Please help me

I've got two new little ones in the preemie nursery who aren't strong enough to nurse yet. They anticipate keeping them for at least a week or two. My little girl Karina is 4 pounds, 10 ounces, and my little guy Kevan is 5 pounds, 9 ounces.

They were 35 weeks exactly -- arrived by emergency C-section due to a placental abruption late Sunday night/early Monday morning. I thought 35-weekers would be a little more hearty, but they seem to be very fragile...I've brought both to the breast, and I swear my nipple is bigger than Karina's whole mouth. Neither of them seemed to know what to do.

Meantime, what do *I* do? I've been pumping, but didn't start until late Monday night, when the LC finally brought me a Medela Symphony. (You'd think they'd get it together at a hospital that claims it has 46 lactation consultants on staff.)

Anyway. My milk isn't in yet, even as of this morning. If I do get a couple drops of colostrum, I take those to the nursery, and they're happy to give them to the babies. But, they are also giving them a high-calorie formula every three hours, by bottle. Both seem to be taking the bottle just fine.

I've read here that so many of you wanted to avoid formula altogether, so as to establish a good nursing relationship...but, I am unsure what to do in my situation, if I don't have any milk to give them yet. Should I request that they *not* give the supplement? I'm so confused.

I'm also in a tremendous amount of pain, and they switched me from Percoset to morphine yesterday, because I wasn't dealing well....I literally cannot stand up and walk. So, getting up to pump often is a challenge, and then getting in a wheelchair and finding someone to take me to the preemie nursery....I try to sit there as much as possible to hold my munchkins, but it's been tough.

Please help me -- how often should I pump, and for how long? When will I start getting some milk? What else should I be doing? I feel like I've failed my munchkins already -- I wish I had been more prepared for this!

 

Hi Becca,

Congrats on the babies! I think the first rule of thumb is always "feed the babies" so getting your preemies to eat whatever they will (colostrum, formula, whatever) is key. getting them to breast will be possible over time, but you may have to un-train bottles some. It is doable -- my son Cole switched to breast after being bottle fed for the first 6 weeks (due to jaundice).

Since you were early delivering, your milk may take a few more days to come in. Any colostrum you can give the babies is AWESOME as it is packed with even more good stuff cause they were early. get as much out as you can -- the symphony is a good choice (I use it). your milk should start coming in by day 4-6 is my bet, and you'll laugh at how little there is at first -- but keep in mind that the babies' stomachs are small.

hang in there, get an LC who can visit you once you're home with the babies and can help you get back to breast. pre-term babies lack the fat pads in their cheeks to suckle well. they need to build up the muscles -- geting them to breast as much as possible is key to getting them to be good breastfeeders, If you have help at home -- take it as long as you can so you can get the babies on the right track once they are home. It's totally possible.

Cheers and hang in there -- you definitely can produce enough milk to feed preemies/twins and the first 6 weeks are tough, but it gets so easy.

Teri D

 

I second everything mentioned above. The Medela Symphony is an excellent pump. I use it as well. And you really need a relationship with an LC who will come to your home. It was a life saver for us and the only reason that BF took. I had a similar situation to yours...sort of. My twins were born at 36 weeks my boy was 5 lbs 9 oz and my little girl was 4 -7. The didn't spend anytime in the special care nursery, but we had a wicked hard time getting them to latch and an even harder time getting them to stay there. Also, it took a full 5 days for my milk to come in. Don't worry about the formula at this moment. We supplemented, because they were so tiny and jaundiced -- and we had no trouble cutting out bottles when they were one week old.

Keep pumping - pump every three hours if you can, even after you put them to the breast pump then. You need an LC and you should try to get them to the breast as much as is possible. Also, we used nipple shields for their first month and then weaned off of them. The nipple shield was a lifesaver for us -- but that is just us. OH! I almost forgot...skin to skin contact is HUGE!! It really helped my kiddos start rooting for my nipple. They were in their diaper and I was naked from the waist up. We did it all the time at home and still do often. Skin to skin contact is great for babies.

DON'T WORRY! You have not failed them. You are prepared for this - I promise.

Hope this helps and remember you can always post for more support here.

Hang in there --- breastfeeding is AWESOME once you get it established.

You carried them and brought them into the world. They are your children and you are their mommy. You are doing everything right.

:hug99:

 

I was in your exact shoes. I had Matilda and Oscar at 34w1d and it took us til about 8 weeks old to get her fully at breast and he JUST got fully at breast at about 3 months! It CAN be done. I won't lie- it was hard, and the longer it takes the harder it will be. But be persistant and determined and you'll get there. And if not, you'll at least walk away knowing you tried your hardest.

