Baby in Neo Natal unit (doing well) want to breastfeed eventually

[DuelingFanjo]

Just a quick message/question as I have to go back to the hospital soon so will read the replies in a couple of days.

Baby was born early hours of wednesday and apart from one emergency formula feed has been fed through a drip and then finally today got my Colostrum today through a nose tube.

I have had much encouragement to express and have been doing well every 4 hours, I have a good store waiting for him.

My question is, once they know he is taking the feeds well through the tube - they and I would like to get him on the breast. Can anyone talk me through how difficult this might be (or how easy)? will he be all confused and reject me and might I have to try both bottle and breast for a while? Any tips or advice would be much appreciated. His birth weight was 6lb 15 oz and he does lots of lip smacking.

many thanks in advance.

Ps, I am assuming the formula was also fed through his tube rather than a bottle.

I don't have an answer about the feeding, but just wanted to say congratulations and welcome to your new DS.

I'm sure someone knowledgeable will come along soon. Good luck getting the feeding established.

First of all, congratulations!!
My boys were born at 36+3, and were fed through NG tubes for 8 days.
They had formula through the tubes, as well as the teeny amounts I could express. They took really well to bfing, and I ebf them for 19 months altogether.
They didn't have any trouble with confusion, and the SCBU staff were fantastically helpful with the feeding.
Good luck!

Quickly as I am on stocking-filling duty :)...congrats on your new baby, DF, and sorry, I don't know the details of why he is being tube fed.

But tube fed or not, all babies benefit from skin to skin/kangaroo mothercare (and you can find out why this is esp. important for vulnerable babies here www.kangaroomothercare.com. This is enormously important to early bf. No need to worry about confusion, IMO - this is grossly exagerrated as babies who can manage the breast don't get confused.

Lip smacking is a great sign!

4 hourly expressing is not normally enough to build up and maintain a supply, but if he gets good at feeding direct, then this infrequency is not so important.

Good luck!

I can't help much but have a huge congratulatory hug and this should keep it bumped until someone handy comes along. Yay for you! :)

Ah safe hands have arrived :)

Hi,
My DD was tube fed for the first week in NICU - main thing is keep expressing and pumping when your milk comes in. As soon as you can try and get him to the breast and demand as much support as you can with this (I was breastfeeding and tube feeding by day 3 but it was astruggle as DD was very ill and kept falling asleep as soon as she was in my arms!)

Have to be honest it was absolute hell for first 16weeks (didn't have painfree feeding until then as DD's tongue tie wasn't diagnosed til 7weeks and she took 6 weeks to regain birthweight so was on top ups as well- while I pumped) but now DD is 11months and has 1 to 2 feeds a day and is honestly my proudest achievement!

I ended up phoning the NCT helplines from hospital as my hospital gave shite support sometimes.

Anyhow happy to help with anything just give me a shout with any questions.

P.S You may want to look into hiring a hospital grade breast pump from NCT for when you get home- other pumps dont come close! I used mine for first 3 months and it was a godsend!

P.P.S and congrats on LO!

I had a similar situation, seek out my threads in this topic

It all worked out, by his 6th week he was fully bf directly, and he fed til he self weaned at 14 months

good luck and congratulations

Hey DuelingFanjo, many congrats on your LO! How many weeks is he? Sounds like he is a healthy weight already.

Just wanted to mention that there is no particular reason to go down the bottle route at any point. There has been a fair amount of research on this and it turns out that it is actually easier and better for preemies to feed from the breast than a bottle. They have been observed to demonstrate better breathing coordination and fewer symptoms of stress when feeding from the breast as compared to bottle.

If he does struggle to latch on at first, that would be no different to many healthy full term babies who often take a few days to learn how to latch well with no dire consequences. So if you can, I would seek out someone knowledgeable locally who can help you while you are both learning this new skill. With a healthy full term baby, it would not normally be advisable to introduce formula or bottles during that period as both can interfere with the establishment of breastfeeding. But in your case, I'm guessing you will probably need to take the paediatrician's views into account too!

