Nursing a Preemie

Even with the nipple shield my premie had trouble sucking. What finally worked was completely cutting out bottles (we did this around six weeks). I think it confuses them to go back and forth. My dr. told me the same about supplementing with bottles, but my baby actually started gaining better when I stopped using them.

You sound identical to me. I have a 35 weeker (who is a month old today) and a 16 month old. My 35 weeker only stayed in NICU 6 days but other than that they sound the same. My little man is just a little lazy I think. The breast shield worked some but my prblem is that he gets tired of sucking and bottle just continue to drip. He knows that if he stops long enough I'll get the bottle. Good luck!

Sorry I don't have any great advice... I just wanted you to know that you aren't the only one... and it is nice to know the same thing on my part.

My son was born at 34 weeks 6 days...a preemie also! my advice and it seems you have plenty here is to relax i also had another little one...my older son was just 13 months old when my little guy came early...i found that the best results i had were when my older son was napping or down for the night...i know you can't wait to feed him but the times when you both have the least amount of distractions will benifit the process of him learning how to suck and swollow...

Hi R.,

I had a preemie at 32 weeks and he stayed in the hospital for 11 days also. It was very hard to teach him to latch on because we did not get that initial one on one contact right after birth. But a few things I tried helped. I had to drop a little milk on my breast to help him out. Once he figured it out he latched on and begin to swallow. Now his sucking and swallowing was developed before we left the hospital. But my girlfriends told me that I had to stop the bottle and just nurse him, which was hard and I could not go that route. But it is very time consuming and takes a little more effort than a full term baby. You gotta nurse him as often as you can. Once he gets hungry enough he will latch on and not let go. By the way, the breast sheild does work. It helps them because it feels a little more like the bottle and it something they are familiar with. I truly hope it works for you but it is difficult and especially since you have another little one. I do hope it works out for you.

R...

9 years ago in June, my son was born. He was 33 weeks, 5 pounds, and he was in NICU for 11 days. I pumped and expressed for a long time. It was exhausting. Hang in there! I finally decided to supplement formula because my body wasn't keeping up. He would nurse for 45 minutes, sleep for 20 minutes, and be ready to nurse again. I tried a little of everything to make more milk - nothing worked. Take care of yourself so you can take care of him and your other child. Off the subject advice: refuse to believe any preemie myths about development. My son was ahead of schedule in everything but walking. He was 15 months when he decided to take his first steps. He is perfectly normal and very smart! Believe in yourself as a mom FIRST. Trust yourself to make the right choices and decisions. People mean well when giving advice, for sure. Just listen to your heart and your instincts. Everything will be just fine!

I don't have much experience with this but maybe la leche league or a lactation consultant would have some good advice for you.
Good luck!!!

Hey R.,
I have a son that is 9mo now and he was difficult to nurse. He was no preemie, born at 40wks, but I had flat nipples which made it difficult. I used a nipple shield, you can find them at Target where the breast pumps are. There a little difficult to get on right when you first start. A lactation consultant would be great, I had one come to my house and help me. I also pumped so that I would have milk for my husband to use when I went back to work, and I would pump on one side and feed on the other. They say spend 10-15min per breast when you nurse, but my son was fine with feeding on one side at a time, and my breast got used to it. Maybe that will work for you and save you a little time. Also, I used a silicon nipple shield for 4mo, and I tried to use bottles that were similar to the nipple shield to limit nipple confusion, which may be more of a problem for a preemie. This is all I have, hope its useful.

M.

I personally have not had a preemie, but a friend of mine had a baby with the same sucking problem. She pumped soley for 6 months and enjoyed it as she said with a double pump it took so little time! From my own experience, I believe in breast feeding, but with my last baby it was so hard (she was so hungry and I didn't make near enough milk)I was making myself miserable. Just do what is right and keep yourself sane!

the advice that was given to me (learning to nurse in the middle of the blizzard of 1978 snowed in)remove the nipple off the bottle place it over your own, let baby latch on and the sucking will pull your nipple deeper into the bottle nipple and baby will develope stronger sucking technique....believe it or not you and baby will be professionals at this in about four weeks! God bless you and baby

Hello R.,
I am new, just signed up here today, and wanted to give you my two cents. My son and last daughter was early but luckily they didn't end up in the NICU. While I was in Guam I learned some things (we were in the hospital for a week after birth due to illness) that may help you. My nurse was so helpful. While I would try to nurse I would pump the other side. It was a bit uncomfortable but with the other children I didn't have the time to waste. Not that it is a waste but if you can cut time, go for it. Congrats on the new baby and keep working at it, you will get it to work out.
S.

