Anyone successfully transitioned a preemie from bottlefeeding EBM to at-breast?

[chipmonkey]

dd was born at 28 weeks and is now 35 weeks corrected. She is now home from hospital. I have been expressing for her since she was born and have a great supply. She was tube-fed, then bottle-fed in the hospitial. I put her to the breast about twice a day when visiting her and have put her to the breast every feed since. But if she does latch on, it is only for a minute and then she stops trying. She is still very small, 2.2 kilos.

The nurses in SCBU told me that if I persist in putting her to the breast, she will "get it" and to keep trying but to be perfectly honest, I don't feel that anyone in the hospital was bothered whether she latched on or not, they just wanted to get her big enough to leave!

I am finding the constant feeding, expressing, sterilising round the clock, exhausting. But I do want her to have breastmilk and I am the type who will do this for 2 years if I have to, I just would prefer her to feed from source.

Anyone with any tips or suggestions?

Yes eventually but my baby was born at 35 weeks so a big difference. He had no suck reflex at all, had to be tube fed, eventually managed to get home after jaundice when he would take a tiny pathetic amount from a bottle. When he latched on he would stay there for a bit but his mouth was tiny and he wasn't getting enough of the breast in his mouth, so he sort of hung there and fell off!

The expressing is exhausting because the tiny ones are hungry so so often. However you are in a good place to start BF from source because you have a good supply. I just put DS in the bath with me one night and cuddled him, and it was as if he smelt the milk and realised where it was coming from, he sort of moved up and latched on by himself. After that I used to hand express a bit before a feed so he could literally see the milk dripping out, then I had to wait till his mouth was really really open wide and sort of shove the breast in, contrary to all advice!

Have you tried Bliss, they might have some advice, or the La Leche League helplines might have specific advice for prem babies. I don't know if this is encouraging but I was later told that it is easier for prem babies to go from bottle to breast than another newborn, no idea why.

Congrats :) Yes, try giving LLL a call, they will be able to give you some ideas. There are some resources on the website here about premature babies.

You might find this helpful as well, it's not specifically about preemies but you might find the methods useful. A lot of skin-to-skin might help, you could try laying back like in the biological nurturing video with your DD laying on your chest and just let her find her own way. Make sure she's not too hungry so you don't both end up frustrated. Making sure you're both relaxed should help.

Thank you both!
The latching-on advice by LLL looks good as does the biological nurturing video.
I was wondering if nipple shields would help but don't really want to end up with another thing to wean her off.

Lots of skin to skin, let her mouth at and mess about at the breast, even if she isn't doing much sucking as it will still help stimulate your supply.

Much admiration for the hard work you are doing, if you can get her feeding well at the breast it will be so much easier than the expressing malarkey - good luck with it.

Hi chipmonkey

We were in a similar position, DD born at 31 weeks. I expressed for her and she was tube fed then bottle fed. My hospital don't have a weight requirement for babies to come home so their big priority was getting her taking her feeds from a bottle and retaining her own body temperature (ie out of the heated cot). I also felt that they were more fussed about getting us out the door than on getting DD breastfeeding.

I'm not sure about kilos but when DD came home she was 4lb 4oz and had been tube out, bottle fed EBM for 48 hours.

I knew I was producing enough milk for her as I was expressing more than her bottle feeds, but she just wasn't interested in feeding from me.

I don't know how much of it was just luck that DD seemed to suddenly click on to how to feed from me, but what I did was this:

1 EBM in bottle was at room temperature, so not as warm as it would have been straight from my boob.

2 I bottle fed her with her sitting on the edge of my knees facing me, so not in the cuddly breastfeeding position.

3 I moved her from the hospital bottles, which kind of dripped the milk into her mouth without her making any effort, onto tommee tippee closer to nature bottles. These made her open her mouth (the hospital ones could basically be crammed into a half closed mouth, but her mouth had to be wide for the tt bottles). And if you believe the marketing hype, the way babies feed from the tt bottle is similar to BFing.

I didn't offer her the boob at every feed as I just found it so disheartening when she would just stare closed mouth and bemused at my boob. In truth I probably went some days without offering her at all because I found the whole expressing rigmarole so depressing and I just hated the feeling of her refusing to feed.

Anyway, one day when she'd been home for about a fortnight and was the equivalent of about 37 weeks I offered her my breast and she just latched on and she didn't look back. We had health visitors coming out twice a week to weigh her so I decided to be brave and just immediately ditched the bottles, didn't offer her another bottle once she'd taken a feed from ms. I just felt that I knew I had enough milk for her, and that with her frequent weighing if she wasn't getting enough it would be picked up on quickly.

I still had to keep expressing for a while due to the fact I had previously been expressing more than she took but that calmed down within about a fortnight.

DD latching on seemed to coincide with her generally waking up and seeming much less sleepy prem and more just a normal newborn. She did quite quickly lose her hospital routine because once she'd discovered the wonders of mummy's boob she wanted it all the time! But again that may have been all part of her reaching term.

Sorry that was an epic post. If I've missed anything off feel free to ask. It us possible and lots of people have done it but at the same point, if you find you do struggle try not to beat yourself up. Come back on here for advice and support however it seems to be going