Breastfeeding a preemie

Lacey - posted on 03/20/2009

My little guy was born at 34 weeks...well the pediatricians said 31 weeks. I exclusively breastfed once he came home from the hospital. At first it was difficult because I was only allowed to feed him once or twice during the day in the NICU and the pump just didn't get things going for me. So when he came home I started BF for all meals and he ate about every hour to hour and a half to get my supply up (this was with meds to help me let down) he gradually worked his way up to 2 hours between feedings and ate every two hours until he was about 4 months old...he is 7 and 1/2 months now...eats 2-3 servings of baby food each day and nurses about every 4 hours. Seems like he's always eating. Also from feeding him so much in the beginning I had really really sore nipples. Yay for Lasinoh nipple cream.

Kristi - posted on 03/20/2009

Hello Ladies! 

Thank you again for sharing your stories and tips.  My little guy is now 13 weeks (5 weeks adjusted) and still will not bf for more than the let down.  I continue offering my breast and then pumping and giving him my milk through a bottle.  I talked with LLL a couple weeks ago and she gave me confidence to try bfing exclusively again.  He wasn't happy with it.  Then I had a one-on-one consult with a nurse from the special care unit.  She didn't think he was latching on quite right and said he's getting too cozy.  I'm still hoping he'll "just get it" as many of you have experienced.  For now, I'll keep going! 

You are all amazing women!

Susan - posted on 03/20/2009

Have patience... it is really hard.  Both of mine were preemies.  I gave up breastfeeding the first and really stuck with it for the second and I am exclusively breastfeeding him now (he is 4.5 mos now).  I went to the lactation ctr at my hospital and they showed me little tricks like wearing a plastic breastshield because that is closer to a bottle nipple.  Make sure you squeeze your breast and have some milk in there first so they will smell it and give it a try.  Also, try to feed him by breast first for about 5-10 minutes.  Then, if he doesn't take much, give him a bottle and pump afterwards.  It takes forever that way, but sometimes it works.  Also, if he is really hungry and gets fussy when you try to BF, give him a little from a bottle first to settle him down, then try the breast.  I really didn't have too much luck until right around him due date, and then he seemed to just wake up and get it.  By then, he was old enough and had enough weight that I pretty much just gave him the breast and said you need to pick this up because he would cry on my breast and just wait till I gave him the bottle (sneaky thing!).  ANother mom I know did this and they do pick it up fast because they want food.  If you do this, make sure he is peeing and pooping enough and isn't losing weight.  If that happens, he still needs bottle backup.  Good luck.. it's really hard, but soooo worth it if you can hang on!

Cassandra - posted on 03/09/2009

Firstly, well done to you and all the other Mums out there for expressing all those months! It can be sooooooo tough, can't it?
My daughter was born 8 weeks early and spent 5 weeks in hospital. She was tube fed for a month before being bottle fed for a week before coming home. Like you, I thought that it would be so much easier to BF when she came home, but as it turned out she refused the breast totally (she would have one - two feeds in hospital a day before that). She wouldn't latch, and if she did because my letdown was slow she wouldn't keep sucking... I was so distressed and upset, after all, I thought BF was suppose to be this natural, instinctive process, but as I have found it is a learned skill both for Mum and bubs. I kept expressing for another month, occasionally trying to over a BF a couple of times a day. I had resigned myself to expressing and giving it to her in a bottle when my maternal nurse made an appointment with a lactation specialist - I had nearly given up trying her on the breast because it was so upsetting for bubs and I. Guess what? My DD decided to have the perfect BF in front of the expert, making me look like a liar! She literally decided she was going to start BF that morning. I'm pleased to say that we are away feeding, although its not easy and I do worry she is getting enough. I was told that if she refused to latch within 15-20 mins, give her the bottle, and if she was feeding poorly at the breast, give her the bottle well before 40-50mins so she doesn't get too tired. The trick is to keep Prem babies awake enough to suck, I find tickling her toes works. Like many milestones in babies lives, they will just turn that corner when they are ready! I have found that as long as she is having 6-8 plus wet nappies a day, and regular dirty nappies and seems happy most of the time, she is getting enough milk (my letdown is also better now she is feeding off the breast). Just be careful with using any hormonal contraception, I found that my supply did drop a bit after being on the Minipill for a couple of weeks but I have managed to get it back by expressing straight after her feeds and watching my water intake.

