Milk supply for premature baby

[Lmc1978]

Hi there,

Im not sure if I’m posting in the right place so i hope someone can help me or offer advice.
Long story short, my daughter was born by C section 9 weeks ago at 26 weeks gestation due to pre eclampsia. We got the shock of our lives and we have travelled a long road to get to where we are but thankfully she is doing well now, although we are still in NICU and close to making the transition to going home. I have been expressing milk for her since she was born but my supply has never been great so when she was tiny I was able to keep up with her feeds but now she needs top ups of formula to meet her needs. I am still expressing and had originally intended to breastfeed. (I have 3 other kids and breastfed/pumped for them for varying lengths of time. All were full term and i was able to take them home as normal from hospital). Anyway, she is now 35 weeks corrected she is still having apnoeas and the occasional bradycardia especially while feeding. She has been fed by tube and is now starting to bottle feed and seems to be doing well but her apnoeas get worse during feeds which is very distressing. I have been trying to put her to the breast before feeds and she seems to be doing well but then gets very tired and then the feed will need to be finished by tube. Then the following feed will usually be done by tube to avoid over tiring her.

My questions are: has anyone left the hospital while bottle feeding and while at home successfully established breastfeeding for a premature baby? and if so, did you top up with pumped milk/formula or were you able to exclusively breastfeed and ensure that baby was putting on the required amount of weight? Also, did anyone’s milk supply for pumping improve after getting their baby home from NICU?

PS am double pumping every 3 hours and once at night and drinking water and taking fenugreek etc.... and at early morning pump i get around 50ml and then at others it varies between 15ml-35ml. she needs 55ml every 4 hours but i think the stress/exhaustion of her being in NICU is causing my supply to remain below that level....

Sorry if my post is a bit rambling…Thanks in advance for any advice anyone can offer….

[scrumptiouscrumpets]

Congratulations on your baby

I managed to bf a preemie after bottle feeding initially. My son was born at 30 weeks and never took much from the bottle for the first 7 weeks, until he suddenly took an entire feed, literally from one feed to the next. I bottle fed until his due date and then switched to the breast. He was agonisingly slow - I spent most of the time feeding, but he put on weight well. Never had any latch problems or similar issues. I had always had a good supply so never gave top ups.

I was told not to expect a preemie to bf before his due date. I don't know how true this is because I only tried to bf him a handful of times before. The way your LO is feeding is perfectly normal for her gestational age and isn't an indication of whether she will be able to bf.
I can't answer your other questions unfortunately because as I said I never had supply problems.
Hope you get your LO home soon !

[ImYourMama]

I'm 40 days into my NICU stay, my daughter was born at 28+6, I hate to say it but to increase your supply, you need to pump 3 hourly through the night as well as day, supply and demand means your not stimulating enough at night, when your baby will be feeding regularly night and day. Hope that helps :) us prem mum's are made of strong stuff!

[earthmoon]

Ds3 was born at 33+1 I have been able to stop the bottles but only after his due date and only through gradual weaning. He left nicu whilst on three hourly feeds but when bf he woke up much earlier and needed to be feed much earlier. Even now at 12+5weeks he still is not back to 3hourly feeds.
I second the advice of pumping more in the night.

[xMamfax]

First of all, congratulations!

My daughter was born at 30+4 and I also wanted to breastfeed, so I expressed for her straight away.

When her sucking reflex came in we tried and tried to nurse but she struggled to latch and wasn't able to effectively transfer milk using a nipple shield. We stayed an extra week in hospital with the breastfeeding midwife to try and sort it out but it just wasn't working.

She started having to have bottle top ups (EBM) instead of tube top ups in order to get her tube out and come home. As soon as that bottle was introduced, that was it. She got increasingly frustrated at the breast and with little support at home, I decided to
exclusively express for her.

While in hospital I was making maybe 70ml at a time. After coming home I was able to express more regularly and was less stressed so my supply increased. I now make at least 150ml at a time (up to 250 if I go over an hour or two for sleep), pumping 7 times per day. I have 33 litres frozen and have just had to buy a small chest freezer to make space for more, so it IS possible.

There are lots of ways to boost your supply. Drinking LOTS, especially drinks with electrolytes, eating porridge/oats, power pumping etc. You can also ask for Domperidone on prescription from your GP to boost your supply. Also, some people fine that Fenugreek diminishes their supply, so it doesn't work for everyone.

There are Facebook groups dedicated to breastfeeding and exclusively expressing for ongoing help and support too.

Hope this helps!

[xMamfax]

I've just seen the date of this and realised it was a few months ago so you've probably gotten settled into a way of feeding that suits you by now. Hopefully the information is useful for someone though.

[EggysMom]

I desperately wanted to breastfeed and, after pumping for 8 weeks before they removed our son's NG tube in NICU, I kept trying our son on the breast both whilst still at NICU and at home but he never did take to it; he took very well to a bottle instead. I figured he was still getting breastmilk which was good for him, so I sucked up my price and carried on pumping & bottle feeding until he was six months old. We then switched onto high-cal formula at the Paed's suggestion.

My supply was pretty well established by the time he left NICU, but I was only ever getting 100-150ml per time, double pumping, and that was with a fairly hefty dose of Motillium from the pharmacy.

[EggysMom]

*pride, not price!