What worked for me for Matilda was I told my hubby to be a "breastfeeding nazi" ie he had to ride my butt about it, trying to get me to nurse her instead of use the bottle. I found a position that worked for me (side-lying) and just kept offering it. Of course, her latch was way better than my son's and I'd at least been letting her lick around and suck a few sucks since a few hours after her birth. He was another story altogether. He had pneumonia within hours of being born and was ventilated by 24 hours after birth and remained on the vent for a while. Even when he was off it, his breathing was awful. He came home on oxygen and the cannula also made things difficult. Not to mention he was just so weak from his illness and was a lazy latch/nurser. For basically the whole time he came home I kept saying to myself "I'll let him get well, then I'll start trying to nurse." Well, days became weeks, and weeks became 2 months, and when my daughter turned up nearly a lb heavier than him, when he was heavier than her at birth and all times before, it really got a burr up my butt to get him to breast. So I did the same thing with her- just offered it. I started slow, maybe once or twice a day if he seemed froggy. At first, he was so used to the bottle he wouldn't latch at all, wouldn't even root! So my MIL and I did a switcheroo with him. I put on a nipple shield and we got him started on a bottle. Once he was sucking good on the bottle, we just pulled it out real quick and popped in the shield/my breast. It took 2 or 3 tries but he eventually latched on and nursed for a fair amount of time. He just didn't get enough b/c within 30 minutes he was hungry again. So I would continue to do that and just top him off with a bottle. Then in a few days, he didn't need the "switcheroo" and he would latch onto the shield on his own. So at that time, I started pulling him off after a bit and trying to get him to latch on my nipple. Continued the topping off after feeds, which by now were also improving in duration and also how much milk he was getting since he'd take less of the bottles afterwards. At this point, he started preferring me to the bottle and paci. He'd make a pouty face when offered a bottle (I was doing the breast about 2 out of 3 bottles, or every other bottle) and grin when offered breast. So I started letting him use me as a pacifier at night (we co-sleep). Anytime he wanted to nurse, be it for food or just comfort, I let him. His suck improved and he started not taking ANY of the top-off bottle. Voila! He's been at breast every since. In the month prior to being at breast, he gained just a lb. But I had him weighed after 11 days of just breast and he'd already packed on a lb and 4 oz! He is visibily much chubbier and I swear his fussiness problems are all but gone now. Not only that, but he bridged the gap of his developmental delays in less than a month! Before, he was usually about 4 weeks behind, even for his corrected age. Now he is spot on for his birth age! I firmly believe it was the breastfeeding that made a difference. It's the only thing that changed.

I wish you the best and if you need any more advice, feel free to pm me.

 

Thank you guys, so so much. It really helps to read your stories. I will be at the hospital through tomorrow evening, and have made a "bedside" appt with the lactation dept -- meaning, an LC will meet with me next to each kiddo's nursery bed, and will help get them latched on. Their primary nurse agreed that we could definitely start working to get them breastfeeding....

Hopefully I can do the LC appt this evening, and tomorrow again before I leave. And, the babes are doing well -- so there is a good chance that we'll be able to take them home this weekend. I am hoping! They have to maintain their temps before we can do that, though.

I will ask the LC about using nipple shields if we need them. That sounds like a great idea. I don't know if they make home appointments -- will have to find out.

I so appreciate everyone's support and encouragement! Meantime, I am pumping pumping pumping...can't wait to see some milk!

 

You've gotten some great stories here! You have NOT failed!!! I think bf'ing preemies is a different ball game. I have nursed a full term singleton before, but this was all new for me.

My boys were born at 34w2d (they're 8 months now). They were 4 lbs 11 oz and 5 lbs 12 oz. They were so tiny and I remember their little head being smaller than my areola :lol:

We had to supplement with preemie formula until my milk came in (they were losing TOO much weight) I pumped every 3 hours, and my milk came in on day 3. We did continue to supplement, but it was becoming less and less once I was able to get a good amount from the pump.

And, one of my boys would not latch on. Ryker had no problems but Ronin would not nurse. So, we did LOTS of skin to skin contact. No shirt, and him with just the diaper. It was amazing to see him search for the nipple. We did a practice session once a day.

It took about 6 weeks for him to finally latch on, and he's been breastfed ever since.

Lots and lots of support, my husband was a HUUUGE supporter, as well as the nurses at the hospital. You can do this!!

 

Congratulations!!! You have not failed them!

PUMP every 2 to 3 hours to get your supply going! Drink tons and tons of water and eat often.

The NICU should give you bottles to pump into and you can send the bottles to the NICU to store. Ask your NICU for specific directions on how to package/label the bottles.

It took mine about 2 weeks to get the hang of feeding from a bottle and 3 months to nurse, so don't worry! They will get it eventually!

The symphony is a great pump. Be sure to massage your breasts while pumping and apply lansinoh to your nipples BEFORE pumping!

I hope things improve quickly :hug99:

 

He Becca,

Mine were 35 weekers as well, you can see their weights below. I don't think I would have been successful as I feel i am without the help of the great LC at our hospital. They immediately brought me the medela symphony and had me pumping for 20 minutes at a time every 3 hours. We also went straight to nipple shields, never even tried bare breast. I also had an LC meet me in the NICU several times, and they were SO helpful...just don't worry about modesty! Also, I'm not sure why, but mine had the nasal canulas for feeding, rather than bottle, and they did get formula that way, and also any milk or colustrum i pumped. They said if they'd nurse for 10 minutes, then they would give them a feeding. It was totally exhausting being wheeled by my DH every 3 hours to the NICU to try and nurse them, but we were diligent, couldn't have done it without him, and they are both still BF today.

My advice to you is to pump as much as possible, for at least 20 minutes at a time, even if nothing is coming out. Nurse as often as they'll let you try, and go get some nipple shields ASAP...they have smaller ones for preemies so make sure you get those. One thing though, check with the NICU staff regarding your new painkiller to make sure it's OK for the babies....

This is an AWESOME resource, so make great use of us, that's what we're here for! You'll do great mama! Hope you're feeling better soon!