Don't let anyone make you feel bad about choosing to solely express and bottle feed or go onto formula, you do what is best for you and bubs. If trying to breastfeed makes you and the baby upset, its not worth it. The best advice is not to stress - worrying about my milk supply only made it so much worse... it got better when I finally decided it didn't matter, it will happen or it wouldn't!

Good luck with getting bubs to BF. Its worth it if you can persevere, but not worth it if you and bubby get very distressed trying to do it. Congrats on already doing so well, as I have found most Mums I have talked to gave up within the first few weeks of expressing.

Leslie - posted on 03/08/2009

My daughter was a 24 weeker. She had no suck reflex but I tried. She actually latched on a few times but was never too sure if she was getting enough. I pumped for 6 months which lasted a while cause she ate such a minute amount in the beginning. But my milk never really came in. I tried herbal teas and message, it helped but never too much. I think as long as they get that first milk with all the good stuff in it they will have a healthier start than just purely formula fed babies. They don't call it liquid gold for nothing! The biggest thing that upset me was that I had to ask the nurse about breast feeding ans was never approached about it. I was totally out of it after I had her and never pumped for quite a few hours after her birth. I always wondered if I had pumped right away if it would have mad a difference... But today she is one of the healthiest kids I know, and she is not a good eater really. It is still struggle but she does like healthy fooods which makes me happy. But she will never turn down a cookie or candy...Don't stress too much--this coming formt he queen of stressing out. I think the fact that you are worried about it makes you a good mom.

Tracey - posted on 03/08/2009

My daughter was born at 31 4/7 weeks. I pumped for six months. The only time I could nurse her was first thing in the morning when I was "full" and only if I was laying down. She was "lazy" and would not work for it and the when she did my let down was too quick. I did use a shield for a while but it didn't work for me. If you really want your child to have breastmilk, it does not matter the method it is given, bottle or breast. I think you are doing a great job. Keep up the good work

Colby - posted on 03/07/2009

i had my daughter 5 wks early and for 3 days they had her on a iv then i started to breast feed she would lach on and suck fine but then she would just play with the nipple and get all wet so i started pumpin and it went well for about a month and a half then i found out that u need ur baby on ur boob the odd time for the baby spit on ur nipple that helps u get milk so my doctor put me on the med that helps ur milk come in but after 2 days of takin it my nipples cracked really bad and i had to give her formula for a few days until i could get in to see the doctor and the doctor told me that i can still give her breast milk but i have to nurse her and i wouldn't b allowed to pump so i just stuck with the formula cause then i also knew how much she was getting... so u can try pumping the odd time and still nurse but just in case the med that i got to help my milk come in is called DOMPERIDONE MAL 10MG

Alicia - posted on 03/07/2009

My son was 6 weeks early and I chose to breastfeed. The nurses were a little concerned because I was in icu for the first 24 hrs so he had to bottle feed, but he took to the breast with no problem. I also had to supplement extra calorie formula and didn't know that it would make my milk supply lower. I couldn't figure out why he was only feeding for a few minutes at a time and then stopping. I tried to pump, but after about 30 minutes I only had an ounce of milk; very frustrating. I ended up having to give it up when he was 8 weeks old because I had to go back to work and couldn't spend as much time as I needed to breastfeed.  I do wish I had stuck it out a little longer and talked to my dr about why I wasn't producing enough milk, but he did just fine with the formula.

