Establishing breastfeeing when your baby is in NICU/SCN.

[DaintreeDream]

My baby is due to be born in December. She has a heart problem 'aortic interruption' and a small 'hole in the heart' and is going to require admitting to NICU and surgery shortly after birth. It is my understanding she will spend 2-3 weeks in hospital.

When my DD was born she was also admitted to NICU and spent 3 months in hospital, she would not latch on due to having pierre robin syndrome (cleft palate and small jaw) and I was offered no support in establishing any kind of breastfeeding relationship, they did not even suggest me to express for the first time until 24 hours after her birth. I did end up expressing full time for 11 months until falling pregnant with this baby.

The hospital where I am delivering understand how important it is to me to breastfeed my baby and are going to arrange for me to see a LC before my babys birth, I think that this is a great start.

My baby will be transferred to another hospital, an hour away, this could be immediately after birth or within 48 hours, I may require a CS and therefore not be able to go with my baby if she leaves straight away. I was thinking of attempting to express some colostrum before babys birth to take to hospital so it can be transferred with baby if needed. (I will talk to my LC about this when I meet with her).

I basically want to know how hard it is going to be to establish a breastfeeding relationship with my baby when she will be in hospital (based on me being able to hold and feed her when required if her medical needs aren't to great).
Will I need to stay there 24/7 or would I be able to establish day feeding and go home to be will my DH and DD at night? (Once again the hospital will be about an hour away from my home)
I will refuse any FF being fed to my baby, she will have exclusive EBM.
Should I refuse them to feed her with a bottle as this would cause confusion? I believe she will have a NGT for at least her inital days in hospital until she has recovered from her surgery.

Once again these are all questions I will be asking my LC when I meet her, however I just wanted to get some ideas/understanding in the meantime and I am sure that more questions will arise before her birth.

Thankyou for any assistance you could provide.

[MantaRay]

DD, it must be so stressful for you atm, but you are doing a wonderful job of preparing things in advance.

Establishing bfing in that situation is certainly more difficult, but definitely possible. The two keys are frequent expressing, and as much skin to skin contact as you can. While you are separated obviously you can't have skin to skin contact, but you can make up for it when you are able. In your situation, expressing colostrum from 36 week is probably a good idea.

I really suggest you give the ABA helpline a call on 1800 mum 2 mum to talk it over. The ABA has two really great booklets about this - Breastfeeding and Hospitalisation, and if you need a caesar there is a booklet for that also. They are just $5 each and have lots of practical suggestions and quotes from mums who have done it before.

All the best hun. I know things are going to be tough for you, but if anyone can do it, you can. You have done such a great job with Miss M.

[The[cookie]Doctor]

My sisters were in hospital for five weeks. Premmies, and NGT fed for the first two-three weeks. They never had a bottle in hospital so yes I think you can and should refuse it. RWH used to get the babies to suck on those little finger dummies while feeding to help them learn to suck.
Not much help and I know your circumstances are different, just my slice of input.

You sound really prepared with LC etc, good luck.

[BellyBelly]

I had a client who had to have a c/s due to placenta previa - she started bleeding and had to go in. But before she was in theatre, I asked the midwife for some test tubes and we were able to express loads of colostrum just in case something happened and they could feed the bub colostrum after the birth if needed. Luckily the midwife was very supportive, even enthusiastic that I asked and gave us a hand. I've seen bubs been given sugar water before and things like that, so we decided to be one step ahead and have something ready. Might be something you could organise too should it need to go down the path of c/s

[Sally2]

Often babies can be successfully bottle fed in NICU/SC and gradually move to exclusive breastfeeding as their health/energy levels pick up. As much skin to skin as you can helps, if possible, hold her on your breasts while she is getting a naso gastric tube feed so she associates the smell & sensation of your breasts with getting a full tummy.
The nurses at Mercy were FANTASTIC with encouraging breast feeding and exclusive EBM, it's soo much better for babies, particularly sick and vulnerable kids. Our son had exclusive EBM during his 11 weeks in hospital, even though his Tummy Mummy had lots of problems with supply due to his being so prem, mastitis etc but he learnt to breast feed before he went home. Unfortunately, he just didn't have the stamina to keep up with it once we got home, he was still so small and after a long, agonising few weeks, we made the decision to put him on formula. The first three months for him having that breast milk though made such a huge difference.
Good luck with your NICU journey, sending you lots of breast feeding vibes!

