How to feed EBM to 3 week old?

[Laranna]

My CHN recommended I express after every feed to boost my supply and that I could feed DS the expressed milk as a top up if I wanted to. I assume she meant to feed it to him via a bottle but I am reluctant to do this as I am scared of nipple/bottle confusion. DS is 3 weeks 3 days old.

What is the best way to give my little man a top up of my EBM? Or should I not worry about it and put it in the freezer for a rainy day?

[The[cookie]Doctor]

Get a syringe from the chemist (a decent sized one) and get him to suck on your finger while you squirt it in!
Does that make sense? Means there's suction there so it doesn't dribble out but he can still take the milk.

If you do decide on bottles I found the Tomme Tippee wide ones to be excellent. They're shaped just like a breast and nipple and we didn't have any issues.
Good luck!

[KatieRabbit]

You can get a feeding tube from an LC but there isn't really a need for it. To boost your supply you need DS on the breast as often as you can- every 2 hours. If you do then express, you could just freeze it in 50 ml lots in a new plastic ziplock bag. Hopefully Barb will be in as I would have thought that expressing after every feed is not what you need. If you can express it, bubs can drink it. Perhaps there is something more to your situation? Why does the CHN think you need to boost your supply?

[Astrid]

Barb is having a few Internet issues at the moment, so she may or may not be on.

Depending on what is going on, then expressing and feeding the EBM to bubs may be needed (it is needed in my case). Barb will need to know all the details in order to advise the best method of increasing supply, if it is needed at all. It is probably better to call in a LC now, rather than later.

As for bottle feeding EBM it worked fine with both my DD's and have not had any issues with nipple confusion. DD1 preferred the Avent teats and DD2 prefers the cheap Happy Baby ones. The main problem I find with bottles is that it is easy to become to rely on them and begin to doubt your own body, especially when bubs is screaming and fussing at the breast. So just keep that in mind if you go down the bottle path. You can cup feed, I found that very hard to do though. Best to have someone teach you how to do it.

Just a correction on storing EBM, apparently normal zip lock bags are not advisable, something about they are not for storing liquids and chemicals can leach into the milk

[KatieRabbit]

I didn't know that Astrid! And an LC at the Breastfeeding Centre advised me!! I have them like that in the freezer!!!

[Laranna]

Thanks for the replies...the CHN recommended I express after each feed to boost my supply because DS hasn't regained his birth weight yet. So she thinks he hasn't been getting enough from me. I had only been feeding on one side each feed so she has suggested to feed both sides and then express a few minutes afterwards.

Joshua was 3 weeks early and his weight gain has been:
Birthweight 3195grams and lost 10.9% at day 3
Day 6 back up to 2950grams
Day 10 3000grams
Today day 24 back up to 3150grams

He is almost there but he has only put on 150grams in the last 2 weeks when he should have put that on in one week.

I think my attachment is pretty good, my nipples come out the same shape afterwards and they are not sore or grazed.

I am just now paranoid that DS is not getting enough to eat!

[Astrid]

Laranna - how often is he feeding and also how is the nappy situation? Are there enough wet and dirty nappies?

[AndiE]

Hi Laranna,

I know each baby is different but in the first three weeks of my DS's life I introduced him to my boobs, an Avent bottle and teat, a Pigeon peristaltic bottle and teat, a dummy AND a nipple shield. We had early issues with BFing and him gaining weight, so I had to give him EBM. You'd think it would be total confusion for him, but luckily for us, DS was (and still is) an adaptable bub and after three weeks of taking EBM via a bottle and me persisting with BFing, he became a fully fledged booby baby and is gaining loads of weight. It appears there was no nipple confusion at all with him. He's still happy to take a bottle and he still sucks on his "dum dum" .

If you go down the path of bottles ... we found the Pigeon bottles and teats to be the best for us - DS seems to suck in less air. Our CHN gave them the thumbs up too.

I was keen to introduce DS to a bottle early on so that DS could learn he could feed from a bottle and not just my boobs. It meant that he didn't see me as the only food source, and dad could feed him as well. After our early EBM efforts, DH gives DS one bottle feed per evening while I express and freeze my BM. Mind you, I've used zip lock bags to store the EBM in too, cos that's what the midwife told us to use in our ante-natal classes!

