18 answers

My Preemie Won't Eat!!

Help!!! My son was born at 36 wks 2 days and weighed 5 lbs 10 oz.. After only 36 hrs on oxygen he no longer needed any extra help and is doing very well. He had a long bought with jaundice and was on phototherapy for a week after we got home from the hospital. Once his bilirubin levels started to drop off (they peaked at 6 days) he was slowly nursing better and becoming more active and social. Granted he was still sleeping a lot but there was a noticeable improvement. He was even gaining weight very well. Until recently that is. All of a sudden he wont latch to nurse, he's a LOT sleepier never waking up and crying to eat so I set my alarm then spend the majority of our nursing session trying to wake him up. I've even resorted to pumping and bottle-feeding him breast milk but he won't take it! He spent the night in the hospital for testing and observation in which he started nursing a tiny bit better but it's still an absolute struggle. All the tests came back normal so the doctor doesn't know why he's not eating well all of a sudden. Please, any of you out there who nursed a preemie help me to know what to expect. The nurses in the hospital said he's be sleepier than a regular newborn for a couple weeks but he's now 16 days old and seems to be regressing!

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My son was also a preemie who was too sleepy to eat. We tried everything to wake him up enough to eat - dressing him down to only a diaper, tickling his feet, wiping his head and face with a cold wet cloth. I also used a nipple shield which seemed to help.

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Been there done that - my daughter was born at 35 weeks - we had to force feed her every 2 hours - she was sleepy - she had a jaundice bed, a nurse came daily to our house for 2 weeks. She didn't maintain her temperature. It as all very stressful.

Until much later meeting other newborns - I didn't realized how much more she slept - how not alert she was. Basically keep in mind - anytime til her due date - they will not act like a proper newborn.

We did weeks of force feeding - finally when she was 8 months old she caught up - and grew like a weed - now she is 3 and super tall and heavy.

So do everything you can for him. Keep up the good work - it's hard but really just remember he shouldn't even be born yet.

We followed advice similar to Katie's and it worked. Woke him every 3 hours, breastfed with nipple shield and topped off with the bottle. I pumped every 3 hours, too, to maintain my supply since my 35 weeker ate so little. We were in the NICU for 3 weeks so we had guidance through this process. Call La Leche for additional advice and support. We eventually dropped the shield and the bottle and my now two year old looks like a three year old and is still breastfeeding. Best of luck.

It sounds like he is just exhausted! Waking too often will make his sleep less restful, so if you are waking him at night to feed him, you may consider letting him sleep until he wakes on his own. If he needs to be woken up to eat, then make noise around him and gently let him wake on his own over about 10 minutes or so. If he wakes on his own instead of being awoken from a deep sleep, he will be able to stay awake longer. During the day, feed him hourly if you can. Strip him down to his diaper and talk to him while you nurse, stroke his face and run your hand down his body. The contact and stimulation will help keep him awake.

You will probably just have to bear with him for a few days. When babies go through growth spurts, they have to sleep more, and the last weeks of pregnancy are one huge growth spurt. He has a lot to make up for right now and is not developmentally ready to stay awake for very long.

Something we did was ask the doctor for a big syringe hooked to a tube. We filled the syringe with pumped breast milk and while he was latched on, I slipped the tiny tube into the corner of his mouth. When he stopped sucking, I gently pushed the syringe to squirt milk slowly into his mouth. Their reflex to keep from choking is to swallow it, and swallowing and sucking are the same action, so it keeps him nursing.

I don't want to freak you out but preemies can have issues with brain bleeds and intestinal issues. If he hasn't had a head scan of his brain I would ask your doc to obtain one just to be sure, given his sedation. Additionally you don't mention whether or not he is having normal amounts of poop and pee and this would be very important to know. If his stools are black, tarry or current (redish) colored you need to let the doc know ASAP. It is probably nothing, but if your mom instincts are telling you otherwise, then be the squeaky wheel!

My experience in this area is limited to mums with no healthcare/hospitals available to them.

What they do:

Wear their babies 24/7, skin to skin...no bra or shirt, with the baby's mouth right at their nipple. The babies don't have the strength to cry, and only enough strength to nurse for perhaps a minute or two at a time. Every baby I've seen, save one very very early baby whose lungs probably weren't developed enough, pulled through fine. The general rule of thumb is to keep this up until they've been alert & crying about a week, but once they became alert/cranky everyone always breathed a sigh of relief.

Even with medical care available, this might be a good option, but premies and NICU stuff isn't my specialty...this is just what I've seen premie mums do in war zones.

Best of luck to you!!!

My 36 week boys both went through hills and valleys with breast feeding. As long as there numbers were good the doctor told me not to worry. I did end up using a nipple shield with my first as he was much more tiny then his brother and I have very large breasts. It just worked better for him to latch on. He used it till he was 4 months old.

I of course worried about them both (still do :-), but the doctor pointed out the sleep is also essential for building and growing. So, I didn't walk him and he has always been a really good sleeper. Even now at 2 he will sleep 12 hours a night and take a 3-4 hour nap a day!

I hope it gets better soon!

Oh how I feel for you!!!! My daughter was born 7 weeks early and was in the hospital for 9 weeks because she didn't have the energy to eat. They didn't know why - ran all kinds of tests, MRI to check to make sure she didn't have any brain injuries from birth, occupational therapy tests to check for development and her ability to suck. We finally resorted to giving her a couple of doses of EPO to help her red blood cell production. She was slightly anemic, but not so much that she should be so tired. EPO is typically used for cancer patients that need help with red blood cell production. It's also a popular doping drug for cyclists, so you'll see lots of info on that if you do any research.
http://en.wikipedia.org/wiki/Erythropoietin
We were much more comfortable with this solution than with a blood transfusion (a common procedure for preemies).

Anyway, one day, she had the energy and it was all over. She can home and was a wakey, screamy baby from then on.

Now that I think about it, it was at about the same age as your boy's that she got so tired. Babies are born with an influx of red blood cells from their mother (that's why we are so anemic during pregnancy). There's a period of time where the baby uses up the extra cells before their kidneys tell the body to create the rbc. It could be that your child has used up the stuff you gave him, but hasn't started creating his own.

Keep up with the nursing!! You can use a supplemental nurser, which will make nursing easier for your sleepy baby, but will keep you away from bottles for now.
http://www.motheringfromtheheart.com/catalog/58supplement...

I hope this info helped and you are able to get some answers soon.

You should not have to figure this out on your own. Make sure you leave every doctor visit with a follow-up time and an absolutely-call-if... list. I would get an appointment right away with Doris Onnis, a lactation consultant for Providence at St. Vincent. She works there and has her own lactation consultant business. See contact info below:
http://www.babystepsconsulting.com/
and
Postpartum Care and Breastfeeding Center at Providence St. Vincent
9205 SW Barnes Road, Suite 730
(Medical Office Building)
Portland, Oregon 97225
Open from 8:30 a.m. to 5 p.m., seven days a week
###-###-####
I recommend her because she is just so good with new moms, and she has great experience with preemie babies.
She will definitely be able to teach you something you didn't know before. I had two separate friends tell me that they went to her and she was head and shoulders above other lactation consultants they saw. They called her a miracle worker, even and said she put them so at ease. I know that the Providence Breastfeeding Center is open 7-days-a-week and they will get you in the same day if you call.

What you shouldn't do is wait. This all could be nothing--maybe your baby has just stabilized and so she is sleeping longer and deeper stretches, but if it is something less healthy, you should definitely be on top of it and have as many "emergency" contacts as you can.

Good luck. I'm sure everything will be just fine.

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