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09/06/2012, 11:50 PM
DS (32 wks) is now 35 and ready to come home. He feeds beautifully, is putting on masses of weight and has been independent of monitoring for over a week. There is a catch though, he can't take a bottle terribly well. In the land of SCN the babies must take " suck" feeds before they are let out, and for the most past this is generally a combo of breast and bottle. I wont be using bottles at home anyway, but the midwife in level 1 is refusing to recommend his release. She will only Release him if I stay on site a week to make sure he is ok before she recommends he leaves. 1 week? It's OTT to me.
I just want him home!
Is this normal? Am I crazy for thinking that being able to feed successfully 5/7 feeds is a pretty good indication he can feed? ( the 2 feeds have been tube feeds over night)
10/06/2012, 12:03 AM
A week does seem over the top although I don't know your DS' circumstances. Yes, we do want babies going home on all suck feeds, be it breast, bottle or both. But usually (IME), one they can do that, we keep mum in as a boarder for a 24 hour period and then they are set to go.
Is it only 1 midwife you are dealing with? Is there not a paed involved in these decisions? Can you talk to someone else and find out what the normal policies are?
IN any case, congratulations on your little one and I hope you have him home with you soon! I had one in SCN for 16 days and that was bad enough (although did trigger a career switch for me!). hugs!!
10/06/2012, 12:03 AM
As hard as it is for you OP, you just want your dear little baby home with you. If he's still requiring those tube feeds he's not ready. They can go backwards so quickly when they
are so little. Its the midwifes job to make sure he's ready and that means tolerating all sucking feeds all the time. Have you asked other midwives in the unit about his readiness ?
It's common practice to have mum stay over for a while just before going home. It helps to ensure he gets the best possible start at home and you don't end up back in hospital with a sick bub.
10/06/2012, 12:18 AM
Congratulations on your new DS and it's wonderful news that he is putting on weight and doing so well.
My understanding is that the suck reflex doesn't come in until around 34-35wks so that may be why he is not strong in this area, yet. It will come.
My DS (29wks) was transferred to a smaller local hospital (after much persuasion) which allowed me to spend more time trying to establish feeding. I had to BF him for 48 hours and have him put on weight in that time before I could bring him home. The first 48 hours he actually lost weight and I cried! Then after that he put on weight and I was allowed to take him home at 36wks.
Hang in there. I know it's hard, but is is important for him to continually put on weight through suckling, especially as they are so tiny and frail.
10/06/2012, 08:58 AM
Congratulations on the birth of your DS! Having a bubba in SCN is a difficult time, and I have to be honest there are still the odd occasions when I remember how sick and little DS was and get teary (DS is now 29mths). For such little people, they have amazing strength though and they grow so quickly!
Regarding your DS's feeds: I'd assume the nurses are attempting bottle feeds when you're not there and if DS ends up tube feeding unfortunately it's because for one reason or another, the little fella isn't feeding from the bottle. My DS was in a similar situation and in our case, once DS really had his suck feeds from the breast down pat, nurses and I realised he was a baby who just disliked bottles. It still took 24 hours of me being there for every feed (with no bed for me as it was occupied but you know they had a lounge lol) before they considered discharging him. Then once discharge was considered, the attitude of the nurses really lightened and it happened within 48hours.
The nurses may also be talking to you in expected time of stay in hospital rather than definite time "you must be here for a week" as it really can be back and forth between feeding and not feeding ok (for us, they kept saying another 2 weeks he'll be in until DS had a day of no tube feeding, then it was right if he keeps this up then he'll be home in 48hours). It may be that you're there for 48 hours of DS not tube feeding and then he's discharged.
It is stressful, and worrying and a lot of people don't understand the ache you get from not having your bubba home with you. Hang in there, and good luck! I hope you have your little bubba home with you soon.
p.s. I hope this wasn't too much about me, just wanted to share my experience so you can compare?...
eta: Paeds and nurses explained to me sucking reflex doesn't kick in until 37 weeks (DS came home at age 38wks+2)
10/06/2012, 11:38 AM
Congratulations on the birth of your DS.
What is the hospital policy regarding discharge? Sometimes baby needs to be over 36 wks before discharge and the "policy" may be why the midwife is reluctant for your DS to go home????
