Tuesday, 7 January 2014

Triumphant Tuesday: Breastfeeding a Hospitalized Premature Baby

Giving birth prematurely can provoke feelings of maternal inadequacy. The guilt of one’s inability to carry the pregnancy to full term is confounded by the fact that there is very little Mom can do to help her baby while he is confined to the NICU. Is it any wonder that mothers of preemies typically feel like helpless outsiders deferring to an army of health professionals?

There is, however, one gift a mother can give her premature baby that no health professional can – her unique breast milk. Not only does Mom’s breast milk confer unparalleled healing properties to her baby, it also instils in Mom a sense of maternal responsibility and control which can aid in her mental recovery. Win-win right?

Alas, in too many instances, a jostle for control ensures between the mother and the health professionals; the premature baby being viewed by the latter, as an open invitation to over-zealous intrusion, as this story illustrates:


“During my pregnancy a routine midwife appointment picked up on high blood pressure. A subsequent urine test showed 4 +'s, which is apparently very serious. I was put on medication and hospitalised but my blood pressure was still too high and the protein in urine was getting worse and so I was artificially induced at 32 weeks and 3 days.

The induction process meant my son's heart rate started dropping and so we had an emergency caesarean. As this was my first child I had no past experience and so took the word of doctors and nurses as law.

Didn’t see baby for 10 hours

Yahya (meaning God is gracious) was born weighing a tiny 3lb 4oz at 1:04pm, a gorgeous little fighter! As soon as he was born he was taken to NICU (intensive care for babies) thankfully he was breathing independently and didn’t need oxygen but was struggling to regulate his temperature. I had always wanted two things when pregnant, a natural delivery and to breastfeed. As the natural delivery didn’t happen I was absolutely determined to breastfeed my son.


The first time I saw him was not until 10pm later that night. It was the most amazing sight! He was so small in his incubator but unbelievably beautiful (yes I am a little biased)! I felt very scared as to whether he would survive or have any long term impact from his prematurity. The experience felt a bit surreal, we paid more attention to the beeps and machines to tell us the status of Yahya's health rather than actually looking at Yahya! I started hand expressing that night, then later used a hospital pump as my supply came in.

I was spending all day and night with Yahya. As I was still a patient in the hospital, it meant I could see him as often as I'd like. He couldn’t breastfeed as he had not developed the sucking reflex being born so early, (the sucking reflex develops at around 34 weeks).

Baby losing weight

The first three times Yahya was weighed it was revealed that he had lost weight. This was an incredibly worrying time, but I persisted with pumping and feeding him through a tube. I tried putting him to the breast frequently and he would often lick and suck but would tire easily.

Nonetheless, we persisted. There wasn't huge pressure to establish a good latch as he would be tube fed if he didn't nurse properly. With support, finally Yahya started nursing efficiently! At first it would only be for a few minutes then he would have a top up of breast milk through his tube. In addition, he was moved into Low Dependency and onto a cot warmer with the temperature being reduced slowly so as to wean him off it eventually.

Home and back again

After a week and a half, the hospital discharged me as my blood pressure had stabilised and they had no reason to keep me. At the risk of sounding dramatic, this was the hardest day of my life. Leaving Yahya in the hospital was unbearable. I cried each time, all the way home and all night until I saw him again. I was unable to really function or focus on anything else. Being away from him made me feel incomplete and incredibly stressed!

After another week with Yahya nursing more frequently and for longer, the doctors asked me to 'room in'. Gratefully, I stayed at the hospital for 2 weeks to fully establish breastfeeding. Yahya was now nursing for 25-30 minutes on one side, and then 10 mins on second side, every 90 minutes. When he was 20 days old, his feeding tube was removed. By this point he had nursed 10 times properly and fully but I was told it may need to go back in if he required it.

During this time, for 3 weeks in total, I pumped round the clock every 3 hours. It was mind numbingly exhausting. I borrowed a hospital pump and had to pump, store the milk then wash the parts, only to sterilise 2 hours later to pump again. I cannot explain sufficiently how tiring this was. I was quite literally running on empty, only going for the sake of my vulnerable and helpless baby.

Over-supply caused by over-zealous pumping


All this pumping resulted in a massive over-supply. I had engorged breasts which would leak and were incredibly painful if I waited a minute more than 2 1/2-3 hours to pump. This meant that when Yahya would nurse, afterwards I would have to pump to stop my breasts from hurting from engorgement.

For the first week I was still pumping every 3 hours and throwing the milk away as I had no place to store it (such a huge loss, in hindsight)! In the second week, I gradually stopped pumping and we were finally exclusively breastfeeding!! This was wonderful, difficult and worth it. Eventually on 9th September after a long 31 days we were discharged!

Attempted sabotaged by health visitors

Once home, Yahya gained weight and was meeting all his developmental milestones. However, now I was having to deal with home visits from health visitors who were hell bent on sabotage. They were rude and interfering. They were constantly weight obsessed as Yahya gained weight slowly and sometimes insufficiently (according to the charts). I was polite and adamant I would continue to breastfeed and not supplement, despite the health visitors constantly encouraging me to formula feed. Some of their comments include: “You are creating a rod for your own back”, “formula isn't damaging, it wont hurt him”, “your milk might not be filling him up”, “your diet is poor and so he isn't getting the nutrients he needs”, “everyone else gives formula and their kids are healthy/chubby/fine”, “introduce formula in case you get ill, then who would feed him?” (How morbid!)

Despite the confident and stubborn ‘front’ I showed to the health visitors, inside I felt incredibly worried. Sometimes I wondered that maybe I needed to just give formula to help him gain weight and to accept breastfeeding may not be for me. The health visitors’ comments made worse my already-deep fear that I was damaging my baby by being so persistently anti-formula.

In addition to this, the behaviour of my family and in-laws was frustrating. They frequently asked whether Yahya was full/ did I have enough milk/why was I not supplementing. There were many times when even my husband discouraged me to breastfeed and told me to offer formula (normally when Yahya nursed like a champion every hour, hour and a half for 40-50 minutes). We would argue because, of course, he took the word of any healthcare worker as law. It didn’t help that formula was, by far, the norm in both our families, so my husband felt it was an unnecessary battle. Despite these pressures, I was adamant, and sometimes blunt, that I would continue to breastfeed. Whenever I felt like giving up I came to thealphaparent and re-energised by reading other mom’s stories.

Aiming for 30 months of breastfeeding


Now, at 15 months, we are still going strong. Breastfeeding is the most rewarding and fulfilling experience. It has been a difficult and amazing journey. My advice to any new mother is: do not allow formula in your home! Throw away samples! When you are tired and your baby is crying for the tenth time that night, you will turn to formula if it is in the home! So avoid that trap! Also do not surround yourself with negative people who will encourage you to formula feed at the smallest difficulty. Expect your child to feed every hour sometimes, they have tiny tummies and breast milk is so amazing it is digested very quickly. Finally, arm yourself with facts and knowledge so you are certain you are doing the best thing for your child.

Just last month my husband mentioned how glad he was that Yahya is strictly breastfed as he has only been sick twice in 15 months! Besides these health benefits, it is important for me to breastfeed on a spiritual level. Being Muslim, I am encouraged to nurse Yahya until he is 2 years old, with an extra 6 months for weaning. We’re on track to meet that goal!”


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