Breastfeeding a preemie is completely different than breastfeeding a baby born full term. I had 2 full term births. I thought that instruction for breastfeeding was not needed. Oh, how I was wrong. I probably delayed my baby's discharge by at least a week by not asking for help. Because of that, I write this page.
I certainly feel that breastfeeding is very important for a preemie. I also feel that it is important that the staff be as helpful as possible in your goals of breastfeeding.
I didn't realize it but the nurses caring for me after surgery certainly helped me to deal with pumping. They kept telling me that no matter how small an amount of breast milk pumped, it's good! GOOD THING cause the first time I got anything, it was only a few drops.
To me it sounded as if they were condescending but when it all came down to it, I needed them to take that two drips of milk to the baby. :-)
I also needed help fitting the pump correctly to myself. I had hurt myself causing my breast to blister by improper use of the pump. It is important to ask for help even for the simple tasks of breastfeeding. If I remember right, I had to change the size of shield to stop the pinching. Simple, but I had no idea. Pumping is not natural and one might need help learning the techniques.
A baby should be TUBE FED until she (my preemie's a female) is ready to breastfeed. Learning to suck a bottle first may cause what is called "nipple confusion". A baby will learn that food comes from latex texture instead of flesh texture. They will refuse to suck the breast as it makes no sense to them. I've seen and heard of it happening much too often to not believe that it is a REAL potential. There are also other reasons for nipple confusion. Sucking from a bottle is so different from the breast that a baby has to adjust the tongue, throat and suction method. **see links below for more on NIPPLE CONFUSION.
It is VERY possible for many preemies to learn to breastfeed after first taking meals from an artificial nipple but the risk is not worth it to me. Talk to your health care workers. Let them know that you intend to breastfeed and that the use of artificial nipples is not to happen until AND unless the breast is considered and attempted first! It may seem a longer road since babies DO tend to suck from a bottle easier but the threat of loosing a year or so of breastfeeding to a week longer in the hospital is far too great!
Elizabeth Grace laid on my bare chest, Kangaroo care, as often as was at all possible. When we moved to the lower need nursery, I continued Kangarooing. Then the nurses explained to me how to prepare her for initial breast learning....
I was to PUMP ALL the milk that I could from my breasts THEN offer the breast to her. This was so that the letdown and actual milk would not startle her. She learned to feel full when in that position as I tube fed her as she laid near my breast. It wasn't a session or two (or maybe more) when she began to lick the area. THIS IS THE FIRST STEP of knowing that she's getting the idea!
Then as time went on, it was time to let her latch on. Um, I was BIGGER than her mouth! So we had to continue with the first step as she continued to grow.
Soon though her mouth was big enough to fit.
I immediately fell into the fallacy that I was not the same as other women. Sure in the pumping room there were posters that explained proper technique for holding one's breast for feeding but I chose the position that was said to be WRONG. It was called the CIGARETTE HOLD. It so much easier than trying to twist one's arm in the position to hold under the entire breast to support it.
This is where I failed to question the nurses and the nurses figured I knew what I was doing. I struggled with Elizabeth Grace for 5 days. Two days of no weight gain and 3 days of consecutive lost.
The nurse caught me putting EG back to bed. She asked how she did. When I told her that we were unsuccessful she was alarmed. I was confused.
I had spent nearly an hour and half trying but failing to feed the baby. The danger of weight loss was so alarming to the nurse while I hadn't even considered it. She then asked me if I had seen and read the posters in the pump room. I told her I'd looked but not really read them.
She felt bad that she had assumed I or everyone read the posters. I felt bad that I hadn't. She did not put blame on me. I was doing a good enough job that she didn't need to.
She then instructed me how to hold my breast UNDERNEATH, with my thumb extending to hold the tiny baby's head. She was so supportive and understanding. She checked on us often after that and I asked many more questions after that!
EG did stop losing weight but did not gain. What more was wrong?
I had to weigh her on a special very sensitive scale before and after each feeding. Since breast milk weighed one mg/cc we knew just how much she had taken and finished with tube feeding the amount required for her to grow.
I was so scared that she'd get reflux from over filling her. I was worried that she'd spit up and aspirate. I was very uncomfortable feeding her more than she'd take. It all ended up fine though. She did grow. Going home was once again in our vocabulary.
The next problem was learning how to get her to eat when she should and not sleep through a feeding. The very same nurse taught me what I termed "a preemie time out." If EG would not take from the breast but rather sleep, I had to put her in her bed and not give her any touches or sweet whispers. These were comforting her into sleeping but not eating.
Just as the nurse said, 5 minutes into being sent back to bed, she'd start rooting and crying. I would get her out of bed to feed her. If she fed well, she would stay on my lap. If she didn't, I had to put her back to bed until she woke and asked to be fed again. Each of these sessions began with a weighing and finished with one. I do not mean each time she was sent to bed. I mean each time she was to be fed, every three hours.
The next obstacle was to teach her to take from both breasts. She much preferred the right as it was smaller. With her growth, she could feed well from both. She just KNEW which was which!
For this, I had to call the La Leche League (LLL) support person. Praise the Lord that she was also one of EG's nurses. This made it so much easier to describe the situation and to show her what was happening. I also tended to ask her all my questions after I found that out. I do not know why, the other nurse had done such a good job at teaching me! Never under estimate the power of STRESS !!! LOL!
Well, the solution was so simple. All that I had to do was feed EG in the SAME POSITION as I did for the right breast. I had always "flipped-the-baby". But instead of doing that, I slid her across the pillow I had on my lap. So, I started football style on the right, and slid her across to the left with her feet pointing toward the right. It worked like a dream!!
Our breastfeeding went on for a perfect 18 months. My first goal was 18 months actual age. I then had a goal of 18 months adjusted. Then I had a goal of her VERBALLY asking. :-)
I used the Le Leche League (LLL) for asking questions about medications that I was on when DOCTORS, PHARMACISTS and individuals told me that my baby was sick because of medications that I was taking. If I'd have not called the TOLL FREE phone number found in the phone book, I'd have stopped breastfeeding much sooner than I did.
I did listen to what the LLL ladies read to me about the medications I was taking. I understood the risk. It was virtually none existent. When I finally got the baby to the cardiologist, he verified that the dose that the baby was getting through the breast milk COULD NOT HAVE CAUSED HER TO BE SICK, I was so GLAD to have called and listened to the LLL!
I did began having health problems that required(s) constant medication that was not compatible with nursing. I was so happy to have made it as far as we did. We nursed until Elizabeth Grace was 18mo actual age.
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I hope my experience will help someone else breastfeed their Tiny. If you do not find my page helpful PLEASE CONTACT THE LLL. I could have breastfed all 3 of my children much longer if I had had their support. I had greatly under estimated how much they can do!
Nipple Confusion Links
Nipple Confusion -What it is and How to Avoid it
A success story-Preemie Twins experience Nipple Confusion
Finger-Feeding a Preemie
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