nursing a preemie

[mom41]

anybody has any advice on nursing a late preterm preemie? i have plenty of milk but most of the time my guy just hangs out at my breast with the nipple in his mouth (kind of funny) or fusses .. Bottle gives him the instant gratification and he has been gaining wt. So far I do not mind pumping. I am going to work June 1 and I am not sure if i have enough time to get to nurse .. Any advice if appreciated. Thanks,

[m]

A nipple shield did the trick for me. We tried and tried nursing and then gave up and pumped and bottle fed for a long time, then we were able to transition to breastfeeding with the use of a nipple shield. Some pharmacies carry them; I got some from the hospital; Target also has them.

[MaisiesMama]

We also used a shield for a while, but it was when I tried without the shield one day that she really took off and breastfeeding became a success for us. I had feeding therapists and lactation consultants evaluating my daughter and giving me "reasons" why nursing was just not working. Turned out, I think my daughter just needed more time. It was around 4 months actual that we finally had it down. My daughter was earlier than your little one though, so I suspect it won't take you two that long. Our routine was to nurse on each side as long as she wanted to or stayed awake, then supplement with a bottle and then pump. It was basically my entire life for a few months, but the payoff of having baby nurse was worth every moment.

My advice is to make sure he is getting a good, deep latch. I once read in a book to imagine what it's like to take a bite of a big sandwich. Sounds goofy, but it helped me. Breast should hit his bottom lip first with nipple aimed toward the top/back of his mouth. You could also try hand expressing a little or pumping just for a minute before he nurses so that your letdown happens faster once he latches. Sometimes they don't have the patience or energy to wait it out. Also, try different positions. I learned through trial and error that my daughter only liked to lay on her right side so when nursing on the right I had to use the football hold. Any other hold and she just laid there being fussy. Who knew??

I would really think that if you stay consistent and get him lots of practice, he will get the hang of it. Good luck, and congrats!

[lemons]

Before trying a shield (which I used with great success so I am not against them), I would try pumping until you have a let down and then try to latch on your baby. Drawing your nipple out will help him latch and having your milk be ready will give him that instant gratification he is used to from the bottle. And if he is still uninterested or confused about what is going on then I also recommend trying a shield. It works by keeping some milk in the nipple of the shield mimicking a bottle and by contacting the roof of baby's mouth to stimulate the sucking reflex. The size of the shield is determined more by the size of your baby's mouth than by your breast. Look at them in the store and make your best guess as to what would be comfortable for your baby. (My baby's nurse tried to make me use a size medium with my then 4 lb baby and was surprised when my daughter couldn't fit it in her mouth. LOL.) And again, I also recommend pumping until you let down for the first couple of times you try the shield so that your boy gets that instant gratification. I was able to transition away from using a shield using the same idea (pumping for 30 secs to 1 min and then offering to baby). And it only took two to three times before she realized that she could do that work herself. Good luck! It isn't easy breast feeding a preemie!

[trish]

My 36 week preemie had bottles in the hospital because she lost more than half a pound the first 2 days (I think she probably just had extra fluid because I had so much extra fluid/swelling) and because she was under the bili lights for 3 days. We BF but after the "easy" bottles it was rough at first and because we only had 10 min. to do it every 2 hours before she had to be back under the lights - STRESS! Anyway, I think the pumping for a minute before baby latches is a great suggestion. The milk is then ready and waiting with little effort just like a bottle. And trying different positions - some positions are just easier for baby to get a good latch.

Good luck to you!!

[mom41]

Thank you girls, I think we figured it out - at least for now
Pumping a little before latching helped the most - it also made my breasts less full and he had easier time latching, and being patient and trying over and over again is paying off.
I am lucky to have plenty of milk and the skills/experience from nursing my first son are very useful. Lets see if i can nurse during the day, give bottle of expressed milk at night and continue to pump to have enough supplies before I go back to work June 1 ! These rainbow babies are so special.
I wish all the girls on the forum are as lucky as I am.

[lemons]

So glad to know that you are having an easier time!

[Nizmo]

A breast shield is your best friend when you are trying to breastfeed a preemie. The reason being is that its much easier for a preemie to practice with the shield because their mouths are often too small to get your nipple and enough breast tissue in their mouth. Being patient about it is a key factor. Preemies have a hard time coordinating suck, swallow, breathe because their brain is still immature. You also have to keep in mind that breastfeeding and bottle feeding for a preemie is a lot of work. The closest thing that you can compare it to is like running a 50 yard dash. When they fall asleep you can take some of their clothes off, tickle their feet, rub their head, you can also try tickling under their chin that reminds them that there is something in their mouth and sometimes they will suck a little bit. I have also found that faking them out by pulling the nipple slightly but not causing them to pull off gets their attention, switching sides will also help. Another thing to keep in mind is staying calm and not getting upset, they can sense your mood and that can cause them to become stressed also.