Tag Archives: Expressing

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. 


If you liked reading Sarah’s’ story and would like to help us raise awareness, please use the Facebook and Twitter buttons to SHARE!

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.

breast feed

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.

nicu

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

Feeding – that time of year again!

It’s that time of year again when perhaps our waist bands are feeling a little tighter and when New Year resolutions sounding food and drink are made and broken.

CYXlNzmWcAARASiAnd… it’s that time of year again when The Smallest Things will be discussing all things surrounding feeding a premature baby in NICU. From expressing to NG feeding; mls and hours; suck reflex and breast feeding – we’ll be looking at everything!

Did you know – a baby develops their suck reflex in the womb at around 34 week’s gestation?

So, for babies born before 34 weeks gestation many are feed via a nasogatric (NG) tube (a fine tube passed through the nose and into a baby’s tummy).

Did you know – mothers express for their babies in NICU on a 3 hourly cycle? Neonatal units have ‘expressing rooms’ where mothers gather to pump milk for their babies and sterilise expressing equipment. Some mothers have a plentiful supply of milk, whilst other mothers can find establishing milk supply difficult – often due to the stress and environment of the neonatal unit or recovery following birth trauma.

Expressed milk can be given to babies via their NG tubes and many mothers remember the first time they see their baby having their expressed breast milk.

Did you know – Expressing mothers set their alarm at night to continue expressing on a 3 hourly cycle; getting up throughout the night to feed a baby who is not with them and perhaps they have not yet held.

Establishing feeding – breast, bottle, expressed or formula in neonatal care can be a difficult journey and through our stories and experiences we hope to shine a light on the NICU world and offer hope to those embarking on this journey.

If you have a story to share please contact Catriona at smallestthings@yahoo.com

 

Feeding a baby born too soon

NG tubes

NG tubes

In January the Smallest Things dedicated a week to raising awareness around the realities of feeding a premature baby.

A babies suck reflex develops at roughly 34 weeks gestation, meaning many babies born too soon are not yet able to coordinate the suck and swallow action that is required for them to feed safely. Others are simply too small or not medically stable enough to feed and for some their mothers are not well enough and recovering from the trauma of birth. Babies born too soon are therefore given milk (expressed breast milk, donor milk or formula) through a nasogastric (NG) tube – a fine tube passed through the nose down into their tummies – to establish feeding and to enable them to grow. Feeding becomes an integral part of NICU life and for many is the key to coming home.

Before having their baby some mothers had strong views on how they planned to feed; for others they hadn’t even thought that far ahead – after all they hadn’t anticipated the sudden and early arrival of their little one! I’ve spoken with mums who were sure before birth that they would bottle feed… only to find themselves plugged into an expressing machine on the neonatal unit and well on their way to breastfeeding. Others I know had been sure they would breastfeed and were then devastated when for one reason or another they couldn’t.

The course of establishing feeding in NICU rarely runs smoothly and the Smallest Things are grateful to all the mums who shared their stories to help raise . In her post photo 2Mikaila describes her guilt at continuing to breastfeed her baby despite his slow weight gain. Of how she wondered if he would come home more quickly if she converted to feeding with bottles. Her determination to feed her baby though won through, helped by the added confidence she had gained from it being her second time around.

In Charlotte’s guest blog she describes the frustrations of trying to establish breastfeeding on the unit. Of arriving to feed her baby only to find that he’d already been tube fed. Or arriving to feed her baby only to find that his feed times had been changed. This frustration of poor communication and handover is often mentioned by parents who have spent time in NICU. I remember it well – arriving, breasts full ready to feed, only to find that your baby is fast asleep with the remnants of formula milk in their NG tube. Yes, there is frustration, but there is also heartache too as you head to the mothers room to express your milk when instead you should have been putting your growing baby to your breast.

