Feeding issues with preemie

Hi Everyone,
I hope I'm posting this in the right forum. I have not posted in a while. I gave birth very, very early to my mono/di boys due to TTTS. They were born at 27 weeks and spent 12 weeks in the NICU. Fast forward and we have now been home for 4 weeks. My one son is feeding very well. In fact, sometimes I wonder if we're overfeeding him. Last Friday he weighed 8.2 pounds and he regularly wants to take 5 ounces (even more) of bottled breast milk. The issues are with my other son. He was Baby B and has always been smaller. The gap is widening though. He was 7 pounds on Friday and I can only get him to take about 3 ounces per feed (sometimes 2.5). I have been told they should be taking about half their weight (ex., 8 pounds would take 4 ounces), so it looks like I have an overeater and an undereater. I am worried about my little guy though. He feeds well through about 2 ounces and then starts grunting, groaning, pushing, turning bright red, acting like he wants the bottle and then refusing it when I put it in. He even cries sometimes. Has anyone dealt with a preemie who had feeding issues and seemed to undereat? Any ideas why he does all of the pushing and groaning? I burp regularly. He does have reflux and is on Prevacid. Sometimes I use Mylicon drops, but am never sure if he needs them. Any thoughts on what is going on would be helpful and tips on what you have done to improve feeding patterns in preemies who are problem feeders.
Many thanks!

 

Welcome to the first year and congrats. I have 6 week old Mono/di boys as well they are TTS survivors, but I made it to 37 weeks. My baby B was/is also smaller then his twins by a good 2lbs. William does the same thing as your baby does. We have had feeding issues with him since day one, and I was told he was/is very preemie like. He does the same thing your guy does. I find when he starts grunting and groaning, pulling away he needs a burp. It takes a LONG time to get it out of him though. I usually have to let him sit a bit and then burp him. I also give him smaller amounts and feed him more often. 2-3 oz every 2 hrs. We did that until recently, now he can handle 4-5 oz every 3-4 hrs. We did the 2-3oz for almost a month though. Hope this helps. Good luck

 

just like you, my TTTS survivors were born at 26w6d. Mine are onto 2 meals a day with baby food and Jaxon will do the same thing while feeding him - grunting and making noise, but only sometimes with a bottle. Just give it time and he will be fine. I agree with Slipper's suggestion of feeding him more often, but I would mention it at your next pedi appt too. He's probably still getting used to feeding from a bottle since he was on the feeding tube for a while. I wouldn't worry too much unless he isn't gaining weight correctly.

Congrats on your baby boys!! They are so much fun!

 

Hi I had preemies at 28 weeks. We had and still have major feeding issues w/ one of my boys. He had refllux and was on medication, but not enough. So I would just make sure he is on enough. At athat weight mine were on prevacid 7.5 TWICE a day. he was on it once a day and unfortunately, resulted in him continuing the reflux, which we didn't know--it was more silent reflux. By the time we moved him up, he had aversion. He was also only tkaing about 2 ounces a feed. Just make sure he is on enough to keep the reflux under control.

Glad they are home with you!!

 

my boys' weren't that premature, 5 weeks early, with no NICU time, only PICU and never feeding tubes but they did have a lot of trouble with bottles in the beginning. not so much the grunting, turning colors like you mentioned but they wouldn't latch on to the nipple and couldn't coordinate how to suck and swallow. we had to teach them, rubbing underneath their chins pushing their cheeks together, etc.

my boys' also have horrible reflux and have since birth. they are on 15mg solutab prevacid once a day now. i remember when they first came home they grunted a lot and made a lot of funny noises when they ate.

i know it's a pain in the tush but if you have to just feed the little one less more freqently. it helps a lot with reflux babies, athough it didn't seem to matter with mine. if they didn't want it, that's it they didn't eat and could honestly (to this day) care if they got another bottle so i have to be sure to offer them food every so many hours and make sure they eat.

GREAT weights though!! that is excellent!

 

The only thing I haven't seen mentioned (sorry if I missed it) is dairy intolerance like milk protein allergy. It's common with prematurity because of the underdeveloped systems at birth. I don't recommend soy formula because soy allergy is very common as well (in addition to soy not being good for you), but alimentum and nutramigen make a world of difference. In full disclosure I will admit that they are very expensive, but it is worth the cost. If it is a dairy allergy of some sort, it is commonly outgrown, but my milk protein allergy baby still is a little lactose sensitive. GL!

oh also wanted to tell you that 2.5-3oz is all my little ones took per feeding until after 6 months. I think the more important number is the amount consumed in a day, not in a feed.

 

Had same problem-was tiny air bubbles-bought dr browns bottle and issue resolved after baby got used to new bottle(2-3 feedings later) pain to wash all the parts but did wonders for our DD who finally learned to suck/eat/drink happily and is now 15lbs 7oz at 6 MONTHS! Lol! This is after losing 10 ounces out of hospital and sucking/feeding issues. Getting a good early feeding "experience" is key to not having fighting and forcing bottle issues later-so the bottle was well worth the money.. Check ebay for bottles for a good deal and then just buy new nipples(level 1 for feed issues) at store

 

I think 3 ounces per feeding is pretty par for the course for their adjusted age. But it also sound like his reflux is not under control. I would talk to the Ped about it. The Prevacid may not be working or needs to be adjusted. We had terrible reflux and it took a little experimenting before we found the right combination. And if you dont make any headway with the Ped ask for a referral to a Pediatric GI. This was the best for us.

As for reflux, some things that worked for us:

He is upright for at least 30-45 min after each feed (including at night).
A hypoallergenic formula
Prevacid
Adding cereal to bottles to weigh the contents down (per Ped GI).
Sleeping in a swing, car seat, bouncy at night. And elevated PNP during the day.

Totally agree. Lots of babies with reflux have an issue with milk proteins and they cant tolerate soy as well. I also would suggest switching to a hypoallergenic formula like Alimentum or Nutramigen. It made a world of difference in our reflux babies.

 

Both of my girls were problem eaters. They both have reflux and we had to go through a couple of different medications for each of them before we found one that worked, one is on Previcid 2x daily and Karafate before each bottle and the other is on Axid 2x daily. My baby B has is bad and we just recently switched her to the Previcid/Karafate combo and it seems to be working. The other also had a protien allergy, we switched her to soy and after still having it with that we had to switch her to the hypoallergenic (Nutramigen) formula. It's tough and I wish you luck. Don't over stress about it though... I did and I think I was almost making it worse by force feeding. I finally just said they won't starve, she was gaining what she needed to and I let them make their own schedules. It really seems to be working for them, unfortunately I feel like all I do is feed sometimes but that's okay!!

 

I was going to suggest Dr. Brown's bottles as well! Sometimes it's a bottle problem and not necessarily a baby problem. You could buy one or two and give those a try. They mimic breastfeeding and really reduce air intake during feeding. We love them.

 

Congrats on having your twins home! For your little one, how are his poops? My refluxer ended up horribly constipated on prevacid. We ended up switching to Nexium and had a new baby after that.