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Thread: Choking all the time

  1. #1

    Default Choking all the time

    *I posted this on another forum but didn't get much response. I'm hoping that someone will have more advice for me here.*

    I'm the mom to a little girl who was born at 33 weeks gestation. She was in the NICU for 5 weeks. She is now almost 8 weeks old and we are having a lot of problems with her breastfeeding. She is my second child and I nursed her older brother until he was 29 months old.

    My daughter started off on breast milk in the NICU via gavage. After 10 days, they found that she was not gaining weight and that there was blood in her stool. They discovered that she had a milk-protein allergy, and was switched over to formula while I removed the dairy and soy from my diet. She did fine on my milk when they re-introduced it. She figured out how to take a bottle, and I was able to nurse her for one feed a day (this was due to the fact that we lived so far from the hospital that I could only be there once a day). She left the hospital on 7 feeds through bottle and 1 through breast a day. We switched her to all feeds on breast when she got home.

    She has been home for 3 weeks and the issue we are having is with her choking. She chokes at every feed. They are really scary choking fits where I have to literally pound her on the back to get her breathing again. They last anywhere from about 10 to 60 seconds. It has gotten to the point where I am terrified to nurse her.

    I know that I have oversupply and overactive letdown issues. I have tried block feeding, and expressing milk into a towel first. My supply has slowed down, not not enough.I have tried reclining and feed her mostly sitting upright. I have added a bottle a day to try a reduce my supply. Is that a bad way to go? Should I add more?

    One thing I realized yesterday is that she also chokes on EBM through a bottle. She is good with formula, but I think that is because it is so thick (ready-made Alimentum). Should I add some formula to EBM to make it thicker?

    I plan on talking to her ped next week about all this, but I'm wondering if anyone else had dealt with any of this.

  2. #2
    Join Date
    Jan 2006
    Posts
    18,063

    Default Re: Choking all the time

    awe hang in there most babies born early don't nurse well untill after their due date.

  3. #3
    Join Date
    Jan 2006
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  4. #4
    Join Date
    Jun 2006
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    4,894

    Default Re: Choking all the time

    Congrats on your baby! I have a 33 week preemie myself, now nearly 5 years old. I can tell you that while pumping is crucial for a preemie (tube/bottle feeding EBM) it is also our worst enemy. I also had an insane oversupply issue. I remember only feeding from 1 breast in an entire day. I would pack the pump away for now. No matter what, don't use it. It will only increase or at the very least maintain the supply you have.

    Position is important. The link Andrea suggested is great. Definitely continue block feeding. It might take a few days to see a difference but it's worth it. I would not however add formula to your breast milk. Perhaps finding a slower flow nipple would help.
    If you obey all the rules, you miss all the fun. - Katharine Hepburn

  5. #5
    Join Date
    Jan 2008
    Posts
    1,081

    Default Re: Choking all the time

    The choking fits sound scary! My son used to choke on his spit-up (he has reflux) and it was definitely scary.

    I am not sure if this would be a good idea for your supply, but I'm wondering if you pump until your milk flow slows down and then latch her on to nurse...then maybe she can handle your flow better. If it works, you could do that until she's a little older and better at handling your flow.

    Another thought is to feed on the same side for 3 feedings in a row.

    Are you able to meet with a lactation consultant or a feeding therapist (preferably one who has experience with preemies)?

    You could also try using a nipple shield, as it doesn't have nearly the amount of places your nipple does for milk to come out of. It will come out of the nipple shield much slower and could help her handle swallowing better.

    Another thing you could try (talk to your Dr about it though) is adding Simply Thick to your breastmilk when you give her a bottle and see if it helps. When my son started drinking from a sippy cup, we noticed that he choked and aspirated on the water and so we had to thicken to nectar consistency with Simply Thick to help him swallow it normally. It's a thickner that doesn't add calories/change the taste of what you mix it with. It's not a prescription or anything.

    Has your daughter gotten sick from the choking episodes? I ask because my son used to, due to aspirating on what he was drinking, and it's important to take that seriously.

    As you've probably heard, it can take preemies time to coordinate suck, swallow, breathe pattern. But, I would definitely talk to your Dr about the choking episodes - even get a few on video. Good luck mama.
    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


  6. #6
    Join Date
    May 2011
    Posts
    12

    Default Re: Choking all the time

    You can try simply thick it is a gel food thickner that was used for our girl. unlike most it will thicken breast milk. But you might want to have them do a swallow study ( not sure of the med. term ) to see why she is choking.

  7. #7
    Join Date
    Nov 2010
    Posts
    30

    Default Re: Choking all the time

    I had this problem with one of my preemie twins. I had an overactive letdown and quite an oversupply. We just kept trying. I sometimes pumped some off before to help. Lactation suggested that. Otherwise she would cough and choke and then relatch and kept going. Both of the twins also have reflux too and are still on medicine. They are almost 12 months old and have been breastfeeding them most sessions since December. It seemed to work itself out so keep trying!

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