Well, hell. Simone failed Bottles. Her speech therapist (Speech! I know! So advanced!) has tried various nipples and feeding positions and pacing techniques, all to no avail. Give my girl a bottle and she gobbles at it, aspirates milk into her lungs, and stops breathing. A swallow study has been ordered for tomorrow morning.
What I find so damnably frustrating is the fact that she can take full feedings by breast with no problem. We use a nipple shield, but the rest is all her: she sucks like a champ, remembers to stop and breathe, and even does this comedy bit where she growls and shakes my nipple like she’s trying to break its neck. The lactation consultants came to consult but left unneeded, shaking their heads in awe. Alas, Simone will be sent home on a growth regimen that includes two feedings of milk fortified with formula, and if she cannot take those feedings by bottle, she will end up with a g-tube.
I do not understand. Obviously she can drink without aspirating, because she does it several times a day via my mammaries. Simone’s nurse can’t remember another baby who couldn’t take bottles yet could breastfeed. My child is a puzzle wrapped in an enigma wrapped in a milk-stained onesie. The best-case scenario would for the swallow study to show that she does not aspirate as long as the milk is thickened with rice cereal, so let’s hope for that. Better yet, let’s hope this has all been a clever ruse designed by my daughter to bust out of the NICU for an hour, and that once she is down in radiology she sucks down an unthickened bottle without incident.
Until tomorrow, I leave you with a video. The first act is a simple rendition of the hiccups, but the second act showcases the “door in a haunted house” sound effect Simone has been perfecting for weeks now. And at the end of Act III…well, see for yourself:
UPDATE:
Simone aced her swallow study. Unthickened. No aspiration, not even a suggestion of milk that looked like it might be considering possibly heading for her airway. As this is the only of her dozen or so attempts to bottle that has not ended in alarms and a blue baby, I am thinking my “clever ruse to score a field trip” idea is the only explanation. The speech pathologist was baffled.
“I can honestly say I have never been more wrong,” she said. But it’s not her fault that my child is so contrary. I swear the radiologist thought we were making the whole thing up, for kicks.
As Simone obviously can bottle feed safely, the plan is simply to keep trying and thicken with rice cereal if needed, to slow things down a bit. I saved the bottle they used (same kind as yesterday) just in case it has Magical Powers. The upper GI series showed grade 3 reflux, but that was no surprise.
So, uh, move along, nothing to see here! G-tube threat level reduced to Puce, or NONEXISTENT.
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That smile made me smile!
gah! the smile. love it.
crossing fingers that simone totally sucks down the bottle.
Oh Alexa, that video is just too much! She has the most adorable little smile I have ever seen! Much love to you both! Oh, and can you really blame her for not wanting a bottle when she can get mommy-milk?!? I too agree with those you think breast milk “should” be enough, but then again, I’m not a doctor so what do I know? She seems to be gaining well though – just look at those cheeks! She’s just perfect! Hope all goes well with the swallow study.
Heather
Awww – sweet baby noises! And that smile at the end? *swoon*
My situation was a bit different because I had a slow gainer, but we needed supplemental calories for a long time; most of her first year, in fact, even though breast milk was her primary source of nutrition.
Have you tried something as simple as a slower flow nipple? The nipples they use in the NICU are actually pretty gushy. She’s not choking on breast milk because she controls how quickly it comes out and the flow stops when she stops sucking. With a bottle, it dumps down her throat whether she wants it or not. If they’ll let you take in a bottle, try the Avent newborn nipples which act somewhat like a breast. I think Avent is making a “safe” bottle that doesn’t have any of the bad plastic.
Oh god, that video is precious. It captures all the sweetness of the infant in one little show!
I had a full term baby who was on the small side (6 lbs 10 oz at birth, down to 5 12 in a few days) and she was a bad gainer–with BFing and supplementing with BM and formula it still took forever (6 weeks) for her to regain her birthweight. You do what you have to but it sounds like simone is doing WAY b etter eating than many full-term (lazy?) babies like mine. BTW, mine is now 17 mos old and a decent eater but still on the smallish side . . .
OK, the smile is priceless! But I do think the haunted-house-door sounds more like a creaky rocking chair. Just my opinion!
Hi! I never have commented but have been reading Simone’s biography for a little while now. I was struck way back then and even more so now, having seen that wonderful video, by the way Simone looks so “plump” and healthy for not only a premie but a newborn as well! I have 4 children and all of them were full term but small and sickly looking. But your beautiful daugher is just a show stopper!!
She’s so adorable! That smile just made me melt like a bowl of ice cream left in the sun.
