Getting a bottle fed preemie to nurse

[motzie]

Has anyone here successfully been able to do this? DS was a month early and never successfully latched for more than a second at the hospital. We started him on bottles and I've been pumping ever since. I can get him to latch with the nipple shield about 1-2x a day where he'll actually nurse for a few minutes. But then he quits and gets frustrated so we go to the bottle. I don't want him to get too frustrated with it so I haven't been pushing it when he gets upset.

Lactation said I should be working with him for 30-40 minutes each time to get him to feed, but that's just not going to happen. He'd be a starving, inconsolable mess if I made him try that long. Also I have two other children so I can't focus on anything for 40 minutes.

I'm not ready to give up just yet, but its starting to feel hopeless. Any tips or anecdotal stories are appreciated!

[househunter]

Check out a supplemental nursing system

[kershnic]

I'm sorry you're having a hard time. Whatever you decide to do will be okay, and there's no shame in either deciding to pump exclusively or deciding to either supplement or switch entirely to formula.

The good news from my story: Yes, I successfully got two bottle fed preemies to nurse. The bad news: It was a lot of work, especially for one of my kids. A lot of the details are pretty fuzzy for me now but I'll tell you what I can remember. In addition to being a preemie F was small for her gestational age, so she was only about 4lbs when she came home - which meant she had a tiny mouth and my nipples are kind of huge - which was definitely a barrier.

My girls were born 6 weeks early and spent about 2 weeks in the NICU. Neither one really successfully latched in the hospital and they went from IV nutrition to pumped milk in bottles. Thankfully I had no supply issues. At each feeding I would basically try to get them each to nurse as long as I could until either I or they got too frustrated (I was pretty persistent, but there were a lot of tears from all of us) and then quit and they got a bottle. S picked up breastfeeding with a few weeks and never looked back. F didn't really learn to have a good latch until she was somewhere in the 2-3 months old range.

I did hire a lactation consultant to come out to the house for F when she was around 6 weeks old. She set me up with a nipple shield and finally got us to the point where she was at least transfering milk (even though she still usually needed a bottle to finish a feeding). Sometimes when she was really upset and hungry I would try giving her a bottle for a minute or so at the beginning of a feed and then switch to nursing and then finish it up with a bottle at the end. But mostly I just tried to get her to nurse for as long as possible as often as possible. I did not start nursing her overnight until she was able to transfer milk consistently at about 3 months (bottles overnight).

Only you can decide how much work this is worth for you. I don't have any older kids and I really wanted breastfeeding to work. S learned fairly quickly and her success helped me keep going for F. Plus I had infant twins and no other kids so I wasn't really expecting to get anything done other than keeping the three of us alive.

Good luck with whatever path you take.

[Jalapeñomel]

Yes, I did it! But the nipple shield was what made a difference. I used it for 6+ months, and EBF until a year.

[motzie]

househunter, I think my sister actually used one of those with my nephew, That might help us get past the frustration of him waiting for let down. Thank you for the suggestion!

[motzie]

kershnic, Thanks for giving me hope! And for your kind words. When he started latching a few times it felt like success, but now we need to get past that hump. I'm glad to hear it can be done. I'm happy he's fed, so I'm trying not to stress over it too much either way, I just miss nursing more than I thought I would. And the bottle and pump washing is destroying my hands. I will keep trying for sure.

[kershnic]

Nov 12, 2016 21:36:02 GMT -5 motzie said:

kershnic, Thanks for giving me hope! And for your kind words. When he started latching a few times it felt like success, but now we need to get past that hump. I'm glad to hear it can be done. I'm happy he's fed, so I'm trying not to stress over it too much either way, I just miss nursing more than I thought I would. And the bottle and pump washing is destroying my hands. I will keep trying for sure.

Oh, also, we kept the bottles with slow flow nipples and tried hard to use paced bottle feed to avoid getting her hooked on getting the milk too fast. Also, when I did have her latch on I would try to hand express a little to be right there in her face and also use compressions to make sure the milk kept flowing quickly.

I read somewhere that babies can definitely learn up through at least 4 weeks past their due date, possibly longer. That helped me keep going when I knew we were still in that window even at 10 weeks old.

