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Thread: Worried about getting to exclusively breast feeding

  1. #1

    Default Worried about getting to exclusively breast feeding

    I delivered my son on May 3 at 31 weeks. He is currently still in NICU but may soon be released. I have been pumping all along and doing well with that.

    With my first son, I successful breastfed him until he was 18 months old (he is now 3). So I am well versed in all the benefits of breastfeeding and I am a big advocate.

    But with my youngest son being in NICU, I just have a lot of doubts and concerns about how successful we can be breastfeeding this time.
    1) We haven't had as much opportunity to master breast feeding.
    2) The doctor has had them mix 3 parts breastmilk with 1 part formula for a while. And they just recently switched to breastmilk only with some rice cereal. So I have concerns about what he's already been exposed to.
    3) I have a large stockpile of frozen breastmilk and I'm worried that it may just be easier to keep bottle feeding
    4) As a premie, there is a lot of emphasis on how much he is injesting and it's really hard to know when he does breast feed.

    So I'm sending this to introduce myself, ask for your advice on how to create the most successful environment and to learn what support is out there for me. I would also love to know if you have any impressive premie breastfeeding stories to help keep me motivated.

  2. #2

    Default Re: Worried about getting to exclusively breast feeding

    Welcome to the board!

    I know we have some moms of premies here, hopefully some of them will chime in with their experiences.

    Have you been able to feed at the breast yet? Does your baby latch on okay?

    As far as support, I would definitely recommend getting in touch with your local LLL. You may be able to find some other moms of premies there. Here's the page for finding the nearest group. A board certified lactation consultant could also be a big help in making the transition from bottle to breast, and would be able to help you make sure your baby is getting enough milk from the breast.
    Karen
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  3. #3
    Join Date
    Jan 2008
    Posts
    1,081

    Default Re: Worried about getting to exclusively breast feeding

    Hi Mama!

    Congrats on your little one!

    My son was born at 29.6wks and spent 53 days in the NICU. He was on oxygen and was tube fed for all but the last few days. He was getting breastmilk mixed with human milk fortifier through the tube or at the end bottles. He only latched on a few times during his NICU stay because there was so much emphasis placed on measuring.

    Once he was home I worked with a few International Board Certified Lactation Consultants who helped a ton. I used a nipple shield and would attempt to get him to nurse and then feed him a bottle of breastmilk after. I rented a baby scale and started weighing him before and after, as well as at the same time each night, and recorded everything. As I got him to latch and nurse a little, and the weighing before and after showed he was taking in 2oz I wouldn't feed him a bottle after. I kept him very close to me (wore him in a Moby Wrap, often skin to skin) so I could tell when he was hungry again. He continued to gain weight so I cut out more and more bottles after breastfeeding. It took about 2 months to swtich to exclusive breastfeeding.

    It wasn't easy - in the beginning when he came home, I would try to get him to latch, then bottle feed him, then pump. And about an hour later we'd have to start all over again. I had my daughter, who was 2yrs at the time, to care for in between. It was tough. But, I was still nursing her, so like you, I really believe breastfeeding is so important. And I was determined to make this work. I felt like I had no say in anything else that happened toward the end of my pregnancy and his first 53 days of life, so I clung to being able to eventually breastfeed him. He's 16mo/13.5mo right now and loves to nurse.

    Let us know if you have any other questions!
    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


  4. #4
    Join Date
    Jan 2010
    Location
    Cleveland, Ohio
    Posts
    104

    Default Re: Worried about getting to exclusively breast feeding

    My DD was born at 30 weeks and in the NICU for 7 weeks. During that time, she was fed fluids from an IV, then EBM through an NG tube, then EBM with fortifier in a bottle and "topped off" through the NG tube...several weeks before she came home, we started trying to BF. I wore a nipple shield at first, and during the first few times she tired very quickly - like after 5 minutes - and we would give her the rest of her feeding though the NG tube.

    The nurses were concerned with her burning more calories trying to eat than what she would ingest actually eating, since it seemed like her gaining weight was their primaty concern. One of the nurses that was caring for my DD almost every day was an LC, so she helped us tremendously! I that lady for helping us so much - she encouraged us to try BF every day, and left notes for the other nurses if I would be coming to the NICU to try to BF during a shift she wasn't working. Eventually, she would BF for 10 minutes or so, then we would finish with a 40 mL bottle of BM.

