Category Archives: Feeding in NICU

Expressing for Baby Noah in Neonatal Intensive Care

Our baby boy, Noah was born on 10th November 2015 weighing 3lb 4oz at 29 weeks. It was a complete shock having our baby born prematurely after a normal pregnancy.


I always planned to breastfeed my baby, but when your baby is born early, it seems everything is taken out of your hands. You have to put every bit of faith into the wonderful Doctors and Nursing staff looking after your precious baby. One thing that I could do to help right from the beginning was express my milk. I remember being delighted when I expressed 0.3ml for the first time. I was very strict to myself, making sure Noah could have these tiny amounts of colostrum every hour. The more I expressed, the more I produced. The nurses were brilliant at giving me encouragement and I felt I was doing something to help our little Noah. 


When Noah was 10 days old I was able to have skin to skin for the first time. Each day I would have kangaroo (skin to skin) cuddles with Noah, I loved having him tucked into my top, often, I used to express the most milk after having these cuddles. Leaving Noah in hospital was one of the hardest things I have ever done, broke my heart each day when I had to say good night to him, wishing I could just take him home. Once we had left the hospital each night, I would try and think positively about the next day and being able to see him again.


During Noah’s stay in hospital, I made sure I expressed 8-9 times per day, throughout the day and night. Setting my alarm twice at night. There is something very lonely about pumping on your own especially in the middle of the night when all you wish for is your baby to be with you. I used to ring the hospital for an update, my heart used to pound until they would tell me Noah was ok and if he wasn’t, I felt so tense, then I would start to worry that the tension would reduce my milk production. Some nights, I couldn’t express anything because I was tense, I would cuddle a warm wheat bag in bed along with Noah’s cuddly toy and blanket to try and get the milk production working again. These things always helped. I put a lot of pressure on myself but I was determined to make it work. 


Noah first breastfed at 33 weeks, he fed for a few minutes and I remember being so surprised that my tiny little boy had the strength to be able to feed. I was thrilled. Of course, for some time after this, some days he would feed and others he couldn’t as he didn’t have the energy and was tube fed instead. Noah’s feeding tube stayed in up until we ‘roomed in’ prior to discharge where we began to establish breastfeeding.

Altogether, I expressed my milk for 8 weeks until the day Noah came home. It was hard work, at the beginning my pump was like my best friend, I wouldn’t go anywhere without it. Towards the end I hated it, I just wanted my baby to be able to breastfeed. I put every ounce of energy and determination into making it work and I am pleased to say I have been able to breastfeed my baby exclusively and we are still going today! 


It’s been one of the biggest challenges of my life having a premature baby and breastfeeding him with the constant worries surrounding weight gain and reflux. There have been many days/ weeks where I have felt completely out of my depth wondering how I was going to make this happen, but I did and I am so proud of our little Noah. 
With thanks to Sarah Weatherhead for sharing her story as part of our ‘Feeding a baby born too soon’ 2017 series 9-15th January. 


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My day as a NICU Mummy

Guest post by Becca Hilton, Mum of Max, as Part of World Prematurity Month 2016

Waking up from what feels like a continuous bad dream, the house is filled with silence yet I have a crib next to my bed and bottles on the side.

I switch on the television for some company and begin to express milk ready to take with me to the hospital. Doing this brings me some sort of comfort and helps me to feel closer to my son.

I arrive at the hospital, my tummy fills with butterflies and I cannot race quickly enough to the door. Lovely nurses buzz me in and welcome me with a smile and a chirpy, “hello mummy”! My heart races as I walk over to him, so perfect laying there calm but with a maze of wires surrounding him. I gaze over at his chart to check his weight and to see which nurse will be caring for him today. I wash my hands and warm them up ready to let my son know that I am there.

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I stroke his ear and watch a small smirk raise from the side of his mouth, he knows his mummy is with him. The nurses always encourage me to be ‘hands on’ with him and help do the baby duties whilst I am there. This makes me feel so happy; I feel like I am finally bonding with him, I now feel like his mummy.

