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Old 07-15-2010, 10:08 AM   #1
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Latch issues, maybe prefers the bottle and he is premature

I have been very luck in the nursing department up until now. I nursed my oldest DS for 10 months and my DD for 17 with no issues. Then came along my 8 week premature DS complete with a NICU stay. Since he was so early he was feed by a nasogastric tube for a week and a half then we feed him by tube, bottle and breast. I was desperate to get out of the NICU and he had to eat all feedings by mouth. I was under the impression that this was easier for them to see if was given a bottle.... Later I was told they could had weighed him before/after feedings to see that he has ate. So, here we are home. I am nursing him as much as he will but have to follow up with a bottle of pumped breast milk. The pump, a whole different issue, I hate it! The past 2 weeks I have been really working with him and trying to transition him off of the bottle with very little to no success. At first I thought he was to weak to nurse but now I know that he is at a place where he can. When I go to nurse him he roots around a lot but 1)wont latch 2)latches, falls off then wont/cant re latch or 3) latches, nurses for 10 minutes or so then falls off. Once he pops off it is darn near impossible to get him back on. He roots around like crazy but wont latch on. I do not have tiny or inverted nipples, I dont know what the deal is. Also, he don't latch like he should.. I dont think he has enough of my nipple in his mouth. I have shoved as much of my breast in as I can when he is rooting but then we are back to the above scenarios and by the time something happens if he latches its only nipple, no areola. I guess this could be because he has a smaller mouth than what I am use to nursing?

I am desperate to get him on the breast. I hate pumping, I hate the 3 hour feeding schedule, I hate the extra work of cleaning the pump, cleaning the bottles and I hate spending money on renting that pump. I am so tired since I have to bottle feed, pump and clean up every.single.three hours. I have caught myself thinking that it would be easier to just formula feed him, at least I wouldn't have to deal with the pump. So please help me figure out what is going on here, I have to get him on the breast asap.

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Old 07-15-2010, 11:21 AM   #2
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Re: Latch issues, maybe prefers the bottle and he is premature

Aw.. hugs mama, that sounds tough

My DD was born full term (8lbs4oz), but she still had trouble latching at first. She didn't seem like she could get a wide enough latch either, and after latching on, she would sometimes fall right back off. I figured out that my breast was too heavy on her chin, that's what was causing her to fall off. I sandwiched my breast for her to latch on, then released my hold a bit, but not all the way, that way she didn't have so much pressure on her chin. I did that for about 2 weeks, and now she can latch on and nurse just fine. Maybe your DS just needs a little bit more help since he's teeny?

Also, what position are you trying to nurse him in? The only way I could get a newbie to latch (with DS & DD) was to do the cross cradle hold. Here is a bunch of different positions you could try.
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Old 07-15-2010, 04:02 PM   #3
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Re: Latch issues, maybe prefers the bottle and he is premature

I went through this same problem. I had successfully breastfed my first two but when DS was born early it was a whole different experience. Nursing a preemie is like starting all over again.

Like PP said, definitely make sure your supporting your breast. When they're so small, they need the extra support. I know it can get tiring so make sure you have all of the Boppys and pillows you have within reach to get both of you into a comfortable position. Even though my DD wasn't a preemie she was small and required a NICU stay so the beginning was difficult. I found that the football hold was my friend! I wouldn't have been able to breastfeed without it. You will be able to see your breast and your baby's mouth at a better angle and it makes a HUGE difference. I had forgotten about it when Ds was born. He started out tubefed also and when we tried BFing I was sooo frustrated. Then one day DH said, "Why don't you try to hold him like you did with DD?" It really helped! For the first couple months though I would say it would take a good 10 minutes or so to get him properly latched on. I know it is really frustrating but I think it really will get better. One day DS just got it!

