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Prem baby tube fed in SCBU. Reassure me about BFing please!!

(35 Posts)
JoyceBarnaby Tue 07-Jun-11 23:47:05

DD (DC2) was born less than 24 hours ago at 35 weeks. Weighing 6lb 3oz, she's doing really well. However, she is still on a drip and is being tube fed every 2 hours. Her blood sugar has been very up and down.

I have hand expressed colostrum 5 or 6 times already (up to 1.5ml a time so far) and this has been given to her before any formula top-ups. I have no problem with formula top ups at this stage - so long as my colostrum is priority and she is getting what she needs, it's fine. I am holding her skin to skin and offering boob whenever I can, but she has shown absolutely no interest so far.

I had terrible difficulty establishing BFing with DS, although we did eventually get the hang of it and BF for over a year. He wasn't prem - just not very interested in any feeding at all!! So, does anyone have any advice on what I should be doing with DD? I know it's early days and I need to take each day as it comes, but I really need to know that BFing will happen again!!

Thanks x

Checkmate Wed 08-Jun-11 00:29:48

Congratulations on the birth of DD!

Firstly, it sounds like you're doing everything that you reasonably can for this early stage. Hand expressing colostrum is excellent, try to do it at least 8 times in 24 hours including in the night, to encourage your supply. From day 3 it may be worth using an electric pump instead but depends on the person.

Is there a bf counsellor in SCBU? Oftentimes it's a paediatric nurse with additional training. I would be asking for some advice from them as soon as possible.

Continue with as much skin to skin as possible. When ds1 was in scbu I used to change his blanket everyday, taking the one that smelt of him to bed with me, and giving him the one I'd slept with thenight before. I would smell his blanket while expressing and looking at his photo.

Checkmate Wed 08-Jun-11 08:29:20

Bumping for you, so the experts see this thread.

How has it gone overnight?

Iwasagnome Wed 08-Jun-11 08:31:51

Some electric pumps are much better than others,the NCT should be able to advise and probably lend you a good one

Primafacie Wed 08-Jun-11 09:10:00

Congratulations on the birth of your daughter. Sorry she is in SCBU, it is a very stressful time but things will soon get better and easier. I am not an expert, but my son was born at 34 weeks and is EBF. He did have the sucking reflex though - does your DD have it? I think trying to put her on the breast as often as possible might help. It can take days or even weeks for preemies to start sucking, so keep on trying and it may well work. Also see the Bliss website and leaflets, they have one specifically on BFing preemie babies. Well done on expressing colostrum, I did that too for the first couple of days when my son was under bililights, they only need a tiny amount at that stage. Your milk will probably come in a day or two and they can use it for nose feeds if she is still not taking the breast. Good luck, thinking of you. If it helps my son is now six weeks and thriving. Wishing you all the best.

Albrecht Wed 08-Jun-11 09:45:48

Congratulations on your new baby!

Keep expressing - 8 to 10 times a day including in the night. It doesn't have to be evenly spaced, don't wait til you feel very full, the more 'empty' your breasts feel the more they will get the signal to produce milk.

Keep giving dd milk any way she will accept it (does your hospital have access to donated human milk?)

Keep trying her on the breast, when things settle down you can try biological nurturing (plonk her on your bare chest and help her to find your nipple herself - Youtube if you have time to watch)

Kangaroo care (put her down your top) will help stabalise her heartrate, breathing and temp but will also get her used to your smell and taste which should help get her interested in the breast.

Good luck. Hope others who have been there and done it will be along soon to reassure you that it happened for them.

EvaPeron Wed 08-Jun-11 09:56:17

Congratulations! and keep trying with breastfeeding.

My DS was 6lb 13 at birth and lost weight to just under 6lb (and he was full term). I found him easier to feed after a few growth spurts when his mouth got bigger. I think it is harder with little one, but Alrecht has some good suggestions.

hildathebuilder Wed 08-Jun-11 10:11:45

Congratultions. First I want to tell you that it can be done. My DS was 3lb when he was born at 29 weeks, was discharged fully breastfeeding at 4lb 14 and is still BF 15 months later.

Secondly I would advise many of the things which have been said here

1. skin to skin, lots of it, and kangaroo care. Try and time it so that you get a long period with dd without interuption (ward rounds etc)

2. Keep expressing. I agree with at least 8 times in any 24 hours. Personally I am less sure about overnight but I was very lucky and went from 11pm until 6 am (against the advise of the bf counsellors - it worked for me, but I am the exception so probably don't take that bit as gospel. i also knew i would need energy for the weeks of DS being in hospital).

3. Get onto a double pump as soon as you can. The scbu may have one, if so borrow it if they will let you. If not get hold of one (hire from NCT, buy one)

4. If your DD soesn't have a sucking reflex don't worry. Give her the opportunity to nuzzle. Don't worry if it takes time before that comes.

