Breastfeeding after baby has been in the NICU and had formula-- any experience/advice?

Pregnancy
1

Hi girls:

I am still pregnant (29 weeks today) but I'm trying to plan ahead.  My OB told me this week to accept that our daughter will most likely be in the NICU with low blood sugar after birth.  Because low blood sugar in infants is so dangerous, she advised that the baby will likely receive glucose in the NICU in the form of formula until her pancreas stabilizes and her blood sugar returns to normal. 

Did anyone else have this experience, and if so, how did it affect your ability to breastfeed (if at all)?   I plan to breastfeed and have heard that when infants receive formula before breastmilk, they tend not to take to the breastmilk. 

Thanks so much!  :)

2

Not always true. I had complications all through out my pregnancy. I had to wear a pessary from about 28 weeks because my uterus was too low and my cervix was thinned, I was borderline for too much amniotic fluid, and at 35 weeks I began to get hypertension and showing sign pf pre-e. I stayed in the hospital and on bed rest till 37 weeks when I was induced. My baby girl was born with a fairly low blood sugar (I think it was in the 40's I honestly don't remember now but I do have it wrote down with her hospital records). She never went to the NICU, after a bottle feeding her sugars went back up and never lowered again. My milk actually did not come in for about 6 days. I latched her continually everyday and pumped till my milk came. Finally it came and my sugars were so out of whack that I only breast fed for about 2 weeks.

If you really want to breast feed but she needs a bottle, just make sure you continually latch her (even if you don't have milk).

3

I can't believe this website actually puts stars when you write the word b r e a s t LOL It's not a dirty word when you are talking about feeding a baby!

4

Don't stress.  This will sound crazy, but I think breastfeeding advocates are like the mafia these days.  They tell scary stories and make vague threats to get you to come around to their way of thinking.  

It took almost a week for my milk to come in because my son was induced 2 weeks early and I had a cesarean (both delay milk production).  The hospital didn't want to feed him formula because they didn't want to interfere with his ability to breastfeed.  I threw a fit after 3 days because he was hungry and they were withholding food.  He was actually dehydrated!  So they started giving him formula from a little shot glass.  Even after my milk came in and we were back home, my husband still used the little shot glass for the 10pm feeding so I could get some sleep.  After a couple weeks we started a bottle and my son had no problem switching between bottle and breast.  I wish we had just skipped the glass and used a bottle; I'm convinced my son would have done fine.  If your baby isn't strong or isn't a big eater, I think the "no bottle" rule may be helpful.  But most babies have zero problem eating from breast, bottle or both.  

Does your doctor have a reason for thinking your baby will have low blood sugar and be in NICU?  If it's just because you're diabetic, that's silly.  There's no reason your daughter won't have a normal blood sugar when she's born as long as your diabetes is reasonably well controlled.  

Congratulations on being a mom.  If you haven't read Cheryl Alkon's book about managing pregnancy with pre-existing diabetes, I really recommend it.

5

My daughter was in the NICU for 8 days after delivery (I was induced at 35 1/2 weeks because of low amniotic fluid and her lungs needed more time to develop). We are now able to happily breastfeed almost anywhere... restaurants, the mall, at home, at friends homes, etc. We even went to a "Mommy Movie" today and I fed her while watching The Artist.

In the NICU my daughter started with an IV with nutrients, then went to formula, the pumped breast milk from a bottle. Then she nursed and I would supplement with pumped milk (I used a nipple shield for a while to help with latching), and then finally one day she got all she needed from me and now I just pump in case someone else (like my hubby) wants to give her a bottle, plus I'm starting to freeze some milk before going back to work.

If you do have to go through this (which you may not, many women here post about healthy full term babies) keep in mind that it can be very hard to start breastfeeding. This is also true for non-diabetic women. Something that seems so "natural" doesn't come always naturally to baby or mom. I have been going to a weekly breast feeding support group led by a lactation consultant at the hospital where I delivered. It has been an amazing motivator during the tough times, and I've met some other great moms to hang out with while I'm on mat leave. The lactation consultant informed us that breast milk is actually sweeter than formula, so babies prefer it. Some babies could get nipple confusion I guess, going from bottle to breast, but that didn't happen to me and my at all!

So, if you want to breast feed, stick with it and most likely you will end up making enough for your baby and your baby will learn to latch on! And it is great!

Good luck!

T1 since 2000. On multiple daily injections and use Dexcom CGM.

