Breastfeeding premature baby, help please!!

[featherbag]

Hi all, really hope someone can advise and/or reassure me. I'm writing this in the mother and baby room in the neonatal unit where my ds has been since his birth on 2nd October at 32 weeks, weighing 5lbs 3ozs. I've worked really hard with expressing, and despite a rocky start he's been tube-fed breast milk just about every feed. A week ago I started bf him once a day, then went to twice, yesterday I did 3 consecutive feeds and today I'm doing 4. The plan is to room in tomorrow night and Sunday night, then take him home on Monday if his weight's gone up. He dropped 7ozs in the week after birth, and has only just regained and passed his birth weight today.

The problem - when I'm bf him, he never seems to latch on for long. He'll have 5 or 6 good sucks, then fuss for a bit, then another couple of sucks, then half-hearted sucking/licking for a minute or 2, then seems windy and uncomfortable. So I wind him, then start again. This morning he fed for over an hour, but I would say only about 15 minutes of that was feeding, the rest was fussing/winding.

I'm terrified that after rooming in for 2 nights his weight will have dropped and they won't let me take him home. I'm struggling a bit if I'm honest, it's getting harder to stay positive and not just sit and weep when I'm not at the hospital. I'm convinced he can't possibly be getting enough food from bf, and that it's the tube-delivered breast milk that's been increasing his weight. If anyone has any words of wisdom I'd be forever grateful.

X post featherbag
Pleased you've had a good feed.

I totally understand and agree that you're using them to get feeding established. But I do know some people get stuck using them, so that's maybe something you can take advice on once you've got him home.

Well done.

Thanks for that, I've actually got a couple if boxes of the closer to nature bottles that a friend gave me, it's good to know you found them useful!

I appreciate all advice, including those warning against shields, but by this point I was so demoralised and desperate to get some food into him the shields seem the lesser of all evils, as he clearly wasn't getting enough from straightforward bf alone. I hope I've made the right decision for the long term, but I know I've definitely made the right decision for now, if it makes things more difficult later then I'll live with it.

Congratulations. Ds was born at 33 weeks and weighed the same as your ds. He was in SCBU/NICU for nearly 4 weeks and it was only the last few days there that he managed to latch on. He continued to lose weight at home and the hv and hospital threatened me with re-admitting ds. Eventually I gave in and did mixed feeding - one bottle a day. I had great support from the NCT breastfeeding local co-ordinator and the weekly breastfeeding at our local cottage hospital (not where ds had been).

I found it really really hard but perservered until ds was 11 months. He was always underweight and I felt a real failure as a mum. However he is now 7 yrs old and a big, strong lad. He's still skinny but he is fit and well. If someone had told me when he was born that this is how he'd turn out I wouldn't have believed them.

Good luck. I had a very supportive GP fortunately but my hv was dreadful (had no experience of poorly prems). I also had support from NCT mums that I met after ds left hospital (missed the course as he was too early but was still included in the coffee mornings, which were a real lifesaver).

I'd add that I had to use a nipple shield on one side the entire time I breastfed ds. Not a problem at all.

One word for you, Featherbag - RESPECT!

I think you are doing an AMAZING job, and would agree with others who say feed, feed, feed when possible.

I do know someone who bf well with nipple shields and she had her twins early.

I hope you can catch some rest when your baby rests, and best of luck with the feeding.

Yay congrats on a successful feed, its amazing when it happens. The midwife who was with me when DS first latched for a proper feed whispered to me "please breathe!!" I was holding my breath without even realising.

Please don't worry about using shields, prem babies have a poor suck so its so much harder for them to latch.

I found that I didn't use them for too long. I did about 4 weeks both sides then till about 6 weeks on just one side.

I found that the older midwives on the ward were very reluctant to discuss it but the younger ones were all for it so maybe its a newer thing?

Its a right faff after a few weeks especially if you are out and about, I would feed with shields on then when DS would have a little rest I would try him without. I had quite short nipples (although not anymore after 2 DCs and lots of bfeeding !!) so it was better for him and easier for me if nipples were a bit pulled out, its made it easier to latch.

Well done and keep at it, I agree with byanothername you are SO nearly there, worst is over I reckon.

Good work lady, you're doing brilliantly.

Hi - my first ever post here but wanted to offer some support. I've been where you are my DD was born last year at 32 weeks and well under 3lb. She couldn't even take expressed milk at first and had TPN for a week and then EBM via an NGT for another 3-4 weeks. It took until she was about 35 weeks to get anywhere with the breastfeeding. I also used a nipple-shield, having failed to get DD to latch on at all without them, but got a lot of advice (in particular from NCT) about how terrible they were. One person even suggested I may as well not bother breastfeeding at all! In the end UI used them the whole time and EBF this was for a year. In DD?s last week in SCBU she was on EBM via bottle when I wasn't there and a breastfeed when I was. I was lucky enough to have lots of milk and not find expressing difficult, I felt so as long as she got the BM it didn?t really matter how (and once I was using the nipple-shield I was less worried about bottle and breast confusion).

