Bottles & Nipples for a preemie on formula & cereal

[NewGrandma]

My grandson is 8 weeks old and home from the NICU. He was born 12 weeks premature and is now a little over 5 pounds. He is breastfed for half of his feedings & bottle fed NeoSure with rice cereal for the other half. Cereal has been added to his formula for reflux. My daughter is having difficulty finding a bottle/nipple that will work for him with the formula/cereal combination. Is there anyone that has had to feed their baby the same thing and found a certain nipple that worked the best? We have tried cutting the nipples(per the hospitals suggestion) but there is no consistency there. The flow is sometimes too slow/difficult for him & sometimes too fast. If you have had any experience with this please tell us. We would love your suggestions!

NewGrandma

[shyviolet]

I work in a NICU and we use premie or cross-cut nipples when feeding our babies a formula with rice cereal, such as Enfamil AR. Sometimes we need to cut the nipple too. The premie nipples have a faster flow rate so that premies do not over-exert while sucking, and may have to be bought online. Cross-cut nipples can be bought at a local store, I know for sure Gerber and Avent make them (Avent's is called variable flow). Maybe you could call the NICU and ask one of the nurses if they could give you some nipples to try, so you don't spend alot of money on something that doesn't work. It's very important to find a nipple that will allow him to feed easily, because if a premie takes longer than 30-40 min to feed, they are usually burning more calories than they are taking in, so I'm sure the nurses from your NICU or the neonatologist would be more than happy to help you.

[Rachels]

Please get a second opinion about the cereal. That is outdated advice. Current research doesn't show any benefit at all to using cereal with a reflux baby, and the digestive tract of a tiny baby is simply not ready to handle grains and solids.

-Rachel
Mom to Abigail Rose
5/18/02


"When you know better, you do better."
Maya Angelou

http://www.gynosaur.com/assets/ribbons/ribbon_sapphire_24m.gif Two years and counting!

[C99]

I can't help with the nipples because, honestly, I am surprised that they have a preemie on cereal/formula for reflux. My son was 5 weeks premature and developed reflux within a month of coming home from the hospital. My pediatrician put him on Zantac and he did much better with it. He was exclusively breastfed, however. Although the NICU and the ped's office would have had me supplement with formula, independent research proved that breastmilk is really the best form of food for babies and especially so for preemies. I don't think they gain weight as fast as formula-fed or formula-supplemented babies, but my son is now consistenly in the 25th-50th percentile for his (unadjusted) age and I am happy with that as that is where I think he should be.

[tinkerbell1217]

I didn't have a preemie, but I used Gerber cross cuts and they worked as long as I adjusted them a little. Meaning cut a tiny bit more. Lots of luck!!

BTW, I don't think a NICU or doc would give "outdated" advice to a new mom of a preemie. There has to be a good reason for what they told her to do.

[stillplayswithbarbies]

Doctors give outdated advice all the time. Not all doctors keep up on the current info.

It's important to be an educated consumer.

...Karen
DS Jake Feb 91, DD Logan Mar 03
http://members.aol.com/khowe14494/superpower.gif http://members.aol.com/khowe14494/borntobebreastfed2.gif

[Rachels]

Agreed. My baby has reflux, and I researched like crazy. Some of the docs we worked with were well aware that using cereal with a new baby is likely to cause more problems than it helps, and others hadn't read an article on that since med school. I'd never assume all doctors are infallible, and to entrust everything about my child's health to that asumption. Some are bound to be wrong some of the time. This one is one example.

-Rachel
Mom to Abigail Rose
5/18/02


"When you know better, you do better."
Maya Angelou

http://www.gynosaur.com/assets/ribbons/ribbon_sapphire_24m.gif Two years and counting!

[C99]

They do it all the time. They also give advice or give orders that aren't necessarily the best for the baby/mother.

[sntm]

There was actually a study that showed a 10 year lag time between moderately important medical advances and "universal" implementation. Lag time due to time to publication, time for corroborating studies, time for education of doctors, time for education of support staff, time for changes to the infrastructure of medical practice, time for information to move from academic centers to community centers, etc.

Just came from a grand rounds give by a distraught pulmonologist who is tearing his hair out because this MAJOR multicenter, very famous, several-year-old trial which was the first to show an intervention that reduced the mortality of ARDS still hasn't led to changes in practice even at the centers that participated in the study! And one of our chief residents was still arguing it based on one anecdote!

edited for spelling error
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shannon
not-even-pregnant-yet-overachiever
trying-to-conceive :)
PREGNANT! EDD 6/9/03
mama to Jack 6/6/03
http://www.gynosaur.com/assets/ribbons/ribbon_gold_12m.gif[/img][/url]
Breastfeeding 16 months and counting

[tarahsolazy]

I agree the rice business is antiquated stuff, but we still thicken feeds for micro-preemies, but usually to help them feed, ie if they have swallowing immaturity, rather than for reflux. And, we use Thick-It, and inert substance with no grain in it. I agree that talking to the ped and the neo involved should help. Or, hey, just stop the cereal, and maybe the Neosure (preemie formula) and see how he does.