Pauline,
How about using a nipple shield to transition him to breast? She can place it over the SNS. Also, if he doesn't have the stamina to breastfeed efficiently, the shield may help him to increase the flow from his mother. I work in a NICU as an LC and we have used shields for this purpose before. She should also use breast compression while she is nursing to increase flow and promote complete emptying. This may also hep increase her milk supply.
As far as her freezer stash is concerned, she should use some frozen breast milk each day, maybe a feed or two a day until it runs out to get some protection from her milk for a longer period of time.
She may want to consider Reglan or Domperidone(depending on its availability) to increase her supply.
Good luck!
Maureen Allen RN, BSN, IBCLC
Boston, MA
-----Original Message-----
From: Pauline M. Gabriel <[log in to unmask]>
To: [log in to unmask]
Sent: Sun, 18 Dec 2005 20:35:32 -0600
Subject: Freezer stash
First off, I'm not a professional, just a mommy with a passion, and
wanting to help another mom out - so pardon me if this is a 'duh'
question. *laugh*
I have a mother who has a 4month old (born 3 months premature) who
just came home from the NICU - all the time, she has been pumping for
him, and using every trick in the book she can think of (btw, her
hospital is in the US, but it is one that is 'baby friendly' and she
has been working extensively with the LC's there, etc) to keep her
supply up. In efforts to get her son home, she made the mistake of
getting him on a bottle for some feeds, and breast for some - and he
has developed a preference to the bottle (#1 Avent nipple), and
can't/won't take a full feed from mom. To complicate matters, he has
a touch of BPD or chronic lung and so his stamina for getting a full
feed from mom (who is a 'tough to milk breast').
Mom has been putting him to the breast twice a day in NICU before
coming home, and since being home (as far as I understand), but has
started to push away, or latches on and 'hangs out'....waiting for
the bottle.
Her husband goes back to work in 4 weeks (baby will be 5 months old
by then - 2 months adjusted), and she doesn't feel she can keep up
with the pumping AND feeding of baby, especially when he's eating as
much, if not more than she's making. She has 'maybe a month of
supply frozen' and she's considering stopping the pumping when her
husband goes back to work.
She wants to keep up breastfeeding, but doesn't feel she can, and has
pretty much resigned herself to formula pretty soon. (it's not for a
lack of trying tho.....she's been thru a lot).
Her big question, is how to use her freezer stash to be the most
beneficial. Should she be exclusively using EBM until she runs out,
then go to formula? Should she be giving one bottle of EBM a day,
and drawing out the stash for months? Which is better for baby?
(this is a very new question for me, so I didn't know how to answer
her).
And if anyone can think of any suggestions for her - she's tried dom,
and several other drugs/herbs, water, oatmeal, pumping every 2 hours,
using an SNS (which she's doing now), etc. She really would like to
keep it up, but just doesn't feel she can handle pumping and bottle-
feeding (along with things like eating, sleeping, etc).
I'm hoping someone out there has some answers to her freezer stash
question, and maybe even a suggestion that we haven't thought of for
her to continue.
TIA!
--
Pauline M. Gabriel [log in to unmask]
Breastfeeding supporter for all stages of a woman's life. :)
http://groups.yahoo.com/group/first-time-nursing/
http://groups.yahoo.com/group/extended_nursing/
http://groups.yahoo.com/group/ttcbreastfeeding/
http://groups.yahoo.com/group/pregnant_nursing/
http://groups.yahoo.com/group/tnl/
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