Asmaa - posted on 03/07/2009

if you really want to breatfeed dont give up!  my son was born @ 26weeks and stayed in the nicu for 2months and all that time i had to use a breastpump. but i faced many challenges, as a pump doesnt offer the same stimulation as a suckling baby, so after about 3weeks my milk was almost down to nothing, the nurses still gave him whatever milk i was able to produce,in addition to formula. 2weeks before i took him home, i consulted my gynea and she prescribed a pill (cant remember the name)  and my milk started filling up again. That was about the time we decided to try him on the breast, which was more difficult than it seems, and once he slipped of it, he would refuse to latch again.  But thankfully by the time i took him home, it was easier for him to latch, but i continued feeding him on one breast per feed in stead of switching breasts after ten minutes. he is now 19 months old, i put him on fresh milk when he turned one, but continued to breastfeed. Now he only drinks from one breast (so i have different size boobs)  and some days doesnt drink at all.   Mothers milk is the best for your child, thats why we have it!!!

Christine - posted on 03/05/2009

My son was born at 29 weeks and 5 days and was in the NICU and step down unit for 6 weeks. I pumped every 3 hours except for a 6 hour break to sleep. After about 4 weeks the doctor let my son "nuzzle" while he was getting his gavage feed. I would put him at the breast after I had pumped and just let him kind of smell and lick...it was kind of weird at first. Then, after a few days, we started him learning with the bottle. They would let me do one bottle feed and one breast feed per day and increased it gradually. I think the nuzzling helped him kind of learn where he was supposed to be and associate it with getting fed. I also had to use a nipple shield at first when we started to breast feed because his mouth was too small but, I tried to not use it once we got better at the whole thing. Now, he breast feeds for all of his feeds except two because he is anemic and has to have vitamins. I mix them with pumped milk in a bottle because it irritates his stomach less. I still pump after the two bottle feeds to have fresh milk for his next bottles. Good luck!!

Pamela - posted on 03/05/2009

My daughter was 32 weeks. I had no problem with supply, I started pumping 2-3 days after she was born. So, I was able to stock up the freezer. But, she never quite got latching on down. She would with a nipple shield, but that was spotty and if I forgot the shields when I want out, then what. After many months of struggle, and a lactation consultant, I decided I had enough of the battle (she was very colicy as well). But, continued to pump until she was 6 months. It is amazing how much more work it is to pump. It looks easy, but it takes a lot out of you. 1/2 to pump, 45 to bottle feed and changing, etc. She was never a sleeper and still isn't - she is 6 now!

Katie - posted on 03/01/2009

I am so glad that you have stuck with it! I promise very soon it will be as easy as it is with a full term baby.

I think I fed my son 30-40 minutes before giving him a bottle with expressed milk, but recent studies I've read say they get more from breastfeeding. I would go with instincts. If he seems not to be getting enough, give him a bottle. My breastfeed 40 minutes, bottle feed about 10-15 minutes, rest until baby wakes up (and pump, normally), start over took a full 1.5-2 hours, or until he seemed to be hungry again. When he falls asleep, let him sleep. When he starts nuzzling then feed him. His stomach will catch up with him appetite soon and his sucking will get strong enough to fill his stomach. Keep doing what you're doing!

Becky - posted on 02/28/2009

My daughter was born at 30 weeks weighing 2 lbs.,9 oz.  She was in the Nicu for 7 1.2 weeks.  I would nurse her whenever i went to visit her and she sort of got the idea of what she was suppose to do.  When she came home from the hospital she was still under 5lbs.  I tried nursing her when she came home too, but since she was so tiny,s he would get tired very quickly and she wouldn't fill up.  So, I had to feed her, then top her up with a bottle and then pump.  I had to do this every 3 hours.  It was exhausting and to top it all off, I had a 19 month at home as well.  I even went as far as sending my son to my parents house for a week so that he wouldn't distract me when I was nursing and I could focus on my daughter.  After trying to do this for a month, I was exhausted and it wasn't far to my son to be spending that much time with my daughter and being tired all the time, so we switched to formula.  i don't think anybody has the right to judge you if you decide to switch to formula.  It's your own personal opinion and nobody else walks in your shoes and knows what your life is like. You should do whatever you feel comfortable doing and whatever is best for your entire family. 

