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Preemies
Transitioning to BF?
Does anyone have any advice on how to transition to breastfeeding? We are up to 3 bottles and 2 breastfeedings per day, still on 3 tube feeds and I'm starting to freak out about how to time everything.
I'm already spending about 10 hours per day at her bedside which is three or four feeds. Today I did both breastfeeding times and one bottle feed, leaving the other two bottles for the night nurses. I'm afraid its too much for her to have all three feeds back to back without a break (I know she'll have to get there eventually). She had a really hard time waking up staying awake for the last breastfeed though she did complete it.
I really want her to be primarily breastfed and the Neo is very supportive. I also need to be able to bottle feed her without her choking or having Bradies so I feel like I need to practice both. Obviously no one else can breastfeed her. Any ideas on how to time all this? Do I just need to move into the hospital before she comes home so I can be sure she can eat well?
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Re: Transitioning to BF?
I only have my own experience to go by - my hospital is also extremely pro-BF but BF'ing takes more energy so we're at once/twice per day and the rest bottles. I think he's been off his feed for 4 days now. He spent the first 48+ hours bradying like crazy whenever he'd eat (no matter where - just trying so hard and wearing himself out) - now we are 24 brady free. I'm at the hospital for many hours/day, too...remember to take care of yourself, though (so that would be a no, don't move in!) - I tell myself that the time I spend away from him is also good because as much as he loves me, he needs rest. I think holding him takes energy because he tries to be social with me...tries to open his heavy lids, etc. He gets the most rest while we kanga so I've been trying to do that more.
But to answer your question (as best I can) - you really can't transition to all BF at this point. Everything depends on LO's timing; I'm sure you hear that a lot.
I moved into the hospital! They have a boarding room that nursing moms can stay in while their babies are in the NICU. These guys are our first and my hubby can be a capable bachelor when necessary, so I was able to do this. The nurse would call me when one of the babies was hungry (around the hands on time) then I would feed them both while I was there. They were both using nipple shields until this week, when I started working with DS to wean off. Sometimes we have to start out with the shield, until I deflate a bit then he can usually latch on and finish the session with out it. Now working with DD to do the same!
At first it broke my heart to have them be given bottles, as I had big plans of EBFing, (just another dream flushed down the toilet when you have a baby in the NICU!) but now I am thankful that they're able to do both! I was afraid they would prefer the bottle, but I eventually decided that if they needed the occasional bottle so the docs could see what volumes the were taking in, then so be it. We'd hire a private LC when we got home if necessary...not necessary!
If your hospital doesn't have a boarding room available, ask the manager if there is something they can do to find a place for you to stay in the hospital. After a few weeks the boarding room was closed and they basically said you have to move out, but didn't offer another option. I just told the manager that nursing was very important to me and that it was important to me to be available throughout the night. She did some looking around and they had some empty antipartum rooms in L&D that I was able to stay in for the rest of the time! Doesn't hurt to ask!
Hang in there! It can be really hard to BF in the NICU, sounds like your hospital and the docs are behind you. I really enjoy the time spent nursing our babies and I love knowing that its good for them and me! Best wishes!
Just wanted to add that I hear what you are saying about it being hard to schedule everything, because you don't want to wear them out by bf'ing back to back. I had a hard time trying to organize that too, when I wasn't sleeping at the hospital...I just had to keep telling myself that I could only do what I could do, and me sleeping in order to provide milk was one of the top priorities.
I had to let go of a lot and just told myself that we would really focus on BFing when we got home if it was too challenging in the NICU, its okay if you don't get it down right off the bat...your LO can learn later too!
Thanks so much ladies! Your success stories really help me believe we will get to a place where she can be primarily breastfed. I will definitely be coming to you with more questions as we figure all this out. She did great with her 2 BF times today so I have hope!
I do think I will be able to stay at the hospital when she gets further along in the feeding process. The 20 overnight rooms at our in-hospital Ronald McDonald House are given to interested parents based on the seriousness of the babies situation, distance from the hospital, and breastfeeding needs. Since we have been very lucky with a relatively easy NICU stay and live 15 min away, I haven't signed up for overnight yet. I know there is limited space and other parents need that more than I do. Hopefully when she is able to do more breastfeeds I will be able to get a room!
Any tips on how to organize time around feeding and pumping every 3 hours with a reflux-y baby who does best if held for at least 30 min after a feed? I feel like all my time is scheduled by my breasts these days!
