Tiny newborn will not open her mouth

[metsa]

My baby was delivered by C section on Wednesday 20/2. She was 36w+2 and weighed 4lbs 13. We just got home from hospital with her last night and the problem we're having is she that she simply isn't interested in feeding at all. She's formula fed. The first problem is getting the teat into her mouth - she just will not take it. I spend solid minutes rubbing the teat gently over her lips and gums before she'll eventually let it in. We're using Tommee Tippee bottles and teats, and there is milk dribbling out when we do this, which she lets run out of her mouth.
Once we do get the teat into her mouth, she has very little interest in sucking and feeding. This was a problem in hospital too and is partially why we abandoned breast feeding. I've just fed her for 50 minutes and got maybe 5-10ml into her. We need her to be getting much more than that. I watched the nurses and assistants in hospital, who were able to get more into her and I just don't know what I'm doing wrong. She's asleep most of the time during feeding. She has mild jaundice but not enough to need treatment.
Should we change to a fast or medium flow teat? We're currently using a variflow one, in the hope she would get more than through the slow flow recommended newborn one. How can we get her to open her mouth? Does anyone have any other tips?

To answer some question: she's gone through her meconium and we're on green poo. The hospital supplied us with 100ml premade formula bottles with disposable teats, they were much firmer than the teats we have at home for her. Those bottles also had a volume indicator on the side so we were more sure of how much was going in her. I looked for those teats online, but the only ones I could find that looked the same stated that they don't fit the premade 200ml formula, which is what the supermarket sells. Then we tried Clara on the Tommee Tippee teat and she seemed much happier to suck so we've stuck with it.
She did have a tongue tie but it was sorted before we left hospital.

All my babies loved the cheapy long skinny bottles, you can get them in most supermarkets and chemists.
Scbu told us they were the easiest to use for the first few weeks and most like hospital teats. Then I switched to mam ones a few weeks later.

We went through practically every bottle brand when dts were getting ready to leave SCBU. In the end the closes thing to the hospital teats were the 3 in a pack from the pound shop ones, the nurses recommended them to us. As they got stronger we were able to move on to the avent variflow.

It was easier to get more into them by kind of sitting them on my lap facing me with their head on the palm of my hand so not in the crook of my arm which just made them fall asleep even with stripping them off, tapping and twisting the bottles etc

She had another bad feed so we called the hospital who put us through to the local midwife. She spoke to the paediatricians who are happy because she is still weeing and pooing. The midwife is going to come out and see her tomorrow morning. She also told us to move onto premade formula for 24 hours, rather than powdered, in case the powder has constipated her.

Definitely try the cheapy bottles for a while.
Her body will adjust to the formula, premade is so expensive!
Does she have a dummy, to encourage her to suck?
Hope the midwife gives you a bit of support today

When my dc was in scbu the nurses said tommee tippee are a nightmare for preemies to feed from. We tried all sorts of bottles and in the end it was the cheapy ones that did the job, we used the ones from boots iirc.

Also we used premade formula for a little while as they struggled with the transition from having that at the hospital to powdered at home.

Hi, our DD (3weeks) had a tongue tie and even after it was snipped kept her tongue to the roof of her mouth. This meant bottles went in under her tongue, she'd suck but the amount in the bottle didn't really go down and milk would dribble out when we took it away - exactly like you describe - NICU nurse described it as a 'non-nutritive suck' like having a dummy in.

I find holding DD facing me rather than cradling her means I can see into her mouth and strike when the tongue is down. If she's really not getting it I stick my pinkie finger in there for 'practice' which makes her more likely to open up.

I didn't use formula but did have a 36 weeker by emcs. He just wanted to sleep and sleep, usually in a tight little ball. If woken, he howled in anger. They tried for days to tick the "baby has two eyes" bit of their discharge form but he was asleep or screaming with eyes shut every time the paed came round.

I expressed milk and squirted it into DS's mouth using a syringe. Just a small amount at a time but very regularly which was enough to keep him hydrated and gaining weight and I fed him in his sleep too when he would latch and dream feed. He finally "woke up" at what would have been 39 weeks gestation and latched effectively.

Well just to update this thread, baby continued to not feed well. The community midwife saw us on Sunday morning and arranged for us to go to the hospital to get Clara checked out and hopefully get a solution to the feeding problems. We stayed in overnight and were taught a different hold for feeding her and more tricks to make her swallow and encourage her to feed. She was also examined by the doctors and bloods were taken. Physically, she is fine - verdict is she is just lazy and won't suck. When she does suck, she has a strong suck. I am a bit offended at my tiny baby being called 'lazy' but they're the experts. The nurses at the hospital were amazing with us all, they managed to get good feeds into Clara but they also experienced her being very difficult so I felt at least a little validated. The doctors said that if she won't take her feeds orally, a feeding tube would have to be fitted to give her the rest of her feeds that way. I hate the thought of this and it would mean her staying in hospital longer when I just want to be at home as a family.
On Monday (yesterday) her feeds went well, so we were discharged and went home. She's on a 2 hourly feeding schedule and has to take 24ml per session. My OH took the first shift last night and hit target each time. I took over at 6am... and once again she won't feed for me. I have no idea why. I am doing exactly what I did in hospital and we are using the same milk. I feel so frustrated and upset. I don't want to end up back at the hospital and I don't feel there's much point unless I'm willing to pretty much move in there since what works there doesn't seem to work at home. I'm just going to keep trying. I'm also going to see about expressing breastmilk to see if she'll take that any easier.

