Breastfeeding a Premature Baby

Laura Duncan - 28 Feb 17

This post first appeared on Like Real Life. You can read it and more using the link below:

http://www.likereallifeblog.com/2015/06/13/guest-post-on-breastfeeding-a-premature-baby/

You know how when you get pregnant you just assume everything will be OK? Well I did. Until I was told it wasn’t going to be. I had to have my baby at a hospital in London. I wasn’t planning on that. I wanted plinky plonky whale music, a water birth, all natural. That sort of didn’t happen. My baby was born eight weeks early. He was born unable to swallow. He had osephagal atresia, a condition where the baby’s osephagus and stomach don’t join together. Once he had arrived and was safely tucked into his new bed in the NICU (neonatal intensive care unit), the midwife came in to see me, still in the labour suite. “Time to start expressing,” she called cheerfully. I was not feeling particularly cheerful. I had a very easy labour, around two hours, no complications, but I sort of cheated, my baby was only 3 pounds! Still, I was exhausted, having given birth at 3:34am (why is it that you never forget the time?). I was given some syringes to express into and the midwife sat with me to explain how to hand express.

I squeezed my very sore breasts, feeling contractions each time I did. I welled up. Nothing was coming out. My husband held my hand. I thought about punching him. Some time later I tried again. And again. I was getting colostrum by this point and each time I filled a syringe, I labelled it up and waddled over to the NICU so that the nurses could put it in the freezer. I could not hold my baby. I could not change his nappy or dress him. But I could sit and squish out milk to feed him. That I could do. And I did it, hoping that one day I could actually breast feed him. He was fed my milk by a tube into his tummy, starting at just 1ml every 3 hours if you can imagine an amount that small.

A couple of days later, one of the nurses suggested I try the electric pump. That was bound to hurt, right? It is fair to say that hospital pumps are stronger than home pumps. It felt about 100 times stronger! I thought it was going to actually take my nipple off! However, I used to quite enjoy waddling into the expressing room, plugging myself in and having a good natter with the other mums. There were mums of twins, young mums, old mums, mums of all shapes and sizes. When you have a premature baby you blame yourself. You start to analyse all the things you did or didn’t do during your pregnancy. Then when you realise it can happen to anyone you start to relax a little.

Premature babies need breast milk and either you gave them yours or they had donor breast milk. Nurses would remind you to express and there was an expressing room in the NICU so that we didn’t need to be too far away from our babies. Mums whose milk didn’t come in were offered drugs to stimulate their milk production. It wasn’t a discussion, you just did it. I never even questioned it. If you gave birth at 25, 26, 27 weeks you would be very lucky if it came in. At 32 weeks, my baby was what they called a late pre-term so my milk came through (fortunately) and I got pretty used to just popping a boob out to express.

When he was just two weeks old the nurses suggested I try “sham” feeding him. This meant putting him onto an empty breast and letting him suck, the tube up his nose sucking out any milk he had swallowed. A nurse sat with me and showed me how to hold him. Poor love, his head was smaller than my breast. She squashed him into my chest and he grabbed onto me with both little fists. He latched on and sucked and I couldn’t believe it, this tiny little baby was feeding!!

From then on I sham fed three times a day, every day. He was the only baby with his condition and the only breast feeding (sort of) baby in the NICU. I fed him while he had his tube feed so he learnt to associate feeling full with suckling. Various consultants debated the sham feeding. Suppose he aspirated (fluid went into his lungs)? Suppose he choked? I carried on regardless. I was going to bond with this baby.  My friends and family were all used to the sight of me, boob out, plugged into the mains. At night, in the charity house I lived in, my friend used to get up at 3am with me while I expressed, chatting to me about everything and nothing.

He had many operations during his five month “London holiday”. Unfortunately, due to the number of times he was ventilated (three in six weeks) he completely went off breast feeding. He wouldn’t even have a dummy. I despaired, desperate to feed this baby, to continue our bond. They sent a breastfeeding specialist, one of the nurses on the unit who had been trained to help mummies and babies to feed. She sat with me and got me to squeeze some milk onto my finger. I then let him lick the milk from my finger. Once he was comfortable doing this, I gradually moved him closer to me until he had latched on. Each time he would suck until the milk came, cry and pull away. I just didn’t know what to do.

I ran out of time. He had his “join” surgery to connect his osephagus and stomach and so the breast feeding went on hold, but the expressing continued. A week after the surgery I heard the words I’d been waiting to hear for the last five months. I was told I could start feeding him! Hooray! Except he wasn’t interested. Still tube fed while he recovered, he wasn’t keen on having to work for his lunch. Humph. For three weeks I tried and tried. He wouldn’t have a bottle either. There were tears and tantrums and all sorts but still no breast feeding. I was just so keen to re build our bond but didn’t know how.

I also had another fear. Breastfeeding in public. Whilst I had been very happy to feed in hospital, I was terrified of doing it in the real world. People understood what I was doing in hospital and celebrated it. Out in the real world I would face disapproving glares surely? My friends rallied around, offering words of support and reassurance. On our first outing out of the hospital, once we had left London and moved to a local hospital, Mum took me to a cafe and I sat, feeling nervous. I attached my little teeny six month baby to my chest and he settled in for about five minutes. There was no vomit, no shrieking, no glaring from anyone. I can do this, I thought. If he is willing, then I can be too.

We left the local hospital with him tube fed for 12 hours and doing very little breast feeding for the other 12. When we got home, his feeding tube blocked (we were terrified!) And so he breast fed. In fact he couldn’t get enough of it. When it was replaced we were told to just keep the tube for emergencies. He pulled it out three days later. I was nearly sick on the carpet. Since then he has had two best mates. They don’t do very much but he seems to really like hanging out with them. A lot. Day and night. In fact at the start it was every hour and a half, day and night, just like a new born. It took a while to become confident in breast feeding in public, I still feel that feeling of worry, that someone will complain, or glare, because they don’t understand, they don’t know what we have been through. I won’t pretend it was easy. It was not. I had mastitis. A lot. I got fed up of the pump. I cried at my baby pushing me away. But looking at my boy happily feeding at last, I am glad we got there.

I had a completely different idea about breast feeding before having my baby. I just thought you attached the baby and off they went. When I realised what we would be facing I was terrified. I thought I would never be able to breastfeed him. I thought he would be tube fed until he was two or three. If it had not been for the nurses and the mummies that I laughed with, joked with, cried with along the way it would have been so much harder.

We still have a way to go with him. He has moved onto solids, but due to the surgery he struggles with lumps and so we are very used to choking, vomits and being covered in his food. It will be some time before he can eat the foods that other 12 month old babies eat but he is very determined and is the hungriest baby ever. And he wants whatever you are eating. And now I have a different fight on my hands. With just six weeks until I go back to work I’ve got to wean him off. Having spent so long trying to get him to feed it seems mean. If I could just detach them I would. But I can’t. So after spending the last four months breast feeding, I’ve now got to get him used to bottles. And that is a whole different fight. But we’ll get there.

Laura Duncan

I'm 33 years old and live in Kent with my husband and two year old son. I love crafting, creating and writing. I am a Duke of Edinburgh's Award Leader and an Early Years professional. You can follow my adventures at www.luckystardesigns.co.uk.

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