Intro and a Q about BFing!

amye84 · December 2011

Hey ladies! I have lurked on this board for quite some time because 1. I am a NICU nurse and I find it very enlightening and helpful professionally for me to get some perspective from families going through the NICU experience. And 2... in May of this year we found out we were pregnant with fraternal twins! Knowing what I do from work I was a basket case about having early babies. Sure enough, I went on bedrest at 23w6d for pre-term labor/contractions.

After 11 weeks of bedrest, three hospitalizations, two rounds of steroids, the dreaded magnesium, and countless prayers and tears we welcomed our girls into the world at 34w5d. Now I truly have perspective as a NICU nurse and a NICU parent!! Kate and Violet spent 9 days in the NICU. We were very fortunate that they had no respiratory issues and just needed a little time to adjust to eating and keeping their temps up. We've had them home for 2 weeks now and are loving every sleepless second Big Smile

Here is my question... Our girls obviously got used to drinking from a bottle in the NICU. I put them to breast a handful of times when they were inpatient and worked some with a LC. I started pumping in the recovery room just 2 hours after our c/s and have been consistently pumping every 3-4 hours since. Now we are trying to transition to breastfeeding these girls and it is very much a work in progress. I started out putting them each to breast once/day and they weren't able to take a full feeding. I would have to bottle feed after and THEN pump. Exhausting. Now thankfully they are both able to take a full feeding from the breast and I increased to giving them each two opportunities to breastfeed each day. I am doing them separately now, I'm not talented enough to tandem feed yet!

For all of you ladies who transitioned to EBFing (or close to EBFing) after the NICU. How did you do it?! Some days I feel like it is do-able and other times it seems totally unattainable. Any help/advice would be greatly appreciated!

Wally3 · December 2011

I only had 1 baby but at 5 days I started nursing in the NICU. I worked with a LC and she said do the best I could - the nurses would sometimes give a bottle afterwards. I nursed 2 or 3 times a day in the nicu. He came home after a week. I nursed every other feed. THen in every 3 days a would replace a bottle with a feed. EBF was much easier then bf and pumping, even if it was stressfull in the beginning. Good luck.

urbanflowerpot · December 2011

Hello and welcome! I'm glad you decided to join us Well, you know what I mean! Congratulations on keeping them in so long! That's wonderful! I've always imagined it stressful for pg women who work in NICU. My grandparents both did but unfortunately they passed away lonnnng before I knew what questions to ask and which stories to remember.

DS was nipple confused - it took me a long time to figure that out - but we went from EP (yes, pumping, bottlefeeding, repeat takes forever!!) to EBF. The pump is officially packed in the attic but I still have panic attacks that I'll need it again (or that my supply has vanished).

Here is my story: https://preemiemomblog.blogspot.com/2011/11/nipple-confusion-and-how-i-transitioned.html

Please let me know if you have any other questions about specifics

SushiNoMore · December 2011

Congratulations on the birth of your girls! And, great work getting them this far with BFing! I'm so glad to hear that you're able to get them to take meals at the breast - that's great!

My son was born at 26 weeks, and I EPed for the 70 days he was in the NICU. When he came home at about 36 weeks gestational age, I was determined to breastfeed. A couple things helped with me.

1) I used a special needs feeder by Medela (the sell them on Amazon) to help teach him proper sucking techniques. It only allows milk to flow when the baby actually sucks (unlike a bottle that will constantly drip), so I think it helped "train" him to breastfeed.

2) I used ultra-slow flow nipples after I went back to work. Our NICU did a study to understand which nipples are the slowest flow, and they figured out it was the Similac Slow Flow nipples. They're sold as disposable, but you can wash and reuse them. We bought a case of 50, and we still have a bunch left.

3) I used a nipple shield. That helped my son get milk when he was very tiny. After awhile, though, I felt like it was actually hindering his ability to get milk. I had to use a very small size for his tiny milk, and it hurt my nipple. I also think it sort of constricted the flow.

I just gradually increased the number of feedings I did by breast. My son was in the NICU so long that he came home on a pretty regimented 3-hour schedule. He'd take bottles at 3, 6, 9, and 12. the nursing didn't replace the bottles 1:1 (I usually had to nurse more often than I would have had to give bottles), so I'd allocate time periods where I would only nurse and not give bottles. So, at first, I'd nurse between 12pm and 3pm every day (replacing 2 bottles). Then I'd extend it to 6pm. Then 9pm. By that point, he was strong enough where he was nursing well, so we just went cold turkey to nursing, and we never looked back.

