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Wonderstruck

Premie and deciding whether to stop breastfeeding...

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Wonderstruck

I'll preface this by saying I hated breastfeeding my first and had a crappy start to it with a 2.5L PPH and psorasis on my nipples. DD1 (born at 40 weeks) damaged them so badly in the early days that I couldn't even pump without bleeding. I stopped mixed feeding after a few weeks.

DD2 was born at 34+6 unexpectedly and is in special care nursery. I hand expressed collustrum and started expressing milk. She was given formula as well.  She is only allowed to try and suck twice a day but she tires within a few minutes and often is too tired to feed for the second attempt. She's now 36+1 and still barely sucking and still on 2 suck feeds a day. 

I'm expressing 5 times a day as it's all I can manage without going insane (I also have a 3.5 year old, we are moving and have so struggle to find spare time with the special care visits etc). I tend to only get 20-30mls and notice I get a little more if she suckles but that's not often. They're giving her 3 hourly 50ml feeds so I barely get half of what she needs for most of the feeds.

I'm tired of spending time with the pump and cutting short cuddles with DD2 in the nursery to pump and losing time with DD1 in order to pump. 

I'm torn. I want to give her breast milk as I know she's little and needs the best start but I know exclusive breastfeeding won't work for us but even mixed feeding is a battle. I was almost in tears as she was crying and I couldn't hold her as I was pumping. 

I want to give up but it feels like a cop out. I don't know what to do. 

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Riotproof

Giving up is not a cop out. Trying a few different things is also not ridiculous if you want to continue pumping at least for a time. 
 

I had zero issues breastfeeding ds, but when I had a premature baby, the stress of it, meant pumping was hard when I went home. I thought something was wrong with me. I thought I had bought the wrong pump. What was really happening was I was just so broken, I had to remind my body that my baby wasn’t lost, she was in hospital being cared for. 
It might not be for you, but it is very early days. I encourage you to talk to the lactation specialists at the hospital. Be kind to yourself. You are doing your best. Fed is best. 

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Mum-mumMum

I gave up breastfeeding after the first attempt with my twins. It reminded me how much I’d hated it with my first. I expressed a few weeks more but drs agreed it wasn’t worth the stress when I wasn’t getting enough milk to feed even one twin each day. Bottles were so much easier for me.

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Paddlepop

Being a prem I'm guessing she's at risk of necrotising enterocolitis and needs breastmilk to help protect against that? What about using donor milk? Can you access a human milk bank that collects screened milk that is as safe as possible? It's expensive but for a few weeks until she's able to be discharged it might be worth it. It would free you up from the pump, give you more time with her, more time with DS, and help keep her protected against NEC. 

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frazzle

A fed baby is best - regardless of whether it comes from a breast or a bottle. And a baby needs a mum who is not so stressed - and you are also juggling a toddler.

I've have two prem births (singleton at 31wks and twins at 32wks). First time I had enough milk for 1/2 a baby, second time enough for 1. And that was with expressing every 3-4 hours.

I couldn't take my first baby home until the nurses saw her gain weight, was sucking well and not become drowsy. That meant a bottle. And the midwives completely supported me when I said let's go with the bottle and formula.

That doesn't mean you give up breast snuggles or even allow baby to suckle. I still did that and it felt wonderful.

Take care.

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IamtheMumma

You're doing a fantastic job juggling everything that is going on in your life. You've given her an excellent start in life already. Take a few big breaths in and listen to the quiet inside you. You'll find your answer. You should be supported either way. 

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Silverstreak

Whatever you decide will be the right choice. I had a rough time breastfeeding for various reasons and went exclusively formula after five weeks. I gave it my best shot and then switched over. Eight years later DS and I have a great relationship and a strong bond. 

Good luck and all the best xo

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.Jerry.

I had a 27 weeker.

Based on the increased risk in prems, I strongly believe breast milk is best.  At the baby's age now though, she may be at less risk of NEC.  Breast milk fed babies certainly have less risk of NEC, so always preferred where possible.  But if the risk at the baby's gestation now is low, then go to formula.

Personally I would keep expressing a little bit while you can and use EBM where possible for a bit longer.

I never pumped through the night and luckily was able to build up a good freezer stash of EBM, but I also didn't have another child at home to care for too, so understand it may be best to give up and balance everyone's needs around.

