Prem baby not taking to BFing

[rascal1979]

My baby was born 9 weeks early and has been having EBM since about day 3. However despite trying to breast feed for over 3 weeks we don't seem to be progressing. She has latched on a few times and sucked 3-5 times but that's it. I try her to the breast upto 3 times a day when she is about to/being tube fed. She will hold my nipple inher mouth and suck /lick the milk or just let it flow into her mouth and then swallow bits but not actually breastfeeding properly.

I'm starting to get really despondant as other mums inthe unit seem to be doing far better at actually feeding.

She is now 36 wks gestation (5 weeks old) and weighs 3lb 2oz. The nurses just keep saying that she is small and she will do it eventually but I'm starting to worry that she won't.

Anyone else had a similar situation with a happy ending! or does it look like she won't be able to feed?

My little girl was born at 35 weeks and I was told that the sucking and latching on reflexes don't develop until between 35 and 36 weeks so not to worry till then. I was convinced she would never do it and became really fed up - finally a week after she was born she did manage it. It was due to a very patient and very skilled midwife who sat with me until we got it sorted. I would say that if you can face it, it would be worth trying before every feed. It's a catch 22 with the tube-feeding, of course they need it but I sometimes found that an an overenthusiatic midwife would tube feed her before I got a chance to breastfeed and then of course she wasn't hungry. Are you staying in with her? I found the best time for me and her to get breastfeeding sorted was in the middle of the night when there were no visitors and it was all quiet and calm. 3lb 20z is still pretty little too, I think it can sometimes be hard for little ones to physically latch on and be strong enough to suck. If you're feeling up for it I would try to hang in there and with luck and goodwill your gorgeous girl will do it. (by the way after my dd did manage it she has never looked back since and is still a dedicated breastfeeder at 22 months!).

rascal - but you are doing absolutely fine!!! I would say that keeping her close to the breast, kangaroomothercare style (there is a website), will continue to help you get going, but your expectations that a little 36 weeker will bf effectively and often are w....a.....y too high. Holding and licking and sucking and swallowing are all great signs that she is on her way.

You need to be expressing at least 8 x a day inc at least once at night, of course, to lay good foundations for the future.

Good luck and keep us posted.

Sorry just a quick reply- you are doing great... Both of mine were just like your DD, and in the end DS (who was born 10 weeks early due to HELLP) only got the hang of BFing after we'd been home a couple of weeks- just after his due date in fact. Even then with both I only managed to get them to latch and stay latched on by using nipple shields- this may be worth a shot? See this link for more info:

www.mc.vanderbilt.edu/learning-center/pted/docs/hc0155.pdf

DS finally stopped needing nipple shields to BF when he was about 5 months old, & we contined to BF until he was 10.5 months old. DD is still on nipple shields but that's due to other reasons. It is so so hard and very emotional at the start when they are prem- I really sympathise ((((( )))))

Good luck xxxx

PS. you csn buy silicone nipple shields in any large pharmacy- Avent & Medela make them- I find both great, and they allowed me to BF when I'd almost thought it would never happen!

I have a friend whose ds was born 10 wks prem. by the time he was term, he was bfing despite the atrocious lack of support by the scbu nurses.
do you have good support nearby? Have a look at the BLISS webpage if you haven't yet. also call one of the bfing help lines for more 1 to 1 chats if you think you it.

and of course there is always a mner around to support.

Hi Rascal, I just asked how the breast feeding was going on the prem baby thread! I'm no expert but this sounds fine to me. Just what ds was doing and he was much bigger. Tiny babies get very tired doing the tiniest amount of sucking. Ds came home at 42 weeks gestation and had only been "properly" bfing for about a week - ng tube had been out for less than that. He is still happily bfing at 17 months. I'm sure you will both get there in the end!

Thanks everyone. Had a really 'down' day today depite two (out of three) really good attempts at BFing.

Off to have tea and try to chill out. All just feelign a tad too much at the moment []

Rascal,

{{{Big HUGS}}}}}}

Everything will work out good. Just keep hanging around here for the much needed support and encouragement. It won't be long until she is a pro at bfing.. all the signs that you have are very positive and encouraging. Hang in there

Thanks Determination

It's so difficult and people don't seem to realise just how hard it is - even my DH isn't really fully appreciating that I'm the one there all day, speaking to the Dr's etc and on top of all that I have the added pressure of getting her to BFeed

Kiskidee: Which SCBU was your friend on? The one where my daughter is is not that great re suporting BFing. Today I was advised to use a dummy and bottle to get her to suck and improve Breastfeeding !!!!!!!!!!!!

