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Breastfeeding challenges



 
 
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  #1  
Old July 21st 06, 04:23 PM posted to misc.kids.breastfeeding
cjra
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Posts: 1,015
Default 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  
Old July 21st 06, 05:00 PM posted to misc.kids.breastfeeding
[email protected]
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Posts: 161
Default Breastfeeding challenges

cjra writes:

: 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.

I would not be so eager to wake her every 3 hours at night. Let her
sleep longer. If hse is feeding well durign the day, this should not be
a proglem.

Larry
  #3  
Old July 21st 06, 05:12 PM posted to misc.kids.breastfeeding
PattyMomVA
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Posts: 143
Default 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


  #4  
Old July 21st 06, 05:23 PM posted to misc.kids.breastfeeding
[email protected]
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Posts: 22
Default 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.

  #5  
Old July 21st 06, 05:57 PM posted to misc.kids.breastfeeding
cjra
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Posts: 1,015
Default 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!

  #6  
Old July 21st 06, 07:56 PM posted to misc.kids.breastfeeding
PK
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Posts: 37
Default 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

  #7  
Old July 21st 06, 08:02 PM posted to misc.kids.breastfeeding
Anne Rogers
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Posts: 1,497
Default 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


  #8  
Old July 21st 06, 09:04 PM posted to misc.kids.breastfeeding
Beth Kevles
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Posts: 269
Default Breastfeeding challenges


Hi --

First, DO wake your baby during the day, since that's when you want her
to get most of her feeding in. Check with her dr. about how long you
can let her sleep at night. You may need to wake her every 4 hours, or
you may be able to let her go 6 at a stretch, or even longer.

THe rule of thumb is 6-8 soaking wet or poopy diaper/24 hours. The
poops should be very wet themselves at this stage, and yellow-ish.

If your baby is sometimes refusing to nurse, consider using some of the
EBM to trickle down the outside of your breast, or even rig up an SNS
(supplemental nursing system), in preference to using a bottle. For the
time being, your goal should be to NOT use bottles at all. Your baby
will get used to nursing, and the SNS will help ensure that she doesn't
get dehydrated.

In general, it sounds as though your baby is having normal newborn
issues, which is terrific!

Now, just because your baby is sleeping longer at night doesn't mean
that YOU need to be uncomfortable! If you've got too much milk, express
some and save it in the freezer. You can use it in the SNS, or later
on you can use it if you want her to get used to a bottle again so you
can go to work, leave her with a sitter, or whatever. But if you extend
the time between night feeds gradually, you probably won't have this
problem.

In the first 6-8-ish weeks of life, you and your baby are working out
your nursing partnership. This means that sometimes your baby will
nurse without cease, and other times you'll be engorged while your
recently-fed baby sleeps soundly. But over time you and your baby will
establish a routine of sorts, and your milk supply will regulate itself
accordingly. There may be times when you get stuck with nursing
"marathons" again, but that just mean that your baby's appetite is
increasing (it's called a "growth spurt") and she's nursing a lot to
help you increase her supply. Once your supply readjusts, she'll nurse
with her normal frequency again. (THat's why moms who need to go back
to work often pump even in the early days. You not only take advantage
of your extra supply but you also trick your body into providing one
extra feeding per day, to go directly into the bottle.)

I hope this makes sense.

COngratulations on your baby's arrival!
--Beth Kevles

http://web.mit.edu/kevles/www/nomilk.html -- a page for the milk-allergic
Disclaimer: Nothing in this message should be construed as medical
advice. Please consult with your own medical practicioner.

NOTE: No email is read at my MIT address. Use the AOL one if you would
like me to reply.
  #9  
Old July 21st 06, 10:59 PM posted to misc.kids.breastfeeding
Catherine Woodgold
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Posts: 153
Default 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.
  #10  
Old July 22nd 06, 01:11 AM posted to misc.kids.breastfeeding
cjra
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Posts: 1,015
Default 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.

 




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