doomed to pumping & bottle-feeding forever?

3litttlebirds

My preemie was in the NICU for 2 weeks, so he mostly received bottles of my BM, but I did breastfeed 1-2 times per day. Mostly had to use a nipple shield and he would nurse for about 10-15 minutes. 

Since he came home 2-3 weeks ago, I have mostly pumped and given bottles of BM and have only breastfed a handful of times for the following reasons:

1. He started coughing with both bottle and breast, but more so with breast because I think the flow is too strong for him. He has done better with a preemie nipple on the bottle.

2. I was scared to give the breast more than the bottle because I wanted to see how much he was getting and make sure he was taking enough, as he tends to get very sleepy during feedings and sometimes has to be woken up several times during a feeding to take a decent amount. 

3. I cannot get into a comfortable position breastfeeding. Because he coughs with my flow, I try to get in a reclined position, but it is hard to do myself and make sure that his position looks okay too. Seems we both end up uncomfortable.

4. I've been trying with and without the nipple shield, but I feel like I'm confusing him by using so many different nipples. Sometimes during a feeding, we'll start out with the nipple shield and when I remove it, he makes a face like something is not right. Then I try back and forth with him trying to take the breast with/without the shield. Then I end up giving him the bottle because I worry he hasn't gotten enough and so he makes a face when he gets that nipple. He does fine with the bottle otherwise...just seems frustrated/confused when we try breast/nipple shield/bottle during one feeding. Or maybe that's just my interpretation. When we are trying the breast, he does better with the shield...latches better and tolerates flow better. But I read to only use nipple shield for 2-3 weeks, but no reason was given as to why. Does it make it harder to break? Does it make breastfeeding less special?

5. Even when I try breastfeeding, I still have to pump afterwards to drain breast he fed from and pump other side....so it takes sooo much time out of the day. I'd rather just be doing one or the other. 

...So I end up feeling guilty that I didn't try to keep up with feeding from the breast more. Also, his feedings are already a bit stressful due to his coughing issue (doc thinks mild reflux, but not enough to medicate), and I feel like I'm making things more chaotic by trying to start the process of switching him to breastfeeding.....but also feel guilty that he is not breastfeeding and receiving bottles BM.

So I don't know what to do or where to start. Any advice? 

xp: BF board 

AndBabyWouldMake5

Firstly, HANG IN THERE!  It took us 2 months to get everything down! 

We started off with ebm and formula supplements in a bottle with an ergonomic preemie nipple, then right when I was about to give up she started nursing with the nipple shield.  We used the shield for about a month and then I started offering her nipple first and if she wouldn't latch I put the shield on.  Once in the middle of the night she just latched on and we haven't needed the shield again.

I might not offer all 3 during one feeding, but I'm not an expert.  I think I'd offer either bottle or breast, maybe alternate so you know baby is getting a good feeding every other.  It took me a while to be comfortable enough that she was getting enough from the breast, it is hard to go from such regimented feedings to a more unexact way.  Trust your gut... if baby is happy and content after a feeding they got enough.  If they are crying half hour later make up a bottle!

Audtee

Hi! I rarely post here, but your story made me search high and low for my log in and password :

My preemie was born at 33 weeks, and in the beginning I only attempted to breastfeed DS a few times in the NICU mostly for practice while he was being tube feed. I switched to just bottle feeding him expressed milk with neosure to get him home more quickly. For quite awhile, I had given up on breastfeeding and thought I would be pumping for the year too. Feedings were really stressful for us because he had a choking and coughing issue too. He had choking while feeding episodes while in the NICU, but I felt like I was the only one concerned. The NEOs, specialists, and nurses all told me there was no reason he could not eat normally and that he'd grow out of it closer to his due date... He used to turn blue during the episodes and sometimes even Brady. The NICU nurses taught me to sit him up straight and rub his back to help stimulate his breathing when he started choking, but other than that I kept getting told that it was a preemie thing and he'd grow out of it. The discharge with this issue so, i started looking for my own solutions...Using Dr Brown's preemie flow nipples for a long time, either sitting him in the boppy in front of me or holding him so he is sitting up almost straight to feed, burping very frequently by sitting him on my knee and rubbing up, holding him in a sitting position for about 20 mins after each feeding, etc. Nevertheless, through all of this he still had a really strong rooting reflex though when he was hungry. So, when he was about 2 months old actual and the choking had improved some, I decided to give breastfeeding another try. I started with a nipple shield, but got rid of it after both of us getting frutrated with it and to my surprise he latched right on. We worked up slowly to more feeds mostly because it was painful until he got the hang of it. Now he switches easily between breastfeeding and eating a bottle of expressed milk. I hope it works for you! Good luck!

sucrets4

Do you think you have an overactive let down?  If he coughs more in the beginning and can't deal with the flow, I'd pump until you let down and then let him latch afterwards.

DD did the bottle thing for awhile and it was stressful to try to pump and nurse, but keep going with it!  DD wound up rejecting bottles around 2m actual and only wanted the boob, so from my experience, there's hope!  She didn't really get the hang of BFing until around her EDD. 

I also wouldn't try to do too many things in one feeding.  That does sound confusing. 

GL and stick with it!!  I did the BF, guess, pump thing too and it sucked.  But it got better as she got older.  I'd give your LO a little bit more time before throwing in the towel.  There IS a light at the end of the tunnel since your LO will be more like a typical newborn soon.