1 question I have for you. When you pump, does your DS take the entire amount from a bottle? I found that I was pumping a lot more than he would take. You might want to get a scale (you can rent one) to way before and after for piece of mind. I didn't do it at home but did in the NICU. What you'll hear a lot about BFing and from your previous experience is to nurse 15 minutes on each side. Your DS might not need to nurse that long to get all that he needs. I was able to nurse my DS for about 10 minutes and found that he got as much if not more than he was taking during bottle feeds. Just because they'll take a bottle after nursing doesn't mean their still hungry. They can just be wanting to suck for comfort.

I hope this helps. It WILL get better!
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Old 07-15-2010, 08:58 PM   #4
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Re: Latch issues, maybe prefers the bottle and he is premature

I definitely support my breast. I am pretty large chested and had to do the same with my two other children. I actually think that my breast weighs more than him and is definitely bigger than him.

I have tried different holds. Us both lying down seemed to be the best position today but we still have the issue of the frantic rooting and refusal to latch. He gets so frustrated some times so I give him the bottle and then try to nurse him again before he finishes.


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Originally Posted by Stouffers3 View Post
1 question I have for you. When you pump, does your DS take the entire amount from a bottle? I found that I was pumping a lot more than he would take. You might want to get a scale (you can rent one) to way before and after for piece of mind. I didn't do it at home but did in the NICU. What you'll hear a lot about BFing and from your previous experience is to nurse 15 minutes on each side. Your DS might not need to nurse that long to get all that he needs. I was able to nurse my DS for about 10 minutes and found that he got as much if not more than he was taking during bottle feeds. Just because they'll take a bottle after nursing doesn't mean their still hungry. They can just be wanting to suck for comfort.
I do pump more than he eats at one feeding. He eats around 1.5 oz at each feeding and he is 5 weeks old and I pump about double. I am afraid to scale down my pumping because I don't want to dry up. He is quickly eating more and more and I know eventually he will catch up. I also need some extra milk to give to him with his supplemental feedings... granted I do have enough in the freezer to last a year or more of supplemental feedings. Really, I am afraid of drying up thats why I keep up the pumping every 3 hours even if he nurses.
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Old 07-15-2010, 11:50 PM   #5
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Re: Latch issues, maybe prefers the bottle and he is premature

Have you tried a nipple shield? That may work to just stop the pumping.. then you can work on transitioning him off the shield. My twins were premature too and one of them ate better with a shield (I too was desperate to get them home, so I tried the shield on the advice of a nurse). He used it for the first 4 months, but it could have been less if I would have helped him get off of it sooner. What I did was start him off on the shield and then when he wasn't so hungry, take him off and he could concentrate easier on his latch.

My friend ended up doing the same thing you are doing when she came home with her little guy (almost full-term, but only 5lbs. when they came home). The nurse finally told her to just stop giving him the bottles and he would "learn" to latch and stick with it. She had to feed him more often, but only for a day and then he quickly caught on and gained fine. It was probably around 5 weeks when she quit giving him the bottles. Good luck, mama and congrats on your new addition!
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Old 07-16-2010, 06:49 AM   #6
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Re: Latch issues, maybe prefers the bottle and he is premature

You are doing a great job! I'll be back later to see if I can give you any pointers.
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Old 07-16-2010, 09:54 AM   #7
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Re: Latch issues, maybe prefers the bottle and he is premature

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Originally Posted by briannah View Post
Have you tried a nipple shield? That may work to just stop the pumping.. then you can work on transitioning him off the shield. My twins were premature too and one of them ate better with a shield (I too was desperate to get them home, so I tried the shield on the advice of a nurse). He used it for the first 4 months, but it could have been less if I would have helped him get off of it sooner. What I did was start him off on the shield and then when he wasn't so hungry, take him off and he could concentrate easier on his latch.

My friend ended up doing the same thing you are doing when she came home with her little guy (almost full-term, but only 5lbs. when they came home). The nurse finally told her to just stop giving him the bottles and he would "learn" to latch and stick with it. She had to feed him more often, but only for a day and then he quickly caught on and gained fine. It was probably around 5 weeks when she quit giving him the bottles. Good luck, mama and congrats on your new addition!
I have tried the nipple shield, I immediately went out and bought one. I had to use one for a few weeks with my oldest son. Its a big no go... he does not like it at all. I can't even get him to attempt to latch with it, he just keeps pushing it out of his mouth. He does better without it than with it.

