Preemies

bottle feeds at a stand still

Willa was first offered a bottle on Thanksgiving.  She has never been consistent with taking bottles.  One day she will take 5 fulls and the next, not finish one.  I think even the NP's and Dr.'s are not sure what to do with her.  They tried giving the go ahead to give her a bottle at every feed.  She did well the first day and then the next totally regressed back to not wanting to finish one and kind of throws a fit when you try to even offer her the bottle.  I find myself leaving the NICU very frustrated and I hate feeling this way.  She is going back and forth between the Similac and Enfamil nipples and thickner is added to her "recipe" depending on the nipple we use.  I am able to try breastfeeding once a day and that doesn't go much better.  We use SNS and a nipple shield.  She is 38 weeks adjusted and really we haven't seen much progress for the last few weeks.  Her suck bursts are only about 2 or 3 and she needs alot of help being paced.  I will take any advice that you all can give me on what to do to help her make some strides in the right direction - should we try a different nipple, should I stop trying the breastfeeding daily and just concentrate on the bottel?
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Re: bottle feeds at a stand still

  • I know it can be very frustrating. At the end of my DD's NICU stay, bottle feeding was the only thing keeping her there. Some days she did better than others. Sometimes she just didn't want to be bothered. I felt like this was going on for a couple weeks.Then one day it seemed like she just decided she wanted to go home. She pulled out her NG tube and drank every bottle from that point. She went home like 2 days later. Sometimes they just need a little time and they will get there.

    Does your NICU have an Occupational Therapist? Ours has a OT that works with babies on feeding. Maybe you can set up a consultation? He/She might have some suggestions on to help your DD with feeding. 

    Good luck!

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  • imagekelkel09:

    I know it can be very frustrating. At the end of my DD's NICU stay, bottle feeding was the only thing keeping her there. Some days she did better than others. Sometimes she just didn't want to be bothered. I felt like this was going on for a couple weeks.Then one day it seemed like she just decided she wanted to go home. She pulled out her NG tube and drank every bottle from that point. She went home like 2 days later. Sometimes they just need a little time and they will get there.

    Does your NICU have an Occupational Therapist? Ours has a OT that works with babies on feeding. Maybe you can set up a consultation? He/She might have some suggestions on to help your DD with feeding. 

    Good luck!

    Willa pulled out her NG tube 2 days ago and they gave her a try at finishing the bottles before having to put it in.  It lasted a whole 3 feeds before she had to get it put back in.  We do have a OT that comes once a day on the week days to work with her.  She has given us some great pointers.  I think Willa just keeps changing up what she wants.

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  • Lots of questions come to mind.

    Have you considered bringing in different bottles? (If your NICU would let you do that?) Maybe something else would work better for her? Or maybe there are already too many options? Does she eat better for you, your DH, or the nurses? Are they giving her enough time to try? Sometimes nurses are too quick to tube a baby when they just need a long time to finish.

    My DD did best on Dr Browns preemie nipples and really took off once we were consistant about what she was getting. I also BFed several times a day with the goal of leaving on breastmilk only. Feeding can be such a long frustrating experience--they told us one day DD would just "click" and that turned out to be true for her.

  • imagekck329:

    Lots of questions come to mind.

    Have you considered bringing in different bottles? (If your NICU would let you do that?) Maybe something else would work better for her? Or maybe there are already too many options? Does she eat better for you, your DH, or the nurses? Are they giving her enough time to try? Sometimes nurses are too quick to tube a baby when they just need a long time to finish.

    I agree with this. Are all of the different options being tried in one day or a few days apart?  I know that when we were at a standstill with Owen and the OT came for three feeds straight to try different things Owen just got overwhelmed and shut down.  Maybe if one "theory" is tried for a few days then adjustments could be made from there - i.e. different nipple, thickened, different feeding position.

    Owen had a lot of trouble feeding as well and he ended up needing thickened feeds because he had trouble swallowing. Once we figured out that we different three different types of thickeners before we found one that agreed with him.

    good luck and keep us posted.

     

    BPF May 12, 2013 :: EDD Janaury 22, 2013 :: MC Began On July 14, 2013 at 12W4D

     

    Born at 34w2d:

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  • Does she have reflux?  C started eating pretty well early on and then totally regressed due to developing severe reflux.  Meds and thickening her feeds helped.  Just a thought! 
  • When they pulled the tube- did they let her go ad lib (as in take what she wanted) for volume or did they hold her to the set volume?

    Henry never consistently took the volume they wanted him to, so we pulled the tube and made him ad lib. He wouldn't take much for a feed or two and then would have a big one. Sometimes he also needed to sleep longer than 3 hours. When we woke him up he was just all disorganized and did worse.I was so afraid he wouldn't gain weight the night before going home and to be honest the nurses "fudged" it a bit and weighed him late. He actually did so much better at home where we could just get into a rhythm BFing.

    Sometimes you need to try truly letting them ad lib for 24-48 hours and only put the tube back if they get dehydrated after that period things sometimes "click" and they can do it on their own. In the end, you would want the goal to be ad lib feeds and still gaining weight to go home. It might be worth a try to push her a little bit, but then again, preemies have a mind of their own, they will only do things when THEY are ready. It's rough for the momma! Hang in there! ((HUGS))

    BFP#1 9/14/10 (EDD 5/21/11); no fetal pole 6w6d, 7w4d, d&c 10/8
    BFP#2 3/16/11, beta 138; 4/12 Baby/HB DS born 9/10/11 at 29w4d due to partial abruption and PTL
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    BFP#3 8/19/13 Another boy! 17P, modified bedrest and Nifedipine helped us have a termie! DS2 born 4/19/14 at 38w5d.
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  • I haven't read all the responses so sorry if this is repeat info. Cameron was the exact same way for the longest time and I was so frustrated. Are you using the NICU's bottles? I didn't think she was going to get it any time soon so I brought in my Tommee Tippee bottles and she was taking full feeds by mouth the next day. I strongly suggest you bring in your own bottles and IMO Tommee Tippee is the way to go. Also OT came to see Cam the same day I brought in the bottles. I don't know if it was a combination or just the bottles but everything just clicked for her and she came home like 4 days later.
    Born at 26 weeks 2 days gestation, 2 pounds 2 ounces due to IC/PTL,
    and after 82 days in the NICU, our little girl is home!
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