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Success! You CAN Do it Right with a Preemie!

Short Little Success Story

Recently had to attend a birth for a 34 weeker who had been threatening labor since 32 weeks. She had been given a regimen of steroids and antibiotics per our protocols. The parents had a beautiful birth plan. They wanted Skin to Skin at birth, baby nursing before any separation and were adamantly against formula if at all possible. Both were frightened of the preterm birth, worried for their child’s safe transition and concerned that none of their wishes would be carried out.
I had the opportunity to discuss some of these with the Neonatologist and the parents before the birth. The doc was all for doing as much as they’d wished for at birth (that we could) provided the baby did not require respiratory support…

The baby was delivered hollering at us, alert and pinked up nicely! After observing and examining him for a short period, the doc gave the go ahead for Skin to Skin as long as I could stay and observe. Happy to oblige, I had that 4 LB naked baby up on mom in no time surrounded by her warmth and love.
I did the babies first glucose check (while STS) which was at a great level. Mom proceeded to start latch attempts. The baby did nuzzle and lick the copious colostrum she offered but wasn’t able to accomplish a latch. Vitals were stable, they were snuggling… but by an hour– the Neo was getting antsy. I had to take him in to the NICU with Dad in tow. No resp symptoms. Pink stable and alert. Placed up on the warmer table and connected to all the monitors for observation, he had his second glucose check. We expect it to drop at this time which is the normal nadir. It was however 38 which meant we had to feed. I asked for 5 min. This mom had a copious colostrum flow. The baby was not symptomatic. I had another RN watch him while I scooted back to L&D with a pump and small collecting cups. I figured we may have to hand express because many moms don’t respond to a pump quickly. This mom did respond and in a few minutes we had about 10 ml !!
I took that right in to the NICU leaving mom to finish a pumping session. We syringe fed the 10 ml and a subsequent glucose check was 54. Mom sent in a container of 15 more ml 🙂
They got to have a beautiful experience with their preterm boy who never got any formula … at least not in the NICU before discharge.

Yay!

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9 Comments Post a comment
  1. wow!! i wish my sister had a similar supportive neonat! my preemie niece was born at 33weeks and the neonat refused to administer even colostrum because baby might choke. instead, she was given IV drip and eventually glucose water orally before my sister was allowed to BF her. thanks for sharing!

    January 12, 2011
  2. Sara #

    My mother gave birth to my sister and I almost 30 years ago at 31 weeks and we were never given formula! I never knew how special that was until I started researching preterm birth and breastfeeding while pregnant with my daughter. That was way before Skin-to-skin was used, also. By the time we came home we were both feeding from the breast exclusively. My mom must have been really determined to breastfeed!

    January 12, 2011
  3. I wish that I had a similar experience with my own 34-weeker, who was born healthy and alert at 5lbs. Sadly, though, she was taken to the NICU immediately.

    I’m glad that change is coming, though. I hope that we continue to make more efforts to keep premature infants and their mothers together as much as possible.

    January 12, 2011
  4. Wow! Thank you!! As an LC I know what a huge difference nurses make to empowering moms to having their feeding wishes respected when it is possible (and I know it’s not always possible). And fabulous that you were also ready to help her hand express since that is often the best way to get colostrum. Love it!

    January 13, 2011
  5. That is beautiful. I have just been posting my journal from when my 34 weeker was born 13 years ago and looking back I am appalled I never was encouraged to try to latch him on until he was 9 days old! I was pumping for him. I don’t even remember doing skin to skin before 9 days. He was healthy, just needed to grow.

    http://enjoybirth.com/blog/2011/01/11/preemie-nicu-experience-first-breastfeeding-at-9-days/

    It makes me sad. But I am thrilled that this mom and baby had better care.

    January 14, 2011
  6. MomTFH #

    What a great story about cooperation and good medical care.

    January 16, 2011
  7. kassedi #

    aww thats awesome my daughter was born at 34 weeks all natural pink and screaming with skin to skin right after but they wouldnt let me nurse her for five hours cause her respiration was a little fast and i couldnt spend the night with her she had to be observed for twelve hours oh yeah i found your blog off of the unnesceserean, hope you dont mind hehe

    January 21, 2011
  8. NurseJannie #

    That sounds really wonderful. My son was born at 32 weeks with an APGAR score of 9. My husband went with him to the NICU and sat with him skin to skin while I got sutured ( ouch). When I arrived at the NICU myself I took over and the little guy started to lick colustrum. The first two days he got donated breast milk by NG tube to supplement my own pumped breastmilk. We were discharged after only 17 days when he was able to feed all on his own. I breastfed him for 10 months and he never had any formula. Even though it was a struggle sometimes I have never been more proud of anything. So yes – it is indeed possible to succesfully breastfeed primies. ( Much praise to the wonderful NICU nurses and my amazing lactation consultant. They were a godsend 🙂

    June 29, 2011

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