And I think the creaky door noise is akin to a rocking chair on a wooden porch.
That is the best smile! She knows her Mommy!
So cute! I forgot how adorable those new baby noises are!
My son also was a champ on the breast but could not take a bottle. He would choke on the bottle and aspirate. Luckily he did pass his swallow study and everything improved after a bit more practice at swallowing. My theory is that breast fed babies learn to latch on and suck hard to get the milk and that the milk from the bottle just comes out too fast, even with the newborn bottle nipples. I wonder if there are any low-flow bottles?
Simone is beautiful!
ok, my ovaries just exploded from the cuteness.
I have been following you and every move that Simone makes….first time commenting. I have to say that “Hi Honey” Smile is PRICELESS!!! She is adorable!! Enjoy every sound, every smile and every move she makes…..I feel like I turned my back for just a second and mine is about to get her driver’s permit!! Soak it all in!!
Cutest smile ever.
Come on, Simone! Show them what you can do so you can bust out of there!
My daughter would not take a bottle. She would chew on it, throw it, push it away screaming. Breastfed like a champ from day one, but she hated, HATED the bottle. We just kept trying.
She was about 8 months (I know! 8…months…) before she would take a few oz. without screaming.
Good luck, keep trying, she’ll get it.
Well Good Lord, woman, you get so many comments I can’t take the time to read them to see if I’m redundant…but has anyone mentioned how much slower breastmilk tends to come down, save for right at that initial let down, verse a bottle? It’s one of the main reasons BF advocates don’t want to even use a bottle if you want to BF for some weeks. A bottle come faster, and steadier…the breastmilk has to be, well, milked. Does that make sense?
Our baby was in NICU for a VERY SHORT STAY SO NO COMPARISON, BUT BUT BUT the nurses told me he couldn’t go until he would TAKE A BOTTLE. And he was nursing fine. And I said, well, hell, I don’t plan on giving him bottle for weeks, or months, or maybe never (I stay at home, don’t have a job out of here but this one, so I can do that and he was our last of 4 and I was feeling all aaaawwwww, baby, last baby and stuff). So anyway, the nurse looked puzzled, check with the doc, who said, oh, OK, so he doesn’t have to have a bottle, meh.
I’m no professional, but I find sometimes those that are? Not always the most common sensical. Just a thought. All I know, is that if my gut was saying so, I’d be fighting a G tube. Or even rice thickened formula…look at those cheeks on that girl! But again, I’m no pro.
I’m 40 and have 3 kids–all who are fully capable of sucking the life right out of me by oh, 3:30, but after seeing Simone, I want another!!!! She is absolutely beautiful and I know you know how lucky you are!!!! I don’t have any totally useful assvice for you, but ask lots of questions so you can understand what’s up. I’m sure she’ll do just fine with the bottle eventually. Breastfeeding and bottle feeding use muscles in the mouth completely differently and perhaps she needs some practice. God bless and good luck.
Dude, I needed the smile I got from Simone. Thanks, Simone.
And silly baby not wanting to take a bottle properly. Send her over, I’ll teach her! I’ll demonstrate on some bourbon.
She is so, so adorable. Thanks for sharing that video! What a beautiful baby.
Oh my goodness . . . that is by far the most adorable thing I’ve seen all week. Her smile just infused me with joy :)
Too cute for words! It’s good to know that she can help out with the bills around Halloween! :)
Look at that chubby girl! I could gnaw on those cheeks for days. Congratulations on everything. She’ll get the hang of that bottle soon.
Oh she’s just crazy adorable. I snorted coffee when she started making that creaking noise. Her smile is just precious.
And yay, I get to post after the update. You go, Simone. I think you’re right about the field trip. Or she just enjoys being contrary. Look out!
My daughter was born recently at 36 weeks and spent 9 days in the NICU with jaundice. She did well at the breast, well at the bottle and then she had a few of those blue episodes. Then, not to be accused of predictability, she just sort of stopped (which is what the neonatologist told us would happen but I didn’t believe her even though I am a speech pathologist and I specialize in swallowing!).
The bottles are much faster and NICU’s tend to just have one kind of nipple. Some women have a strong let-down so a baby will do great on a bottle but struggle a little at the breast… but they all seem to get over it and it seems Simone got that memo!
I predict the supplemental feedings will be short-lived.
Yea! She’s gorgeous. My near-term girl was dozing in my lap as I watch the video and gave a little shout-out moan back to Simone’s creaky door impression.
