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Normal newborn/premmie behaviour or something else


Wonderstruck

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I never experienced a 'normal' newborn so not sure if what I'm seeing with DD2 is normal.


DD1 was born term, had severe reflux and non-ige CMPA. She power spewed and comfort fed a lot.


DD2 was born at 34+6, she spent 24 days in special care learning to feed and adjusting to the outside world. She will be 4 weeks tomorrow (38+6 corrected). She is just shy of 3kg.


She basically wants to feed all the time - if she's awake she's rooting, if she's finished a feed she's rooting. She's taking 180ml/kg/day 4 hourly so 90ml feeds. She polishes these off in 15-20 minutes on a pigeon wide neck SS teat and gulps it down. If I offer bigger feeds she has more reflux and belly pain.


She grimaces, raises her legs and grunts during most sleeps - most of the time. She is awoken by reflux and gags. She's been fully formula fed for a week (previously EBM and formula) and her poos to me look like they have mucus - they're runny, wet and shiny.


I'm trying to determine if she's just a hungry baby or comfort feeding to soothe pain such as reflux or gut pain from possible CMPA.


Is it normal that she eats as if her life depends on it? I don't want to underfeed her but she seems to have no full button then ends up in more pain?

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I don’t think that’s a particularly premmie thing. Or at least it wasn’t in my experience.

It almost sounds like she’s eating so fast, she doesn’t realize she’s full? I imagine there is a way of managing that with bottles and teats? Maybe feeding half having a break and offering more?

Is she still gaining?

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I don’t think that’s a particularly premmie thing. Or at least it wasn’t in my experience.

It almost sounds like she’s eating so fast, she doesn’t realize she’s full? I imagine there is a way of managing that with bottles and teats? Maybe feeding half having a break and offering more?

Is she still gaining?

 

She was gaining huge gains the whole time in special care - her first at home weigh in is on Friday. She's on the slowest teats i've found thus far and certainly slower than the hospital ones. We stop her for burps and breaks but she's so frantic rooting around your shoulder and throwing her head around the whole time. I do feel she feeds way too fast - it's like we don't feed her!

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God I wish they could talk. Maybe it’s too slow and she’s getting frustrated?

 

She's drawing down on it so fast she almost chokes herself. Too bad the baby health clinic drop in clinic is only for breastfeeding

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Do you have a pharmacy with a child health nurse near you? Mine was AMAZING.


I had one particularly hungry newborn (my DS1). For the first few weeks it was basically if he was awake he wanted to be eating. My second was less so, but still feeding frequently.


I feel like 4 hourly feeds for a baby so young is a long time between feeds, is that 6 feeds per 24 hours? I guess the first thing I would try is to feed more frequently than that (my babies were feeding approx 2 hourly at that age - but BF, so I don't know what difference that makes). And give her more? (I guess that's hard if she's then going to puke - I had a puker too, and it often felt like heaps of his feed came up after).


Does she take a dummy? This helped a lot with my second who had (mild?) reflux. I'd give it to him straight after a feed and keep him in the baby carrier or bouncer for a good 30 min after too - so he'd be more comfortable and spew less.


Also, and you've probably already heard about/tried this, paced bottle feeding? 15-20 min seems like a reasonable time to take 90ml (i.e. not chugging it down in 5 min or whatever) but could still be helpful to try it if you don't/haven't?


When you say the drop in clinic is only for breastfeeding - is that a specific breastfeeding clinic? I guess it varies between states, but here (Perth) the local child health centres would take drop ins for any reason. Could you call your local centre?


Good luck, sounds a bit stressful for you both!

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Do you have a pharmacy with a child health nurse near you? Mine was AMAZING.


I had one particularly hungry newborn (my DS1). For the first few weeks it was basically if he was awake he wanted to be eating. My second was less so, but still feeding frequently.


I feel like 4 hourly feeds for a baby so young is a long time between feeds, is that 6 feeds per 24 hours? I guess the first thing I would try is to feed more frequently than that (my babies were feeding approx 2 hourly at that age - but BF, so I don't know what difference that makes). And give her more? (I guess that's hard if she's then going to puke - I had a puker too, and it often felt like heaps of his feed came up after).


Does she take a dummy? This helped a lot with my second who had (mild?) reflux. I'd give it to him straight after a feed and keep him in the baby carrier or bouncer for a good 30 min after too - so he'd be more comfortable and spew less.


Also, and you've probably already heard about/tried this, paced bottle feeding? 15-20 min seems like a reasonable time to take 90ml (i.e. not chugging it down in 5 min or whatever) but could still be helpful to try it if you don't/haven't?


When you say the drop in clinic is only for breastfeeding - is that a specific breastfeeding clinic? I guess it varies between states, but here (Perth) the local child health centres would take drop ins for any reason. Could you call your local centre?


Good luck, sounds a bit stressful for you both!