    Once we came home, I tried to BF at almost every feeding - I knew when she was too tired to try, though - and I would just give her a bottle at those feedings...with a slow-flow nipple. Then I would have to pump...the whole process took about an hour, then 30 minutes later, we would start all over again. It was exhausting!

    After a few weeks, I was able to do all but two of her feedings at the breast. I had (still have) supply problems, and her two evening feeds would be mostly bottled BM. Eventually I burned through my freezer stash, and those feedings became formula .

    Fast forward to now, and she still has two formula bottles per day...but she does get mostly fed at the breast. Those first few months were brutal, though! I was exhausted, and she was (still is, but not as bad) a very high-need baby.

    Hang in there, mama! The best advice I have is to ask your NICU nurses to use slow-flow nipples when bottle feeding, and insist that you try to BF there at least once per day. My husband really helped me with this - he wasn't afraid to tell the nurses that BF was important to us. In fact, he was the one who first asked the nurses when we could try to BF her. The more practice you get at the hospital with your tiny baby, the better it will be once you get home!

    Good luck!
    I'm Candice
    WAHM to Lauren
    Born 11/2/09 at 30 weeks due to Mama's HELLP Syndrome
    2 pounds, 14 ounces
    7 weeks in the NICU
    6 months: 11 pounds, 9 ounces
    7 months: 13 pounds, 13 ounces

  5. #5

    Default Re: Worried about getting to exclusively breast feeding

    My daughter was born at 31 weeks, 5 days. She stayed in the hospital for 29 days and was able to go some exclusively breastfeeding. My main advice is to be you and your child's advocate. It is NOT easy, I understand. I would cry to my husband every day that I was worried I was not making the right decision or making life to hard for my DD and the nurses. I was fortunate to have some very supportive nurses/midwives in the around me in the NICU who encouraged me to continue breastfeeding. I did have the advantage of not having another child to be home for, which allowed me to spend a lot of time at the hospital.

    My DD never had a bottle. She was on tube feeds and during the last two weeks of her stay I would attempt a bf once a day, then twice a day, and so on until the last 2 days of her stay she was getting all her nutrition from bfing. When we came home she did not gain weight for the first week, which had everybody in a panic. We were sent back to the hospital for blood tests to determine if she was dehydrated (she was not) and received extensive support from the breastfeeding support midwife. From that point on, she hasn't stopped gaining weight and is now 14 pounds, 5 ounces at 6 and half months (4 and half months adjusted). She had very quickly gone from having half her feeds in a tube with fortifier to exclusively bfing. My gut feeling had been that she was getting used to that change and would catch up and I was right. Good ole' mommy instinct!

    We later tried to use up some of that excess milk by giving her the occasional bottle. She did not like the bottle and we stopped trying. After all that hard work to get her to bf, I wasn't going to complain that she wouldn't take a bottle. I go back to work part time in a few months and will transition her straight to a cup for the times I am work.

    A few bits of advice:
    - As I said before, be your child's advocate!
    - Block feeding really worked for us to ensure she was getting more of the higher fat hind milk
    - Gently rubbing her jaw seemed to wake her enough to continue a feed when sleepy and we woke her every 2 hours to feed in the early days

    It is hard work and very time consuming in the beginning, but very worth it. I am so proud of my daughter and myself for doing this and we have a lovely bfing relationship now.

    I hope this makes sense and is not just rambles. I also hope this encourages you

    J

  6. #6
    Join Date
    Jun 2009
    Location
    New Zealand
    Posts
    94

    Default Re: Worried about getting to exclusively breast feeding

    Congratulations on your son. It is definitely possible to still exclusively breastfeed a preemie. As the previous posters can attest to.

    My DD was born at 30 weeks, and spent 7 weeks in NICU. Like the others have said, she was initially fed IV fluids (glucose), then EBM through NG tube. We began trying breastfeeds when she was about 3 weeks old (33 weeks gestation), she would tire easily, and we only did one try per day. She'd get a time to try, but would fall asleep, then be given a full EBM feed by NG tube. Over the weeks, she eventually learnt to latch properly, and would stay awake long enough (about 10 mins max) to feed a bit.

    It was only in the last week before we brought her home, that the NG tube was taken out. She was having top ups by bottle, but we were trying breastfeeds twice a day. She still wasn't getting full feeds (ie; the volume that we were feeding her by tube every 4 hours), so I'd top her up with EBM.

    The hardest part we found, was swapping from the hospital feed schedule of every 4 hours, to just breastfeeding on demand and trusting my body.

