Struggling with feeding 4 wk old prem baby

[anne74]

My baby is now 4 weeks old and was born at 34+5 just before Christmas. He was on the neonatal unit for 9 days and was being formula fed through a tube and I started trying to bf at about 6 days. He was being exclusively bf at 8 days. I've been really struggling with it though. I've been getting really sore nipples particularly on one side and have seen bf counsellors several times. Tongue tie was picked up 10 days ago and he has had 2 snips at it, the last one being on Monday. I saw a bf counsellor on Thursday and she showed me a new technique which in principle should work. Essentially it involves putting him in position with nose to nipple and then just waiting for him to open his mouth wide and then pushing him on. I've been trying it since I saw her but my baby is finding it really frustrating. If he doesn't get it quickly he ends up screaming blue murder. She did say yesterday that he is used to having my nipple put in his mouth and now he will have to work for it.

The whole process of bf has been really stressing me out and has been affecting my relationship with him. I don't want to give up and go to bottle feeding but I don't know how much more of this I can take. I can be up for 2-3 hours at a time in the night trying to get him to feed.

Does anyone have any top tips for me, please?

Have you tried seeing if he will self attach? So, lying back in a reclined position with him lying on top of you tummy to tummy with his head above your breast, and his natural nipple-seeking instinct should kick in.

If you google biological nurturing or laid back nursing you should find some photos/videos.

Anne I know how you are feeling. I had twins born 6 weeks early, were in special care for 2 weeks nad then transitional care for 2 weeks. They never managed to latch on once. I was giving them expressed breast milk down thier ng tubes. The pressure in hospital to do the breastfeeding was huge, I got really stressed trying to do it and it failing (they just fell asleep, the never managed even to latch on for a second it was very demoralising). In the end I decided to give them EBM in a bottle. they took it straight away and we were soon out of hospital. If you feel you can keep going trying then do by all means, but for me I wanted to enjoy my babies and not be stressed about feeding all the flipping time. As it was, using the bottle was better for us as DH could do some feeds too. Plus I had no milk supply (was on meds to make it come but still was a small amount), had blocked milk ducts, etc etc

people put so much pressure on to breastfeed but at the end of the day the main thing is for you all to be happy together,if you are stressed and exhausted that isn't great for you or baby. you could give him EBM in a bottle, that may be easier. whatever you decide - good luck

I had a small baby and had the same problem plus some others problems with getting engorged.

I ended up expressing all my milk for DC as at least that way the baby got the goodness. I'm not saying that you should give up trying to breastfeed but for me it got too much and baby just wasn't getting the hang of it. Turns out also that I have small nipples so the latching was always going to be a problem (found this out after having the DC2).

The breastfeeding counsellors always say that everyone can breastfeed but not in my experience.

My dd has health problems, op at 1 week, small, NG tube fed for a while, got exhausted feeding etc. When we were in SCBU a nipple shield was suggested. Fully expect to be flamed but it bloody worked. Makes it easier for baby, bigger nipple/ teat etc. Made difference between bf and not for us. Used to take it out and about in a little pot of Milton. Quite cheap, I got from amazon, medula. Hope things get easier x

craftyfox you certainly shouldn't be flamed for suggesting a nipple shield! But, like a lot of things they are brilliant as a tool for certain things and in other situations can cause more problems than they solve.

anne74 you really need professional help. When you say you saw a BFing counsellor, is that defintely what her qualification was or could she be a peer supporter? There's a massive amount of difference between the training of the two.

I would personally see if your local NCT BFing counsellor can come to see you, or if you can get out go to your local baby cafe, or breastfeeding meeting (ask your midwife for information on this).

This sounds to me like a fairly straightforward latching skill problem and I am sure that with the right help you can quickly resolve this and find breastfeeding settles down to be straightforward. He will need to learn to latch again after the tt was snipped and also he's more used to fast delivery so you just need some support to get through the next couple of week and it will all come together.

You could phone the NCT line on 0300 330 0771 to get help and support and info on how to contact your local NCT counsellor. Or click here www.nct.org.uk/in-your-area to find your nearest branch.

Thanks for your advice and support. The last few days have been really tough. On Saturday morning I was so exhausted and frustrated that I gave in and gave him a bottle of breast milk which I had expressed and frozen while we were in hospital. I felt so awful doing it and was in floods of tears all morning. I felt like I was punishing him when he was trying so hard to get to grips with the whole thing. Over the last couple of days it has felt like I have taken a backward step with the feeding and can't even remember what I was doing before.

Anyway, today I have been back to the breastfeeding clinic again. The people there are infant feeding advisors who work for the PCT. The person I saw today gave me different advice which did seem to work a bit better. She's advised me to go back to the clinic on Thursday to see how I've got on. He is at least latching on today, still not brilliantly but he's at least on the boob. We'll see how the next couple of days go. I did have my first pain-free feed at the clinic so hopefully it is possible. I was thinking that I might have to go down the route of nipple shields as I do have very flat nipples but I would like to avoid them if I can.

Thanks again

anne - so sorry that you are having problems. I had my twins 6 weeks early and they were also in special care, fed through a tube, EBM in bottles and bf when i was at the hospital.

I would like to second craftyfox with the nipple shields - they work brilliantly for us, and we are still feeding at 13 weeks. In fact i used them to feed my DS till he was 17 months, so i know they can be used for an extended period of time with no effect on supply etc.
That's not to say that you shouldn't get the help you need to get your DS to feed directly from you as organiccarrotcake advises - it's a bit of a faff with the shields, and i do wish i could do without sometimes. i just wanted to say that they could be of help to you, and i hope you do get things sorted
good luck

Hang in there. We also had the scbu-tube feeding-easily tired baby-latch issues scenario and are still working at it at 6 weeks, but now its mostly good. My DD had to have top-ups of formula+ebm, then just ebm when my supply upped. I bawled when we had to go back to formula and then when we had to give top-ups after stopping, but we're still going with bfing and DD is now thriving.