Feeding and Weight Gain for Prem Baby

[AndiFR]

Hi there - I have also posted this in Childbirth as I hadn't seen this topic heading...

I am after some info or support on feeding prem babies.

Basically, DS was born at 30weeks, and came home from SCBU at 36weeks. (He has now been home for a week and a half). Although he has not lost weight since leaving hospital he is not putting on weight very quickly, and definitely considerably slower than when he was in SCBU. Although we are not too worried at this stage, we clearly don't want him to lose weight, and feeding takes up quite a lot of our energy as he is never very interested. We often need to wake him to feed (so he doesn't go longer than 5 hours), and if we wake him sooner (say at 3 hours), he just refuses to feed.
He is totally breastmilk fed, but due to his lack of weight gain we suspect he is not taking enough from the breast.
Whilst in hospital trying to establish breast feeding (we were in our own little room), he did feed every 2-3 hours, but this was when he lost weight. Thus the hospital insisted that he had an expressed milk topup (this was initially by tube, and then later we eventually decided to use the bottle). I am now nervous that if we use the bottle too much, that he won't go back to the breast (and he is already significantly lazier on the breast than the bottle).
I am not sure how to balance his requirement for nourishment/to grow etc, and our desire for him to use the breast. We are looking for tips/info/encouragement from anyone who may have had a similar experience.... We have read books and talk to pediatricians and breast feeding counsellors... But all they do is completely contradict each other, and none of them seem to suggest a solution that has seemed to work for DS... (they normally suggest more regular feeding or longer on the breast or offering the second breast but DS isn't interested in any of these). If we have to be more persistent with a routine, we are happy to try this.

Thanks

[magnolia1]

Oh Hun, sounds hard work and I have some experience but my preemie was 33 weeks so a bit older. She was tube fed in hospital and I went into the sideroom for the 3 days before she came home. I have just looked at her red book with the weight chart and this is the weight she put on in the first few weeks. She was fully breastfed with no top up bottles. weight is pounds and ounces
3 weeks of age 4.14
4 weeks of age 5.2
5 weeks of age 5.11
6 weeks of age 6.4
7 weeks of age 6.8
8 weeks of age 7.2

So the most in a week was a gain of 9 ounces and the least was 4 ounces but it was pretty slow going and I was tempted to use a top up feed but didn't and when she got bigger and stronger she was awake for longer and fed better.
In my opinion (and its only the opinion of another mum) I wouldn't give anymore top up feeds and just feed as ofetn as he wants without letting him go too long. I would always changer dd4's nappy half way through a feed to waker her up. Or make sure they are barely clothed (not outside of course) as if they are too warm they will be more sleepy.
I think the problem you may have is that you want a routine and having had twin preemies and then another preemie I found routine impossible for the 1st few weeks

[mears]

I posted on your other thread. If you still feel he needs topped up with EBM, have you considered cup feeding? That is what is done where I work to prevent babies getting too used to teats. Preterm babies are very good at it. The cups come with the breastpump kits

[mears]

here is another alternative

[LaDiDaDi]

I too posted on your other thread but didn't have the time to post all that I wanted to share.

When I brought dd home from hospital she initially had a tube in but I quickly tried to get her to demand breastfeed. It didn't really work for us, in retrospect she was clearly constantly very hungry, didn't gain any weight and actually probably had the bare minimum of milk to keep her well. I decided to give her formula as I knew that she wasn't growing without it. It did make me feel happier at first as she had heavier wet nappies, seemed more satisfied and gained weight.

Now I'm getting fed up with expressing to keep up my supply each time that I give a bottle (3 per day) and I'm going to try to reduce the formula feeds if I can manage to do so and if she gains weight ok, she's now 9 weeks and 6lb 6oz. I'm quite lucky in that dd happily goes from breast to bottle etc without any probs.

I'd reiterate what someone else said on the other thread, that we all know breast is best but babies need to grow too! You are clearly working hard to do the very best for your ds but try not to get too stressed about it all or to beat yourself up if you give formula or expressed milk top ups. You have done so well to give your lo breastmilk up to now during what must have been a difficult time. I'm telling you this because it's what everyone's been telling me . When I was preg I really wanted to exclusively breastfeed for 6 months but that hasn't happened and I don't feel sad about it because after we were both poorly dd and I are now happy and well and that means much more to me than how I've fed her. This isn't meant to put you off breastfeeding but just to try to stop you from feeling guilty about this, however you end up feeding.

i'm sure someonewho can offer you actual practical advice, which is probably what your after, will be along soon.