the NICU because not all the baby situations are the same.... For us, we forgot about schedule, I would nurse DD first, then give her a bottle with HMF as long as posible... and gradually watching her confort or disconfort I would add more milk to her bottle... so if she was nurse for 20 min each breast, she would get a 1oz bottle with HMF, but if she was still hungry I would had giving her another oz... and gradually increase the amount in her bottle or nurse.....
    my DD was very small and not a great nursing so most feeding were bottle feeding but I never stop pumping (also for Day Care she needed bottles)


    Am I still supposed to wake him if he sleeps longer than 4 hours - like you would with a newborn?
    Like other poster said, no more then 4 hours...

    If he's used to feeding every 3 hours and then wakes up less than 2 hours after his last full feeding, does it mean he's hungry?
    Migh be diaper change too, but the more they grow the more they will want...

    What constitutes "waking" with a need to feed?
    Usually fussiness and rooting...

    Should I try nursing every time he roots? Or if a pacifier sedates him, is that okay?
    We had a paci but DD didnt like it... I would said Nuse every time he is rooting

    How often do you change their diaper overnight if you're not on a 3-hr schedule (from the NICU)?
    Same as during the day, after or before each feeding... Usually after feeding..

    How long should he be nursing/session? Right now I try to make sure he's on the breast for at least 20 minutes. Occasionally he goes longer. Sometimes it seems he wants to be there for nearly an hour, but isn't really sucking much. What do I do then?
    Yeap, sometime DD was like that too...

    To keep it simple I would say forget about the clock, and nurse, nurse, nurse... Of course dont forget to feed him HMF after nursing as recommended... do diaper changes after or before each feeding... you will be tired like h11 but it will be for a short period of time.... This is nothing like the confort and quite NICU

  5. #5
    Join Date
    Mar 2008
    Location
    central IL
    Posts
    173

    Default Re: Transition from NICU schedule to more of a demand schedule - HOW?

    I only have a few comments.
    the paci issue I think is an individual choice. If you think your supply is good enough and are not worried about nipple confusion, etc. then you could go ahead and give a paci. just make sure that he is still eating often enough. As for the feeding schedule, it depends on his weight gain, especially for the sleeping for more than 4 hours. My dd nursed on demand from the time we got home and gained weight better than she did on the 3 hour schedule. We still made sure she did not sleep more than 4 hours. I think most people do this until baby is around 40 weeks or passes about 7-8 lbs. I hope this answers some of your questions.
    Chelsea
    Mommy to:
    Nate 1/17/07 Emma Lynn 7/13/08 @ 31 weeks and Clara 2/26/10
    Cloth diapering convert
    love to and

  6. #6

    Default Re: Transition from NICU schedule to more of a demand schedule - HOW?

    My son was born two months premature and was in the NICU for almost two months. In regards to waking him for his feeds, our pediatrician had us do this until he was was 1 month old corrected (at that time he weighed about 8lbs.). As far as the pacifier goes, we gave him one when he rooted and it didn't cause nipple confusion, but what ever works for you is great. When my DS came home from the NICU, he required a diaper change before every feeding because he had a BM at each feeding.
    Hope this helped some! Hang in there.
    Mommy to beautiful baby boy born 9/24/08


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