[Spring Angel]

Flowerchild did an amazing job expressing and then BF her DD who was born at about 27 weeks I think. Hopefully she will pop in.

I also had a friend who's DS was born premie and didn't have the suck reflex at all. It took three weeks of expressing and he eventually managed to latch on and continue to feed for months.

Sorry I don't have any first hand advice, just wanted to give you some postive stories.

Spring xx

Oh about the expressing, I know that it is sometimes recommended for women with GD so I think it sounds like a really good idea if it works for you.

[LucaJack'sMum]

Both my DS' were in SCN for about a week, I expressed and INSISTED that I come down and feed when I could (not always possible as we could not always touch or hold them) BUT when we could I insisted that I was called and the they were not fed formula if EBM was there... they did have to be bottle fed sometimes but you gotta try as hard as you can to establish a good breastfeeding pattern if for no other reason than to bring your milk on

Good luck! xxxx

[*Beema*]

DD I am sorry that you are travelling a difficult journey once again, you are a strong woman and I hope that with all of your research and preparation that you will be able to achieve a beautiful feeding relationship with your DD.

Some of the recommendations above are brilliant, expressing from 36 weeks or so is a great idea, every ml will count. With the feeding these are the things that I found worked for us. Our SCn journey was only 11 days, but we took DD home on a 40gram loss and she didn't gain weight until she was 23 days, so it was a very stressful time, but it can be done.

Inititally we were only allowed to have one BF attempt a day, DD was still recovering from extremely low BLS and was a 33 weeker so not a lot of energy. I took it as an opportunity to get some lovely skin to skin, she didn't really suck, more as played, but she was able to smell and find the BBS.

We did NGT feed with her skin to skin when we could, even place her near the breast and feeding through the tube at the same time. We only used a dummy when we were doing the NGT feeds, so that she learnt to associate sucking with getting a full tummy.

I did use a bottle a couple of times for top ups or if I couldn't get her to feed from the breast (while still in hospital as I boarded with DD), but it was after breast, so she had less energy left but had already "worked" for her milk.

We had to intorduce some formula top ups at 10 weeks as DD started losing weight and was already 1kg below the bottom of the chart, so we didn't have room to move as such. But we always offered breast before bottle, and we still managed to achieve exclusively breast feeding/ebm at about 6 1/2 months.

I expressed until 6 months before having a short break (sanity break from the pump ) and then began again for feeds while I was at work.

I am not going to say it was easy, and yes there were times I wanted to give up, but in the end it was work every second, and every drop of EBM or BF she received was worth it.

If you want to PM me I am more than happy to chat on Messenger or something like that

Take care
xxoo

[Ellee05]

Sorry to hear that the road is not smooth for you, but wonderful that you're able to be prepared and are seeing a LC. DD spent 9days in NSCN, being my first bub and no warning that she was going to make an early entrance I wasn't educated or prepared. The others have given some great advice and ideas. As already mentioned, skin to skin contact is great if you can have it. Another thing my sister read was to put some EBM on a cotton bud/ball or something and put it near nose so bubs got used to the smell. We also took a dummy in and requested that bubs try to suck only when having NGT to associate sucking for a full tummy. We did have a lot of formula as my milk took about 4 days to come in. But during this time we would hand express and later express with pump inline with her feed times and gave it to her first at the next feed.

It was also suggested to me that when I express to have a photo of bubs to look at, not sure if it helped my supply or not. The NSCN had pumps there so could sit and watch bubs and pump at same time.

I'm by far an expert and you probably already know all of this, hope that everything goes as smooth as it possibly can.

Oh, I wonder if the lactaction cookies could help with your supply if you're going to express from 36wks? Just a thought.

[Ellee05]

Oh dear, I just realised I said "I'm by far an expert" so sorry, I ment I'm so far from being an expert as in I don't know much.