# Nursing a prem baby - dietary help



## kyles (May 29, 2009)

My baby was born at 27 weeks gestation. His consultant has requested that I express with a view to nursing, which I am happy to do.

He has asked me to eat healthily but....to aim for 3000 calories a day!!!!! His reasoning is this - a normal woman needs 2000 a nursing woman needs 2500 but preemies have specific dietary needs, mainly more fat, so 3000 calories is desirable.

He has said no crisps/chips, but chocolate is fine 

Trouble is I have been eating 1500 calories for so long I am really struggling. I have very little appetitie for anything other than fruit and veggies, even bread and other carb rich foods are not appealing to me at all.

Help!!!!


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## luvs (May 29, 2009)

maybe try ensure plus. it's nutritionally sound, 360 calories a bottle & doesn't bloat you with fullness or stuff like that. also, i must say it tastes pretty okay!

also, benecalorie. you mix that with other drinks.http://www.google.com/aclk?sa=L&ai=...d=2646519578&ds_e_matchtype=search&ds_url_v=2


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## bethzaring (May 29, 2009)

do you like ice cream? 
add butter and sour cream to mashed potatoes
cheese sauce on veggies
sweetened whipped cream with fruit
ever had spinach dip?  I think it has loads of fat, like cream cheese and mayo
I'll keep thinking..


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## Alix (May 29, 2009)

Kylie, is he ONLY getting your expressed milk? If he is getting any supplement at all then you can likely just add a few more calories to your diet. Keep in mind you need to stay healthy too and too many extra calories might not be in YOUR best interests. Do you have a dietician that could assess this? Your angel's consultant is thinking primarily of him, but a dietician could likely balance things a bit better for you both so you won't compromise your own health and cholesterol levels.


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## linicx (May 29, 2009)

Years ago nursing mothers were told to drink beer to increase milk production. I am not sure it is good for baby.


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## kadesma (May 29, 2009)

Kyles, listen to Alix, she is right on..Go to a dietitian and ask for help..Over doing the carbs and calories is not really going to add that much for your baby..You need to be on your toes and in good health...Please listen to Alix.
kadesma


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## kyles (May 30, 2009)

Um this is England!!!!  Ha Ha !!! You can't see a dietician here unless you have a mega serious health problem!!! I did double check Joseph's consultants advice with my own general practitioner and the obstetric registrar, who confirmed that it is correct advice for prem babies nutrition. They confirmed I can't see a dietician!!!! You don't even get your own ob/gy here. I've seen 20 different ones in four weeks!!!!!

The 2500 calories is standard advice in the UK and what the government recommends, so it really is not an issue. I can understand the reasoning for the 3000 but I think I will only hit that on occasional days. Joseph is on supplementary feeding as well as breast milk, but the total parental nutrition is being reduced all the time, and he should be totally breast fed by the end of next week....woo hoo My milk is being stored, I think I have about 100 60 ml bottles in storage. Its important that the milk contains a good proportion of fat, otherwise he'll have to go on formula and I DO NOT WANT THIS AT ALL!!!!! Breast feeding is really important to me.

I am pretty nutritionally aware, so I don't think cholesterol will be an issue, I just need to find ways to top up each meal. I have been hitting 2000 - 2500 most days, and have already lost about 20 pounds in 3 weeks!!!! It's all fluid rather than fat I think!

I think adding cream and full fat dairy to everything isn't the way to go. I need to add more protein and good carbs, its just hard because I am still only 3 weeks post op and don't have a lot of appetite.

Luvs, we don't have those supplements here!!!! England is rubbish!


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## bethzaring (May 30, 2009)

well, how do you feel about beans?!  they are prefect high quality protein and good carbs...


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## Alix (May 30, 2009)

Holy crap Kylie, I had no idea it was so hard to see a dietician. I have two friends who are dieticians. I'll be seeing one of them on Tuesday so I will ask her for some specifics for your diet then. In the meantime a couple of little bits of info for you. The "fore milk" is the first stuff that leaves your body (like you couldn't guess that huh?) and it is higher in proteins and lower in fat. The "hindmilk" is the stuff that has a higher fat content. I believe its usually something like 2oz where it changes formulation a bit. The other bit (and I'm sure you know all this stuff already) is to be sure you sleep well. Your body produces prolactin while you sleep so its really crucial to sleep regularly when nursing. (Tell that to a colicky baby!!) Look for a support message board that deals with nursing issues, I know they are out there, and I know they have just a wealth of info for you. Nursing is tricky at first and he might not go for it at all. Keep the faith though and keep expressing. The important piece is that he gets your milk not so much HOW he gets it. (It sure makes life easier if its direct though!)

I think my suggestion for you would be to snack a bit on things like peanut butter and apples or crackers and cheese. That way you up your fat intake and you do it with proteins that will be good for him. "Good" fat if you will. Upping your dairy intake is a great idea too but I think rather than adding sour cream etc you could easily just switch from 1% or 2% milk to whole milk. Add cream to your tea instead of milk. Small adjustments but ones that might really help. Good luck and I'll post what my friend suggests on Tuesday.


