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#1
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Breastfeeding challenges
My daughter is now 18 days old, but spent the first 17 days in
hospital. She was on a ventilator for 8 days, began tube feeding EBM at day 5, mouth feeding 2x/day at day 11 - via bottle which she didn't take to well at all. At 14 days started on the breast. She immediately took to it on her first try, but subsequent feedings didn't work. On day 15 I fed on demand as much as possible, and she'd take the breast about 30% of the time, the other times we'd (myself, the nurses, the LC) give her EBM via syringe or bottle, tho she was still lousy on the bottle. The NG tube was removed (well, she pulled it out and the nurse agreed to leave it out). Day 16 she suddenly liked the bottle more and did well at the breast about 50% of the time. While at first we all said NO bottles, even the LC agreed we needed to get her fed so we could get her home (she was healthy by now and feeding was the only hold up), and to do whatever it took. So now we're home. She seems to latch on well most of the time, I can hear her swallow. Tho there are times I think she's just got the nipple - I use my hand to stimulate milk flow and I know she's getting it. She'll feed 15 mins on one side, konk out totally for 15 mins or so, then is hungry again but will only spend maybe 5 mins on the other side at most. She will feed every 1.5 hrs, max 2hrs. She did well all day, but at night she doesn't wake and I have to wake her at 3hrs to feed. She doesn't wake up fully and really struggles with the breast. In the day she'll use her mouth to seek it, but at night she purses her lips and wants nothing to do with it. So I caved and gave her EBM, and this morning she's doing ok with the breast directly again. Any suggestions to improve the night time feeding? I haven't mastered the knack of laying on my side to feed, but will practice that. She had oral aversion issues initially due to the ventilator, so we were less worried about nipple confusion and more about her just taking something. |
#2
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Breastfeeding challenges
"cjra" wrote and I snipped:
My daughter is now 18 days old, but spent the first 17 days in hospital. She seems to latch on well most of the time, I can hear her swallow. Tho there are times I think she's just got the nipple - I use my hand to stimulate milk flow and I know she's getting it. She'll feed 15 mins on one side, konk out totally for 15 mins or so, then is hungry again but will only spend maybe 5 mins on the other side at most. She will feed every 1.5 hrs, max 2hrs. She did well all day, but at night she doesn't wake and I have to wake her at 3hrs to feed. She doesn't wake up fully and really struggles with the breast. In the day she'll use her mouth to seek it, but at night she purses her lips and wants nothing to do with it. So I caved and gave her EBM, and this morning she's doing ok with the breast directly again. Any suggestions to improve the night time feeding? Are you sure she needs to eat during the night? It sounds like she's nursing very well and often during the day. Could you try and let her go 4 or 5 hours and see if she wakes on her own? I know you've been through a lot and are anxious for her to be healthy, but it's possible that the NICU schedule has you thinking that she needs to eat at least every 3 hours. I've certainly heard of healthy babies who sleep throughout the night from their first week of life. The key here is to keep an eye on her wet diapers to know if she's getting enough. The trick I heard is to set out a pile of 8-10 diapers at the changing table. If you've used them in 24 hours, she's doing well. HTH, -Patty, mom of 1+2 |
#3
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Breastfeeding challenges
PattyMomVA wrote: Are you sure she needs to eat during the night? It sounds like she's nursing very well and often during the day. Could you try and let her go 4 or 5 hours and see if she wakes on her own? Hmmm. I thought I was supposed to wake her if she slept more than 3 hrs, and I'd read that longer than that was a sign of not taking in enough (altho that seems counter intuitive to me). My concern with letting her go too long is that the one time we did (during the day at the hospital following an NG feed), she was *too* hungry to feed. That's when we started with the syring feed just to calm her before she was ready to latch. I know you've been through a lot and are anxious for her to be healthy, but it's possible that the NICU schedule has you thinking that she needs to eat at least every 3 hours. I've certainly heard of healthy babies who sleep throughout the night from their first week of life. You mean we could be so lucky????? Question - if I do that, what do I do about me? My breasts fill up during the night (I was pumping every 3 hrs since day 1, but had slowed to 5 hrs at night, til they ran out of my EBM and I upped production). Now I'm afraid if I don't