Premature Newborn - Feeding Problems

[DottieDolittle1986]

Hi all,
Ok, so baby boy was born 8 days ago now. He was born at 35 weeks and weighed 5lbs 9oz.
He was Jaundiced enough to go on light therapy and after 2 days, levels have dropped enough below treatment line for him to come off.

The worrying part is that baby boy is not rooting for feeds, and does not have the sucking reflex. NG tube in situ currently.
SALT visited today and said that he should be showing cues and sucking by now, so they are going to be running further tests.
Usually sucks 2 or 3 times and then gives up and falls asleep. He is so sleepy and doesn’t cry very often. Worried sick, and wondering if anyone was in the same position where the issue rectified itself?
Thanks in advance

Hello Dottie I would ask @MNHQ to move this over to the Premature Birth Section as feeding can be completely different from a full-term baby.

I hope you get someone along soon with experience

Mine was tube fed to start with (31 weeks prem) But when I tried, I couldn't breast feed her even though I tried. She just would fall asleep and not get enough milk in her. I was expressing with a machine borrowed from the hospital and freezing it for the hospital to feed her in the tube, and then went onto bottle feeding a prem baby formula along side breast milk.
I hope they find out what's going on and your baby starts to thrive soon. It's a scary time with prem babies

Congratulations on your new baby!
I had a 35 weeker, a bit smaller than your son. She was jaundiced at birth and started out with a feeding tube due to no suck reflex. She developed the reflex within a few days but remained VERY sleepy for the first few weeks and had to be woken for feeds. I also learned lots of tricks to stop her from falling asleep such as tickling her feet and changing her nappy halfway through a feed.

I'm a bit confused by your post - does he suck and then fall asleep, or not suck at all? If the former then that's very similar to dd. I would try to feed her then she would fall back to sleep so she had to be topped up via the tube. As the days went by she was able to feed for longer and longer periods. She was however a sleepy baby for the first month or so and often had to be woken for feeds.

I also expressed milk to start with to be given via tube and also to build up my supply. Are you hoping to breastfeed?

Hi, thanks for your reply, that's really reassuring. How long did it take for your little one to start sucking some more and taking the whole feed?

He sucks around 2-3 times and then falls asleep as he gets tired.

The SALT lady also mentioned potentially developmental delays, did they mention any of that with you?

Thanks :)

I can't remember exactly how long it all took, my dd is now 8 so it's all a long time in the past. We were discharged home when she was about 8 days old so I guess she must have been feeding reasonably well by then. However when we were discharged I still needed to give her expressed milk in a bottle to top up her feeds, I also needed to wake her for feeds every 3 hours (she rarely woke by herself at that point) and make sure she didn't go to sleep too soon during the feed.

I was told that premature girls often cope better than boys so your ds may just need a little longer than dd did.

35 weeks is regarded as a healthy gestation and I was told that the chances of long term issues are low. Do they have any other reasons to suspect there may be developmental delays? premature babies do tend to develop according to their adjusted age, so you would expect your ds to smile, roll over etc about a month late. Age 8 dd is a completely healthy bright child so this doesn't mean there will be long term problems.

Although it was a long time ago I remember the stress and worry of having a premature baby very clearly so for you.

Really feel for you OP, my little boy was born in September, at just turned 36weeks- he looked good to start with but was also just a very sleepy little think and developed jaundice. He also lost 13% of his body weight.

I don't have experience of an NG but I'm assuming you can get nutrients directly into his little tummy( and try to feed on top of this?)

The good news my little baba he's now a very busy, happy 6 month old, meeting all his milestones- but in the beginning he'd have honestly slept 24 hours a day if I'd let him- it took weeks for him to really wake up and like your little one, he would suck a few times feebly and then just nod off again- it was so disheartening.

I was on a feeding plan to get him nourished and strong- the stronger they are, the more they are able to feed, and the reflex took a while to really kick in- so every time we fed it was initially offer breast and then top up with a bottle of expressed milk- no less than 3'hourly- and like other posters, we would gently blow on his face, tickle him, nappy change etc, to rouse him. A cooler baby is more likely to feed too, too hot =sleepy. We were struggling and had a few days of formula top ups too, to held add more weight- so he'd get a full 3 courses at every meal. He's now EBF and feeds like a champ but it took time.

