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?

Hi L&L

Had an up and down day. Had a discharge planning meeting with the consultant and she said that if she can get started on feeding then it isn't unrealistic to say she could come home in the next two weeks . However that is a big IF cos she seems to have gone back to square one with the feeding today. The consultant said that she may take 4 weeks or longer depending on how the feeding goes.

We have started a new regime which we will be trying until Monday then assess. She is on 3hrly feeds - through the day I have been advised to wake her up at each feed time and feed firstly from the breast and top up with NG tube. In the night she will have alternate cup feed and then NG feed.

I am really starting to feel the stress and a few nurses have suggested bottle feeding emb. I feel strongly that I want to breast feed and the BF co-ordinator has said that bottles are not a good idea until she is established with Bfeeding.

Her feed at 1pm was okay and we knocked 14ml off her NG tube top up. But at 4pm she was hardly interested - took 10ml by cup but nothing from breast. At 7pm she took a little from the breast - nurse helped and we tried nipple shields which worked a bit but not massively. Then DH arrived and decided to start to pressurise me into using a bottle . he thinks I'm being 'blinkered' by not trying a bottle and made me feel as though it's my fault that she is still in hospital - despite being in the meeting this morning where we were told bottle feeding won't get her home quicker. We ended up having an argument and I asked him to leave the hospital - which he did then I felt bad cos he hasn't had a cuddle with DD for 2 days now - yesterday she was resting cos she was exhausted.

Just feel so fed up and don't know what to do for the best. It's so hard and I'm fed up of trying to cope. I keep telling myself to keep going and take one day at a time but when each day is the same and everyone else is going home it's sooo difficult and I just keep finding myself in tears over it.

Has anyo0ne else had experience/thoughts on bottle and breast feeding. There is another mum on the unit who is doing both and seems to be doing well...but I really want to breast feed and I am scared of jepordising her being able to do it by giving/not giving a bottle......arrghhhh

I know that my friend who gave birth at 31+6 gave ebm in a bottle to her baby at night time so that the nurses could do that if she wasn't there. However, I don't know how established her DD was with BFing. I think that all mother and baby 'teams' are different I would suggest talking to a BF counsellor who is experienced with premmies. You could also get your DH to ring one of the helplines and talk it through with a BF counsellor if you think it would help.

Rascal...

I just wonder why a bottle has been mentioned at all.. I thought your dd was a pro a cup feeding, is she not?

By cup feeding you are not satisfying her NEED to suck and as a result this will increase the likelyhood of her latching onto the breast to satisfy this need. If she is given a bottle or artificial teat of any sort then she is able to suck and satify the need and get tired too.

Realistically, if you want her to bfed and not waste any energy doing anything else, artificial teats need to be removed from the scene.

Hope you have a better day today.

This must be a really difficult time for you and your husband. However, you really need him to support your decision to bfed. Does he know the benefits of breastfeeding for both you and the baby?

Some usdeful articles;

Breastfeeding Premature Babies

Fathers and Breastfeeding

The Breastfeeding Network (BFN) - Supporter Line 0870 900 8787 - The service operates from 9.30am to 9.30pm every day of the year.
La Leche League Great Britain - 0845 120 2918
National Childbirth Trust - 0870 444 8708 - 9am to 6pm, seven days a week.
Association of Breastfeeding Mothers' - 0870 401 7711 - Open every day from 9.30am to 10.30pm

benefits of breastfeeding

Oh I'm so sorry you're having a down day and it sounds like your dh isn't being terribly supportive. I guess it is very stressful for both parents but it is probably hard for him to understand just how much pressure you are under, being in hospital all day and feeling the whole burden of feeding on your shoulders. I have just told my dh about your problems to help me remember how ds was at that stage, and he has pointed out that this is just the worst possible time to have to make important decisions together - you are both probably very tired, very stressed, very worried and still in a state of shock. Your dh is probably, just like you, desperate to get her home, and doesn't understand how important bfing is to - a lot of (if not all) dads are like that.

We did allow ds to have a bottle in the night if he was rooting. I can't really remember how established the bfing was then, but it can't have been brilliant because he didn't really feed properly until a few days before he came home. TBH I didn't even know cup feeding existed, no one suggested it to us, and I coudln't stay overnight in the unit, so there wasn't really an alternative. It never caused us a problem with bfing. I was there for more than half the feeds which I think must have helped. But I suppose no one will be able to predict how your dd will react to a bottle; I would think that if it won't make things any better (according to the consultant), and you feel strongly that you don't want her to have one, there isn't really a reason to try.

