Feeding a slightly early baby - advice please!

[lotsofcheese]

I'm 35+5 & just had steroids for possible delivery by CS on Friday.

My last baby was extremely premature & I expressed for him for 3 months - I eventually got a good supply going but sadly he wasn't able to breast feed for various reasons (he was on oxygen & was too weak to suck).

This time, I'd really like to be able to breast feed, but wondered if anyone has experience of feeding a baby of that gestation?

I've still got my pump, know how to hand express & am prepared to consider top-ups till feeding is established.

I can't face leaving another baby behind in hospital again so I'm really keen to get feeding going.

All advice/experiences appreciated. Thanks

[lotsofcheese]

Thanks for asking. I'm now home & my milk has come in nicely. I'm expressing 6-8 x day& getting a good supply. She is being fed by tube & no longer needing formula top-ups.

My young missy is a bit uninterested in the breast - she tries to latch on but my boobs are so big the nipple barely fits in her mouth.

The unit have asked me to think about whether I would rather she had breastmilk through her tube or in a bottle.

She's always pulling her tube out & I feel it's distressing for he having it passed. But on the other hand, it could be a nail in the coffin for BF......

Having a teary/hormonal day which isn't helping either.

[lotsofcheese]

And I'm not able to get in that much for feeds, which isn't helping either. Am sure if I was in more often she could get more practice at BF - so feeling guilty about that

Also got a 4 year old who is in nursery & i can't drive post c-section plus no family support nearby.

[HadALittleFaithBaby]

We had the same problem. What with DD being small and me being of ample breast. The nurses supporting me at the hospital suggested trying nipple shields - I think they gave me a these ones. If you use them you have to express afterwards to prevent blocked ducts etc because they don't drain all the milk but its been a great stop gap getting her into the habit of latching. I started using them Thursday and she's now latching without it most of the time.

[lotsofcheese]

Thanks for the tip - I'll ask the unit about nipple shields. I've also asked if I can room in before she gets home so I can get a prolonged period of time with her, rather than rushing in/out around DS's nursery hours.

The staff are very supportive of BF.

[HadALittleFaithBaby]

It's great that they're supportive - my unit were too. I'd have given up without their help (especially since DH kept pushing bottles!).

[minipie]

lotsofcheese, I greatly sympathise as DD was much the same, sleepy and uninterested and wouldn't open her mouth enough to get my nipple in. it's so great that you have a good supply though.

please don't feel guilty about not being there for more feeds. I was able to be there for virtually every feed (as have no other children unlike you). however I really don't think it helped her 'get it' any quicker, she took her own time about it. there were mums in SCBU with me who were only there for one or two feeds a day and their babies got the hang much quicker than my dd (prob due to DD's tongue tie I now suspect).

I resisted using bottles for the EBM due to worry about nipple confusion but am still not sure whether that was the right decision tbh. I now think, do what you have to do to get her home quickly, even if that means bottles - I don't personally think that would mean the end of BFing provided you keep pumping and keep trying to latch (such hard work I know ESP if you have another DC).

rooming in was a bit of a catch 22 for us, I was convinced rooming in would help her learn to feed, but wasn't allowed to room in until she was feeding well enough . do press for it though, I suspect as you are an experienced prem mum they may give you more leeway iyswim.

very best of luck.

[lotsofcheese]

Thanks everyone. I'm feeling very torn & like I am being a crap parent to DS.

You are right: Life will be much better when I get her home. I can give him more attention & concentrate on her too.

So maybe that is the way to go. Just discussed things with DP & we both agree that bottle is better than NG feeding for her. I just hope I've done the right thing.

[elfycat]

When I mixed fed for the first few days I was told to use a syringe and to get DD1 to gently suck on my little fnger which had been cleaned within an inch of its life As she sucked I gently pushed on the plunger and she drank the milk (expressed and donor/ff). If she wasn't sucking I didn't release milk.

My BF advisor suggested it so she didn't get used to a bottle teat and confused while we worked on estabblishing BF. Have you had a chance to speak with an advisor?

I would say that NGs are irritating beyong belief and bottle would be more comfortable and is certainly not a wrong decision. You are doing great and you must be so tired with recovering from the birth, hanging out in hospitals not restful and then the nervous energy of trying to make best decisions.

[lotsofcheese]

Thanks again everyone - your thoughts have helped me get some perspective. I phoned the ward this morning & she has taken all of her feeds by bottle, so I'm glad we made that decision & her NG tube is out.

She may get home in the next couple of days, on a hot cot

I'm still expressing, but have a lumpy area on my right boob, despite regular expressing, massage, hot shower etc - hoping it doesn't turn into mastitis.....

[lotsofcheese]

I'm now having a confidence crisis - can anyone offer some advice?

DD is taking EBM from a bottle 3-4 hourly. She gobbles the bottles down. I am (just) keeping up with her by expressing round the clock. My right boob is making only 1/3 volume of the left side, after yesterday's lumpy area.

We're using nipple shields as she was having difficulty latching on without, but she takes a few sucks then just holds it in her mouth before falling asleep.

I'm rooming in tomorrow (I hope, if her jaundice is better) to try & crack the BF. She'll be coming home this weekend & I feel under pressure to have her exclusively on the breast, as I won't have time to express, bottle feed & look after DS.

Any advice on how I can encourage her to take more by breast?

[minipie]

have the lumps gone now? hope so. hopefully your supply will recover soon if so.

you may be doing all this already but here are some ideas...

strip her off so she's more alert for feeds

squeeze some milk into the nipple shield so she gets an instant reward

use breast compressions when she is sucking so as to make it easier for her and more like bottle fast flow.

(controversial) try to persuade nurses to give her bottle 4 hourly not 3, so she is hungrier when you offer boob. I found dd wasn't much interested in boob while she got 3 hourly NG feeds.

good luck, you're doing really well and it's great that she is feeding well from bottles, at least that means you have an option to get her home if you want. hope rooming in goes well.

[lotsofcheese]

Thanks for the quick reply!

Yes, I'm squeezing a little milk into the shield before feeds.

She is 4-hourly & trying with boob 1st but only making it in for 1-2 feeds daily - but rooming in will do more.

She is stripped as jaundiced & on light therapy - am also doing nappy before to wake her up.

[lotsofcheese]

Yes, managed to get rid of the lumps, just hoping it didn't affect supply too badly.....

[minipie]

oh, having jaundice will make her so much sleepier and less willing to put effort into BFing (at least that was definitely the case for us) so hopefully it will be a different story once jaundice is sorted. to be honest I wouldn't be trying too hard with the BFing while she is jaundiced as it will only dishearten you!

glad the lumps have gone, come on right boob!

do try not to put yourself under time pressure, though that is easier said than done I know... if you want her to come home this weekend and she hasn't quite cracked BFing by then, a bit of mix feeding isn't a disaster, or if you want her to be EBF, then a few more days in hospital till she gets it isn't a disaster either (though I can fully understand it might feel like it)

[lotsofcheese]

Thanks for the reassurance. Just want to know I've done everything possible.

[minipie]

totally understand. sounds like you are doing everything possible, it will just take a little more time till she feels ready. on the plus side, it's amazing how quickly they can go from being uninterested to totally getting it once they are ready. hope that happens for you v soon, SCBU is so frustrating!