DD is in SCBU, struggling to establish breastfeeding, any advice?

(50 Posts)
minipie Wed 07-Nov-12 21:50:23

DD was born unexpectedly at 34 weeks 10 days ago, so she is now 35+5. She had no breathing issues but has had jaundice and reflux related de saturation episodes and temperature issues. These at now largely sorted and the only thing keeping her at hospital is establishing breast feeding which I am struggling with.

I have a large milk supply and she feeds well some of the time, mainly in the evenings. However much of the time she falls asleep after only a very very short feed (a few sucks) or just doesn't wake up when she ought to be hungry.

Any advice? The nurses are lovely but they seem unsure what is best. Some advise holding off tube feeds and letting her get hungrier, others say she's in a sleepy phase and we should just wait for her to get more interested. We tried on demand feeding yesterday but she didn't feed much and today is back under uv lights for jaundice which I think means she didn't get enough yesterday sad and I feel so guilty. I don't want to rush her into full breastfeeding before she is ready but I would so love to take her home...

I know someone who took her twins home at this stage, still part tube feeding. But I think she had to fight the hospital and I am not sure I have the confidence to do that.

Any experience or thoughts most welcome... I really don't know what is the best course from here. Thank you.

sheeplikessleep Thu 08-Nov-12 13:50:38

Are they monitoring her jaundice levels?
If I were you, I'd demand to cup feed (it is not to replace breastfeeding, it is there as a temporary solution rather than bottlefeeding, in long term interest of breastfeeding).
It is so frustrating that there are some quite lax nurses and doctors out there.
I also suggest you post this in breastfeeding part of Mnet - Tiktok and others will have ideas I'm sure and really help you to get your daughter feeding.

Yy, good idea to repost/ask MNHQ to move to breastfeeding - tiktok is amazing & will give fabulous advice smile.

Good news they're letting you stay overnight - slightly odd on the cup feeding though, I agree - I think of that as a way to move babies from tube to bf rather than bottle, but I'm no expert.

Keep letting us know how you get on - even if it's just to offload.

<un-mn hugs>

bytheseaside Thu 08-Nov-12 14:54:46

We also did some (very messy) cup feeds too, suggested by nicu nurses, didn't take off for us , but clearly not considered a universally bad idea in nicus! With the benefit of a few weeks hindsight i would say if you want to do something that others have found helpful but nurses say no, ask what medical evidence there is for their decision, ask whether you have any say in the matter, and if it won't hurt your baby insist. remember that you are the mummy! A lovely nurse said this to me after id been a bit bullied by other nurses about being in nicu so late at night, made me really cry with gratefulness and was subsequently really empowering. great you can stay tonight, good luck!

Welovecouscous Thu 08-Nov-12 15:04:32

I agree with you are the mummy - remember you know best what dd needs and have the mothering instincts in her interests.

Would definitely recommend calling la leche league - bf counsellors are highly trained and will want to help you.

minipie Thu 08-Nov-12 15:19:03

to be fair to the nurses here they are lovely and supportive and will listen to me. the trouble is I dont have a clear view myself.

they will give her cup feeds at night but not when breast is available - ia that unusual? thing is im not sure how much cup feeding will help, if she isn't awake enough for bf then she isn't awake enough for a cup...

i am also worried about my bf technique even when she is awake - she will often latch on, take good sucks, but then sort of squirm an crunch up her body as if her tummy hurts, and bring herself off the breast in doing so. then obv she has to begin all over again with the latch which is exhausting... will post in the bf section as suggested.

thanks for the support and advice. x

EyeoftheStorm Thu 08-Nov-12 19:14:31

Just to say bottle feeding expressed milk doesn't mean the end of breastfeeding.

DS2 born at 30 weeks and had terrible trouble getting hang of it - also very sleepy baby. In the end I expressed and gave bottles as it was holding him back from being discharged.

I went to bed with him when we got home - lots of skin-to-skin, trying to breast feed, giving bottle to top up. Slowly but surely we got there. Dropped the bottles when he was taking more from me and went on to breastfeed for over a year.

I found that every nurse in the NICU had a different opinion on bottle/breast which made it difficult. I just put my head down and dealt with it when he was home.

Good luck.

