Late feeds making establishing bf difficult?

[stillfrazzled]

DS2 is 2.5 weeks old, born at 35+3 with IUGR weighing 3lbs 5ozs. (have separate thread on SCBU and guilt).

He's still mostly fed by tube, but I'm trying to establish bf, with mixed results. He's on a four-hourly schedule - with the aim of making him more awake and hungrier at feed time.

I've been asked to try every other feed to bf, starting half an hour before the tube feed time.

He doesn't usually take much from me, mostly because he falls asleep on the boob and then it's time for the tube feed.

But the last couple of days I've noticed that he's very often fed late - 45 mins y'day after my bf, 25 mins late today when DH was there.

If he's fed late, and I start half an hour early at the next feed (like tonight), that's only 3 hours between feeds - the time frame I was told wasn't enough to get him hungry or interested in the breast.

I don't want to get shitty with the nurses, who are all lovely, and I know they're busy, but I am getting very upset and stressed about the feeding and feel like mine and DS's efforts might be being undermined by erratic timekeeping.

Would you say anything? If you would, what's the least snotty way of saying it?

Hello lovie,
Hope you are ok, and perhaps a little less stressed.
I had a horrendous time with our prem baby, and was so very confused whilst she was in SCBU. A lot of the MWs contradicted each other, and yes, the timing was a great issue. I remember it well. I ended up in tears so so much, and was so very stressed - something that did not help my milk production at all - but actually caused it to decrease.
Heinsight is a brilliant thing, and if i had known then what i know now, and if i had had the energy/reserves etc i def would have said something, and not have let it get to the point that it did before my husband had serious 'words' with the head honcho!

If i were you, speaking from past experiences, i would most definately say something. Perhaps speak to one of the MWs whom you have grown to like, or ask to speak to someone senior etc... It can't do any harm. If you don't, you may end up like me regretting having not done it. It's entirely up to you.

Please don't lose 'faith' in yourself. The time in SCBU is the hardest thing i have ever had to deal with. I still am suffering, with lots of issues.

I wish i had realised lots of things whilst i was there, but was so numb at the time.

Please feel free to message me if you would like to chat, or cry, or vent off. I am always here.

Let me know how you get on.

Loves, xxxx

I came across this poem today, and it touched me so very much,, although it made me cry and cry. Just wanted to share it with you.

How Preemie Moms Are Chosen
(Adapted from Erma Bombeck)

Did you ever wonder how the mothers of premature babies are chosen? Somehow, I visualize God hovering over Earth, selecting his instruments for propagation with great care and deliberation. As he observes, he instructs his angels to take notes in a giant ledger. "Beth Armstrong, son. Patron Saint, Matthew. Marjorie Forrest, daughter. Patron Saint, Celia. Carrie Rutledge, twins. Patron Saint ... give her Gerard. He's used to profanity." Finally, he passes a name to an angel and smiles. "Give her a preemie."

The angel is curious. "Why this one, God? She's so happy."

"Exactly," smiles God. "Could I give a premature baby a mother who knows no laughter? That would be cruel."

"But does she have the patience?" asks the angel.

"I don't want her to have too much patience, or she'll drown in a sea of self-pity and despair. Once the shock and resentment wear off, she'll handle it. I watched her today. She has that sense of self and independence so rare and so necessary in a mother. You see, the child I'm going to give her has a world of its own. She has to make it live in her world, and that's not going to be easy."

"But Lord, I don't think she even believes in you."

God smiles. "No matter, I can fix that. This one is perfect. She has just the right amount of selfishness."

The angel gasps, "Selfishness?! Is that a virtue?"

God nods. "If she can't separate herself from the child occasionally, she will never survive. Yes, here is a woman whom I will bless with a child less than perfect. She doesn't know it yet, but she is to be envied. She will never take for granted a spoken word. She will never consider a step ordinary. When her child says 'mama' for the first time, she will be witness to a miracle and know it. I will permit her to see clearly the things I see ? ignorance, cruelty, prejudice ? and allow her to rise above them. She will never be alone. I will be at her side every minute of every day of her life because she is doing my work as surely as she is here by my side."

"And what about her Patron Saint?" asks the angel, his pen poised in the air. God smiles.

"A mirror will suffice."

Hi stillfrazzled
I'm far from an expert but wanted to post to try and help.

I don't think it does any harm to mention it to the nurses. Maybe say that you are concerned BFing not going as well as you'd like, and ask if they think he might not be hungry. I think that way you get to mention the late feeds but without sounding confrontational or accessing anybody of anything.

For what it's worth, I'm not sure it's the case that he's not hungry. I know all babies are different, but my DD was over 4lb before she was put on four hourly feeds.

