Breastfeeding and Prematurity

One thing I always knew I wanted to do as a Mother was to be able to breastfeed my babies. I managed easily with my first born and he fed from me for 9 months– until he developed far too many teeth and learnt to bite! This time around, it was a no-brainer, breastfeed again and hopefully for longer. There were for 2 reasons for this, 1 because I loved the connection that breastfeeding brought me and my baby and 2 it’s free and so convenient.

What I didn’t envisage happening was for this baby to be born prematurely. After a few problems in my pregnancy, my little chap decided to make his entrance into the world at just 32 weeks gestation. Being born so early usually results in your baby being taken immediately to the neonatal unit for specialist care and we were no exception. Even though I had been given steroids to develop his lungs 2 weeks previously, he still couldn’t breathe on his own and needed assistance. He weighed just 4lb 2oz and was a tiny bundle of skin and bones. My first instincts as a Mother were to hold him and feed him but because of his age he needed to be inside an incubator with his feeds administered via a tube, provided by me through expressing.

I knew I would find this tough. I hadn’t managed to express with Jake no matter how much I sat and tried. I used an electric one, a manual one, I tried hand expressing but nothing ever came off. Being told that I would need to express regularly throughout the day and night to provide for William felt like a huge pressure on me but I had to get on and give it a go.

If you have never expressed before it can be excruciating. I never experienced pain whilst feeding Jake and never understood that toe-curling comment so many Mums would make. I felt it through expressing though! Oh, the pulling, the sensation, even the noise of the pump gives it the feeling that you are doing something so unnatural, I hated it all. Plus it’s a huge battle at the start. I managed to get off a measly 0.5ml in one expressing session and I just felt as though I was letting my baby down by not providing him with what he needed. But perseverance does prevail and as the days passed I gradually began to produce more for him.

 

However, from the moment he was born I did go on about feeding him directly from my breast. As a preemie Mum, I was told straight away that babies do not develop their suckle reflex until 35 weeks gestation. I listened, of course I did, but being the type of person I am I still wanted to try for myself. For me it was a maternal pull that I found very hard to ignore and I was so worried that my milk supply wouldn’t sustain itself, that the baby wouldn’t want to latch on to me after weeks of tube feeds and having to move onto formula when it wasn’t something that I wanted. 

I asked a few times in the first couple of days and I was always met with a smile or a ‘one-day’ response. That was until I pointed out to the nurses that he was suckling on his dummy as they fed him via his tube. For me, this was a positive sign that he did have that instinct and it gave me some leverage to ask again. This time I asked the right nurse and she agreed that it was worth a shot!

Now, nothing can prepare you for the size of your prem baby’s mouth compared to the size of your nipple! As soon as I saw them close together I did wonder if I had been silly for pushing the nurses on it but if you are in a similar situation don’t let it put you off. I had to see what he could do and he didn’t disappoint.

 

breastfeeding my prem baby for the first time

 

He knew what to do and as soon as he managed to get his mouth wide enough he popped my nipple in and began to feed… probably one of the best feelings I’ve had. Here I was thinking I wouldn’t be able to feed my own baby for 3 weeks and 2/3 days in he was proving how much a prem baby can actually do. And this is the thing, I do wonder if we underestimate these little ones a bit. Just because they are younger doesn’t mean that instinct isn’t there earlier than research suggests. No, they won’t have the energy to breastfeed for every meal and they may not suckle for long so will require a top-up via their tube, but there is no reason not to give it a go.

Breastfeeding isn’t only about delivering a feed. It is about developing a bond between Mother and baby and providing the antibodies they need. It can be very hard to establish that bond when your baby is in an incubator for most of the day and touch/kangaroo care is limited. The closeness that breastfeeding brings is indescribable. As for the antibodies, breast milk alters what it provides dependant on how your baby is that day. Their saliva carries ‘messages’ to the breast and your body adapts the milk to give your baby what it needs. Clever eh?! 

Of course, our journey hasn’t all been rainbows and magical breastmilk. I’ve had to work on getting him used to where the nipple is actually located! His latch varied depending on how much had gone on in NICU that day and there were times when he just didn’t have the energy to do it so I didn’t push it. My breasts also had no clue on how much milk to produce so at one stage they went into overdrive and I was close to developing mastitis. Since being home, colic and reflux have taken hold (as if he needed anything else going on in his little body!) and when he is in pain whilst feeding, my god, I have never felt anything like it. For a few days my nipples were red and sore and completely battered and my boobs felt as though they couldn’t manage another intensive comfort feed session. We did battle through and I am learning that he may not be as good at feeding as Jake was but he is giving it a damn good go and as long as he is thriving I know it has all been worth it. 

 

Em xx

 

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