When I started rooming in she was on feed every 4 hrs, over the weekend this moved to 3hrs and for the first week at home she was on a 2hr cycle. For rooming in I still expressed as and when but only really to relieve the pressure. Have to say the stock of frozen milk I?d build up was a life saver as DH could do the odd feed (and even did all the night feeds once) to give me a break during that first week back. It got so hard I was ready to give up ? feeds were taking an hour and then only an hour break before it all started again. My local NHS breastfeeding support team were great and did a home visit to help. They were pragmatic about things and encouraged me to stop feeding if it lasted longer than an hour and to top up with EBM. Part of the reason was to get DD used to taking the volume needed to go longer between feeds. A day of that and we were back to 3 hrs between feeds ? and that never changed until I started weaning (and think is common for breastfeed babies).

Do persevere ? you may need to top up with bottles on occasion for another couple of weeks (and if you can, carry on expressing and give EBM for the top ups) until your DS has a strong sucking reflex and can get all he needs from you.

DD also found normal bottles difficult and even the slow flow was too fast. Found the medela calma bottles fab ? yes they are expensive but really worked for us, so worth every penny. I found DD impossible to feed out and about (she was so small I needed a big pillow to get her in the right position, and then once big enough was far too interested in the world to feed properly) so the bottles got a lot of use. Also gave me a little break now and then.

Finally, I?m very pro breast feeing but also strongly feel that mothers shouldn?t beat themselves up if it doesn?t work. You?ve done amazingly well so far, but if it all gets too much formula on occasion is not such a big deal. Ultimately the most important thing is to ensure your DS is well fed ? however that may be.

Sorry this is such a long message but I hope it helps.

Just wanted to say again (sounding a bit pathetic now!) how very much I appreciate every post and word of support/encouragement - none of my close friends have babies, and no-one else in my family tried to bf, my DH is trying his best to encourage me but it's not the same as having someone tell you their own experience, so thank you!

I was the first in my family to breast feed, and whilst they tried to be supportive I had MIL commenting that she hadn't as she couldn't face it and my mum and sister saying as was putting myself through too much (esp. as I was still unwell). I set myself small goals which helped, I wanted to get home with DD breastfeeing, I wanted to get to 40 weeks with her breastfeeding, I wanted to get to 1 month then 3 months etc. That all helped as whenever it was getting too much (and it did on and off for the first 4 months or so) I told myself only a week etc to go until I've got to the next goal. Reaching each goal made the next feel that much more achievable. DH was so supportive, and him being able to give the odd bottle helped me stay sane and him get extra lovely cuddles with DD. Just take each day as it comes.

I just wanted to add some supportive words as the mother of a 30 weeker. It sounds like you have done an amazing job already; I know from experience how difficult it can be to breastfeed a premature baby.

By the way, you don't sound at all pathetic! I found the shock of the premature birth and the concern about my daughter very difficult and I wish I had asked for more support.

Just to add to the supportiveness my mum wanted me to add a virtual hug and well done. She, after two weeks of tube feeding, managed to successfully bf her 32 week old baby (me) in 1975 in the face of incomprehension on the part of her family, and some of the MVs and HVs. She said it sounds like you are doing really well, and should be really proud to have got this far!

DS1 was born at 34 weeks, he weighed 3lb6, went down to 3lb4. He was in SCBU for 4.5 weeks. For that time I expressed and he was fed via a tube. After the first 5 days (I think) I was able to start putting him to the breast to see what he would/could do. The first time he did really well with sucking! But every feed after that he just couldn?t do it, he would fall asleep after a minute or so, it was constant tickling/undressing/different positions etc etc for a few weeks. It was very tiresome and stressful. But for some reason I was determined to bf. I kept on and on at the nurses to go over the latching with me.

Eventually when ds was 4wo they roomed us in together. Before this point we had only been ?allowed? to try bf 1/2 x a day, he had always had a top-up of expressed bm. From the moment we roomed in I had to exclusively feed him from the breast. Oh my goodness were those first few days/nights hard!

The first night went OK, I couldn?t sleep much with worry though, and I had to check his temperature etc regularly. I think he probably fed every 2 or 3 hours, which I was very please with! But, the second night came and it was HARD, he literally fed constantly, and we were all alone in this room with no-one to lend a hand. My dh wasn?t allowed to stay as they wanted to see that I could manage?! The third night was much the same as the second. I was exhausted! But I kept it all to myself, terrified they?d keep him there.
DS was 4lb4 when we took him home. I then just bf on demand, and it was pretty much constant for weeks and weeks. I think he fed for about 1 and ½ hrs each time too! But he failed to put on much weight. For weeks he only put on 1 oz, maybe 2, sometimes static. It was VERY stressful. Added to that the HV had to come and weigh him weekly, she was getting to the point that we would have to start formula. I was losing complete faith in my body.

Luckily one week the HV couldn?t make it, so sent the nursery nurse. I was flapping that I couldn?t produce ?enough? milk. She just looked at me and said: ?of course you will!? She then explained how it was supply/demand etc. She gave me the encouragement to continue and believe in myself. So we carried on!