Hi Rascal, 9 weeks ago I was you! I sat there all day, waiting for the next feed to be due, watching my sleepy prem ds - born 7 weeks early, desperate for him to feed so i could take him home, regularly in tears when he just wouldn't wake up. Ugh. Biggest hug ever to you. But suddenly, he just got it! And now, I'm sitting here with him resting on my shoulder, just waiting for his huge last bf to in down! In now feeds brilliantly - every 2 hours. I wish I'd known about kangaroo care, I only did it when home and it made such a difference to feeding and bonding. Also, see if you can get a bf counsellor to come to the hospital to help you. It wasn't til ds was home for a few weeks that i finally got help and a proper latch. Cos they're so little they need a really good latch to transfer milk well. Good luck. You're doing a fab job. You'll get there. Love Anna

her ds was transferred between 3 units before release - teesside / durham. unfortuneately, poor support in all 3.
she was told the same thing about dummies.

is your dd in one in newcastle?

and about bottles

Oh Rascal, I'm so sorry you're feeling down, it is really tough being in SCBU all day and feeling like you're the only one dealing with everything. But you and your dd are honestly doing brilliantly, hang on in there, take it one feed at a time and try to get plenty of rest and chocolate. Don't forget you've just had a major operation. Is there a family room in your SCBU or are you just having to hang around a hospital?

Ds had a lot of trouble breathing and I remember comparing him to other babies who were much smaller and breathing fine on their own. It is really hard to see other babies who seem to be doing better, even worse when you see lots of babies arrive after you and leave before you! My dh used to say that ds had to be in longer because he was so sophisticated that he needed longer to develop than your average baby .

On the bottle/dummy side, ds was given a dummy whilst being tube fed and then a bottle after the ng tube came out, but only when I wasn't there to bf him. I don't know what the official line is on this, but we didn't have any problems exclusively bfing when he came home.

Do hope you are feeling better today. Keep posting as we know what you are going through and can offer lots of sympathy!

Just to echo what was said above about the suckle thing not being developed yet - I was told it was at 37 weeks this happened, and right enough, it was after he would have been 37 weeks that DS started to feed.

It was still a struggle, and we didn't really get the hang of it until about 10 weeks, but he was feeding

All the best

rascal, ds3 was 8 weeks prem but a good 5lb 3oz at birth so a little different from your little mite! SCBU were not great at helping to initiate bf but I kept putting him to the breast anyway. The fact that she is licking and trying to suck is GREAT! Keep that up and she will get the idea. Another thing you could try doing is breast compression
breast compression video If you scroll down the video clips on the right and click on "Compression" you should be able to download a video of this. It means that the baby gets some milk without having to work too hard for it and help her to get the idea!

Oh yes, and ds3 was fed from a bottle and given a dummy but it didn't seem to adversely affect him. We bfed with occasional EBM top-ups when we got home and I ended up bfing him till he was 2.8

How was things today?

Please talk to the Drs about kangaroo care as this is prob the best thing for you both... push for them to allow it. Print off some info if necessary..

Prematurity.org

kangaroo mother care

google search results

Hi everyone

Thanks for all your support. One of the nurses (my fav!) sat with me as I tried to breastfeed this morning. She was really helpful and tried to help DD latch on. My nipples are quite flat and she has been having trouble latching on and staying on cos of this.

After a long attempt with DD showing LOTS of enthusiasm to feed we discussed nipple shields and I tried using one. DD immediately latched on and had a feed of - on gu-estimation - 10ml. Topped up with NG tube feed.

Next feed she was flat out from the effort sow as just tube fed.

Next feed had a really good go and I esimated she had probably taken around 20ml-30ml this time. She pulled out her NG tube during the feed! so we have not 'topped up' this feed in case she was sick - they will give her the rest of the feed over the next few feeds in the night.

Feeling much more positive about it all today but must admit a little concerned about using nipple shields as I wanted to breast feed 'properly'. I do understand that she will hopefully - once she is stronger and able to latch on easier and have a stronger suck - not need the shields in time..

ANyone else used Sheilds and then gradually stopped? especially with a prem baby. My BFing co-ordinator is against the use of them and she is very good at giving advice and very supportive so a bit torn at the moment.

