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Preemies
3 hour vs 4 hour feedings?
hey ladies,
so my twins were eating every 4 hours and eating b/w 2-3 ounces. well our pediatrician said hthey needed to be on 3 hours feedings and now it's like sometimes we are just waking and forcing them to eat. they are only eating b/w 1.5-2 ouncs every 3 hours. it's so frustrating b/c we feel like they aren't eating good.
their weights today are 5.6 and 5.13 and they are 6 weeks old..
what to do..
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Re: 3 hour vs 4 hour feedings?
Honestly, feeding is one of the most difficult things I've every attempted to tackle in my lifetime. Until Evan was born, I just thought it was one of those things that just happened.....boy was I wrong! It's so incredibly complicated. If only there was a manual, or some crystal ball to just tell us what to do. Heck, if one kid's answer could just work for all kids, I'd be rich.
That being said.....thoughts on things.
Only change one thing at a time, Give each change a chance to work. If you change too many things at once, you'll just be questioning which made them worse or better. Also, too much change too fast, just confuses the LO's. So, as PP said, try this for a couple of days or so, and just see what happens. It'll become apparent if it's better or worse with time. Maybe you'll end up doing a modified schedule,....4hours at night, 2-3 during the day.
They're really little, so alertness, and energy put into eating will be a big deal. Try feeding in different positions. My son did better laying on his right side and with his head elevated at that size. This position allowed him better control of the milk flow. Nipple speed can be a big deal, and a bear and a half to figure out. Too fast, and they'll be gulping and feeling like they're drowning, if they get overwhelmed with the speed, they'll likely stop sucking all together. Too slow, and it'll be too much work to get the milk out, they'll tucker, and stop before they get what they need. Dr. Brown's stage 1 was our answer, but like I said, all LO's are different, and maybe you have the perfect set up right now.
Stimulation is a BIG deal. Their little bodys can only take so much sensory imput at that size. Too much imput, and they'll start to shut down. This always led to a bad feeding for Evan. This can be mistaken for falling asleep. Things that count as sensory imput....touch, sound, body motion like rocking in a rocking chair, the bottle, the milk, all of it. Try sitting completely still, in a silent room (well, as close to silent as you can possibly manage), while they eat, it may make a big difference. Sometimes swaddling can help.
Another thing I learned the hard way, is you can't make a kiddo eat. When they're really little, sure, spinning the bottle, rubbing the cheeks all that stuff can get a few more drops in. It very well may be fine, and needed while they are this little. Just be ware, that as they get older, and more aware, it can lead to more feeding refusals. Heads will turn to the side, and tongues will thrust, and fits will be thrown to get the bottle out of the mouth. Definitley not where you want to go.
You can try to go up on the calorie count of the food. Your doctor would suggest this if they need it. Whenever we tried with Evan, it lead to more puking, but he can't have corn syrup or too much dairy fats, and we didn't know that then.
If they're limiting how much they're eating due to an upset stomach, you could try some different formulas. Disregard if you're breast feeding, in that case you could try eliminating some things from your diet, like spicy foods, or dairy, or both. The first two I'd suggest are nutramagen, or nestle's good start.
Limit activity, baths only 1 every 3 days max, unless they get really dirty. Limit visitors. Try to conserve their energy for eating.
If they're really tired a lot, it might be worth asking your doc about checking their labs. Something like anemia could really throw the LO's.
You're in a tough spot b/c most moms of premature babies are advised to really feed on demand as long as possible, but with twins I understand the need for a schedule even at this young of an age. I honestly would try to keep on or at least near the 3 hr feeding schedule. DS was EBF once we were home and I fed him every 2 hrs around the clock until he was almost 6 mo. It was exhausting but he was really able to gain weight rapidly and catch up a lot b/c of it. Maybe try every 3.5 hrs if you feel they're just really not hungry enough at 3 hrs and not feeding well then.
If you only just switched to a 3 hr schedule, I'd give that at least one week to see how they adjust to it before abandoning the pedi's suggestion.
We had this problem with DD in the begining DS was the same way when he was born as well. What we did was give them what they would take down every three hours and wait a little bit then give her the rest. They both did it this way. They want DD at almost three months now on every three hours and there are times we just cannot get her to eat it all at one sitting so we give her the rest 30 mins or so later and at three months she is already at 11lbs so i know this is working for her. It is definately frustrating at times and if she doesn't want the bottle she will pull her head to the side so that you take the bottle out of her mouth. We have now been adding some rice to her bottle and i'm not recomending that for you but that has worked for us in terms of getting the extra colories in there for her and she tolerates it, but not all kids can.
WE were told to feed Andrew every 3 during the day and every 4 hours at night. But when we woke him, he was way tooo tired to eat and would barely eat at all. And then he'd be tired later. It was a vicious cycle.
So we told the pedi we didn't feel it was the right thing for him. he needed his sleep. He was so tired. We insted did on demand and the pedi and he said we could try it and if he gained weight it would be okay. He was surprised, but he gained weight.
He was a 26 week preemie, tired as heck, did not eat well at all, but still gained..I'd talk to yorur pedi.