Some babies are incredibly stubborn and can take time to adjust being in the world

I’m guessing she’s more difficult with you because she knows you and just wants to snuggle in to you like she did in the womb.

She maybe picking up on your stress when you are feeding her. Trying doing some deep breathing exercises before you feed her.

Try holding her away from you when you're feeding, sit her on your lap facing you, with your hand around the back her neck
Being snuggled in sometimes makes them snooze.
Also break the seal on the teat, wiggle the bottle around a bit when she slows down/gets sleepy.

It will get better, you're not doing anything wrong. Some babies are just slower out of the starting blocks.
I'd choose sleep over eating any day
You sound like a lovely attentive mum.

Lamkin, I don't snuggle her in. I was at first but the hospital taught me to hold her kind of sitting on my lap with her head tipped back and held by my hand. Similar to your suggestion :). The feed is going really well if she manages to create a proper vacuum seal on the bottle, most of the time she doesn't.

What bottles are you using now?
I went through loads. My 34 weeker went through a similar phase. Finally settled on Mam ones.
He turned out to just be a 'snacky' baby, and is still the same at 9 months, although he does have cmpa and reflux.
Does she have any other symptoms? Fussiness, wind etc?
Try a dummy between feeds and see if that helps too.
Really hope she picks up soon for you, it's so stressful.

Currently we're using Sterifeed reusable baby bottles and teats, which is the same brand as the hospital uses. I tried her on some expressed milk, she drank the necessary amount but she didn't seem impressed with it.

Oh that's good. As long as it's going down 😂 Breastmilk is fattier than formula so don't be surprised if she takes a little bit less.
Fingers crossed for you.

DD didn't get along with TT bottles at all and they caused colic too - we switched to MAM and have never looked back.

I'd definitely think about trying different teats - was specially if she was better with the disposable ones, they are by NUK I believe so you could try their bottles?

First of all congratulations!
35 weeks is when babies go through a stage where they can really struggle to feed. Our SCBU wouldn't let our 31 weeker home until they were sure she wouldn't go through this. Apparently a lot of babies get to the stage they'd be 35 weeks and stop being able to feed. They did say it's very short lived though, if they need a feeding tube it is normally for a few days and they pick it right back up again. So don't be too worried about it if she needs to go to hospital and have this, it's a tiny stage they go through.

Also Tommee Tippee are known for babies not getting on with them especially small/early babies. MAM bottles seem to be the top recommended bottles by NICU staff. Our daughter picked it up fairly quickly when we started with those.

Good luck.

Well it's now just about a month since I started this thread, and things have really turned around with my baby.

She is now just over 4 weeks old, and she feeds really well. It took effort, but a few days after this thread she started to reliably feed more. The hospital gave us guidelines on how much formula she should be consuming per day, and I've logged nearly every feed she's had since the 25th February. She continued to have small feeds quite regularly, but balanced this out with larger feeds and over the day she'd hit her target.

We might now be having the opposite issue with her. The amount that she consumes has gradually gone up, as has the amount she needs to consume as it's based on her weight. Yesterday she took more than double the needed amount. She doesn't vomit much, and we're mostly demand feeding but don't let her go more than 3 hours as per the doctor's instructions. I'm going to speak to the GP about it at our 6 week check, which should be in a couple of weeks (but no appointment yet).

If her weight is ok, it's maybe time to spread the feeds out a little bit. I worked out how much milk my DS needed every 24 hours & spread it out over 8 feeds as a rough guide, I started to try & let him demand to be fed, if he was on 3 hour feeds, I let him go to 3.5 hours before I would wake him, if he woke early, I fed him. At night, I gave him a bottle around 10.00 & then topped him up around 11.45 to try & get him to sleep a bit longer. If she is taking a lot more than her recommended amount each feed, she is probably having a growth spurt, which will show up next time she is weighed. It's horrible at first when they don't want to feed, my DS took around 2-3 weeks before he really started feeding properly, before then it took ages to get 30ml down him & he was 6lb 4 when he was born at 37.5. It felt like we had only just got him settled after one feed before it was time for the next one. By 6 weeks he was demanding to be fed when he wanted it & I threw the schedule in the bin.

DD2 was also a small baby, a 35 weeker that weighed 4lbs 2oz on discharge.

It would take 1.5 hours to get her to take 15ml of milk and she fed every 2 hours. It was awful, I existed on catnaps and coffee for the first few months. I had to squeze the teet on the bottle to help her get through her bottle as she kept falling asleep and nothing else worked. We tried the feet tickling, stripping her down, gently squeezing her foot - she just kept sleeping.

For a while we thought we'd have to be readmitted but I had her weighed every week at the clinic and although she was off the bottom of the growth chart she maintained her curve so the hv was happy with our progress.

It does get better but it's exhausting for the first few months.

So pleased to read your update and that feeding is going well. Parenting can feel impossible at times but you will get through the hard times like this and before you know it they are forgotten!