Heather - posted on 02/27/2009

My daughter was 33 weeks; 5 lbs, 5 oz. at birth.  She came home after 38 days in the NICU.  She had had to stay on formula the last few days she was in there, and for a week when she came home because of an infection she got.  Honestly though, after I put her to my breast, within a few weeks she would no longer take bottles.  I should mention that I pumped with a medela double electric pump religiously while she as in the NICU, and during that first week home.  Then I just pumped after feedings to relieve some of the fullness I was feeling because basically I had been overpumping.  So we had to adjust a little.  She was great, and actually didn't give up nursing until after her 3rd birthday - at that point it was mostly just bedtime ayway.  She is now 4 and is a happy little girl going to preschool.

Hope that helps a little.

Sandy - posted on 02/27/2009

My daughter was born at 32 weeks - weighed 4 lbs, she was in the hospital for a little over 3 weeks.  When I first brought her home and tried to nurse, she would scream and cry and I couldn't get her to latch on.  After several days and almost giving up, a friend of mine said "she's probably starving...she was fed via the gavage, then bottle fed which is instant gratification..."  I didn't realize the reason she wouldn't try was because she was too hungry.  So - I started by giving her a bottle of 2 or 3 oz. expressed milk, then moving her to my breast.  It took me a little over 2 weeks to wean her off the bottle and onto my breast - it was worth it, but it was hard work.

Schmoopy - posted on 02/27/2009

I BF my DD (a 29 weeker). The hardest part was establishing my milk supply with a pump (instead of a baby, who would do a much more efficient job). After that, another challenge we faced was my DD never learned to latch on properly. So we ended up using a nipple shield the entire time. (They're available at Target and Walmart.)

Stick with it - it's so rewarding. And there's no better feeling than knowing you're giving your preemie every advantage in strengthening his immune system. Good luck! Keep up the good work!

Julia - posted on 02/26/2009

I wanted to breastfeed, but it was quite hard for us also. My daughter was born 7 weeks early weighing 4lbs 12oz. It was just too hard to do because she didn't latch on and I had to use a nipple shield...by the time I got her to start feeding I was sweating like a banshee and then she would stop sucking after a few sucks. So I chose to pump because I still wanted her to have the breastmilk. I pumped every 3-4 hours every day around the clock and by the time my daughter was 6 months, I was sick of lugging my pumping stuff and bags around with me wherever I went. Also trying to find a clean, comfortable place to pump was hard. I had enough milk in the freezer to last 3 weeks after I quit pumping, so she had breastmilk for almost the first 7 months. I'm really glad that I did choose to pump, but I really wish I would have been able to actually breastfeed, I probably would have done it much longer. If you can do it, do it, but if not, don't beat yourself up about it and don't let anyone put you down if you have to switch to formula.

Andrea - posted on 02/26/2009

MY little girl was born at 29 weeks 6 days at 2 pounds 11 ounces. I pumped from the beginning and was able to do that for three months. My daughter spent 2 months in NICU. I tried sooooo hard to nurse her once she came home. She wanted nothing to do with the breast and completely preferred the bottle since that is what they started her on in the hospital. After a tortuous month of trying to nurse - we were both miserable - I gave up and she went on formula. Although I felt guilty at the time, it was the best decision I could have made. I started enjoying my time with her instead of dreading the next feeding. We were both so much happier! And at 2 1/2 years old she is one of the healthiest and smartest toddlers I know! I'm glad she got breast milk those first three months, but I have no regrets about switching to formula when I did.

Liz - posted on 02/24/2009

My son was born at 33wks, in the nicu for 25 days. If it wasn't for one nurse having me try a nipple sheild in the nicu I don't think my son would have come home breastfeeding. It was one of my toughest challenges. Once home the county health nurse visited my home once a week for 3 weeks(per order of the nicu- it was arranged at discharge) and she is the one who helped me the most with the breastfeeding. she helped with positioning and trying to get him to latch on with out the sheild. I breastfed until my son was 2mo, then supplemented with formula for another month, then just formula. I don't think I had good milk supply and probably shouldn't have gone back on the birth control so soon as well. I supplemented with formula because he was so hungry all the time I just couldn' t keep up and gave in and gave him a bottle. I was determined to get rid of the nipple sheild and I did by the time I decided to quit and use formula! I wish I could have breastfed longer and if I have another baby I will be more determined to do that. I know how frustrating it can be but if you really want to do it, don't give up and seek out the help you need, either ask the nicu or call your county health dept. Good luck, hang in there!