You can read others in our feeding series here: 30ml Mum | Establishing breastfeeding in NICU: The ups & downs | Second time around | I need a breast pump! A mothers need to provide for her baby | Best Laid Plans |

In our next series of guest posts the Smallest Things will be looking at communication. If you have a story to share please do get in touch. Write to Catriona at e. smallestthings@yahoo.com

30ml Mum

No one had spoken to me about expressing before.

I guess I’d never thought of it before and at 30 weeks pregnant preparing to feed my baby seemed like a long way off.

seeing our son for the first time

seeing our son for the first time

And now here he was; covered in lines and tubes. Monitors beeping and in a pespex box so far removed from me.

My waters had broken with little warning and he’d arrived soon after. The labour was straightforward and I was discharged from the ward. And there he was, in NICU. And there I was, getting ready to go home.

I was exhausted, numb and in shock. We’d spent the afternoon sitting by his side – watching, waiting – taking everything and yet nothing in. The nurse looking after us suggested we went home to get some rest. She knew we had a long road ahead of us. Leaving the unit the breastfeeding nurse caught up with us – had I started expressing she wanted to know. The blank look on my face told her all she needed to know. I was taken into the expressing room. Had I not been so emotionally and physically shattered the site of tubes, machines and buckets of sterilising equipment could have been enough to terrify me. “We’ll just start with a small syringe” she said. That was the image that terrified me until I realised she didn’t mean needles! I was taught how to hand express and produced just a few drops. Then off I went with a brown paper bag full of 1ml syringes and sticky labels, leaving our new born son for the first time.

Express every 3 hours I was told – so sobbing for the baby who was no longer with me I climbed into bed and set my alarm. It was a long night. It was a surreal night. I put on the TV to try to keep me awake as I chased rolling droplets of milk around my boobs, try to catch them into the syringe. It was tricky, almost like some sort of bizarre game! I changed to expressing into a bottle, but the tiny droplets took up such a pitiful amount of space that I reverted back to the trusty syringe.

There’s not much on TV at that time of night and I switched over to news 24. I expected that to be quiet too, but instead I found myself watching rolling news of riots breaking out across London. I knew I was exhausted; I knew I was probably in shock – but really?! My whole world was turning upside down!

NG tubes

NG tubes

Over the next few days I continued to hand express and would proudly present increasing sized syringes of my milk. I would watch as tiny amounts – 1ml / 2ml would be given to our baby through his naso-gastric tube. Day 3 came and I was told it was time for the pump! The machine whirred as it pumped. Your milk should be coming in around now I was told.

10mls, 20mls – sometimes 30mls. It wasn’t enough to keep up with my babies increasing demands. “Don’t focus too much on it”, one nurse told me – stress won’t help your milk come in. Then another nurse would tell me “You need to be producing more, we won’t have enough for your baby.”

Everything revolved around expressing. Was I doing something wrong? Why couldn’t I produce more? Other mums would enter the expressing room and fill bottle after bottle – I couldn’t even get half way.

“Are you producing anymore?” I was constantly asked. My answer was always the same.

“How about expressing by the cot side – that might make you feel closer to your baby”. It had the opposite effect and instead reinforced the distance that there was between me and my baby.

And then came the day I was told there wasn’t enough of my milk left – they would need to top up with donor milk. I was devastated. I had failed.

But then it became a relief. My baby wouldn’t go hungry. He wouldn’t be left without milk. I was producing what I could and would continue to do so, but in some way the pressure slowly lifted. I never produced much. On good days I would get 60mls, occasionally 70mls, but generally my expressing number was 30mls.

first breastfeed

first breastfeed

Breastfeeds were introduced slowly as he grew – giving him a chance to just ‘practice’ to start with. “Putting him to your breast will help with your milk supply,” I was told.

My expressing number stayed at 30ml.

“Domperidone may help” – I stayed at 30ml.

“Are you drinking enough water”, “Are you getting enough rest” (seriously!), “Are you eating well?” (Hospital canteen sandwiches that were grabbed during a quick break from the ward…)

I stayed at 30ml.