When was her due date? I remember she was due in feb.. I also remember how much the time seems to drag once you get past the due date. You have both come so far and are doing so well! Keep at it and she will come home soon. Hope you have a better day today.

Sorry for all my waffling, determination has managed to come up with much more helpful posts while I was typing!

Thanks L&L and Determination. DH has been far more supportive today. We have made a conscious effort to work as a team today with some success. She had 2 small cup feeds overnight - 5ml and 10ml. She fed at 10am but only couple of sucks, 1pm was the same and then did skin to skin for 2hrs. She fed better not really sucking much but more interest at 4pm feed and at 7pm she was better still not suckign at suck but kind of latched on and used her chin to 'milk' my breast.

DH and I have beenout for a meal to have some normality and had a lovely chat

Hoping for more tomorrow but will take it one step at a time.

Kangaroo Care doesn't have to be about feeding. Open your shirt and bra (drop your cups if it is a nursing bra or remove it) put her between your breasts and then wrap your clothes or a blanket over her. Allow her to stay there as long as you are happy to, even without feeding. I found that after that was a good time to pump.

You still haven't emailed me, I think you will like what I have it was going to go to the local NNU so sending it to you instead doesn't make a difference to me. I've not said what it is because I don't want you to say anything before you get it IYKWIM.

WRT to breast and bottle, there is some evidence that bottlefed babies spend on average a week longer in hospital. I know in my case it wouldn't have happened because they keep breastfed babies in an extra week on the ward with mum to bed in.

I know what you mean about wanting to get to a normal life and being a family, but you will be surprised, when it happens it will happen quick. I asked two days before what happens next and no one could tell me, the next day we had two unsupplemented feeds in a row and the following day I came in and was asked "How would you like to go to Ward 2?" (I refused to go home for my clothes or leave her side in case they changed their mind lol).

When it's over you will look at it as being a completely different lifetime and will be amazed at how quick it went really and how long ago it seemed.

You are getting closer!

Hi Tinkerbelle - sorry I've not emailed - I've not had chance to find your email. Could you email me at [email protected]

thanks starlight - I certainly don't feel it at the mo!

Update!!
Had a chat with the consultant today because she is getting no better at feeding. She has suggested that we need to do something to get her sucking so has suggested a bottle. I have agreed cos I really can't see any imrpovement with the breast feeding at the moment.

She has gone back onto 4hrly feeds and they are going to give her a bottle of EBM at 4am and tube the rest of the night. In the day I am goign to continue to try her at the breast and top up with tube. Hopefully she will start to take to the breast but I'm prepared for her to not do . Not to say I am givign up just I feel better about her being given a bottle to get her 'feeding' rather than being fed by NG tube.

Off to try her at the breast again now - but firstly going to give her a bath! (only her second in 8 weeks!)

OMG talk about 11th hour!

Just come back from the hospital. She had her bath and was rooting like mad so we tried her on the breast and FINALLY she had a proper feed for about 25 minutes!! Stayed latched on the whole time [grn] it made me feel amazing couldn't stop grinning!

I was unsure about whether to still let them give her a bottle tonight BUT they have said to still try her and they can assess her sucking and one bottle won't ruin everything and I am going to carry on trying her on the breast at every feed during the day.

I'm soooo happy - it was as though something just 'clicked' with her and she realised what she was supposed to do.

Lets hope that she carries on tomorrow. She's also weighed tonight so fingers crossed she has put on a decent amount!

arrrghh I'm having second thoughts about letting her have a bottle....just been reading some info on Kellymom which says nipple confusion can start after just one bottle.
Really worried
Don't know what to do
they may have already given her a bottle at her 12 o'clock feed.

Anyone around who can offer advice.

can't get through to NICU - phone rang out and now it's saying out of order.....do I take this as a sign to leave things as they are?

I'm sooooo confused. I'm scared to ask them not to feed with bottle incase the BF before was a one off and she still struggles and therefore not trying her with a bottle will increase the likelyhood of sucking issues but on the other hand I am scared of bottlefeeding incase she gets nipple confusion.

Just that now I've had time to think about things I don't see how giving a bottle will enable them to assess her sucking cos it will be a completely diff suck to BF suck.

arrghhhhh

Me again I finally got through to Nicu and had a long chat with one of the senior nurses. Told her that I was unsure about the bottle and she said they she still felt we should try as the consultnat had requested it... I agreed but we compromised nad rather than trying to give her as much as possible they gave her just 20ml - enough to test her sucking but (hopefully) not enough to cause any problems.

I rang to check how she did and apparently she did really well and sucked fine.

