Breastfeeding in NICU

Jenn06L80 · April 2014

I have identical twin girls that were born at 36.3 weeks. They were IUGR and are now at day 9 of their NICU stay.

We have been dealing with temperature regulation, jaundice, and feeding. Feeding and growing is our main issue.

Our routine is attempt breast feeding, supplement via bottle or tube, then pump. The girls are getting better with the bottle and only ok at the breast. I really would prefer to breast feed rather than pump and bottle feed. The nurses comment that they are bottle spoiled and the bottle is much easier. Does anyone have any advice or success stories about breast feeding in the NICU.

Missi576 · April 2014

Have you tried using a nipple shield for now? Mine have been in the NICU since 26 weeks and 3 days gestation. When they were getting ready for bottles, we started doing non-nutritive feedings (putting them to the breast after just pumping). Right before starting bottles, we did a few nutritive feeds and they still did great at suckling. Once the nurses started bottles, they started being less happy with straight breastfeeding because it was.. different.. and they were used to the pacifiers and the bottle. The lactation consultant gave me nipple shields and as much as I was frustrated by the fact that they were necessary, they work amazingly well. Both girls do a great job at the breast now even though it is harder than the bottle. As they get stronger (after we go home), I will work on weaning them off of the shield, but for now, it works great for an in between.

KatFCo · April 2014

Have you seen a lactation consultant? They would be able to help you with making sure the latch is good.

Jenn06L80 · April 2014

Thanks for the advice. I am using a shield. I just get frustrated about how better they are at the bottle. My hope is as they get bigger and stronger the breast will get easier and they won't favor the bottle. I never realized how long feeding and growing could take.

PurpleIris30 · April 2014

Jenn06L80 said:
Thanks for the advice. I am using a shield. I just get frustrated about how better they are at the bottle. My hope is as they get bigger and stronger the breast will get easier and they won't favor the bottle. I never realized how long feeding and growing could take.

Breast will definitely get easier as they get bigger and stronger! We started much the same as you (identical girls but born at 32, so took them a while before we could introduce breast) and very gradually they would have one great breast session, but then be tired and need bottle/tube for a couple of feeds. It helped to be selective about which sessions i tried to breastfeed - if they seemed tired or sleepy to begin with, it wasn't going to be very successful.
My bigger twin by discharge had worked up to all feeds by breast except for two bottles a day of breast milk mixed with 24 cal supplement and the polyvisol with iron. My smaller twin went home on o2, was weaker, and it took her a little longer until she didn't need to be topped off with a bottle.

As encouragement, we were able to move to exclusively breast feeding (until I went back to work, but they still receiving all pumped milk in bottles). So it's definitely possible!

It's frustrating when it seems like it's taking forever, but once they get strong enough, it was kind of like a lightbulb went off for them.

Jenn06L80 · April 2014

To the PP thank you for your a advice. I think I may need to be more selective when I attempt to breast feed so the sessions we do are successful.

You mentioned the lightbulb. I think every nurse we have had as mentioned that to me. I can't wait until it happens with the girls!

carrotcake06 · April 2014

My boys were born at 34w and we were allowed to attempt BFing right away. One got it and the other didnt. I attempted to BF each one once a day, not at the same time. My milk is excruciatingly slow to come in, so it was all non-nutritive. I gave it a go for 20-30 min and then they got a full feed via bottle or tube. I didn't need to use a nipple shield.

Around 35w, it clicked much more than it had been w them. Plus my milk had come in and was no longer so colostrum-y. I really had to petition to get BFing counted as a feed, which was frustrating bc I knew they were getting volume. The NICU wanted to fortify bottles and have them go 4hrs between feeds whereas I wanted to bf them every 2-3 hrs.

This whole time I always pumped after, though. Also around 35w is when we first tandemed. I will never forget how that felt

. It was awesome.

When we were discharged, the NICU wanted me to do half bottle half BF and fortify bottles but I didn't do it and just bf them on demand. They gained and I got the official all clear.

I had to do a lot of advocating for actual breastfeeding over feeding pumped bottles.

Jenn06L80 · April 2014

Thanks for your reply. My girls are just really used to the bottle. The majority of the nicu nurses just try to get me to give them bottles and and say if I want them to get home I should do bottles.

My hope is when I get home I can slowly incorporate breast feeding sessions as they get stronger. Today one girl took 18 and the other only took 1. But they both took 38 from the bottle every time they were due for a feed.

Labyrinth3000 · April 2014

Don't let the nurses manipulate you. They're your girls and if you want to nurse then try! I had a similar issue when my twin girls were switching from the feeding tube to bottles. The nurse would say, "Oh. She's tired. We can try next time." I'd go right over and wake them up for a bottle. No laziness on my watch.

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