 

Due to covid a lot of the pharmacy nurse stuff is not operating in NSW. The early childhood nursing centres are so underfunded that the first appointment for the early childhood nurse was 4 November and I booked that a week ago, despite her being prem etc. There are no drop in services in my area except for breastfeeding which did not work out for us due to me struggling to make it work with pumping and being away from her/her getting too tired to suck at the breast.


The 4 hourly feeds work well as she's quite tired between feeds but it's all guess work at this point I guess?


I plan to see the GP Friday and next week the early childhood nurse will come but I guess her being in special care is we didn't get the getting to know you time in the postnatal ward in an environment where the midwives are there to help.

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God I wish they could talk. Maybe it’s too slow and she’s getting frustrated?

 

She's drawing down on it so fast she almost chokes herself. Too bad the baby health clinic drop in clinic is only for breastfeeding

Poor poor darling. The nurse is a good idea, if you can find a good one.


I would call the hospital and ask who to contact. There had to be someone.

Is latch a concern with bottle feeding? Could that be affecting things. So sorry if that is a stupid suggestion.

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I don’t know if your already following this guide but I’ll share anyway. I was told to feed using the following guide for formula feeding.


Weight x 150ml / 6 feeds per day


EG - 4kg x150ml = 600ml per day.. divide by 6 feeds per day = 100ml every 4hrs


As they get older you increase the bottle and increase the interval.


Sorry if this isn’t helpful - I sae you mentioned belly ache and drinking fast but I don’t have suggestions for either of those.

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It makes me really sad (and also mad) for you that things are just so much harder due to covid. Good luck with the GP and the nurse next week.

 

Thanks Lou Bags. It has made the pregnancy and birth more tricky. It meant that DD1 and family didn't meet DD2 until she was discharged from special care due to covid visiting restrictions etc.


I've also forgotten a lot. DD1 will be 4 in Feb!

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God I wish they could talk. Maybe it’s too slow and she’s getting frustrated?

 

She's drawing down on it so fast she almost chokes herself. Too bad the baby health clinic drop in clinic is only for breastfeeding

Poor poor darling. The nurse is a good idea, if you can find a good one.


I would call the hospital and ask who to contact. There had to be someone.

Is latch a concern with bottle feeding? Could that be affecting things. So sorry if that is a stupid suggestion.

 

Special Care said I could contact but it's hard as they're limiting out patient stuff due to covid so its just by phone. They had originally said they'd get her back in for a weight check etc but they now want me to get her weight checked locally as they want to limit people coming in - so frustrating

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It’s a different world now, bloody COVID. But I hired a home visit midwife to help me mix feed my first son. Actually our private ob paid for her first two visits to us. I wonder if you could look online and find a private home visit midwife or child health nurse?

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That’s very disappointing. Do any of the pharmacies have scales you can use?

 

I think most of them have put them away..I heard someone asking after the blood pressure machines they let people use and they put them away.


Our GP will weigh her no issues. I'm just glad I'm not a FTM navigating during covid it's so messy.

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It’s a different world now, bloody COVID. But I hired a home visit midwife to help me mix feed my first son. Actually our private ob paid for her first two visits to us. I wonder if you could look online and find a private home visit midwife or child health nurse?

 

Definately worth considering. Services like Tresillian and Karitane are still operating so they might have some help too.

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gatheringpieces

Hi Wonderstruck, firstly sending good wishes for your and your fam, it's hard going at the moment.


To me, it does sound a bit like maybe bub is having issues with dairy, whether CMPI or CMPA? Getting doctors to listen can be a whole other issue.

My #3 had all sorts of issues with weight gain and it was hard work to get anywhere with it. He was breastfed and we figured it out/helped him with removing dairy from my diet. He is 4 now and still can't eat dairy :/

#4- born this January- showed signs similar to your bub and I jumped on it straight away and cleaned my diet back up again.


Sorry for babbling, but yeah have a chat with the nurse/doctor and maybe try a dairy free formula. It can take a few weeks to get big improvements but the mucous will usually start settling within a day

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Dear OP, I would definitely get her checked out by someone/Paed maybe?

My first was born at 36 weeks and was very similar. He had reflux. He was always hungry and would polish off a bottle really quickly and then be in pain/sleep and then want more. Everyone I ever saw (so many people) said oh well he is just a happy chucker (he wasn't a happy chucker- he would cry a lot). We basically had towels on hand.

So please don't let them fob you off.

I am imagining some lines like...

"She is just catching up.."

"She is just a hungry baby, all babies are different"

"She is gaining well, I wouldn't worry"

Etc etc. I swear some people just want the consultation to end instead of carefully listening and responding.

You know your baby, you also know as you have been through it with your first baby.

If they do try and fob you off, ask for some concrete evidence. Ok, so you are telling me that it isn't _________, can you please give me reasons as to why you think this?

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Hi Wonderstruck, firstly sending good wishes for your and your fam, it's hard going at the moment.


To me, it does sound a bit like maybe bub is having issues with dairy, whether CMPI or CMPA? Getting doctors to listen can be a whole other issue.