Susan - posted on 02/24/2009

Hi Kristi,

  Don't give up! my daughter was born at 31 weeks, 2 lbs 15 oz. I started pumping at the hospital and they gave her breast milk by gavage for weeks.  They tried to show me how to get her to latch on at the hospital but she was just not strong enough to "suck".  So, I rented a breast pump and pumped every few hours around the clock.  It helped that she was my first.  Still, when I returned to work, I took the breast pump along and pumped on my breaks.  I never had any problem with my milk supply.  I made sure I drank plenty of water & skim milk to help with that.  I did have very sore nipples at one point and was told that I didn't need to have the pump turned up full blast, and they gave me some vitamin E oil, both of which helped.   I also had an infection in my breast at one point, but that went away quickly as well. 

  We continued to bottle feed the expressed breast milk in the tiny little bottles that they sent home from the hospital for some time.  Finally when she was about 4 months old she was strong enough to nurse the "natural" way.  SO, DON'T LET ANYONE TELL YOU THAT YOU CAN'T TEACH A BOTTLE FED BABY TO NURSE, because I did it! 

  Bottom line, I think that if you really want to breast feed, you can do it.  The nurses at our NICU were very encouraging and that helped.  I live in a small town, so we did not have any "la leche" groups or anything of that nature at all.  I just read books & magazines and did what the nurses advised at the hospital and we did just fine. 

  Our second child was only 3 1/2 weeks early and he was a great nurser right off.  I had more of a problem trying to get him to take a bottle when I went back to work, than I did getting my daughter to nurse after being on bottles of breast milk.  With him, my milk supply did decrease after a few months, but I increased my milk & water intake and tried to eat healthier and my milk supply went right back up. Don't give up! 

Lisa - posted on 02/23/2009

I did try to breast feed, and my son that was 3lbs also, did not latch on, but I found it very uncomfortable, because I have large breasts that I had to hold up! The whole thing felt creepy to me... I decided to pump all my milk, and it was fine.

Kristi - posted on 02/23/2009

Ladies, thank you all for sharing!  I was a fool to think that bringing him home would mean smooth sailing.  I can see myself in many of the above posts.  He was in the SCBU for 6 weeks.  He's been home for 3 weeks and is now 2 months old.  I've been pumping since day 1 and my deep chest feezer is overflowing with milk.  I have 3 older children (7, 5 and 2).  Right now I'm breastfeeding, pumping and bottle feeding.  I don't think his latch is quite right (he's small, I'm big).  He sallows through the letdowns, but quickly falls asleep after.  I think I have my supply under control.  That's to say, he no longer chokes during the letdown.  You've inspired me to keep going...Thank you!  To those of you who breastfed then topped up with a bottle , how long did you breastfeed before offering a bottle as a top up?

Jen - posted on 02/23/2009

My son was born at 35 weeks and had to stay in the NICU for 12 days because he had to be tube fed. I didn't produce milk for 5-6 days, but luckily my hospital has donor milk. Once mine came in, I pumped and brought it to the hospital. Even with seeing a lactation consultant, he never would breastfeed. I pumped and bottle fed until I got a bad flu when he was 3 months. I got dehydrated and my milk dried up and I couldn't get it back. Good luck.

Loren - posted on 02/22/2009

My girls were born at 34 wks and had a problem learning to suck, swallow and breathe.  I had been pumping while they were on the feeding tube and tried to breastfeed them but they couldn't manage it.  I pumped for a while so that they could at least get the benefit of breastmilk but was never able to get them to latch on correctly.  I also have two older girls and pumping made life hell - (1 hour to bottle feed the twins, 25-30 minutes to pump leaves very little time for my other children).  I would encourage you to stick with it if you can - I wasn't able to keep up our routine and now both girls have spit up and constipation issues with the formula.