HI!!! My daughter was born at 31 weeks and 6 days and stayed in the NICU for 3 weeks. I was adamant about breast-feeding her, but preemies don't have the strength or stamina that a term baby has, so I had to use the nipple shield until she was a little past term. It creates a vacuum inside the shield that keeps them from having to suck so hard. It is also a miracle for sore nipples, so hey, get a few of those, yes, a few, because you can't really gauge the best size for you and your baby until you try out a few different sizes. I had to pump when I went back to work and since I'm in the habit, we only breast-feed on the weekends and I just pump throughout the week and I use the Avent bottles. She's doing great and I feel like I'm doing the best thing for my daughter by getting her my milk, no matter how it comes out! Good luck!!!

Hi R.! I can totally relate. I also had a 35 week old and was intent on nursing. The nurses told me to use a nipple shield until she was 40-42 weeks gestation (when she was supposed to be born). I honestly don't know if that was a good choice or not because the lactation specialists wouldn't allow me to try the "normal" way, they immediately gave me the nipple shield because they said that she wouldn't be able to suck effectively without it. I wish I would've been able to try at least because the nipple shield is messy, inconvenient, and difficult to wean off of for the baby, but if it was what was best for her, then that's great. She seemed to get enough, but it took me at least an hour to feed her and she was gassy from sucking the air that is created from the shield. I also felt like my supply went down because I didn't have that direct stimulation from her mouth. I don't know if this is helpful at all, but she did continuously gain weight while using it. Good luck!

my daughter was born at 38 weeks and had the same problem- would latch but not suck...for me the only thing we could do was continue the supplements until she was bigger and stronger..i also had a shield at first because she couldn't latch any other way..babies on shield tend to not gain as much is what my lact cons said...she was 3 weeks old when we completely weaned off shields and supplements..or at what would've been 41.5 weeks...hope this helps..just keep at it! i also took fenugreek (lact cons recommmended) to increase my milk supply

Hello R., I have never had a preemie so I can't really help with that particular nursing issue. However I have had to use a nipple shield. My daughter was a terrible Nurser and we used one for 8 wks. The only problem was she had to learn how to latch on without it. That only took a few days though. She knew her food came from there so she was very persistent about eating. She was breast fed for 14 months. It was a wonderful experience and if it hadn't been for the nipple shield I would have never had that. Also, another mom commented on using a small feeding tube in the babies mouth while you nurse to supplement. I have done this too with my son. It takes a minute to get situated, but once you do the feeding is fine. After a few feedings like that my son learned where his food was coming from too and he was more willing to work for it. Plus I made him suckle for a minute before allowing the formula to come down, so he got used to working a bit before he was fed. Good luck to you, and congratulations on a healthy baby.
T.

My dd was born at 33.5 weeks. We had to work for a while before she had the ability and the stamina to nurse for a full feeding. Until then, I would offer her my breast for as long as she could do it (if at all) and then feed previously expressed breastmilk. Then I would finish pumping. And it took me at least 40 minutes too. We did try the breast shield while she was still in the NICU. It didn't seem to help her much, but it might be worth a try with yours. The lactation consultant helped us a lot while she was still in NICU, and the best thing she did was help me be more "forceful" putting her mouth on my breast. I had to position her head and really put her on there. The consultant helped me figure out when she was latched on, and if she wasn't, pull her off and try again. The good thing is that she had no issue switching between bottle and breast.
My best advice is to try different positions (mine liked the football hold) and persevere. And if you have to go with the bottle exclusively because of your other child's needs, no guilt and no worries. I believe what is best for the whole family is what is best for the baby.

Definitely contact a lactation consultant or the La Leche League. I used the supplemental nursing system marketed by Medela (as mentioned by someone else) with my ds who is now 15 months. It worked wonders to beef up his weight. He wasn't preemie, but would only nurse for 5 minutes before falling asleep. It was still a little work because I had to pump at the same time I was feeding, but eventually he would stay awake longer. :)

Hi R.,

I had identical twins born at 29 weeks. They came home at 37 weeks. I decided to just let them figure out the bottles while in the NICU instead of nursing since that way they could come home earlier! I had a lot of the same problems you had. I had no problems nursing my now 5-year old and 2-year old. Preemies are a lot different.

They get very sleepy for awhile. I found that nursing was more tiring than the bottle. It was a lot of time and patience, but they both caught on eventually. I think they were around 46 weeks when they finally caught on. I know it is a pain to pump with your other children around. I think preemies have so much going on with their little bodies that they just need us to respect that they need a little more time to go between breat/bottle.

