Breastfeeding a Premature Baby: A Guest Post
This is my first guest post! Houston Mom Erin wanted to share her story of the struggles she faced as a new mom with a “healthy” premature baby, who took a little extra time to figure out how to pack on the ounces and pounds! If you are looking for techniques on supplementing a breastfeeding baby, I would also like to recommend you check out this article, which really breaks down alternatives to a bottle. Thanks for sharing your story, Erin!
A Weight Problem
On the morning of Monday, December 19, 2011 I woke up feeling great. I had been very productive over the weekend and my due date was exactly one month away. I was looking forward to the long Christmas weekend- four days off to celebrate and REALLY get ready for our baby’s arrival. I left our New York City apartment and took the subway to my 35-week OB appointment. I arrived at the doctor’s office a few minutes before my 8:45 a.m. appointment, pretty good for a Monday morning!
Before I could sit down my always-prompt doctor called me in for my exam. The nurse took my blood pressure and her eyes grew wide- it wasn’t good. She took it again, no positive change. After a brief exam my doctor said that I needed to go to the hospital for observation, but not to worry, her husband- another doctor in the practice- would be there to monitor me.
Oblivious to what was really about to happen I took a cab to the hospital and called my husband to let him know what was going on, but told him not to come because I was probably just going to be sent home to rest. We welcomed our daughter, Genevieve, all 6 pounds 8 ounces of her, at 10:52 that night.
I soon learned that she was considered a late pre-term baby which meant a few things. Because of her early arrival, she was extra sleepy and her sucking reflex wasn’t very strong. She was also jaundice, but as long as we could get her eating well that would go away within a few days.
Getting her to nurse was challenging, to say the least, but my nurses were terrific and showed me how to get Genevieve to open her mouth as wide as possible to latch on, and instructed me to undress her, stroke her jaw, tickle her chin- anything to keep her awake and actively suckling during her feedings.
In addition to nursing, they showed me how to use a breast pump then use medicine syringes to suck up every drop I pumped and feed it to my baby a few milliliters at a time. After learning how to use the pump and syringe feed, the nurses brought out formula- not something I thought I’d be seeing or using in the Baby-Friendly Hospital where I delivered. My husband fed her the formula from a little medicine cup and she lapped it up like a puppy!
You might be thinking, “Why not just give the baby a bottle of breast milk or formula?” The nurses assured me that the syringe and cup feeding were the best way to fill my early bird up (without over-feeding her) and allow for the two of us to develop a successful nursing relationship. They explained to me that by offering a newborn a bottle it can cause nipple confusion and hinder the baby from nursing properly or at all. (Both the nurses in the hospital and Genevieve’s pediatricians recommended waiting until she was four weeks old to offer a bottle and until she was two weeks old to offer a pacifier.)
I started a cycle of nursing, syringe feeding the pumped milk, cup feeding formula, pumping, and cleaning pump parts every 2-3 hours. It was exhausting to say the least and certainly not how I expected to spend the early days of my daughter’s life, but I was so grateful she was healthy that it didn’t really faze me at the time. And with instructions to keep up this cycle and track the number of wet and dirty diapers, we were discharged from the hospital right after lunch on Wednesday December 21- Genevieve was 40 hours old and weighed 6 pounds 4 ounces.
The next day my husband and I took our baby to the pediatrician for her newborn check-up. She weighed 5 pounds 14 ounces- 10% down from her birth weight. We were instructed to keep up the feeding cycle, keep tracking her diaper changes, come back Tuesday, December 26th and call if we had any questions at all throughout the holiday weekend.
By this point I still wasn’t producing much and the cycle was wearing on me and nursing and pumping were becoming very painful. Friends suggested getting a nipple shield so I sent my husband and mother-in-law out on a mission to find one. It did help alleviate the pain, but now I had a baby who didn’t stop crying and who wasn’t producing enough wet and dirty diapers. I will always remember Christmas Eve 2011 as the day my baby cried all day—I know that was the day she reached her lowest weight, my guess is around 5 pounds 10 ounces. Then my milk finally came in- Merry Christmas!
By Tuesday her diapers were in line with what they should be for a one-week old baby, her jaundice was still present but improving and she weighed 5 pounds 12 ounces- not great, but the doctor and I agreed she was doing better. She started to fill up on breast milk alone so we stopped offering her formula and I stopped having to pump as much. Over New Year’s weekend I felt engorged for the first time and had extreme pain in my breasts. On New Year’s Day I spiked a fever and had chills- I attributed my symptoms to overdoing it the day before running an errand and doing laundry (basically not following my discharge orders to take it easy until two weeks postpartum).
On January 2nd Genevieve’s weight was up a little, but not enough and I was in excruciating pain when I nursed. The pediatrician recommended that I contact a lactation consultant so we could pinpoint the issue. He gave me a list of lactation consultants, but I knew who I was going to call. My lactation consultant spent 2 ½ hours with us and determined that I was likely producing enough milk, but Genevieve’s latch wasn’t great and she wasn’t actively suckling. I wasn’t using the nipple shield correctly, likely had mastitis in both breasts (remember the fever and pain?) and needed to go to my OB as soon as possible. She helped me immensely with positioning Genevieve and using the nipple shield properly, both of which allowed my baby to nurse more effectively. Her instructions were to nurse, offer pumped milk in a Haberman feeder (to avoid nipple confusion), pump, and clean pump parts every 2-3 hours. She left a Haberman feeder with me that afternoon and I did the best I could with this cycle. She also recommended that I rent a hospital-grade pump, but I didn’t take that advice because I was comfortable with the pump I had by that point… And in New York City, it would have cost $90/week to rent one from the location closest to me, and also meant one more trip I would have to take alone with my two-week-old baby.
I did have mastitis which made the rest of that week very tough. Genevieve actually lost a couple of ounces, but after the infection cleared up things finally started to go uphill. I followed my lactation consultant’s instructions, but found if I waited about an hour after nursing to pump I produced quite a bit more, so I started doing that a few times during the day rather than around the clock. We continued going to the pediatrician once a week until Genevieve was six weeks old when she weighed 6 pounds 10 ounces- finally, she was over her birth weight!
Our biggest success came at her two month check-up- I placed her on the scale and 8 pounds 3 ounces lit up on the display! Her rate of growth was great and she was even “on the charts” for her weight- 5th percentile.
My little peanut’s growth really took off around five months and by her six month check-up her pediatrician didn’t even recognize her. She weighed over 17 pounds and by 12 months she was in the 85th percentile for weight and height.
Today, Genevieve is 15 months old and our nursing relationship is great, but I feel it’s coming to an end pretty soon. I’m hanging on to her bedtime feeding and she loves her breakfast feeding- then eats as much as I do in solid food!
The first six weeks of my sweet Genevieve’s life was one of the most physically and emotionally exhausting and challenging periods of my life. If I had an option to go through labor and delivery twice and get a baby who took to nursing naturally I would probably take it. Breastfeeding was important to me and I’m so glad we stuck with it. If you and your baby struggle with breastfeeding in those early days and weeks, then find good, supportive people to help you! It’s not your fault, and with some guidance, support, and time, it can get better.
Erin Bain recently returned to Texas after living on the East Coast for six years. She has worked as a fundraiser for the past 6 ½ years and is currently working part-time as a consultant for a small Houston-based non-profit and staying home full-time with her daughter, Genevieve. She and her husband, Joe, met in college at Texas A&M and have been married for 8 ½ years. She recently started her own blog, Domestic Improv, where she shares about her ventures in the kitchen and life raising a toddler in Houston, Texas.