3 week old baby in intensive care. Need advice on expressing & continuing feeding when he's better

[girlsyearapart]

Hi my 3 week old son is in icu on a ventilator so is being tube fed ebm up his nose.
He had been a good feeder having breast feeds all day then a formula top up once a day around 9pm then bf in the night.

Since he was admitted on Wednesday he has only had ebm but I'm not- and never have been - a very successful expresser.

So need some tips on how to get things moving a bit better.

Using a medela symphony pump which is good and expressing off one side
then the other. Doing well (ish) on the left but paltry amounts on the right.

Also would like tips on keeping him feeding once he's better?

Hope your little boy gets better soon. Keep trying from the right, you are still stimulating milk supply by using the pump. Hopefully someone more knowledgable will be along soon. Have you called la leche? Or ask the midwives if there is a breastfeeding counsellor in your area?

Poor little man :(

Maintaining bf is best done with frequent expressing - at least 8x in 24 hours inc at night. Switch from side to side - when you get no more than a trickle from breast 1, switch to breast 2, and when only a trickle from there, switch back to breast 1 and so on. You might 'do' each breast 1-3 times each session.

If you can keep him skin to skin when he is in hospital, yes, even with the ventilator , you will be doing a wonderful job in reducing his stressors and soothing him.

Thanks. Technically I'm not even meant to touch him so def can't pick him up. Will keep trying to express as much as poss. I'm not doing anything else..

Hi, sorry to hear about your wee boy. I hope he's better soon.

I've just been in a similar situation so will share in the hope it might be of some help to you.

My baby boy unfortunately caught RSV & developed bronchiolitis at 6 days old. He was admitted to hospital at 8 days and put on a ventilator at 9 days which meant an air transfer to the nearest PICU (200 miles away). He was on the ventilator for 5 days, then cpap for a day and then was transferred back to the original hospital where we still are. He'll be 3 weeks old on sunday and we're now on day 12 in hospital. He's almost ready to go home, just need to get him off oxygen.

He was tube fed EBM for 8 days although he did have some formula mixed in at points when I struggled to keep up. I pretty much did exactly what tiktok recommends, i expressed often - every 3 hours, even more frequently at times, and also overnight. I also switched breasts as needed, tending to have 2 or 3 'goes' on each breast per ssession. I also have a 'better' side, in my case the right, and could never get much from the left but felt as long as I got something that would keep my supply going.

I was worried he wouldn't take to feeding again but it's actually been fine. I was really nervous but he latched on fairly easily. The first night I had to wake him for feeds but since then he's been wanting fed all the time. He feeds every 1-2 hours through the day and 3 hourly at night &

Oops, Sorry I'm on my phone & wasn't finished - was going to say he's putting on weight nicely now. The very frequent feeding is tough as I'm so tired now but we're managing.

I know how you feel about not being able to pick him up, It's so hard. Hang I'm there x

Hang in there was what I meant to say! I'm not used to posting from my phone.

I know how tough it is, especially if you have other children too. I'm really missing my other boys & dh & just want to get some sense of normality back.

I'm really sorry to hear about your little boy and hope he makes a fast recovery. It sounds as though you are doing brilliantly. I was in a similar situation earlier this year, though with an older baby. My son was 10.5 months when he was admitted to PICU for a month where he was ventilated for 4 days and on dialysis for 2 weeks.

Although I had reduced bf's before he was ill as he was on solids, for much of his time in picu he could only be fed tiny amounts of ebf through a nasogastric tube. Like toomuch, I did as tiktok recommends - expressing every 2-3 hours day and night - and was able to maintain a good supply from my right side (oddly I have only ever managed to express from the right) which I supplemented with formula as he started to recover and was able to take larger amounts.

I have never felt as powerless and useless as I did while he was in picu - expressing during that time was so important to me as it was the one thing I felt I could do that would actually help him, especially during the time I was unable to touch or hold him. I was also very worried that it would mark the end of bf'ing - but as soon as he was well enough for me to hold him he latched straight back on and now at 21.5 months he is showing no signs of wanting to stop...

Hang in there - it is such a difficult time. I hope he gets much better very quickly and that 2012 brings you both health and happiness.

Yes he has Bronchiolitis & rsv as well but they think there's something more so are waiting for swabs to show pneumonia & doing a lumbar puncture to see if he has meningitis.
It's very hard leaving the kids they are 4,3& 17m & though Dh is very capable and we have family nearby helping it's not like having mummy there is it?

I expressed for ages earlier switching over & switching back but only got about 2.5 oz.
It's just so disheartening.

How awful to be transferred so far we were also transferred but only to a hospital about 45 ish mins drive. Came in the intensive care ambulance.

Glad your little one is on the mend happy new year for you!!

X posted with you isitwakeuptime

Thanks- I have been in hosp before with dd3 who had Bronchiolitis aged 4 months & it did stop the feeding for her. I think that's why I'm so nervous this time as he's so much smaller.

It's true though there's nothing to do for him except express so I will do all I can to get as much as poss

Make sure you try and drink and eat well too to help your supply - it's probably the last thing you feel like doing, but it will help...

girlsyearapart, my DS had RSV/bronciolitis and Hib at 4 weeks, and spent a week on a ventilator - this was 9 years ago - he was taken on ventilator on Christmas day 2002!

