breastfeeding premature baby

(17 Posts)
BigPigLittlePig Mon 07-Jan-13 20:54:57

My dd (now 6 wks old) was born at 35 weeks too. We managed to avoid scbu, but she was rubbish at latching on for a few weeks. It's really worth persevering though and getting as much help as you can. My midwife sat with me for 30 mins at home helping which was invaluable as my nipples were ready to fall off Don't worry about not being able to express much, it's still early days. Congratulations on your lo though!

sparklekitty Mon 07-Jan-13 20:48:34

Just wanted to say, I have no experience of preterm baby (dd was 4 days over) but we had issues with feeding at first and she lost a bit of weight, it took her almost 3 weeks to gain back (she's now over a stone at 3.5 months) so I wouldn't worry too much, I'm sure its even harder for a prem baby too but I guess what I'm trying to say is that even term babies can take a while to get back to birth weight, sounds like youre doing great.

Just wanted to pop on and say that I could have written your posts about DD1 when she was born 5.6 years ago at 34+6 weeks. What you are saying seems typical of a pre-term baby but should be closely monitored. I had to express between feeds for DD1 but I gave up trying to get a good latch with her and used a nipple shield because it was so difficult (having BFed two more babies since then, I can confirm that DD1 was particularly tricky to latch on and had no patience if it didn't go right first time). We bucked the trend and managed to feed using a nipple shield for 16 months with brilliant weight gain. BUT, I did need to keep a close eye on her weight at first to make sure that she was doing OK.

Pre-term babies can be very hard work. You are doing an excellent job. Just keep on persevering, arm yourself with all the facts and remember to treat yourself!

Expressing is a much less efficient way of getting milk from you than a baby, your LO will be getting as much as they need, don't worry.

One thing you can try is hand expressing a little milk at the start of each feed, this is the thinner fore milk, for thirst quenching. The higher fat hind milk comes towards the end of a feed, so could be worth checking your LO isn't full of fore milk before the hind milk comes iyswim.

Just an update - DD was weighed again today and has put on a little bit of weight (40g) since Friday but is still 20g short of her birthweight. Today's midwife therefore suggested I continue to express after daytime feeds, and give this in a bottle after each feed. I am much happier doing this than feeding formula as hopefully it will increase my milk supply (I can hardly express anything at the moment so am a little worried that I don't have enough milk). It's exhausting but I figure it is only for a short time and if I get really good at expressing I can make DP do some night feeds in the future. We're also going to wake her every three hours for a feed.

Thanks everyone for the advice.

I'm also going to go to a breastfeeding group tomorrow - as well as getting advice I'm hoping I might meet other people with similar aged babies, as I missed my antenatal classes due to DD being born before they started!

NettletonMummy Sat 05-Jan-13 02:42:13

My dd took over 2 weeks to get back to her birth weight. She lost quite a lot of her birth weight in SCBU, and then lost a bit more when we she came off the tube feeding onto breast. Once she started gaining, it was steady progress and we didn't look back.

Definitely worth starting to express after feeds - it'll help boost your milk supply and useful to have in stock anyway - stick it in the freezer!

Thanks again everyone.

The midwife came today (she cancelled yesterday) and weighed DD and she was the same weight as last time. She said this isn't great but isn't awful either.

I am holding onto some hope - possibly misguided - as last time she was weighed just after a feed whereaas this time she was weighed before a feed and after a big poo. I have no idea how much difference this would really make.

The MW said she will come back on Monday and if she still isn't putting weight on then she would recommend topping up with a bottle. I don't really want to go down this route so I thought I could start to express milk after every feed on Sunday so if she hasn't gained weight on Monday I can use expressed milk instead of formula - is this a good idea?

Nettle how long did it take your DD to put on weight?

ResponsibleAdult Fri 04-Jan-13 07:02:56

Prem son at 35+5, 6lb 12. Three day delivery, emergency c section. We came out of hospital exhausted. DS cried slept and cried. I persevered with breast is best. HV visited daily, but no one weighed him. Day 5, my shrinking baby was weighed, he had lost 25% of birth weight. Admitted to scbu dehydrated on a cellular level, ie starving. Naso gastric tube for 5 days. Dropped off centiles. Took 6 months of expressed milk from bottle, 15ml in 20 mins, sleep for 20, eat for 20 until DC ate properly. Some prem babies have disorganised feeding ie can't suck swallow breathe in the correct order.
V sensible senior MW suggested with second child mixed feeding. Advantage is you can see what is being eaten in a bottle, someone else can do it so you can rest and have advantages of BF. DC ate slept ate, settled quickly into regular feeds. Both DC teenagers now, never stop eating. OP persevere if you can, but don't feel pressured if you DC fails to thrive and you feel you need to mixed feed

NettletonMummy Thu 03-Jan-13 20:03:20

My dd1 was in SCBU for 2 weeks after arriving at 34 weeks. I found that the nurses were more concerned with developing a 4 hourly routine than supporting bf, and advice from hv was more useful. I fed her every 3 hours during the day when we came home and let her go 4 hours at night. Had to wake her to feed for several weeks, but eventually she started waking herself and being ore alert. She's now a lively and healthy 3 year old.

Jeggie Thu 03-Jan-13 19:55:21

Thanks for updating! Every 2-3 hours sounds good, well done mama and baba! I'm sure the group will reassure you when you get there. Hope you were pleased with weight.

