Establishing breastfeeding in NICU – the ups and downs

Guest Blog by Charlotte Abbott – posted as part of our feeding a premature baby awareness week (12th – 18th January 2015)

My second son was born unexpectedly at 28w in December 2013 via a very emergency section, 15 hours later I was finally allowed to visit my beautiful tiny little boy, and the expressing began as soon as I returned to my room.

My eldest son had also been in SCBU so thankfully I knew how to hand express, It seemed to take the best part of an hour to get less than 1ml, and I then somehow managed to drop this first syringe on the floor, which was devastating, So I started again. I stayed in hospital for 4 nights and by the time I left I’d progressed from the 1ml syringes to using a pump.

While in NICU, I ensured that every time I visited the hospital I used their pump once, as it was so much easier and quicker than the pump the hospital lent me. As our eldest son was at home it was hard to divide our time, so most of the time I expressed at home. I will never forget the endless washing up, the cold wet pump from the cold water steriliser, and sitting in the lounge in the middle of the night looking through photos of my baby as I pumped.

As my son got bigger and older I was encouraged by the NICU staff to put him to the breast, nobody expected him to do much as he was so premature, but there was no harm in trying, he’d have a go, and fall asleep because of the effort, but it felt brilliant trying.

After nearly 5 weeks in one hospital, our son moved to our local hospital so that we could try to establish breastfeeding. Despite being 5 minutes away, every time I had arranged to go in and try and feed him, he’d either been fed, or his feed moved, and because there were also more staff caring for him, there was no consistency, one nurse would say I couldn’t try and feed him because his tube feed was due, whereas others encouraged me to try, it was absolutely infuriating and it felt like everything was against us!

Due to my overabundance of milk, I looked into donating milk as the staff on the unit seemed annoyed that my milk was taking up so much freezer space. Even though the milk bank don’t normally accept donations while a baby is still in a unit, they did, and I felt brilliant to be able to help other babies who needed it. However, the second time they collected it, one of the nurses gave them everything she could find despite it being labelled. I was so upset as it included some of the first bottles of colostrum I’d expressed and which I’d planned to take home once discharged.

Our rooming in experience was utterly traumatising, we went from 3 hourly tube feeds to trying to breastfeed at every feed, it was sort of working, but he started to get frustrated and I knew he wasn’t quite getting the hang of it. I had asked one of the nurses to cup feed him so I could try again when he was less distressed and hungry but I was told by the nurse that she didn’t like using them, and another told me that tube feeding him at this point was abuse – I hadn’t asked to tube feed him, I just wanted some support, but all they wanted to do was get me to use nipple shields. Having previously had an awful experience of these I really didn’t want to, but nobody seemed to want to help me, they simply wanted to get him feeding somehow so we could be discharged.

Although getting my son home was obviously more important, it was so frustrating that when I needed it most, breastfeeding support was unavailable, the hospital had an amazing lactation consultant, but she couldn’t be there 24 hours a day! Reluctantly we used them and our son came home, despite not really being able to feed properly. However as he was on gaviscon and other meds I needed to express to give him these in a cup. However my frustration at using shields took over and within a week I was expressing exclusively and he was being fed by bottle.

My day revolved around expressing every three hours, which mostly worked fine, but as my freezer stash had been given away, the pressure was enormous, and not having enough time to eat or drink properly my supply really suffered. It got so bad that on some occasions I had to stay up and keep pumping to ensure I had enough for the next feed, not daring to sleep in case there wouldn’t be enough. I tried power pumping, ate oats, drank fennel tea, and took fenugreek and domperidone to try and increase my supply, which gradually started to work, but I knew I needed to be breastfeeding as it was too stressful!

Thankfully I was able to meet up with the hospital lactation consultant, she reaffirmed that I didn’t need nipple shields that our positioning etc. was perfect, but despite all her help it just wasn’t working for some reason. We had an appointment with a consultant to determine if tongue tie was a factor, but this was discounted, so she recommended Cranial Osteopathy. It was like magic, I couldn’t explain what he did, but as far as I’m concerned it was a miracle! All of a sudden my son could breastfeed. We didn’t rush into it because I wanted to make sure he was feeding properly before I stopped expressing, but we gradually replaced expressed milk for me feeding him. A few weeks later that was it, no more expressing!

Since we got to grips with it, we haven’t looked back, yes I could do without being the sole parent responsible overnight, especially when you have a baby who won’t sleep for more than a couple of hours, but a year ago he was in a NICU, and as much as I would love a proper night’s sleep, I know that when I’m no longer feeding him I will really miss those beautiful cuddles in the dark when he falls asleep in my arms or on my shoulder which make it all worth it.