Baby in SCBU, trying to get her back feeding from me... Help!!

[MissingMyHeels]

I'll try and keep this fairly brief, baby Matilda was born on Sunday morning and immediately fed well for about two hours. Then had a very long sleep and wouldn't latch on properly 5 or so hours after the morning feed. The next day she began vomiting bright green bile so was admitted to special care, transferred to a different hospital to me and now after two days away she is back to my local hospitals neo natal unit - had a contrast dye as she was suspected to have a bowel blockage, there is no blockage but we are still waiting for blood tests to rule out infection. She is currently being fed a mixture of EBM and formula by a tube straight into her stomach every two hours. I am keen to begin breastfeeding her but there are a couple of problems, the main one being that she won't latch on to me as my nipple doesn't seem to protrude far enough and she isn't getting her tongue out to really draw the nipple in. They have suggested nipple shields but I'm not really sure what they are/do and the neo natal nurses aren't really there to get me breastfeeding.

Second issue is, she doesn't seem to be hungry, she gives latching a very half hearted effort, tries a few times and then gives up. Obviously as she is being fed very regularly it's possible that she isn't emptying her stomach. How can I get past this without asking them to just stop feeding her? They can't do this because they need to keep stuff going through her to monitor the throughput.

Thirdly, I discharged from hospital early so I could visit her when she was transferred so I am not sure how to feed on demand when I am not with her 24/7?

Any help would be really appreciated as I'm feeling pretty useless and REALLY want to get her breastfeeding from me, especially as her problems have been tummy and bowel related. Thanks in advance

My dd was in scbu for 2.5 weeks, and was fed ebm by ng tube for a while. She was on medication that meant she was hardly ever awake, and also, like yours, wasn't ever really hungry.

They encouraged me to put her to my breast as much as possible, and I carried on expressing to keep up supply, and I had a lot of help from the nurses - they also had a hospital bf counsellor, and they arranged for her to come and help.

We also got a chance to room in a few days before she was d/c to establsh feeding while still in hospital.

It was difficult because she was so dozy, and once at home for a while I found it incredibly hard to get her to latch on, especially one side, but I persevered and 2 years on she still adores it.

So it can be done, but ask for all the help you need, and persevere if that's what you want to do.

Good luck

Don't feel useless, you are already doing the best for her with the EBM. I am not an expert but I would say there is no reason at this early stage you cannot get her back to bf if you get some help and as long as all her tests come back ok. Is she your first? Bf can be v v hard in the first few weeks anyway without the issues you have had and physical separation in particular. In my experience the best thing you could do on top of the EBM is get hold of a trained bf counsellor to come and chat with you, watch what you are doing and give you some advice. Please don't just accept what the nurses/mws say as, sadly, they are not always the best people to talk to about bf I have found. Most importantly, look after yourself and try and relax, hard, I know. Also, try skin to skin contact if you can - really helps, and don't tense up. Good luck, and don't give up, a friend of mine gave her baby EBM for 8 weeks before he started bf and then went on to bf for a year. I think it can be done.

bump.

but also try bumping this during hte day, i'll give it a shot if i'm around.

Thanks for your responses, I will try and bump this tomorrow if I am around and see if I can contact any breastfeeding counsellors.

Good to hear some positive stories and that it can be done, they asked me today if I had some formula and bottles at home for when she comes out

Also I think the fact that she did feed initially straight after the birth is very good news. My first would not bf at all until the 5th day as he'd had a difficult birth and was very jaundiced and sleepy. I went on to bf him for a year. You are only on, what, day 4. That first big feed may have been enough to see her through for a bit, they are born with fat reserves to keep them going too.

Ignore them for the time being if everything is ok medically - rememeber they have an agenda to get you processed and the "baby feeding regularly" box checked so they can discharge you. The hospital should have a bf councellor or you can phone the NCT or LLL helplines who I am sure would find someone in your area to come and see you, someone will have the numbers to hand for you tommorow I am sure.

I have no advice but just wanted to say good luck and I think you are amazing xx

Ask to see the hospital bf specialist - they will have one, and she'll be able to help you much more than the neonatal nurses.

DS was in SCBU as he was prem, and once he was strong enough, I put him to the breast at the time that his next feed was due and then I put his milk down the tube once he was done, and then expressed. When he had started to really feed, I roomed in and fed on demand and when they were happy that he was getting enough, they took the tube out.
I was lucky in that I managed to hide on the postnatal ward for 4 days and then go straight to rooming in on SCBU. I did find that some of the SCBU staff were better than others in supporting bfing - the best was one who had had prem triplets who she'd bf'd. After having to have some formula down his ng tube before my milk came in as he had low blood sugar and jaundice, DS was exclusively bf for 6 months, and still bfing at 22 months, and never had formula again.