5. Try to eat well, and rest when you can, its very stressful

6. while the formula top ups by tube its easier? If they ask about bottle you can refuse that and leave the NGT in, or ask if they can they be switched to cup at all. If they are by bottle try to put her against your chest before the formula is given (assuming she is stable) so she gets the "right" associations.

7. If you do not want to be you can refuse to have DD discharged until you are happy with feeding.

8. Don't worry (easier said than done). There is no reason why BF shouldn't work, its just a bit harder. But if it doesn't work, don't worry about that either. Many many prem mums don't manage to BF, for a number of reasons, and if that happens with you that is ok. One of the reasons is that you just want your DD home and that is often the right decision.

9. Many people find expressing with a photo of their ds.dd helps. I found expressing doing anything else was easier (TV, reading, emailing etc) as I worried less

10. Most people express most first thing in the morning, try and prioritise expressing 2 hourly at your most productive time

11. Enjoy your dd!

Poledra Wed 08-Jun-11 10:26:40

Congratulations on your new daughter!

DD3 was in SCBU with NGT and drip, though she was full-term (she had HDN, so very sleepy and not interested in feeding). I found the hospital's electric pumps were great for expressing milk (had been absolutely pants at doing it with a hand pump with DDs 1 and 2). Hilda's given you a great list to help out there - something else my hospital were prepared to do was to set up a screen so I could sit with DD3 in SCBU and express while I looked at her, if I found it easier.

Like Hilda, I didn't express through the night, as I wanted to get some sleep so I was fine for DD3 (and for seeing DDs 1 and 2) during the day. The nurses in SCBU were great about using my milk first before adding any formula to the tube too - they had a system for 'filing' your milk in the fridge so the night-nurses knew whose milk was whose!

We left hospital after 6 days, with DD3 fully bfed, and she bfed till she was 16 months. Oh, and I had the most awful problems establishing BFeeding with DD1, but it was soooo much easier with both DD2 and DD3.

Good luck with it - you'll get there!

ifitsnotanarse Wed 08-Jun-11 10:31:34

Hi JoyceBarnaby, congratulations and ditto what everyone else said. My DS2 was born 32 weeks, 4lb 80z, and spent 24 days in SCBU. Everytime I visited I would to ask for a screen, undress him and place him on my boob for an hour or so. I would express a little milk by hand and rub over my nipple and place a little on his lips so that he would associated my boobs with food. His sucking reflex came in at about 12 days and he started licking the milk of my nipple and on day 19 he breastfed for the first time. Next day he wouldn't take and had to have a bottle but I got nipple shields (most nurses/midwives advise not to but one nurse said if he takes using them then great!) and he BF from then on. Only off them 1.5 weeks though - at 7 months old he had decided he doesn't need them anymore grin.
Don't forget to ask the unit for empty sterilised bottles for your expressed milk - they will provide them free of charge. If you find you have more than is needed, freeze it or bring to the unit and they will freeze it - that way it they won't run out if you can't get there in time for feeding and there shouldn't be a need for formula.

KD0706 Wed 08-Jun-11 10:41:04

I agree with all of the advice you've had so far and wanted to add my voice to the list of 'it can be done'

My DD was born at 31 weeks, 3lb 3.
She had no sucking reflex and was tube fed for four weeks then bottles of expressed milk. At about 38 weeks she just clicked with bf and now at 13 months she is still bf.

Prior to 38 weeks she would occasionally lick at my boob but other than that she just stared at me with her lips pursed together. I found it so disheartening and I planned to keep expressing etc till her due date then stop because it was just all so much work and I never thought she would manage to bf.

You are doing so well and it will all be worth it.

mamadoc Wed 08-Jun-11 10:56:49

DD was born at term but IUGR (weighed 5lb 4oz) this was unexpected and I cried buckets when they took her away from me to SCBU where she stayed for 10 days.
I think having bf before is going to be a big advantage to you. I felt I should just do as I was told and not all of it was good advice but we went home fully bf and never looked back.
DD was also tube fed formula at first but like you I expressed for her from D1 and before too long I had enough for her not to need any formula. Then they let me bf her properly and top up with the ng after and finally just bf (I had fed her right after the birth so I knew she could they just wouldn't let me).
It depends on the hospital I guess but I was never encouraged to hold her and felt quite pushed out. I knew that I needed to express in the night to get my supply up but I was thought quite odd by midwives etc for doing this. I also found that they were quite obsessed by calculating exactly how many mls she had per hour and that my bf directly messed this up and made them uncomfortable.
My best advice is to stick up for yourself and DD, lots of skin to skin, express loads with double pump and you can definitely do it.

JoyceBarnaby Wed 08-Jun-11 11:53:18

Thank you so much for all your messages - I have skimmed them just now and will read them all properly in a bit.

I am speaking to some proper BFing counsellors this morning, which is good. Also, I do feel supported by the nurses in SCBU - although they are keen to keep an eye on her tube feeding, she is hopefully coming off the drip today and they are encouraging skin to skin and BFing attempts. On that note, I am really pleased to report that she has now actually latched on and fed twice - once really well, once less well.