Debbie - posted on 02/22/2009

my girl was born at 25wks 5 days & she was too weak to breastfeed. We tried but wasn't working so I expressed for just over 3 months & put the extra in the freezer (i had heaps of milk) & gave it to her in the bottle. Once she was home from hospital I found expressing too tiring so I stopped but she was able to have breast milk for the first 6 months. I think Premmies find it rather hard.

Brooke - posted on 02/21/2009

Hi Kristi,

Abby was born at 33 1/2 weeks but was big for her size at 5.2#.  She was still tiny though and was in the hospital for 11 days.  I breatfed until she was 15 months, it made all the difference.  I had to pump because her little mouth and my huge boobs/nipples didn't fit.  At about 2 months she could finally latch and it was smooth sailings.  Good luck and keep with it, it truly is the most amazing thing I have done.

Karena - posted on 02/21/2009

My son was born at 26 weeks, weighing 2lbs 2 oz. He just celebrated his 1st birthday.

I was determined to breastfeed him - so I expressed the 4 months we were in hospital. I didn't get to start nursing him until he was about full term - the only problem was that my letdown would come too fast and he would choke and desat - this happened over and over again - so the nurses started to give him bottles mainly because we just wanted to get home. Long story short I kept pumping to keep my milk supply up and it took us 3 months once we got home to get him hooked on nursing - now he won't take a bottle!

I hope you're efforts pay off, it was tiring and soo hard but I am glad I kept it up.

Good luck!

Amanda - posted on 02/19/2009

Hi, my son was also born at 32 wks. He is 9 yrs old now, time has flown.

I was very lucky as I worked on the mat ward at our hospital I new the staff and the breast feeding adviser very well. She helped from day one of me trying and it lead to me feeding him for 10 months. The thing I found hard was the constantly keeping him alert enough to feed and wondering if he is taking enough. I had him weighed every week to make sure he was gaining weight and if I was worried the health visitor would visit. I also had a nurse from the baby unit visit us for a while after coming home.

You are doing a great job, you have given him a great start, take care xx

Liz - posted on 02/18/2009

My twins were born just one day shy of thirty four weeks.  I expressed milk.  My daughter hated the stuff and it was more of a fight than it was worth.  My son loved it but I wasn't able to produce enough so I ended up having to switch to formula.

Jennifer - posted on 02/18/2009

I had my daughter at 30 weeks. She was only 2 1/2 lbs. She stayed at the NICU for 8 weeks. I pumped the whole time she was in there to keep my supply up. When she came home she was still only like 4 lbs. Her little head was way too tiny amd she wasn't strong enough to breast feed straight on. I used the nipple shield. It was a little annoying but once you get used to it, it was really nice. You can get them anywhere. I know for sure babies-r-us has them. They are near the normal breastfeeding things.  Kayle used the shield the whole time until my milk supply ran out.

I used the same thing with my full-term second daughter. She used it for like about a month and once strong enough, she can breast-feed without it now.

It also helps if they get used to it... it helps with the transition to bottles. Both of my girls loved the shield(and boob) and bottles. So i always knew i could leave them with others.

Good luck! :-)

Vickie - posted on 02/17/2009

My first son was also born at 32 weeks. One suggestion I can give you is to always offer the breast first. If you feel the baby did not get enough milk or for your own piece of mind, you can always offer a bottle of breastmilk following your nursing session. I wouldn't worry about nipple confusion as long as you are always offering the breast first. Do pump after nursing and if you don't feel you have enough, you can always make the bottle 1/2 breastmilk, 1/2 formula. I agree with others who suggest a lactation cosultant. With all three of my children, I had problems with getting them to latch on correctly. The lactation consultant is the only way I would have been able to continue nursing. I ended up nursing my third child for over a year. Many pediatrician offices either have a consultant on staff or can direct you to one. And insurance does cover a lactation consultant!

Jessica - posted on 02/16/2009

My daughter was 12 weeks premature so I had to pump for the first 2 months. When she was finally strong enough she got the bottle first and then we moved on to breastfeeding. My husbands job was to piss her off, mine was to shove her on the breast (per the nurse). She wasn;t to into it till the day I brought her home, she latched right away, after that there was no problems.