My boys are 6 months (3 1/2 months adjusted) now and nurse 7 times a day. I still need to pump to times a day to give them 2 bottles of fortified breastmilk. They go between both no problem! Hang in there!

-A.

Call your local hospital. Many hospitals have lactation nurses on staff to assist you. If your hospital does not have one call Vanderbilt University Medical Center in Nashville, TN. I know they have lactation nurses on staff. I had the opposite problem. They helped me when my baby would only nurse and would not take a bottle.

I don't know about the preemie part so much, but many babies can have a difficult time learning the proper way to suck. I have a 2 month old that I have had a tough time with. My little girl--NO PROBLEM! One thing that I have done is to take away bottles completely. Nipple confusion can be an issue. I also try to nurse him in the same place each time in the same position...or his preferred position. Also, my midwife recently told me "No way" on the shelids. It can actually exacerbate the problem.

The way that baby has to latch is completely differant; the way they have to use their mouths to suck is completely differant...not to mention the fact that it is harder work to breastfeed than to use the bottle. Like you mentioned, the one nipple was just pouring the milk into his mouth. This was definately a problem with my son. He got lazy and then became frustrated at the breast when it didn't flow as fast. Also, the nipple is postioned differanty in their mouths and they have to swallow differantly to accomadate this. At the breast, the milk essentially sprays to back of their throats and is swallowed. (My son is still getting choked sometimes.) The bottle allows them to push the milk back using their tounges.

I'm not sure there is a trick that will eliminate the trouble, but since eliminating the bottle, my son is doing much better with nursing and so am I. It just requires patience, love and diligence! Hang in there. He'll catch on in time. It is what is best for him; it's just tough to convince them sometimes. lol Enjoy your new baby boy and best of luck to you.

My dd was a preemie and my first and I tried and tried to nurse but it just wasn't happening. I think you should contact a lacation consulant for help. You can find one at the Baptist Women's hospital on Walnut Grove. They have a store inside the hosptial and you can set up an appt with the consutant and they will help you with the problems. I wish I would have found them sooner with my dd!!

I had to use a breast shield with our first son, and it worked great. I used it for about three weeks, and weaned him off it gradually so that I could nurse naturally. It is definitely worth a shot. Good luck.

I would not use a shield unless he just can't latch on. If it is because he is not sucking, I would get him to practice sucking. Does he use a pacifier? If so, I would get him to use that to practice sucking. My daughter was not a preemie, however she had not developed her suck muscles and we had to go to speech therapist to help her breastfeed. They recommended her use a pacifier. You can also call your local hospital and check to see if they have a lactation specialist to talk with and work with. Often they will work with you, even if you didn't deliver there.

My son was born at 27 weeks and was in the NICU for over 2 months. I switched him over to BF within a couple weeks of being home. It sounds like the bottle nipples have a bigger hole in them, so your baby doesn't have to work for the milk. When he does nurse, he probably expects the milk to flow the same way, so he's not working as hard. I would be persistant with the nursing, massage the ducts on the side while he's nursing to have more come out. You can also look into a feeding system that has a thin tube that goes into his mouth to provide supplemental milk while he nurses at the breast, I've heard that they are helpful for preemies. I know the pumping/nursing is hard work, but keep it up- it makes a huge difference for these little guys! My preemie is now a bright and extremely active 3 year old. You'd never know he started out so tiny!

My daughter was born just short of 35 weeks and spent 3 nights in the NICU but before we were discharged I was warned that she fed slowly. They said it was normal and sure enough it would take about 30-40 minutes to feed her 2 ounces the first month or so of her life. I bottle feed her but still that might be problem. Is the baby latching on properly? Good luck.

Hi R.,
My son was born at 36 weeks 2 days just last June. He was not premature, but he was "early". So he was not interested in nursing. I had to pump full time and give him breastmilk from a Haberman bottle (Medela makes them, they are not an easy flow nipple, the baby has to suckle it like a breast in order to get the milk out). It was a lot of work, but I was persistant in getting him to breastfeed. I consulted a wonderful lacation consultant who will come to your home. I will be happy to give you her info if you would like it. When my son turned 6 weeks old, he started latching and nursing one day and we have been going strong ever since. Babies born early by 3 or more weeks will usually take longer to initiate breastfeeding. But if you keep plugging along and offer the breast everyday in addition to using a bottle, he will pick up on it when he is ready. The hardest part is waiting to get to that point. Let us know how it all turns out for you!

