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.

that is, happy you now have your baby, obv it is very hard for you that he is in hospital,

shuts up as realises lips are flapping, but hopes you get what i mean

Congratulations! Glad it's going well for you. My baby was in neonatal and tube fed for weeks. We gradually introduced breastfeeding, beginning with her just suckling while having a tube feed to get the association between boob and full tummy. For quite a while she had breastfeeds followed by top ups, by ng tube in hospital and expressed milk from a bottle once we were at home, until she was strong enough to get all her milk from the breast. You will need to stay overnight to get her exclusively breastfeeding before you can go home though (in my experience).

Haven't read all the answers but here's mine.

I'm currently tandeming my 31 weeker and my 35 weeker.

My eldest was the hardest to get on the breast but it wasn't that bad and it shouldn't be if done properly. At a week old she took her first feed, not a proper feed but a suckle. From then on we did it once a day (anymore and it is too much effort for them which could put their progress back) and it was topped up through her nose. When she was stronger and making more effort they didn't top her up one day, when she lasted until the next feed they skipped two top ups the following day. From the next day she was breastfed and after a week on transition ward we went home (24 days old/ 35 weeks) fully breastfed.

I am so sorry for posting again. I just feel really emotional about all this and need to get some help/opinions/support as I don't know if I am being precious about his feeding.

I went to see him last night and was told he wasn't due for a feed for another hour but he was displaying some really good feeding cues. I should have picked him up and just got on with it but was a bit scared to until the receptionist there said 'you know he wants feeding son't you - go ahead' So I fed him for over an hour in total and it was lovely. He stopped halfway through, filled a nappy, then carried on once I changed his nappy. He fed to sleep.

Just called to ask when he was last fed so I can time my visit and they say 'the nurse is now doing four hourly feeds' and told me to come up around 1pm when he is due his next feed.
I had wanted to feed on demand and don't really want a routine of any kind apart from a baby led one, but I do understand that he's ill, there are other ill babies they need to care for too, and the nurses probably do work better with a routine. Trouble is he is my baby and I want to bond with him and be with him and just assert my self a bit so I can feel more confident. I feel tearful all the time (this is natural, right?) and a bit like I'm not being considered in all this.

Do I just fit in with the 4 hourly feeds and make sure I am there as much as possible so I can feed him - none of this is really going to harm him is it?

I feel better for writing it down. Thanks.

DF, how horrible, to be made to feel you cannot feed your hungry baby :( Perfectly normal to feel really teary anyway, can't imagine this situation helps.

I would say be there as much as you can and feed on demand whenever there (don't know what other commitments you have which might make this difficult). I also feel 4 hourly is a long time for such a little baby to go between feeds, have you asked them why they are feeding 4 hourly and whether it would be possible to feed more frequently? Understanding their reasoning may help you. I was lucky to be able to stay in hospital when my ds1 was in nicu, and the staff were happy for me to try and feed him as often as I could (he wouldn't latch for a few days, but just the holding close was lovely).

I'm not an expert though, hopefully one may be along shortly.

is there any restrictions on the amount of time you can spend there with him?
I would just stay there demand feeding him as much as possible, then the 4 hourly nurses feeds will only be overnight, and that'll only be one feed really?

congratulations, hope he's home soon

and tears are very normal

x

I don't think they want to make me feel like crap, I just do and am probably being a bit emotional anyway because of the whole baby blues thing etc.

Last night, by the time I managed to feed him (they told me to change his nappy first) he was fractious and I found it hard to get him on the breast. I should have just picked him up and got him on, and I will next time. On the positive side he latched on well and fed for ages.

I'm a first time mum with very little experience of babies so I feel a bit out of my depth. In normal circumstances they would have given me the baby, let me go home and I would be working this all out for myself. As it is I feel a bit like I am being observed. Plus it doesn't help that he seems to have been given the grumpiest nurse in the unit! Maybe she was just fed up to be working on Christmas day.

The only restriction is 9.30 - 11 when the consultants do their ward rounds. I think I will just go up there now and stay all day. Thanks guys, I just needed to chat to someone and DH is in bed sleeping off his Christmas hang-over!

