Friend in labour with prem bub how can I help?

[Janie]

Oh yeah, the ABA has a booklet (quite detailed) on BFing prems, it should be available from their website for a small amount. I'm sure it would be very useful for her!

How is she going? Have you heard anything later today?

ETA If you go to the Mothers Direct website (which is the ABA's shop) and look under booklets you will find the premmie one, it's $5

[Liz]

re the blood sugar levels.. DD was put on a drip to fix her blood sugars while we waited for my milk.. no formula She was on it a few days. They were still threatening formula, but when i asked if the drip was maintaining her levels and they said yes, then I just said, well she can stay on the drip until I have enough EBM!

Not sure how/when the drip can be administered, but it's obviously an option.

We were allowed all sucks to start with coz DD was so good at it, but she lost a STACK of weight with the effort (down from 3.5kg to 3kg), so it had to be cut back to 1 suck feed to 2 tube feeds. Again, I didn't let the staff bottle feed her, only tube feed her, while I went and sat at the dairy again and again. LOL. Gosh I knew that pump so well.

I ended up with SOOOOOO much EBM it was ridiculous. But the freezer broke and it all thawed, not long before we were due to go home. So a lot of it got dumped Wish we could have handed it round to all the little prems that weren't getting any breastmilk

[Visitor8]

If she is going to be expressing, having a photo of bub there to look at while she pumps can help with milk supply too. And can she give bub a small teddy or blanket that has her smell on it?

[*Beema*]

If she is going to be expressing, having a photo of bub there to look at while she pumps can help with milk supply too. And can she give bub a small teddy or blanket that has her smell on it?

Great suggestion, we gave N a small panda, which sat on her isolete and in her cot when we couldn't be there and she loves it now, I think Panda will be a stayer!

Wish we knew about the drip option Liz, I guess N had enough needles and stuff poked into her, and in the end it didn't matter.

To encourage her suck feeding, we gave her a dummy and held it for her to suck when she was getting tube feed, this encouraged the when I suck I get full, we didn't try this until we transferred but it made a big difference in her suck feeding. We also only gave bottle after boob, on 2 occassions, the rest was tube feeding or boob.

[BekZ]

Thanks Ladies for your overwhelming support and advice.

I met the little miss today and she is just beautiful. Tiny and petite!!

Thankfully mum and dad refused bottle feeding and they are now not allowing formula. Mum's milk is coming in today too. Bub has had 3 bf's in the last 24hours. The hospital have only just given mum the option to express if needed but they are determined for bub to bf as often as possible. Bub is still so sleepy. I was there for one hour and she just would not wake to feed, this was after 6 hours of sleep. We tried everything to keep her awake and finally she attached and sucked for 15 mins. If bub feeds well this arvo they are going to let her stay with mum overnight.

Now I am off to the ABA website to get that booklet....mwah and heartfelt thanks

[Yael]

I have no experience with prems, but i just wanted to say my daughter was born at 42 weeks, and was only 2.7kg, so you can tell your friend she did fantastic growing her to 3kg at 35 weeks!

Just remember to give your friend lots of cuddles, and also maybe something special for her? Like a nice giftpack of shower stuff or something to make her feel nice? I'm sure she is exausted from all of this, and not at all like she was thinking the first few weeks would be like.

[Inanna]

Bek firstly what a kind and good friend to be doing this....

That's a great weight - and she will be sleepy for a while - she is meant to be in amnio land for a while longer!

Help with breastfeeding is important - and if the baby was hypoglycaemic it sometimes is necessary for a bit of formula. Depending of course on how low the baby's bsl was. I am extremely pro breastfeeding but prems can sometimes bottom out and in the absence of an iv line to which a bit of glucose can be added a few mls of formula can do the same. So maybe this is what happened & perhaps why she wasn't asked. My guess is that her bsl was too low and action was required. Hypoglycaemia is not something we want in a newborn...
She does need to express every 2-3 hours around the clock. This is so very important for supply. It's not easy, it's tiring so she needs lots of kudos and support for this - without being too pushy. She will be feeling stressed about her baby being in SCU without feeling stressed about her boobies too!

A lactation consultant is a good idea - and the ABA will be able to help there.

She needs loads of support, loads of congrats and loads of love. Being the mother of a prem is damn hard, challenging work.

Congratulations to your friend!

[Inanna]

I just feel the need to say. If a baby has no iv line & BSL's are very low the quickest and most effective method of increasing the blood sugar levels are colostrum. With a prem that is in SCU or NICU this is near impossible ( expressing immediately post op after an emergency c/section is a big ask).

IV access is painful and invasive and this needs to be weighted against some formula via syringe.

I am very very very pro breast feeding & formula is not something I have ever used - however my DD4 was very hypoglycaemic post birth and after much trying to raise her bsl's with breastfeeding some formula on a finger raised them in a flash. Just once to prevent a hypo.

Decisions always need to be weighted on individual situations. As a nurse I would be very very anti putting in an iv line for glucose rather than trying some formula first. It is traumatic and painful for a baby to have an iv inserted and this is only done on a need to basis...

[Liz]

Yep, like I said, I don't know how/when the drip can be administered, and my memory fails me on why Kayla was on it in the first place (should dig through my buddies thread and see if wrote anything) I just remember her being on the drip and they were still pushing for formula until I questioned it. Just thought I'd mention it as this is what helped me avoid formula. I'm glad too, coz her gut flora was screwed up enough by the antibiotics I had in labour, I'm sure of it. Hate to think how colicky she would have been if she'd had formula too. Just shows how much sugar is in formula hey if just a bit on a finger can raise the sugar levels

I had some absolutely beautiful, supportive midwives & nurses in the NICU who helped me stand up to the paeds when they did their rounds. Except for one cranky one who kept telling me to wean DS and who used a bottle for one night feed which distressed Kayla, and the other nurses told her off for me LOL. Anyway, that's a bit off topic!