Theres others on here with much more experience of life on SCBU and getting a baby to full bfing than I have- Sparklygothkat in particular has been through it all recently.

Hi MMH, our story was rather different as dd was very premature so feeding was not what was keeping us in hospital.

I do think that it can be hard to access good bf support in SCBU, many nurses there don't have any specialised training in helping to get babies breastfeeding.

As others have said, ask to see the infant feeding specialist and ideally get seen in SCBU. This is particularly important if you are being made to feel that the neonatal nurses are not there to help you BF. Getting a SCBU baby feeding IS one of their responsibilities.

I am cross that shields have been suggested to you but no one has offered to show you how to use them. I really think that you should take this to the sister in charge or nurse manager as she should know which member of the nursing staff is best placed to help you.

Are you able to have Matilda out for skin to skin/kangaroo care? If not, ask to do this because having her close to you will help your milk supply (at 4 days it will not yet be established) and will help you to start seeing her feeding cues.

Above all, keep pumping (8-10 times a day if you can) and do not be afraid to be an advocate for what you want. If you find it hard then ask your partner to help - when I was really emotional the nurses often found it easier to talk to my husband. Sounds weird but the week after you have a baby is a very strange time.

Does the hospital have a parents room attached to the SCBU? If you were on standby the staff could call for you when baby is due for a feed.
DS1 was tube fed and in SCBU for the first 5 days. The staff recommended giving him a dummy to encourage the sucking reflex as we never got to try latching on at birth. I don't know if this is advice given in every circumstance but as I was unable to hold him I thought it might be comforting. (I was anti-dummy until this moment)
DS1 had difficulty latching on and we used nipple shields until about 8 weeks when he managed to latch on for short periods.
Eventually he BF properly and continued until he was 10 months.
It can be done, but it's not easy and you will need lots of support.
Another thing i did which might be nice to do is that i slept with a muslin in my shirt to make it smell of me and in the morning placed it in his incubator. Sounds a bit weird but I think babies love the smell of their mummies.

Just thought i would offer a bit of a support and let you know it could all work out fine, my DS2 was born at term and came home but wouldn't latch on and feed properly, became jaundiced, then got bronchiolitis and spent two weeks in hospital being tube fed, his latch was even worse when he came out than when he went in, but i bought some mothercare breastflow bottles to feed him ebm with and put him on the breast regulary to try and help his latch, it didnt improve so after a bit of research tried cranial osteopathy hes had two sessions and is now almost totally back on 'proper breastfeeding' aged nine weeks old so, so long as you keep your supply up by pumping its never really too late for lo to get the hang of it. I really cannot rate the cranial osteopathy high enogh, if you're near sheffield i can highly reccomend someone!!

also your nipples sound a bit like mine, ds1 never had any trouble but ds2 has so my local breastfeeding counsellor taught me exaggerated attachment which really helps.

you are doing a fabulous job and deserve a round of applause, people thought it was crazy that i wanted to keep pumping and persevering, my gp said i was mad and should switch to formula but i knew i wanted to and its all paid off because i dont think it will be long before i can stop topping him up!

Congratulations on your baby girl! I know it's easy to feel useless with a baby in SCBU, but please try not to, you are already doing brilliantly by expressing for her.

My ds was prem, so my experience is probably not all relavent, but here goes. I was told in SCBU that it is unusual for a baby being fed ever 2 hours to feed well from the breast because they don't really get hungry enough, often made worse by them being very tired if they are prem/small/ill. My ds didn't really get going until he was on 3/4 hour feeds. The nurses are unlikely to "let" you feed on demand just yet. Try putting dd to the breast as often as possible before (and maybe during) a tube feed. Don't worry if she doesn't latch on, or doesn't suck - it's important for her to be near the breast and associate it with food. You might be able to express a little onto your nipple at the start so she gets the idea. As she gets better and the nurses are able to space the feeds out more her feeding should improve. You could also try a few pumps with breast pump just before feeding to draw your nipple out a bit more if this is a problem.

Definitely ask for a bf specialist and keep up the good work with the expressing. Ds was only 6 weeks prem but didn't start bfing properly until about 6-7 weeks after he was born - he is still bf at 19 months so with the right support it is definitely possible! Good luck

MMH - Hang in there! My DDwas born 9 weeks prem and it took us until almost her due date to get her feeding.