She also put 105g on (since Thursday) and now weighs a massive 4lb 1oz. I am really pleased with this as the Dr and nurses (And Me) expected her to either remain static or put on only a little bit, because we have messed around with her feeding a lot since Thursday, been trying to wake her from sleep rather than letting her rest as much and also dropped the 1/4 pre-aptimil from her tube feeds (which she was on to increase her calorie intake. But it would appear that being on just EBM has made her put on 25g more than her usual 80g!!

Feeling better in general but now my new concern is my milk supply.

I usually pump anything between 90ml (at very least - usually middle of the day at the hospital) to 190 (personal best). I also have a fantasict let down when attempting to breastfeed. However over the weekend I have noticed that my letdown when trying to feed hasn't been anywhere near as good - think that this is due to me getting stresed. But also not getting as much milk off when I express. For example at this time in the morning I can get normally between 110 and 170ml but just got 90ml. I know it's still a good amount but for me its a decent drop.

Will speak to BF consultant, express as often as possible (expressed at midnight, 5am and 8am today already but only got 290ml in total) and try skin to skin today again but any suggestions on anything else I can do. I really don't want my supply to dry up just as we are finally getting started with feeding.

Don't panic! Although it's probably a bit late to be saying that - did you manage to get through? Did she have the bottle? How is it all going?

I know some people have very strong feelings about no bottles, and I don't know much about nipple confusion. But as I said earlier ds had bottles, and several of the bfing mums I spoke to on SCBU also allowed bottles, and we were all fine - don't know if that's just luck or not. I don't think I can advise you whether to give a bottle ("it worked fine for me" isn't always terribly useful advice!), but if she hasn't had one yet maybe you should see if you can get another good bf in before she has one.

But SO fantastic that she had such a good feed, I'm really really pleased for you!! And great that you and dh are getting on better as well. Really good idea to go out for a meal and try to remember each other, because it's so hard when you have a little one in SCBU.

Do hope all is OK, let is know how you are doing.

Hi L&L - see post just before yours!

Just spoken to the BF co-ordinator and she is annoyed (with NICU staff) as she says she feels I was pressurised into them giving her the bottle - there are issues between her and NICU - and there were other ways of testing her suckign reflex HOWEVER to not worry about that and to concentrate on BF from now on. She is really positive and just what I needed to reassure me. She sai not to worry about the reduction in supply as I am well established and it can dip with stress etc so just refocus and carry on doing what I have been.

I mentioned that she seemed to be struggling with cupfeeding when she had been really good with this but as she pointed out she is nearly term now and term babies do struggle with cup feeding.

She is going to come and see us tomorrow and assess firsthand how she feeds.

Well today she has been hopeless but I don't think that it is anything to do with the bottle feed last night.

She has been very sleepy so no real attempt at all today but the few sucks she had were fine - ie no sign of nipple confusion. I'm going in at 8am tomorrow to try feeding - just in case a different time of day helps! The BF counsellor is also coming to see us either at 12pm or 4pm fingers crossed she can help

Hi Rascal, how's things going today? It's a shame the bf co-ordinator and SCBU don't seem to get on, would be much more helpful if they were actually working together!

Try not to worry too much about your supply if it's a stress-related dip - you must have plenty of back-up in the freezer if you have been expressing so much. In fact if you are expressing much more than dd needs, you might find you have the opposite problem when you switch to 24hr bfing - I got terribly engorged and had to carry on expressing a little bit for a couple of days. And the let-down thing definitely has a huge psychological component, so I'm sure if you are really worried when you sit down to feed, it won't flow as much.

Hope everything is good today!

Hiya

All going really well now - which is why I've not been on line. She has taken 4 full breastfeeds since 1pm yesterday (1pm, 8pm yesterday, and 1pm and 4pm today) and in between she has had good feeds with some NG topup. The only two feeds she didn't have a go at are 12 midnight and 4am - I am sleep ing over but she was too tired each time - so I just did skin to skin with her whilst I tube fed.

She is going in the right direction and I'm getting plenty of support from staff and BF counsellor. Fingers crossed if she carries on progessing like she is then she may be home next week eeeeekkkkk!

Will keep you all posted x Thanks again for the support xx

for rascal and rascal's little rascal

Yippee! That's fab! I'm so pleased. she'll be home before you know it. Isn't amazing how they suddenly work out what to do and have the energy to do it. Hooray.

Update
She has BF for 24hrs and has pulled her tube out! if she keeps this up and puts on weight she can come home on Monday ...will keep you posted.

Trying not to get my hopes up or get too giddy but difficult not to.