Good luck, and hopefully someone with more experience of breastfeeding preterm babies will come along.

... and they did come along! x-posts

Congratulations!! I just went thru a similar experience so wanted to share & offer some support :)

My son was born 6 weeks premature on 2nd Dec. He weighed 4lb but did very well & came home after 8 days in NICU. Similar to you he was fed my milk through a feeding tube the first few days. He's now home & breastfeeding exclusively & thriving. Things that helped...

• I was advised to express every 2-3 hrs & only go 4 overnight
• nurses started to introduce breast milk in a botttle the same time as they poured it into a feeding tube so he associated having a full tummy with sucking
• I started b/feeding within a few days - he started slow and had to be topped off with a bottle at first but now doesn't need that - nursing is hard work & tiring for premies & the bottle just helps them get what they need without expending loads of energy.

In a nutshell - be patient and it will come! You're doing all the right things & he is getting your milk which is most important. I had no trouble with nipple confusion -try not to worry about that! Be kind to yourself & good luck :)

Hi, I am still feeding DD, she had 4 days in nicu/scbu, just let him cuddle up on you and offer the breast as much as possible. She was fine despite having one of those dummy things in nicu. DD is 8 months now, has no formula. Good luck. When they were letting me get started with the bf they brought her to the ward and I fed her, then after 4 hrs they checked her blood sugar, it was ok so she stayed another 4 , checked again and once more I think, then she was allowed to stay with me. It will be harder to get it going without baby being right there, but I don't know what your circumstances are.

Practice, practice, practice!

My DTs were 6 weeks prem and fed expressed milk through nasal tubes, never a bottle. Every time I visited I tried breast feeding. I spent more and more time at hospital as the days passed, until I was there all day, then for several nights and then we all came home

The good thing about spending 3 weeks in SCBU was I got a lot of breastfeeding lessons from the amazing staff, rather than going it alone at home with twins.

It was really hard for some time, but my babies were a lot lighter than yours, and their mouths and heads were tiny compared to my boobs! They did lots of head shaking and bobbing, it was very frustrating but we persevered and are still breasfeeding at almost 11 months.

You are both in the right place to get loads of support so when you come home you will hopefully have breastfeeding fairly well established.

Many congratulations and good luck x

Hi. My DD was much smaller than yours. She was born at 31+1 and was 3 lb 3.
I expressed every three hours. Sometimes slightly less frequently overnight if I was totally exhausted. I think they recommend expressing at least eight times a day to build up and maintain your supply.
I second the suggestion of hospital grade pump.

Does your NNU not have breastfeeding specialists you can talk to?
I think all babies are different and a lot depends of why your LO is in NNU and being tube fed.

With us, we first got DD onto 'normal' bottles, with a teat that we could push into her mouth, and that dripped a bit without her having to suck much. Then we moved onto the tommee tippee closer to nature bottles which taught her to open her mouth and to suck/manipulate the teat to get milk.

Whilst doing this I tried her at the breast once or at most twice a day. She was tiny and attempts at bf were really tiring fir her (because we then had to bottle feed her).

Eventually she just clicked and started latching on to me. This was when she was about 37/38 weeks, and coincided with her being much more awake, so I think she was just ready for it.

Dont know if any of that is helpful.

One tip we used was to bottle feed milk which wasn't warmed. At warmest it was room temperature. This meant that once she could latch on, she had a breast preference because she was getting nice warm milk straight from mummy, rather than the slightly colder stuff from the bottle.

I think that the tommee tippee bottles were as much work for her as the breast.

Congratulations on the new arrival and I hope your DS us home soon. DD is just coming up eight months now and breast feeding is going strong so it is possible, if not easy.

xx

Congratulations. Do insist they don't bottle feed. There is a possibly awkward transition between tube and bf. Ds took some time to get the hang of it. They would try to get him to feed everytime his tube was changed. Mostly unsuccessfully. When he did need feeding not through a tube they used a cup so he wouldn't get used to a bottle.