I would suggest;

Get in touch with the BF counsellor - SCBU are not experts in BFing and in my experience some are actually against it.

Lots of skin to skin

Put her to the breast whilst she is fed by tube - even if she doesn't do anything (and I know this can be VERY disheartening) she is associating feeding with the breast.

Make sure you keep expressing 6-10 times in 24hrs - including night to keep your milk supply up.

Nipple shields do sometimes have a place but if she can latch on to your nipple - which she has done then not sure how much use they would be. In my experience and others on SCBU with me they didn't really help - babyrascal just used to let them fill with milk then lick at them in a very lazy way

It is very difficult and it would be so easy to give up but we have now been home for almost 5 weeks and babyrascal is now feeding well and slowly gaining weight.

Could I also ask why she is having EBM and Formula rather than just EBM? I was coerced into giveing baby rascal formula and EBM for weight gain but it had no real effect.

Good luck and keep posting it really helped me to get the support of others on here.

Hi L&L

Wow - all of this advice is great! I have been put in touch with a bf counsellor who is going to visit me this afternoon to see if she can help. I had a bit of a teary hormonal moment with the nurse today and explained how keen I am to bf and that I felt my wishes were being sidelined and she has subsequently been a lot more helpful and Tilly even latched on very briefly this afternoon but swiftly fell straight asleep

They are going to let me room in for two nights prior to discharge when they have a date for when she can come home. She should be ready and finished anti b's by Sat but they can't discharge over a bank holiday so hopefully early next week she will be home. I have also bought a pump this morning to ensure I can express enough as I had been told to rest overnight by the midwife and have subsequently learnt that it's necessary to do it at least once during the night.

I was told that she needed formula to fill her up and put weight back on her as she lost 1lb 2oz off of her original birth weight when she was nil by mouth. They have been mixing the two together to feed her and she had two cup feeds overnight and hopefully her feeding tube should be removed tomorrow.

Thank you all so much for your replies and stories, I was feeling so disheartened but starting to feel it is possible again - will be trying everything mentioned and looking at the cranial osteopathy when we're out. You've all done so well, I hope I can do the same!

Our ds was also in SCBU, tube fed a mix of EBM and formula. tbh, he wouldn't really latch until the tube feeding stopped - the formula was making him too full/sleepy. One day (day 6, he was in a room with me by then) he finally latched, and I just kept putting him back to the breast every time he looked a little bit awake and didn't put anything down the tube. Until then I'd been trying to get him to latch before every tube feed and putting a little EBM on his lips while tube feeding him in the hope he'd get the taste. No idea if that made any difference!

Not sure how much this helps, just to say that it can work out - he's now 7 weeks, excl bf, and the hv couldn't believe I wasn't using formula top ups bc he's grown so much.

Think seeing a bf counsellor to learn a good latch is best advice, but keep expressing to get your supply up, and keep trying to put her to the breast.

I am an ex NICU nurse and would have said everything rascal1979 I am really glad you have had better support from the nurse caring for her but it is sad it took what it did it should have been automatic

To get your nipples to come out a bit try
a find somewhere quiet and stimulate them your self with a little tweaking
b get on the pump for up to 5 mins as this can help draw them out
c put nipple shields in your bra and leave them there until it's time to feed this will for Many Mums bring them out enough until the baby is big enough to do it them selves.
The one problem using nipple shields to feed is they can get slippy and they can mean that your baby is not compacting the ducts that store a small amount of milk so you do not get adequate stimulation. Saying that I know a few Mums who have successfully fed using them as well as many who they just caused more problems.

Skin to skin or you will sometimes hear it called Kangaroo care is fantastic (well I am a big fan anyway for term as well as prem babies AND Mums) it not only helps increase your milk supply but also your confidence and the babies interest in feeding. Mums confidence is nearly always knocked when a baby is admitted to NICU/SCBU and with all those hormones rattling round it just makes it feel all the worse. Take in a large shirt which buttons down the front in (DP's are often best and it means he can do it too and we don't want Dads to feel left out) and leave it there so what ever you wear in you can do a quick change. It is most effective for Mum and baby if done for a min or 45mins preferably longer. On our unit the best times to be able to do this were often our quiet hour which was at lunchtime as KC was considered restful for the baby (IMO more so than sleeping alone in incubator) and we had the lights down and only parents visiting too which just made it more special, and in the evening when it was a little quieter fewer doctors and only parents (for Mums still in early mornings were a nice time and perfect way to start the day). But we could accommodate it at most times of the day, only time I discouraged it was about the time we had ward rounds because parents were asked to leave the room and it meant disturbing a time which was special to both Mum and baby.

