Establishing BF with week old baby coming out of ICU

[mildmaygrovenorth]

I am looking for any tips/guidance in relation to establishing BF with my 6 day old DS. DS was admitted to ICU a few hours after birth with fluid on the lungs and a lung infection. This is clearing now and he is coming home tomorrow (hooray!).

For the first few days in ICU DS was tube fed and then bottle fed every three hours, all with my expressed milk. For the past two days I have tried BF a few times a day. DS has a good latch (I think) and strong suck (I know). But he seems to have 4, 5 or 6 sucks and then rests before starting again. He has fallen asleep at the breast everytime. I can stimulate him to get it going again but sometimes he continues sleeping.

There are strict vising times at the ICU (three times a day totalling 2 hours 45 minutes). The BF sessions allowed in the ICU are also time limited to half an hour (I am based overseas - think it is different in the UK). He isn't getting enough in that time and so the nurses top up with my expressed milk. (He is jaundice and under phototherapy so needs to have his hydration monitored).

I really, really want DS to be exclusively BF and am hoping that this stint in ICU hasn't messed that up.

My plan is to withdraw bottles completely and spend the next week in ed with DS having skin to skin and offering him the breast whenever he appears to want it.

I have access to lactation consultants but no LLL.

I wondered if anyone had been in this situation (or not) and can offer any guidance or tips? I am a (slightly anxious) first time Mum.

Thank you in advance.

Congratulations - my heart is with you as I was in an extremely similar position with DS1 - fluid on lungs, in NICU for a week before home and limited time to establish feeding whilst expressing (our limited access was oxygen levels initially then more to do with the jaundice). I may have been slightly luckier that he was never bottle fed - just nasally - but I get the impression that due to much improved design to bottles and slow flow teats, nipple confusion is not that common now.

And I don't have a magic answer but my advice is to do what you're doing - get in a lactation consultant as soon as possible (and you may need a follow up). Make sure latch is good, keep offering breast and possibly keep expressing a bit between feeds as well to get your supply up and give your baby that as top ups (but maybe with a syringe at home?).

I had a rocky start - nipples got in a real mess due to poor latching (and ignoring it as I was just so happy he was out of NICU and on the breast) but a doula helped me with the latch in a couple of sessions and we ended up breast feeding for 7 months (I stopped in order to start fertility treatment).

Good luck. Whatever happens it will be amazing to be at home, I have a photo where I've never looked so happy.

Thank you HighVoltage, it has been an emotional start but like you, just so happy to be heading home. I have just contacted a lactation consultant and hope she can come over on Monday. I shall buy a syringe in preparation.

Thank you for sharing your experience - it is really helpful to hear about other experiences.

Gosh poor you with those restricted visiting times you must be so pleased he's coming home.

Ds was tubes fed for the first week and a half. I then started bf him and for a day they topped him up by tube after that it was all me...

I can't help with the falling asleep I think your plan sounds like a good one. Expect most engorgement to disappear once you stop pumping and feeding on demand. I'm sure he will work it out, he's probably quite a sleepy baby after being so ill.

I'm sure others will have good advice. Congratulations

My little one was a tad early and quite jaundiced so we were in for a week. Because he was small and also very sleepy from the jaundice we were unable to fully establish breastfeeding and were sent home offering bottle top ups. When I got home my MW recommended dropping the top up at alternate feeds initially then reducing to a top up morning and night before dropping them altogether. As he got stronger and was able to stay awake for longer time at the breast gradually increased until we no longer needed any top ups. Luckily we had no nipple confusion and he seemed to move with ease between both. We ditched the top ups within about 5 days. We are now 4 months in and feeding is going really well with good weight gain etc.

Great news you are heading home - glad to hear your baby is better .... I am sure you will get bf fully established in no time.

This is very reassuring, thank you all! I have someone coming on Monday to help support us with the feeding. I plan to get in bed with DS and stay there for a week!

We have travelled to a third country to give birth (because of poor health facilities where we are resident) and so feel a little adrift at times. I feel much more confident after reading your successes!

Wow, it will be great for you and ds to be at home to do your own thing - those visiting and feeding restrictions are very outdated, and work against bf :( :(

Your plan to restore normality is spot on!

Hope it's a lovely time for you - there is no reason why this should not work out just fine :)