205: Preemies: Nursing a Preemie

by | Aug 12, 2021 | Mama Thursday | 0 comments

Welcome, Mamma Crew, to another chaotic, exciting, but always beautiful day of an older mom like you!

When I was pregnant with the girls, I would console myself with the idea that even though my pregnancy had been so incredibly challenging, everything would be normal when they were born. One of the things that I really used to look forward to was nursing them. I thought that it wouldn’t be a challenge because I knew many women around me who had chosen to nurse and had no difficulty whatsoever.

They really made it out like, “all I had to do was pull my breast out, give it to the baby, the baby would just latch on, and everything would be so easy!” 

I thought it was that way with everyone. Of course, now I know that it’s a bigger challenge for some women than for others, and I know it can be very challenging to breastfeed preemies.

The challenge, of course, begins the day the babies are born.  You have preemies, and they’re in the NICU. It is quite a letdown, especially when it’s your first child, that you can’t be with them. This is really compounded by the fact that you can’t nurse them. 

In my case, there was absolutely no way that I could have breastfed.  Both of my kids were intubated. I’m sorry. I always get a little sad when I think about that. I wish I could go back and tell myself that things would get better because it was so hard. No one in my family had ever had premature babies. No one in my husband’s family had had premature babies. None of his siblings. So, nobody really knew what to expect. 

When the babies were in the NICU, they were first intubated, then extubated, and then on a cannula.  Their biggest challenge was not just to grow but to learn to breathe, suck, and swallow. We don’t even think about those things. We take them for granted. We see babies do it all the time, but a preemie isn’t necessarily capable of doing that; it takes a while for them to get the hang of it.

The one thing you can do is you can pump. I was fortunate that the medical insurance at the time covered an industrial-grade breast pump. Yes, I have to admit I felt a little bit like Bessie the cow every time I connected this thing to myself. But, you know, I was encouraged that the nurses kept telling me that the colostrum was magic.  It would do great things for the babies, and that nothing was as good as breast milk for preemies. The doctors kept saying the same thing. So, that encouraged me to go through the process. 

It’s not to say that it was an easy process. It’s not the same thing to have a baby latch on to your breast as it is to have a machine suck the milk out. It’s a totally different experience. But I did it. I went through the whole process of milking myself literally every three hours. Eventually, my babies were able to drink my milk via a feeding tube that went through their little noses all the way down to their stomachs. And yes, eventually, they drank it from a bottle, my breast, and even a cup because I pumped for so long.

It’s challenging when you have been pumping yourself for so long to switch to breastfeeding. I mean, it could really be a bumpy ride because it’s a lot easier to suck the milk from a bottle than it is to suck it from a breast. Our babies get used to it. In addition to that, a preemie has a tiny little mouth. It doesn’t have a regular baby mouth. I mean, my preemies were so tiny. Their preemie clothes were like three times too big. So, it was a bit of a challenge to get them to latch on. I had to wear a “nipple shield” that made a smaller, thinner nipple for the babies to clamp on, latch on, and suck much easier. Be able to nurse. 

The other challenge was that we needed to supplement my breastmilk with formula. My preemies needed to gain weight, and they needed to gain it a little bit faster than they were gaining it. Interestingly enough, one of the things that you can do in that situation, so that you don’t stop nursing, is to tape one of the little feeding tubes on your breast. The baby can suck the supplemented milk along with breastfeeding on your nipple. 

Emmi Changed Quickly when I was Allowed to Take her Home!

Now, in my case, I didn’t realize that you could do that. I was not aware of it. You know, that was fourteen years ago, and the internet back then wasn’t what it is today. So, I tried to alternate between suckling, nursing my babies, and allowing them to have the bottle. That was really challenging because, as I said, it’s a lot easier to get the milk out of the bottle than it is to breastfeed directly.

One of the things that I did find, though, is that my babies did enjoy nursing.  Even though they had a harder time getting the milk out, they were really comforted being in my arms.  This was especially true if they were fussy or were having some kind of a tummy problem.  They both had acid reflux. It really comforted them to nurse rather than to drink from the bottle.

Now, as I said, sometimes doctors will supplement breast milk with formula.  It’s necessary for your child to develop properly and gain the right amount of weight at the right pace. But you do have to keep in mind that despite the fact you’re supplementing, breast milk is the best thing out there for preemies. It’s easy to digest, and preemies fed breast milk could do a lot better long term than preemies that only receive formula.

