My Preemie Won't Eat!!

Updated on July 02, 2013
A.B. asks from Ferndale, WA
18 answers

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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answers from Eugene on

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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answers from Portland on

My son was born just about a week earlier than yours. He wouldn't latch on at all until he hit what his original due date was and then suddenly something clicked and he started latching on. For the first month I pumped and supplemented with some formula to get his weight up. He did always eat pretty well from the bottles, but just didn't seem able to nurse until he was about 4.5 weeks old. Hope things work out for you.



answers from Seattle on

My son was born preterm (born at 36 wks but weighed 10 lbs. 5 oz.) and struggled with eating too. He was in the NICU for 10 days before we learned to eat and we could bring him home. However, someone told me that bay boys don't mature as early as girls and don't learn the suckinng technique until about 38 wks. So, hopefully your little guy will start to pick it up and start eating better.

We used a tried a nipple shield because I had flat nipples but it wouln't stay put and would move and my son wouldn't get anything. When we went it for his 6 mo. check up he hadn't gained any weight since 3 mo. and so we switched to formula. I tried pumping but didn't have enough supply because he hadn't been getting much of anything when he was nursing. Also, I pumped and bottle fed the first few months but then tried switching to nursing because we couldn't afford to rent the hospital grade breast pump with all the medical bills for the both of us.

Whatever you do, just do what you need to to nourish your son and don't feel guilty about it. I have friends that nurse their kids until they are 2 and others that don't nurse at all, so whatever you decide don't let anyone make you feel guilty about it because your son is more important than their opinions.

My son is now 4 and is quite healthy, he does have a learning/speech delay and we don't know if that is from him not gaining any weight so early in life or what it is from. But everyone that meets him loves him because he is sweet, funny, and smart - in a mischevious way.

I hope everything works out and that you and he quickly find a groove that works for the both of you.



answers from Portland on

Sometimes, unfortunately, doctors and hospitals are not experts on breastfeeding, which, by the way, is exactly what you need to be doing for your baby. You need to get in touch with the local Le Leche League or a lactation consultant. I know they have them at our pediatrician's office. But if there are none at yours, they can probably refer you to one.



answers from Portland on

I have 8 children, my first was 11 weeks early and all but one of the others were born between 2 and 5 weeks before their due dates. I have had a few sleepy nursers.

I see that you took your little guy back in for observation, so I'm assuming that he's not experiencing any apnea or bradychardia while he's nursing. Some preemies really need a lot of sleep to keep going. If you think about it, he's not even due yet. He's not really ready for full-volume sounds, visual stimulation or any of the things his little nervous system is being rushed into dealing with. If he were still in utero, he would be sleeping a lot and the stress of life on the outside is going to set him back a little from where he would be if he hadn"t been born yet. Balancing physical age with gestational age is confusing and every baby is different.

With all that said, try to nurse him as often as he opens his mouth! There are lots of little tricks you can use to keep him awake as much as possible. You can tickle his chin when he seems to be slowing down, give him a little jiggle, change his position, switch sides, play with his feet, change his diaper. For a while, you'll feel like all you do is nurse the baby! I had to use a commercial breast pump for my first baby and I honestly felt like a dairy cow! The more you nurse, the better your milk supply will be. Also, changing from breast to breast frequently during a nursing session will help keep your milk supply going. The bottle may seem easier, but nursing directly from the breast is more effective than pumping and he really will get more per feeding that way.

It's okay if he sleeps at the breast, too. You can wear a babysling and just let him nurse when he's awake, even if it's only for 2 or 3 minutes at a time. My #7, Elena, was like that. She is now 3 and a half and going strong!

I hope some of that helps. I'll be praying for you!



answers from Seattle on

My daughter was born at 33 weeks and was 2.6 pounds. She spent 6 weeks in the hospital - but was only a feeder and a grower. On oxygen for less then 12 hours, in the incubator for 5 weeks, Bili lights and all for about a week.

She would NOT latch until about 2 months of age. I would try each and every meal and she just couldn't do it, until she could. I was told to try for a short time period and then give her a bottle, as she was so tiny they didn't want all her energy to go to breast feeding.

I don't know what else to tell you except keep going and get him back to the hospital if it continues.

Did you go to Children's in Seattle?




answers from Seattle on

i am going threw the same thing. my baby was born on the 12th of june and she is still in the hospital she was born at 36 wks and 2 days the doctors have run a lot of tests aswell they all come back normal they can not figure out y she can not eat either im sorry to hear that u are goin threw the same thing as me so glad i am not alone in this we should not have to go threw this



answers from Seattle on

My son was (is) preemie, as well. He was born at 34 weeks 4 days and spent a week in the NICU because he couldn't latch on, either. Even after he "got it" at the hospital and came home, we struggled with it for a good month or so. He's now 2 1/2 months old and is much stronger so it's better, but I have to use a nipple shield with him. It's the only way he'd latch on. I'm JUST starting to try to ween him, but he doesn't always take the breast without it, and if he's tired he won't at all. Try that. The lactation consultant who gave it to me some said a lot of times preemies who can suck won't because the nipple isn't far enough back in their mouths and they're not strong enough to suck it back. And remember, he's not a regular newmborn. My son slept almost around the clock for the first month. As he gets stronger, he'll come around. And a good way to keep him awake during feedings is to keep switching sides every few mintues. It's a pain, but it works.



answers from Portland on

My son was in the NICU for 1 month. He had feeding issues when he came out. My husband was a big help. He would wake my son for feedings, change him and then hand him to me to nurse. My husband would open our son's diaper (the velcro diaper opening would wake my son) and he would kiss his tummy and use his beard to tickle our son awake to feed. It is very frustrating, but don't lose hope, it will happen for you. Just make certain you pump out both breasts or you will either risk reducing your flow or getting mastitis like me.



answers from Seattle on

Hi A.,

You and your family will get through this.

My daughter was born at 35 weeks. She had a lot of trouble with her latch and sleepiness at the beginning, and we had some unusual advice from the lactation consultant. I'm not sure if this advice will help much, since your little man isn't latching on a bottle well, but I've never heard anyone else suggest this before, so here goes:

1. Wake baby up to eat every 3 hours (start to start). Around the clock.
2. Warm some pumped milk in a bottle while stimulating baby to wake up (changing diaper, undressing, etc. as others mentioned). As a newborn premie, we used 2oz. You may need a bit more since he's a little older.
3. Start baby with a "teaser" bottle. When he starts sucking successfully for a bit (about 10 times), switch to breast.
4. If baby doesn't latch well at the breast, go back to the bottle. After success with bottle, switch back to breast.
5. After 10 minutes, stop using the breast. Top baby off with remainder of bottle.
6. Let baby go back to sleep and pump to stimulate milk supply and fill the bottle for next time.
7. Try to sleep until you start again.

**I was also advised only to let baby nurse from one side at a time so we were sure to get to the hind milk (the extra filling part).

This was extremely exhausting, and I didn't have an older child running around while I was doing it. It took about 2 weeks until I felt she was doing well enough that I started to gradually back off of using the teaser bottle and waking my daughter for night feedings.

We were advised to use a regular flow nipple on the bottle because it was more similar to the breast. However, I believe that there are premie flow nipples that make sucking much easier. Perhaps that may help your little man get started.

Best wishes.



answers from Portland on

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:
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.



answers from Seattle on

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.
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.

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



answers from Portland on

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!



answers from Seattle on

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 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!!!



answers from Corvallis on

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!



answers from Portland on

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.



answers from Corvallis on

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.



answers from Seattle on

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.

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