pump when she doesn't feed - 1. my breasts hurt like hell, but 2, I won't have any EBM if she does need it. btw - sometimes I hand pump a little before she wakes up (about 10mls) - because my breasts get very hard and was told that this could make it more difficult for her to latch on, and anyway allows her to get the hindmilk quicker. I don't always do that, only if they seem to need it. The key here is to keep an eye on her wet diapers to know if she's getting enough. The trick I heard is to set out a pile of 8-10 diapers at the changing table. If you've used them in 24 hours, she's doing well. She's definitely gone through that many in 24 hrs, but most are poopy rather than just wet, though she did have 2 wet ones. Her poop these last few days has been yellow, but mucousy, whereas the first week or so of her getting EBM it was yellow and grainy. Thanks for the help! |
#4
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Breastfeeding challenges
cjra wrote:
PattyMomVA wrote: Hmmm. I thought I was supposed to wake her if she slept more than 3 hrs, and I'd read that longer than that was a sign of not taking in enough (altho that seems counter intuitive to me). My concern with letting her go too long is that the one time we did (during the day at the hospital following an NG feed), she was *too* hungry to feed. That's when we started with the syring feed just to calm her before she was ready to latch. If your DD is sleeping for 4-5 hours at a time, you can ask her doctor if that's OK or not. Most kids will let you know before they get to the "too hungry to feed straight" stage. but if you are worried becasue of A's special issues, do confrim with her Ped first. I was told to wake E every 2 hours too, but that was because she still could not regulate her temperature well, and I had to make sure she was warm enough. Plus we (her Ped and I ) were hoping that the more she fed, the more she would poop and therefore the faster she would lower her bilirubin levels. To wake baby up, I would undo her swaddling and change her diaper. That usually woke her up. Question - if I do that, what do I do about me? My breasts fill up during the night (I was pumping every 3 hrs since day 1, but had slowed to 5 hrs at night, til they ran out of my EBM and I upped production). Now I'm afraid if I don't pump when she doesn't feed - 1. my breasts hurt like hell, but 2, I won't have any EBM if she does need it. You could still pump, but don't wake the baby unless baby needs to feed. She's definitely gone through that many in 24 hrs, but most are poopy rather than just wet, though she did have 2 wet ones. Her poop these last few days has been yellow, but mucousy, whereas the first week or so of her getting EBM it was yellow and grainy. Sounds normal. HTH PK |
#5
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Breastfeeding challenges
ght time feeding? I haven't mastered
the knack of laying on my side to feed, but will practice that. She had oral aversion issues initially due to the ventilator, so we were less worried about nipple confusion and more about her just taking something. I agree with Patty. Is there a reason that she needs to be fed during the night? She was a good weight when she was born. Has she had trouble maintaining weight, staying hydrated? I can see how being in the NICU and being cared for by people who typically need to get as much food into teeny tiny babies as possible would tend to stress the same with an average sized infant but is it necessary? Her feeding pattern during the day is typical of a baby who is 'tanking up' to sleep for a while. She's been through a lot, YOU have been through a lot. Unless there is a reason to wake her, why not let sleeping babies lie? Of course if she needs to feed it's a different story. Have you tried getting comfy laying down or sitting in a recliner and just letting her nuzzle until she decides she wants to nurse? Even Lucy being an older infant without challenges sometimes does better just hanging out with the breast for a few minutes when she is sleepy before she really latches on. |
#6
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Breastfeeding challenges
Any suggestions to improve the night time feeding? I haven't mastered
the knack of laying on my side to feed, but will practice that. She had oral aversion issues initially due to the ventilator, so we were less worried about nipple confusion and more about her just taking something. have you tried leaving the nightime feeding 4hrs after the last feed rather then 3, it is not particularly unusual for 2 week olds to go the long once in the day. The frequency she is feeding the rest of the time sounds ideal, length seems fairly average too. I know what is usually recommended is to make nightime feedings as boring and disinteresting as possible, but it might be necessary to go the opposite way and make them as much like day time feedings as possible, but I think I'd try waiting longer first, if you are not comfortable with 4hrs, try 3 and a quarter and then 3.5 and so on. Anne |