Christine - posted on 02/16/2009

My boy was 4 weeks premature and had difficulty latching. I was told that until his due date that, that would probably be the case. So I pumped evertime I fed him by bottle, and I kept trying to breastfeed him.. Sometime during week 3 I managed to get him to latch with a nipple shield - which was great, but I had midwives who relentlessly reminded me to keep trying to go au naturel.. so we tried and tried.. miraculously about his due date he latched and then it was easy.. It is worth it. (I switched to using formula when he was 7 months because of biting - and its a real pain (but less pain than having my nipples bitten off))

Missy - posted on 02/16/2009

If you are struggling with your supply please be careful of using the nipple shields.  I had to use one because my daughter just couldn't latch on without one, but my supply suffered greatly because of it.  The nipple shield decreases your supply (that is one of the uses -- if say you have an overactive letdown).   It was also hell for me to get my daughter to be able to latch without the shield.  It wasn't until she was almost 3 months old that I was able to nurse her without the nipple shield.  Finally, she would do it.   I pumped for my daughter as soon as she was born.  I did not let down for the pump.  I was one of the unlucky people that could not get milk from pumping.  I was THRILLED if I got a total of 2 ounces when I pumped.  I pumped every two hours for twenty minutes at a time.  Which meant that I never slept.  If I pumped at 2 it meant I was pumping again at 4.  I had to supplement with formula until my daughter finally latched without the nipple shield.  She developed bad acid reflux and we were ordered to stop giving bottles.  No bottles meant no more pumped milk and no formula.  My daughter stayed latched on for hours at a time.  No joke.  My daughter would nurse for three or four hours straight.  If I unlatched her she would scream until I let her nurse again.  When she latched on without the shield I got blood blisters on my nipples.  PAIN.  But we got through it and she nursed until she got pneumonia at 27 months (she went on a strike from not being able to breathe and accidently weaned).  I saw four different LCs in the hospital.  Each one told me something different.  Even the NICU nurses told me different things.  None of the LCs or nurses were helpful.  It was horrible.  I didn't know what to do and no-one was helping.  Having all of the LCs give you different and conflicting advice is not helpful.  I hope you have a LC that actually helps you.  If I have another baby that is in the NICU I will not allow bottles again.  I knew that I should have insisted on no bottles but I was in such a bad place energy/emotional/mentally that I just didn't have the fight in me.  But it is entirely possible to say no bottles and only nurse your baby in the NICU. 

Marin - posted on 02/15/2009

I was just going to suggest the nipple shield.  I had to use it with both of my girls, they are great.  I also had to pump to feed my 27 weeker before she could even nipple feed.  At the time that I was doing all of this, the Jonny Depp version of Charlie and the Chocolate factory was just reliesed on DVD.  We were watching it with our then 4  year old and when it came to the part in the tunnel and they are going past the different rooms, milk room milkshake, etc,  My Katrina looked at the cow hooked up to the milking machine and said "Mommy that is just like you!"  That was so humiliating, but so much the truth, just remember that is for the good of your child and keep trying.  I managed to keep doing it until she was 6 or 7 months old, cronological age.  I wasn't supplying that much either and ended up supplimenting with formula.  When she was really little, tho, at the hospital she was at they had a breastmilk donation thing where little babies who couldn't tollerate formula were given donor milk (they screened the breast milk and did something else to it to make it safer for baby too)  it was a great program especially since we lived an hour and a half away and couldn't always get down there (in the winter) to bring in my milk, they always had that to turn to.

Brandie - posted on 02/15/2009

my son was born at 27 weeks weighing 2lbs 8oz now hes a 1 1/2 i tried to breast feed him but he wouldnt do it.... but breast milk is the best so i jus pumped and gave it to him out the bottle it seemed like a alot more work but its was worth it.. have u tried a nipple sheild/

Valerie - posted on 02/15/2009

Kristi - you are doing great! I struggled to bf my preemie twins (35 weeks - Lily was 5lbs 1 oz and Patrick was 3 lbs 15 oz). Have you seen a lactation nurse/consultant?