Then one day things started to change. I didn’t produced masses, but just enough to see that all NG feeds were from my expressed breast milk with no top ups. It had happened by surprise and although I knew that his demand would go up again, I felt like I’d achieved a small victory in finally meeting his needs.

My victory was short lived. My increasing milk supply was short lived.

The SCBU nurses had watched as my confidence along with my increasing milk supply had grown. They were letting me room-in to establish breastfeeding. We were about to go home. The moses basket was ready and waiting. Then came the worst day of my life. My tiny baby stopped breathing in front of me. We were rushed via resus straight back into intensive care.

We were right back at the beginning and so was my milk supply. It never recovered. My expressing number wasn’t even 30mls any more. More like a pitiful 15ml.

All important cuddlesThe event made me realise though that it isn’t down to whether you are doing things right or wrong. So much of it is to do with the alien environment in which you find yourself. To do with your own emotional and physical needs as you process the trauma of your early delivery.  You are sometimes made to feel like expressing breast milk is the best and only thing you can do for your early baby. I found that the best thing I could do for my baby was to hold him and to be close to him. The nurses in SCBU would say that he would get too clingy, that he would want holding all the time.

But how could he? He’d waited so long for that first cuddle and now still spent so much time in his cot by himself.

And afterwards – He didn’t turn into that clingy baby, instead he grew into content and settled baby. I continued to breastfeed on discharge, but always topped up with a bottle. It was tiring for him though, so the breastfeeds gradually reduced.

Looking back now I realised that in total I had expressed and breastfed, as well as topping up with formula for a total of 5 months. I guess that’s not bad for a 30ml mum!

 

 

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)

smallest things

First Cuddles

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.

Sleeping again - how not to establish breastfeeding!

Sleeping again – how not to establish breastfeeding!

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.

The ever present breast pump!

The ever present breast pump!

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.

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If you believe parents of premature babies need more time, please support and sign our petition to extend parental leave for mothers of babies born too soon – SIGN NOW!

Second time around…

photo 1Guest blog by Mikaila Hopley – posted as part of our feeding a premature baby awareness week (12th – 18th January 2015)

You can read Mikaila’s story of feeding her first son born at 29 weeks here. Now, second time around Mikaila is more confident and determined as ever to breastfeed her son.

In March 2014 I gave birth to our second son (on his big brothers 4th birthday) at 36 weeks. I was so happy to get to this gestation. The further along I got the more I began to hope for the experience of that precious skin-to-skin contact and that first feed; but unfortunately it wasn’t to be. After a c-section this time (because of placenta previa) he was also taken straight to NICU as he was struggling with his breathing. As they took him away a paediatric doctor peered over me and asked if I would be happy for them to formula feed him if he had low blood sugar. She was taken aback when I quickly replied – “No, as soon as I’m
finished here (in theatre) I’ll be expressing!”

This time I was ready for it and I knew what I was doing. I got back to the ward and asked for a sterile pot and syringes, no pump this time, as I knew I would hand express this time. I got 20mls straight away and asked for it to be taken straight to my baby as I still wasn’t able to move or see my baby myself.
Later that night I was taken in a wheelchair to see him properly for the first time, he was crying in his incubator and I just wanted to cuddle and feed him. I asked if he could come out and he was given to me on my lap.  He latched on and had a good feed, and then he had to go back in. Feeding over the next few days were hard, he became jaundiced and required treatment, and because of the jaundice he became too sleepy to feed and lost weight. A nurse monitored me feeding, I felt like I was doing something wrong. I was feeling guilty for breastfeeding when he was slow to gain weight and began to wonder if he would do better and would get home more quickly on formula. I soon remembered my initial determination though to breastfeed with my first son and I knew that I would do exactly the same again. I would continue to breastfeed for as long as I could and for as long as it felt right. We were discharged a week after I had given birth, exclusively breastfeeding and 9 months on and we’re still going strong.