#7
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Breastfeeding challenges
How long you leave her at night depends on how
well she's gaining weight and how well hydrated she is. You said 2 wet diapers in 20 hours: that sounds like possibly too little to me for a newborn, though it depends too on how wet they were and whether there was another one soon after the 20 hours ended. Normally, even newborns can be fed with a cup, spoon or eyedropper, which don't interfere with breastfeeding as much as a bottle does. In her case, I'm not sure if she would have trouble with those feeding methods too. They're more work for the parents than using a bottle. Good luck: I hope the whole situation continues to improve. |
#8
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Breastfeeding challenges
Catherine Woodgold wrote: How long you leave her at night depends on how well she's gaining weight and how well hydrated she is. You said 2 wet diapers in 20 hours: that sounds like possibly too little to me for a newborn, though it depends too on how wet they were and whether there was another one soon after the 20 hours ended. Let me see my chart... Since 4:30 pm yesterday (it's now 7:09 pm, so almost 27 hours), she's had 10 stool diapers (and pretty messy ones at that) and 4 wet diapers. Normally, even newborns can be fed with a cup, spoon or eyedropper, which don't interfere with breastfeeding as much as a bottle does. In her case, I'm not sure if she would have trouble with. those feeding methods too. They're more work for the parents than using a bottle. Yeah, it's a pain, but I'll do it more if necessary. We'll see h ow tonight goes. She's been sleeping a lot more during the day today, going a bit longer between feeds now, so maybe I screwed up her schedule last night! Good luck: I hope the whole situation continues to improve. Thanks. |
#9
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Breastfeeding challenges
cjra wrote: Let me see my chart... Since 4:30 pm yesterday (it's now 7:09 pm, so almost 27 hours), she's had 10 stool diapers (and pretty messy ones at that) and 4 wet diapers. Bear in mind that a lot of those stool diapers may also have urine in them. In the beginning, it was rare for my daughter to have any diapers that were *just* wet (and it usually meant we'd jumped the gun in changing her!) I'm pretty sure the wisdom at this age is that as long as the number of all diapers together is within an acceptable range, you should be fine. She couldn't poop if she weren't getting milk, and if she's getting enough milk to produce poop that often on what is essentially a liquid diet, I don't see how she could be dehydrated. It's not like she's eating pretzels. I wouldn't worry if I were you. Of course, if you're prone to worry anyhow, keep your eye on whether she has a slobbery mouth (good!) or lethargy and sunken fontanelles (bad!) In general, if she looks and acts healthy... she probably is. You're doing great |
#10
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Breastfeeding challenges
Andrea Phillips wrote: cjra wrote: Let me see my chart... Since 4:30 pm yesterday (it's now 7:09 pm, so almost 27 hours), she's had 10 stool diapers (and pretty messy ones at that) and 4 wet diapers. Bear in mind that a lot of those stool diapers may also have urine in them. In the beginning, it was rare for my daughter to have any diapers that were *just* wet (and it usually meant we'd jumped the gun in changing her, I wondered about that - how many were both, since we're still using paper diapers right now and they wick away the wetness so she doesn't fuss much - whereas she goes nuts as soon as she poops. I'm pretty sure the wisdom at this age is that as long as the number of all diapers together is within an acceptable range, you should be fine. She couldn't poop if she weren't getting milk, and if she's getting enough milk to produce poop that often on what is essentially a liquid diet, I don't see how she could be dehydrated. It's not like she's eating pretzels. I wouldn't worry if I were you. Her poopy diapers have been pretty wet and mucousy, and she had 2 this morning which were sort of green/brown rather than yellow, but now it's back to yellow. She basically poops every time she nurses - during, and in the 20 mins or so after. Given she's nursing every 1.5-2hrs max, she poops a lot. Of course, if you're prone to worry anyhow, keep your eye on whether she has a slobbery mouth (good!) or lethargy and sunken fontanelles (bad!) In general, if she looks and acts healthy... she probably is. So far so good on that account. We have a pedi appt for Monday, and that will have been 4-days post-discharge so we will be able to see if there's real progress. I *am* worried she's not latching on well, as my nipples hurt like hell, but she *is* getting milk because I can hear her swallow. I tend to help the nursing by using my fingers close to her mouth/on the breast to stimulate flow. You're doing great Thanks. |
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