Oh God, this is giving massive flashbacks - I wanted to be with DS all the time but I was afraid that I was 'tiring him out' and one nurse said to only go in for "care" time. Which was every 3 hours.

I regret it so much - not just sitting next to him with a book or whatever or doing more skin to skin. You should feed him when he is hungry of course - I stuck to the hospital imposed routine but that made no difference when I got home - he just fed all the time so don't worry that he will be a routine led baby.

My thread from Feb when I asked for help is here. There are loads of lovely helpful replies:

www.mumsnet.com/Talk/premature_birth/916332-My-son-was-born-on-Monday-at-35-1-because

Good grief, a 4 hour feeding regime for a prem newborn who has been poorly!!

I think your instincts are absolutely right, DF - sounds to me like you would be doing the best possible thing for your DS to go there and take care of him yourself during the day. It sounds like you are already aware and responsive to his cues, which staff on a 4-hour schedule ain't gonna be.

And don't worry about being emotional, anxious, or whatever. All of these things are to be expected. You are your DS' strongest advocate and your feelings are important - there's no need to apologise for them!

Good luck, and keep posting!

I was in hospital with DD for a week after she was born and just sat reading and eating next to her, I remember that 'observed' feeling, but you have to remember that he's your baby - you give them permission to do things to him, not the other way around.

It's so hard, especially with your first, but he'll be home soon, and having been through this will just make that feel all the sweeter.

x

FOllow your instincts DF, four hours is too long for such a tiny baby.

My DD2 is 6 months old, now formula fed and only goes two hours between feeds, 3 max!

he's not premature thankfully - I was 11 days over.

I've been up and just went ahead and picked him up as soon as I could see he was hungry so big

his feeding tube has gone and he looks so much better.

I swear the nurses get grumpier as the babies get better. Today's was a right old grump! Going back later for more feeds.

DF when ds was in SCBU and I was no longer in the hospital I used to come in about 6am and stay to 11p m (he was my first so no other dcs at home to worry about). I found it really helpful to be there when the night shift changed at 6.30am so I could find out how ds had been. I also found his night nurse to be absolutely fab. Daytime ones were good but there were more looking after ds during the day than at night.

Sounds as if things are going well. You may be right about the nurses but the main thing is the care they give when babies are so ill is simply fantastic. Ds was born at 33 weeks but when he was a week old I was told he was unlikely to survive. The fact that he is a healthy 6 yr old now is testament to the care he had in SCBU and subsequently.

Thank you Mollie
I really admire your stamina! I am hoping to increase the amount of time I spend there from tomorrow onwards, though it looks like there is a possibility he will come home at the end of the week so it won't be for long

Lovely to hear about your son, there are lots of very premature babies in the unit, it's so heartbreaking. Though I met some people today who were taking their little girl home and there's another very small baby boy in the nursery now who seems to be making a very good recovery.

Df it was quite an ordeal but frankly I was better off doing long days at the hospital rather than sitting at home worrying and crying on my own (dp became an ex whilst I was pregnant). Hopefully it won't be long before your Ds is home. I don't know about you but I didn't feel like a proper mum until I took him home!

I've skipped some replies because I wanted to answer. Four hours is pretty standard for a premature baby. They are giving a set amount that they have worked out based on a calculation of weight etc. As soon as you go to fully breastfed the routine will disappear, right now he's getting a set amount that will be enough for the four hours but when he's on the breast he will take what he needs and wants for now and he will be strong enough to feed that often without using more calories than he can take. However if he's rooting then it's good to encourage that by giving breastfeeds.

When my youngest was in I was woken early the first morning to be told a porter was on the way for me as the unit needed me. My heart was pounding, I was very scared! Although she was older in gestation so doing OK and had gone straight to the nursery, I had spent a lot of time in the unit with my eldest and was aware of how bad things could be there. When I got down there the nurse said "She was rooting and she's not due for an hour so we thought we'd call you to feed her"

Going through the replies now.

OK, so not a premature baby but they like to do that with sick babies too so they can preserve calories.

