Help - breastfeeding not really happening, options, thoughts please???

[Nikki2510]

Hi All,

Well, our DS arrived at 33+3 and spent 10 days in SCBU. I expressed during that time but have not had huge amounts of milk and this doesn't seem to be improving. In SCBU he then had a combination of whatever I'd expressed and FF either through his NGT or as he got stronger a bottle with me also putting him to the breast.

We brought him home at 35 weeks (last sunday) and since then I've really struggled with BFing him.

Currently I BF him and then he has a bottle top up. But, he takes over 35 mins to feed on each boob meaning the BF alone can take up to 1hr 30 mins. He then also generally has a bottle top up - if I don't give him a topup he is hungry again after 20 mins and won't settle. He is quicker on the bottle but total feeding time inc winding and settling down can often be 2hrs. Now this is ok in the daytime but I'm starting to struggle with it at night.

I'm also not sure what he's getting from my breast - his poo is the dark greeny colour of FF and although he can suckle quite strongly I don't really see him suckling and swallowing in the same way he does on the bottle.

I have had more conflicting advice from people at SCBU (not dissing them at all though, they are amazing people) and from the HV than you can shake a stick at and I'm really confused as to what to do now. I was given Nipple shields by SCBU because DS was prem and finding it difficult to latch and because I have flat nipples. The HV seems to think they are the devil incarnate and basically blamed any and all issues on the fact I am using them but he won't latch on without them - at least not at this stage.

I don't just want to FF him but I'm not sure how much longer I can cope with the length of the BF/bottle feeds. So my thoughts were as follows:

• Just persevere with the BF/bottle top ups and hope that it improves over time
• Express and either feed pure Expressed breast milk if enough or mix with FF and feed through a bottle.

I'm sort of leaning towards the second option at the moment but I don't really know what the pro's and con's are. Am really confused and emotional too which doesn't help.

Any thoughts from people on here would be really gratefully received as I just don't know what to do for the best anymore

Have also posted in the premature section.

Thanks,

I'd go with option 2 - then he's getting the breast milk without you having to spend 2 hours at a time. It also means that the option is there to let someone else do the feeds!

Can you get in touch with an nct bf counsellor? You don't need to be a member. Ime SCBU nurses are indeed great, but they don't really know that much about bf. Here they go on a short course but not more than that. I think a proper expert would be much more helpful.

I would plonk yourself on the sofa and pretty much breast feed all day, no formula you milk will increase, you will bond and eat loads do this for a few days if u can 35 mins is a normal feed length for a new born

And good look xxx

I'd say first ignore HVs, too many give bad advice - the SCBU people or other midwives are probably a safer bet. DON'T go with your option 2 - you could easily see a reduction in how much milk you make, machines don't do as good a job as you need your baby to do. Ring LLL (La Leche League), NCT BFing, or phone your hospital and ask if they have any HVs to specialise in breastfeeding problems (mine does, she is fantastic!). Focus on getting baby feeding better - anything else could cause more problems in the future.

Good luck!

sorry, typos:
"phone your hospital and ask if they have any MIDWIVES WHO specialise in breastfeeding problems"

D'Oh!

The reason he is hungry again after 20 minutes is because he's doing a very clever thing and trying to increase your milk supply to meet his demand. Because of your tough start he has the missed the first few marathon feeding sessions that are designed to increase your milk supply. If you keep giving a bottle soon enough you will be more bottle than breast and then it's a slippery slope to no boob at all. Obviously if this is ok with you then go with option two but if you really want to keep bfeeding then sit yourself down on the sofa and let him feed, feed, feed! It may take a few days, even up to a week but his feeding will calm down. Get yourself some yummy snacks and drinks and put a box set on the telly. You've done an amazing job getting this far so well done you xx

Another one backing the feed, feed, feed option. Although also acknowledging how hard and possible dull this will be. You will require total support from your other half.

I have a friend who used nipple shields the entire time she BF ie about a year so don't worry there.

Thanks All, am pursuing the BFing option and definitely going for the feed, feed, feed option and then topping up with a bottle if he needs it at night (this is probably desperation on my part to be honest to get him to settle for a couple of hours) tho is a bit difficult with xmas in the middle but I'm sure we will manage.

Spoke to the HV again today who thinks we are on the right track and rang the BF co-ordinator at the hospital but went straight to voicemail so will try her again after xmas.

Thanks for all your advice anyway, its really good to know that others are in the same situation too

Have a great xmas

OP, many congratulations on your LO's birth and return home from hospital. I would strongly suggest you get some properly skilled, RL hand on help to support you as parents of mildly preterm babies are often very poorly supported with breastfeeding both in hospital and in the community. If you PM me I can suggest some specific options. In the meantime, here are a few suggestions:

Bear in mind that babies' feeding reflexes aren't fully mature until 38-40 weeks and that babies with other challenges may take longer to properly co-ordinate suckling, swallowing and breathing. Even prem babies who are breastfeeding effectively can be sloooooow feeders.

Flat nipples+prematurity are often not a helpful combination, so yes nipple shields are often helpful in stimulating a baby to latch and maintaining a latch. However it's really important that they are appropriately sized (as small as you find comfortable) and that positioning is as good as possible - have a look at the LLLI website for some good information. I would also suggest that you get someone skilled to rule out tongue tie, both anterior and posterior as it's often missed in SCBU.

It's also really important to support your supply, particularly if you've never expressed very large volumes. Would you consider renting a hospital grade double pump, eg Ardo or Medela? Contrary to what one poster has said above, a baby who's not feeding very effectively may not stimulate your supply fully. Have a look on the BLISS website for their downloadable guide to expressing and feeding prem babies- although some on the pictures will be of much smaller babies than your DS the information is just as relevant. It's also worth looking at the Best Beginnings UK website - their film called 'Small Miracles' has some more good information.

I'd stress again that the above is intended to be helpful but isn't a substitute for RL help - do PM if you want to.