I am asking this question for my daughter. She delivered her baby just over 8 weeks early. From the start, she was interested in nursing so began the pumping immediately. She has been very successful at that so he is totally on breastmilk, not formula!
Her baby started taking the bottle before released but was still too tiny to begin nursing. He is now just over 3 months old and she was finally able to get him started this week. But she says it is very painful. As much joy as she is getting out of this achievement, the pain is overwhelming.
She asked me for ideas as I nursed my babies until they stopped at around 18 months but that was so long ago, and I had no problems like this.
Can anyone with experience of successfully getting a premie from the bottle to the breast give any advice for her? Does she need to start slowly, maybe once a day, then twice a day, on up to every feeding over the course of a few weeks? Once she started, she nursed at every feeding and I'm wondering if that was too quick for her body? Is the La Leche League still around for helpful advice?
Thank you in advance to anyone who can give me suggestions for her. I think she has already succeeded as far as providing him breastmilk - I am very proud of my daughter. But if she can get the full experience, save on bottle washing and stop the pumping, I think she would be thrilled.
Thank you everyone. She has located at support group and will go to that meeting next week.
I am very proud of her.
I agree that a lactation consultant can be very helpful. There should be some at the hospital where she delivered who she can contact. Has she tried nipple shields? My first was full term, but we had some problems at first and those really helped. It's still something she'll have to wash, but much less than all the pump accessories. ;) Also, Medela makes a product called Tender Care Hydrogel that may help. Good job and good luck to her!
Sounds like a little of "nipple confusion" and (im)proper latching. Babies given a bottle in the hospital (ooh, I hate that! IMHO) can confuse how to drink from a bottle and how it is different from how to drink when nursing at the breast.
Please feel free to visit http://www.llli.org//Web/Texas.html and find a La Leche League group near your daughter. My aunt was in LLL a long time ago and it is amazing but true: that organization is still up and certifying leaders / consultants. (It's great.)
Please let your daughter know it is okay to _liberally_ apply lanohsil (not sure I spelled that right), _after_ the baby has nursed. Getting help ASAP with the correct latch hold and position will reduce (and remove) that pain really quickly.
One thing to note, with my premie, my lactation consultant showed me how to help him retrain his latch ("posture" or position, so to speak). It may very well be the same with your grandchild.
And, btw, there is no such thing as "too tiny to nurse" IMHO. Please encourage your daughter to nurse on demand as often, and as much, as she can stand it.
Good luck!
congrats to her for pumping and trying. I'm a big advocate of breastfeeding for all the reasons you listed.
My 14 yo was in the NICU for 72 days but I still remember it!! They told me it was because she was a preemie and too tired to nurse so I only got about 2 months nursing time with her. She also had a hard time getting the hang of it due to bottles in the NICU!! So it will be the most frustrating thing for your daughter but the most rewarding. Sounds like she is doing everything right but might want to find a local person who can come and observe if she is comfortable with that. And try other positions-lying down is the easiest. Your daughter may not be aware of it but she might start stressing and that affects the baby cause they feel it.
If it does not work, she should still be proud of the fact that she tried and as you said, she got him some breastmilk. As soon as I got some to my DD and she was ready for it in the NICU, she came home w/in 2 wks. My husband calls breastmilk liquid gold!!
Congrats on the grandbaby and if she has anymore ?'s on preemies, definitely ask. BTW, my daughter is great now-just crawled/walked later than most!!
It's going to hurt for a week or 2 until her nipples are used to the sucking. Pumping is not the same as the baby actually latching on and nursing so its going to hurt her. Use lanolin on them all the time!!! It is wonderful and will help them not crack or bleed and feel better. She can put them on after every nursing and rub them into the nipples and she wont have to wash it off before the next feeding because its natural and wont hurt the baby. Also she needs to nurse every feeding so her body will adjust and also the baby will get used to nursing from her and not a bottle. Good for her for starting to nurse after 3 months!!!
First, congratulations on the birth of your grandchild!
My second son was born 9 weeks early and, like your daughter, I found nursing him excrutiating in the beginning. Their little mouths are so small and they don't really know how to latch on correctly. I would sit there and cry while he nursed. I think my biggest issue was that it was so hard to get him latched on, that I didn't want to unlatch him and try again if he latched on incorrectly. But - I finally started doing this. It was extremely frustrating to have to unlatch him over and over, but eventually he would get on correctly and it was so much less painful. So, make sure he latches correctly and take him off the breast if he doesn't. If that doesn't help, then have her call the nicu and they will put her in touch with a lactation consultant. Best of luck to her - breastmilk is so important, especially for these little preemies! :)
She should contact a lactation consultant who can watch her feed and see if it is a latching problem. Nursing at first can be a bit painful, as the breasts haven't been used like that before. The first few days are the worst, but it does get better. If she is in so much pain that she wants to keep pumping, she needs to see someone about it and get the support she needs. You may also want to call the hospital and see if there is a breastfeeding support group. She can also try nursing on one side each time to give the other breast a bit of a break.
