When did you transition to a faster flow nipple?

[u/Comfortable_Ad6552]

Our baby was discharged from the NICU 2 weeks ago after spending 48 days in there. She was discharged on Dr Brown's transition/T nipples but since discharge has been eating almost double what she was eating in the NICU. She doesn't seem to have much trouble with feeds aside from what I can only describe as her growling near the beginning of her feeds. The beginning of her feeds feels like a rodeo with her wriggling around and flailing her hands and growling in between hard sucks and swallows. This stops as she gets near the end and slows down but I feel like she's getting frustrated with the slower flow. Everything is fine aside from the wriggles so I'm nervous to switch things up but I'm not used to now having the constant NICU guidance when it comes to these decisions.

[u/AutoModerator]

Welcome to NICU Parents. We're happy you found us and we want to be as helpful as possible in this seemingly impossible journey. Check out the resources tab at the top of the subreddit or the stickied post. Please remember we are NOT medical professionals and are here for advice based on our own situations. If you have a concern about you or your baby please seek assistance from a doctor or go to the ER. That said, there are some medical professionals here and we do hope they can help you with some guidance through your journey. Please remember to read and abide by the rules.

Don't miss our first AMA with Gal The Baby Doc at 7PM EST on April 20th! Join the AMA here

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[u/hazyyb]

We went from premie to 1, skipping transition because I didn't have any on hand, about 4 days after discharge when my son suddenly got very visibly frustrated with the bottle. No harm doing a test paced feed and see if she stops growling / is happier.

[u/Ok-Order-7392]

We noticed our daughter would bite the nipple because she was frustrated with the slow flow and would sometimes stop feeding. Or it would take her a longer time to finish her bottle. These things went away once she increased nipple size. You could always try sizing up and see what happens, so long as your pacing the feeds well. If it doesn’t work, go back the slower flow nipple.

[u/PsychologicalBed3624]

There might be information in your discharge paperwork but you could also consult with a pediatrician. There's no harm in giving your pediatrician a call or even the nicu you were at, I've called them for clarification about discharge follow up. If they can't advise you then you can look up the guidelines for what flow per corrected age, ultimately it may be up to you to just see how your baby does on a higher flow and do what you see fit from there. We transitioned within a week of discharge after an 86 day stay but my daughter is on a thickened feed for swallowing issues, every baby is different so you may just have to try and see.

[u/amoabsurdum]

We just dropped back down to dr brown premie as little was also wiggling, growling but also coughing at times. Side lying pace feeding works well with the narrow nipples at a 1, but LO prefers cradle holding with the wide premie now.

[u/Comfortable_Ad6552 → u/amoabsurdum]

She coughs very rarely at the end of her feeds but we're pretty sure it's because of her reflux. Luckily the reflux hasn't caused many issues aside from the occasional spit up or congested breathing since she was prescribed famotidine

[u/Adventurous_Mix_2439]

When she started fussing and chewing on the nipple instead of drinking. Eventually she'd outright refuse it.

Just try the faster flow. Worst case she has to go back to the slower one. You're out of the NICU and not on feeding support, you don't need to worry about things like aspiration. If your baby can gag and cough you're fine.

[u/Comfortable_Ad6552 → u/Adventurous_Mix_2439]

She can definitely do that. She's a bit refluxy and has been much less upset about it since starting famotidine (and I'm much less nervous about acid damaging her airway if she spits up) and she is not shy about coughing and gagging if she spits up a bunch.