I need a breast pump! A mother's need to provide for her early baby

Guest blog by Mikaila Hopley – posted as part of our feeding a premature baby awareness week (12th – 18th January 2015)

Giving birth 29 weeks into my first pregnancy meant that nearly everything was taken out of my control, well the things you can control during pregnancy and birth anyway; planning maternity leave, maybe a baby shower, a decorated nursery, (any baby things at all for that matter), neatly packed hospital bags, a birth plan that my husband would also be aware of, which probably most importantly of all would include planning to have that first skin-to-skin and breastfeed after delivery. Giving birth prematurely to my son that night sent all of the above crashing out the window and suddenly all that actually mattered was that he’d be ok.

My baby, once stabilised after a difficult birth was taken immediately to NICU, and I was taken to a room away from other mums and their newborns. A midwife asked me how I had wanted to feed my baby…. I wanted to breastfeed.

The midwife told me I would need to express some milk as soon as possible as it’s supply and demand. She told me not to expect too much considering my baby was so early and I felt like she didn’t hold much hope. She wheeled in an electric breast pump, sterile kit and syringes; it was so far removed from how I’d imagined the beautiful moment of skin-to-skin and that first feed after delivery. She briefly explained what I needed to do and left me and my husband to it. I was not told how to hand express or how massaging my breast would help to stimulate the milk to flow, I wish I had been or remembered that section of the pregnancy book I’d been reading, but at the time I didn’t know any different so I just got on with it. I attached myself to this pump and watched in horror (along with my husband) as my breast got painfully sucked down a cone over and over again, slowly that liquid gold colostrum began to trickle out and I was able to draw it into a syringe and label it ready to be taken to my baby. Similar to childbirth I forgot about that initial pain and loss of dignity and instead felt proud of what I’d just produced. I would later learn that colostrum from mothers of premature babies is even more potent with antibodies and nutrition for our more vulnerable babies, our bodies can be truly incredible. Finally my body was doing something it naturally should, this was relief as I’d started to feel let down by it – why hadn’t it kept my baby safe inside for longer.

The next morning I woke after only a couple of hours sleep and got ready to see my baby. I expressed a bit more and took it with me. When I got there though, I was told that my baby wasn’t ready to have milk. All his nutrition was  currently being given via TPN (total parenteral nutrition) through a long line into his veins. My milk wouldn’t go to waste though, as it could be refrigerated or frozen ready to use when he was stronger. I felt expressing my milk was all I could do for my baby and even that wasn’t needed right now. He wasn’t strong enough to be held but I could touch him and let him know I was there. I sat there staring at him stunned for a while, a nurse suggested I get some rest whilst ward rounds took place so I returned to my room. Another midwife came to check on me and said I would be discharged before midday. She was very matter of fact when she told me “you can’t do anything for your baby at the moment, it’s no good you being here”. I know now that she was right to a certain extent but I’d never felt more useless and unworthy of a bed space. I’d given birth in quite traumatic circumstances less then 12 hours previously and was now being separated again, further away from my baby.

My husband arrived and the anxiety about leaving our baby began to build. I became quite irrational, “we need to get to Mothercare, I need a breast pump” I insisted! (I wish somebody had told me that I could borrow or hire one from the hospital or even that I could use their pumps and sterilising facilitiles). My husband told me that I needed to rest and to go home, “NO! I need a breast pump!” I became so worried that my milk supply would disappear. When we arrived at mothercare I hobbled in holding onto my husband. I didn’t think about or look at the pregnant women (that still should have been me) or other new mums with their newborns – I was on a mission for a breast pump.

Once home I began to read as much as I could about expressing and premature babies whilst my husband set up our newly purchased electric breast pump and steriliser. It was at this point that my husband became my rock with expressing, I’m not sure I could have done it for the following two months whilst our little boy remained in hospital, without his support. The ritual of meticulous cleaning, (I was so paranoid of germs making my baby sicker), sterilising and setting up before and after each time you express is hard. Every 2-3 hours and through the night is harder still – in my opinion this role was as important as the expressing itself.

We quickly settled into a routine of expressing and being at the hospital. My fear of not making enough milk was short lived, I was one of the lucky ones as my milk flowed and I was filling the fridge and freezer at home and on the unit. This was despite the stress of learning over the next few days that our baby had a bleed on his brain, suspected sepsis, apnea and bradychardia, jaundice and then an infection requiring him to be in isolation as well as everything else that having a premature baby means… inluding leaving him every night. Each day I would take one of his blankets home to smell and would look at his picture to help me express through the night until the next day.

Gradually our baby was able to have my milk, the tiny amounts he received via his feeding tube slowly increased and he became stronger. He was strong enough to hold and we were able to have precious kangaroo care and skin-to-skin. Our tiny boys instincts also came into play as he sniffed and licked my chest for milk during skin-to-skin time. I was finally able to try him at the breast 6 weeks later when he had mastered the art of breathing, sucking and swallowing at the same time – he was doing it, we were doing it! I cried tears of happiness, it had all been worth it.

Breastfeeding soon became established and the nurses and doctors began to trust me that he was feeding well. It’s a hard transition as the nurses, doctors and yourself included are so concerned by exactly how many feeds your baby is having and precisely how many millilitres is going into that tiny person. I was encouraged to think about formula top ups to be sure he was getting enough as he was a little slow to gain weight but I worried he’d become confused using a bottle and would reject my breast. After all the work and what I’d been doing for the last 7 weeks I wasn’t prepared to risk that.

It wasn’t completely plain sailing, as the week we ‘roomed in’ at the hospital to fully establish breastfeeding and prepare for home our little boy had a few set backs. He began to struggle to regulate his temperature, became anaemic nearly requiring a blood transfusion and needed to go back into an incubator briefly. But thankfully he managed to overcome it all and eventually we were discharged home 8 weeks after I’d given birth, breastfeeding exclusively.

It wasn’t always easy as his reflux worsened once home, requiring more medication and what felt like never ending feeds but, successful enough for me to end up breastfeeding for over two and a half years. He didn’t want to stop and looking back I guess I wasn’t ready to either.

… later this week Mikaila will be sharing the rest of her story; her experiences of feeding her second child born at 34 weeks, her determination and confidence.