It's a really hard time but stick in there. Just help build baby up, stuff them and, if you want to breast feed, keep offering the breast with every feed, and do skin to skin as much as you can. I'm hoping that the lady you mention is thinking worst case scenario re development- the suck/swallow reflex is the last one to kick in and generally doesn't appear til 36/37 weeks so not sure why she's mentioning developmental delays- your experience sounds very similar to mine.

Lots of hugs x

This time is hard, but

I had a 34 weeker who was like this. It lasted a few weeks of needing tube then bottle top ups after breastfeeds and I had to set an alarm to wake her up every 2 hours to feed. By her due date she was feeding normally. She’s 5 now with no developmental delays - as bright as a button!

My eldest was born at 38 weeks and was exactly as you describe - would feed for 5-10 seconds then fall asleep. He lost 15% of his birth weight in the first 5 days and they wouldn't let us leave hospital until it stabilised (took weeks to get back to birth weight). He slowly started to take more and more & start to thrive. He's now the tallest in his class!

My 24-weeker had an NG tube until he was just past term. He has some developmental delays, but I think it's quite early for the SALT to be specific about this.

Try not to worry, I know how hard it can be. He'll be getting good care there with people who are used to helping premature babies.

Awww, thank you all for your reassuring kind words. I really appreciate it. I will keep you all posted with his progress.
Sorry if I've not posted in the right place etc, I am very new to this!

I hope you had a good night. Is your partner able to visit the hospital?

Hello!

I had a 34 weeker and I remember the nurses in NICU telling me 35 weeks is like “holiday week” for a lot of their prems... the babies just want to sleep at that age. Especially boys!

I think we didn’t get feeding going properly till about 37 weeks, till then it was attempted BF and tube feed top up. Even after that it was hard to keep her awake enough. It’s a tricky balance to keep them hngry enough to want to BF, but on the other hand of course you don’t want to reduce their food intake.

Have you had advice on how to wake him up and keep him awake? Strip down to vest... tickle feet... kiss your teeth (the noise of this really seems to wake them up!)... blow on their ear.

The sucking reflex kicks in usually around 36 weeks. I had 33 week triplets and the 2 boys took quite a while to get the hang of it and there was a technique to get them to suck which scbu will show you. Mine are strapping 21 year old now.

Friend's DTs were 35 weekers. Definitely needed tube feeds for a while to get enough in.

I forgot about the waking up to feed. The 2am alarm clock going off was quite difficult, but obviously essential. For me this was all 21 years ago, but a lot of it I still remember like it was yesterday. Hope you've had a better night with your baby.

Oh yes the 3am feed (and pump!!). I used to reward myself with chocolate hobnobs.

I have treated myself to WAY too many chocolate hobnobs lately! Any excuse though, hey!

My premature baby (31 weeks) was born a long time ago but what you are describing is exactly like she was. She was just too weak I guess to feed for long enough. She had a NGT and was also bottle fed expressed milk.
But in the end, around 4-5 weeks in she had a blood transfusion and things picked up very quickly from there ... she was home in a week and never looked back. She's now 25

I had a 35 weeker too, she had 5 days phototherapy but it took about 3 weeks before she started waking up willingly and rooting for feeds. She was tube and bottle fed expressed milk until then. One day she just kind of woke up.

The constant cycle of waking and expressing is exhausting so be super kind to yourself.

My son was born at 33+5 and to cut along story short came home after 3.5/4 weeks with ng tube I was a mess thinking he’d never learn and literally after about 4 days started to be able to take all feeds by himself it just clicked Salt helped massively with showing us paced feeding and sideline feeding I think it was called he was also given a prem dummy in nicu to help him learn how to suck try not to panic it’s still really early days it’s soo hard at the beginning but it does usually just click one day wish you and your lo all the best

I had 34 week born twins and remember the time in NICU well. They were tube fed with a dummy in their mouth to essentially reach them to suck whilst feeding. They both took to BF’ing really well and they weren’t on the tubes for long... but the tickling of the feet to keep them awake was also advised to me and I pumped in hospital every time they slept to get a supply going and use it for their tubes. I’m sure your little one will get there!

Sorry if I've not posted in the right place etc, I am very new to this

I was just worried that you wouldn't get any replies. So glad you've had some