I don't want to give up Bfeeding, But I don't know what to do..

[sparklygothkat]

As many of you know, I had my second son 3 weeks ago at 33+5 weeks. I was expressing for 10 days till he came home and have been fully BF-ing since. Callum is not gaining weight, in fact he has now lost weight, and weighs less than when he left SCBU and still isn't back to his birth weight.

SCBU nurse came yesterday and re-inserted his feeding tube, because she wasn't happy with his weight. She knows that he is getting my milk as when she inserted the tube, milk came back up it. I just don't know what to do. I have Bf all my kids and I love the closeness it gives. I feels so sad

[sparklygothkat]

please help

[blazingsandals]

Oh how hard for you

Look, if you have to supplement - for his health - that is what you have to do. There is no question of that. There are hundreds of ways to show love to a baby and to be close to one. He will know how much you love him regardless.

Hang in there, I'm sure the great and the good will come along with practical advice. But I just wanted to acknowledge your post and wish you well.

[hunkermunker]

Oh, my love

Ring one of the bf helplines - numbers on my profiles. Or get DH to ring first - might be better in case you have to leave a message. Or have you rung already?

How is he? Alert? I know you said he was weeing and pooing - mustardy poos? Copious?

[sparklygothkat]

I have been tubefeeding him with EBM. All I can do is hope he has gained weight by thursday, when the HV comes again. if not, I don;t know what they will recommend, well I do, and its not what I want..

[Elasticwoman]

Perhaps you need to continue expressing, and offering him expressed milk after a breastfeed. Breastmilk is even more important to prem babies than it is to full-term, but of course it is also important that they get enough.

You can hire an electric breastpump through Ameda Egnell, if you don't still have a hospital one. I guess if you ever had one you'll have given it back by now.

You're doing really well to breastfeed such a prem baby at all. He's not even term yet, and it must be hard work for such a tiny to suck.

[fishie]

oh no, how upsetting. is scbu nurse generally supportive of bf? do you need some specialist advice?

[Elasticwoman]

Sorry I forgot if he has the tube you can't bf him directly at the moment. How are you expressing?

[sparklygothkat]

he is alert when he is awake. He does sleep a lot, but dd2 did that too (born at the same stage) I tried to phone the local breast feeding consollor but it just rang and rang. poos are yellowy

[hunkermunker]

More links on here for info - I appreciate it's a lot of stuff to wade through though

[hunkermunker]

SGK, was that using a local number or the main helpline one? There are more numbers of different helplines on my profile - try one of those, sweetheart.

[sparklygothkat]

he is BF still, but we have to top up each feed. All the nurses and HVs are very supportive and understand what it means to me to keep BF. HV today said that many people bottlefeed prem. babies and I was doing well, I don;t feel that I am doing well, he isn't gaining...

[sparklygothkat]

I have my own medula breastpump

[CantSleepWontSleep]

SGK - can you just feed him more often?

So that I understand right, he's having a 'proper' bf, and then being topped up with expressed milk through a tube - is that right? If so, then I can't see how formula would really make him gain more weight. Surely more feeds would be the way to go?

(but obv I'm not a counsellor, so use Hunker's numbers)

[sparklygothkat]

ATM Ihave to feed every 3 hours, but if he goes any longer we have to tubefed him 40ml. But that means that he isn't hungry when I go to bf him. My supply on my left side is disappearing (he doesn;t feed that well on that side)

[Elasticwoman]

Just had a look at your profile and he looks like a fighter and not a quitter (let's hope he doesn't grow up to be peter Mandelson!). Now that you are supplementing with your own milk through the tube, he must be getting a boost! If it is felt however, that he needs more milk than you can produce at the moment, it's worth asking for milk from the human milk bank, as prem babies should be top priority for this.

[CantSleepWontSleep]

SGK. I don't know what to suggest. Are you pumping more on the left to keep up your supply?

[sparklygothkat]

yes, i feed him on right and pump on my left. I just feel so

[spookthief]

36 weeks is still so early. Obviously you know far more about premmies that we do, do you think he maybe needs more tube feeds as they would burn off less calories than the effort it will take him to feed direct at the moment? Would you be comfortable about mainly concentrating on expressing for the next week?

What do you think they'll suggest? A higher calorie formula to supplement because surely just bottle feeding ordinary formula will not actually give him more?

I hope someone has more knowledge for you. This is such a specialised problem, and obviously so, so much more important (weight) in such a teeny.

You are doing such a good thing for him.

[sparklygothkat]

i did think about just expressing and tubefeeding him. I have never had this problem with my others, they feed and gained weight well. I am just worried they will just say give up bf and bottle feed him

[CantSleepWontSleep]

They can only advise though SGK - they can't actually make you do anything against your will.

How do you feel about him having some formula - would that be as bad as having all formula?
Am just thinking that if, for some reason I can't fathom, they think that the same amount of formula rather than bm would make him gain weight, then could you give a little formula through the tube and express a bit extra to keep up your supply, so that you can revert to bf once his weight improves?

[slimbyxmas]

HI SGK please don't feel sad at all. You are doing an amazing job feeding your DS. I am a midwife and have worked with little ones that are BF ers. Keep going he will start to gain weight and this will all seem very long ago. Smaller babies simply use up more calories sucking and maintining their temps than big babies. Sometimes we give babies who are slow to gain more tube than bf for a day or too, expressed milk of course, to give them a rest, and let them store rather than use their calories. If you are feeding him 3 hourly maybe top up after each feed for a day or two. You are doing the absolute best thing for your baby in BF him.

[sparklygothkat]

he had formula in SCBU, for the first few days while my milk came in, but he was so sick on it. Since he has been on EBM and BF he is hardly ever sick

[mears]

You shouldn't be told to give up breastfeeding him - he will start to gain. The benefits of breastmilk for preterm babies cannot be met by formula. Perhaps he just isn't emptying the breast effectively yet so the tube feeds should help.

How long has he been home? Is this the first time he has been weighed since being home? Different scales give different weights. Is he being weighed naked?

As long as you exdpress to stimulate your supply you will keep producing. In our SCBU, mothers who have difficulty obtaining enough milk when expressing at least 8 times a day are prescribed Domperidone 10mg x 3 daily for 10 days. That boosts the supply.

My DS3 was born at 35 + 4 weeks and initially lost weight. He then stayed static for a week. Once he started to gain weight he continues to do so.

Make sure he gets plenty of skin-to-skin contact to stimulate him to feed. It is a catch 22 when topping up but once he gains a bit of weight you could start letting him dictate the feeds more without top-ups.

You will get there - it will all fall inot place. Good luck.

[hunkermunker]

If you can, I'd stick with the ebm, because his gut's so little.

Tube feeding will be easier for him - can you tube feed him more often than bf, as Slimbyxmas suggests? Lovely positive post, SX - wish there were more midwives like you around!

[hunkermunker]

Aha, another lovely midwife!