I just thought I'd update, yesterday dd seemed to do nothing but eat, waking herself every 2-3 hours for food. She is being weighed tomorrow so will hopefully have put some on.

There is a bfing support group next week so I will go there for advice on latch.

Phew, thanks for all your replies smile

If will definitely try to relax and check out the kellymom website.

Everything is so new and confusing at the moment!

I had a lot of advice from scbu, often contradictory. I'm not sure if they had a bfing expert as such. The other problem is I was transferred in labour to another hospital, so the scbu I was at is an hour's bus ride away, so I wouldn't be able to pop in there easily ...

My prem 31 weeker did nothing but feed, sleep and poo till he reached his due date. He was a bit more alert after that! So I wouldn't be too worried about her being so sleepy, ime it's normal for her gestation. Re routines, they tend to behave as their corrected age indicates, so I wouldn't be expecting things to settle a bit till more towards 9 or 10 weeks.

Did you see the BFing specialist while in scbu? They should have one, if you didn't then contacting your scbu to ask about support might be worthwhile. And yes, MWs & nurses contradict each other a lot! I found a couple of MWs who seemed to get what I was trying to do and really helped, I just ignored the others grin

The Kellymom website has lots of info on BFing, inc of prem babies, so that might be worth looking at too.

Congratulations, and well done so far!

Jeggie Tue 01-Jan-13 17:01:21

Hiya, congrats on getting your baby home. Well done for already managing to establish bf as it must have been a challenging time. I'm a bf peer supporter and i can offer a few pointers for you for now but things are bound to change and fast. And then change again! Things generally settle down a notch about 6w but I'm not sure if this is different if prem. Good to feed baby as soon as they show signs of being hungry. Sometimes waiting till they cry they will be too distressed to latch and may take on extra air from crying. As bf is a demand and supply thing, the more you feed the more you will increase your supply and they say you can't overfeed a bf baby. Re your latch, practice makes perfect, keep at it and always take baby off and relatch if there is any discomfort. There's not necessarily a right and wrong way to do it as its whatever works (you are looking for pain free, lots of wet nappies, satisfied looking baby after feed, nipples same shape not squished after feed), so try not to worry too much about what mw said unless you feel you are having problems. Standard guidance is to get baby to open wide and take a big mouthful of breast. Line nose up with nipple and guide mouth gently to breast when they open up! Many mums find that if they support baby's weight with the opposite arm to the breast they are using, lightly supporting head with that hand, the rest falls a bit more into place (think this is called cross cradle hold). See if you can get along to a bf group and look at kellymom website, la leche league, NCT websites for visual guides to a good latch. There are helplines too where you can speak to bf counsellors if you cant grt to a group straight away, I know NCT have one advertised on their site. Hope that's some help, many congrats smile

givemeaclue Tue 01-Jan-13 16:33:45

Also don't be concerned re only waking for food, that is normal and will change!

givemeaclue Tue 01-Jan-13 16:32:57

Congratulations. You are doing very well, my babies were born at 34.5 weeks and never managed to latch on even once in 4 weeks which was very stressful. We switched to expressing milk and giving in a bottle at that point (tube fed till then) but then moved onto formula for various reasons after 7 weeks.

Your baby is gaining weight and doing well and you are getting support.

I would feed minimum every four hours (from start of one feed till start of next). If asleep then wake up for day feeds, dream feed for night feeds. Use alarm clock set for every 4 hours. If needs feeding in between then of course o so, then set alarm for 4 hours from start of that feed. So basically feed as often as baby needs but don't let baby go more than 4 hours without feed at this stage, even if means waking baby.

Local breast feeding counselor would gel with the latch, don't Be afraid to ask midwives for more help in ugh.

Good luck you are doing great

Dd was born ten days ago at 35 weeks. She was tube fed in scbu for the first few days, then we introduced breastfeeding, and finally stopped her top ups on Friday and were discharged on Sunday when she started gaining weight. She had a bit of jaundice but was healthy apart from that.

Now we are home I am a bit confused about bfing and wondered if anyone else had experience with preterm babies? None of the usual advice seems to apply to her.

Also she is my first and because she was preterm I hadn't been to antenatal classes yet and feel a bit lost. I am normally a control freak super organised so it feels weird to me to be so unprepared.

In scbu she was used to four hourly feeds and has mostly stuck to that schedule. Sometimes she wakes up earlier but often she has to be woken for a feed. She often falls asleep halfway through a feed and I have to change her nappy to wake her up. She is generally sleepy and only wakes up for food. In many ways this makes life easy for me, but I don't know if it's something to be concerned about.

The scbu staff were good for advice but often contradicted each other leaving me more confused. For example one person told me to feed her as soon as she wakes up and starts to root, another said to wait for her to cry so she is good and hungry.

Today the community midwife came to our house. She said dd has gained weight again so we must be doing something right. smile but when she arrived i was at the end of a feed and she said dd wasn't latched on properly. She showed me how to latch properly but to be honest I don't know if I can repeat it. Also if dd fails to latch after a few tries she gets cross and either cries or drops off depending how hungry she is so I am reluctant to pull her off the breast.

Apologies for the long post, but I wondered if anyone is or has been in the same boat, if this sounds normal, and if you can offer any advice.

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