6

Both of my daughters had low blood sugar an hour or so after birth (induced at 38 weeks for both due to different issues).    They were never taken to the NICU - and honestly, other than being away from me for 15 minutes to do the infusion of glucose into their stomachs, they were never away from me.    They checked their BG every hour or so for the first six hours.  Then a few more times (12 hour, maybe?).  They were all good after that one glucose infusion.  

7

First of all, if you have a good A1C prior to the birth, there likely will be no problem with low blood-sugar. My baby's BG never dipped low enough to require glucose. My A1C, tested a month before birth, was 6.2.

However, my baby girl apparently had an infection and was kept in the NICU 7 days for antibiotics. During that time, I was allowed to stay in a room in the hospital for nursing moms, so I basically lived there and breast-fed her, but unfortunately, could not be there for every feeding, so they did give her bottles also. This made breast-feeding very difficult and frustrating for both her and I. It took about an hour (instead of half an hour like it should have been) for each feeding.

(Also, for some reason, they thought she should be supplemented with bottles even when I was there, before my milk came in. They wanted her to drink 2 oz. at each feeding, which for a day-old baby is just way too much. Babies naturally are not too hungry for the first 2-4 days, and mommas naturally make just the right amount of colostrum for them. Then the milk comes in right around the time that babies are needing more food. So if the baby's BG is fine, don't let the hospital trick you into supplementing because "the baby's not getting enough"!)

She latched on just fine, no problem, before the bottles, then like night and day, had trouble after her first bottle. But with a little determination and refusal to give up, I kept feeding her as often as I could, frustrating as it was, and it got better, especially once we finally left the hospital (Hallelujah!). Now breast-feeding is all she wants and it's hard to get her to take a bottle!

So, my encouragement to you is: don't give the baby bottles if you can help it, but if he/she is given bottles, stick with breastfeeding anyway, and if you have to, read books, talk to consultants, read web articles (many good ones at lalecheleague.com I believe it is). You can do it!  

8

All of the ladies posted great advice.  Your baby shouldn't have to go to the NICU.  I did a lot of research and found that if your blood sugars are stable three or so days before you deliver (eaiser if you have a c section to plan) the better your babies blood sugar will be.  NOt sure if that is 100% accurate.  My daughter was three weeks early.  I had a c section, my milk came in 3 days.  until then the lactation consultant came and the nurses helped me express colostrum on a spoon to give her because she had trouble latching.  They say that babies "learn to latch and suck properly" the last two weeks in utero so babies that are born a little early struggle.  This was her issue.  She had problems latching, she would just gum my nipple.  My rule to all the nurses was that if she ever had a low blood sugar, first let me try to feed her my own milk (I pumped and finger fed her and used a shield until I was discharged from the hospital) then if they couldn't bring it up by my milk to use donor milk.  They were great.  Most hospitals advocate breastfeeding and have donor milk on hand.  It actually all depends on your babies temperment.  Mine is very picky and very high needs.  I went to lactation support every week.  I was determined to not use formula, it was my last resort.  She is now 6 months old and exclusivly breastfeeding. I pump during the day so my mom can bottle feed her in the afternoon.  She is a really picky bottle baby too.  We have like spent 80dollars on trying bottles hahaha.  Good luck, just be persisent.  It's hard work but worth it.,

9

My hospital considers anything under a 45 a low blood sugar in a newborn, yet that is no reason to rush off to the NICU... it's time to breast feed. Even if all you have is colostrum, it's better than glucose to raise their sugar... the protein stays wilth them longer and sugar water kind of shoots them up super fast only to bottom out again later (la leche league can back me up on this).

My son ended up in the NICU due to a lung infection and since he had to have oxygen, he was unable to nurse and was given formula via a feeding tube until my milk came in, then he got all Mama milk via the feeding tube until he got off the oxygen. It took a little effort to get him used to latching on again, but we're some crazy breastfeeding fools these days (he's 3 weeks old today) so don't let anyone scare you. It could take a bit of effort to get a child used to the b r e a s t again after having pacifiers or bottles in the NICU (which hopefully isn't an issue for you) but you and your child  will be able to figure it out, it will just take some patience.

Your doctor needs his or her soul slapped...  ANY baby can have a low blood sugar after birth and as long as they monitor your baby's sugar and allow you to stay stress free enough to nurse him often, he or she shouldn't get too low. My little guy was 47 the first time they checked and they just helped me get him latched, 6 hours later, he went down to 43 but couldn't get latched on and I noticed his rapid breathing (lung infection) and we had to give him formula to bring him back up. He would NOT have had to go to the NICU if his only problem had been low blood sugars, but our problem was a bit deeper.

10

Thank you so much, everyone!  I really appreciate you sharing your experiences and advice.