EASY for ex-prem (27 weeker)

[DualTracy]

Dear all,

I have an ex-premature baby, born on 28 May at 27+2 weeks. He is now nearly 7 months old (4 months old corrected on Christmas), and is perfectly healthy except for chronic lung disease, which means he's on home oxygen.

We used BW for my first son (born normally in 2009) with great results, and would like to use it for Noah. However, we are sort of at a loss for a number of reasons.

1) He is developmentally four months old, but does not yet weigh 11 lbs. I therefore BF him pretty much constantly to try to stuff him with calories. (The lung issues mean he works hard to breathe, which uses up a lot of calories and results in slow weight gain).

2) He can stay awake, alert and content for ages. I mean ages. Four hours is no problem for him.

3) His sleep patterns at night vary hugely. We tried the dreamfeed only for it to backfire spectacularly - it became a habitual wake within days, and had no effect on how often he woke during the night. We're STILL trying to get him to sleep through 11pm again (some days he does, others his dad gets him back down again - Noah's even made it to 2.30am without waking a few times).

4) He is exclusively breastfed, though we have been told to give him two bottles per day with a catch-up formula (we refer to it as Weight Gain 4000). He does not take the bottles. Well, he does - if he's just had a BF and has dozed off, I can slide the bottle in. He plays a bit but doesn't drink (except for one weird day, when he downed the lot). Doctors/health visitors have pretty much written off the idea of bottles, but we're still trying.

4) We want him to grow big and thrive but to have a routine that works. He is not 7 months and not 4 months, really - he is hard to pigeonhole developmentally.

His routine, such as it is:
Wake 7am, feed
A: go in pram to drop off older brother at nursery, scream pretty much the whole time, get home around 8.30, another feed
S: 9.30-10ish, following another feed. Can be 1-2 hours (note: he never ever wakes up after 45 minutes. The hourlong naps aren't great, though.)
E: When he wakes up.
E again: Around 2.
S: 4ish, for 1-1 1/2 hours
E: When he wakes up.
Bedtime: 7.30-8ish

Yeah. So that looks messy.

Help!

Yours,
DualTracy (still hugely grateful for all the help we got three years ago!)

[nwmm]

Hi there.

I can't help,but I want to say hi to a fellow mom of 27 week-er.

I admit, I went with the flow more for ours. 

My dr wanted us to "wear" our baby as much as possible due to lack of movement in the womb.  So, I did.  It was nice to keep up with my two year old and my baby slept when she wanted to. 

It all worked out.

Good luck and take care!

[JennŠ]

He is going to be hard to classify for a time.  Basically, he is 4 months old.  Have you tried dream feeding a bottle?  My preemie was bottle fed, so not much help to you about food.  We did a lot of go with the flow as well.   Curious about how much O2 he is on?  It might be worth asking if you should turn it up a bit with feedings, less work for him.  Don't without asking though. 

[DualTracy]

Hello! Thanks so much for your responses-very exciting to hear from fellow mothers of prems! Nwmm, did you have iugr? We weren't advised to wear Noah; by the time he came home, one week after his due date, he was super feisty and liked to play on his mat. (Noah was born early most likely as a result of my problems, not his. I was haemorrhaging for about six weeks before he was born-up until that point, he was at the 93rd centile for his developmental age and had no problems. The lung issues happened as a result of ventilation he needed after birth.) Also, I most likely would have tangled us both up in his trailing oxygen cord! How is your little girl doing?

Jenn, we did try bottle feeding at the dream feed. I expect you could hear the screaming from where you are. He is on 0.2 lpm, though he probably needs less-our community health team don't want to wean him down until after the cold and flu season is over. His overnight sats tests average over 97%, so he's doing pretty well.

Am I right in thinking that you both would recommend postponing the introduction of EASY? If so, I'm very happy to take your advice-you've both been there already!-but what do you do when he wakes up five times in a night? For the record, he is super easy to settle if you feed him, it's just that some of the feeds are 20 minutes, and some are five. Last night one feed lasted an hour! We are exhausted and confused...