Mandy21 Fri 09-Nov-12 12:23:59

Just wanted to post and say congrats, you're doing brilliantly! Its hard when you have lots of conflicting advice (both on here and from the medical staff) and you don't have a firm view of what is best. My 3 bits of advice would be to 1) speak to whoever is the most pro bf'ing at the unit / has most experience and get them to help you with the latching on process, will make such a difference. 2) see if you can be there whenever she seems to be the most alert / hungry. If you can have a good crack at feeding then, it might help at the times when she is tired. 3) change her nappy mid way through, tickle her feet and blow on her face to keep her awake / keep feeding.

I had twins at 27+6, also had a good supply. They had by EBM via a tube for a long time, gradually started putting them to the breast when they were having their feeds, then did mix of bf'ing and top ups. DD willingly had a cup in the night, DS didn't like it and had his tube feeds. Didn't seem to make any difference to how quick they got the hang of bf'ing.

I'd also suggest rooming in or at least being there for all the feeds if you can for a while - we tried twice, and fed on demand. The first time (I think they were about 35.5 weeks, so not that different to your DD), they weighed them before we went to room in, and then afterwards (I think we had 36 hours or so) and despite feeling like I fed them pretty much constantly, they'd both lost weight (about 60g each I think) so they went back on the unit for a few days. I was upset, but kind of confirmed that they weren't quite ready to come home. Tried again a few days later when they were just after 36 weeks and they both gained weight - albeit only 10g each!! They were home at 36+5 - at this stage, each day can make a real difference.

My consultant said the home environment is where they really get it / happy with the environment / you're there all the time. Its hard as you'll be desperate to get your baby home, but just wanted to say it'll come I'm sure - I was really impatient but had to take stock and realise how little they were and they just needed practice and time. Good luck!!

CelticPromise Sat 10-Nov-12 10:05:16

Hey minipie. Congratulations. Sounds like you are doing brilliantly.

Is there any BF support available at the hospital? I volunteer as a peer supporter on the local NNU. There are a couple of breastfeeding specialist nurses too. Could you ask for someone with specialist knowledge to come to see you? Maybe even someone from the postnatal ward? In my experience many NNU nurses are not all that knowledgeable about BF ing. A specialist nurse helped me hugely with DS and really improved my confidence.

minipie Mon 19-Nov-12 15:19:03

Just wanted to come back and update. DD is finally home at 37+2! Feeding still a little erratic, but good enough i hope.

I stayed overnight a few days ago (not rooming in but appearing for every feed) and it went v well, then 2 nights rooming in till she demonstrated weight gain and we could come home.

I did also try staying overnight about a week ago, after posting here. DD appeared to feed well but not enough wet nappies, so clearly hadn't really got it yet. That told menot to push it too fast and be patient.

if she falls asleep, sitting her upright to wind/wake her, and then feeding again, has really helped, as has keeping her cooler, and tickling etc. thanks for the suggestions.

hospital BF counsellor was useless though, just focused on positioning which i was fine on anyway. if anyone knows of a great private BF counsellor who covers SW London, ideally with preemie experience, please let me know!

Off to nap now before she wakes again...

Bramshott Tue 20-Nov-12 09:06:19

Great news minipie - glad she is home and its all going okay.

Jojoba1986 Tue 20-Nov-12 09:30:15

My DS wasn't prem but it still took him nearly a week to get the hang of breastfeeding! He lost too much weight so we had to go back into hospital. Like you, the positioning was fine, our problem just seemed to be that he didn't associate sucking with food. Less than 24 hours of expressing & bottle feeding & we had it sorted! We had to do top-up bottle feeds for a little while until he started gaining weight properly but we breastfed until 8 months! It was hard to fight for breastfeeding when everyone seemed to think we should just give up & bottle feed but we got there in the end! smile

Congrats on your little one! I hope things get sorted out & you can get on with just enjoying her really soon!

agendabender Tue 20-Nov-12 21:53:58

Wow I couldn't walk past this, it took me back two years. DS was a 33weeker, and stayed in without me for three and a half weeks. He struggled to stay awake to feed - a latch takes a lot of effort for them.

One nurse sent me to mothercare one day to buy nipple shields when I was in floods of tears because the hospital required him to feed for 15min several times a day before they would let him come home. She recommended the medela ones. They have a cut-out, which is supposedly for baby's nose, but if you turn them upside down then you and baby get proper contact. While shields can be a problem for some ladies, they mean that premmies have something that they can hold in their mouth with little effort. They can have little rests between suckles (which all babies do) without losing hold and having to put all that effort in again. the shield will fill up with milk between sucks and help them along.