First things first its temperature check time, then nappy change (I can never cover him in time and he wees all over himself ha-ha, typical boy!) As I change his nappy, rearranging the wires around him I can’t help but think how delicate hi is and it’s amazing that something so small can be so strong and fight so hard, a true hero.

Sounds of beeps fill the room and alarms flash and glow bright, what a surreal situation, I can’t believe I’m here. I look around and see familiar faces, some of joy and some of heartache, who would have known that some of them have become friends for life and we share a bond like not many people do.

It’s feed time! I get excited at the thought of helping. At this point max is too small to be bottle or breast fed so he is fed through a tube. I watch the milk slowly go down as I hold the syringe, he lays there so peaceful, oblivious to the chaos around him, my little sleeping beauty.

How exciting, it’s time for Max’s first bath! I’m giddy with excitement. I start to undress Max and the nurse wraps him up in his towel, its hair wash time first. He wriggles as the water drips down the side of his face. We dry his hair and lower him into the water; being careful to keep the wires over the side of the bath. Max kicks his legs out and makes a small slash, tears fill my eyes, I couldn’t feel more proud to be his mum. I wrap the towel around him and embrace him in my arms, at this point I don’t want to let him go.

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All cosy and snug, he keeps warm in his little nest that’s in the incubator. He stretches his legs out and lets out a little sigh and a yawn, he looks so content. I sit back and look around and think what an amazing place this actually is. If it wasn’t for the love, care and support that we have received as a family I don’t know what we would do.

Looking at the clock, it’s nearly time to say goodbye, dread fills my entire being. One last cuddle, I smell his hair and stroke his cheek and whisper I love you. I put him back and say god bless and goodbye, mummy will see you in the morning!

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As I walk to the carpark to be picked up I feel sad and withdrawn, but this is normal right? I don’t know any different. But with reassurance from my husband he reminds me that when the time is right he will be home and he’s in the best place for now.

Early night for me, dreaming of what tomorrow will bring? We will have to wait and see as it’s all a mystery, a day in the life of a NICU mummy. No two days are the same, there may be ups and downs, but they are all part of your journey – be proud! I know I am.

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If you’d like to share a story to raise awareness through World Prematurity Month, please email Catriona at smallestthings@yahoo.com

Daisy Daisy

Daisy Daisy – my friend at university used to call me that, because she said I looked like the comedian Daisy Donovan and had similar facial expressions. As a care free 20 year old I had no idea that one day I’d be called that again, instead because I’d be milking myself several times a day.

I’d had no breastfeeding versus formula feeding ideals when I was pregnant. I felt quite relaxed about the whole feeding thing. As a formula fed baby myself I knew that it wasn’t this big evil devil food that it is made out to be – I had turned out OK! But I was quite open to giving breastfeeding a go, although I’d had a strict word with myself to never get stressed over it. I’d had so many friends who had been truly miserable during those first few weeks, battling with breastfeeding and an inconsolable baby. I was not going to be like that. I was not going to be stressing about milk production. Not me. No way. And then I had a premature baby.

Emma NICU

Less than an hour after my 29 weeker was born, having been resuscitated and rushed off to the neonatal unit, me laying on the theatre table amongst this aftermath of chaos, my poor sliced up womb now out on my belly being sewn back together, the neonatal sister burst in; ‘Michelle, were you planning to breastfeed? We need to know for the care plan.’ My husband and I just looked at each other in bewilderment, each looking to the other for the answer to the question. It was my husband that answered, ‘Erm, we think we were going to do a bit of both?’ I had no idea at that point the direction that my breastfeeding journey was heading, instead I had images of a tiny baby suckling at my breast the next day!

