Premature baby still not suckling - help!

[Nellynoo182]

My DS was born last week at 34+4 weighing 4.6lbs, he is now 35+ 6.

We are in hospital on a transitional ward and he is being tube fed my expressed breast milk and is now starting to gain weight which is great.

However, I am finding breast feeding really hard as DS is just so sleepy all the time and is finding it really hard to suckle. He doesn’t seem to have the strength to suck any milk out the nipple yet and also needs lots of encouragement to go on the breast. He also only has a few good sucks before he falls asleep. We have started using a nipple shield which has been a massive help in triggering his suckling reflex but any advice or personal experience people could share would be hugely appreciated - I am feeling pretty down and disheartened and like we will never go home at the moment ☹️

Hi there NellyNoo - congratulations on the birth of your baby.

We're so sorry to hear that you're having a worrying time. We've now moved your thread over to our Premature Birth page - hopefully someone here will have some guidance and advice for you. Do give us a nudge if we can do anything to help and very best of luck with everything

Hi @Nellynoo182 and huge congratulations! My ds was born at 33 weeks and was tube fed my expressed milk as well. This was 28 years ago! If I remember correctly, it took a couple of weeks of him being in scbu and tube fed. They actually sent me home as I had other small children and that was the norm then. Anyway, he developed the strength to suckle gradually, and I then stayed in the mum and baby unit for two days so they could observe him feeding. Once they were certain that feeding was established we went home. He never looked back. I breast fed for a year and he's now a strapping six footer!
All the best to you both

Ps he was also a very sleepy baby, I think for about six weeks x

Congratulations, it sounds like you are doing great. I had a similar experience with my baby born earlier this year at 34+5 weighing 5lb. He was so sleepy and didn't latch on at all in the neonatal unit. He was fed EBM by NG tube and as he got more strength he started to use a bottle and I'd put him to the breast each feed. I was offered a flat to stay in on-site but like you, felt like he'd never be discharged and I had other children who needed me at home. We made the decision to leave hospital with him bottle feeding and we cracked breastfeeding at home in our own time and with the help of a nipple shield. He was a very sleepy baby for the first few months but breastfeeding is still going very well for us 8 months on. You'll get there, its just hard work for you and baby and will take time x

Could you express and give via a bottle. Then as he gets stronger you can transition to fully breast feeding at home. This is what my DIL did when she had twins and she successfully fed them for a year. She also used a nipple shield until their mouths were bigger.

Has he been checked for tongue tie?

I decided that bringing our premature son home was more important than establishing breastfeeding, so he came home once he was happy to take a bottle of pumped milk. We continued to try at home but he still preferred the bottle, so DH would bottle-feed him EBM at the same time as me double-pumping for the stockpile. He went onto super-strength prepared milk at around 8m simply for the calorific content.

Congratulations Nelly 🌻. My baby was born at 28 weeks and I experienced the same thing. It’s exhausting for them when they’re so little. My advice is to keep pumping, bottle feeding and having a go.

It took me five months to transition to the breast, but once successful it was the easiest thing and we carried on until almost 36 months (through surgeries and baby being unwell).

My DS was born at 37 weeks and just over 6 pounds, so further on than yours and I found bfeeding a massive struggle due to sleepiness. It took a few weeks to get it going. My DS2 who was born at 40 weeks was completely different and I never realised how much of an impact being born early can have.

Sounds like you are doing an amazing job and it's still early days. Make sure you are taking care of yourself too.

Please ask they check him for tongue tie, this could explain it. And if they say it could take weeks, ask for a private midwife to do it who is a specialist, it’s important it gets dealt with quickly

Hi neonatal nurse here,

It could just be he’s not just quite developmentally ready yet.

I would suggest as much skin-skin as you can, make sure the environment isn’t too bright and noisy.

Is there a speech and language therapist or a neonatal feeding specialist that could come to see you.

When he’s feeding a little more reliably, lots of units have outreach services where you can go home with some breast and some tube feeds, under the care of community neonatal nurses.

He will get there, its just one thing the babies have to do at their own pace.

Congratulations and I hope all goes well,

Hi, yes it's so stressful isn't it. I found that my little one (33+1) did not have the strength for breastfeeding at all. She had a good latch but would only suck three or four times before getting exhausted and falling asleep.

