combining expressed breast milk feedings with nursing....NEED HELP

iVillage Member
Registered: 11-16-2013
combining expressed breast milk feedings with nursing....NEED HELP
3
Sun, 11-17-2013 - 12:49am

So heres my situation. I gave birth to a baby girl 5 weeks early. Started nursing immediately in hospital and thought everything was going well until we went to pedi when she was 4 days old and found out she dropped weight drastically and was jaundice. Pedi suggested supplement formula feeding since my milk wasnt in yet. So we started formula feeding but now exclusively bottle feed with breast milk. She is also on billi blanket 24 hours a day. Shes feeding well and has gained weight. Still jaundice and on blanket until next doctors appointment. So my issue is that i really want to breastfeed while giving her a bottle. We are trying to get rid of the jaundice through controlled feedings every 2 hours. When's the best time to feed her from the breast? We still wanna make sure shes getting adequate feedings so the jaundice can make it through her body. Should I nurse her before or after the bottle feeding? If she's rooting should I nurse her then? She roots on and off all day. Dont want to miss any opportunity to breastfeed. Or should we just wait until the jaundice is gone? Desperately want to breastfeed my baby.  

Community Leader
Registered: 06-10-2008

Welcome to the board and thanks for stopping by! Congrats on your new little one! Would it be ok if I asked you a few questions?

- How old is baby?

- Just to confirm, baby is getting exclusively breastmilk in a bottle? What kind of pump are you using? How often do you pump and how much milk are you getting? How much is baby taking by bottle?

- Is weight gain on the right track now? Peds typically look for baby to be back up to birth weight around the two week mark. Is diaper output on track?

- Can you tell me a little bit more about why you're choosing not to offer the breast at all? Is that by doc's advice or personal preference?

- Is bilirubin level headed in the right direction? When is your next recheck?

- Have you been working with a local LC at all since hospital discharge or is this your first time reaching out for help?

- I personally would say nurse directly as often as you'd like. If jaundice is still a significant concern, you may also still need to temporarily pump and bottle feed to make sure input is adequate.

If you can get back to me with some additional questions, I'd be happy to help however I can. Hang in there!

Dana Lauducci, IBCLC

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iVillage Member
Registered: 11-16-2013

She is 8 days old. She does exclusively gets breast.milk in the bottle. Havent had to use formula for about 3 days. I pump every 2 hours and get anywhere from 2-3 oz. I use a Medela PIS. She feeds every 2 hours and usually drinks 1-2oz. She has been having an average of 8-9 wet diapers and about 8 bowel movements. Weight seems to be over her birth weight but thats weighing her on our home scale. Last bilirubin check showed that it was dropping and we have an appointment tomorrow with doctor to check her color and weight. I have been trying to nurse if she starts rooting in between feedings but she falls asleep while I nurse her. Last few times she just fusses when I try to nurse her. Thinking she is having latch problems now or simply doesnt want the breast anymore. I did work with a LC in the hospital and everything seemed to be ok then. Im hoping to make an appointment with an LC this week.

Community Leader
Registered: 06-10-2008

Thanks so much for the info. From what you've posted, it seems like your supply is great and she's taking in a good amount so no concerns there. Hopefully at tomorrow's appointment you get the clear with the bilirubin issues. So your next step will just be transitioning her from the bottle to being able to take all feedings at the breast.

Eating by bottle uses different muscles than eating by breast so since she's been exclusively on bottle for a little while, it will be a little bit of a learning curve for her and will require a bit of patience. I would definitely suggest making an appointment with a board certified LC for some hands on assistance. Here's a directory to help you find someone in your area: http://www.ilca.org/i4a/pages/index.cfm?pageid=3432   If you're comfortable sharing your geographic area, I may be able to recommend someone local to you as well.

In the meantime, keep offering the breast frequently and gently but don't force anyone or make it a big deal. The other thing I would recommend is spending lots of time skin to skin. Take baby's shirt off, take your shirt off put her between your breasts and put a light blanket over both of you. There's been lots of research the past few years about how that investment in skin to skin time early on can really awaken baby's inborn neonatal nursing reflexes and help baby latch on more instinctively. 

Keep me posted how your appointment goes and if you're able to get in with an LC quickly. 

Dana Lauducci, IBCLC

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