Small babies esp those who have been sick are often sleepy and a bit like baby dolls close their eyes as soon as laid across to feed at the breast. There is a position you could ask about which is sometimes better for babies who struggle to stay awake where the baby is held under your arm a bit like a rugby ball because the bottom is slightly lower sometimes you can help them stay awake for a little longer to feed

Is the tube going down through her nose or her mouth? if it is in her mouth then ask the next time it come out and needs to be replaced ask for it to be replaced down her nose, this will allow her to get a better latch on and make it more comfortable for you.

Ask about lodging in it may be you cannot stay in every night but you may be able to stay in 1-2 nights a week. We used to give Mums who's babies close to going home an needed time to establish breastfeeding priority but it does depend on how many rooms you have available.

I hope you find some of that helpful and that you see the BF specialistic and get some proper support really soon.

Just wanted to bump this for you and to say congrats on your little girl. Your story has struck a real chord with me. Our Tilly was in IC for six days after she was born and establishing breast feeding was tough but we did it and BFd for 9 months. I wish you all the best.

Thanks for all your help - today is Matilda's first day at home I roomed in for the last two nights at the NNU which has been incredibly helpful in establishing breastfeeding. However, there are a few problems still - She never seems to be full up so she is still being topped up with formula after 1 hour spent on the breast (a max limit suggested by the nurse). Also, my boobs seem to be empty! I thought milk never ran out yet I have just tried to express whilst she is sleeping and have only got off 30ml compared to the 80ml I was getting before.

I am SO confused but will be trying to contact someone from La Leche League tomorrow or find a breastfeeding counsellor. She really loves being on the breast and I did lots of skin to skin which has been lovely! I just wish she could stay awake when feeding. She has now fed without nipple shields but I am still having to use them to get her on and then take them out halfway through. I'm getting in a bit of a pickle with everything but am still hopeful (possibly misplaced!!) I can get things going.

Congratulations on getting her home

What makes you think that she isn't full up? That she continues to suckle? Is she your first? If so, it's not easy to tell when they're feeding, and when they're comfort suckling. DS1 would feed for three or four hours of an evening, then have a longish break from 11pm until 4am ish. I wouldn't worry about having a limit of an hour if you are happy and not sore.

Perhaps you're not expressing as much because you're feeding more directly? Give it a couple of days of expressing and feeding directly, and your supply will increase. There is a bit of a lag.

Hopefully she will be able to latch on without the shields soon. Once you're past the early days, it does get much easier.

Hi MMH,

I'm so glad that you have Matilda home. My DD2 was in intensive care for two weeks and then in hospital for another four, so I feel your pain!

It may well be that your milk is low because you are purely and simply worn out. I experienced that at times. DD2 was on EBM for three/four weeks and then began to latch on much to everyone's amazement, but I know that my supply was always poor compared to what I produced for her sister.

You have been through a very stressful time and it will have taken its toll on your body. Try to rest more if you can and drink LOTS of water.

You're doing a brilliant job.

Patsy

hi there - that all sounds really great to me - the first few weeks with bf are all over the place anyway never mind with the fact she was in scbu. Seriously, don't give up, sounds to me like you have made a massive amount of progress. It is so hard now at this stage becasue you are knackered and can't think straight. All normal. I would just let her feed as and when she likes and maybe start to reduce the formula so she really wants the breast milk? Either way, I think getting a bf councellor to come and visit, or maybe going to see one to get you out of the house (eg at a Baby Cafe or similar) is probably THE best thing you could do at this stage to continue progress. Well done, your story has really made me feel emotional as I have been through bf issues twice now (both of which worked ot fine) and I know how updetting, yet rewarding it can be. Keep us posted.

soory for typing - am bf at the moment!

Congratulations on getting home, She could well be suckling and building up your supply I would repeat the earier poster commemts don't put a limit on it unless it's getting sore and then get some lansinoh (lanolin based cream) on stand by! I have twice got my dd back onto the breast after two lots of bowel surgery and it's a slow time consuming process as supply and demand even out, but be very proud of yourself it's so easy to give up in such a medical environment but so worthwhile. Particularly being unsupported at the start

Good luck and don't give up just ask for more help.

So lovely that you are all at home and she is feeding well

You will find initially she feed alot she is increasing your milk supply. There is a ballance with making sure small babies don't get tired and allowing her to increase your milk supply. Breastfed babies esp the small ones also often have odd pattens of feeding it is not uncommon for them to have 2-3 feeds close together then a bigger gap.

Would not worry too much about not expressing as much now she is feeding go on her behavour and trust your self.