Contact your local La Leche League leader--she'll be able to help. There is something called a "supplemental nursing system" that basically has a tube attached to a bottle of formula that comes down on your nipple where your baby is nursing. So your baby learns to suckle at your breast (and premies have a harder time learning to nurse, esp. if they were bottle-fed for the first several days). This nursing helps to build your milk supply and feeds the baby (formula) at the same time. I would imagine it would take less time total than what you're currently doing; but if not, it would probably get your milk supply up better or faster than your current system.

R.,
Aren't you wonderful for nursing your baby!! Remember he is a premie and he will fatigue very quickly, this is of upmost importance right now and this is his delemia. I know it is frustrating especially when you had good nurser your first baby. Your new baby is how old now? Remember if he was born at 35 weeks and you have been home with him even 2 weeks, he is not even as strong as a 38 weeker. Just keep at it, don't allow yourself to get frustrated and your MD has advised you well with additional milk for your sake, you will fatigue also. I do not advise the breast shield because this will only frustrate him and he is already trying to gain strength and learn. However R., this is a personnel choice and I won't say it won't work because it may, you will just try but too many things for him will confuse him and he is a hungry baby right now too!! I hope this helps and keep up the good work.

Hi R.
My Daughter was born at the end of the 33 week mark at 4 lbs 9 oz. She was also in the NICU. We tried desperately to get the breast feeding thing down. including the nipple shields. She simply was not strong enough to suck at the breast. The bottle is much easier for them to suck. So by the time she was bigger and stronger, she was used to the bottle and refused the breast. Well needless to say, she still got the breastmilk but it came in a bottle. I was a pumping fiend for her first 5 months, then I couldn't keep up my supply and we went to formula. Anyway, I think the point I am trying to make is that I ended up having to be OK with her not feeding from the breast directly. SHe Got the breast milk and that was what was important to me. Good luck B. M

I used the Starter Supplemental Nursing System (SNS) by Medela. It was given to me at the hospital by the lactation consultant, but you may be able to purchase it online. Some of the other moms have mentioned it, and I think it may work great for your situation. The formula comes out of a tiny tube you put along side your nipple. Your baby is then nursing each feeding (no bottles) but getting formula and breastmilk at the same time. We only needed to use it for about a week before he got the hang of nursing and we were on our way. My husband helped a lot with getting us situated, but it got easier as we went along. Check your phone book too for a store for nursing supplies if you can't afford the lac. consultant. (If it's not covered by your insurance you may be charged--often at $100 per hour!) Best wishes.

Be careful if you decide to use a nipple shield. I used one for several months (not with a preemie) and recently found out that they decrease your milk supply by 50%!! Had I known that, I would have tried to get my son off the nipple shield much quicker than that! I'm now having to nurse him and then supplement with a bottle of formula (also drs orders). It was our saving grace, but it also really hurt us in the long run. Just thought I'd let you know that. Good luck!

I had to use a breast sheild but my problem was latching on. If he can use a bottle though... it may work. Its worth a try!

My daughter (now 10) was a preemie. She could not suck & swallow. Her sister, 2 yrs older, never had a problem. The nurses told me that the suck/swallow reflex was the last to develop and many preemies were not able to breastfeed. It was important to me to at least get the antibodies into her, so I pumped for 3-4 weeks and used the bottle that just pours out. I had to supplement with formula because she didn't seem to like the breastmilk as much. I guess she got used to the other back in ICU (she had a feeding tube then). We stuck it out for a little while, then just changed over to formula. It seemed like I barely got done pumping, feeding, changing when it was time to start over again. This did not go over well with the other 2 children who wanted mommy's attention.
BTW, my little one did have more colds and bronchitis than the other (the one just on breastmilk) but I think it was more due to the fact that she sucked her thumb and picked up more germs. She now is very healthy, only goes to the doctor for checkups and ways almost as much as her 12 year old sister!
Bon Chance. au revior

S.

I had a friend who had to bottle feed due to dr orders and jaundice. The baby only took bottle w/ breast milk for the first 3 months. She would latch and then want milk from the bottle (since it comes out easier). Mom would offer the breast every feeding to encourage the baby and around 3 months, she eventually took like a champ to nursing and has not stopped since. My suggestion would be to offer the breast every feeding and see if baby finally takes to it. Occupying the 16 month old - good luck. My 25 month old loves to hang out with me while I nurse/pump. I found she LOVES Miss Spider's cartoon and I let her watch that while I feed or pump.

Call the hospital and ask to speak to a lactation consultant for more educated information. Jackson General has 2 consultants that were great help to me.

R.