Problems with BF 34+6 preemie, small boobs and inverted nipple

[pixiequeen38]

My dd is now 38 weeks corrected. We spent a week on the transitional ward as she was jaundiced and had feeding issues. I mainly FF via a bottle but started off with cup feeding, she wasn't able to latch on the breast. I then expressed colostrum and breast milk and gave via a bottle. I was told it may take a while before she could learn to latch and suck on the breast.

Since discharge I have been expressing using the Medela symphony but only been able to produce about 50mls each time and I do this 8 times a day. This is just about enough for a feed but sometimes when she's hungry she may take 60mls. I've only got small boobs - B cup. Since yesterday with using nipple shields and three meetings with the breastfeeding counsellor, dd has started to BF for 20 mins at a time. I have inverted nipples but used the niplette device through most of my pregnancy which has helped my right nipple but my left is still inverted. However, I am still able to get milk out from both sides. I think she has trouble feeding from the left side more than the right.

My routine every 3 hours is breastfeed from one side (alternate sides each feed which is what the counsellor recommended to start off with), then top up via bottle with EBM, then express both sides. It takes an hour or so in total and then I have to repeat it in 2 hours which is leaving me exhausted. I'm worried about just BF as she lost 10% of her weight by the time she was discharged but she regained her birth weight (4lbs 14oz) and more and therefore offing her the top up. I have received mixed advice about how much to feed her but I was told 150mls per kg so just under 400mls. How long do I carry this on for? The midwife just said she how she goes and be guided by her. Any advice would be much appreciated!

[MargaretHale]

I have one inverted nipple which ds found tricky and have had success with pumping for just a few seconds before putting him on the breast as it draws my nipple out- worth a go?

[Chickchickadee555]

The one-sided feeding and only every three hours would concern me...why did the counsellor recommend this?
It would be far better to always offer and encourage your dd to take the second side and to be feeding much more frequently. I think it should be 10-12 times a day at this stage.

[eeyore2]

We had a similar thing although no nipple problems. I think 150mls/kg/day is the lower end of the spectrum. We were told it is anywhere between 150 and 200 and we only went down to 150 for top ups when we were also breastfeeding successfully. Now though she is mostly having expressed milk and it is closer to 200. Do you have the special hands free bra thing and a double kit for the symphony? That is what made all the difference to my supply. Good luck!

[Luckystar1]

I have no specific advice I'm afraid, but I can absolutely confirm that the size of your boobs means nothing. I have just about a b cup and I've been successfully feeding for 13.5 months.

Well done for continuing, it will get easier, almost all of a sudden one day!

[artisanroast]

I also want to reassure you. My little girl was born at 35+5 and we initially used expressed breast milk via a bottle and then moved onto breast feeding but it took 4 weeks to establish (it felt like a lifetime)

We used mimijumi bottles as they were similar to breasts (skin colour and require for the baby to really suck to get the milk).

We also did 'the crawl' skin-to-skin every day until my daughter started to feed from me.

I am delighted we persevered as she now happily takes expressed breast milk from the mimijumi bottles or feeds from me. I love the bond we have when she feeds from me. (Says the mum who just dropped chocolate cake in her baby's hair )

xx