feeling discouraged & like a bad mom (feeding issues)

3litttlebirds

I posted a few days ago about some signs that my DS shows while feeding that I'm confused as to what is the cause....reflux? aspiration? gas/bowel movement? 

To recap: He is 3 weeks old, 37 weeks gesation. He gets fortified breast milk via Dr. Brown's bottle with preemie nipple.When he feeds, he coughs about one third to one half the time (although, this is better with use of a preemie nipple). He does not seem in pain and doesn't cry, but he seems awfully uncomfortable by twisting all around, arching his back, pulling his legs to his stomach, grunting, facial grimacing & turning red while bearing down, and frequent hiccups after meals. He does not spit up much at all, but little bits here and there (nothing that I would consider abnormal for a baby). He frequently does pass gas or have a bowel movements during feeding. None of this is making DS not want to eat or take less, but it takes longer to feed him when he is twisting all around and bearing down/straining because, of course, we have to stop during all that and wait.

He did not start all this until about 3 days before leaving the NICU (not sure if it has anything to do with taking more volume). I brought it up to numerous nurses and neonatalogists and none seem concerned. I brought it up to the pediatrician and she did not seemed concerned, but said we could be liberal and try reflux meds if the issues continued to see if that helped.

I know a lot of you have had / do have much more stressful feeding situations with your LOs, and I am lucky that DS has done as well as he has. But the feeding is very stressful to me and today it is just really getting to me. I am making my husband feed DS as much as possible. It seems DS coughs more when I feed him vs my husband, even though I am so careful about positioning and analyzing DS's suck-swallow-breathe and trying to time him better. My husband on the other just feeds him while watching football and DS seems to do better. I don't get it. 

Today when I was feeding him and he coughed, I just started crying about how DS was going to develop pneumonia because I'm choking him everytime I feed him, how he's going to have to go back to the hospital, how I'm a bad mom because I sucked at being pregnant and apparently suck at having a baby too.....just got stressed and snowballed everything into worst case scenario.

Thanks for listening. Just wanted to vent. Seems like everyone I tell in real life acts like this isn't a big deal...when to me it's very stressful to not know what's causing your LO to do things that you consider abnormal or uncomfortable. I actually felt less stressed and emotionally closer to DS when he was in the NICU...now that he's home, I feel helpless and like I'm doing everything wrong and am going to somehow compromise his health. 

SBBBE

My DS had similar issues that also appeared just before leaving the NiCU. As PP mentioned holding him upright should help some. I have found that trying to pace him only makes the problem worse which might be why your DH is more successful than you. It is also worse if he has to wait for the bottle and he is super hungRy so I try to make sure I am prepared to feed him ahead of time which doesn't always work out. Also with the bowel thing, I think my DS had trouble figuring out how to use his muscles to poop for awhile and it was too difficult for him to eat and try to poop at the same time. He has slowly grown out of all of it. He is now almost 3 months adjusted.

SBBBE

Ohh and you certainly don't suck as a parent. You sound way too concerned to be a sucky parent. Sounds like you are working hard and that you are being a good advocate for your child. Hang in there it will get better with time!