It starts with the hand expressing. I was shown this technique by about three different midwives until I was shown the correct technique. I managed to get my first lot of colostrum on the second night, 0.5ml if I remember rightly. I felt like a superstar. I still at that point, had no idea about the pump. I had signed the consent for donor milk, which you don’t even think twice about, because by this point you know how vital it is that your tiny baby has breast milk. It is only now I sit and think about the donor milk that I feel upset that my baby had another woman’s milk in her first few days of life. That was certainly not part of my ‘relaxed about feeding’ plan. I carried on with the hand expressing for two more days when the neonatal sister mentioned the pump. Because I was so tired from all the medication I was taking, as well as my three litre blood loss, she said she would show me the following day.

The following day we arrived to discover that Emma had moved from ITU to HDU. Although just two doors down it was like a different world. Different nurses, different babies, different noises and beeps. I felt immediately on edge, as we had just started to settle in to NICU life, and now our routine had changed. I should have felt elated really, Emma wasn’t sick enough for ITU! But now it was all different. I know now that the sullen and stressed nurse who showed me the pump was brand new herself. It was five minutes of ‘this is how this goes together, use this setting, turn it up as far as you can manage.’ And that was it. I just didn’t know better at the time, I really thought that was it, so I just got on with it. I will never ‘blame’ the nurse for it, but I really think that was one of the main reasons why I always struggled. My milk had ‘come in’ that day. I think I got about 10 or 20 mls. I was told that was brilliant, and so I just carried on. It was so painful that first few times, feeling my wounded insides contracting with every pump, I’d often be in tears in the express room.

Expressing every 3 hours, 8 times a day and during the night is really, really hard work. In the early days I didn’t really take notice of the amounts, I just expressed, almost in a robotic fashion. It wasn’t until I was out of that initial NICU ‘two week fog’ that I started to take notice of what I was actually doing, and also what everyone else was doing, and that’s when the ‘express stress’ began.

The stress starts when you notice the amounts other mums are getting, and then you compare it to your piddly amount in the bottom of the smallest pot. I saw mums with the super duper large pots full to the brim. I also noticed the freezer, jam packed full of milk from the other mums. Why wasn’t I getting these amounts? ‘Because you are anaemic. Are you eating enough? Are you drinking enough? Are you stressed?’ Of course I was stressed, I delivered my baby at 29 weeks, nearly lost her, and now we have to exist in this neonatal unit………Of course I was stressed, and not eating enough, and not drinking enough. I was also hugely jealous of my husband, who got much longer cuddles and much longer quality time with Emma, while I was always rushing off to the expressing room.

I started carrying a huge bottle of water around everywhere I went, eating flapjack like it was going out of fashion, smelling like curry due to my intake of fenugreek tablets, and turned the pump up as far as I could possibly manage. Bad move. Doing that results in horrendously cracked and painful nipples, and eventually, mastitis. This meant that when we started encouraging Emma to latch, it was eye wateringly painful for me. I looked at picture of her while expressing, I expressed by the incubator, I sniffed her blanket like I was told to, I ate a box of ‘lactation cookies’ sent to me by my lovely friend, but nothing worked.

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Twice a week we would get so excited for weigh day, but that excitement then always turned in to anxiety for me. Emma was doing so well, gaining weight like a trooper, but with every weigh day came an increase in milk requirements, meaning I needed to express more and more, and I was still struggling. My ‘personal best’ at this point was around 50mL, I was still on the small pot, and it was really upsetting me. My friends talked of a ‘let down’, of feeling full and empty, but I felt none of these things, and therefore I felt like I must have been doing something wrong.

We continued with the breastfeeding as well as the expressing. Emma did so well breastfeeding and I was starting to enjoy it, until she decided one day to stop breathing while feeding from me – enough to put a halt to the most successful of breast feeding journeys! I decided then to just concentrate on expressing what I could, and we introduced Emma to taking the expressed milk from a bottle. She took to it like a dream, and I managed to just about keep up with her milk requirements. I would still put her to the breast occasionally, and I loved it, but was petrified she would stop breathing again.