Personally I found it a hellish time. Ds had no sucking reflex until he was 36 weeks and even when he came home he struggled to feed well for another 2 or 3 months. Hopefully it sounds as if your Ds does have his sucking reflex which helps.

I hired a hospital grade breast pump from the NCT iirc. Far better than the meleda one I bought from Mothercare.

Good luck.

Congrats!

Dd1 was in scbu for 10 days, and I only started expressing after 3 days/4 days (hazy memories, but expressed every 3 hours (with the odd lapse for an extra hour or two's sleep, which direct bf doesn't give you!)).

Started trying to bf proper at about 7 days after she was getting better. It was fine. By fine I dont mean easy, but no harder than I imagine many other mums find it even with non-scbu babies. Latching was hard as she was still weak, but we used nipple shields and got there in the end (actually I ended up using shields on and off for months, but I think that was largely because I had serious oversupply issues that she couldn't cope with, and it helped slow the flow!). No 'nipple confusion' after the tubes and bottles, and actually it meant she took bottles as well as breast, which was fab (never could get dd2 to take a bottle, ever).

They won't discharge you until feeding is going well, so in that respect you should get more support than may normally be available. If it's not happening though, please do keep on asking for help, sometimes you do have to be a bit more, ahem, forceful. Also, my scbu had great bf cushions called mybrestfriend which were great for learning how to latch on, think a few units have them.

Good luck, I found the staff in the scbu were amazingly supportive of establishing bf (way more than down on the maternity wards), and without them I couldn't have done it. Keep asking until you get someone as helpful, it makes all the difference.

And congratulations again! Not the easiest start, but you'll be home soon

Ps if it makes any difference, dd1 was not prem, 42 weeks and 6lb14 (so actually quite small for the age, but she soon made up for it).

First of all congratulations on your new baby! I hope he isn't too ill.

Warning: mine is a bit of a worse case scenario when it comes to breat feeding as it was never established but I also hope to show that there is an alternative to FF should this happen to you and that you will both come out the other side!

My DS was whipped into NICU 36hrs after being born for about a week - fed through a tube. Before going into NICU he never latched on at all. In NICU I continued trying to bf, every feed and expressed like mad. Some days I was doing every 2 hrs during the day. We then tried for a further 10 days in the transition ward to establish a latch on but it didn't happen and I ended up having to feed him by a cup as he didn't take any milk from the breast. They wouldn't let DS leave while he was being fed by a cup. He wasn't feeding. In the end I gave him a bottle and left hospital within 4 hours! Best thing I ever did. Both of us went from being stressed & knackered to being blissfully happy in the space of 24hrs. I ended up exclusively expressing for 7.5 months.

Advice:

Ask for a bf counsellor at the hospital. The more more support you can get the better. When you leave hospital get as much bf support as you can (especially if you have issues feeding). Can't stress this enough. I didn't and I regret not asking for it.

As tiktok said don't worry too much about nipple confusion - rarer than you would imagine from what you hear in the hospital.

Don't be afraid to be assertive in hospital and ask what is going on and question anything you are unsure of or get conflicting advice about.

Remember this period of your life is very short in comparison to the rest of your life with your LO and you will get through it. Try and enjoy the time you spend with him. Although it was a horrible time for me in hospital I do have some very special, wonderful memories too.

I always wish I had tried harder and longer to get him to latch on - but I honestly thought he never would. If I had been of a different frame of mind and just gently persevered each feed when we got home, the outcome may have been different. I did feel rejected every time he didn't breast feed though which also probably led to my decision to continue expressing.

As I said this is really a worst case scenario - I don't know anyone else who had this type of problem and it was probably a combination of factors that led to it. Feel free to PM me if you do end up in that situation as I'll be happy to help! I wish I had discovered MN at that time.

