Will I be able to breastfeed?

[xMamfax]

Hi everyone

My baby was born at 30+4 and admitted straight into NICU. I started expressing breast milk as soon as I could for her to be fed through her tube.

Once she was out of her incubator and her suck reflex started, I began trying to breastfeed but as my nipples are quite flat and she was still very small, we both found it difficult. We eventually managed to get her to latch on using a nipple shield but it seems that she never gets enough milk when using it (bad weight gain, drier nappies) despite a decent milk supply.

In order for her to gain enough weight and come home it was decided that she was to have top ups using a bottle. With my let down not being that quick and the bottles being quicker she quickly started to prefer them over the breast :(

Since coming home we continued to try using the nipple shield. However she still never gets enough when using it as evidenced by her weight and nappies. She just gets disinterested and falls asleep. We've tried all the tricks to wake her up and keep her going but she just clamps her mouth shut.

Ive also tried direct feeding from the breast but she can't latch still and gets very frustrated. As my nipples are quite flat I've tried pumping a bit just beforehand to get them out and to start the flow for her but it still didn't help. She will just keep her mouth open and shake it side to side as if she can't feel it. Maybe she's used to the nipple shield or bottle teat shape sticking into her mouth where my nipples don't?

The whole process of expressing a bit, breast feeding with the shield, topping up with a bottle, settling her then doing a full express was almost bring me around to the next feed and was just too much.

So now for the last few weeks she has had a lot of just bottle feeds of expressed milk. I'm still expressing every 3 hours to keep up the supply. This is also exhausting.

So I guess, after all that, the question is: does anyone think we'll ever make it to just breastfeeding? Has anyone's baby had latching issues/predominantly bottles then managed to breastfeed? Or do I just come to terms with having to express every 3 hours (my supply dips if I go any longer) and feed by bottle until she's almost weaned?

Sorry for the long post, but any input will be greatly appreciated!

[kippersandcurtains]

I'm no expert sorry - hope someone else can help. I just wanted to say well done you for the efforts you're putting in to feeding your baby yourself. Every three hour expressing is a big ask. Just keep in mind a balance of your own energy/sanity/happiness/enjoyment of motherhood - versus the benefits of breastmilk. I really hope it works out for you - just don't beat yourself up if it doesn't
Oh and congratulations on your baby!

[SpeakNoWords]

It is possible, but it is a hard slog to keep up with the expressing. It might be worth thinking about doing one or two feeds as formula in order to give you a break and a chance to rest and not have to express so often. Then you can offer the breast before (or maybe part way through) each feed and see how she does.

I found using breastfeeding-mimicking teats to be helpful (we used the Medela Calma ones). They aren't free flow, and are supposed to help protect the breastfeeding mouth action. My DS2 learnt to bottle feed first with a free flow teat, then we moved to the Calma ones and then he worked out how to latch on the breast. He wasn't premature but had been tube fed in SCBU. I just kept offering him the breast at each feed. Eventually he would latch for a moment or two, then gradually longer. After a while we could drop the bottles and I could stop expressing.

[Heirhelp]

You are breast feeding. Contact LLL for support.

[DontstopmovintotheSclubBeat]

I couldn't have said what kippersandcurtains said better myself. DS was born at exactly 34 weeks, I expressed round the clock and he started to BF at 36 weeks with a nipple shield but he wasn't gaining weight and the Dr asked that we top him up with formula. I carried on BFing with a formula top up for another 3 months until I fell ill and had to stop due to medication I was taking. It's really hard work BFing with a shield and preparing formula (it's basically double the work!), so I just wanted to say a massive well done! Also I wanted to say don't beat yourself up, what matters most is your LO is fed and has a happy Mum to care for them. I beat myself up badly about not being able to fully BF and then having to stop all together, especially as I knew DS didn't have the best start in life and I so desperately wanted him to, but I remember my lovely HV giving me a good talking to about how amazing I'd done to get as far as I did, DS is now the most lively happy 1 year old you could meet

[minipie]

Has she been checked (by someone properly trained) for tongue tie? If not it would be worth checking as that could be why she can't latch properly. Is she full term yet?

You've given her an amazing start with the breastmilk she's had so far. As others said please don't work yourself into the ground trying to exclusively pump. Breastmilk is great but it's not the only important thing and you have to weigh it up against the benefits for her of you being more rested.

[StarkintheSouth]

Similar experience here in that my DD was admitted to ICU for the first three days of her life and fed through a tube - and I found that it massively disrupted my BF getting off the ground. 9 weeks later and we have issues with my supply, she's a very low weight and we are now giving her top ups of formula as well as whatever expressed milk i can pump. But I'm so tense about feeding and exhausted tbh with feeling guilty and stressed that I'm close to giving up. Totally sympathise with you you're not alone x

[xMamfax]

I think had she been born full term, we probably wouldn't have this issue. She was taken to another hospital soon after being born and I wasn't discharged from the hospital she was born in for 3 days so I never got to bond straight away. She was also just too small and sleepy/weak to feed from the breast properly and she just got used to the flow and feel of a bottle. She is now 16 weeks/6 adjusted so has been feeding from bottles for a while now.

We did try some bottles that mimic breastfeeding like the Medela Calma but when the milk did come out of it, it was too much for her. She also seems to prefer some shaped teats and took well to a Tommee Tippee with a size 0 extra slow teat.

She did also have a slight posterior tongue tie and this was clipped a month ago but it didn't make any difference to her ability to latch.

Just knowing that I've pumped for 4 months means that had she be born term, I'd be 2 months off starting to wean and I'd have been happy to stop if necessary, but as she's only 6 weeks adjusted, I have 4 more months at least until we get to that point now. It's not too bad st the moment as she's still waking herself up every 3 hours to feed so ill express afterwards, but once she starts going for longer stretches in the night, it will be hard for me to keep getting up.

I'd love to feed directly from the breast but I'm not sure if it's too late I just don't know what I'm doing. I know how good breast milk is for babies and that it's even more important for premature babies so I'll continue to express as long as I can until I can either breastfeed properly or get too exhausted.

[SpeakNoWords]

You can just simply try her at the breast at the start of each feed. No pressure, just see if she can work out how to latch. It will be different to the fast flow and little effort needed to get milk out of a bottle, but if you keep offering her the breast she might get the hang of it.

I'm not sure if you need the extra hassle, but you can get something called a supplemental nursing system to use whilst trying her on the breast. It's a small tube that you attach you your breast and you can feed ebm through it to encourage her to be interested in latching on. You could also try putting some ebm on your nipple to encourage her to be interested too.

[McBassyPants]

I'm with heir, you ARE breastfeeding. And doing bloody well at it! You are clearly dedicated and are going above and bey8what many would do. From what you say though (without observing a feed) it doesn't sound like stepping from EBM to direct, from the breastfeeding is happening any time soon.

Do you have a DP who can help with the feeds? You express, he/she gives the EBM? If you were directly feeding from the breast you would still be doing it every three hours (give or take) so tiredness would still be the same.

[minipie]

xMamfax the usual advice for prems (see Bliss website) is to begin weaning at 6 months actual age, not corrected. I think it's because their digestive system has been working for 6 months and the nutrients from the womb have been being used for 6 months - so they advise to start weaning then. So you are only 2 months away from weaning, just as if she'd been term. And you've BF her for 4 of those 6 months just as if she'd been term. She may be only 6 weeks corrected but her digestive system is 4 months old iyswim.

[minipie]

Sorry the Bliss website actually says to wean between 5 to 8 months actual (and probably somewhere in the middle of this range for most babies). So about 6-7 months actual.