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Once home, and having battled with mastitis twice, nearly resulting in an admission for intravenous antibiotics, I decided to stop expressing. At the time I was excited to stop and feel freedom from the pump, but once stopped I felt really sad. I missed seeing her latched on to me, her little face looking up to mine. But I knew that I couldn’t be ill again and look after her, especially now my husband was returning to work. She had breast milk exclusively for nearly 8 weeks, and although I was sad to stop, it is more than I ever imagined I would do when I was pregnant, and for that I’m pretty proud of myself.

This expressing and breastfeeding battle is one felt by many mums of premature babies. Your body isn’t expecting to start producing milk so soon, that’s the first battle. And then you don’t feel all those lovely baby hormones they tell you about, as you have very limited skin to skin time with your tiny baby, and they very rarely latch straight away, so you don’t get that natural increase in milk production. You are stressed, confused, bewildered, guilt ridden, tired, and terrified that your baby may not survive. Is it any wonder that so many have difficulties expressing?

I look back and wish I hadn’t felt so stressed over expressing, as it seemed to dominate most of my time and thinking during the days in NICU. I also look back and laugh a little, knowing that I went against everything I had felt so strongly about, but how can any best laid plans come to fruition when your baby decides to make an early appearance?!

 

From one NICU mum to another…

Hello, I’m Francesca, and my little boy is Harry-this is our NICU feeding story:

Harry was born at 28w4d whilst I was on holiday in France, weighing in at 2lb13oz. He had no sucking reflex due to his prematurity, so was enteral tube fed via his mouth on a continuous pump (standard for prems in France) for the first few weeks of his life. When we were transferred to a UK hospital, when he was transferred to a NG tube and was syringe fed every few hours.

harry NICU

During the tube feeding, I expressed using the hospital pumps. This was something I hadn’t really thought about, and something I had to “learn on the job” thanks to language barriers, and a slightly different approach than nurses here would have! In addition to my milk, during our time in France he was also fed on donated breastmilk. This was because the hospital would not accept milk I’d expressed outside of the hospital. Unfortunately due to Harry’s prematurity, he was in a high-dependency hospital over an hour from where I was staying, so there were points I was expressing at night whilst away from Harry, and sadly had to dispose of the milk- very demoralising!

Harry was NG fed until he was ready to be fully established on breastfeeding, which was around five weeks before his due date. We had three full days of breastfeeding at the neonatal unit, to ensure he had completely got the hang of feeding – only then was his NG tube removed. Although I was exclusively breastfeeding, our neonatal department wanted to ensure he could also take a bottle, to ensure we could administer medications that were mixed into expressed milk – we found this less stressful for Harry, rather than syringe administration of medication.

Francesca and Harry

Unfortunately, due to further medical complications, Harry needed to be transferred solely onto a premature baby formula about 6 weeks after leaving neonatal, so our breastfeeding finished rather abruptly. I was quite upset by this and did worry about our bonding, but thanks to all the skin-to-skin care we’d had during our neonatal journey, this was not a problem.

Due to the traumatic birth we had, I suffered PTSD (Post Traumatic Stress Disorder), and have since undergone CBT (Cognitive Behavioural Therapy) and surgery, but thankfully Harry will have no recollection of his interesting start to life. But we will explain his incredible journey to him when he’s older, as we are so proud of our little fighter that we nearly lost. Harry is now a happy, healthy 18 month baby, who loves his food and is completely “normal” in his feeding.

Harry - Feeding

NICU and the neonatal journey is a tough one, and phrases as “you’re lucky you got to meet your baby early” do not help! But from one Mum who has come out of the other side, please hang in there. Be kind to yourself, and make time to recharge wherever you can. You are doing a fantastic job, and you’ve got a strength that keeps you going, that you didn’t even know you possess!

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If you’d like to share your NICU story with The Smallest Things, just drop us a line! Contact Catriona at e. smallestthings@yahoo.com