This can get you home, but you will then have to wean baby off the shields. It actually took us a couple of months to get rid of them, but my supply remained HUGE and he grew fantastically. He still breastfeeds. He has not yet fed for more than 15min at a time.

You can do this. There are ways. Feel free to PM me if I can be of any support to you.

agendabender Tue 20-Nov-12 21:55:59

Sorry minipie I somehow missed your last post. Glad she's home. All the time you get together will really help with feeding. Best of luck!

Welovecouscous Tue 20-Nov-12 22:00:39

Yay mini grin glad you are both home.

I would contact your local LLL group - they will know who to contact in your area.

xx

Mandy21 Wed 21-Nov-12 13:10:11

Congrats Minipie on getting her home, fab news.

Agendabender's post reminded me that we also used nipple shields - but that was (in my case) down the "flat nipples" blush - the shields have a longer nipple which helps them (as I understand it) as the necessary mechanics for sucking are at the back of the mouth. I used them for about 4 weeks - from about the equivalent of 36 wks gestation to when they would have been term. Just stopped using them, didn't have to wean them off them or anything.

minipie Fri 23-Nov-12 15:28:39

Thanks again and thanks to agenda. DD is still quite sleepy at some feeds (though a wide awake and voracious feeder in the middle of the night - naturally!). During the day it is a real struggle to get her to wake up long enough for a decent feed. Any idea how long this sleepiness/reluctance will last...? I know the answer is likely to be the hospital mantra "every baby is different"!

AmandaCooper Fri 23-Nov-12 17:11:09

Hi minipie sorry to crash your thread but just wanted to say it's lovely to hear she is home. I'll update the WIITs! xx

minipie Fri 23-Nov-12 17:14:13

Thank you AC!

AmandaCooper Fri 23-Nov-12 17:20:58

Ooh hello shock <waves>

Willdoitinaminute Fri 23-Nov-12 17:30:50

My DS was born at 36 weeks ended up in Scbu being tube fed and had to have lot of lighT therapy for jaundice slept for nearly 10 days solid as he was exhausted thought I had perfect baby. Once he had cleared jaundice at around 9 days he started to liven up and feed more often and put on weight. Remember that she is prem and her tummy is very small and cannot take much quantity. Eating takes a lot of energy so little and often. Also how long does it take you to express 2-3 ounces probably under 5 mins. A bottle fed baby has just one hole to suck through your nipple has multiple ducts so breast fed baby's can drink much more in the same time.
Stick at it and relax instinct is often more successful than any amount of advice. Even if you think your question is stupid ask it the staff will not juDge you.
I had CS as well and post natal midwives were very defeatist but scbu midwives were amazingly supportive and we all had a mini celebration when he finally started to bf after 4 days of tube feeding.
I bf until he was nearly 2 and he is now a healthy 8 yr old.

bytheseaside Sat 24-Nov-12 11:48:43

Minipie that's brilliant! Good luck with bf , v.sleepy is normal for a while i think! i was advised that as long as your baby is putting weight on not every feed needs to.be a big one so the odd shorter one in the day is ok if they are guzzling at other times. Worth trying surestart breastfeeding groups / supporters, they are great and free, and may have some prem experience

minipie I've only just seen this!! We've missed you on the December thread. I'm being induced tomorrow at 35+3 so will be in a similar situation. Glad to read that you're home dd was prem and very sleepy too it can be really difficult smile

minipie Sat 24-Nov-12 13:46:52

Good luck Spotty... Hope your little one doesn't have to spend long in hospital x

Valdeeves Sun 25-Nov-12 03:49:16

I have two prem babies now - one at 35 weeks and one at 33.
The 35 weeker only ever fed through a nipple shield for prem babies. Medela (or name that sounds like that! They make the yellow breast pump - the swing one) sell them online and the ward might have a catalogue?
The other option is to get a double pump on hire to keep your milk supply high as you go along. You can cup feed it to them?

My advice is not to put yourself through two much stress if you really can't establish it and just express? My 35 weeker never fed well (boy) and feeding was very stressful for me - we did four months. My 33 weeker (girl) feeds alot better but still a bit hit and miss so I combine feed her. It's a lot less stressful to do both and I enjoy Breastfeeding her alot more.

Valdeeves Sun 25-Nov-12 03:49:54

Btw - good advice on this page

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