View Full Version : I need a lactation consultant. Someone with preemie nipple confusion knowledge.
They let my try to nurse my baby today. He was really really angry, wouldn't open his mouth. He was hungry and wanted to be fed, no matter how much milk I sprayed him with and filled his mouth with he insisted he wasn't going to open up or suck.
He has only had four bottles but that is what he wanted. :o He used up so much energy fighting with me that he ended up with his whole feeding through his tube.
LuAnn
07-13-2006, 10:35 AM
((HUGS)) I can not think of what they are called but its a nipple like that goes over your breast nipple, KWIM? Someone on here will know what I am talking about, I know you can buy them at Target. again ((HUGS)) Ill see if I can find a link for you and come back to edit
eta: nipple shields (I think is the name)
pj and the bear
07-13-2006, 10:39 AM
Get in touch with Tikva18 (Rivka)!!! Onw of the twins had a difficult time nursing and she was able to make it work!!! Good luck and I'm thinking of you all!!!
DixieChick
07-13-2006, 10:40 AM
Try a nipple shield. They are silicone and feel like a bottle nipple so babies will sometimes latch better. They have downsides in that it can cause you to not make enough milk. But, since you are pumping and keeping a close eye on supply and weight gain, this won't be a big issue for you.
Hugs Liba.
littleturtle
07-13-2006, 10:49 AM
Oh honey, your post just brought me right back to that first nursing attempt with greg. It was horrible. The lights nad noises ofthe NICu distracting him,him getting frustrated becuase the milk didn't come out like in the bottle, and just the energy it took his tired, tiny little body to do what he needed to actually suckle. (((hugs))) it WILL get better. those first few attempts are really just nothing but horrible mama-torture.
If you can, the first thing I'd do is kangaroo-care for a bit before you try to nurse (both of you bare chested, belly to belly, with his head resting somewhere between your breasts) You can cover his back with a blanket so the nurses don't get all wacky about his temperature ;) I noticed drastic improvedments in Greg's nursing attemps when we were able to do the calm, skin-to-skin bonding thing for even 10 minutes before we tried to nurse.
Then, I'd always be sure that my breasts weren't overly full, becuase he's drown inthe letdown. So I'd pump before I went into the Nicu, just enough to be sure that the first, fastest letdown had passed. that'll make it easier for him to manage.
For preemies, generally the easiest hold is the football hold, where he's laying alongside you and his face can be propped right up in front of the breast. You want to make it as easy as possible for him to latch, so that he's not wasting any of that precious energy. The best way to hold you breast (and this goes really for any newborn, but especially for preemies with tiny mouths) I call it the "Big mac" hold. Put your hand out like you were holding a big sandwich that you sort of need to "squish" to get in your mouth - making a c, with the four fingers held together and the thumb makin the bottom of the c. Now keepign your hand in that position, you'll put your thumb ont he top ofthe breast, right behind where your areola ends, and the four fingers together underneath the breast, wher the areola ends. Now, you DO NOT want to just press down with your fingers, hat will smush the nipple and wrinkle it, making it that much harder for him to latch. You'll push back into your chest wall first, gently, so that the nipple is pulled a bit taut, then you'll gently (GENTLY!) squeeze down just a bit, so that the nipple will condense and point out. You'll end up with a taut, elongated nipple that is much easier for his small mouth to latch on to.
Tickle his mouth with the very tip untilthe rooting reflex kicks in (with preemies, this rooting relfex can be a bit slow, so you have to have patience and wait for him to open his mouth. I remember it took gregory about 2 minutes in the beginning just to open his mouth wide enough for me to make an attempt to get the nipple in!) Oncehe does open his mouth, you'll do what I've termed "the nipple flip" You don't want to just have the nipple go in straight. You want to angle it, so that as the nipple is going into his mouth, you'll actually be opening it wider as well so he can take more in. To do the "flip", you'll aim the bottom of the nipple (the underside, towards where your four finers are) at his lower lip, with the top of the nipple angled up a bit towads the upper palete (behind where his teeth would be if he had them) istead of towards the back of his mouth. Once his lower lip makes cntact with your lower nipple, you're going to move your thumb on the top of the breast so that the nipple goes from pointing up towards the palate to pointing straight to the back of the mouth. that little movement will be just enough to bring his tongue out more and get him open just a wee bit more. (I'm sorry, this is so much easier to describe and show in person, Ihope it's making sense!)