I ended up with an infection after their birth and was put on IV antibotics which dried up my milk supply just as it was coming in. I didn't get into to see the lactation nurse until they were about 8 weeks and was really struggling with both breastfeeding and pumping. Once she observed both of them feeding, she said that they both had small chins, weak sucks and one of them had a very disorganized 'breathe, suck, swallow' sequence, as well as GERD (acid reflux).

I had no help at home and my DH was working out of town for the first 4 months so I was on my own with the twins pretty much 24/7. I was pretty exhausted, wasn't eating properly and at my wit's end. The lactation nurse gave me some great advice on how to compensate for their problems latching on (nipple shields were my friend), encouraging them to open their jaws wider and feeding/pumping schedules. As well, I was put on prescription Motilium (to increase milk production), fenugreek, and Mother's Milk Tea. I struggled with bfing, pumping and supplementing with formula until they were about 3-4 months. It was really hard to give it up (very rough emotionally) but they are doing fine.

My advice would be to seek the advice of a lactation consultant or La Leche. They can observe and give you practical solutions to any physical difficulties that you two may be having. Also, get lots of rest, water and healthy foods. If need be, put yourself on bedrest for a couple of days. All you do is snuggle, breastfeed, pump, eat and rest.

Katie - posted on 02/14/2009

It's so awesome that you have been able to do it this long! It's so hard. My son was born at 31 wks, 3 days, 3lbs 4 oz. They are so weak for a long time and can hardly get enough out. I think after he came home I didn't wear a shirt for, like, 2 months. I felt like all we did was feed and I rented a pump from the hospital to try to keep my supply up.

When we were in the hospital if I spent less then 6 hours a day Kangarooing him I couldn't hardly pump an ounce for the rest of the day. Fenugreek became my friend and I took in in various doses for the first 2-3 months of my sons life.

When we got home my schedule was like BF for 30-40 min, wait 15 min, pump 10 min, bottle feed the pumped milk to my son because I was told it doesn't take as much energy (I've actually run across studies that said differently recently, but at the time it worked for us) and then nurse him again (he slept through most of that repeated process). I stopped supplementing him with formula and giving him vitamins because his stomach would cramp up and he'd get constipated.

We were in the hospital for 24 days and I rented the pump for two months after that. It took about that long for him to get to the point that he could suck with enough force to get full in 10-15 minutes. I spent most of those early weeks at home still Kangarooing him because it was easy access, it was comfortable, and it sort of recreated the womb experience for him.

I hate when a mother sees me breastfeeding my now very healthy 6 month old and says "Oh, well, mine just would latch on" like she was forced to go with formula for that reason, or "they gave her a bottle at the hospital and she didn't want to breastfeed afterwards" which mine was, too, 6 feedings a day (they would let me do 2) for a week and a half and I still do it. It's so hard and I went through a lot because I really, really wanted it for my son. I am very proud that we got through those first few months and I fully attribute how healthy (knock on wood) my son has been to the fact that I am breastfeeding him. We don't have insurance and haven't yet been able to get on Medicaid (I filed in August) so he isn't able to get Synergis. I take probiotics, drink Kefir, eat yogurt and give all that good stuff to him through my milk. He's unfortunately been around a couple of sick people and hasn't contracted anything. Thank god.

I know it feels so frustrating, try to keep a supply when your little one can't eat as much as he needs to and feeling like your new name should be "food", but it is so worth it. Soon he will be able to eat well.

Courtney - posted on 02/14/2009

I chose to feed my prem twins but they were born at 24 weeks so expressed for nearly 3 months. I found that I had little milk as I didnt have the stimulation of having my babies crying or close to me all the time but I found herbal teas and medication to help. Once I was able to get them to actually feed from me my supply was very low and I wasnt able to do it for long. I was constantly streesing that I couldnt provide enough milk for them which in turn made me produce less. Dont stress about it and it will happen and if it doesnt your still a great mum doing a great job!!!