Hellobee

After exclusively pumping for my first born, a real hater of the breast, I had high hopes for nursing the second. Then to our surprise baby number two arrived ten weeks early. NICU stays are probably the reason I’ve heard cited most frequently for breastfeeding not working out, so with the little confidence I had in my breasts to begin with, I was now full of doubt. This however, is a story of hope! Hope for moms of preemies and NICU babies with hopes of breastfeeding! As it turns out, breastfeeding was still a possibility for our Iris, despite a 6 week stay in the NICU.

I’m not going to pretend to possess some sort of secret for how to make this work; rather I’d just like to share our experience for the sake of anyone who finds themselves in this position and is looking for some positivity.

One of my first visitors in our hospital room after being wheeled back from surgery was the lactation consultant. She set us up with a hospital grade breast pump immediately and I started pumping every 2-3 hours right away. My husband was there to help me set things up and wash the pump pieces while my mobility was still limited. I don’t think it is possible to stick to a pumping routine without his support. The first two days I pumped small amounts of colostrum, and then my milk came in, as is typical. After the first day I was engorged and uncomfortable; my nipples felt raw and sore. I realized I was using flanges that were a size too small and after the lactation consultant brought me a bigger set, the milk started flowing and my nipples stopped hurting.

Iris was not able to receive milk for the first few days so she never had to be supplemented with formula or donor milk. By the time she was ready to eat (through a feeding tube), there was a supply in the freezer for her. I continued the pumping regimen at home and we purchased a deep freezer to store the milk the NICU did not have space for. I will say it again — I was so fortunate to have the support of my family to ensure that I was able to pump around the clock. I spent as much time doing skin to skin care with Iris as was possible, about 3-6 hours a day. A few times this led to “non-nutritive sucking.” If I had just pumped and drained my breasts and she was rooting, I was allowed to put her to breast and let her pacify.

As far as tips go, skin to skin care was probably the biggest factor in increasing my milk supply. I was very fortunate in that department, producing far more than she required. By the time she left the hospital I had a 7 cubic foot freezer filled with breast milk for her in our basement.

Preemies typically start “nippling” around 34 weeks, when their “suck and swallow coordination” is mature enough. Our doctors started her nipple feeds on the bottle, but by the third day I was allowed to start nursing her for one feed a day. To my delight she latched right on and sucked away for 10 minutes straight before passing out on my chest, a joy I never experienced with my first born. At that point she was “nippling” just twice a day, but in the next three days she progressed to nippling every feed, while I was only able to nurse her twice a day. The doctors consider nursing to be more draining for the babies. They claim they use more energy, burn more calories and gain weight more slowly. I do not know if this is true, but with our son at home I was not able to be at the hospital for every feeding anyway.

I found nursing in the hospital nursery to be somewhat challenging. The nurses were supportive of breastfeeding, but it was crowded, privacy dividers had to be brought out, feedings had to be at a particular time, not necessarily when she was most alert or interested, she had to eat within 30 minutes and if she didn’t get enough it threw off her feeding schedule. Suddenly she would occasionally scream and wriggle at the breast from what I assumed was impatience. As it turns out this could have also been due to her reflux. Depending on her mood there were still times she latched right on and nursed peacefully, so I felt confident that in time we would work through this developing bottle preference.

Being still under 5 lbs and pre-term I didn’t want to push her too hard. Even upon discharge the doctors suggested still nursing only twice a day, gradually increasing as she got bigger and stronger. Once we were home it was holiday season, we had family visiting, her apnea monitor made mobility difficult and there was a lot going on. Working on nursing was on pause. I continued to put her to breast with success typically twice a day, with a few attempts rejected. As much as I despise pumping and cleaning bottles, when there was milk available it just felt easier in some moments to feed her the bottle. My supply was dipping down and I worried a little that I wasn’t putting her to breast enough, and I became somewhat lazy with the pumping since there was so much milk in the freezer. Really though, I felt comfortable with alternating between breast and bottle, I felt like that might be the best we could do and I felt good about that.

At that point I was definitely more accustomed to pumping and bottle feeding. Transitioning to full time nursing was as much about my adapting as it was hers. I felt comfortable being able to see the amount she was consuming. Feedings were faster. Then right around her due date, once she reached full term, we reached the point where putting her to breast suddenly felt easier than giving her a bottle. I started nursing every feed and didn’t have to pump.

At first I still gave her bottles at night. This was probably the most surprising part of our nursing journey, since my initial motivation was to be able to simplify the night time routine by nursing at least then. Except that nursing took longer. She’d fall asleep on the breast and then wake back up and want to eat more when I moved her, the cycle would never end and I wouldn’t get any sleep. I liked having bottles ready so that my husband and I could take turns. Finally after about another week nursing at night became easier than bottle feeding at night. I no longer have to pump and wash bottles all day! There’s a freezer full of milk if we’re in a situation where my husband needs to be the one to feed her.

Now I get to experience the joys of raw nipples due to a not always wide enough latch, and the occasional clogged milk duct! Though she is almost three months old, she is only supposed to be two weeks, so I feel pretty confident that we’ll get that all sorted out in time. I have yet to breastfeed her in public, besides the doctors office, so that will be our next adventure! (I am currently deliberating on the merits of an official nursing cover.)

Here’s where I join the chorus of “each baby is different!” Not being able to nurse my first didn’t mean I would not be able to nurse my second. Being a very low birth weight premature baby and starting on the bottle did not mean my baby would not nurse. My two different newborns gave me two very different experiences, without any difference from my end.

I’d love to hear the breastfeeding experiences of other preemie and NICU parents! What worked or didn’t work for you?