I wish I had been offered a bit more support in the beginning but we got there in the end. I just feel lucky and proud that I was able to breastfeed both my children after their premature arrivals.

photo 2                 photo 1

Best Laid Plans

When I told people I was pregnant I started being asked; are you going to breast-feed?

I hadn’t thought about how I would feed my baby when it arrived, as long as it got fed!

I felt the same way about how my baby would be delivered; as long as it arrived in to the world safely did it really matter?

Both of these were taken out of my control.

smallest thingsRocco was delivered 4 weeks early by C-Section and weighed in at just over 4lb and with low blood sugar levels. Suddenly him gaining weight was a key to getting him out of NICU. The way my baby was fed was now THE most important thing.

Decisions to be made

My husband was with our son in NICU directly after the birth and was asked ‘which milk do you want us to use to feed your son’?’. Mr. S had no idea, as we hadn’t discussed it and Mr. S. had been all for me breast-feeding.

He chose one of the brands that were reasonably familiar to him. Bless! It did make me feel very detached from them both. It was a decision we should have made together, if at all.

I needed to recover quickly and get back on my feet so I could visit Rocco, even if only for a short time. I needed to hold him close and feed him.

Now I knew I wanted to feed my son myself but due to all his tubes I couldn’t do it the conventional way. I had no idea how we would do it.

Expressing by hand

As Rocco and I couldn’t have much one to one contact, my milk didn’t flood in, so the NICU team taught me and Mr. S. how to express my milk by hand, into a syringe.

We had to massage my boobs to get the milk flowing to feed my little baby. I was useless.

The nurse suggested Mr. S. had a go. He got the milk visible within minutes, he had the technique – how we laughed.

Then came the hilarious skill of catching that milk in to a tiny syringe, I can still hear Mr. S. saying “keep still, don’t lose a drop!”

The elation of getting 2ml of milk and walking it in to NICU to watch it being put into my sons feeding tube was amazing. I felt like a mum.

Moving on to the pump

I’m not sure when I sent Mr. S. out to buy me a pump so I could express at home, one day rolled into another.

It was emotional expressing night and day to feed a baby that wasn’t under the same roof as his mummy and daddy.

I enjoyed sitting in the NICU Mummies room expressing alongside other mums going through the same thing. It all became very normal.

We celebrated when we hit milestones like moving from filling syringes to filling a bottle; the fridge was full of ‘Gold Top’. We started calling me Daisy!

Making Progress

The day the nurse said I could try to breast-feed Rocco was a huge step. To hold him that close was magical.

But it came with hurdles, we struggled keeping him awake and had no idea how much he was getting. So we topped up with expressed milk and formula. Luckily he loved it all.

After a turbulent 2 weeks we got the little man home, I continued breast-feeding but I became paranoid about him not getting enough food.

I wish my boobs had a gage on to see how much he’d drunk. So I expressed and topped him up from a bottle as well.

Soon I was expressing into a bottle more and breast-feeding less. It did seem a never-ending process but I felt better and Rocco was happy. It meant hubby could be part of the feeding process too.

After 11 weeks I made the decision to stop expressing/feeding, he was less from me and was happy with a bottle. So we moved onto formula only (the one Mr. S had chosen in NICU!)

smallest thingsWe didn’t have a feeding plan but we found our way with guidance from NICU and determination from 3 of us. The little man is now 13 weeks old and over double his weight.

There really is no right or wrong. We still look at the tiny syringe and realize how far we’ve come. Boobs, Bottle, Syringes Rock!

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Guest blog by Tamara, Rocco’s mum | Posted as part of our feeding a premature baby awareness week (12th – 18th January 2015) 🍼

If you have a NICU story to share please do get in touch; just email Catriona at smallestthings@yahoo.com

I need a breast pump! A mothers 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.

photo 1The 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.

photo 2Breastfeeding 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.

If you believe parents of premature babies need more time, please support and sign our petition to extend parental leave for mothers of babies born too soon – SIGN NOW!