I feel really positive that this is a good step forward, so feel better this morning! It will still be a hard time, I should think, but I am feeling more hopeful. Thanks again so much for your thoughts and advice x

Checkmate Wed 08-Jun-11 12:16:36

Fantastic to hear that she's making attempts to latch on! Well done you and her, and remember to look after yourself (as best you're able) as well as her.

peanutdream Wed 08-Jun-11 12:22:50

Congratulations on your new baby grin. Fantastic that she has latched on and is feeding! This video on hand expressing might be worth a watch - apparently if you can crack it, you can get more milk than with a pump. The other videos on the left might help too.

here

TheresAHuppoInMyHouse Wed 08-Jun-11 13:59:26

Well done you and well done to baby for latching on!

My experience was with my DD (born 30 weeks, spent 6 weeks in NICU/SCBU, tube fed, refused bf until 41 weeks). She learned to bf eventually but it took a long time and for ages I didn't really believe she would ever 'get it'! Now I am weaning her at 7.5 months, she has been exclusively bf since 41 weeks. What I did was:

Express, express express for the whole time she was in hospital and when she came home. Overnight as well. Yawn. But worth it!

Look at a picture of her or smell a babygrow while expressing.

Try her on the breast at every feed without exception (once she is home and whenever you can when visiting in SCBU)

After trying her on the breast, give her expressed milk from a cup or bottle

Then express after giving her the ebm from the bottle.

It was exhausting but it really worked. Every feed took 2 hours (attempt, top-up, express) but once she suddenly started sucking I felt such a sense of achievement and the past 6 months have been super!

Good luck!

JoyceBarnaby Wed 08-Jun-11 14:26:58

Thank you so much for all your messages - I have skimmed them just now and will read them all properly in a bit.

I am speaking to some proper BFing counsellors this morning, which is good. Also, I do feel supported by the nurses in SCBU - although they are keen to keep an eye on her tube feeding, she is hopefully coming off the drip today and they are encouraging skin to skin and BFing attempts. On that note, I am really pleased to report that she has now actually latched on and fed twice - once really well, once less well.

I feel really positive that this is a good step forward, so feel better this morning! It will still be a hard time, I should think, but I am feeling more hopeful. Thanks again so much for your thoughts and advice x

bessie26 Wed 08-Jun-11 14:31:52

Congratulations!!

DD1 arrived at 34wks & spent 3wks in SCBU being fed my ebm through a tube. I expressed every 3 hrs during the day and once at night. We attempted bf once a day & she got the hang of bf at 37wks (they told me this was when they develop the ability to suckle) & continued until she was a year old grin - you will be fine. Now go get some sleep!!

AutumnWitch Wed 08-Jun-11 14:41:32

Congratulations on DDs arrival smile

DS1 was born at 34+5 and I managed to express for him to be fed down an NGT. He wasn't keen on the breast at all, really struggled to latch. The hospital convinced me to give ebm in a bottle, I agreed as I was desperate to get us out by then. He took to it happily. I kept trying to bf, but he wasn't interested.
After a few weeks I convinced him (with the help of a feeding clinic) that a nipple shield was an acceptable substitute for a bottle and we carried on like that until about 4 months when I dumped the shield in a fit of pique and he just looked at me like hmm and got stuck in.
So - it took a long time and a lot of perseverance to get where I wanted to be, but it can be done, even if things don't go the way you'd like at first.

Albrecht Wed 08-Jun-11 14:47:35

smile That's fab that she's fed from you and great that you feel supported by the hospital staff. It won't be easy I imagine but you've already made good progress, well done!

JoyceBarnaby Wed 08-Jun-11 14:48:12

Sorry, didn't mean to post that again - damned iPhone!! Just reading all your replies more carefully now - thank you allx

hildathebuilder Wed 08-Jun-11 15:05:57

one other comment is that the "rugby ball" hold is often the easiest for tiny babies at least to start with as you can support them as well as hold up the weight of your breast with the other hand. SCBU or the BF counsellor should be able to help on this. Once we got home lying down worked for similar reasons

japhrimel Wed 08-Jun-11 18:50:35

Just wanted to say good luck and it can be done. DD was tube fed in SCBU for 3 days and then needed bottles and top-ups for a while, but we got her to EBF by the time she was 6 weeks old and are still bfing at 6 months!

JoyceBarnaby Thu 09-Jun-11 09:13:49

DD is doing well - she's off the drip, her blood sugar is stabilised and I am now producing enough milk so that all her tube feeds are coming from me. She fed once in the night last night, but I haven't been able to wake her enough at any other time to latch on.

Now I just need to get her off the tube and feeding normally so we can go home. I obviously want to make sure she's ok and do everything I can to establish BFing, but I miss my little boy (3yo) so much - I know he's ok at home with DH of course, but I hope he forgives mummy for bring away from him for so long.

bessie26 Thu 09-Jun-11 09:33:20

Yay! What a clever girl! grin

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