Beyond the NICU - feeding and growth
A lot of prems struggle to gain weight after they leave hospital, especially if they were IUGR (intra uterine growth restricted) at birth. Try not to panic - almost all of them will catch up in their own time.
Here are some sites and information I found helpful.
WHO Growth charts
A lot of doctors (and I think even the purple book every baby gets in WA) use weight and length charts which are now out of date. They were made in the 1950s based only on formula fed babies from the USA. The World Health Organisation has recently created revised growth charts based on breastfed babies, from a range of different countries. These charts show a much more realistic view of average growth, and you may be pleasantly surprised to see your baby is doing better than you’d previously thought.
Reflux
This is not just a prem thing, but a lot of prems seem to get it, perhaps due to lower than average muscle tone. If your baby is failing to gain weight, and especially if they are throwing up a lot - seek medical advice. There are anti-reflux medications which can make your baby’s life much easier.
Reflux information as published by the WA Dept of Health (from the SA govt’s CYH website).
Breastfeeding
It can be difficult to establish breastfeeding in hospital, and equally difficult to maintain it at home, especially if you are stressing about slow weight gain. However it really is worthwhile to try and breast feed as long as you possibly can (or express and bottle feed EBM) for the protective properties of your breast milk which will give your baby immunity against many bugs for the first six months of his or her life (and longer if you can).
If you have real problems establishing supply, find a sympathetic (female) GP and ask for a decent prescription of Domperidone (Maxilon). It was the only thing that helped me, and I stayed on it for about 9 months.
If you need help with technique, get in touch with the Breastfeeding Centre (based in Agnes Walsh house next to KEMH) and ask to see a lactation consultant. Or try a breastfeeding support group such as the Australian Breastfeeding Association. http://www.breastfeeding.asn.au/ They have a helpline which I’ve not used personally but another mum I know describes as “invaluable”
Dr Newman’s Articles These are not specifically for premmie mums, but have a lot of information. http://www.bflrc.com/newman/index.htm Topics include: Skin to Skin Contact, Colic in the Breastfed Baby, Sore Nipples, Is My Baby Getting Enough Milk?, Using a Lactation Aid, Finger Feeding, Breastfeeding Myths, Breast Compression, Domperidone, Blocked Ducts and Mastitis, Slow Weight Gain After the First Few Months, When the Baby Refuses to Latch On, Expressing Milk, Protocol to Increase Breastmilk Intake by the Baby
Breastfeeding leaflets printed by the WA Dept of Health (originally published by CYH in South Australia).
- Expressing and storing breastmilk