My son is still nursing at 10.5 months, and he's always gotten breastmilk. I went back to pumping when I went back to work, but it sure was nice to have a little while where we could just nurse on demand.

Great job so far! You'll get there. If urbanflowerpot doesn't chime in here, feel free to page her. She has good advice. There's also a link at the top of the page to the Preemie Resource blog. It has lots of advice and ideas.

Good luck!

Mrs. Alice · December 2011

Congrats on the birth of your girls! My mom is also a NICU nurse and definitely knows know what it's like to be on the "other side". I am pretty fortunate to have two pretty good eaters. However, I used a nipple shield for a while that the hospital LC gave me to help keep them latched on. I think that made a huge difference in my ability to successfully EBF. It could take them 30-45 minutes to get a full feeding on the breast when they first came home. Fortunately they have gotten much faster and efficent and can finish in under 20 minutes now. I just started to be able to tandem feed them without someone helping since they are bigger and can hold their heads up. A twin nursing pillow is a must! For the first few weeks and when they've had growth spurts, I felt like all I was doing is breastfeeding all day. It takes hard work and persistance, but the pay off is huge. It does get easier, I promise Wink

Mrs. Alice · December 2011

Congrats on the birth of your girls! My mom is also a NICU nurse and definitely knows know what it's like to be on the "other side". I am pretty fortunate to have two pretty good eaters. However, I used a nipple shield for a while that the hospital LC gave me to help keep them latched on. I think that made a huge difference in my ability to successfully EBF. It could take them 30-45 minutes to get a full feeding on the breast when they first came home. Fortunately they have gotten much faster and efficent and can finish in under 20 minutes now. I just started to be able to tandem feed them without someone helping since they are bigger and can hold their heads up. A twin nursing pillow is a must! For the first few weeks and when they've had growth spurts, I felt like all I was doing is breastfeeding all day. It takes hard work and persistance, but the pay off is huge. It does get easier, I promise Wink

amye84 · December 2011

Thank you guys so much for your responses! Your experiences have given me renewed hope that we can do this Big Smile I tandem fed the girls today for the first time at home by myself... it was a challenge but we did it! I have discovered that I need to give them a little more time to get a whole feeding in (about 45 minutes) so that they are satisfied. I am going to keep at it and definitely will be back here with questions.

Thanks again for the warm welcome!

btsrc5 · December 2011

Congratulations!

PPs shared a lot of great information, but I thought I would add what I did also.

DD was in the NICU for 9 days. After the first two days, when she was starting to eat, I tried to BF at every feeding I was there (from 8am to 10pm). After 20 minutes (10 on each side), I would pump while she got a bottle of expressed milk. At first, she didn't eat from me at all. I added a nipple shield to help and she started eating a tiny bit, but not much. There were several occassions I was in tears thinking she wouldn't be able to BF.

The first week we were home, I continued to try to BF her and then pump and give her a bottle to supplement. I dropped the bottles once I got the ok from her pediatrician because she was gaining weight just fine. At 5 weeks I was able to ween her off the shield. Since then, she has been doing great with BFing.

Long story short, you are doing great and don't give up! It is a lot of work (and I only had one, so I can only imagine how much more work it is with twins!) but it will be worth it.

btsrc5 · December 2011

Congratulations!

PPs shared a lot of great information, but I thought I would add what I did also.

DD was in the NICU for 9 days. After the first two days, when she was starting to eat, I tried to BF at every feeding I was there (from 8am to 10pm). After 20 minutes (10 on each side), I would pump while she got a bottle of expressed milk. At first, she didn't eat from me at all. I added a nipple shield to help and she started eating a tiny bit, but not much. There were several occassions I was in tears thinking she wouldn't be able to BF.

The first week we were home, I continued to try to BF her and then pump and give her a bottle to supplement. I dropped the bottles once I got the ok from her pediatrician because she was gaining weight just fine. At 5 weeks I was able to ween her off the shield. Since then, she has been doing great with BFing.

Long story short, you are doing great and don't give up! It is a lot of work (and I only had one, so I can only imagine how much more work it is with twins!) but it will be worth it.

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