Converting from expressed milk to EBF

[lotsofcheese]

My DD was born at 35+5 weeks & spent a week in SCBU due to low blood sugars & jaundice. During this time, I expressed for her & have built up a good supply. I know i am making enough for her.She's now 36+2.

She was initially tube fed (due to being sleepy & to correct low sugars) but took EBM from bottles well after that.

We're now home & trying to establish EBF - but not having much success. I put her to the breast before every feed & she will take a little - but I'm having to top up constantly with bottles after feeds. She's only had 1 proper BF since she came home. We are using nipple shields as she is still very small - less than 5lb.

Last night I spent 45 mins trying to BF her at 2am, only to top up with 2 bottles - then had a express after - is it's taking up all my time. And again she was offered the breast at 6am when she was starving & I was full, but she took very little & DP topped her up. So I've expressed again after the feed & got over 100mls.

She seems happier on bottles. She has also lost close to 10% of her body weight so I feel pressure to get as much into her as possible.

How can I get her to take more from the breast?All advice welcome.
Any

My ds was in SCBU for a week and tube fed (although this was due to an infection, not being prem). We switched to the Medela Calma bottles and teat system to try and help him get the hang of breastfeeding. It's v easy for babies to get milk from ordinary teats as it just kind of pours out with very little effort. Then when at the breast, it is much harder to get any milk and babies can get frustrated or tired from trying. The Medela Calma teat makes the baby suck like they would have to at the breast as no milk comes out unless they do.

I felt that it helped my ds to learn how to suck better which then helped with breastfeeding. We eventually got to the point where I was exclusively breastfeeding. The only negative thing is that the Medela teats are not cheap, and they are a bit fiddly to put together.

Medela bottle on Mothercare website

Thanks! At the moment we're using the Axifeed bottles that I express into, with disposable teats supplied by the unit - which I suspect are a bit easier for her than a normal one.

I've got Tommee Tippee bottles & will give them a try.

She's on a special hot mattress as she's having difficulty regulating her temperature, so I can't strip her off for feeds (need to keep her warmer than usual).

I'll keep trying to tickle her cheek/toes/ etc to keep her interested - I think she wants instant gratification & the bottle supplies that!

lotsofcheese I feel for you because we had a similar experience and are still battling on. DD was born by ventouse at 40+1, she sustained a lot of bruising to her head and by day two her blood sugar had plummeted to 1.5 and sh ad severe jaundice. We spent five days in hospital with her hooked up to a phototherapy box and I was unable to breast feed her. Because she needed fluids quickly and regularly but needed to stay on the box we fed her expressed breast milk. Teaching her the latch was hard, but she is three weeks old now and we are getting there,slowly. We are still mixed feeding her with formula but she is definitely feeding more from the breast now. I've had some good advice - mostly from really experienced midwives and lactactation consultants. I'd advise trying to see a lactation consultant if you can but some of the best advice they have given me is -

1. do as much skin on skin as you can - place baby on chest as often as possible.
2. always offer breast and get help checking the latch.
3. if baby is fussy offer a small amount of formula first and then offer breast, you can alternate between the two to help things along
4. express milk after feeds if baby refuses breast to keep your supply up. You can always offer this as a feed for the next feed if baby refuses again - but keep trying the skin on skn and offering the breast

Best of luck, it's not easy and we are still a million miles from prefect but you can improve it will take time

Thank you! I really appreciate that advice.

We're still persevering at the breast, but not at every feed - I think I was putting myself under too much pressure (and DD!).

Now that we're home & a lot more relaxed, I am wondering if expressing is the way to go. I had been trying to put her on the breast overnight, thinking it would be easier, but after trying to feed her for 30 mins, followed by 2 bottle top-up's & then an express.... I came to the conclusion that it's easier to express & give it by bottle! We're still using nipple shields, which I find a real faff.

During the day, she will go 4 hours between bottles of EBM. Whereas if I BF, it's 1-2 hours between. Since it takes me 10 mins to express, it seems the better option, time wise. But I will BF at least once daily to get her used to that too. And then hopefully have the best of both worlds..... Well, that's the theory .