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Infant feeding

Get advice and support with infant feeding from other users here.

Original poster

tiktok, bfing gurus, bfers, interested parties of all creed and colour... heyulp! bfing a preemie baby... top tips please

356 replies

Aitch · 12/09/2008 15:46

don't know where to start, really...

dd is two weeks old today (blimey) and put on her birthweight on wednesday so that's great. however of course she didn't start putting on weight until her formula top-ups, topping up with ebm didn't do the trick.

her weight gain today was only 30g (last few times has been double that or more) and i do put that down to the fact that i've been pumping more and therefore have been giving her more ebm top-ups than formula.

question is... what's the tipping point? she is gaining, i am producing more milk (not heaps, but volume-wise we are on target for the SCBU calculations). we were told to give dd 280mls per day in top-ups as well as bf, but with the formula it's been more like 350ml.

so do i accept the 'slow' weight gain and think of dd's longer-term benefits having protected my supply, or do i want her on formula but with more energy to feed, iyswim?

midwife has suggested one top-up of formula, and at the next topping-up with ebm, this seems like a reasonable compromise to me, but am i missing something.

OP posts:
expatinscotland · 12/09/2008 21:12

and lapin needs to change her name to 'iwanttobuyafuglyjumper'

Original poster
Aitch · 12/09/2008 21:13

yep, have been doing breast compression. my tits feel like they've been in a mangle. i'm now thinking that i'm actually getting some pretty piss poor advice from the medical professionals here.

OP posts:
StillGotNoDyson · 12/09/2008 21:14

Me? Nah.....

StillGotNoDyson · 12/09/2008 21:17

Aitch - I'm that you are surprised re HCP advice....I thought we all knew to take them with a pinch of salt and come on MN to find out the real story...!

Will email you....

KashaSarrasin · 12/09/2008 21:18

Aitch congaratulations on getting your DD out of the scbu so quickly! I also think the 15min limit sounds like bollocks - DS2 was in scbu for 5 weeks and I was encouraged to feed him for as long as it took - somrtimes he'd go 40 mins, sometimes just 5. We were topping up with EBM via a ngt to start with then with a cup for his overnight feeds. He never had a bottle.

DS2 was on fortifier for about a week and given the choice I'd definitely go for that rather than formula. It's a powder made up of hydrolised milk proteins (so in theory ok in trems of allergies) and vitamins that you mix with EBM. Tiktok probably knows more about it than me. I remember reading somewhere that an alternative is to skim the fattiest layer off some ebm and to top up with that - I guess you need a fair amount of ebm to do that.

Sorry for typos, typing with 1 hand while feeding DS2... HTH anyway.

traceybath · 12/09/2008 21:18

Yeap breast compression was a little uncomfortable!

I was v glad that my poorly DS was my second or am sure i'd have been persuaded into total formula. Although to be fair the Paeds Consultant did a little dance (i kid you not) when i said i was bf.

Not sure what the etiquette is on talking about other forums but ivillage had a pretty helpful bf support board which i used at the time. I got massively engorged with all the pumping and got so much different advice from midwifes about how to handle it.

KashaSarrasin · 12/09/2008 21:19

kellymom forums are useful too.

Bumperlicious · 12/09/2008 21:24

Hope you are doing ok Aitch. I think you are doing a marvellous job. After struggling so badly with DD1, then to be faced with all this, you are a tenacious little lot you Aitches and little aitches!

Hangingbellyofbabylon · 12/09/2008 21:27

My dd was a 35 weeker and was tube fed for a week. My top tip and what got me out of hospital (she had to get back up to birth weight) was to basically put her on the breast all the time - she opened her mouth to vaguely cry and on she went! sometimes she was feeding every 15 mins, sometimes just hanging out at the breast. I understand the concern about tiredness - but it was really in the very first days of breastfeeding, she would breastfeed then the next one be too tired and have to be tube-fed but as she got better at it she built up stamina quickly. I agree with tiktok that the 15 mins thing sounds like a number they have chosen as an average and that sometimes your baby could feed for more. Whilst breastfeeding for a preemie can be tiring, it is also incredibly comforting and I think the best place for a wee one to 'hang out' is at the breast. I don't think they need to be actively sucking but being tucked in next to a nice warm breast skin to skin is the next best thing to being back in the womb. I would most definatively recommend the stuff a breast in mouth at any opportunity method - it worked for me and the little beast is still feeding 2.5 years later. Hang in there, it sounds like you're doing an amazing job.

BeachBunni · 12/09/2008 22:56

Speak to the hospital about fortifier because as kasha says it's better than formula, esp if you want to carry on bf. Ds had the same thing as your dd and was under 3lb when born and fortifier seemed to add the weight on.
I found expressing a nightmare, honestly it would take me about an hour if not more - and then I had to feed him. Bf is a totally different thing which we never got the hang of but wish I could. That's life.

Original poster
Aitch · 12/09/2008 23:01

have just emailed my obs consultant and head of hosp to complain vividly about not having been offered this fortifier...

OP posts:
SparklyGothKat · 12/09/2008 23:25

aitch, just so you know some hospital will only give in-patients fortifiers, I asked for Callum and was told that the hospital and doctors couldn't give it to me as he had been discharged

Original poster
Aitch · 12/09/2008 23:28

ah right. well they certainly never offered it to me when i was in. i asked them about tpn when i was in recovery, annoying paed was just making up reasons to give dd formula. i thought of you...