Once the nippl's in and he's sucking, you'll probably need to do the chin massage (where you gently, rhythmically rub the soft spot in teh bottom of his chin, right behind the bone of the chin on his neck) to get him to keep sucking.
To be honest, greg really didn't get the whole hang of nursng till we were home and in our own environment. It was always a toss up - some days he's do great in NICU, and then the next he's absolutely NOt want to nurse at all. But when he came home, I was determined that he'd nurse, so we stopped ht ebottles cold turkey, and I just sat on the couch and nursed him all day long for several days.
It WILL get better, I promise!
I wish I could be there with you, next to you and helping you. it breaks my heart :( If you have any questions or just wanna talk to a mama who's been there (and let me tell you, having the lactation knowledge I do really was probably the only thing that kept me sane during it, becuase I felt like I was in control of at least ONe part, so I can imagne the frustration and fear you msut have not havign the benefit of the preemie lactation education) please dn't hesitate to PM me you're number and I'd be happy to call you :)
PS- my keyboard is on strike, so any typos are going live. I really can spell, I swear ;)
DixieChick
07-13-2006, 11:30 AM
Theresa, you rock!
Daniel's Mama
07-13-2006, 11:36 AM
Liba,
:hug: to you and your precious baby boy - I pray that things will get easier for the both of you and soon he'll be a nursing champion :)
Sandi
07-13-2006, 11:41 AM
:hug: You've gotten great advice - I just wanted to offer to pick up some nipple shields or any other lactation aids that you might need and send them over to you. Just LMK what I can do. :hug:
mamajandtheboys
07-13-2006, 11:43 AM
ditto everything theresa said :thumbsup: --- and make sure to spend at least a few holding sessions as just holding skin to skin. that way he won't automatically associate nuzzling with being asked to nurse. it'll calm both of you down and lessen the anxiety.
and remember what your mil did. you can do it too!!! :D :heart:
oh, eta: i would only use nipple shields as a LAST resort. jmo.
littleturtle
07-13-2006, 12:00 PM
Theresa, you rock!
There's a reason I have all this "useless" info floating aroudn my head, right? :D
Seriosuly, it's so heartwarmign to be able to help other preemie mamas, and whenever I get a call from a NICU mama it's like my adrenaline starts pumping and I feel like I'm actually DOING soemthing. it makes me feel likethe whole ordeal with Greg was for something positive yk? It's so different reading about it in texts than it is to BE there.
Anyway, I wanted to add also that I'd really, really try to stay away from teh nipple shields. It *might* seem to help in the short term ( although, IME with preemies, they have difficultly latching on to slippery, big shields, anyway - they are defintiely NOT sized for preemie mouths!) but in the long term, it's just another thing you'll have to deal with down the road. It's defintiely best to just suffer through all the difficulties up front at once (and yes, you will be miserable for a bit there) but then once you're past it, you're past it and you can move forward without havng another issue hanging over you to deal with down the road.
Karen
07-13-2006, 12:34 PM
:hug: btdt. it does get better, but it may take a little time. :hug:
~Cher~
07-13-2006, 05:23 PM
I had major issues with Jack when he was born and we did finger feedings for about a day or so until he got the hang of the correct suckling technique needed for breastfeeding. Using your largest finger, have him start sucking on your finger and after a few sucks, slide in a small, thin tube (similar to the ones uses for a SNS) attached to a syringe. Every few sucks, just push in a tiny amount of breastmilk. Just doing this helped SO much for Jack. Also, in the beginning when I was first pumping so much because he couldn't feed because of his breathing issues, I would use the large syringes that the hospital had to store my breastmilk. It really helped to eliminate a few steps in preparing the milk to be used as I would just thaw it right before I needed it and it was SO easy, especially because in the beginning he wouldn't take a ton at each feeding.