Good luck with things.
Andie

[Laranna]

Astrid - he is feeding every 2-3 hours. I change his nappy before a feed and they are always wet and pooey, although his poos are starting to taper off by 1 or 2.

Thanks Andie - it is comforting to know that it can all still work, I am perservering.

I offered Josh some EBM after his 11:30pm feed and he didn't want it so I can only assume he got enough in the feed. The only thing now is Iin my sleepiness I forgot to put it back in the fridge and it's been 4 hours so I don't think I can use it now.

[Barb Glare]

Hi,

Congrats on your new baby. Weight issues can be so stressful, can't they? The good news is that your little one is "nearly there" - you are onto it quickly and it won't be long til you are going really well.
Tell, me, did the health nurse watch you feed? It can be really helpful to have some-one watch him feed. How long is he on each breast for? Just shortening his feeds down to 20mins on each breast (which usually allows you to sneak in a couple of extra feeds) can make all the difference.
Was your little guy jaundiced? How did the birth go?
Try to get that milk into your baby. Sometimes you have to persist a bit with the bottle - try a few things to get it into him. Re giving bottles - many babies (maybe even most) will go happily from breast to bottle. However, it is quite a different sucking action needed to feed from each. Some babies do get confuesed by this, and will start to refuse to feed from the breast. Unfortunately, they don't have this information stamped on their forehead, so we don't know who of them will find this particularly challenging, and who will be "fine". Many mothers find the syringe or a small medicine cup quite easy to feed their baby a little top up with. More importantly, parents can get a bit hung up with comps/bottles and believe they "need" to see how many extra mls go in. So comps are best used only when really necessary.
YOu seem to be on the right track - let us know how you go

Barb

[Laranna]

Thanks for replying Barb...the health nurse didn't watch me feed, but I did have the midwives and hospital lactation consultant watch me feed while I was in hospital and all were happy with the latch (and many commented that he would be a great feeder!).

Before I saw the health nurse yesterday, he was on the breast for around 30-40 minutes and I was only doing one side. Since then, I have been doing both sides and he is feeding for around 15 minutes each side and sometimes if he gets a bit sleepy I switch him back to the first side again. I am also now expressing after each feed at the advice of the health nurse and am getting roughly 15mls or so.

Nope DS wasn't jaundiced. I feel the birth went really well. I was initially a planned c-section due to placenta praevia but I went into labour naturally at 36+6 with my waters breaking and contractions starting straight away, so had an "emergency c-section".

My milk came in on day 4 but on day 3 as DS had lost more than 10% of his weight, had low blood sugar levels and low temps a midwife decided he needed a top up and he was fed via a tube 3 times. I would still breastfeed him and then he would get the top up. Also the midwives helped me expressed some colostrum to top up with that too.

Since changing to feeding from both sides and expressing, he settled much more easily last night and went longer between feeds - I fed at 11:30pm, 3am, 7:15 and then 11:30 and then he was back to 2 hourly today.

How do I know if I need to give him the EBM as a top up feed? The last 24 hours he seems to be satisfied and is settling quite well...

[Barb Glare]

Hi,

You seem to be doing well. Perhaps one thing at a time. See how the more frequent feeding, both sides goes. Then maybe you can use that expressed milk next week if it hasn't all come together.
Regards Barb

[Laranna]

Thanks Barb...I will keep doing what I'm doing and fingers crossed he is putting on weight.

Also thanks to all the other replies...it is very much needed encouragement when you are starting to doubt yourself! Thanks girls

[Ezz]

I offered Josh some EBM after his 11:30pm feed and he didn't want it so I can only assume he got enough in the feed. The only thing now is Iin my sleepiness I forgot to put it back in the fridge and it's been 4 hours so I don't think I can use it now.

Just as a side issue, I'm pretty sure you can't store the rest of a bottle once DS has sucked on it, due to the germs in his saliva. (it can be really frustrating sometimes! so it's a good idea just to heat up a small amount at a time - you can always do more if you need to )

[MantaRay]

You're mostly right Ezz. Once a feed of EBM has been started, you need to discard that EBM at the end of the feed. I believe the reason is that the saliva breaks down the proteins in the milk (as it's supposed to do when the EBM is drunk!) Freshly expressed BM can last 4 hours out of the fridge, but it's better to refrigerate it where possible.