However it seems the only way I can get her to feed is by using the shields and she has had a brill go with them today.

hi Rascal, glad today has been a good one, sounds like she's getting the hang of it. Well done you! The nurse in scbu told me I had flat nipples too and suggested nipple shields. I bought them and never used them. For me, I knew it was the humidity of the scbu that meant my nipples wouldn't stick out. A fab nurse showed me how to sort off squeeze my breast to help ds latch on. I've read loads on here about nipple shields and merits and drawbacks and i'm sure one of the experienced bf people on here can give full advice. It seems that for some they are fab, but others not necessary and can be tricky to withdraw from. I guess its down to the individual situation and I would lean towards what the bf counsellor says - has she suggested how you might get the latch without the shields? I really understand the feeling to try anything to get it happening so you can get home but i guess sometimes its better to hang on for a shield-less latch if you can hack it and the bf person says its possible. Its a tough one - but you're on the home straight it sounds like - a big hug. Good luck. Anna

I had DS1 at 35 weeks and he had jaundice and I was told that my nipples were a bit flat. I was in hospital with him for 2 weeks. We succeeded after we had been home for a couple of weeks. I didn't find the nurses in the hospital helpful - especially as they had given him a bottle from the beginning and by the time I got him home he was lazy and thought a bottle of EBM was quicker and easier. With the guidance of a great midwife, plus Medela nipple Shields and breast shells we made it clear to him that with the bottle all he got was water and with my breast - and nipple shields - he got the good stuff. I BF'd till he was 16mths - it took me 4mths to get tid of the nipple shields for good. I was quite depressed while we were in the hospital and had some moments when I was back home where I just wanted to give up. I was very lucky that my DH and my MW were very supportive. Good Luck! sim

annabanana - The SCBU nurse tried to 'squeeze' my nipple today to help her latch on but she still really struggled to keep my nipple inher mouth. I agree with what you say about SCBU not being the best place to prevent nipples going flat!

I think that I will try expressing a little befire the feed to draw my nipple out and then see how she goes with that.

I had one visiting MW in hospital that cut the end off the a biggish plastic syringe in order to use it to draw out my nipple. After she helped me, she was asked to show the nurses on shift how to make the device of torture - understandably, I preferred the nipple shield , but I do think you have to get the right size and shaped one.

Eek Sim - ouch!

Sim - did the syringe thing work? Another mum who I've become friendly with and who is also a midwife mentioned this.....

Hi Rascal,

That is FANTASTIC progress im so happy for you.

I used nipple shields with both my dd's as neither of them would latch on. dd2 was born at 36 weeks and would not latch at all in first 3 days so i gave in and used the shield again. Used the shields successfully with great weight gain for around 12 weeks then managed to wean from it - which was quite difficult but, can be done.

i carried on to bfed dd1 until 25months and im still bfing dd2.

Do whatever works for you. Have you tried using a pump to get your nipples properly out before latching? or even just fingering your nipples to get them out? or what about Nipple Formers?

Lots and LOTS of skin to sking contact too

Rascal- so glad you are having more success- it really is a rollercoaster. Your DD is beautiful by the way, and reminds me a lot of my DS at that age! As I said in my other post earlier I had to use nipple shields for DS to latch and continued to use these til he was around 5 months old, when I use to just start off with them then slip them off and as he'd then drawn out the nipple he'd latch back on & stay on. I think breast shells help a lot too (the sort that help pull out the nipple). DS then eventually stopped needing the shields altogether and BF really well.

With DD I still have to use nipple shields (she's 7 months tomorrow) as because of her CF we use enzymes before each feed which could burn my nipple. Suffice to say she still breastfeeds fine, and is gaining weight well, so using the shields in my experience has never interfered with my milk supply. Mind you, I've been lucky that I seem to produce lots (maybe I was a dairy cow in a former life!).

The only thing I would warn you about is the dreaded mastitis. Some people think nipple shields can make mastitis more likely as the baby doesn't drain the breast quite as well (and another draw back that some find is that feeding can take longer...but with DS as I had no other children this didn't matter- and boy did her feed- 1hr+ most times and barely an hour between feeds! but not trying to scare you here...). I have had mastitis 4 times with DS and twice with DD. All those times I have been using nipple shields. But with good treatment it clears up quickly...though v unpleasant at the time.

I really hope your gorgeous little lady keeps going with the feeding, she's doing so well considering she's still so young- as are you!

Many hugs xxxxx