Once he hit the 6.5 lb mark he suddenly ?got it? and began piling the weight on, up to 1lb a week! So we got there eventually!
DS also had cranial osteopathy, which I really felt helped a lot of his ?issues? with feeding and changing etc.

DS?s weight gain was an obsession for the 1st year, but once he turned 1 I felt the pressure lifted and I relaxed into it and stopped worrying about it.

Sorry that's very long! Good luck with it all! And huge congratulations on your baby boy

Hooray featherbag :)

The amount of conflicting advice re bf is incredible. Re the nipple shields, if they work for you then go for it. I was at the point of giving up with dd1 because she would barely latch on and then was also making me very sore. It was only when a bf counsellor very reluctantly gave me a nipple shield to try that bf was saved. They meant I could bf. Without them it didn't work. I got dd on without them at 8 weeks but she and I always preferred using them and so we rarely had a feed without them for 9 months. I think some of th bad press they get is based on older style, thicker nipple shields. The medela ones are nice and soft.

What a wonderful thread! Featherbed just a quick line to let you know I'm going through the same thing as you with my DD, who was a 27 weeker born at 2lb 4 but whose weight fell to 1lb 15oz, and is now home at the grand old age of 36 weeks gestation, weighing about 4lb 2, after 60 something days in hospital.
The bad news is despite me pumping over 1L a day we're on a top up of formula :( My supply is there and she's a great wee feeder but its still a lot of work for her. We tried just BFing, then EBF top ups, then EBF with added hindmilk, then EBF with fortifier but only the fortifier helped her gain weight, on all others she was static or losing weight. Then the hospital told me she wasn't allowed to go home on fortifier as it was for hospitals only, so we have to give her some Nutraprem too. I hate, hate hate doing it. Sitting there giving her a cold bottle of horrid smelling formula was the only thing that made my cry in hospital since she came off her ventilator, apart from her having a lumbar puncture to check for meningitis. I'd give anything for her to gain enough weight not to need it. It's all so surreal because DS was a 9lber and fed like a monster.
Wish us luck as its her first weigh in tomorrow since she came home on Thursday. I have a feeling she's been far too sleepy to have gained weight as I have to wake her for feeds... and administer her 10 different meds a day. I can so sympathise with the rooming in. A tiny, hot room and solitary confinement... so hard. Oh and loads of sources really recommend shields for premmies. We haven't tried it, but I might do if she has lost weight.
Anyway Good Luck. We shall BF our babies. We shall!!

Quick hijack - hello poppet
So pleased to hear your DD is home now. That's rubbsh that they wouldn't let her go home on fortifier. I took my DD home on EBM with fortifier, the packets did say hospital use only, but my hospital were happy to give us it home. Just shows different places have different policies.

Sound like you're doing so well, your DD was so teeny to start with. I'd bet she'll start to wake up in the next fortnight and the weight gain will pick up.

End of hijack!! Sorry.

Featherbag, I could have written your post in May this year when my DS was born at 32 weeks.
I had exactly the same experience. It was very difficult for quite some time but I persevered. I accepted it may take longer to get home breast feeding rather than bottle feeding but it would be worth it in the end. I watched his weight like a hawk and worried about every gram he did or didn't gain.
I had the advantage that I had breastfed my other two DCs, but it was still very hard. The SCBU my baby was on were very understanding and keen to encourage my efforts to breastfeed which helped a lot.
Not sure I have any advice that you haven't heard already, but stick with it, and if your experience is anything like mine, you'll get there.
Good luck, and keep your spirits up, be kind to yourself.

Featherbag- Congratulations! and you're doing really, really well- I just want to say that you should do whatever works best for you and your DS. When I had my DD I thought the choice was breast OR bottle, ie. no middle ground of a bit of both. So I solely BF her for the first seven months. Then, when I tried to give my DD a bottle when she was seven months old and I was ready to cut down on BF, she would not have it- whether the bottle had expressed milk or formula in it.... Now I have DC2 and I am mostly BF him, but introduced a bottle and formula within the first three weeks and he happily takes both now and is putting on much better weight than my DD ever did. Good luck with whatever you choose to do and hope everything gets easier for you now you've got some nipple shields!

Aw poppet, sounds like you've had things much worse than me, well done for not cracking up by now! Sure your weigh-in will be ok, but you've worked really hard so don't beat yourself up if it doesn't go as well as we all hope it does xxx

I'm going to try and grab a couple of hours before next feed, Sam and I have our big weigh-in at 6am, fingers crossed!!

He's still feeding well and has put 5g back on overnight! Waiting on the ward round for the official yay or nay now.

Well done pleased to hear it

Excellent news :)

Well done baby featherbag.

Really pleased to hear that.

OP - not read whole thread but can I say you are doing an amazing job. Just wanted to add a success story. I was born at 28 weeks and tube fed EBM. When I was six weeks old I had my first BF and then my mum was able to build to exclusively breastfeeding me with no bottles for 18 months. She did it gradually e.g. we would practice each day and she would continue pumping. On a side note - I am never, ever ill. DM thinks this is because of all the early BM :-)