Hello,

I myself was 10 weeks early. I was tube fed for a week or so, then bottle fed for 5 weeks (with my mum's expressed milk, she pumped every 3 hours, with a five hour break at night). When I was six weeks old (so 36 weeks) I latched on perfectly first time! And took exactly the right amount of milk (35ml, they weighed me before and after) I then was EBF until 8 month and fed until 18 months. And I am the healthiest person ever. So a good news story for you - best of luck xxx

congratulations :)

ds1 was tube fed for 5 days (mix of ebm and formula). I was expressing every 3 hours (ie 8 times a day). He didn't latch on till day 5, but when he did I just fed him myself every time he opened his mouth or cried (really!), and stopped tube feeding. he was born at 40 weeks, though, and was 8lb and out of nicu by the time he latched, I don't know why your baby's in nnu. just wanted to give you a positive story that the transition from tube to breast feeding need not be too hard, although we needed lots of help with his latch and tongue tie from bf counselors once we went home.

Congratulations.

My DS was born at 35 weeks weighing 4lb 5oz (IUGR) - he was in SCBU for nearly 2 weeks.

The nurses on the SCBU were great at helping me get the latch right etc. What we did from the second day (I think) was to put him to the boob, even if he could only manage a couple of sucks before falling asleep, then give him as much expressed colostrum as I could produce mixed with formula (unfortunately the hospital didn't have a milk bank) through the NG tube.

At first I expressed by hand for about four days, then when my milk came in I'd go to the pumping room straight after his feed and pump for the next one.

Gradually the amount that I was able to feed him directly via breast increased and the amount he was getting down the tube decreased until they took the tube out and said he could be fed on demand. He managed to put on weight without the tube so we roomed in for a night and then we were discharged.

After I got him home it felt like he was feeding constantly, especially from around 7-10pm. I got very very sore nipples but pesevered and they toughened up. He is still breastfed at 10 months and I have no plans to give up any time soon - it's the only time he'll stay still for a cuddle!

Good luck, and make sure the nurses help you. As long as you don't mind they will position the baby's head and your boob correctly and then you can copy how they do it. It can be frustrating waiting for baby to open his mouth wide enough, but worth waiting for the big open mouth as if not enough aureola gets it it can hurt and the milk doesn't flow so well.

Are you pumping during the night as well? You should pump at least every 4 hours round the clock.

thanks for the replies, I will read through them now.

just some extra info.

he is just 4 days old and thankfully since starting the thread I have breastfed him twice, once last night and again at 11am.

He swallowed maconium at the birth and was very floppy so they took him straight to the neo-natal unit. Despite initial improvements he was given extra care, brain scans and a lumbar puncture and anti-biotics after a couple of fits on the first day. He has since improved enough to be taken off all monitoing and is now just finishing the course of antibiotics.

I have been regulaly expressing and can get around 4 oz in 20 minutes using a pump hired from the unit.

This morning he had a bottle of expressed milk and then I breast fed him about 3 hours later. I think the tube feeding will stop now.

I've discharged myself from hospital and will be going to the unit daily to feed at least 3 times but will express through the night and in the day if I can't get there for his feeding times.

Hopefully I am doing all the right things?

meconium!

ok, have had a chance to read through a bit.

I am no longer staying at the hospital, now not sure if I should have stayed but too late :( I have no problem getting there though for regular feeding and if that is what it takes then I will. I can't stay overnight though they have said it may be possible if really needed and if their one room is free.

I did get lots of open mouth from him the two times I breastfed and he seems to have a good swallowing action when he is on the breast but is also a bit fussy and easily distracted. Hopefully when we're in a calmer environment he won't be so distracted.

No one has suggested using a cup, I will ask about that.

I am setting an alarm and pumping in the night. I got some support from the ward people RE using the pump and hand expressing but because the baby is in a different unit there was no real connection between the two. I'll ask.

He may be home within a week and so then I should be able to offer the breast for every feed.

Thanks for all your support and stories, it does feel like compared to others I have been lucky that his stay won't be a long one. :)

enormous congratualtions DF - I am so happy for you :)

Happy Christmas!