Bottle feeding, however, was so much easier for her. She'd be able to finish a 40 ml bottle just fine by 35 weeks but still couldn't really breastfeed at all. This did mean I was stuck exclusive pumping, which is very hard work, but it also meant we got to go home!

I had a 34-weeker. I ended up bottle feeding her expressed milk as she couldn't get the hang of breast feeding. It wasn't what I wanted but she needed to be doing one or the other before she could be discharged and getting her home was my priority.

I've had 2 preemies both born at 32 weeks - #1 DS was very sleepy & totally disinterested in breast feeding. I think he would have been quite happy to continue with a feeding tube & a pacifier, just leave me alone to sleep please 🙂. My boobs were very milk full too so combined with his 4lb3oz tiny baby mouth it wasnt going to be very successful. But I persevered for the 7 weeks we were in hospital (other health issues too) & then he was changed onto a bottle.

#DS2 was able to suckle a wee bit at 2 weeks old - so 34 weeks gestation - then I just expressed for the next few weeks & he was mainly tube fed until I stayed in for a couple of days again to establish BF then I fed him for about 8mths.

A SCBU nurse did say at some point that many babies dont "get" the ability to suckle until about 36 weeks, so dont beat yourself up about the feeding just yet.
Express & maybe bottle feed the expressed milk until you've both got a bit stronger then quietly offer BF again to your baby. Good luck.
PS, mine are now grown at 35 & 32 respectively

I had a very similar experience. We gave mine a dummy to try and help her to suck and I ended up having to give her bottles of my expressed milk as she kept falling asleep and not really drinking off the boob. We also tried different nipple shields too, but she would take lots of effort to latch on take a few sucks and fall asleep. We decided that the best way to get her home to her siblings was to carry on expressing and give her bottles of milk as this was the best way she was putting on weight. She was using up her calories trying to latch on and we'd go round in circles. I was so relieved when she started to put on weight and we could go home after six long weeks. After exclusively breastfeeding her brothers I actually felt like a failure having to give bottles but it was a huge turning point for me when one of the brilliant nurses gently suggested that I could try breastfeeding at home where I would be less stressed, more relaxed and without lots of doctors and nurses coming in and out to check on progress. My baby continued to drink my milk from a bottle much faster and without as much stress which meant my hubby could give the bottle whilst I sat and expressed building up my stock. I would put her on the boob to try and feed first then when she was getting tired we gave her a top up bottle. This worked for us and continued at home for a few weeks. She also needed some bulking up protein that came in sachets which was easy to add to the bottle of my milk. The hospital lent me a hospital grade pump and by the time I went home I had filled loads of drawers of the freezer with my milk. We got into a routine and eventually she built up her time on the boob and we moved to most feeds being on the boob with the odd feed from her dad with the bottle. You will get there, I know it feels like you're stuck in your own bubble and everyday feels like groundhog day but you will leave hospital and get more normality soon. Congratulations on your new baby and wishing you good luck.

Just wondering how you're both getting on now @Nellynoo182?

@PritiPatelsMaker sorry for the lack of response and updates - it has been a bit crazy! I hope you are okay? Feel free to message me.

Thank you everyone for your advice and sharing your story. I will put mine here in case there is anyone else scrolling.

A couple of days after I posted this my DS just seemed to ‘get’ suckling and breastfeeding. We were in hospital for 4 more days and were discharged with him being exclusively breastfed on demand. The things that that we did to try and encourage suckling we’re:

. him being tube fed on my breast to associate feeling full with being by my boob
. introducing a nipple shield - for me this was the difference between being able to breastfeed and I would really recommend trying one if your little one isn’t suckling, it just seemed to engage the roof of his mouth better than my nipple alone. We’re still using nipple shield now to BF
. lots and lots of skin to skin cuddles
. time - as rubbish as this is I think it was just a case of waiting until he was ready to start suckling, it really just happened one day and then 2 days later we were home

Unfortunately, it hasn’t been super easy since. He still doesn’t suckle great and I have been breastfeeding every 3 hours for over an hour a time. He has still been losing weight so clearly isn’t getting enough from the breast so today we have introduced a bottle of my expressed breast milk. I will keep you updated with if he starts to put on weight now using a bottle. I think he is just too little really and is using as much calories sucking on the breast as the milk he is getting. The bottle seems to be a lot easier for him, so hopefully we will see a gain in a few days. Xxx