Baby won't accept breast nor formula - help!

@jayh87 Ive been told I have very flat and small nipples by the nurses & lactation consultant so I can really relate! So it's extra hard for my preemie to breastfeed because he's a tired little guy and my nipples are much more difficult to drink from. I use a nipple shield (16mm size) and he can at least latch on to it. But for weighed feeds he consistently only got 20ml from breast and needed to have bottle to finish the meal. Now we're home and as far as I can tell, he still isn't getting much from me so we primarily bottle feed with milk I'm pumping. I'm hoping he'll get better on the breast as he gets older. Still just 38 weeks (born at 34).
 
@jayh87 Eating is A LOT of work and it can be exhausting and frustrating for all involved. Does your hospital have donor milk? That could help! Like others said I would consider EPing in this instance. Power pumping and that middle of the night pump help alot of folks increase supply. People often say with feeding that one day it just clicks, I'm hoping it clicks really soon for you and baby!
 
@jayh87 Pumping is a good idea, I would recommend doing that to give baby your breast milk. Meanwhile you can still practice putting him to the breast, try to make it the most relaxing sessions. As in, before baby is crying (as this is a late hunger cue) and often baby will be frustrated and unlatch frequently when not receiving a good amount of milk fast enough. Once he is comfortably at the breast I would see how long he goes, burp him, and then top him off with some of your expressed breast milk. Or if he is really not having it, skin to skin is amazing and will help soothe him. You can bottle feed him your breastmilk, place him down, pump, and then once done, unwrap him and place him skin to skin. This will help him build a positive feeding experience and the skin to skin will help with your supply. Baby is still young, at 35 weeks he is still developing his reflex and it will most likely take time for full feeds at the breast. I would also recommend following up with an out patient lactation consultant to establish breastfeeding once discharged. This will help have someone focus on you and your baby and establish a plan to get you started, and perform accurate pre and post feeds to show you exactly how much milk he is getting, some scales in the NICU are not precise enough to calculate that. This is all of course if that is what you would like to do. It can be difficult and a lot of work, and completely depends on how you feel both physically and emotionally. My baby left the NICU after 32 days, I combo breastfed and provided with expresses breast milk as well until about 4 months old, now we are 90% breastfeeding, and an occasional bottle when someone else would like to feed her. I will say all that time really helped me build up my freezer stash. Wish you the best!
 
@jayh87 This might be a long shot because idk how common it is, but my NICU baby wouldn’t take a bottle or boob either. The speech pathologist was brought in (they work with swallowing too) and she did a swallow study. It turns out he has dysphasia and aspirates when he has thin liquids (when he drinks it “goes down the wrong pipe”). The solution for us is thickening his liquids. When he was discharged we were set up with an otolaryngologist (a fancy ENT) and long story short, our son has a laryngeal cleft (a hole in between his trachea and esophagus). It might self correct and it might not (if not we have options when he gets older).

The thing that comforted me the most during his nicu stay was remembering that some day he’d be home and that time would all be just a memory. I hope it comforts you too.
 
@alexus711 Did they diagnose him with dysphasia from that swallow study? Or did they do further testing? My son also aspirates when he eats, but haven’t told us why. He’s going for his second swallow study this Thursday.
 
@wesmurray He was diagnosed with dysphasia from the first swallow study, but they couldn’t diagnose the cause (laryngeal cleft) until they put him under anesthesia. Luckily (idk how lucky it really was)… he needed ear tubes so the ENT was able to look at his throat during that procedure. Apparently there are other possible causes for dysphasia and aspiration, but this is what is the cause for my dude. Feel free to DM me with questions or to vent about all this stuff, my guy is 21.5 months, so we’ve been dealing with it for a while. The ENT is hoping it self corrects, apparently it usually does, but I’m not optimistic anymore.
 
@jayh87 I exclusively pump. I was very sick after my son was born and ended up in the ICU. I wasn’t able to pump for a while, but now I’ve been able to build a decent supply. Pump every 2-3 hours. See if you can rent a hospital grade pump like the Medela Symphony and power pump. Make sure your flange size is correct and stay hydrated. The exclusively pumping subreddit is great, and there’s also tons of very helpful Facebook groups if you have one. In the nicu I would hold my son on my chest and pump at the same time. Hearing his cries and feeling him helped! My son was born at 31 + 2. Feeding was the most frustrating part of our nicu journey.
 
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