URGENT advice needed on establishing breastfeeding while baby in neonatal care

[gladbag]

A very good friend of mine, and regular mumsnetter, gave birth last night - big hurrah !
Unfortunately her ds has a chest infection and breathing difficulties, so is currently on the neonatal ward in an incubator on oxygen and antibiotics. He's a good weight, and hopefully should be out of the incubator within 3 or 4 days. The medics don't want him feeding until he's stronger, so he's currently on a glucose drip (and she has expressly said no formula without her consent). The hospital isn't particularly breastfeeding friendly, and although she has hand-expressed some colostrum (which she initiated) which is being stored, there seems to be no plan of action for getting breastfeeding established once he's stronger, and no help/advice available on the ward. She is trying to contact a breastfeeding councellor by phone tomorrow, and has all the numbers for NCT, La Leche etc, but in the meantime is there any mumsnet advice? She is very concerned that the delay could affect his ability to latch, and that no stimulation may affect her milk supply. She breastfeed her first child v successfully, so she is experienced, but not in this situation.
What should she do? What should she be pushing for from the medical staff? And I'd really appreciate positive stories of babies who have had a delayed start, but then breastfeed well once stronger so that I can pass them on.... thanks

Ds was born 6 weeks early and in NICU for a week. I used a breast pump to try expressing every 3 hours, and once at night, which stimulates your milk to come in. The expressed colostrum / milk was fed to ds through a nasal tube. They topped it up with breastmilk from the milk bank. Then I went to NICU and spent as much time as I could cuddling ds. They had a screen that I could put around my chair so I could get my top off and take ds's clothes off and have skin-to-skin contact. After a few days he started licking and nuzzling me, and he had his first breastfeed by the end of the week. Fully breastfed by the end of two weeks.

Lots of expressing, lots of skin-to-skin, and keep telling the staff that she is going to breastfeed!

Have they given a reason why the baby can't have the colostrum now, through a nasal feeding tube?

I agree with fruitful, I was very luck and had a very very pro breast feeding scbu. They got me trying to breast feed straight away and when it looked like DS couldn't yet suckle properly they supplied me with a breast punp and bottles to store my milk in.

They ensured that DS was given as much of my colostrum/milk as possible through the nasal tube and there should be no reason at all why this can not be done.

They also as with fruitful supplied a screen and foot stool for skin to skin contact and for breast feeding.

She should push at much as she possibly can and if they feed her lo anything without her consent she should complain as highly as she can.

My dd was in icu for a week and feeding her enough was directly linked to her recovery. She was extremely jaundices (so much so they had to dilute her blood ). I was allowed to Bfeed but clearly wasn't giving her enough to flush the toxins out of her system and eventually it got so bad she couldn't be moved out of the incubator. I expressed very little and they topped up with formula. When we left hosp she was on about 50/50 breast and bottle and gradually over the next few weeks the breast went up and the bottle went down to zero ( I had always intended to have her on one bottle of formula a day but it wasn't to be)

Anyway 17mths on and she is still being Bfed (as I type). My advice would be not to be afraid of formula and to insist they mix it with your expressed milk (apparently this reduces the chances of having an allergic response to formula if there is a history of dairy allergy in your family you may want to know that).

I'm not sure about the latching on as DD never had a problem with this and instinct seemed to prevail but she did have some early Bfeeding in her first day so maybe the memory was there. The stress is unbelievable and this can affect your ability to express so anything you can think of to take the edge off would be good. Try and get her to sleep (almost impossible).

Thank you so much for such speedy replies.

So.... she should be asking why her colostrum can't be feed through his feeding tube, and should be expressing as much as possible, and getting as much skin-to-skin time with ds as she can. Yes?

And I can tell her that initially tube-fed babies do go on to breastfeed successfully? (I'm sorry if that sounds patronising, hopefully most do if the mum wants to, but it's not something in either of our experience).

thanks drosophila - will feedback all you've said.

a little bump

DS1 was briefly tubefed, and we did get breastfeeding working.

You want to avoid using bottles. You can give EBM or colostrum by cup.

And yeah, she needs good bf support. I think some women manage to bf in the neonatal ward - get the baby out of the incubator for a bit? If possible?

The sooner she has a go at BF, the better.

gladbag, you don't say if this baby is pre-term or not.

Your friend will find some useful guidance on kangaroo care here

There is no reason why this baby shd be deprived of this, from what you say. It will help get bf going.

Sorry don't have any experience or advice.....just wanted to say congratulations to your friend

breastfeeding your premature baby

this helped me, I've had two in scbu and managed to breastfeed both successfully afterwards, the nurses assumed I was breastfeeding and gave me a pump and woke me up in the night to express, I gave kangaroo care and could take them into a separate room to try and breastfeed, (but they were tube fed for ages) when they could latch on it wasn't long before they came home

nurses can give babies a cup to lap at when they're bigger and nearly ready to come home, rather than a bottle, its in this leaflet

agree with Drosophila - the stress is huge, but it can be done with perseverance and patience

wish your friend luck and congratulations

gladbag, dd was in NICU/SCBU for a total of 2 weeks after birth. She was a tubefed baby who went on to breastfeed exclusively. Agree with the other posters about expressing to maintaining supply.

Dd never accepted a bottle. She was tubefed EBM, topped up with formula. But her jaundice and tubefeeding prevented her from establishing her latch until about 10 days. The problem with tubefeeding was that they were putting so much milk down her (she is a wee one) that she never really got hungry enough to want to latch on for more. Her jaundice did not help. It was very frustrating to establish bf-ing under these circumstances because as a first time mum, I thought I was doing something wrong such that dd did not want to latch on.

It was only after I put my foot down and said no more tubefeeding that dd finally sorted out her latch. She was lovely and gentle and never caused me any pain. She went on to bf exclusively for the next 17 months.

But I was lucky. My hospital was very pro-bf-ing. Had industrial pumps and specials rooms with bf-ing counsellors.

Tiktok - no, the baby isn't pre-term, he arrived on time, and is over 9lbs. Sorry, I should have mentioned that.

Thank you for all these - both links look really useful, and your positive stories will be very reassuring. It must have been a hugely stressful time. I simply can't imagine.

Good news update.

The baby's breathing improved much faster than expected overnight, and he was taken off the oxygen and drip and moved into a cot. Apparently he then cried and cried so they fetched my friend, and he breastfed beautifully for 90 minutes, then fell asleep. He has been feeding every 2 hours since

She'll be fine, glad. Thanks for update

Thats wonderful _ i'm so pleased for them both. Hope baby gets home soon

wonderful news