(((hugs))) This is the hardest part and soon it will be over!
AAHmom
07-13-2006, 05:43 PM
We used a nipple shield as last resort. It made nursing easier to start with and we weaned off of it almost as soon as we got home. nursing in the NICU is very hard. My heart goes out to you.
ryssann
07-13-2006, 06:11 PM
I tried to post before, but my computer timed out, and I haven't retyped it. It sound as if my first son and your son are having similar experiences. This is one of the hardest parts, he has to feed in order to go home, and the hospital likes the bottle, because they can measure input/output easier, and calculate the calories. It took a lot of resolve to insist on bfing. They would also tube feed him after every time I nursed him. Which would leave him too full for the next scheduled feeding. We went round and round.
I know you can do it, and your son will be able to do it as well.
Remember, you are his mother, and you know what is best for him. You are his best advocate.
If you would like to pm me, I can tell you more about my experience, and what our plan ended up being.
I am so sorry that your little one is starting out this way, but it does get better.
Laryssa
fericito
07-13-2006, 08:04 PM
I've just been through it myself. In our experience, the first several attempts at breastfeeding were heartbreaking and ultra discouraging. What I did was non nutritve breast feeding for weeks on end (I'd pump before I went then help him at the breast WHILE he was being tube feed so he'd start associating being fed with the breast.
When he finally started getting the sucking a little bit, then I started nutritive feeding... however our hospital did it so that he had to be weighed before and after - to see how much he was getting. He wasn't taking enough each feeding so they'd gavage the rest of it. After many weeks of frustration because feeding was the only thing keeping him there (he stayed a total of just under 7 weeks) the lactation consultant recommended the nipple shield - the hospital ones have a smaller nipple for tiny preemie mouths.
I really didn't want to because I'd done with dd the same thing and she never weaned off - but when it became apparant that nipple feeding would mean him home really soon, I agreed. It was like a miracle.
He's been home 3 weeks, we still start off with the nipple every feeding but then midway through when I'm letting down, I slip it off and he still latches back on. We'll get weaned off it eventually.
He went from shield nipple feedings to home in just about 3 days so it was worth it to me to have him home. He'd been doing trying to feed with no real success for more than 4 full weeks when I finally agreed.
He's nursing in my arms right now and it is wonderful - you'll get there too mama, just hang in there. I KNOW very fresh and fully how hard and painful this whole thing is. I'm praying for you guys constantly.
lilac
07-13-2006, 11:20 PM
Hugs Mama! You have gotten such great btdt advice, from these kind Mamas. I'm so glad you came and asked- so you can take this info with you.
{{{{{I'm thinking of you two}}}}}
Thank you all for your replies!
Theresa I am printing out your post to read when I am a little more coherent. :)
Livn4them
07-14-2006, 07:16 AM
:hug: I think you've gotten GREAT advice but also wanted to add one more thing. I went through this with T....he REFUSED to nurse while in NICU, he didn't do any better with the bottle :rolleyes: They kept telling me he HAD to have X amount at EACH feeding before he could go home (most of the time it went into this NG tube) :eek: Well...he didn't meet that requirement but since he wasn't LOSING weight they FINALLY let him come home. I had my mind made up *that's the emotional stuff from having NICU babies* that he was going to be my bottle fed baby because he just screamed at the
breast :(
The first day home with him, I tried to bf him, and it was like he had been doing it forever:cloud9: I think NICU was too stimulating which is why he didn't want to have any part of eating (bottle or otherwise).
Don't give up hope. *Yingle* WILL nurse!! I hope he's home with you VERY soon. One more thought....we do not eat the same amount at each *meal* so why would one force a baby to do the same?!
Can't wait to see new pics and a homecoming update!!!!!!!!!!!!!!!!!!!!!
sweetpeasma
07-14-2006, 08:18 AM
Theresa gave some great advice.
My preemie did the same thing, she screamed and flat out refused my breast. The lc consultant there was basically useless. I did finally succeed at getting her to the breast, albeit 6 mths after we got home but it was worth it.
Hugs to you hope your babe will be home with you soon
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