Yours,
DualTracy

[nwmm]

Nope.  No iugr.  They are not really sure what went wrong.  Could have been a result of me having to have had another emergency c section with my oldest.  Could just be the way I was made--not perfect inside.  ;)I too had bleeding.  A TON afterwards.  Water broke super early and I hung on for two weeks before giving birth. 

At age five, doing perfect.  No concerns.  Was diagnosed with asthma at age 5, but doing fine.  2-4 years was challenging with colds, but we have turned a corner.  Whoo Hooo!

In terms of easy, we needed to feed every 2 hours and then every 3 hours for months and months and months.   Certain rules about when to play and when to sleep (so they grow) so I couldn't follow easy and still follow hospital rules.  After what we went thru, I was more than happy to follow hospital rules.

  Mine came home at 35 weeks.  So, still supposed to be inside of me growing, eating, sleeping.

Great news on the sats!  I understand about the cord. We didnt deal with it ourselves, but other family members do and i know about tangling etc.

We were advised to really watch germs that first flu season and for us number two as well. 

What does the dr. say about the hour feed?  I have some thoughts, but I haven't given feeding advice in years so I really hesitate to do so in this situation. Mine two have always been on strict feeding schedules.  We too woke up every 2-3 hours to feed, but I was in a different boat than you.  Mine wasnt considered full term.  My oldest was a preemie, too, but she was considered under weight so we needed to feed often as
well.  I couldn't start BW until mine were older.  I understand about the complete exhaustion. I am sorry.  You never think it will end, but it does.  Remember that.  This isn't forever.

[nwmm]

Is there anyone at the hospital you can talk to --even thou you have left?  We had resources and our pediatrician watched us (meaning the baby and our family) like a hawk--for positive reasons.  Insurance sent a visiting nurse so we didn't need to take the baby out during blizzards and flu season.    Special rsv shots for two winters given at home.

Again, probably slightly different situation as ours came home at 35 weeks.

[JennŠ]

Well, we ended up with AESY for a time.  Then, when she was in reflux mode she would eat, then be upright on a shoulder for 30 min after.  Frequently fell asleep there.  You can do EASY more frequently if babe needs it.  The 5 times a night waking, is he eating each time, or just needing resettling at times?  Oh yes, the RSV shots.  Lucky getting them at home!  But, we did a research study protocol, so had to go in.   Mine had IUGR and a failing placenta/low fluid so she was induced.  Toothpick skinny now like mama. 

[DualTracy]

Hi all,

It's been ages, and I'm sorry I didn't keep talking. Things have improved, but I have more questions!

Current routine:
7: up and feed
8.30: solids
9.30: feed
10-12: nap
1.30: solids
3: feed
3.30-4.30: nap
7.30: bedtime
Around 2.30am: wake and feed
Around 5.30: wake

I'm happy with feeding him once at night-he's about 14lbs now, so he's still catching up. The early waking, less so. Even if I feed him he doesn't settle. He's happily awake and babbling away, which would be okay except that it generally devolves into unhappiness and he doesn't settle again.

I figure some of this is because he's now getting more decent sleep at night, but how do I fix it? Ideally I'd get him up at 7. Any thoughts?

Thank you!

[DualTracy]

Echo echo echo...?

[Buttonbobs]

Hi there, I don't have any advice I'm afraid but just spotted you and will try & get some more eyes here for you. Hugs x

[jessmum46]

Hi, sorry you've waited a while for a reply.  He's about six months corrected now?

For us, wakings at that time would usually be due to OT or discomfort.  Is he teething?  He may well be a bit OT at bedtime because he is doing a full A time after only a one hour nap.  Do you wake him from that nap or is he waking naturally?  Would he take the nap a little earlier, say 3pm and allow him a full 1.5h nap until 4.30pm, then stick to 7.30pm BT?  Or if you like the nap where it is, perhaps a slightly earlier BT e.g. 7pm?

Feeds wise I only see three milk feeds in the day - is that right or does he have one at BT too?