breast feeding a preterm baby

hi everyone. my little girl is 12 days old, and was born 4 weeks early. she is not latching on at all. i have been pumping religiously, and we have gotten to the point where we no longer need to supplement with formula. we did see a lactation consultant the last 3 days in the hospital, but everytime she came near my breast she would fall asleep within 30 seconds (literally- and every time). since we've been home, i try a couple times a day. sometimes she falls asleep, sometimes she just gets very mad. i spoke on the phone to a lactation consultant that my ped recommended 2 days ago. for $150 she comes to your house for 2 hours (but we're working on insurance to authorize it). She said it's ok to wait a while longer before having her come, since baby was born so early and no where near her original due date. she said babies born that early often have feeding issues and need to grow a little first. She also said that she has the greatest success with babies like mine.
So, my question is, how long was it before your babies latched on? i'm especially interested in hearing from anyone who had a preterm baby, but would love to hear encouraging stories from the rest of you whose babies had difficulties at first as well. i want to continue to give her breast milk exclusively, but i am getting exhausted!!! it seems like twice as much work to pump separately and then feed her. thank goodness dh has been home til now to help with the bottle feeding, but he goes back to work monday (and he works 12 hr shifts, so the days he works i'm on my own for 13 hours). i'm not even close to quitting yet, and am determined to keep my supply up until she latches on. i just want to know how far away that light at the end of the tunnel is.

[mgi]

mine was born 5 weeks early
they worked my nipples like crazy in the hospital - literally shoving them into his mouth - it took a very long time for him to latch right BUt I persisited and he did

[Nicki1433]

My oldest was born at 34w0d.  He never latched on.  I tried for 3 months.  

My youngest was born at 34w5d.  He latched on a few times in the hospital, but that was it.  I tried for 3 weeks.  It never worked.

[mum2beagain]

My first was born at 32 weeks, he never latched well, I tried for four weeks, my second was born at 37 weeks (not really considered preemie) but was in the specail baby unit for a day or two, he did latch eventually but I refused to allow him to be given a bottle in hospital and he was tube fed if he didn't breast feed well, back at home my midwife showed me how to finger feed him with a small tube between breastfeeds if necessary so I didn't have to give a bottle, within a couple of weeks he was latching just fine and gaining weight well. Medela I think have a finger feed system, it really works as they don't get used to the latch on the bottle and they have to work hard to get the milk, it's not easy like it is with a bottle.
Anyway, keep persevering and don't beat yourself up about it if it doesn't happen for you.

Best wishes.

[Terri3111]

I am putting in a site with some info about nursing supplementers. This is a way for your baby to recieve your milk while at the breast. It's great for preventing (or correcting) nipple confusion, and it will also help with your milk production (pumping is good, but baby is always better :-)  ) It does say that the finger feeding method might be best for you at this point and then you can go on to use it at the breast later..but you use the same supplementer for both.

http://www.askdrsears.com/html/2/T026000.asp


I'm also putting in a site with just about any info you could want on breastfeeding...the particular link I'm putting in is for preemies though

http://www.lalecheleague.org/NB/NBpremature.html

I wish you all the best. I breastfed all 5 of my babies and was lucky enough not to have too many problems, but I am also a lactation peer counselor (don't know everything, but can be of SOME help lol)
Please let me know if these sites were helpful...if not I'll see what else I can find :-)

[tiredbuthappy]

thank you for all the information. and thanks, terri, for the links. i will try to educate myself on all of those options for when i meet with the consultant. i am afraid to try the cup or spoon,because she was very small and they want her putting on an ounce/day. as it is, we cannot interrupt her feed, even to just burp, because she passes out cold and we can't finish the bottle. occasionally changing her diaper and really pissing her off will wake her enough to finish, but not often. we had been using a preemie flow nipple, but both the pediatrician and lactation consultant advised us to use one with a faster flow to make sure she's getting the nutrition she needs. with the nipple we use now she does fall asleep, but we can usually get her to suck it down as long as we keep it in her mouth.  

[mum2beagain]

Is there someone from the hospital coming every day to check your baby? The reason I ask is I am quite surprised that they let you take her home if she wasn't feeding well (falling alseep, not finishing feeds), with both my infants the hospital wouldn't release them from the baby care unit until they were feeding well and alert enough to feed well, there is not only the weight gain thing but the risk of jaundice and low glucose levels when an infant isn't feeding well and these things are even more of a risk with preemies. I know it is probably  the last thing you want right now but maybe she needs to go back to the hospital for a few more days where they could feed her with a gastric tube for a few days and help her gain some strength and put on a bit of weight, preemies can use so much energy in thier efforts to feed and they could really be doing better by putting all the energy from your milk into growing.

