Breastfeeding NICU babies?

[AahRee]

I'm asking this for my sister, obviously. :) Her babies are both getting BM through feeding tubes right now, but when they take them off tube feedings, they want to bottle feed them. They told her that she can't breastfeed them, because they have to be able to measure the input/output. I don't understand why they can't just weigh them, feed, and weigh again to measure input? Am I missing something? And why can't they do something OTHER than bottles (like finger feeding?) so that they don't get confused and have trouble latching on later? (This is a particularly poignant issue for me, since Katie stopped being able to BF after the nurses in the hospital gave her bottles).

Also, can anyone point me to a resource for her, so she knows what decisions she has a *say* in, and what is best left to the doctors and nurses? For example, her little boy was crying, and she wanted to hold him again (she had just put him down a minute or two before) but the nurses said, "Well, he's going to have to learn to put himself to sleep sometime!" and argued with her about picking him back up. I think she needs an *authority* to back her up, kwim?

[Shel]

Have you tried PMing Kerri? She'll know the answer, but I know someone at our church was using a SNS with her preemie twins.

[Qball's Babe]

I was just in this situation!

You CAN BF NICU babies-BUT, in I have witnessed it takes longer to get out of the NICU if you dont partially bottle feed.

My son BF well. A 30 weeker normally doesnt feed well, until it reaches 34-36 weeks. I knew from BFing my son he was latching on, sucking and swallowing. Because they cant measure input accurately, they didnt know if he was taking the amount he needed to to actually gain weight.

Just from personal experience, bottle feed while in the NICU until they say she can breastfeed/supplement. I was in a huge NICU with over 50 babies, and all mom's started bottlefeeding, then moved to breastfeeding. I think the Drs want to know how much is going in, and if they need to fortify it, they want assurance if a mom is BFing, she can still give the babies the extra calories through bottle feeding, OR a supplementer. A lot of mom's worried about nipple confusion, but with preemies it doesnt seem to be a real issue. A few times of trying and every mom I know, has been successful. If she still doesnt want to try a bottle, how about syringe feeds?

She has say about what goes on with her babies. How premature were they? What issues are they having? Both of the answers to these questions will dictate how much say she has.

At 30 weeks I didnt have a lot of say, at 33 weeks I did. Once he was off of the vent a lot of the care was done by my husband and myself. The week before he went home at 34 weeks 6 days, I chose to try things differently from the hospital when it came to the nipples on his bottle, I bought my own. They worked, so the Dr wrote an order for them.

PM me with any questions...this stuff is all too fresh in my mind!

[AahRee]

Her babies were born at 34 weeks 3 days gestation, and are almost 8 days old (tonight at 7:30ish). I will pass along everything you said to her! Congratulations on your sweet little one. I'm glad he's doing so well and is home with you now!

[Qball's Babe]

Tell her congrats on her twins, they are right at the mark for being able to feed! Tell her good luck, and to talk to her babies' physician, and not the nurses...and to NEVER be afraid to speak up for what she thinks is right!

[Eleanor]

If they're like our NICU- they have a strict feeding advancement protocol that they'll want to stick to. What they let me do was to pump right before I visited, bottle feed the proscribed amount, and then suckle "for practice". After they had her up to ad lib feeds, I could breast-feed whenever I wanted, and just let them know how long she'd nurse, and whether I'd felt like she nursed well, or not so well. And if they're really sticklers about having precise I & O they can weigh before and after- that's how the LC's determine how good baby is nursing.

I'd have Kim get in touch with the lactation consultants directly- they really should help support her in this if they care about what they do...

[Shanna]

My twins were NICU babies, breastfed from day one. We did tube feeds from about 24 hours old until they were probably 8-9 days old. I always nursed while they took their tube feed, that way they learned to put nursing with being fed/full. They weren't gaining too well, and I was hesitant, but nursing, then giving them a bottle to "top them off" helped them to get out of the NICU sooner and they had no problems with nipple confusion, in fact, my pediatrician encouraged me to get breasfeeding comfortable and only when they were able to successfully gain (even if it was only grams) while breastfeeding, then we were able to move to the bottle and go home. And also, on the holding them thing... I was in the same boat, my girls would cry too and I wanted to hold them so badly, but the nurses in our NICU (who seem a bit more caring/have better bedside manner than it sounds like yours sisters do) explained to me how while they are that little, every time they are taken out of their isolette, that uses up calories that they need to be gaining weight and staying strong,t hat crying a little bit helps strengthen their lungs, plus staying in one place helps them to keep their body temperature stable and the body isn't having to use those excess calories to keep itself warm. I knw that being in the NICU with twins was the hardest thing in my life to deal with, but I had to realize that hey... these nurses see this all the time, they KNOW what works. They did listen to what I thought, and went along with it, but they also explained why they recommended things to be done this way and had previous cases they could back themselves up with, plus they were great about explaining things in a way that made my opinion/reasoning/wishes important and ultimately, that was the way it would be done if I were to see their suggestions as not something I wanted to do, but 99% of the time, their suggestions were easily workable with my intentions which were to BF and to get the heck outta the NICU :)