I have breastflow bottles that I switched to yesterday. It took some getting use to on his part but he caught on quickly. Today he seems to be nursing better. I think I am just going to stick with these bottles with trying to nurse for a day or so and then just go cold turkey to the breast. Like PP said he may need to nurse more frequently but he will catch on. I hope this works.

In the mean time, any ideas on how to get him to take more of my nipple in?
And once I get him on the breast can I stop pumping? With him eating so little will I lose my milk? Do I just pump less often? I don't want to keep adding milk to my freezer and have to keep giving him the bottle part time so I don't waist it. Any ideas here? Do I need to post this question over at the pumping forum?
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Old 07-16-2010, 10:35 AM   #8
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Re: Latch issues, maybe prefers the bottle and he is premature

Back to my friend's situation, once he was at the breast and she wasn't supplementing, she quit pumping. The stimulation he provides should be enough to keep up your supply and then your supply will balance out to what he needs and you won't have to worry about oversupply (I had this problem and it was HELL!). That's my suggestion anyway. It sounds like you're doing great... keep it up! You could also try contacting your local La Leche League for ideas. They were so helpful for me, once I called, a leader was over in less than 2 hours and brought us dinner! They're so reassuring and great! I hope things get easier for you!

And about getting more nipple in his mouth... have you heard of the assymetrical latch? Try pointing your nipple toward the roof of his mouth and wait for him to open wide. You could try looking it up online for some pics, that really, really helped me get it! Again, take care and good luck!
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Old 07-16-2010, 12:54 PM   #9
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Re: Latch issues, maybe prefers the bottle and he is premature

i had the same issue my baby was in the nicu for 2 weeks and was 5 weeks early. He had a feeding tube and was desperate just like you but... I refused to give him a bottle. We had issues getting him latched on and I did the nipple shield and it didn’t work. So he is how we did it I held my hand behind him head made a sandwich with my nipple and when he opened I shoved his head to the boob the whole nipple was in his mouth and then i got a syringe with my milk in it and would squirt a little in is mouth. it took a while but he did get it!! Just hang in there!!
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Old 07-16-2010, 12:54 PM   #10
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Re: Latch issues, maybe prefers the bottle and he is premature

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Originally Posted by briannah View Post
Back to my friend's situation, once he was at the breast and she wasn't supplementing, she quit pumping. The stimulation he provides should be enough to keep up your supply and then your supply will balance out to what he needs and you won't have to worry about oversupply (I had this problem and it was HELL!). That's my suggestion anyway. It sounds like you're doing great... keep it up! You could also try contacting your local La Leche League for ideas. They were so helpful for me, once I called, a leader was over in less than 2 hours and brought us dinner! They're so reassuring and great! I hope things get easier for you!

And about getting more nipple in his mouth... have you heard of the assymetrical latch? Try pointing your nipple toward the roof of his mouth and wait for him to open wide. You could try looking it up online for some pics, that really, really helped me get it! Again, take care and good luck!
The feeding before last, I only nursed him and he seemed content. Then he woke up rooting about an hour later. No big deal, I nursed him again. He didn't nurse very long before he feel back asleep. Then he woke up an hour later frantic. Screaming crying and rooting frantically. He nursed again for what seemed to me like a decent amount of time and on both sides but he wouldn't calm down. He got really upset and wouldn't nurse any further. I thought maybe his belly hurts so I patted his back and walked him around and he wouldn't calm down. So, I broke down and got him a bottle. He ate the whole entire thing quicker than I have ever seen him eat. So now what? Is he not really nursing? I now know why people give up. For me to have over 27 months nursing experience and having this hard of a time, I can only imagine how first time mommas feel. I am a very private person and dont like people I dont know well at my house but I may have to break down and call the LLL.

I will definitely try the asymmetrical latch the next time he nurses. Thanks for all your help and suggestions.
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