Prematurity can be frightening

Hello,

I have a premature son who is now 8 months. He still looks like a 3 or 4 month old and as a concerned Mum, I can't help but wonder if he is developing well. His paediatrician hasn't made any major comments other than the fact that he is smaller than most babies and needs to catch up. I breastfeed my son and he seems to eat well but it seems to me that he likes to snack. He doesn't normally eat until he is full and I don't know if there is anything I could do to help him with this problem to possibly increase his feeding intake. Also, is there any thing I can do to help make sure my son is reaching all of his milestones as a premature baby? I know he will need plenty of time to catch up to other children but I just want to make sure I am being the best Mum I can be.

Hi Jen,

I just read another of your posts where you mentioned your son had been born 2 months early.

Obviously, if he is only the size of a 3 or 4 month old, at 6 months of age (adjusted), then it makes perfect sense that you're concerned about his growth rate.

I believe you may be onto something with your concern about the fact that he seems to snack rather than take a full feed and fill his tummy.

There are a couple of things that come to mind that may help baby to put on weight.

The first is using compressions when you are breastfeeding so that your baby is getting more of the hind milk during a feed. The hind milk has more fat and calories and helps babies put on weight.

Here's a video by Dr. Jack Newman, that shows you how to do this (there are actually 3 videos that will play, one right after the other which will show how positioning and compressions can help baby to drink more during a feed).

http://www.youtube.com/watch?v=pxabQ...A714E20310CC24

Here's another video that shows the compressions even better, which helps baby get the extra hind milk he needs.

http://youtu.be/RymUDeCAt18

The other thing that we want to check is the quality of your breastmilk. Some women have very "watery" breastmilk and others have milk that is very high in fat. Most women will produce breastmilk that is somewhere in between that.

My guess is that you've been under stress for at least a couple of years. Your body naturally had extra stress during your pregnancy because it was creating new life and putting a lot of extra into creating bone, blood and critical organs for your baby.

Then your stress level likely went up when you had him early, and had to deal with a hospital stay.

Bringing a premie home was probably stressful in that you had to learn about caring for him and may have even had to learn how to use certain kinds of monitoring equipment to monitor his breathing. Then there were the extra doctor visits and all the worry that goes along with giving birth to such a young baby.

Stress can reduce the quality and quantity of breastmilk. Putting baby to the breast often is important, as is position so that he sucks in such a way that effectively stimulates milk production.

I'm going to create another post with more information on how to improve your breastmilk which will include a video for you. This system is set up to only allow 2 videos per post, so I need to do it this way.

Warm Regards,

Kate

Diet is another thing that will affect the quality of milk. Be sure you are avoiding sugar and simple carbohydrates, and increasing your fruit and vegetable intake, focusing on getting lots of green leafy vegetables into your diet. Your goal should be anywhere from 1 to 3 heads of leafy greens per day.

Two of the easiest ways to get more greens into your diet are by juicing them and blending them into smoothies. Babies LOVE green smoothies so share some with him when you feel your baby is ready.

Here's a video showing you how to make a green smoothie. You can replace the milk with water if you'd like. I have a sensitivity to milk, so I don't use milk in my smoothies, but I will make my own almond milk and use that sometimes, or just use purified water. You can also replace the spinach with fresh kale. Kale is PACKED with calcium and lots of good nutrients, so I prefer to use kale anytime I can get it. Spinach can cause gas or digestive issues for some people, so give it a try and if it causes any kind of uncomfortableness, then try the kale or romaine lettuce or swiss chard or any other green until you can tolerate the spinach. And one thing to keep in mind... if you're body is not used to eating lots of fresh fruits and vegetables you may find that drinking a green juice or a green smoothie will cause some diarrhea. This is just fine, and it won't last. It's your body telling you that you need to cleanse out some toxins. If this happens, just back-off on the juices and then gradually add more in. But my guess is that you'll be just fine if you start with one or two green smoothies a day.

http://youtu.be/TE16waPuiRc

And as for helping your son reach his milestones... I would start with improving his breastmilk intake and improving your breastmilk while offering him some green smoothie each day. Right now you could be fully breastfeeding your son and giving him all the nutrients he needs. After he turns one he may need some other foods, but, remember, if he was born 2 months early, you'll be able to give him 2 months more of fully breastfeeding which I feel would greatly benefit him if you can get more of that hind milk into his system.

Once he's putting more weight on then he may be able to reach more milestones.

Hope this helps, and please leave a comment letting me know your thoughts.

Warm Regards,

Kate

I have to say Kate. I am quite impressed with the responses I have received from you. I have gone to a few breastfeeding clinics and even my son's Paediatrician recommended that I supplement my son with Neosure, a higher calorie formula, but I never felt right about it. My son refused to drink out of a bottle after being home from the hospital for a month or two. I have even tried hiding the formula in his baby cereal, but as you read in my other post about feeding solids, he doesn't always go for that either.
I will try the green smoothies and the compressions and hopefully I will begin to see better results.

Thank you so much,
Jen

I would definitely try improving your breast milk and trying to get him to stay on the breast longer, taking a full feed, before offering supplemental formula. You may find that your son will take a 20 minute feed on one breast (using compressions so you're sure he is full), and that you won't have to offer both breasts. The next feed would be a full feed on the opposite breast. I actually found that this was easier for me, especially at night, so I breastfed some of my children, offering only one side per feed.

Let me know if the compressions help to keep him on the breast longer (getting more hind milk) and if you're then able to go 2 to 3 hours between feeds. Ideally 2 hours between feeds is good if he's getting plenty of hind milk, and will keep the breast stimulated to continue to produce lots of milk. Oh - and be sure you are drinking plenty of water throughout the day because breastmilk is comprised of 88% water and 4.5% fat so make sure you are getting enough Essential Fatty Acids (found in Salmon and other fish or as a supplement) and that you're drinking plenty of water.

Here's a picture I found on Wikepedia that shows foremilk and hind milk. The white milk is the fatty hind milk that comes from an almost empty breast. Thought you would appreciate seeing this (click on it to see a larger image).
Attachment 85

Warm Regards,

Kate