Finger-Feeding a Preemie

by Jude Kurokawa, CNM

© 1994 Midwifery Today, Inc. All Rights Reserved.

[Editor's note: This article first appeared in Midwifery Today Issue 29, Spring 1994. Reprinted in Midwifery Today's Breastfeeding Book.]

Master Zacheriah Hawkeye Wilson came home from his six-week hospital stay weighing a lusty 3 pounds, 15 ounces, up from a birth weight of 2 pounds, 13 ounces. He was born 10 weeks early by cesarean, necessitated by my daughter's severe pregnancy-induced hypertension. He was very small but healthy, in spite of his rude entry into the world.

When he came home, he was mostly bottlefed pumped breast milk, with two attempts at breastfeeding per day. The NICU nurses repeatedly reassured my daughter Kari that "Preemies don't get nipple confusion." To that I say a re-sounding "Baloney"! Within a few hours at home, I recognized typical nipple confusion behavior. He would either take three sucks and fall asleep, or would "bob" frantically at the breast while screaming, then fall asleep.

We followed the nursery schedule for the first few days, offering Zach the breast, then cup feeding him the rest—an extremely frustrating experience. Finally, after four days of this, we decided to "cold turkey" him. The lactation consultant suggested he might have a "skin aversion" since he was hurt nearly every time he was touched in his first few weeks. She recommended "wearing him" skin to skin nonstop if Kari was willing, and of course, she was. We stopped all bottles, pacifiers and cupping, and offered the breast at least every two hours. If he had a dry diaper after two to three hours, we "finger fed" him. This was a new trick to me, but it worked like a charm.

For the uninitiated, finger feeding is taping a number 5 French infant feeding tube to the side of the middle finger and inserting the finger into the infant's mouth, pad side up. Attach the feeding tube to a 30 cc syringe with the plunger removed. Fill the syringe with breast milk and let him suck; he is rewarded with every suck. We only had to do this for a few feeds before he got the idea that the same thing works on the breast. I came home from work the next day and there was Kari, staring at Zach at the breast. She looked at me and said, "He's doing it!" We held our breath for two days, afraid it might be just a fluke, but he never slowed down after that. We weighed him every other day, and the first two days his weight stayed the same. Then he began gaining between one-half ounce to an ounce each day. At three months old, he weighed a gigantic 7 pounds, 1 ounce.

I hope the finger feeding technique is as helpful to others as it was to us. I can't give enough thanks to LaLeche League lactation consultant Linda Healow, RN, in Billings, Montana. She was so reassuring and positive. Even though I'm a retired leader myself, it just isn't enough when it is your own "world's greatest grandson."

Jude Kurokawa works full-time at a rural health clinic and does family practice volunteer work at the Indian Health Service in Wolf Point, Montana.

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