The hospital policy where my prems were was that baby must be feeding, gaining weight, regulating body temp, be over 2kg and over 36wks corrected age.
Our DS (33wk1d) was allowed home at 35wks 6d. I was rooming in. He was on straight breastfeeds and gaining weight well but there was a lot of "umming and ahhhing" before we got the ok because of their policy.
FWIW - I had a sign put on my last 2 prem's crib "Strictly no formula or bottles". When it was time to come home for DD (32wker) I had to room-in for 2 nights and she needed to gain weight on straight breastfeeds. She went from 4 breastfeeds/4 NG feeds a day to straight breastfeeds. (She was never able to drink out of a bottle.)
10/06/2012, 01:03 PM
I can understand you wanting your baby to be home but sometimes at that gestation a period of vigorous feeding can be followed by a period of sleepiness and this is the reason most SCN are reluctant to discharge before 37 weeks or before they are sucking well at every feed over a few days.
It will not be the decision of the midwife, you baby's discharge date will be decided by the paediatrician, she is just the messenger IYKWIM.
It really is all about preventing a rebound readmission which is very traumatic.
Perhaps you could ask to speak to the paed and discuss what you'd like to happen to get your baby home?
I don't know your family situation but if there is a chance you can 'live in' for a while and be there to breast feed all feeds I think it would be good idea. If your little fella still gains weight, maintains his temp and blood sugars whilst just on breast milk then I am sure everyone will feel secure that he will continue to do well at home.
Lots of luck and hoping your baby is home soon.
10/06/2012, 02:46 PM
How much does he weigh ?
10/06/2012, 02:55 PM
Firstly, congrats OP.
My 32 weeker was in hospital 4 weeks and 3 days. He only started on round the clock suck feeds 3 days before discharge. That was the first time he had ever had a bottle as they wanted him to have suck feeds over night when I wasn't there. (He was BF during the day with no EBM top ups at that point.) We roomed in on the third night and everything went well so we were free to go!! DS has been exclusively breastfed ever since so nothing was lost. They do need to be sure that prems can handle full suck feeds and gain weight before you go though so hopefully it wont be too much longer. I do know you want to bring your baby home. I've never brought a baby home from hospital with me at my own discharge so I understand!! It wont be much longer though and before long it will all be a distant memory. All the best.
10/06/2012, 04:36 PM
My little guy was 34+5 when he born and was in NICU/SCU for ten days all up. We were in a similar situation - couldn't work out why he was still there when he had met all his milestones. Eventually we were told he needed to be able to consume 70ml in less than 20 mins for at least six consecutive feeds with no top up by tube (this is in Ireland, in case the requirements might be slightly different). Like you, we weren't using bottles at home (he was having ebm in hospital). And like you, I had a nervous breakdown that they weren't letting me take my baby home
When the dr finally said that this was the requirement, I said "there's no point telling me - tell my son!". The dr looked at me like I was some crazy woman and then turned to my son and explained what he needed to do. Later that night, he woke up, pulled off the tape holding his NG tube and then slowly pulled the whole tube out. He then downed every feed in the requisite time and we were able to take him home late the next day.
Hold in there. He just needs to grow a little stronger and then he'll be home with you in no time
10/06/2012, 06:10 PM
The MW last night handed over to the day time MW this morning who was also confused as to the stay over, especially knowing I didn't want to room in. She asked the paed on rounds this morning for a discharge which we were granted.
We are now at home!!!!! Yay, what a joy and my amazing little man I have.
Thanks so much for all your replies, your thoughts and explanations are so much appreciated.
10/06/2012, 09:07 PM
Wonderful news. Congrats again.
10/06/2012, 09:09 PM
Great news...enjoy your little guy!
12/06/2012, 09:11 AM
YAY! I have only just seen this now but congratulations!
Sometimes it is just a matter of standing up for yourself and your little one.
My DD was discharged at 34 weeks on full suck feeds, a record for my Paed and she thrived beautifully, I also refused to room in! Mind you it was at my insistance and refusing to allow the NG tube to be put back in once she pulled it out. I just found that if the nurses were busy at night during feeds, they simply found it easier and quicker to do a tube feed rather than perservere with a bottle feed thus a baby learning nothing.
I hope it all runs smoothly for you from here!
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