My son couldn’t latch on to the breast. The PT in the NICU *insisted* he use wide-mouth nipples to avoid nipple confusion — the Playtex really hard to manipulate kind. We took him home when he could nipple for 24 hours, he started losing weight, feeding was a nightmare, tried everything… and then went to the softer, small, preemie bottle nipples. Wide nipples were impossible for him because of high palate and low tone. I clung to it because “they said this was the right thing.” Bleh.
All this is to say: They have their ways, Simone has hers, you have yours. Last two count the most. :) If she’s gaining weight, who cares?
Yay!!! I’m so glad she aced the swallow study.
It took the janitor three hours to clean me up off the floor after I melted at that smile!!!
She is so adorable for such a tricky little wench. Scored a field trip for sure!
The smile is seriously devastating. Glad that everything sucks literally, rather than figuratively. Go, Simone!
ENCORE!! ENCORE!!!
Damn she’s cute!!!
I too read this post and thought supplemental feeding system. If a bottle is really necessary, I’ve had good luck with the Avent ones. You could also try googling “Boobie Bottle” to find the (don’t laugh) breast shaped bottle that several of my friends swear by. Hey, how often does one get a chance to legitimately Google “Boobie Bottle”?
Good luck to you!
I also wonder about using a slow flow nipple. Even at a very experienced university hospital NICU, I had to suggest that to the doctors and lactation consultant. They hadn’t thought of it.
I also am a bit mystified by the mention (again!) of a G-tube. My daughter had one because she couldn’t swallow when she was discharged. It’s a fairly serious surgical procedure…seems like a NG tube, if a tube is needed at all, would be a better short-term solution. Very annoying, but doesn’t involve an invasive surgery.
To the above posters, I had a 26 week old and I’m pretty sure the supplemental/bottle thing are NICU rules, and not so easy to fight. It’s been a couple years, but I seem to remember that they want to be sure the baby can feed by bottle JUST IN CASE the breast doesn’t work out and Neonatologists are pretty stubborn on supplementing so long as the baby is below a certain weight. They are not just going to say “Well, go ahead and we hope it works out”.
Simone is absolutely GORGEOUS!!
Like you need more advice… but I have a full term (37 weeks), who had reflux and just would not suck on my boob w/o a nipple shield (still won’t, 13 monhts old… yeah, I know) She also had odd issues with swallowing while on bottles and while not that severe, were similar. For us it came down to nipple type. Nuk orthodontic (favorite of NICU), but the wide mouth variety. She liked gettin her face in it I guess. Nuk bottles contain BPA, but Green to Grow bottles work with the nipples. They had me test some sealing discs for their bottles, so I have some extras I would be more than willing to “shower” you with, if you want to try. (I could even drop them off someplace anonymous, since I’m local) Since preemie feeding stuffs need to be sterilized, making sure you have a non BPA bottles is really important, since high heat is a factor in leeching.
I agree that the NICU team isn’t going to just say “Oh, she likes your boob. You’re good! Go home.” like someone else mentioned. They want to know that she can take a bottle if needed, especially after the struggles she’s had just to get this far.
I’m as shocked as others are though at them mentiong a frigging G-tube AGAIN! For the love of pete! Are they just determined to have her model one or what? For a couple of supplemental feeds a day? That makes no sense to me. Then again, I’ve only had 4 preemies and had 3 of them in the NICU so I wouldn’t know what the hell I’m talking about either ;). My-now 5 month old- was in the NICU in Dec, and her ped said that as long as she was going to the breast then to not worry. Unfortunately we had nursing issues so I ended up just pumping for awhile and giving it to her that way. her ped wanted the ebm fortified though, so I did. And her weight gain went from “eh.. okay I guess” to “really, REALLY good”. She’s on just the Enfacare now(I stopped pumping when I had some health issues pop up) and has turned into quite the chunky little thing.
That video was entirely too precious. all of the little baby noises! Mine is already outgrowing them! My son(almost 4) was in here and was convinced that it was his baby sister on the screen and made me play it 5 times in a row until I kicked him the hell out of my room.
Congrats on your beautiful girl. I’m so proud of her and happy for you that she’s doing so much better!
Her smile brought tears to my eyes… just beautiful. And she’s plumping up so nicely.
So happy for you all!
I’ve been lurking for the past few months but just couldn’t keep quiet now. That girl is positively CHUBBY! Deliciously squeezably chubby! You have some amazing breast milk, I must say. What a change from her first pictures. I can’t see any preemie-ness left at all! I could watch that video about twenty times, I swear. How do you ever tear yourself away from staring at her??
Oh my, I never comment, but always read. That video is too much cuteness. I can’t take it. yummy.
