My preemie needs to move from bottle to breast. Help!

[Anonymous]

I have been pumping since the day my baby baby was born at 33 weeks, and she has been exclusively breast milk fed though a bottle. I've been trying to get her to feed directly from the breast without much success. The NICU nurses, the pediatrician, and the LCs have all said that preemies tend to "get it" as they near their due dates, and that I just need to hang in there. However, she is over 6 lbs now and her due date is next week and we're really no where closer to breastfeeding. She seems to do a little better with a nipple shield - I can tell that she gets SOME milk from the breast, but certainly not enough for a meal. She won't even suck the nipple without the shield - she latches and superficially sucks or just chomps on it for a while.

I'm starting to get frustrated and sad that she may never learn. While I'm happy that she's still getting the medicinal benefits from breast milk from my pumped bottles, I'm frustrated with the amount of time I spend each day attempting to BF, bottle feeding, pumping, and then cleaning all parts. By the time the cycle is complete, I have only 1 to 1.5 hours before I need to begin again. I've been doing this for 6 weeks now, and I'm not sure how much longer I can keep up this routine. I've read that some preemies NEVER figure out how to breast feed after learning to eat by bottle. Has anyone had success transitioning to the breast from the bottle? Any tips?

[Anonymous]

Don't worry!
I remember it was tricky at first with my 32 week preemie, but the NICU nurses were very helpful, and after a few days my son learned to take the full nipple in his mouth. It took a few weeks for him to get a full meal exclusively with breastfeeding, maybe around his due date (I can't remember). During the first attempts, I was more successful if I:
1. deposited some milk on my nipple so he could smell and touch it with his mouth.
2. squirted some breastmilk in his mouth first right before presenting the breast, so that he was already swallowing his first milk and opening his mouth for more when I inserted the nipple.
One problem we had at first was that he could not make the effort to nurse at the breast. When he got hungrier and stronger, it worked so much better.

Good luck and don't give up!

[Anonymous]

Good advice from 17:32

[Anonymous]

It's tough, but can be done. My 34 weeker finally switched from bottle to only breast at around 3 months, so a full 6 weeks AFTER her due date. Before then, we always started with the breast, and depending on whether she seemed hungry, she got a bottle. Eventually at 3 months, once I realized she was quite good at the breast, but possibly getting lazy once the letdown wasn't as fast, I just stopped giving the bottle after cold turkey. She went a few weeks of nursing every 2 hours (from 3-4 hours) but then quickly learned that all she had to do was just nurse properly, and then she could go longer without eating.

We're still BFing at 14 months.

[Anonymous]

The washing sucks! One trick I used was to put the parts in the fridge and then that saved me one or two washings!

[Anonymous]

really? How does the fridge help?

[Anonymous]

DD wasn't preemie but was a "lazy sucker" so we had to do a month of trying to nurse, pumping, and supplementing. What helped her finally move from bottle to breast was finger feeding - we would stick a finger and a little syringe (from our pedi) filled with breastmilk into her mouth, and when she'd suck, she'd get rewarded with a squirt of milk. It was tedious (and messy) but I'm convinced it's what made nursing finally click for her. You are doing an awesome job for your baby OP - good luck!

[Anonymous]

My 35.5 week old took about 6 weeks of trying to get breastfeeding, but we are still nursing at 18 months. I went to the Breastfeeding Center in DC, and Pat gave me a lot of good tips.

[Anonymous]

really? How does the fridge help?

Not the pp, but I learned this trick too for pumping at work - if you put the parts in the fridge right after pumping, you can use them 2 or 3 times without washing - the milk in them is safe as long as its been refrigerated. That said, I started doing this when DS was a big strapping 4MO. not sure I'd take the risk of possible bacteria with a young preemie. Hang in there OP!

[Anonymous]

Same advice as 17:32, and also I would like to add to try feeding her when she is relaxed.

Hang in there. Mine wasn't a preemie, but I spent 2 weeks like you -- pumping and bottlefeeding the milk. I just kept trying until she got it.

[Anonymous]

I'm the PP. It might also help if you try BFing when you're very "full" of milk, so a lot comes out.

[Anonymous]

The Kellymom site has some helpful resources, as well as a good chat forum for NICU moms, many of whom have dealt with the same issue and gone on to successfully breastfeed. My own baby (not a preemie) was in the NICU and I did the pumping/bottle feeding thing exclusively for 3 weeks and know how exhausting it is. Now she's breastfeeding rather well, after being a bit "lazy" at the breast and certainly with an imperfect latch, though I'm still needing to supplement with pumped milk or formula since my supply hasn't caught up.

[Anonymous]

Oh, OP a BIG hug to you!
My baby was born early, too, and smallish with jaundice and we had the every two-hour pumping/ feeding/ sleeping thing too. Hang in there, it will get better. Some tips:

Buy extra breast pump flanges etc. It will make the washing/ drying part less time consuming.
Get some of those "snappies" (google it). They can be used with a Nuk nipple and can attach directly to the breastpump flange. No extra bottles needed. You can buy them directly from the manufacturer.
Have a friend or family come over and do everything house-related for you for a few weeks if you can.
Bring in a lactation consultant to your home if you can to keep giving you guidance and tips.
The baby will get stronger, will eventually take greater interest in breastfeeding and will "get" it. Our baby did and is now a big fat baby (our baby is so fat...)

[Anonymous]

OP, won't repeat the good advice. My non-preemie took six exhausting weeks to "get it.". I was jealous of my husband because he got the cuddle time and I got the trying, nipple shield, crying, pumping, lactation consultant appointment routine. I worried that the routine was getting in the way of play, reading, bonding. At the end of six weeks, my supply was intact, baby could breastfeed, we could relax and enjoy more, baby would take a bottle too and DH has cherished memories of that time.

All this is to say hang in there and good luck, I hope your investment pays off as it did for me.

[Anonymous]

you might also look into the supplemental nursing system to see if that option may help you.