Risk of NEC in 6-month premie?

[saintvron]

Hi everyone, my daughter is currently 9 days shy of 6 months actual. She was born at 35 and 0 weeks via planned C section bc of my placenta previa/potential accreta. She was 6lbs and 1 oz with APGARS of 8/8 but was taken to the NICU because of mild respiratory distress. She was discharged on day 9 after a pretty uneventful NICU stay where she learned to maintain her temperature and to take bottles.

My daughter is currently exclusively fed breast milk. I am interested in starting to transition her to formula because pumping at work is really tough and I feel like all I do is pump/breastfeed, but I’m TERRIFIED of NEC. I tried formula a few days ago and she projectile vomited nonstop, which landed her in the ER. Maybe it’s an allergy or maybe I introduced it too abruptly but now I’m even more terrified of giving her formula. I combo fed her brother, which was full term, with no issues and no concerns. But I’m pretty much scared of everything with this baby because of the NICU experience.

Has anyone dealt with this fear before? Does this seem like an irrational fear at this point considering she’s almost 6 months and was late preterm? Has anyone had the same fear/issue with feeding formula? I love her pediatrician and I know she would say I’m crazy for worrying about NEC at this point but wanted to see if anyone here that’s gone through the NICU experience has had similar concern. Any advice would be highly appreciated!

 

[straykat]

@saintvron The risk for a now 6 month old, ex-35 weeker would be very low, probably not appreciably different than the risk for a term baby.

Vomiting is probably either a tolerance issue (you could try hypoallergenic formula like Nutramigen or Alimentum if you prefer) or just a “nature of formula” issue - there’s a lot more air in a freshly made bottle of formula, due to shaking, than there is in breast milk. When this is the problem, batch-prepping formula or just letting the bottle sit for 10-15 minutes before feeding can help.

 

[saintvron]

@straykat Thank you! I’m going to try Alimentum when I’m ready to transition her. I’m a bit worried from doing soy, which the pediatrician recommended. I’ve read online that it’s not recommended for premature babies, although I’m not sure if the same concerns apply to a 35 weeker. She wasn’t that small at 6.1 lbs and 19.3 inches.

 

[mike84761]

@saintvron Pretty sure NEC is not a concern at this point. You may just need to do a slower transition and/or try a "gentle" formula to make this process easier. It's gonna be okay eventually! Hugs.

 

[landygirl]

@saintvron Don’t know he odds, but know it decreases the later they were born, and the older they are(actual). One of our twins(28+2) developed NEC. Now 11 mo actual, 8 adjusted. We feed her a mix of ebm(fortified to 24kcal with nutramigen) and 24kcal nutramigen. Has tolerated that with no issues

 

[saintvron]

@landygirl Did she develop NEC early on? My ped recommended a non-premie formula for my daughter.

 

[landygirl]

@saintvron Yes at about 3 weeks actual, was a bad case, but once she cleared that(including losing 1/2 her colon) she has had no issues with formula

 

[slashin8r]

@saintvron I don’t know the actual statistics but I’m pretty sure she would be okay. At our hospital they only provided donor milk to babies until they reached 35+6. After that they would be given formula if mom want providing (enough) breast milk. At six months I would imagine it would be significantly safer.

 

[jsw3883]

@saintvron We had a NEC spell and the dr said after 36-37 weeks the chances of NEC go way down. I would imagine at 6 months is not a problem but give your pediatrician a call, or someone at your old NICU.

 

[lorien]

@saintvron With our 27-weeker the neonatologists told us we were “pretty much out of the woods” for NEC when he hit like 34 weeks

 

[sparklepaws23]

@saintvron My 34 weeker born 5 lbs developed NEC at 36 weeks after being discharged from the NICU the first time. I’ve asked the “what are the chances of NEC returning” question more times than you could imagine…I was also scared to give her formula post NEC after I had mastitis and my supply tanked.

Here’s what I’ve been told - the older (and heavier) the baby is, the smaller the already small window gets. I understand your fears. If it makes you feel better, be vigilant about checking diaper for blood after bowel movements… but please also know that bloody stool is not always indicative of NEC. In fact, my daughter had had multiple bloody stoop since NEC and after many ER trips and x rays later to rule out NEC, we’ve determined she has a CMPA.

Hope this helps

 

[zango11]

@saintvron I tried my twin A on formula since I couldn’t keep up breastfeeding both. He experienced a major allergic reaction to it - Projectile vomiting, swelling, welts, difficulty breathing. The next day all of his previously drawn labs resulted and he is allergic to cows milk. This MAY be something that could have caused it. I suggest getting the cows milk allergy test before introducing any formula that contains it.

My twin B had a significant bowel situation (potentially NEC but all other symptoms of NEC were normal). While he was still in the NICU, I had them test him on hypoallergenic non dairy formula. He had to go through 3 different formulas before we found a perfect fit (Neocate). He currently gets breastmilk fortified with the Neocate but if I decide to stop pumping, he can have the formula.

On a side note, some of the formulas taste horrible. My son literally spit it out so my husband tasted it and was like no wonder he won’t take it

 

[kevintri99]

@saintvron Pretty much zero

 

[saintvron]

@kevintri99 Thank you! That’s good to hear.

 

[helper_pni]

@saintvron I would not be worried since she was 35+ weeks and is now 6 months old. I had similar anxiety with my 32 weeker twins and transitioning them to only formula. I am a very anxious person and looking back I wish I would have not been because they didn’t get sick and I spent a lot of time worrying for no reason.

 

[saintvron]

@helper_pni Thank you! I suffer from health anxiety, so very hard to not worry. The NICU experience has heightened my anxiety. When did you transition them?

 

[helper_pni]

@saintvron I transitioned them to completely formula around 5-6 months. My supply sucked. We LOVED Bobbie! It was so gentle on their bellies and I trust the ingredients. Expensive but worth it. I would just keep mixing both formula and BM until she can keep it down better. If she didn’t have issues with your BM and you eating dairy then she should eventually transition.

 

[jesusiscomingbacksoon]

@saintvron My 34 weeker daughter started vomiting once we switched to formula after 3 months actual. Later we found that she has cow’s milk protein allergy. She is doing a lot better on Similac Alimentum now. No more projectile vomit, less gas. She’s eating more than before. Please check if she has CMPA.

 

[saintvron]

@jesusiscomingbacksoon Thank you! I am considering giving her a mix of Alimentum and breast milk to transition her. Was the vomiting severe? Hers was quite severe. She was super pale and lethargic. Did your baby have any other symptoms? She has a very smelly poop sometimes — smells like rotten vinegar.

 

[jesusiscomingbacksoon]

@saintvron If she has CMPA you have to stop taking dairy as well as she is getting breastmilk