Any advice for SIL with prem baby

[Bobsmum]

My SIL has just had a beautiful baby boy 5 weeks early (5lb 14oz). She's very keen to bf. As her ds has had a few problems with his blood sugar level, she's been told he needs to be formula fed as her colostrum is not enough. Is this true?
She's coming home tomorrow and has only been allowed to try to bf twice so far. She's really hoping to keep giving bf another shot. Her ds is now 5 days old and a sleepy c-section baby. Any advice I could pass on?

my was term but still only 5lb 14oz, and he was taken to SCBU - they never said for me not to BF, even though he had similar?? If I was her I would keep expressing, even if she throws it away while in hospital to keep her milk up and then try again once he's home?

Your sil should have been given a breast pump to take home to express milk and establish a milk supply. Her ds may need top-up with formula until she is producing enough milk for him. At 5 days she should start to see more milk coming through rather han colostrum.
She should be encouraged to breast feed him if he is now sucking. At our unit babies are cupfed when their mothers are planning to B/F and the baby has not got the hang of it. He should either be tube fed or cup fed, but not given a teat. I presume he is not ready to go home yet.
My third ds was 5 weeks early and ventilated for a week. Once he figured out what to do on the breast he fed very well.
I did not go home until my baby was ready and I spent the time visiting him or expressing. I sent the extra milk home for the freezer. Does your sil want to go home?

sil is desperate to go home. Her ds is going tomorrow too.
He's been feeding using a teat - it looks like an orthodontic shaped one rather than a "normal" one if that makes sense.
The couple of times she's tried feeding, her ds has not latched on, but he can take a bottle apparently.

My advice would be to get a breast feeding counsellor to help. It is absolutely ridiculous that this has happened to your sil. The baby should never have been established feeding with a teat when her intention had been to breast feed. It can be turned around, but support will need to be given. Perhaps the community midwife will be able to give advice and support. Basically, your sil should be expressing regularly - probably 3 hourly if the baby is not B/F. She should also be offering the breast at every feed. Has she made it clear that she wants to breastfeed? It is possible to get breast feeding established but I would advise avoiding giving teat feeds but cupfeeds instead.
This is when I get absolutely mad - your sil has been ill advised and has obviously not been given support to breastfeed. It is appalling infact!

Mears is absolutely right ! Get help !

Bobsmum, the exact same happend to me - dd 5 weeks early, then they did blood sugars and gave her a bottle. I just gave up trying to bf -so desperate to get away from midwives ramming her (screaming!) head at my boobs. I SO SO wish I had stayed in hospital and got help from a bf counsellor. Or contacted one once I got home. I just thought I was a crap mother who couldn't "do it" and gave up trying. I will always regret not trying - please tell your SIL to ask for help.

Just as an update. Unsurprisingly, based on the rather dodgy and outdated advice my SIL was given, her ds is now completely bottle fed. He came home at 2 weeks and is well.
However, a friend of my MIL trains b/f counsellors in the region and has just learned about what my SIL was told on the ward.
She was so shocked (and agreed with everything mears said btw) that she is planning on making several unannounced inspection visits to the hospital just to see what's really going on.

Could your SIL bring herself to write a letter to the head of midwifery, Bobsmum? She needs to stress she was planning to bf and was v keen to do so. The poor practice in SCBU needs addressing - it is no surprise at all she is now formula feeding. However, she could relactate - with support and good info and a co-operative baby, it can happen. It is by no means too late.

Thanks toktok - that's very encouraging. Who would she go to for support? NCT? LLL? She's in Birkenhead.

sorry - TIKtok!

www.nctpregnancyandbabycare.com/nearest_branch_7.asp

hi there
sleeping babe on lapso lowercasse

above web site for nct local contacts

will do lll next

bf counsellors are fab

www.lalecheleague.org/WebIndex.html

lll localctcs above

british bit unfortunately temporarily not working

good luck

aee also association of breastfeeding mothers pages

home.clara.net/abm/pages/index.html

but if in doubt your hv/gp should have local ctcs

Bobsmum - so sorry to hear of your SIL's hard time. I had to be adamant that my dd was not to be routinely bottlefed when she was born 9 weeks prem. It took 6 weeks to establish bf. During that time whe was also tube fed. They bottle fed her expressed milk overnight and wanted to bottle feed her during the day when she wasn't gaining weight but I insisted that they tube fed her as I had been told about the potential problems if she was bottle fed. I had a very easy birth so had the energy to fight my corner, but it shouldn't have been necessary.

I'm sure NCT will help. If your SIL has any difficulty getting help in your area and wishes to pursue the matter, do post again.

Just wanted to add my support and hope your SIL gets the support she needs if she wants to re-establish breastfeedin.

DD wasn't premature but was admitted back into hospital at 3 week, weighing in 2 pounds lighter then when she was born.

Like Jude I insisted on a tube, and I also only let her get food through the tube when I was breastfeeding. She was too weak for ages to actually suck for herself, but the idea was to associate a full tummy with mummy. Once the tube was in I was shown how to check the tube was still in the stomack and then I was just left to give her the food in the tube myself. It took about 5 weeks in total until DD was getting all she needed from me.

Perhaps your SIL could ask for a tube, that way the medical staff wouldn't be able to tell her that bottle feeding had to continue for sustanance as the babe would still be receiving nutrition.

Best of luck to you SIL!!

Thought i'd update after feeling guilty about not acknowledging (cf not saying thanks thread).

SIL never did re-establish bf in the end. Having spoken to her since I get the impression that she was never genuinely that interested anyway....

Nephew's weight gain seems to be immense, he's doesn't register on the centile chart (for his age - not taking prematurity into account) MIL says she's been overfeeding him. SIL started him on solids at 9 weeks. He'll be 3 months old in a couple of weeks.

Needless to say I'm a bit disappointed that SIL has gone from apparently very keen bf to overfeeding to weaning very early. She's never been one to actually listen to advice, so I feel a bit daft now for getting all concerned on her behalf when she was never going to take on board anything I said anyway. Rant over

Thought i'd update after feeling guilty about not acknowledging (cf not saying thanks thread).

SIL never did re-establish bf in the end. Having spoken to her since I get the impression that she was never genuinely that interested anyway....

Nephew's weight gain seems to be immense, he's doesn't register on the centile chart (for his age - not taking prematurity into account) MIL says she's been overfeeding him. SIL started him on solids at 9 weeks. He'll be 3 months old in a couple of weeks.

Needless to say I'm a bit disappointed that SIL has gone from apparently very keen bf to overfeeding to weaning very early. She's never been one to actually listen to advice, so I feel a bit daft now for getting all concerned on her behalf when she was never going to take on board anything I said anyway. Rant over

Anyway, thanks everyone for all your great suggestions.

See- doubly grateful

Bobsmum - you tried...... she should be grateful..... but you can lead a horse to water but....