[stretchad]

DS was a preemie, and we had to work pretty hard at breastfeeding. We sort of always used a combo of breastfeeding for some sessions and pumped bottles for others. But once he got the hang of it, it was smooth sailing from there on out.

If you're having a little bit of trouble getting your letdown to start, then try pumping just a bit to get things going then put baby on. You could use a manual pump for this.

Hope that helps!

[starlily]

DD1 just wouldn't nurse, despite multiple attempts at everything the lactation consultants could think of.

DD2 would only nurse from one side. My supply was low though, so I supplemented regardless.

Both were 5 weeks early.

[mccallister84]

We are going through this right now as well. E isn't a preemie but was born at 39+1. However, I always thought my due date was early based upon ovulation so I think she's closer to a 38 weeker. All the lactation consultants have independently said she acts like a late term preemie. She is very, very sleepy and hard to wake. We have to strip her down and work for every feed.

I thought she was doing really well but it turns out she was using me as a human pacifier and wasn't transferring any milk. She dropped more than a pound and wasn't having enough wet diapers so we started supplementing. They day we found out she had dropped so much weight we did a weighted feed and that's when we learned she wasn't getting anything from me.

When we started supplementing I started pumping. Then we learned my supply wasn't any where near what she needs. So we rented a hospital grade pump and I added a power pump session to boost my supply.

We haven't been at this very long - just since Tuesday but I'm already started to see some improvement. She will latch and transfer milk maybe every other session. It's definitely not enough to stop supplementing right now but it's something. Some things that we found helpful: suck training on my finger, giving her an 1/2 ounce and then putting her on the breast, pumping for a few minutes to draw out my nipples. Apparently my nipples are flat and wide and her mouth is small.

My concern is when H goes back to work on Monday. This is sustainable right now because there's two of us. I have been shocked at how important the breast feeding relationship is to me so I'm willing to work this hard. But my sanity is also important so there's the need to balance that
The LC asked me to give her two weeks on Wed. I couldn't do that, I have to take it one day at a time
But we are making incremental progress, which is encouraging.

[Jalapeñomel]

Is your baby in the NICU or at home?

One thing that may help you is to wear your baby when you aren't nursing. The NICU nurses swore by kangaroo care, and I found that it helped encourage me and feel like I was doing ok.

(((Hugs)))

[motzie]

Nov 13, 2016 9:04:32 GMT -5 Jalapeñomel said:

Is your baby in the NICU or at home?

One thing that may help you is to wear your baby when you aren't nursing. The NICU nurses swore by kangaroo care, and I found that it helped encourage me and feel like I was doing ok.

(((Hugs)))

He's at home. He's a month old now. We luckily didn't have any nicu time. I had been wearing him in the moby but this week he was not happy about it. I think he's big enough now to try out the Beco.

[motzie]

Nov 13, 2016 0:40:24 GMT -5 stretchad said:

DS was a preemie, and we had to work pretty hard at breastfeeding. We sort of always used a combo of breastfeeding for some sessions and pumped bottles for others. But once he got the hang of it, it was smooth sailing from there on out.

If you're having a little bit of trouble getting your letdown to start, then try pumping just a bit to get things going then put baby on. You could use a manual pump for this.

Hope that helps!

I tried this just now with my manual pump and it helped. Well, stinker still wouldn't latch, but I will keep doing this as a primer. Thank you!

[longtimenopost]

hugs! Yes, my former 26 weeker nursed for over 2 years. She came home from the NICU on bottle and breast, and since I had to go back to work 3 weeks after she came home we continued that way but slowly transitioned to only boob when I was home.

I second the manual pump to pump up nipples first, and don't try breastfeeding when hes's super hungry because he'll just get frustrated. Give him a couple ounces from the bottle then work on latch and let him stay as long as you can to comfort suck. If you can let him do some marathon nursing in the evenings after your older ones go down that would be great too!

[ijack]

I did, but it was when DD was about 4 months old (1.5 month adjusted). I'm not going to lie, it took a lot of time. I used a shield and I would put her to breast every single feeding. If he's impatient I would pump/hand massage until you let down and then try to get him to latch. But she emphasized that you should try to latch every feeding and then bottle feed if it doesn't work. Once she started latching we would basically spend all day nursing on and off while she figured it out (much like you do with a newborn). I also spent a lot of time at the LC's feeding clinic a couple times a week.

