Agitated preemie, eating enough?

For discussion of issues that arise in the early days of breastfeeding
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Agitated preemie, eating enough?

Post by babyk » Fri May 19, 2017 11:16 am

Morning all!

My wife and I are struggling a little bit to work out what is agitating our little one so would like to get some opinions on perhaps where we are going wrong or what we could do better.

- Our little boy was born Friday evening, right on 36 weeks and @ 2.4kg
- Healthy mum and baby but due to early birth, we remained in hospital for 5 nights (we came home on Wednesday)
- He had lost 3.3% of his original birth weight, then put on 46g, then another 12g in the days following whilst in hospital which the doctors were pleased with
- My wife has been breastfeeding with quite good milk production and we've been storing the express milk in the fridge/freezer
- The lactation consultant advised we should be breastfeeding first and then because he is a preemie, we should always top up with the express milk. The volume to be determined by how well the breastfeed was. We were told to give 46ml if he does not have a good breastfeeding session, otherwise we have only been topping up between 10-20ml for decent feeds.
- We have been feeding on demand and every 3 hours.
- He has been weeing and pooing quite a bit, nappy needs changing every couple of hours when we feed.

So up until last night, we felt like everything was under control (well as much as it can be for first time parents). He had been feeding relatively well, sleeping well enough, making occasional noises/grunts but nothing excessive, crying only when we strip him down to change his nappy and to bath etc

Last night (night 7) things changed quite a bit, this is what unfolded following the normal 7:30pm feed:

1. 10:30pm - 11:30pm: we fed him like we normally did but he just would not settle and he looked very agitated and uncomfortable (kicking his legs out quite strongly etc). When putting him down to sleep he would cry excessively until we picked him up. He was also making more grunting/breathing noises. We tried to put him to sleep for an hour with no luck.
2. 11:30pm - 12:30am: He looked hungry as he couldn't stop sucking his thumbs and wrist so we fed him again (he didn't take much though). Tried to put him to sleep but the exact same thing happened i.e very agitated, grunty, cried when we put him down etc
3. 12:30am - He started looking hungry again so was breastfeed, this was a very good and successful feed. We put him down and for the first 10min he was doing well before the agitation, noises and crying started again. He also looked hungry again.
4. 12:45am - 3:30am: I took him to another room and topped him up with 10ml of express. He eventually fell asleep but still looked a little uncomfortable, making a few noises whilst sleeping.
5. 3:30am - 6:30am: Breastfed really good. He slept relatively well and much better, but still didn't look and sound 100% comfortable.
6. 6:30am - 9:30am: Breastfed really good. He slept much much better, grunting noises started to reduce somewhat and we had to wake him up for his 9:30am feed.
7. 9:30am: He didn't take much breastmilk so I topped him up with 30ml of express which he took quite well. Still looked slightly agitated and still looked hungry but decided to put him down to see how he goes, he was quite awake but content for the first hour or so but has now dozed off to sleep, once again with only minimal grunts/noises.

Other things to note:
- we do try and burp him after every feed, however he still does hiccup 75% of the time after a feed. This doesn't 'appear' to bother him too much and it eventually goes away.
- he has not really vomited at all, but occasionally after feeding express spits up a little bit of the milk or when we put him down too quickly after feeding
- As mentioned above, he has been weeing and pooing pretty consistently and frequently!

Our concern is the following:
1. The agitation because it looked and sounded like he was really uncomfortable - is this normal?
2. The fact that he appears to be very hungry quite a lot, so whilst he is going to the toilet appropriately, it feels like he is not getting enough food. Is this normal at this age and should we try and step it up? If so, how would we do this when he may not always take to the breast for a long session?

Anything else that anyone can share would be greatly appreciated!

Thanks in advance!

hiccups a lot
no vomit but occasional spitting

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Little Tiggermum
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Re: Agitated preemie, eating enough?

Post by Little Tiggermum » Fri May 19, 2017 9:11 pm

HI, congratulations on your baby boy!!
I've heard mums of premies talk about their babies going through a wake up phase where they act like you've described. They started off as quiet easy going baby's and then turn into voracious monsters. so its probably normal. YOu can check with the hospital.
The best way to increase a supply is to feed from the breast more so you could try getting him to have top up feeds at the breast or try the breast every time he wakes or makes a noise ( actually this is probably a very good idea to try and help you work out what he wants... I used to try breast first before anything else... it led to some very wet nappies before I remember that they needed nappy changes too with my first... in my defence it was the first night and I was still so new to this mummy thing)
burping is generally not neccessary after a breastfeed as the babies don't take in much air if they have a good latch... but I'm not sure about after a bottle.
another thing it could be is he's still getting used to the act that he is a separate being from your wife. babies often can't understand that this is a possibility and some babies can freak out if they're not held... this is normal and they will grow out of it as they develop. but as always if you're worried you can always contact your health professional and get him checked out. In actual fact that weight loss is brilliant. most babies lose up to 10% in the hospital so your wife has done well keeping him fed enough to only lose 3%... well done
if you want to talk over any of these points you can call 1800686268.
DD#1 Boozo 15
DD#2 Puddins 12
DS Emperor Bulldog 9
DS2 Pumba 4
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