P.S. I wanted to say well done on your efforts with pumping, you are doing really well to have her exclusivly on breast milk, it really is "liquid gold", I hope you get that latch in the end, best wishes Jo.

[tiredbuthappy]

Luckily, we are able to get her to eat what they want. it is just quite a chore! like i said, we basically have her inhale everything without interruption. for example, she was just asleep as she finished the second half of her last bottle. she's 13 days old now, and generally will take about 2 ounces every 2 hours (occasionally a little less, but she ends up being hungry sooner so we are starting to really follow her cues more than the clock. we never let her go much more than 3 hrs btw feedings though). she was gaining weight properly in the hospital, and has been gaining a minimum of an ounce a day. at our last dr's appointment she had gained 3 ounces in 2 days. i assume the doctor's not worried about jaundice and glucose since she is eating and gaining.

i tried putting her to my breast again this am. she usually will barely open up enough to fit my nipple. she'll do a very light suckle or two and try to pull away. i firmly keep her head there, and she will proceed to make faces that remind me of trying to force feed pees to a toddler who hates green foods.(it's actually amusing). this is what she does if she's hungry. if i try any other time, she just lightly suckles once or twice and falls asleep. i have tried giving her some bottle first, thinking if she's not as ravenous she may not get as frustrated, but she falls asleep. i have tried pumping a bit first, then trying to have her latch on so that the milk is flowing better.

thanks for the mini pep talk. we are actually proud that we have gotten to the point where we don't need formula. it was very hard work (and dh did play a part in helping with so many other things).

[Cheyenne_08]

I have been pumping since my baby was born 6 weeks ago! We have not been able to out him to breast because he has not grasped the concept of sucking, swallowing, and breathing in a rhythm. Right now they are trying to get him to take his food by bottle, then try to transition to the breast! Pumping for 6 weeks has been a LONG road;)

[mum2beagain]

You know that sounds like the exact same thing my first did, making the force feed faces! (He still does it now at 3 years!). I ended up bottle feeding him, expressed milk at first then switched to a  special preemie formula after my milk dried up (i was given some bad advice about pumping, but that is another story) he often slept through his whole bottle but so long as they are eating you don't mind right! With breastfeeding though they need to be a bit more alert with my second I had to keep tickling his toes and all sorts to keep him awake, I found stripping him off helped and I always did a diaper change half way through to wake him up a bit! With him it was hard for the first four weeks and I probably gave one or two finger feeds each day, I also pumped a couple of times a day to keep my supply going. It sounds like you are doing everything right you just have to give your little one a bit of time to build her strength up, the lactation consultants are well worth every penny, think of what you will save in formula alone!

Keep us posted on how it goes!

[tiredbuthappy]

how frequently are you pumping? i find my back can't support my boobs if i wait any more than 2 hours.
other than feeding issues, how's your little guy doing? is he home yet?

[Terri3111]

The supplementer was really what I wanted you to try (she should still be able to get what she needs from that) like the finger-feed method until she's able to open up enough to suck at the breast. I'm just worried that if she gets used to the nipple, she won't take the breast when she is able...which will eventually affect your milk supply. I'm a lactation peer counselor and our job is to do home visits to help with moms who are having trouble nursing. We don't have the formal training of a lactation consultant (who is called in if we can't help with a problem). I can't believe they are making you wait for the LC to come out. The longer you wait, the harder it will be to correct the problem. It might be better to contact your local LLL league leader. They have lactation consultans they can call also that might be able to get you the help you need sooner. I hope I'm not sounding pushy. I just hate to see someone who wants to breastfeed, that's having problems and can't get the help they need. Especially with a preemie who really needs the extra benefits of breast milk.
And please, don't get me wrong. If nipple confusion does become a problem, it isn't impossible to fix....it does take a lot of work though. And if your supply does drop from not enough baby stimulation, that's not impossible to fix either (there have been women who have never had a baby and been able to nurse their adopted babies!). I would just like to see you NOT have to go through those problems :-)

[tiredbuthappy]

i was thinking about contacting LLL and i think i will after reading your thoughts. what i read about the supplementer was that you should get help using it. and you're not being pushy- i appreciate your honesty. we go to the ped again on tuesday- i'll see what kind of progress they made in getting insurance to authorize the LC.

[Cheyenne_08]

My little man was taken off breast milk today and given Neocate because they think he might have a milk allergy....its practically unheard of in breast feed babies, but other than that, he is doing just fine:) He can come home from the hospital as soon as he starts eating better!

[mgi]

i squirted milk into his mouth forever till he realized what it was
then I tried like heck to keep him awake - he always slept and couldn't feed
BUt the doc said by two week appt all is OK if he is back to birth weight? (meaning they ex[pect them to lose some then gain it back)