Gigi
Ah, so cute. I have watched the video at least ten times. I love the double chin. She is growing so much bigger everyday!
Hi, I am not sure if this has been brought up and I am out the door and haven’t searched the comments but why couldn’t you use an SNS to feed the formula stuff. It could be done all with the breast that way. They are usually used for supply problems but why not use it to stay away from needing a bottle?
http://www.medelabreastfeedingus.com/products/breastfeeding-devices/52/starter-supplemental-nursing-system-sns
Just a thought.
Good luck mama.
She is SOOOO adorable.
I have to say that’s a priceless smile.
I’m also going to say that they need to stop mentioning that freakin’ g-tube. I swear, they slap those things on every third kid that comes by. Mine had a g-tube put in at four weeks! He wasn’t premature, but they did section me three weeks early. Technically, the kid was like a week old. By the time he was two months old, we were done with it. I felt like an ass putting my child through unneccessary surgery. We still thicken now (personally, i don’t like rice b/c I think it’s rough on an underdeveloped digestive system. We use Simply Thick which is wonderful if kind of frightening at first), but his OT thinks that it’s probably not neccessary now.
I like the comment someone said about a tighter nipple. Those hospital nipples are pretty gushy–she might just be getting too much milk in one gulp.
Cute! Cute! Cute! I love your daughter. those little noises are the best! All she needs is a couple of coconut shells to make the sound of a galloping horse and she has the market cornered on neonatal sound effects.
I used to think it was so funny when my son got the hiccups when he was in utero. After he was born, he’d hiccup and then look around accusingly as if to say, “hey! Who’s making that noise? Can’t you see I’m trying to sleep?”
Babies are the best. You’re going to have such fun with that little one.
♥♥♥♥
OMG her SMILE!!! Way to rock the swallow study, sweet girl!
And OMG she’s getting chubby! I have tears in my eyes!!
wheeeeeee! so glad to read the update. go simone go!
OK, listen to me — DO NOT have a G tube put in! There are a million things you can try before you go that route, i am serious — it would be a huge mistake in this situation! Second, I STRONGLY suggest you look into a product called Simply Thick. It is miraculous. Rice Cereal is difficult to use, hard to mix correctly, can cause worse reflux, etc. Other thickening products are very difficult as well. We used Simply Thick for almost a year with our difficult to feed and refluxy preemie, and it saved our sanity! It’s a gel, mixes easily, can be mixed and stored like regular formula, and is not hard on their bodies. The only problem is that it adds a bit of volume with no calories, so you have to mix your high-calorie formula a bit higher to compensate. No big deal. Medicaid will cover it, if you qualify, which you should.
Please email me — I’ve emailed you before about my micro-preemie background with my 25 weeker, Isaac. I would love to talk you through our experiences!
Erin
emyersc at uark dot edu
I don’t know if others have mentioned it, but I’ve seen special bottles for premies that has a smaller tip and a small kinda…drip area thing. UGH. Google time for me.
I don’t have anything to say except for she is CUTE. But you knew that already.
Ok, I feel like a small penis in a very big vagina commenting here anymore. Sigh. Poor me, lost in your popularity.
What adorable noises! I’m becoming *that* silly woman cooing over a cute baby as soon as I venture over here to gaze upon Simone.
Also, seriously, I know you’re busy and all, what with the baby and this fabulous writing (you are killing me with your brilliance lately), but I need you to email me an answer to my Simone-related questions. Preferably before the kid is going to Prom.
Hi…I don’t usually comment here, but had to on this topic. I found your blog via preemie blog moms, have my own 23 weeker, and happen to be a level III NICU nurse.
My daughter came home breastfeeding ONLY. She also sucked at eating bottles. Fortifying bottles is nice, but absolutely not neccessary. Even if all she can do now is breastfeed, I promise you that it will not last forever. My daughter took about 4-6 weeks after coming home to really get the hang of bottles.
See if they’ll let you essentially move into the hospital to do all of her feedings by breast. If you guys do that (for 24-48 hours) and she continues to gain weight, then everyone should be happy!
And, just so you know, my never fortified breast milk fed baby caught up to her real age quicker than anyone expected (she’s now 21 months, and 26 lbs). Your body knows that it’s feeding a preemie, and the fat content of your hind milk is probably between 28-35 calories/oz. Your body is an amazing machine…trust it to do its job.
I hope that helps. I’m so glad that Simone continues to do so well. You guys are going to be home before you know it!
She is positively PLUMP. I wasn’t expecting that… what a beautiful surprise! I agree w/comments from Eliza about pumping out the first milk and feeding on hindmilk… what a great idea!
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