[sent]

DD came home at 4 pounds. I struggled with trying to get her to nurse with a shield until she was about 2 1/2 months old and then I gave up and went to EP and bottles. She would never nurse to satisfaction and was constantly hungry. She also had reflux which probably didn't help her issues. Once we move the bottles, she would fill her tummy and sleep peacefully which gave me a chance to rest and get better as well. In retrospect, she was too tiny to be successfully nursing at least in my experience. No regrets, I liked the closeness from bottlefeeding more than nursing anyways. And also liked that bottlefeeding could be delegated to others.

[motzie]

mccallister84 Good luck to you! Did LC give you the shells to try for your nipples? Mine were also flat before DD1 and they helped until they came around after nursing for a bit.

[mccallister84]

Nov 14, 2016 12:58:37 GMT -5 motzie said:

mccallister84 Good luck to you! Did LC give you the shells to try for your nipples? Mine were also flat before DD1 and they helped until they came around after nursing for a bit.

It is so, so hard. We are using the shield. At the pedi today we tried to do a weighted feed and she lost half an ounce. I know she transferred milk that feed - it was all in the shield and pooling out of her mouth. They're not really set up for that though, the scale only goes in .5 ounce increments. I didn't notice if the nurse who weighed her first made sure to zero out the scale, so I'm wondering if her first weight was off. It's also hard to get help. Almost all of the hospitals around here only offer inpatient service. We paid out of
pocket for someone to come to the house. I finally found somewhere I can take her that our insurance will cover, but the first appointment they have is Thursday and we have a breastfeeding support group then where we meet with a LC and of course they don't have a Friday appointment. I feel like I need someone to come spend the day with me and just watch all her feeds and give advice. At this point I think I've set Thanksgiving as my goal to reevaluate this.

[mccallister84]

Nov 12, 2016 20:13:24 GMT -5 motzie said:

Has anyone here successfully been able to do this? DS was a month early and never successfully latched for more than a second at the hospital. We started him on bottles and I've been pumping ever since. I can get him to latch with the nipple shield about 1-2x a day where he'll actually nurse for a few minutes. But then he quits and gets frustrated so we go to the bottle. I don't want him to get too frustrated with it so I haven't been pushing it when he gets upset.

Lactation said I should be working with him for 30-40 minutes each time to get him to feed, but that's just not going to happen. He'd be a starving, inconsolable mess if I made him try that long. Also I have two other children so I can't focus on anything for 40 minutes.

I'm not ready to give up just yet, but its starting to feel hopeless. Any tips or anecdotal stories are appreciated!

Just wanted to check in and see if you guys had any more success...

[nannerl]

I don't go here, but both my oldest and youngest sons had latching issues and although they were not preemies, we went down the pump and bottle route. DS1 figured out the latch between 8 and 10 weeks old, and I'm working with DS3 right now to transition him. What worked for us:

--Pump and bottle feed on demand with slow flow nipples to help with max sleep and weight gain.

--Treat nursing like a hobby in the beginning-- we went for comfort nursing with a shield to get them used to the process without being hungry (then hangry!)

--At about a month to six weeks, switched to Calma nipples for the bottles to help train them to control flow.

--Slowly introduce more "hunger nursing" with shield but have a bottle ready if kiddo gets frustrated and desperate on the breast

--Start comfort nursing without the shield.

--Start hungry nursing without the shield. Slowly phase out bottles.

It was/is currently tough slog (at least for me), but it's doable. And if it doesn't happen, that's ok! You do what you need to do to have the best possible feeding relationship, whatever form that takes!!

[FloFTW]

My 29 weeker never got it. I pumped and he got bottles up to a year. I was really happy with that.

My 32 weeker used the nipple shield for 3 months then I nursed her until 18 months. Those 3 months were HARD as I was also dealing with over supply. Then suddenly it was like she just caught up with me and it was smooth sailing.

[motzie]

mccallister84 Not much progress, but we're going back to lactation on Friday. Some days he just screams and refuses completely, and then like today he will latch and suck a little bit, but then quickly get frustrated at the speed. I'm really hoping lactation can help us.

I was ready to give up and just pump, but now I'm apparently having a lipase issue so keeping and storing milk is a whole other process added on.

Thanks for checking!