HELP! Getting EBM bottle fed baby back to breast

[KernowMother]

Please help ... sorry for long post, but am reall frustrated.

DC3 (daughter) born at 36 weeks on 19th September. Ended up in SCBU for 2weeks + 4 days with respiratory problems (in IC for 9days) and then prlonged jaundice. An underlying diagnosis of congenital hypothyroidism was discovered through the Guthrie test and medication started on day 11.

I hand expressed immediatly and baby had all colostrum, she had to have formula for 36 hours until milk came in, which it did in abundance and has been receiving just EBM since day 5. Supply not a problem, I have and still am xpressing loads.

Whilst in SCBU I bf when possible but incubator and phototherapy needs limited amount of time - however she did bf well and still does but just once a day.

She was fed by NGT and then I introduced the bottle as it became clear we weren't going to establish bf in SCBU and I needed to get my family back together sooner rather than later. EBM by bottle seemed small price to pay and I thought we could just pick up bf when we got home.

Came hpme on Thursday and she is mainly taking EBM by bottle. She will take the breast, but only once a day, however it is effective feeding when she does.

I am offering breast at every feed but most times she doesn't take it properly - she'll lick, nuzzle, gape but not attach properly or if she does, she soon comes off again. I am so sad, trying skin to skin, trying handexpressing and finger feeding to get her interest, but time for this is limited with two other children to look after and copious amounts of expressing to keep on top of supply.

Can anyone help - anyone been in this situation, anyone got any ideas? I bf my two older DC's really well, so I am gutted that my baby appears to be rejecting me. I really want it to just click. It's been an horrendous scary time and I am so grateful to have her home ... but I really want the feeding to go well.

bump - because I really need some help :(

Sorry I have no experience but bumping anyway.

I do know some MNers who have used a supplemental nursing system with success.

bump.... maybe nipple shields as interim measure? SIL's baby would not latch on and ended up in SCBU and NGT but would feed via nipples sheilds. Now at 6 weeks she's managing to ditch the shields.

First of all, let me say congratulations on the birth of your daughter! You've had a hard start to your life together!

Where do you live - what part of the country? You really need to see a BFC!

You've done really well to ensure she's just on breastmilk - bad supply is one thing that's quite hard to fix.

There are lots of ways to lure a baby back onto the breast. I know people who use finger feeding, as that gets babies off the bottle and used to sucking harder, and on skin ... Oh, wait, you say you've tried that, with the tube and all?

A BFC might be able to talk you through other ways to lure her back, with different positions, etc etc. Skin to skin is a great start ...

How big is you baby now? Has she got passed the jaundice.

I can't say I've been in exactly the same position but I had a tiny prem baby who spent 8 weeks in NICU and then SCBU coming home at 37 weeks weighing 4lb 14. His biggest problem with BF was he did not have the strength all the time to get a good feed in. We worked on the basis that we would try to get 2 BF in 24 hours, and if in those 2 feeds he would manage even with one again off again 10- 15 minutes we'd leave him without a top up. Then we would never try to make him bf the next feed until he was bigger and therefore stronger. He had plenty of skin to skin, cuddles etc between feeds, in fact he regularly slept on my chest. The nuzzles, licks etc all led to him getting the hang of BF but it took him a while to go from one to another because he was weak.

I know this goes against the usual advice about bf, but he just wasn't strong enough to feed all the time and the consultants were all in favour of giving him some easy feeds to get his strength (and weight) up. When we did that I would also pump to keep on top of supply.

I never found that side of things a problem, and even now can pump while playing with DS, MNing, working even. I haven't yet managed to pump while cooking or cleaning but that's about it. To do that I did need to find a way to pump hands free though. I have a hands free kit with my pump but in reality just found the angle to hold the pump shields in my bra.

Finally whatever happens you are not being rejected, and unfortunately it doesn't always or even often just click when a baby has been in NICU and or SCBU. It is different because you don't have that immediate relaionship you have when a baby is not in incubators etc. Most of the SCBU mums I know did what you did, to get the baby home and the family together. It's normal to want that and to do whatever it takes to achieve it. It is not failing if the price of that is either short or longer term problems with BF. You've had a tough time, you did what you had to to get yourself and your family through. Please don't underestimate how hard that is.

Good luck

give her time - it took me a month to get my 38 weeker feeidng. When they get bigger it is easier for them to feed directly. It can take quite a qhile for the sucking instinct to kick in properly.

Try and stay calm and not take it personally. It is a skill she has to learn.

Hi there, don't have any experience when baby has been in SCUBU but did get baby back to BF after 3 weeks FF.
I think you're doing everything you can with finger feeding, expressing, skin to skin etc.

Have you tried to switch to breast half way through a feed once she's in feeding mode, I also used to offer breast between feeds, esp when sleepy and ds would comfort suck rather than have a big drink but I think this helped.

I understand how difficult the feeding/expressing thing is esp with other children and hope you can get baby back to BF asap, this must be so frustrating and time consuming.

Hi KM - just thinking about this some more, using supplemental nursing system instead of bottle might help LO stay at breast longer when she does latch as she won't have to work hard to get milk. they are faffy to use but it could speed up transition process, so you can ditch the pumping quicker, just a thought, wish you best of luck.

You may just need to wait until she is stronger. My DS was prem and did exactly as you describe your DD doing - perhaps one decent feed a day but the rest of the time not really interested. He was born at 33 + 4 and only took to bfing at the equivalent of term + 1.5 weeks. He was totally bemused by the whole thing up to this point and he was fed EBM in bottles.

I'm another one who had a prem baby who didn't manage breast feeding 'properly' till she was that bit stronger. You are doing so well so please be proud of yourself.
All the nuzzling etc does help and I think it will lead to more direct breast feeding.
I'd second the advice to speak to a breast feeding councillor. Our neonatal unit had breast feeding councillors on the unit. Maybe ask about that as they will have loads of experience of just your problem.
And I think just keep going w all the cuddles, skin to skin etc. And don't push baby too much. I'm sure the feeding will come in time.

xx

Hi KM. I was thinking about you this evening and I remembered that on our neonatal unit they never heated the EBM. It was just room temperature. This was to try to stop the babies getting bottle preference. They had the choice of nice warm milk direct from the breast or tepid milk from the bottle. Maybe something like this would help?
I don't think you said how big your DC is but maybe as they get stronger you could stop warming the EBM as much. That way if baby is capable of breast feeding then they might be more inclined to do so.