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## ErikC (May 30, 2009)

I think avocados are high in fat too, but no cholesterol. But I agree with those who say you should get whatever professional advice you can. Sorry to hear about the health care situation there...I think we Canadians take our system for granted sometimes.


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## Katie H (May 30, 2009)

First, congratulations on your little one.  You've embarked on one of the most challenging and most rewarding adventures of your life.

I breastfed all my children and found great help and information from the La Leche League, here's a UK link for them.  Perhaps there's a group near to you.


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## Alix (May 30, 2009)

ErikC said:


> I think avocados are high in fat too, but no cholesterol. But I agree with those who say you should get whatever professional advice you can. Sorry to hear about the health care situation there...I think we Canadians take our system for granted sometimes.



Very true Erik! 

I'll keep forwarding my info to you Kylie.


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## kyles (May 31, 2009)

At the moment, I find La Leche and NCT (national childbirth trust - of which I am a member) a bit difficult to deal with, as I am not breastfeeding exactly, he is in an incubator and being fed through a tube in his mouth. The long line should be coming out today and total parental nutrition stopped.

I rang the La Leche league in the beginning for support and their advice nearly stopped me expressing altogether, they said I should be aiming for every two hours! I had enough breast milk to feed a small third world village, and engorged breasts. I'm now doing every 4 hours during the day and dropping a feed at night. I can always express more often if I need to. I already have loads in storage.

I've had to find my own way for the moment. I actually feel quite alone, all the other mums in the unit are formula feeding and none of their babies are as critical as Joseph. Every midwife, doctor and nurse says different things. Joe is getting excellent care, but I've had to resort to the internet to find out what I should be eating - its not very fair.

On the dietician thing, you can only see one here for an acute phase of a chronic condition, or a new condition eg newly diagnosed diabetic. Private dieticians don't exist up here in the north!

I have had very good healthcare herethough, I wouldn't dare criticise. I was hours away from death. I got experimental treatment most hospitals in the UK don't pay for. And I have my son!

I just need to find my sanity!!!!


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## Katie H (May 31, 2009)

Omigosh, kyles.  By all means, express as much as you can and store it for your son.  Sorry that La Leche was not so helpful.

The best thing you can do, from personal experience, is to express and save.  There's nothing better for your baby than your own milk.

Hang in there, darlin', things will improve.  Just cuddle your beautiful child.  It will all work out.  Sometimes it takes TIME.

I just wish I could give your a great big hug.


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## Alix (May 31, 2009)

Kylie, Katie is spot on. You'll get where you need to be, it just all takes some time. And Erik and I weren't bashing the UK system, rather we were just commenting about our own. Its easy to find a dietician here, or any other professional you might need to see. We have wait lists in some areas, but you can get whatever you want whenever you want it. 

Have you switched from expressing to nursing directly yet? Hes so preemie you might have issues with the latch. Don't be too discouraged, just keep doing what you are doing and keep trying. La Leche might be helpful there (do you have lactation consultants in the hospital?) and we are always here to help as we can.


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## Constance (May 31, 2009)

I drank two beers a night when I was nursing, and it certainly did not hurt my baby. 
I ate lots of eggs, cheese and dairy, including 4 big glasses of milk a day. Besides your 3 regular meals, eat morning, afternoon and bedtime snacks. Jello with fruit, cottage cheese or puddings make good snacks...with a glass of milk, of course. 
Eat good whole grain breads and pastas and a variety of vegetables. 

Good luck, and remember, this is the natural way. There is nothing better for your baby than mother's milk.


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## mudbug (May 31, 2009)

good to see you back here, kylie.  Joseph is lovely.  I don't have any good advice for you like Alix and Katie, but just keep your own health up and it is sure to affect Little Sweetie Pie.


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## bethzaring (Jun 1, 2009)

what about olives? do you like them? I thought of you yesterday as I was making this salad, is one from GB....I went heavy on the olives..I also doubled the peas..

Black Eye Pea Salad

2 cups black eye peas
4 oz. white onion - diced
6 oz. red bell peppers - diced
4 oz. black olives - chopped
1 tbsp oregano
4 oz. parsley
(great with cilantro too)

For the dressing:
6 oz. EVOO
Zest of half a lime
4 oz. white vinegar
1 tsp chopped garlic
1 tbsp sugar
salt and pepper to taste

Combine first 6 ingredients in a large bowl.
Mix dressing in a separate bowl and pour over salad.
Adjust with salt and pepper to taste.

This is even better the second day.


We all are pulling for you and Joseph!


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## MomsKitchenAndStuff (Jun 1, 2009)

I always check Kelly Mom for all my mommy questions...she has pretty much EVERYTHING. Here is her page about nursing a preemie...I hope you find some good info there


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## kyles (Jun 3, 2009)

He's still only 30 weeks, so is tube feeding. I am pushing to start breast feeding as soon as possible. He probably won't be able to latch til 34 weeks, but they like to start asap. Unfortunately he is still in an incubator, but he is now in High Dependency rather than Intensive Care so hopefully soon I will have more access. I don't think the unit are used to people who are determined to breast feed!

We'll get there, but its so hard. I hate having to go to hospital twice a day, and its not really set up for parents at all!


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