jennbent

It's funny how stressful life AFTER the NICU can be. Just know that your feelings are normal. We've been out for almost 10 weeks now, and I still feel an incredible amount of pressure/stress/anxiety surrounding my DS' feedings. Kind of like how you said you feel you sucked at being pregnant...well I feel the same way, like I screwed up, so in my mind, one of the most important things I can do for my DS is to get him to eat well and gain weight so he can grow and be a "normal" child. These feelings are only just now starting to lessen in the past couple of weeks because he is gaining great ... and has really started to pick up his feeding volume without me having to force it. I'm sure it will get better for you too. Anyhow, as for your specific problem...google "gastrocolic reflex". From what I've read about it, essentially, the act of eating triggers a reflex to poop. My DS has/still does all of the behaviors you described..specifically the straining/bearing down/grunting during feedings. When we first got home it looked so painful to me that I was convinced it was reflux. As I've gotten to know him better and learn his behaviors, I look back and I'm pretty sure it was just an immature digestive system. As I understand it, babies, especially preemies, come out not really knowing how to poop. They writhe around, grunt, strain, turn red, etc...all because they don't know how to do what you and I take for granted - simultaneously relax the pelvic muscles and push down at the same time. (Kind of gross but you get the picture.) So in my DS's case...the simple act of sucking on a bottle triggers the need to go poop, but at the same time, he's not really an efficient pooper, so that causes him to writhe around and act like a crazy man during bottles. We sometimes pause and let him grunt it out, but as soon as he starts drinking again, he starts bearing down again. It used to happen with practically every feeding and can be so stressful I know! I think I told you in my other post, my DS also has reflux and throws up his entire bottle at least a couple of times a day, but he doesn't seem to be in much pain from it. He's on Zantac, so that probably helps. Our pedi told me Zantac is very safe, so if you want to look into getting him on that just to see if it makes a difference, I'm sure it can't hurt. Also, the coughing could just still be him trying to figure out the suck-swallow-breathe thing. He's still pretty young. My DS didn't really get it together on the feeding issue until we were realeased from the NICU 5 days after my EDD. Hopefully some of this helps you and you get some answers. BTW...my son's writhing around, grunting, and straining has gotten MUCH better with age. It seems my kid has finally figured out how to poop without all of the antics, but -- he still does poop during nearly every bottle. I guess it's just what he does!

jennbent

I have no idea why my above post came out with NO paragraph breaks!!!  I'm so sorry!  What a nightmare to read!!!  Oh the Bump.

I also wanted to mentioned one more thing...we've been told over and over again that the formula that we fortify with breastmilk is very hard on their tummies.  My DS came home on 27 cal breastmilk fortified with Neosure and has recently been bumped down to 24 cal, so that could be another factor why he's not straining quite as much anymore.  So it could also be the formula too.

3litttlebirds

jennbent:

I have no idea why my above post came out with NO paragraph breaks!!!  I'm so sorry!  What a nightmare to read!!!  Oh the Bump.

I also wanted to mentioned one more thing...we've been told over and over again that the formula that we fortify with breastmilk is very hard on their tummies.  My DS came home on 27 cal breastmilk fortified with Neosure and has recently been bumped down to 24 cal, so that could be another factor why he's not straining quite as much anymore.  So it could also be the formula too.

Thank you so much for your posts! It does make me feel better knowing that someone else has gone through the same thing and that it does get better! My ped did mention that we could try Zantac, so I'll keep that in mind if it continues/gets worse/seems like he is pain. I also wondered about the formula used to fortify breastmilk being the culprit of an uncomfortable tummy. We were sent home on 22 cal Enfamil Enfacare. We are supposed to put 1/2 a teaspoon in 2 bottles a day, but I have split it into 1/4 teaspoon into 4 bottles a day to see if less at a time makes a difference. Also, we were sent home on multivitamins with iron, Poly-Vi-Sol. And I'm wondering if that causes stomach issues too. I'll definitely have to ask my ped at the next visit. Thanks again for your posts! 

kelly321

I have no advice for your particular solution, because I know that for us, holding DD more upright made no difference at all. She projectile vomited essentially the entire bottle at least 3 times a day for about a month and no one would take me seriously, saying "as long as she's gaining, everything's fine." I was at my wit's end and had several breakdowns about it because I felt so completely helpless and only DH understood how bad it was. Finally my midwife was here one day when it happened (where I live, it's normal for the MWs to do PP visits), and she was shocked, got me in for an u/s appointment to check for pyrolic stenosis (DD didn't have it, thank goodness), and from then on was completely and totally supportive.

Honestly, though, nothing helped except time. After about 2 months of this (and one month after my supply tanked and I stopped pumping and switched to formula completely), DD all of a sudden stopped drinking 2.5-3 oz every 3 hours and went to 1 oz every 20-30 min. Immediately, the projectile spit-up stopped and I was thrilled. After 2 weeks of that, though, I felt like I was going to die. Feeding an infant 1 oz every 30 min is simply not sustainable, so we had to work on upping her feedings again slowly and extending the time between them. But the horrible reflux didn't come back.

Anyway, what I want to say is that as horrible as it sounds, some things are out of your control. Get the best help you can for your DS, but if even that doesn't help and all signs point to him otherwise doing well, then you may just have to wait it out. I hope, though, that you find something that helps him!