My #3 had all sorts of issues with weight gain and it was hard work to get anywhere with it. He was breastfed and we figured it out/helped him with removing dairy from my diet. He is 4 now and still can't eat dairy :/

#4- born this January- showed signs similar to your bub and I jumped on it straight away and cleaned my diet back up again.


Sorry for babbling, but yeah have a chat with the nurse/doctor and maybe try a dairy free formula. It can take a few weeks to get big improvements but the mucous will usually start settling within a day

 

I do have a tin of Allerpro here which is we tried on DD1 at 8 months old and for the first time she slept soundly. We soon moved to dairy free but it made a huge difference.


My current GP I found when I was a mess after dealing with so many doctors brushing us off with DD1. She had a cmpa child herself so I think she'll listen. She otherwise will be followed up by the neonatal paed but not sure when that will be.


My DD1 also sees a paed gastro who is excellent but that won't be straight away if we end up with her so hoping the GP can get her started.

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Dear OP, I would definitely get her checked out by someone/Paed maybe?

My first was born at 36 weeks and was very similar. He had reflux. He was always hungry and would polish off a bottle really quickly and then be in pain/sleep and then want more. Everyone I ever saw (so many people) said oh well he is just a happy chucker (he wasn't a happy chucker- he would cry a lot). We basically had towels on hand.

So please don't let them fob you off.

I am imagining some lines like...

"She is just catching up.."

"She is just a hungry baby, all babies are different"

"She is gaining well, I wouldn't worry"

Etc etc. I swear some people just want the consultation to end instead of carefully listening and responding.

You know your baby, you also know as you have been through it with your first baby.

If they do try and fob you off, ask for some concrete evidence. Ok, so you are telling me that it isn't _________, can you please give me reasons as to why you think this?

 

Sounds like my DD1. She was a power spewer and constantly wanted to feed. Gained well but screamed for hours a day.


This bubba is similar but I don't think has the energy to scream as much. I had to get up and hold her just now as she was thrashing around and I could hear her swallowing constantly in the bassinet (which is already raised next to me).


I'm hoping they don't say she'll grow out of it etc as my first is 3.5 and still medicated (and the need for same confirmed by scope at 2).


This GP knows the path I travelled before I saw her so hoping she's proactive tomorrow.

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OP I have no experience with bottlefeeding, but you mention she's being woken by reflux and gags; is carrying her somewhat upright in a sling or in your arms an option? It will can help if she's reflux-y or slow to burp. Also maybe break up the feed into two parts, with a good opportunity to burp in between.


Congrats on the little one!!

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OP I have no experience with bottlefeeding, but you mention she's being woken by reflux and gags; is carrying her somewhat upright in a sling or in your arms an option? It will can help if she's reflux-y or slow to burp. Also maybe break up the feed into two parts, with a good opportunity to burp in between.


Congrats on the little one!!

 

Being upright definately helps her. She's a little small for my carrier right now but she'll be big enough soon.

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Hi Wonderstruck,

Glad to hear your home now, sad that your struggling a bit with your daughter. COVID really makes things much harder.


My DS was a 32 weeker and we got told with him that slow feeding is more typical for Premmies because they’re using all their energy to develop when they should have still been growing inside. So the fast feeding seems a little unusual from that point of view. DS took 65 mins to feed and then wanted more 2 hours later (didn’t help tha5 it was summer, so he was probably thirsty too).


What you’re describing seems more akin to what we had with DD - she’s egg, dairy and soy intolerant!


I’d look into the dairy free options, but check if your existing stuff is hydrolysed dairy as some kids can’t even have that (DD - case in point). I’d also look at feeding slightly smaller quantities each feed (5-10ml). If she can keep the smaller quantity down - win! Potentially even look at feeding more frequently, so she gets smaller quantities, which might help for her smaller tummy.


We also got told with DS that premie guts aren’t fully developed, so it can be very common that they chuck as they cope with food. DS chucked until he was taking sufficient solids to help keep his food down. (Or he had grown enough to cope!).


In terms of support - is there anything through your hospital? Our hospital had parenting, mid winery, lactation etc support available up until 6 months.

Are there any online groups? I found a breastfeeding and intolerance group, which has been helpful, not sure if there’s something for formula.


PM me if you want more info from another prem Mum!

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ClaudiaCosette

I don't have any specific advice to offer you, but just wanted to say I hope you can get some support and things improve for you and dd.


My twins were born at 31 weeks and I mix fed (breast feeds/expressed milk/formula) them for 6 months until I switched just to formula. Your dd doesn't sound like my girls as premmies, even once home they were very sleepy and struggled to feed efficiently. I remember celebrating every time they would drink anything out of a bottle (my supply was so low so I knew they weren't getting much from bf). One was still very sick once home (on oxygen), was very small and she had reflux also, but the other was relatively healthy, and even she was not a big eater.


So this doesn't sound like your dd at all, sorry I can't give you any help. But having a prem baby is such a stressful time so I wish you all the best.

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