Sounds like they're doing really well BekZ. It's definitely tiring trying to feed a prem, it takes forever to get them to wake up enough to get a good drink. I found it impossible to document how long she fed for, coz I could be sitting there for an hour and she could have fed for 5 lots of 5 minutes or something.. I'm sure I fudged my figures a lot of the time LOL. This is probably why they like to bottle feed so they can measure it. And then after an hour of feeding, I'd do 1/2 hour of expressing, then you'd have about an hour to go and do something (sleep was rarely an option LOL) before you had to be back for the next feed. Thankfully all my meals were cooked for me! altho I had a lot of those cold coz they arrived while I was feeding or something. So yeah, some well-timed hot meals would probably be appreciated! heh.

[BekZ]

A huge kiss and hug to everyone!!!

I am pleased to say that mum and bub have gone home and breastfeeding is happening!!! I mean really happening, apparently she is a hungry little mite.

I am going over to see her this arvo

[Liz]

Aww that's great to hear! Enjoy your cuddles

[rufalina]

Oh yay. Pleased to know they are going well. Hope it continues. xo

[*Beema*]

It's definitely tiring trying to feed a prem, it takes forever to get them to wake up enough to get a good drink. I found it impossible to document how long she fed for, coz I could be sitting there for an hour and she could have fed for 5 lots of 5 minutes or something.. I'm sure I fudged my figures a lot of the time LOL. This is probably why they like to bottle feed so they can measure it. And then after an hour of feeding, I'd do 1/2 hour of expressing, then you'd have about an hour to go and do something (sleep was rarely an option LOL) before you had to be back for the next feed. Thankfully all my meals were cooked for me! altho I had a lot of those cold coz they arrived while I was feeding or something. So yeah, some well-timed hot meals would probably be appreciated! heh.

I have to agree with you here, I think I was a zombie for the first 8-9 weeks, as the neborn stage lasts until they would have normally gotten over being a newborn. For me feeds to and hour and a half, then expressing, sterilizing, oh,, gee almost time for another feed But looking at it now it was all worth it.

At the hossy without fail food arrived when I was expressing or feeding! And I don't think I ate a lot at home.. .. but museli bars were really handy cos I could just rip one open and eat it and get a boost!! Wish I had someone to cook for me!!

Great news Bekz, enjoy your cuddles, give her a kiss and cuddle for us!!

[BekZ]

Well bub did not stay home for long. She has jaundice and has lost too much weight. I knew they went home too early.

I don't know much more than that but I am sure the hospital will be trying to get bub to feed as much as possible.

[*Beema*]

BekZ

Gee I can't believe they let her go home only for overnight in the end.. poor mum it must be very hard.

I hope she can just have some more time to get things happening

We didn't have a weight gain until day 23, which was 12 days after leaving hospital, infact on the day if disharge she lost 40grams and was 10 grams above her lowest weight but her Paed was happy for her to go home (on a Friday). The following Wednesday we had her weighed and she had lost another 10grams, so was back to her lowest weight. We were lucky that the RN wasn't too worried (albeit I was shattered) and we went back the next week and got a decent gain!

DD also had jaundice, was under lights for a couple of days. It also got worse when we were home but we hadn't realised how bad (as she was really yellow and we didn't know any different and our private MW/LC wasn't concerned until it had returned to her torso) at 10 weeks, we had her Bilirubins done and they were the same level as they were when she had just finished her phototherapy, so we were lucky we didn't have to go back in, but it also meant that she wa probably above that for quite some time and had just gradually come down by themselves.

DD's Paediatrician said that in breast fed infants, the same thing that breaks down the breast milk also resolves jaundice, he referred to it as breastfed jaundice. So it is common for Breast fed babies to be jaundiced for 3 months or more (especially premmies).

I hope that with a bit of phototherapy and adjustments with her feeds that they can return home and stay there. xxoo

[Liz]

Oh dear. Sorry to hear this. Must admit I thought it was early to let them go home too, I thought they liked to keep them until they were close to 37 weeks?

Jaundice is a common problem, I hope it's just a mild case. Kayla had to go under the lights, but then hers went away. DS tho, who was born at 37 weeks had breastfeeding jaundice for a long time, but never needed the lights.

Weight loss.. that's pretty common too with prems. They're not meant to be burning all this energy eating and breathing and all that comes with being born. They should still just be floating and growing!

I hope she's not too disheartened. Tell her to hang in there, bub just needs time to rest and catch up with things. Hope it's all sorted soon for her. It's such a waiting game really with a prem.

[Janie]

Oh I'm really sorry to hear that Bek. I hope she can come home soon.

Gosh, I never really thought about it too much, I just thought we were a bit lucky bringing our 35 weeker home with us. I guess we were REALLY lucky. DS was jaundiced, and we did think he would have to stay in, but his last BT on the day we were going home showed some improvement, so we got to take him with us. Yeah, I guess we were very fortunate.

[BekZ]

Baby Maja is home...for good!!!

They got home yesterday and so far she has gained 90g since being at home. Mum is breastfeeding really well thankfully.

Thanks so much for support.