    Every hospital seems to do things differently. My DD was never given any fortifier to boost my BM. She was never given formula either while in hospital. They solely relied on the EBM. So long as she was gaining weight at each weigh in, they didn't worry too much about "how much" weight was being gained.

    As others have said, if you feel strongly that you want to breastfeed, you need to try and advocate for your son, and when you feel the time is right, to try him at the breast, and continue to try. He won't be able to do much but just getting him there is a great start.

    Knowing how much they're drinking at a breastfeed is hard, and that's another leap of faith you have to do once you bring him home. We got so used to giving prescribed volumes of EBM at each feed, and having a set feeding schedule, that we felt a bit overwhealmed when this didn't happen with exclusive breastfeeding once home. But it got there fairly quickly, we got our own schedule, and our daughter is still breastfeeding at 23 months old (21 months corrected).
    Alison, mummy to Erin
    Born @ 30 weeks, 2nd July 2008, 3lb 11oz, fully breastfed

    cloth nappy wearing bub.

  7. #7

    Default Re: Worried about getting to exclusively breast feeding

    Quote Originally Posted by @llli*ooligator View Post

    The hardest part we found, was swapping from the hospital feed schedule of every 4 hours, to just breastfeeding on demand and trusting my body.

    Knowing how much they're drinking at a breastfeed is hard, and that's another leap of faith you have to do once you bring him home. We got so used to giving prescribed volumes of EBM at each feed, and having a set feeding schedule, that we felt a bit overwhealmed when this didn't happen with exclusive breastfeeding once home. But it got there fairly quickly, we got our own schedule, and our daughter is still breastfeeding at 23 months old (21 months corrected).
    Yes, I completely agree with those two statements, but even though it takes times, it will get easier to trust your body. I think it is hard, at least as a first time mother, to go from the routine of the NICU where there are countless nurses to answer questions to home where you need to trust yourself and enter into your own way of parenting (attachment parenting in my case).

    I hope you get to bring you son home soon!

  8. #8

    Default Re: Worried about getting to exclusively breast feeding

    Wow - thank you all for your support. We've had a few more changes since I first posted.

    Our son was coughing and sputtering with each bottle feed and even on the breast at one point. So they did a barium swallow and learned the fascinating information, that he was coughing and sputtering when he started to get a little tired. Luckily they tried him on both breast milk and formula, and there was no difference, so I wasn't encouraged to switch to formula. So they put him back on tube feedings for a full day and are bringing the bottle back slowly. Today we are up to every other feeding being a bottle feeding. They are still including the rice cereal to help slow him down and to thicken the milk.

    I'm going to ask if I can start nursing again starting Sunday.

    VTgirl How does "block feeding?" work

  9. #9
    Join Date
    Feb 2008
    Posts
    2,005

    Default Re: Worried about getting to exclusively breast feeding

    just wanted to say welcome and offer some
    Proud mom of 2 boys, both weaned gradually and with love.


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  10. #10
    Join Date
    Jun 2007
    Posts
    736

    Default Re: Worried about getting to exclusively breast feeding

    Block feeding is normally used to help with overactive letdown and oversupply issues.

    Basically, you feed from the same breast for a certain # of feedings before switching.

    From this page at kellymom:

    ... try keeping baby to one side for a certain period of time before switching sides. This is called block nursing.

    * Start with 2-3 hours and increase in half-hour increments if needed.
    * Do not restrict nursing at all, but any time that baby needs to nurse simply keep putting baby back to the same side during that time period.
    * If the second side becomes uncomfortable, express a little milk until you're more comfortable and then use cool compresses - aim for expressing less milk each time until you are comfortable without expressing milk.
    * In more extreme cases, mom may need to experiment a bit with time periods over 4 hours to find the amount of time per breast that works best.
    In this case the idea is to get her to eventually get to the fattier milk that comes at the end of a feeding. As I understand it, in the beginning when your milk flows, it is "thinner" and doesn't have as much fat in it. As the feeding progresses it gets "thicker" and fattier -- this is typically called hind milk. I'm sure the lactation consultant attached to the hospital (hopefully there is one?) could do a much better explanation.
    Momma to K 05/24/07 (due 05/31/07)
    Momma to I, 06/04/10 VBAC'd (due 05/31/10). Read about it here

    Exclusive Pumper to first for 18 months.
    I got my VBAC!

    Struggling with nursing but one way or another breast milk is all they get.

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