You need to do what you are doing - maybe the hospital has a special breast pump you could use? (Mine was at St Thomas' in London, and they had an electric pump that was very effective...although I felt like a cow! ). Be sure to keep up your owm food intake and drink plenty of fluids to maintain your supply. The ICUs are very hot, so you will need to drink plenty. ANd also, I found there is a tendancy not to eat as you are super stressed. Make sure you make yourself eat 4-5 times a day, even if its half a sandwich and a piece of fruit.

When DS came off the ventilator, they had been giving him very little fluids, as they had found (at that time) that it helped reduce the volumes of secretions and therefore gave the body time to recover better. But once he was off the vent, he was STARVING and had a really good feed within a few hours. I was left with melon-like boobs, because I had been expressing so regularly. We sorted ourselves out after a couple of days and he went on to feed for a year.

wishing you both stength to deal with this horrible illness.

Been just where you are RSV is just so awful, my DD was also on ICU ventilated for 5 days she couldnt actually tolerate even a normal NG feed ( not even 5 mils of milk), she was continually fed (a drop at a time) using a kangaroo pump. Like everyone else has said just keep doing what your doing and make sure you drink LOADS!

My DD was 3 weeks old when she got RSV i continued to BF her with no problems at all til she was almost 2

Everything crossed that you DS is soon on the mend, they do get better VERY quickly once they have turned the corner.

Thanks everyone.
I'm at St Georges we did nearly get transferred from Kingston to evelina at St Thomas's but they had a bed for him here.
They are now testing for meningitis & pneumonia as his blood results aren't what they should be.

Dd3 also had rsv but at 4months was stronger & though we were in 5 days with ng tube feed & oxygen she was never this poorly.

Im being given meal vouchers so im eating fairly well but I do need to drink more

Went through similar, sorry for your little boy & hope he's better soon. Sometimes I found holding a warm cup of tea against breasts & switching between them helped get a better let down. Also warm bath & forcing self to try relax, although I know it's hard to do

Girls - I'm sorry you are going through this, it's something I'm quite familiar with due to DD3 and her 10 admissions for bronchiolitis in her 1st year (though luckily for her it never got worse than NG tube/head box). DD3 is bfing at 2.2y so it doesn't have to mean the end and in fact when she was well enough to bf, bfing made her heart rate drop and her O2 stats rise so was good for her too.

Can you ask for a second collection kit for the Symphony (I'm assuming you have a 24hr use disposable pump kit given to you by the hospital)? Double pumping is quicker and easier than having to pump single sided and I found it increased my yield as did breast massage before pumping, compressions during pumping and hand expressing after milk stopped coming out with the pump.

Don't worry about the differing amounts by side, breasts are rarely symetrical inside as well as on the outside so do produce different amounts and this is normal.

You don't need to force yourself to drink Xmls a day just drink to thirst and that's all you need (drinking lots more than you need can actually lower supply so don't try downing litre after litre if you aren't thirsty). I found getting a big bottle of juice from the canteen and watering it down from the hospital water jugs they provided helped me get drinking, tasty but not too expensive (I spent so much on drinks before I found this out!).

Is there an Infant feeding co-ordinator or bfing specialist MW who can provide you with tailored support on the ward or who would come and visit you and baby?

Fingers crossed for a negative result to the menegitis/pneumonia test. All the best.

Thanks. I may go home at some point to have a bath. At the moment I'm expressing by his bed and in an hour & a half I got 60 ml..

I don't have any advice for you on expressing as I am rubbish at it, but just wanted to say I hope your little one gets better soon. Take care.

DD3 was on 23ml of milk an hour at 3 months as they didn't want to over fill her (puts pressure on the diaphragm and makes it more difficult to breathe) so 60mls for a 3w sounds great.

I found that for me expressing more often worked better so I did 12 times a day and block pumped too (double pump for 10, rest for 10, double pump for 10, rest for 10, double pump for 10) really helped increase how much milk I got the next day. If you only have a single then you just alternate sides so they each get pumped 3 times but it is longer to do singly.

He is on 19 ml an hour so 60 wil last him 3 hours but i pumped again after that effort & got less than 30 mil so the amount I get is reducing each time.
Now up in the night to pump & in nearly ten mins I have not even got a drop.

It was the feeling of needing to feed that woke me so why is nothing happening??

Trying not to let it stress me out but failing..

Have you been shown how to massage your breasts to stimulate flow? Before feeding, with warm hands, make fists & use the back of your fists to massage from the outside of your breasts towards your nipple for a few minutes then try to pump.

It must be a very stressful time for you, try your best to relax.

I've also heard that different psychological approaches - either thinking lovingly about your baby or thinking of something else entirely - can work for different people.

Hope your little boy is on the mend soon x

Thinking of you op. my dd was in similar situation at 10 days old and I know it's hugely stressful. Just do what you can with bf, I had to supplement with ff at points as I was so tired etc but did re-establish ebf after we got home. My dd will be 12 years old next birthday and is a strapping great thing! They do get over it. All the best x

Poor you and your family. Ds was in at exactly the same time of year for exactly the same thing in 2001.

Everyone else has given better advice than me but one thing I would say, even when he comes out he will probably cough for weeks and weeks and it often makes them vomit up feeds. You need a lot of perseverance and patience and it's hard when you have older children too.

I hope he gets better soon x

Girls have you tried looking at his picture when you are expressing? It's v v v hard to express when you are stressed so don't be too hard on yourself.

If you've got an iPod or similar you could try listening to this as listening to relaxation tapes while pumping have been shown to increase yields.

I'm near St Georges. Will you let me know if there's anything you need? I have no big plans today.

Hope your little boy makes a swift recovery and that you are feeling strong.

Smarty x