Lots of prems get formula, so don't over think it.

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lucky 2

That's tough. x

Stop pumping if you think that is best but if you are conflicted, could you reduce the sessions of expressing to 3 or 4 or even less. Whatever you can cope with. You are entitled to make this up as you go, you've got a lot of pressures.

Holding baby whilst you express sounds too stressful for you. Your sweet baby will love those cuddles, they are therapeutic too!

It doesnt have to be all or nothing unless that's right for you, and you don't have to express forever or mix feeds when you home.

If you express aim for efficient sessions, double pump 15 + mins and single 20+, always less than 30mins.

Is there a LC in the sun that you can hash through how you are feeling and thinking, it might help. Not to pressure you but to give practical support about how to manage your lactation, or even turn it off!

 

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Fluffy Potatoes

Ds2 was 35wkr and spent 5 days in NICU, 10 days in total at the hospital. He couldn’t feed on either breast or bottle until this amazing speech therapist consulted and sorted all our issues out in under an hr. That woman wears a halo for sure!

Ultimately though, you don’t need anybody to give you permission to stop breastfeeding. If it feels right for you and your family then it is the right choice. 

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Freddie'sMum

When DD#1 was born and in the special care nursery the information that I was given was that they wanted her off the feeding tube and having 6 'sucks' in a 24 hour period.  The 'sucks' could be either breastmilk or formula - just as long as she was actively taking in milk / formula over a 24 hour period.  OP you need to do what feels best for you - you have an older child and other responsibilites.  I felt such guilt that I tried so hard to breastfeed DD#1 and she simply wasn't interested - feeding from a bottle was easier for her.  

As long as she is fed - that's all that matters.  Give her lots of cuddles (are you allowed to do skin to skin contact with her?) and loved then she will be fine.

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AdelTwins

I’d probably try and persist for a little bit longer if you can.

I made it to just over 5 months expressing with my 35w twins but I couldn’t keep up and understand exactly what you are going through. They thrived on formula.

My third had food intolerance issues that we couldn’t pin point. He had to be fed with elemental formula from one month. I continued to pump and dump hopeful that I could bottle feed him my milk with a reduced diet. It never worked out. He also thrived on formula.

I’d try a longer double pump at night after your other child is in bed. Then get up once or twice in the middle of the night to pump, then first thing in the morning again. It’s brutal - but that would be what a newborn at home would be doing. As for the day pumps, I’d put your daughter in front of the TV for 20mins.

Make sure you drink (and eat) lots. If you can’t get your supply up, then you can move on knowing you did everything you could.

It’s not easy. I’ve been crying on the floor from knocking a bottle over or having to stop pumping because one twin woke up early. There’s absolutely nothing wrong stopping if you can’t do it. Your mental health is more important.

ETA - I was never able to breastfeed directly. All 3 had bottles of expressed milk/formula.

Edited by AdelTwins
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AdelTwins

Also - I wouldn’t stress about the sucking. It’s like a switch that just turns on. One day they can’t do it, the next day they are guzzling! Mine were close to 38w before they “got it”.

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Threelittleducks

Are you using a hospital grade double pump, hands free?

I would try to rent one and see if that makes a difference. And discuss with lactation consultant and GP about boosting supply.

I've been there with prem babies and pumping and it's hard, so if you are keen to try, use the best equipment possible.  I always found setting the alarm for a 5am feed got me the most milk on the pump while mine were in NICU. The early days with sleep deprivation and the stress of a prem wreak havoc on supply, so be kind to yourself on this one.

Otherwise, moving onto formula and bottles exclusively is a great option too.

Fed is best. Good Luck.

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Wonderstruck

Thanks everyone, lots of advice here. 

Yesterday was a hard day. We have so much going on and so much of this birth was unplanned despite trying to plan and have a less stressful experience than DD1. 

I did speak to the hospital LC but she was trying to encourage me to pump 3 hourly in the day and 4 hourly at night. She didn't quite understand what I was saying about that being unsustainable in current circumstances and the fact longer or morr pumping sessions aren't increasing my supply. The only time I get more milk is when she's had a suckle which she only manages once a day and she often isn't awake enough for one in the afternoon even when we try. The hospital social worker and my psychologist totally understood where I was coming from. 

I'm not keen on donated breast milk and no one has mentioned NEC risk. 

