Breastfeeding a premature baby

[Sterny]

Hello everyone,

I have a five month old son, who was born prematurely at 34 weeks and was in intensive and then special care for a total of three weeks.

While I was pregnant I decided I really wanted to breastfeed. As soon as he was born they took him away and the midwife told me that 'they would probably have to give him some formula' in intensive care, despite my saying repeatedly that I wanted to breastfeed. I was then discharged from hospital and told nothing about expressing milk etc. I was very dazed and confused at this point and it was all down to my husband who is a vet and has worked with dairy cows and knows all about the ins and outs of lactation in animals (!) that we realised that we must do something to get my milk supply going. When we visited the hospital to see our boy we asked about using a breastpump and were shown a room containing about ten pumps and left to it. I asked the woman who showed us to the room about how often I should express and she basically shrugged her shoulders and said she didn't know.

Anyway, thanks to the power of the internet I found out what to do and established a good milk supply so that my son didn't have to receive any formula.

I must say that I found the hospital absolutely crap about encouraging breastfeeding for prematures. We live about 30 miles from the hospital and I kept telling them to ring me if my milk ran out in the freezer and I would rush some more in but I went in one day to find a nurse giving my son some formula and was enraged! None of the nurses seemed to know anything about positioning or when my son might be ready to try breastfeeding. I was the only mother on the whole of the special care unit (to my knowledge) that was trying to breastfeed. When I was rooming in to try and get feeding established and my son was very unhappy and cleary not feeding properly I asked one of the nurses for help and she said 'go back to your room. If you ask for help I will have to write on your record that you are not coping'!!! I was also told that my nipples were too small and that I should go and buy some nipple shields (complete rubbish). I was also told when experiencing breastfeeding difficulties 'just put him on formula, you'll get him home much quicker that way'.

Anyway, I did eventually get breastfeeding established but I just wanted to see what other people's experiences were and say that it would be so great if someone with breastfeeding experience could perhaps visit a special care unit to give advice and encourage mothers who want to breastfeed. Not sure how it would/could work. Seems unbelievable to me that it is so important for these babies to get breastmilk, yet the staff are so not bothered half the time.

Sorry this has turned into such a long post. I would like to add that I don't have anything against mothers that decide to ff premature babies for whatever reason!

Well done Sterny, and congratulations on your baby. Is he home and doing well now?

I shared some of your experiences, though not all. Dd1 was born at 36 weeks, but was small and very sleepy and not feeding (though otherwise well) and was fed by NGT for a couple of weeks.

I was told that she needed to be given formula immediately at birth. I said I wanted to bf and they did put her to my breast (she was breathing by herself, so no urgency; the only thing 'wrong' with her was that she was a bit cold) but she was really sleepy, so they said, no, she'd have to have formula instead.

Having said that, they did encourage me to express and showed me how the pumps worked. They also let me bring in my own hand pump (I hated the industrial, milking-machine type ones) and sterilised it for me, so that was good. It took me ages to get any milk to come in at all, so for about three days dd had formula. Then I topped up the formula with any milk I managed to express. I pumped for 20 minutes every 3 hours for about a week (even setting my alarm to wake me up to do it in the night) because I was so desperate to get some milk into her.

I was discharged after a week and dd had to stay in, though I kept expressing. I also kept trying her at the breast, though she was always totally uninterested. At this point I did get some of the myths that you had... my nipples were too flat (actually, they are quite flat and dd2 also had some problems latching on, so maybe there was something in that, though I did get the hang of it with dd2 eventually), I should just give her a bottle in order to get her home quicker, I should use nipple shields. In the end, I was so desperate to get her home that I did resort to nipple shields. I fed with them till she was 6 weeks old. However, she wasn't really growing (she was still under 6lbs at 6 weeks) and I was advised that this was because the shields were restricting my milk flow. She still wouldn't latch on at all without them (and I did get some help with trying to position her correctly and so on, but to no avail) so at 6 weeks I gave up and switched completely to formula.

I'm sad that I didn't get better help at the time, though I don't beat myself up too much (any more - it's now 7 years on, mind you) about moving to formula. Dd thrived and it was a relief to feel that she was doing well. (And I'm glad that I did at least give her what I could during those first 6 weeks.) However, I might have persevered more if I'd had a bit more encouragement.

It comes to something, though, when the best advice you can get is from a vet... even if he is your dh!

Good luck to you and your ds.

my ds was born at 33 weeks and I was encouraged to express so that he could have my milk.
after a week we were transfered back to my local hospital who had a milk bank and was given the choice between using donor milk or formula if my milk got low - I chose the donor milk as it was screened several times. I'd rather that than formula plus if they had to give donor milk I was always asked before it was given (even if it was the middle of the night!)

I managed it with two in SCBU at two different times.

Ds 1 was 5 weeks early but weighed only 3lbs 13oz and as you can imagine there was considerable pressure to get weight on him but I stuck to my guns and told the SCBU he was only to have a breastmilk from me and nothing else. Luckily I had laods and even donated to the milk bank once he was home. I also didn't want him to be bottle fed and actually wrote out a note in which order they were to do things ie breast, then tube, then cup, then bottle and they stuck to it. I fed him till he was 12 months.

With ds 2 I was wise and went from the off even though he was 8 weeks prem. I was more relaxed about the use of formula but more uptight about the use of bottles which I forbid. Again I was luky and had loads of milk and also the SCBU unit put all the babies of mother who were attempting to breast feed together and those who were bottle feeding in another bay. There was certainly a generation gap! I fed him for 15 months.

Thanks for your replies. It is great to hear from other mums with premmies.

My little one is absolutely fine now and has been home for over four months. He weighs about 15lb now - what a porker!

Ellbell - my husband also had to do all my postnatal checks as the hospital turned me away because they were 'too busy'. He kept comparing me to a dog that had just whelped. It was very surreal!

I think this sounds like an issue that should be looked into by lots of hospitals, dd was born at 36 weeks and was in isolation in scbu, I was told by one nurse that to try and put her to the breast would interrupt the feeding routine (she was being fed by Ng tube and cup), as if I had anything else to do ! I also had to ask for a chair to sit on the day after she was born and was given a hard plastic canteen chair, it wasnt until a kindly night nurse offered me a foot stool, a comfy chair and a pillow 2 days later that i felt someone actually approved of me wanting to bf. Iam sure if she had been my first baby I wouldnt have been as confident and insisted on establishing bf.