Decision time

It’s come down to this:

If we want Nathan home before Christmas, we’ll probably have to introduce a bottle (with fortified breastmilk, not formula) once or twice a day.  The day of my last post, Nathan had a significant gain of 55 grams.  The next night, his weight was up another 4 grams, and then last night, it was down 4 grams again.  So he is sitting at 2130 grams or 4 lbs 11 oz.  During rounds today, the doctors and I discussed our possibilities.  At this point, his weight is the only thing keeping him here.  If he has good weight gain for 48 hours, they are willing to send him home.  At first, no one straight-out said to introduce the bottle, but there was hinting.  Finally, one of them said, “Introducing a bottle will be the fastest way to get him home.”  And then the attending physician said, “But don’t tell the lactation consultants that we said that!” =) I know they are right, though.  At this point, his breastfeeding is a little hit-and-miss, and he does seem to need the fortifier to make up for some of the calories he is burning or missing from some breastfeeds.  The best suggestion was for me to breastfeed during the day without top-ups so that he is hungry for his next feed and to give two bottles at night (at 3 am and 6 am) with fortified breastmilk.  They will also increase the fortification.  I’m still not 100% sold on the fortifier, because it has made him a little refluxy again and his bowel movements are not as regular.  Furthermore, yesterday I only breastfed once and he had 5 NG feeds of fortifieed milk, yet he still lost weight.  (Though that reassures me that it is not the breastfeeding that is the main culprit – he just really seems to need extra calories.)

I spoke with my lactation consultant, Beth, on Friday, and she convinced me to hold off on introducing a bottle.  It may very well make it more difficult to establish good breastfeeding.  But she agreed that if we want him home before Christmas, it is probably our only option.  Furthermore, the nutritionist thinks that Nathan may need the fortifier until he reaches term (in about 4 weeks).  So, as much as I agree with Beth, I think I am leaning toward introducing a bottle.  I have a meeting with her at noon; hopefully she can offer some helpful advice.

Please pray that we will make the right decision.  Please pray for stamina for Nathan to breastfeed properly.  Pray also that Nathan will gain weight over the next few days so that he can take him home!

2 thoughts on “Decision time

  1. It’s hard to make that kind of decision. We had the same with our first two preemies, and they did really well with the bottle, though that wasn’t our first choice. The breastfeeding continued to go well (and I had the option of sleeping at night once in a while, while Eric gave a bottle). All the best!

  2. KAren,
    I know that you don’t want to bottle feed him, but sometimes even if only one more bottle a day you are more aware of the exact amount Nathan is getting at each feed. We give Benjamin a bottle each night at 10:30 of pumped breastmilk. We do this for 2 reasons. #1- So Derrick can also enjoy feeding and bonding with him and #2 (more importantly) so that I can go to bed and actually sleep until Benjamin’s next feed,around 2am. If you can breastfeed and bottle feed with breastmilk, I don’t see what the problem is. I know you worry about nipple confusion, but some babies manage fine and don’t get confused at all. Maybe Nathan won’t get confused and if it’s breastmilk than you can be assured he is still getting the benefits it offers rather than giving him formula. We will continue to pray for your little man to come home for Christmas. Thinking about you.

Leave a Reply

Your email address will not be published. Required fields are marked *