I do so understand the desire to 'achieve' bf. But if your wee lad is that sleepy, would it maybe be better to just have him out for a cuddle, kangaroo care etc then tube feed him? The nurses ought to be able to chat this through with you. But I know that often it's hard to get a chance to discuss etc because they seem so busy.

What if you just gave him tube feeds for a couple of days? Give him a chance to rest up and see what that does to his weight gain etc?
Honestly, when he's ready to have the tube removed it will be so obvious, and I don't think you'll delay his coming home by having a couple of days off.

At some point as well, once he's a bit more awake, you might want to give thought to giving bottles of EBM, getting him home that way abd then establishing bf. That's still a wee bit away but is what I did with my DD. My personal opinion is that the hospital is a really hard place to establish bf.

Sorry if this is no help. Or isn't what you want to hear?
I know how important every day seems when baby is on SCBU. I was so desperate for DD to start feeding independently. Every day that her tube was in felt like an eternity. But suddenly one day she was ready (to take bottles in her case, she took an extra few weeks to 'get' how to bf).

I felt like it would never happen for us, but it did. And it will happen for you too, your DS will get home and it will be you on MN giving advice to another prem mum.

Lots of hugs. You will get through this and you are doing so well.

xxx

I've posted on your other thread but just wanted to second what Iwanttoeatcake said. I remember so well the panic and stress as DS2 got closer to his due date - everyone told us to expect to be discharged around that time - and he still wasn't breastfeeding.

Every time we tried I could feel myself get stiff and anxious. A nurse told me we'd be able to get it going at home but I didn't believe her. Eventually I decided to express and bottle feed - I even ordered a book by a woman who'd expressed for a year.

All it took was our home environment, a relaxed mum and a relaxed baby. I really feel for you. I always felt everyone had an opinion and kept telling me different things. But once I decided to go along with DS2 rather than force the pace everything fell into place.

I'd definately suggest you say something rather than let yourself get over stressed. There's nothing wrong with finishing your bf and asking if they could set up the tubefeed so that you could hold it up for them. You don't need to feel bad but i suppose if it made you feel better you could even tell a white lie that you're wanting to go get a drink but would like to tube feed before you go. I take it you're not allowed to aspirate or set it up yourself? And you really mustn't be hard on yourself about bf - I think it's really difficult to establish bf in SCBU because of the schedules they set (and then change!) and the surroundings. I found myself going bottles of EBM in hospital and then switching to bf at home. The bottles of EBM were Partly because of the staff insistence of saying he didn't need tube fed anymore and then wanted to know how many mls he was taking - and also because I was sure he'd get more in bottles of ebm than a bf and I'd get him home quicker!

With my 27 weeker the nurses simply decided one day to start giving him bottles of my EBM rather than tubefeed him it. Any time I mentioned bf him it wasn't convenient and a couple of times I had to pull him off the breast because a dr came in to do a ward round and parents had to leave. I did find that snuggling up to him while giving him a bottle of EBM helped my own supply. However, even though he'd been bottle fed for weeks in hosp he did learn to bf reasonably successfully at home and I used that at night though continued to express for the majority of daytime feeds for 9 months.

On the other hand my experience with a 3lb 33 weeker early last year (in a different hospital!) was that I didn't give myself a hard time with bf but rather expressed while he was in hosp and gave him the EBM by bottle - so that we could get his weight up as quickly as possible and get him home- and then went to exclusive bf once we got home. Even with a tongue tie he's managed to bf fine at home for a year.

Everyone's different but I definately think the best option for us both times was to establish feeding as quickly as possible albeit with bottles of EBM so that we could get his weight up as quickly as possible and get home to surroundings that were more suited to bf.

Hope all the tubes/lines get removed soon and that you'll be taking him home very soon.

Well done you for starting to breastfeed your little one :) I echo what everyone else has said about definitely saying something to the staff if the situation is stressful (who cares if you sound snotty - just say what you need to!) also that BF'ing is easier to get going 'properly' once you're home - but remember that every little bit now helps.

My DS was 34 weeks & the staff at our NICU had him on a 3 hr feeding schedule which he's still on now at home (sort of!). Not sure what your DS is getting through the tube but breastmilk gets digested quickly so once you're exclusively breastfeeding going 4 hours (in my experience) could be a bit of a stretch for him, esp. because he's a premie. Try not to worry about 10 or 15 mins here or there...although the SCBU revolves around measurements, timing, statistics , details etc. what kept me sane in the early days of BF'ing at home was trusting that it worked & going with the flow.

He's falling asleep on the boob because BF'ing is very hard work for these little guys. It used to worry me too and I tried all kinds of things to keep him awake - in the end we just needed patience and perseverance. As your DS gets bigger & stronger he will take more from you. The best advice I was given was to relax & stick with it - both of which are easier once you're home, which you will be soon. Good luck.