They do like you to change the nappy first because the messing about wakes them up enough to feed, but some babies aren't like that and need to be changed afterwards. My eldest was like that, she's too laid back and wouldn't be bothered about nappy change and then I could never get her to wake up enough to feed her because she was used to being messed with.

I was "fortunate" (not sure either way lol) that I was kept in too with my eldest as I was also poorly. I spent a lot of time with her and they only kicked me out when I fell asleep in the unit at 2am! If we were there during quiet time or rounds (sounds like your hospital combines them) we'd be asked to leave the room (for rounds) or the unit. I was in there most of the time because even between feeds/ all cares I'd have people call me to take them to the unit as the parents have to be there with any visitors. It is hard work to be there that often and I found myself living on chocolate bars and Pepsi because I forgot to look after myself as I was giving everything to my baby. It meant it took me longer to recover. When you're home you won't be sat by your baby's bedside all the time so don't feel bad about spending some time away from the unit.

Hi Fanjo,

You've had some brilliant advice here.

My DTs were in NICU for 4 and 5 days being tube fed what I could express (not much) and formula 3 hourly because of low blood sugar (I had pre eclampsia and they were born at 37w3d). I also latched them on and tried to feed them before each tube feed.

I know exactly what you feel like re the ward staff 'telling' you what is and isn't convenient. Stick to your guns.

For what it is worth, I was told that 3 hourly feeds are much more appropriate for a baby who will eventually be ebf and I insisted that is what they did. DTs were off NICU by Day five and ebf by day 6. The first few days of cold turkey from formula were hard work (!) but from day 5 they were ebf until 6 months and we went on till 10 months.

Sounds like you are doing an amazing job! Hang in there. Loads of skin to skin really helped us.

No advice, just massive congratulations on your ds and I hope you have him home soon

DS1 was 5 weeks prem and on SCBU for 10 days. He was tube fed at first, for a few days, while I expressed his feeds. Then I started to breastfeed him myself, and he took to it well. I breast fed him for 15 months.

Having a baby on SCBU is hard in a million different ways, and one of the difficulties is the sense that it isn't your baby, because the doctors and nurses seem to make the decisions. The only way I could cope with this lack of control was to be there as much as I possibly could. I was lucky in that I had a room on SCBU, and I rarely left DS's side except for short bursts of sleep. I think that being there a lot means that the nurses take a step back except for crucial medical things. I was glad I was able to do nappy changes and feeds, and when DS was well enough to come out of the incubator I just sat on SCBU with him in my arms for hours on end.

My advice would be to spend as much time there as possible, get to know your baby, so you can feel more connected with what is going on, and have more control.

Rebecca, I remember that feeling, it was the hardest thing about being in there! I had PTSD as well and didn't think she was my baby so when they were making all the decisions and telling me what to do or I had to ask for permission to pick up my baby it reinforced my feelings. For me breastfeeding was really important because I would sit in the feeding room or behind a screen just repeating to myself "no one else can do this"

Just to add my thoughts,DF, I agree that you should try to be there as much as poss and follow the baby's feeding cues yourself.
My DD was on NNU for a month and I totally understand the feeling that you have to ask nurses permission to touch the baby. But try to keep reminding yourself it's your child and you can do what you like!

An enforced four hourly routine sounds wrong to me. When DD was on NNU, she was put into a four hourly routine. But it was feed every four hours, or sooner if demanded. Eg she couldn't go longer than four hours between feeds but could be fed sooner if she wanted.

I was home by the time this happened, but the babies who had mums still in hospital, mum was called to come down from the ward to feed the baby as soon as baby was showing feeding cues.

Sorry this is a bit rambled but I just mean that you are right to feed your LO on demand...

Ps I always took grumpy nurses as a sign DD was getting better. They were always really nice to me when DD was poorly at first, and when there was bad news coming about her latest tests etc.

Thanks again all. I have been told that barring anything going wrong we should have him out by Friday. They hope to be able to offer us the overnight room for the night before so we can all spend it together as a family.

Have managed a couple of feeds today and he declined a top-up feed of my milk from the bottle, prefering my breast instead which has made me feel really hopeful.
Feeling so much better :)

Really glad that feedng is going well df.

You'll have bob home with you before you know it.