Our precious girl, born at 27 weeks.
I pretty much lived at the hospital. Not only is it good for you to be there for the feeds, babies thrive from having their mom's right there next to them talking to them, holding their hand, doing at least 4 hours a day of kangaroo time (even after you go home). I would go home after the midnight feed and be back at the hospital by 5am (I wanted to be there in case he wanted to eat before the 6am feed). Either my husband or my dad would be there for the 3am feed. That would give me time to go home, sleep, shower, regroup and start over again. My hospital allowed me to bring in the bottles I would be using at home to practice with ahead of time. I used Dr Brown's preemie nipples (ordered off of amazon) and gave him pumped breast milk. I wanted to get him eating right and get him home, so I only bf'd once or twice per day at the hospital and used a nipple shield to help him latch on (it also helped slow the flow down). Once we went home, I bf'd each time with the nipple shield and offered him a bottle of breast milk afterwards. After his due date arrived, I started off using the breast shield and halfway through the feed on that side, I would remove it and try to get him to latch on without it. Then I would start the otherside with it and remove it halfway through again. At first I would have to put the nipple shield back on after a minute or so. Evenutally, once he was one month past his due date, he finally got it - no more nipple shield or bottles! Now he is almost 4 months old and he's a breastfeeding champ! Never give up on it if you want to do it. Follow breastfeeding with pumping to keep your supply up. It took many exhausting hours to do it, but it was definitely worth it.
I had a late term preemie so not much helpful experience but I see that your LO's adjusted age is around 36 weeks. I know for the time we spent in the hospital she was super sleepy and BFing was hard for her so I would do her first of the day, then sometimes the next one, then skip (bottle) for the next, and then do one or two more before going home for the night. We live about 5 mins from the hospital, though.
By the time she was 37/38 weeks gestation she was much better at it, although we still had to do a diaper change mid-feeding in order to keep her awake long enough. Lots of naked time was required to keep her awake.
We're in the final stages of transitioning to BF. For me, I spent almost all day at the hospital, and I'd only nurse him once or twice while there (gave bottles the rest of the time). Our NICU was not as supportive of breastfeeding. They said they were, but they didn't really support me much. If our kiddo go hungry before his next scheduled feeding time, for example, they'd usually just make him wait. It's pretty hard for a preemie to be able to breastfeed enough to make it for 3 hours until the next scheduled feeding.
All that being said, I think this is one of those things that is just helped by time. We started non-nutritive sucking at like 31 weeks or something, and we struggled and struggled. Then, within the last 2 weeks or so (38+ weeks gestation), it all started to click. We're really hitting our stride, and our pediatrician even said we don't need to give him anymore fortified bottles anymore.
My baby was a micropreemie, too (although not as early as yours), so expect that it might just take a little bit of extra time for you. Try to be patient - it'll happen! We also still use the nipple shield sometimes when he seems like he's still hungry but is struggling to latch. That really helps.
Good luck! I've been there, and I've been crying while he was crying and struggling to latch. it can be so so so frustrating, but it's worth it now that we're almost fully transitioned to breastfeeding. I think your baby will let you know when she's able to handle more breastfeeding.
I was at the hospital 10-14 hrs a day near the end to give everyone a chance or two at the breast. After getting overwhelmed and feeling like a boob-assembly-line grunt, I scaled back to once per baby (still 3 feedings).
My point is that if you're overwhelmed and/or spread too thin with the schedule, once a day is good practice for your little one. All 3 of mine switch between the bottle and breast with no problems now, and they still only get one (sometimes two) boob visits a day.
Keep in mind that your LO is ahead of the learning curve on feeding, and you'll still have plenty of time to establish her eating routine/preferences once you're home. It's sooooo much easier there.
This x1000. People always told me that everything would be easier at home, but I didn't really believe them. It's true, though. Everything IS so much easier at home. Especially breastfeeding.
Thanks so much ladies! Your advice came at exactly the perfect moment. I just got home from a very frustrating night of a sleepy baby who wouldn't wake up to breastfeed. We are up to 3 bottles and 3 breastfeeds a day which seems a bit much for right now so she was exhausted by her 9 pm feed. We'll try again tomorrow, its good to know things will get easier. I know she is doing great for her gestational age, I just get impatient sometimes.
Our precious girl, born at 27 weeks.