Breastfeeding in NICU

[Dotty08]

Hey mums
So my baby was born premature at 35 weeks and with a congenital heart defect.
He’s doing well, much better than consultants thought he would antenatally but is waiting for an op and needs to pile on the pounds in the meantime.

He’s been tube fed breast milk from as soon as he could. He’s now two weeks old.
He wants to breast feed, and so do I. He latches well but then seems to get very tired. He’s up to around 15 mins on the breast - but with some long pauses and he can only seem to do this once a day. Then the rest of the day he’s really tired and only does a few minutes on the boob.
I’m just looking for some advice as I’m really struggling. I’m in Ronald McDonald house and so so grateful for this but it’s still a good ten minute walk from the house to nicu. He’s on three hourly feeds so through the night I find this hard constantly walking back and forth and by the time I get back it’s time to go again as after the feed I’m topping him up with a tube feed, settling him etc and then I need to pump because I’m still quite full of milk. I’d really love to do this for him but just can’t see how I can sustain this. Im so so tired and sometimes feels the nurses in nicu expect too much. Im still recovering from an emergency section and surviving on no sleep.
Any advice would be so helpful.

Can you ask the nurses to do the tube feeds through the night, and just breastfeed during the day and only pump at night? You need to rest and recover too, or you will be no good to him. Tell the nurses you are exhausted and burnt out and some help. They are there to do his care and if you were not breastfeeding they would not expect to go in and formula feed through the night.

Congratulations on the birth of your baby! My DD is 16weeks old now and was in NICU/SCBU for two weeks and i felt exactly the same as you. The nurses were amazing with my LO but i felt under a lot of pressure with regards to BF. A few thoughts:

1. i think 15mins feeding is amazing! My LO was born at 38w and was in neonatal due to sepsis but could only ever manage 7/8mins at a time and had a very weak suck. She didnt improve until we'd got home really.

2. Walking to and from RM house does sound exhausting and you are amazing for doing it so far. Are there any closer beds that you could use even if just for one night to get some rest? Our unit had a room with 3 camp beds in next to the SCBU for parents to use. This might help you catch up as you get more rest between feeds.

3. Could you build up some expressed supply for baby to have one night? Then you can still wake every 3hrs to pump to keep building your supply but take it all over in the morning and use that night to catch up on sleep.

4. We agreed for DD to have donor milk to supplement as well so i that i could recover - i had a vaginal birth but a very severe UTI a couple of days after delivery and the midwives weren't happy with the amount of walking i was doing to and from the neonatal unit.

5. Is there a particularly friendly nurse you could confide in? I had a bit of a breakdown at 5days post partum in the middle of the night with one really lovely nurse looking after our DD. She spent time chatting to me and really helped put everything in perspective. I think they are so focused on the baby, they may have not realised how you are feeling and they may also have some ideas.

Good luck. It is emotionally exhausting having a neonatal baby as well as physically exhausting recovering from birth. You are doing a brilliant job!

I wanted to tell you that it gets better. I have been in your situation and it’s hard. Really, really hard, I’ll never forget the tiredness which was on another level. All mums with a two week old are tired but your situation ( physically and emotionally) will magnify it all. But you sound amazing, and don’t ever forget that. You should be so proud and your baby is very lucky to have such a devoted mum.

You need to recover from the birth too and process all the emotional aspects of it all and at 2 weeks you are just at the start. Can you sleep in the day at all?

When I was in with my son the nurses were fantastic, could you have a chat with them and see what they suggest? I bet they see it all the time and might have some suggestions.

I’m up feeding my fourth baby now, ( 6 weeks) and while tiring is nothing compared to when I was in hospital with my elder son after his birth. I wish I known that instead of ‘beating myself up’ about how I felt.

I want to send you the biggest of hugs and the promise of easier days to come xx

I also wanted to add we are combi feeding. Our LO wasn't allowed to leave SCBU until she had gained weight for two days. She just kept dropping and dropping. I was so stressed. In the end it was making me ill and so we agreed to introduce 1oz of formula top up after each feed. The difference in her was amazing! She got home, we got settled and with her gaining weight, other things started to click into place.

We had a bit of a wobble later on (losing weight again and reflux), so we upped the top ups to 2oz and now she is thriving.

I was (unreasonably) devastated at having to introduce formula - i think BF was the only element i had in my control at such a stressful time. But an amazing nurse helped me to process that there was no shame in supplementing if it worked best for her. It also meant my husband could take over and do the bottle feed after I was finished BFing so i could get an extra 20mins sleep. This might not be something you are considering but wanted to put it out there in case.

Honestly OP, in your position, I'd have a mad day of pumping, then just stay at the house overnight and get up once or twice to pump there and let the nurses do the overnight feeds. Is this possible for you, that's what I did.

It sounds very very hard on you. I was at least going home on an evening, which was hard in another way but at least meant I did get some deep sleep.

Wishing you and your baby all the best

Thanks lovely ladies for all your help and support I feel lots better after reading your responses.
I have been expressing for his tube feeds all my trays in the nicu fridge and freezer are totally full so they can tube feed him there’s more than enough milk but whenever I ask them to do tube feeds in the night they say ‘oh but he’s doing so well on the breast we think you should establish breast feeding you’re only over the road’ it makes me feel guilty but I’m killing my self trying to do this. I do want to breast feed him so much and I do appreciate I’m over the road but that’s very different from him being with me at home. He’s also getting very tired when he breast feeds, they insist when he feeds on either not giving him a tube feed at all or just giving him half of what he would normally have but I think when he feeds that should just be like some bonus calories for him because he works so hard. Any thoughts?

That is different from the experience we had in NICU.

They were VERY keen to let him rest at night and bank up the calories because that would mean he had more strength during the day when we were there and also that he would put on weight quicker, making him stronger and therefore more able to BF and more likely that he would be home quicker.

In fact, when he was really tired, they sort of pushed for him to be tube fed so that he could sleep. It's a LOT of work for prem babies!

It's really hard to do, but unthinkingly need to advocate for yourself and tell that what you intend to do. Do you plan on breastfeeding full time at home, or will you express so your partner can do some feeds too? I did and it worked wonderfully for us for months.

I feel for you, they should be supporting you, not telling you what to do when it's clearly pushing you to the point of total exhaustion. Not cool.

How are you doing @Dotty08 ?