Breastfeeding a preemie

[Socalledchaos119]

My baby girl was born at 35 weeks to the day, she is 2 weeks now but they had me bottle feeding her pumped breastmilk in the hospital.  I want to get her on breast only but I don't know how to do it.  I can get her to latch and take occasional pulls at the breast but then she stops or falls asleep.  She takes the bottle but is even kinda lazy on it sometimes.  Right now I offer her the breast then follow up with giving her a bottle.  It upsets me that the doctors want me to measure how much she takes to an exact science...when I get her to finally take what they want they up it again.  Now I find she is spitting up a lot and idk what to think.  They also get mad at me about her weight.  She was 6.1 at birth then got down to 5.9 and Thursday she was 5.13, they wanna reweigh her next Thursday.  I'm trying my heart out.  My goal?  To exclusively breastfeed and stop the bottle.  How do I do it?  I don't want her weight to crash and how do I get away from the "science" of intake?  Also she doesn't wake herself up to eat...I wake her every 3 hrs.  Please help?

(sorry for being gone so long I know I posted on this before..thank you in advance!)

[Socalledchaos119]

Thank you!  I just placed my order for the sns system, I'm willing and committed to trying any and every option before giving up!  Id rather be able to say I tried it all.  I had not heard of that and I'm thrilled at the idea!  

I spoke to and met w lactation consultant from the hospital but they have not been very helpful at all.  They throw theories at me and would leave...they did the same with throwing a pump at me and saying this goes to this then this do it for 20 min, left me to it,  and I ended up using it incorrectly and had blisters on my nipples and was in horrible pain for days!  YouTube, google, and this site have been my only help in this process.  I finally got in contact w the local LLL and they have a breastfeeding dr here I'm calling in the morning I hope to see and I want very much to go to the meeting this week. I'm looking for ideas and support cause i really need it and it's been hard to find.  I will ask and look into the scale thing too, the measuring science hasn't set well with me.

When we left the hospital she took 15 cc every 3 hours she is now at 2 1/2 oz every 3 hours.  That is what I know she is getting from bottle.  We try latching and sucking but it hasn't gone well cause she just isn't getting enough milk to encourage sucking right off.  I'm hoping the sns can help now.  I watched videos on Dr Jack Newmans breast compressions today and I don't think I'm good at that, lol.  I have big breasts and I'm still very ackward with positioning and managing it was just too much till I have more experience?  Idk but I thank you for the new thoughts!

[steph_ut]

Our daughter wasn't a premie (she was born on her due date!) but I had a similar experience of sleepiness, weight concerns, spitting up, etc. There are systems available called supplementary nursing systems (SNS - I think Madela was the brand we had) that is effectively a small container that can be filled with expressed milk or formula with a thin hose that runs along your breast. When the baby latches, she then gets liquid both from the breast and the tube. They can be used by narrowing the gauge of the tube as the baby's strength/eagerness to nurse increases so she takes more from the breast, with the goal of eventually getting her off the system completely - I know someone who did so successfully even though I failed. It is time-consuming since you have to pump as well but perhaps not much more so than what you are currently doing since you're pumping for bottles.

As for sleepiness, stripping her down to her diaper, playing with the elbows and ears, and even blowing on her tummy or using a wet washcloth helped rouse her enough to feed a little but sleepiness with a big problem for us too.

One way to judge consumption is by weighing her. We did it with a lactation consultant several times - you would need to rent or buy a scale from a lactation store, or invest in a decent quality kitchen scale that can weigh 10+ pounds so you can place her in some kind of container for weighing. I didn't like the approach of saying she "had" to consume a certain quantity of milk, especially since it turned out she seemed to have some reflux problems, helped with medicine (perhaps prevacid?) so we dutifully brought her for a nurse's visit once a week for I think about 10 weeks. I'm not sure why they're being so pushy since she's only a few ounces shy of her birth weight at 2 weeks but medicine isn't a firm science and maybe premies are a higher concern. Not that it was a good thing (I was terrified to be honest!) but our daughter only regained to her birth weight at about 4 weeks and has turned out fine despite my maniacal commitment to exclusively breastfeeding..

This is getting super-long but a few thoughts:
1) The hospital at which you delivered should have lactation consultants you can work with even though you have been discharged. Ours were provided through  the ward we stayed in after we had her (not l&d but the name escapes me). We also sought private lactation consultants through our doctor - she visited our home and it was pricey but I found her more helpful than the hospital ones.

2) You might also check for your local chapter of the La Leche League. Even if there isn't a meeting this week you can attend, you can probably find a local contact that you can call or e-mail. I found a few a bit too militant and overly-critical when we finally decided to stop trying but supportive and helpful when we were still trying.

Good luck! Feel free to drop me a note if I can help, even if it is to simply share experiences that sound similar.

[MamaBear0612]

I've worked with a few preemies and I would say the doctors are worried about her weight for a reason. What do the doctors say about the conflict you're having between breastfeeding and getting her to eat enough?

My concern is that preemies are typically very hard to feed and get to take enough food as it is. By breastfeeding her first I wonder if she's not getting much out but wearing herself out in the process. Is she taking more or less out of the bottle than she did in the hospital?

I worked with one preemie who was fed every two hours. She would take about an hour on the bottle, falling asleep the whole way so we'd have to actively encourage her to eat, then she'd sleep for an hour and then we'd have to start the whole process again. Exhausting. I know it's a hard place you're in, so wish you both luck.