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Premature birth

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how do you establish proper breastfeeding with LO in SCBU?

8 replies

thomsonf · 03/05/2008 14:01

Hi

By way of background, I am new to this forum as my second daughter was born at 32+6 last friday, after I developed severe pre-eclampsia out of the blue on the Thursday. She weighed 3lb 2oz at birth and was 2lb 13oz when weighed last night. She is in SCBU and doing okay, spent a little time on ventilator before moving to CPAP for three days and now breathing by herself, just finished treatment for jaundice.

She is being fed EBM by tube but we have started trying to establish BF properly in the last two days and she is showing a real interest and has a decent little suck going! My question is how on earth you establish a real routine of BF when the amount of time I can spend with her in SCBU is limited. I have a two year old daughter at home and although I have help with her, I feel I need to be there for her important times of day (waking in morning and after lunch time nap, going down to bed at night etc) as she has been thrown a little off by mummy going to work one day and ending up in hospital for a week. Also, as I had an ecs I am reliant on friends driving me to the hospital on the days DH is at work. so I can really only be there for two of her daily feeds at the moment.

I know I am probably getting ahead of myself as we are still 3/4 weeks from getting her home but as this is one of the few 'natural' things I feel I can do for her I am thinking ahead and want to have this clear in my mind. Do you have to practically move in as they get closer to coming home? I would really like to hear people's experiences of how they have managed this so thanks in advance for any replies.

fiona

OP posts:
rascal1979 · 03/05/2008 15:00

Hi Thomsonf

I had my DD In Dec 9 weeks early due to HELLP. It is difficult being there for all feeds so establishing BF is difficult but not impossible. My LO came home exclusuvely BF after 9 weeks of expressing.

Right noe you need to express often and try her at the breast every opportunity you get.

When you can't be there the unit shoulf cup feed her rather than use bottles. This helps strengthen the muscles used in bfing.

Once my DD was ableto B I spent about 4 nights rooming in with her to get her fully BFing.

Good luck xx

shreksmissus · 03/05/2008 18:09

Message withdrawn

babyjamas · 03/05/2008 20:48

hi - congratulations on the birth of your daughter.

my dd2 was born 2 years ago at 27 weeks. likeyou i jhad older ones at home - aged 5 and 9 then - so my time at the hosital was limited. As time went on and she was more stable i used to put her to the breast at every feed i was there for - which was easier in the earlier days as her feeds were at specific intervals so i knew when to be there and could arrange things around those times. when it came closer to her coming home and we moved towwards demand feeding it became much more of a challenge with me trying to second guess when she would be ready for a feed. luckily the hospital was great and would call me when she started to look like she was waking up and i would get in if i could. i was never going to be able to spend nights at the hospital - and as she was a shocking cup feeder, she had bottles of ebm during the night, but we dropped these as soon as she came home. i won't pretend it was easy - 11 weeks of expressing (i expressed all the time she was in SCBU) was such hard work and i found it very stressful butit was so worth it. however most people who were in SCBU with us did not leave bf - and it was not the end of the world for them. For me it was one of the only things that i had some control over in a pretty awful time. she is a strapping 2 year old now - full of fun and the light of all our lives - spent this evening annoying her big brother and his friends by trying to climb all over them whilst they watched Dr Who - never thought 2 years ago it would all ever be so 'normal' again!

PTA · 03/05/2008 20:56

Hi there,

Congrats to you and it does get easier! Ds2 was born 10wks early, needed an op and had Down's. Long story short, continue expressing, put your ds to the breast whenever possible and try not to worry!

Ds2 was in hospital for 9wks and I only roomed in for two nights before getting him home. The staff just wanted to make sure that he would take every feed at the breast as he had also been taking bottles.

bruhaha · 03/05/2008 21:01

my ds was born at 32 weeks - same as everyone else - expressing and then i roomed in for 5 days when he was getting ready to come home. It was hard but worth it and i'm still bf now and he's 8 months.

I was only able to be at 2 of my lo feeds during the day as we lived 40 mins from hospital and i used to do his 1ish and 4ish feeds, we were limited as well because you weren't allowed in during ward round and shift change.

TinkerbellesMum · 05/05/2008 02:19

This is a copy of one of my other posts. It is very possible to nurse a premature baby, I had a E-CS with a GA, I didn't see Tink till she was 5 hours old, I didn't express for 48 hours and it was after that before I could even hold her.

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Isobel was born at 31 weeks under general anaesthetic, I got a brief push past (in my bed) when she was 5 hours old and wasn't able to see her until the next day then.

I was given an expressing set but not shown what to do until she was two days old. I didn't manage to get much out at a time, I now know this is normal as colostrum only comes in teaspoonful's at a time.

At six days old she tried to latch onto her dad's shirt pocket button, so the next day, younger than they normally let them, they allowed me to do the first PTB. We did a supplemented PTB daily which was more than the babies who were a week older than her and born at 32 weeks were able to do. I kept expressing and the little amounts I had were given to her through her nose.

At two weeks I started to get real amounts of milk and a couple of days later they decided to let me do two unsupplemented feeds in one day. The following day we were on the transition ward. They wanted to do a feed every 12 hours but Isobel, ever independent, decided that only Mummy would do and cried after an NG feed until she was given the real thing. For the next week there were only two times when she was hungry but too tired to feed and had to be given NG.

We had our ups and downs but now, at 21 months, she is still breastfeeding!

It is possible to breastfeed but it takes a lot of work. My tips for successfully getting a prem baby on the breast are:

  • Don't offer any artificial teats - bottles or dummies
  • Don't try to feed a very prem baby more than once a day at the start, this is about learning and your supply, not food. See below
  • Pump every four hours day and night - night pumps are really important to your supply as that's when prolactin is at it's highest
  • Keep the clothes baby wore yesterday with you and a photo, use these to help you get in the mood when expressing
  • Do as much skin-to-skin as possible
  • Strip baby off before a feed

The first few times you put your baby on they may not get anything, they may get a little, but they're most likely not going to get enough to fund the calories required to feed let alone enough to help them. By trying to do this too often they will get very tired. When the feeds are built up and they're able to feed substantially then let them have unsupplemented feeds. If they manage well on one, then try for two. Once you're there you will find that baby should start to dictate feeds. There is no rush, they will learn in time.

I was fortunate enough to have Tink in probably the best hospital in Birmingham. I've heard from other mums who had their prem babies in other hospitals in Birmingham and the big difference I have seen is that at the hospital Tink was in no one went home on a bottle that planned to breastfeed, they were often going home sooner than babies at other hospitals - not scientific, just observation from the people I've met. I've just finished training with the NHS to be a breastfeeding supporter and have trained with the same people who trained the NNU staff.

thomsonf · 05/05/2008 03:54

Than you for all your replies - I am sitting here expressing religiously now!

OP posts:
rascal1979 · 05/05/2008 10:49

Well done Thomsonf keep it up and she will be home before you know it xx It's a difficult journey but we all made it and you will too x

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