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Habbibu · 12/09/2008 23:32

Would Yorkhill be any more use, Aitch? Would a referral to a paed there help, do you think? Don't know much about their baby care, it's just the specialist paed element I was thinking about.

Original poster
Aitch · 12/09/2008 23:37

i'm going to speak to the midwife about it on mon, habs. she's from yorkhill, obv the community care just comes from the nearest hospital. but i want to kick the arse of the prm a bit if they should have given me that option and didn't. i do think they're good, though, but it's been interesting seeing how casual the paeds are with other people's bfing. they're paying lip service, but it's like dealing with the actual physiology is your problem alone and nothing to do with their job caring for your child.

OP posts:
Habbibu · 12/09/2008 23:41

I think that if you get great care from one area of a hosp (e.g. your obs), you kind of expect it from the rest, and it's enormously disappointing if it doesn't happen. The paed reaction seems daft, given that they know that bf is good for the child. Not what you need at all, after everything. Hope mw is good.

tiktok · 12/09/2008 23:48

The no-fortifier-outside-hospital thing will be - I feel sure - a red herring. You will need to get it on scrip, I expect, and have someone explain how to use it.

www.ich.ucl.ac.uk/clinical_information/clinical_guidelines/cpg_guideline_00040/ is something I found which might help.

It is formula, though, and don't let anyone tell you it isn't! It certainly is not made from human milk (though I have met healthcare professionals who thought it was....)

Original poster
Aitch · 12/09/2008 23:54

lol, that's exactly the link i just sent to the divine obs, tiktok.

so did you hear about what happened to me, tiktok, wrt to the 'what is formula made of' question? you will shake your head.

OP posts:
Original poster
Aitch · 12/09/2008 23:56

afaic, it seems to me that the only reason they should be advising formula is if they had worries about hydration, but they never have. so i want to up the punch of my ebm, and allowing dd to stimulate supply.

OP posts:
StillGotNoDyson · 13/09/2008 08:42

oh tell me that story please!

chipmonkey · 13/09/2008 09:28

Aitch, ds3 was born at 32 weeks and I found our SCBU less than helpful when it came to bf. I got a lot of the "We can't see what he's getting" malarkey. I'm in Ireland and the staff were a mix of Irish and Asian. That shouldn't be relevant but Ireland has a very poor bfing record compared to most other countries, only about 41% of mothers initiate bfing.
Well the Irish staff were all about topping up after every feed, even though I could see that ds3 was latched on correctly and he just was not interested in the bottle once he had been on the breast for 15 min. I actually used to tell lies and tell them he had taken a 25ml top up when he had only taken 10ml.
But a filipino nurse and an Indian nurse were that I was topping up after a 15 min feed so I got the impression that it was just an Irish thing.
When it was time to go home, the Pakistani Paediatrician said to go home and breastfeed, the Irish nurse said go home and bf but top up after every feed.
So I went home and bfed! Ds3 gained very well by feeding on demand with no top-ups. Tbh, I was so exhausted anyway that operating the steriliser and the breast pump seemed like an awful faff.
Ds3 did get fortifier in hospital which, had I known what it was I would have refused because ds1 and ds2 had issues with cows milk but I later did some research and found that apparently there is evidence that babies who are given fortifier do better than those just given EBM but didn't go into the research in too much detail as this was months after he was born so no longer relevant to me.

bronze · 13/09/2008 09:59

Chipmonkey. Glad I'm not the only one to tell lies.

Aitch I'm glad you're sounding strong enough to stand up and fight.
I can't imagine what its like being a first time mum with all the stress on top trying to do the right thing. Maybe us mums with subsequent babies need to start saying more so that the others don't suffer.
I used to say that SCBU staff had small power trips from being able to dictate.

mspotatochip · 13/09/2008 11:00

aitch my dd was induced at 34.5 weeks for pre eclampsia and was 4 pound 2 at birth. I was lucky she didn't need SCBU just a warmed cot and I had a very energetically pro breast feeding midwife with me constantly for the first while (I think it was me they were worried about not dd bp didn't settle and had dural tap).

She encouraged us to take clothes off her, tickle her anything to get her to stay awake to feed. i don't remember a 15 minute limit but I was pretty zonked all i had focus for was holding her and feeding her everything else just went over my head.

Anyway dd latched on from birth but no-one really believed me. They cup fed her aptamil top ups and we were encouraged to do so. I am a bit stubborn and just kept putting her to the breast and filling any old anything in on their stupid forms re top ups.

Literally every time she was awake she was offered boob. She regained birthweight in 2/3 days and has never looked back apart from a spot of jaundice. We were in for ten days my issues not hers!

I think you are doing brilliantly obviously taking on board hcps concerns and considering their advice but also following your instincts!!

mspotatochip · 13/09/2008 11:03

chipmonkey your post is v interesting I'm Irish but live in UK. My family were horrified that I BF, couldn't belive that I continued for 7 months (and would have longer) and my aunts are all nurses!!! Ireland has a long way to come on bf

Original poster
Aitch · 13/09/2008 12:06

heard back from my obs, he's given me the email of the paed consult... i'm on the case.

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