I use a spectra s9 at home and the hospital pump (medella symphony). The pump doesn't seem to matter, more so DD2 having had fed. 

Hopefully I'll be a little less rushed next week on DD1 daycare days so I feel like I can spend a bit more time with DD2 that isn't pumping and feel like DD1 isn't missing out. 

I'm continuing to try and take it day by day. It's just that she's been in the SCN for 11 days now and still such a sleepy feeder that it feels like it will be ages before she's feeding well. 

 

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Redchick2

I think LCs will encourage you to keep pumping/BFing (after all that it their speciality) but other health professionals (including midwives) could talk to you more about other options. Like PPs have said, fed is best (for mum and bub- and the rest of your family). 
 

My boys were born at 37+1 and it still took them a good week or so before they were feeding properly (they had NG tubes for top ups). Your little one is putting lots of energy into growing, like others have said the sucking (whether breast or bottle) will come in time. 
 

🤗🤗🤗

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Riotproof

@Wonderstruck I don’t think waking up overnight without the baby is the best idea. I did wake up at 5 am as that is a peak time for milk production, but that was all. 
be kind to yourself. Of course you are shell shocked. It’s completely to be expected. Whatever happens, your LO one has had breast milk for 11 days. That is a huge achievement. It is completely okay to say that you can’t do it anymore. 
 

is she gaining weight? Are they tube feeding? 

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lucky 2
5 hours ago, Redchick2 said:

I think LCs will encourage you to keep pumping/BFing (after all that it their speciality) but other health professionals (including midwives) could talk to you more about other options. 

🤗🤗🤗

The lc isn't meant to pursue her goals for the mother and baby, her role is to facilitate the woman to achieve her own lactation goals, to support the mothers decision making in these very personal situations. To see the woman and baby pair as unique.

Hence it isn't the role of the lc to encourage bfing or expressing unless the goal of the woman is to bf or express.

She could have talked through all feeding options if that suited the situation, that's her job!

Sorry to hear the scn lc didn't seem to hear and see you fully, it was a wasted opportunity for you to recieve more practical support. x

 

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Not Escapin Xmas

Sounds so tough OP. Is it possible for your first child to spend a few days/nights at grandmas or a friend so you can get some rest and have a really good go at it? And make sure you look at pics of your baby when you pump, that is supposed to really help. Regardless of what you decide, I’d give it maybe one more week and then stop (unless your miraculously start producing loads of milk with ease).

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Wonderstruck

Tomorrow will mark 3 weeks of pumping and offering the breast. It's longer than I suspected I would get. 

She'll be 3 weeks tomorrow and 38 weeks corrected on Friday. She will likely be discharged Friday or Sunday.

She will take the breast but tires easily and takes the bottle much better. I think we will slowly phase out the breastfeeds as I won't be able to pump at home and she struggles to stay awake at the breast. 

I'm pleased to have given her collustrum and breast milk to this point but of course have some mum guilt about it all.

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CrankyM

You've done really well Wonderstruck. Glad to hear she is doing well and will be home soon.

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Riotproof

Wonderstruck, you’ve done so well, things are changing so quickly. One day at a time. :) 
 

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Ruf~Feral~es
On 10/10/2020 at 3:30 PM, frazzle said:

A fed baby is best - regardless of whether it comes from a breast or a bottle. And a baby needs a mum who is not so stressed -

This is worth repeating - over and over.  As well as others who have said that you have done amazingly well so far.

I had DD at 33+3, and did the same as you.  I was lucky she had no breast confusion and was happy with either that or a bottle - it made things much easier.

You will find judgy people everywhere, as you probably know from your first.  I was judged for having a caesar (even though it was an emergency), bottle feeding (even though it was mostly expressed milk) returning to work (even though I loved my career and needed the money) etc etc etc.

What matters now is that my 33 weeker is now a wonderful 16 year old human.  She doesn't care how I fed her when she was a baby, or how she emerged from my body, or anything else.  What matters is you and doing what you need to do to be the best parent you can - which is exactly what you are doing.  No guilt! 

Keep up the great work, and enjoy your newborn and toddler snuggles - they matter more than the judgement of others.  

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Jenflea

If you got a group of 20 1yr olds in a room together, you'd have NO idea which ones were breastfed or not. 

Fed is best and if pumping isn't do able, then don't.  It needs to work for you both. 

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