No experience with premies, but I nursed my two. For a few weeks it was torture and I have a high pain tolerance :D Tell her to hold in there! She is doing GREAT! The lactation classes I took said "if it hurts at first, you're doing it wrong". I found out after I weaned my second one that THEY were wrong because it is a sensitive area and how many of us go around with 6-pound vice-grip pliers hanging on our nipples? lol
Congratulations on her success at pumping for so long and having him completely on her milk! That is awesome! I didn't produce enough, so my babies got milk and formula. Your daughter is an awesome mom!
I no nothing about premies but I do know when I started nursing, the pain was severe. Bleeding, cracking, etc. Whenever the baby would latch, it was so painful it would bring me to tears (the pain would subside some after a couple of minutes). I had heard from others that if I would just stick it out, the pain would eventually go away. They were right. I endured 5-6 weeks of this. The pain just stopped very suddenly. There was no gradual improvement. Not everyone experiences pain like this; I think we all have different pain thresholds and it depends on the type of skin we have too. One of my babies had a latching problem and that experience was more painful than the other. However, even with my good latcher, I had plenty of pain and problems. Have her give it 6 weeks but I would highly recommend seeing a lactation consultant right now (to make sure the latch is good). When my babies would latch, their bottom lip would be turned under. I would have to take my thumb and pull down on their chin at every single nursing, to open up their mouths wide and get that bottom lip turned out instead of under. His face should also be push up right into her breast (to the point where it seems as if he might not be able to breath). Just make sure a portion of one nostril is exposed and he'll be fine. It gets easier!!! I commend her for this commitment!! She's doing the best thing for her little guy! Nursing is no cake walk but once you get through the tough part, it's SO much easier than bottles. By the way, you can contact La Leche league but I would start by calling the hospital she delivered at or the NICU he was in. Ask them if she can get a free consultant through her insurance. Many hospitals do this (but not all).
I had three preemies, one born at 32 weeks. She started nursing at 33 1/2 weeks gestation. But she also had a big mouth. My second hated nursing thanks to the way the NICU started her breastfeeding off. My third was born at 36 weeks and her mouth did not open wide enough. Because she couldn't latch on properly not only did she not get enough milk only nursing, but I was in horrible pain. I cried the whole time. I did see a lactation consultant or two, but didn't get any help.
Eventually she got big enough that it didn't hurt as much.
In her situation he might be opening up just fine, but it does sound like some kind of latch issue. WIC has free lactation consultants, she might be able to see one.
She needs to make sure that they are belly to belly, line the baby's nose up with the nipple prior to latch, pull the baby towards her breast with the chin coming to the breast first, mouth open wide and covers some of the aerola (they say much of it, but some women like myself have a very large aerola.) Make sure the tongue is down.
Remember the baby is learning at the same time she is!
She is welcome to email me doula at birthspring dot com I'd be happy to help as I can.
OH- I just saw that she is in an area south of Houston. Do have her contact me, I might be able to come meet with them and see what I can do to help.
S.
I would be willing to bet that her little one isn't latched properly. Yes, La Leche League IS still around, have her look them up, they are so helpful. If she has been pumping without pain for the last 3 months, baby must not be sucking quite right.
I cannot respond on the issue of a preemie, but on nursing in general. Irritation is a normal part of starting to nurse but ongoing and deep pain is not. It might mean her latch is not good for some reason.
My first advice is to have her ask her OB for this prescription from a compounding pharmacy. It saved me a lot of pain. I'm no crazy homeopath, it is something my lactaiton consultant recommended and my OB perscribed and it really helped much more than lanolin. Just make sure as a preemie there are no counterindicaitons. I pasted it at the bottom of this response.
Second, I urge her to see a lactation consultant. They are much better than just a nurse on the postpartum ward. Pay for a private session or two where you can work on the latch and sucking. I don't see any reason she shouldn't nurse at all feedings if the latch is right and not causing pain. A LC is a magician at fixing problems. I found La Leche was a nice support group of nursing moms, but to deal with this you will really want somone hands-on. I nursed for well over a year both times and both times I had major start-up issues.
Congratualations and good luck!
APNO (All Purpose Nipple Ointment) is a compounded ointment mixed from the following ingredients:
Mupirocin 2% ointment (15 grams)
Betamethasone 0.1% ointment (15 grams)
To which is added miconazole powder so that the final concentration is 2% miconazole. This combination gives a total volume of just more than 30 grams. Clotrimazole powder (not as good as miconazole) to a final concentration of 2% may be substituted if miconazole powder is unavailable, but both exist (the pharmacist may have to order it in, but compounding pharmacies almost always have it on hand). Using powder gives a better concentration of antifungal agent (miconazole or clotrimazole) and the concentrations of the mupirocin and betamethasone remain higher. Sometimes we will add ibuprofen powder to a final concentration of 2%.
The ointment is applied sparingly after each feeding (except the feeding if/when the mother uses gentian violet). “Sparingly” means that the nipple and areola will shine but you won’t be able to see the ointment. Do not wash or wipe it off, even if the pharmacist asks you to. The APNO can be used for any cause of nipple soreness ("all purpose nipple ointments"), not just for Candida (yeast). Use the ointment until you are pain free for a few days and then decrease frequency over a few days until stopped. If you are not having less pain after 3 or 4 days of use, or if you need to be using it for longer than two or three weeks to keep pain free, get good help or advice.
