Monday, July 30, 2012

Our Story... all about learning to eat those first few weeks

There is a great preemie resource blog out there. If you are interested in checking it out you can do so by clicking here. I was asked by the creators of the blog to write a story about how I taught Isaac to breastfeed. The hope is to inspire other preemie mommies to breastfeed and to let them know that it is possible. I was honored to do it. So I am reposting what I sent to them. If you aren't interested in reading a post about boobs and breastfeeding then please do not continue.

It was tough for me to write about this at first. The whole process of teaching Isaac to breastfed brought back a flood of memories of our NICU experience. It's been almost five months and everything still seems so fresh. Still so... raw. As I began to write about it.... it took be back to hospital room he was in. The sounds. The feelings. The emotions. Still.so.hard.to.think.about! I am grateful for how well he continues to do but man it's hard to look back at those first few weeks.

I also want to say I have nothing against those that choose not to breastfed. There are plenty of mother's who want to breastfeed and can't and there are plenty of women who just don't want to. As long as you are feeding your child thats all that matters. (To some degree. Clearly, I don't think people should feed their infant old ice cream sundaes, pizza or regular cow's milk but I think you get my point.)

When I found out I was pregnant I knew I wanted to breastfeed. The thought of feeding my child any other way never crossed my mind. I even had conversations with a few friends who were also pregnant at the time. They had mentioned their desire to breastfeed as well but also their fear that it just wouldn't work out. That thought never crossed my mind.


While this is a story about my success with breastfeeding a preemie I need to start with sharing a bit of Isaac's birth story with you. My pregnancy was going great. Until the last trimester. Enter high blood pressure, pre-eclampisa and bed rest. Add in a baby that quit growing and you have a 3 pound 4.5 ounce baby born at 35 weeks.


I had a few strikes against me right from the start. First of all, I had to have a c-section. I had no labor at all. The combination of having Isaac early and the c-section confused my body. I mean I was still suppose to be pregnant after all. My body didn't know right away that I had had a baby.
Before Isaac was born they told me if things looked okay we'd be able to try and breastfeed and do skin to skin within the first hour after he was born. Unfortunately he was having problems breathing in his own. So there was no way we could try breastfeeding or do skin to skin. Enter strike two.
Strike three is probably the hardest of them all. Isaac needed a NICU. The hospital we were at didn't have one. So he had to be airlifted to a NICU 1.5 hours away.  I didn't see him for three days.


I started pumping within an hour of Isaac's birth. I continued to pump every 2 hours during the day and every 3-4 hour at night. For the first two days it was all about signaling the body that it was time to produce milk. I didn't get anything from pumping except a few drops every once it awhile. It was very discouraging. At one point I got about half an ounce and I wanted to jump for joy. By the time I was released from the hospital I was probably producing less than an ounce a day. Whatever I managed to get with pumping I would save for Isaac. Pumping was extremely hard to do simply because there was no emotional connection. I was able to hold Isaac once before he was airlifted. Not being able to see my child made things extremely hard. Looking at pictures helped. But it was still hard.


When Isaac and I were reunited it was still to soon for him to try nursing. He was still really little and slept a majority of the time. So I continued to pump. The NICU had a room with a pump so I was able to stay at the hospital as much as possible. We tried to do skin to skin when we could and finally when Isaac was a week old I met with the lactation consultant, LC, for the first time. She helped me with getting him latched and told me what cues and signals that I needed to look for ensure he was sucking and swallowing. I was watching for raised eyebrows and ear wiggles. That's how I knew Isaac was swallowing.


Once we started nursing I wanted to do it all the time but I couldn't. Isaac was still really little and still slept a ton. Nursing was something that really pooped him out. He rarely ever cued that he was hungry so it really was all about going through the motions. Once Isaac was nursing successful with one feeding we increased it to two. We continued to increase the feedings when he did well. It didn't always go well though and it was emotionally draining on those days. Somedays he'd show no interest in nursing at all. Sometimes he'd get latched on but wouldn't do anything but sit there and he wouldn't eat. When he did nurse he's eat for a few minutes and then fall asleep. We kept working at it though and I met with the LC many times. I continued to pump the same amount I was before. Every 2 hours during the day and every 3-4 hours at night. When Isaac nursed I'd pump afterwards.


I'll be honest. Nursing in the NICU kinda sucks. We were put on schedules of when I had to try nursing. Typically they were always on the hour but they wanted me there 30 minutes before just in case Isaac was wanting to eat before. If they wanted me to try nursing at 8am they wanted me there at 7:30 just in case. He had to be awake to eat and sometimes he'd be sleepy. Sometimes he wouldn't wake up, even when we tried to wake him. After every time he was awake and nursed they'd ask me how it went. They'd ask me if I thought he ate enough and if I thought he needed more. I was a first time mom. I had no idea. There was so much pressure. Most of the time they'd give Isaac more milk through a feeding tube. When we were first trying to teach him to nurse they usually give him a few tube feeds in between our nursing sessions. I really just wanted to feed him on demand. I wanted to feed him when he was showing signs of hunger, but it can't be done that way. Not when you have a tiny baby on your hands.


Isaac was released when we were able to successfully nurse a full day. They took his feeding tube out and we (my husband and I) roomed in with Isaac. He was released the next day. Isaac and I continued struggle at home with latching on and the length of nursing but we weren't bound by schedules so it made things a lot easier. When Isaac came home the LC told me to keep up with the pumping after every feeding and then drop a pumping session every few days. I am not sure why they wanted me to do this but as a first time mom I listened. It created an oversupply issue which made nursing even more challenging. I was almost always engorged which would often cause milk to get everywhere whenever Isaac would try to nurse. I did some research and spoke with the LC who told me to stop pumping and then try block feeding. I had to nurse from one side for several hours while leaving the other side alone. Then after 2-3 feedings I nursed from the other side. It was an extremely painful process. But it was corrected after a few days.


Isaac is almost five months old and we still need to use the cross cradle hold because he still needs my support with his head. Sometimes we are able to do the cradle hold but not very often.  A majority of the time he is able to get latched on right away with no issues but it took a long time for us to get to that point. His nursing sessions are never very long. Usually only 10-15 minutes. Sometimes a little longer. And he rarely nurses from both sides. At first I was concerned, especially in the NICU because all the classes and books say 15-20 minutes on one side and 10-15 on the other side. But he was always getting enough. I guess the books and classes are wrong sometimes. It was a long process and there were so many times I wanted throw in the towel. It was really hard but I just couldn't allow myself to do that. Now I look back at everything we went through and I am so proud that we managed to beat every obstacle that came before us.


3 comments:

  1. You are doing great. Nurses have a way of making you worry more than need be. I wanted more than anything to breastfeed, but Sylvia would not do it, after a month of trying, so I just pumped. I'm glad Issac does.

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  2. Hi Jana,

    I remember our visit in NICU and all your concerns with his feedings. He is doing so well and it's all the Momma's Milk he has gotten! He looks fantastic and what a fun story to read and see the outcome of!

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  3. Jana, I am so proud of you for sticking through it! I know the feeling of not even thinking of any other way of feeding, in Molly's first week I dealt with cracked and bleeding nipples and even though it hurt like heck to feed her, never once did the thought cross my mind to just give her a bottle of formula that was sitting in our room, thanks to the pediatrician (ugh!). I didn't have the challenge like you had with Isaac, but I can relate to some degree. I still only feed Molly on one side each feeding now, and I think breastfeeding is full of questions that can't always be answered right away.

    Way to go :)

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