Now I’m not shaming anyone. I know that some moms just can’t do it. I get that. It was very difficult for me when I was nursing. I had to look for a job, and sometimes I have to travel cross country. I traveled through Southwest Airlines most of the time, and they were not very kind to me. They would get infuriated that I needed to go into the restroom to pump. And the bottom line is you can only hold that breast milk in your breast for so long it becomes excruciatingly painful. So, it was quite a challenge! 

I remember going to a job interview, and my breasts started very small. I was an A cup when I got pregnant, and slowly by the time the interview was over, I was like a double D! I was huge! Because typically, the way academic interviews were handled (I don’t know if they’re still handled this way), you go to the college. You get a tour of the college. You meet several of the faculty members. Then you have to give a teaching example, and there’s usually a dinner afterward. So, these interviews were typically a day long. In some cases, they were two days long.  So, my breasts just kept growing, and one of the female professors said to me, “You know, I know that this is highly inappropriate, but it’s just I’ve been watching your breasts, and they just keep growing. I don’t understand.” 

I just explained I have newborns, and I’m breastfeeding. And she’s like, “Oh my gosh! You must be in so much pain!” 

And actually, that time, it worked out well because the professor drove me to my hotel, I pumped, and then she drove me back to the interview. So, that was really nice. But to be honest with you, I was never comfortable asking anybody for that kind of help. That was an accident. Regardless of the challenges, of which there were many, I constantly reminded myself of my goal. I wanted to breastfeed my babies. 

I would have liked to breastfeed my babies exclusively, but I couldn’t do that. I did have to supplement. The bottom line was that if I wanted my babies to have that breast milk that is supposed to be so beneficial for them, either they would have to nurse, or I would have to pump every three to four hours. When I traveled, I literally could pump a gallon a day of milk! I was shocked by how well my small breasts did during this time! 

Of course, as an academic, I couldn’t help myself, and I did a lot of research on the benefits of breast milk versus formula. And ladies, there’s no denying it. It seems like breast milk is quite miraculous. Studies show that when moms of preemies breastfeed, the milk they produce is richer in protein and has slightly different fats than later breast milk. So, isn’t it just amazing how our body compensates to help our kids? I mean, how does our body know that our babies are premature? It’s just amazing to me! 

But when we are breastfeeding preemies, it seems that our breast milk is specially designed to help our premature infants through those difficult first weeks. And let me tell you, it did miracles for my babies! I’m going to post some pictures of them before and after when they were in the NICU. And you can really see this with Emmi. She was tiny. She looked like a fetus that still shouldn’t have been out of the womb, and when they told me I had to take her home, I freaked out because I was like, “I don’t think this baby’s ready.” 

And the nurses kept telling me, “The best thing you can do is take her home and breastfeed her.” 

A week later, she looked like a plumped baby! I couldn’t believe the difference it made to take her home and just breastfeed her myself.  Giving her the bottle and that extra attention that she obviously craved.

Now, in the case of premature babies, moms are dealing with a lot of challenges. We’re very stressed out, especially when we have one baby at home and the other one’s still in the NICU hospital, and maybe we have to go through a C section. I mean, I found myself in the position of developing Type 2 diabetes because I had two placentas in me. Then my gallbladder crapped out. I took the babies home, one of them in the middle of July and then the other one in late August, and I had my gallbladder out the day after my birthday, September 6. One of the babies dislocated my ribs, not once but twice, repositioning herself. I had lost a lot of muscle tone and the ability to move around.  I had gone from 170 pounds, because I had been on Lupron before my pregnancy, it was either 110 or 115 pounds, possibly even less. My memory is not as good as it used to be, and I am turning fifty-five this year. But I was down to nothing! 

So, while my husband was very supportive of me breastfeeding, a lot of my relatives were not. They thought that I was insane. They thought it was detrimental to my personal health and that I should really stop. They keep saying things like, “It’s for your own good that we want you to stop.” 

And listen. I get it. I looked terrible. I felt terrible, especially when the babies were infants. But I had set my goal of twenty-four months of breastfeeding because they were preemies. Had they not been preemies, I think my goal would have been twelve months. But they were preemies. So, I thought I should try to make it to twenty-four months based on the studies I had read. 

Additionally, not only was my family not supportive, my body was not cooperating. I understand because I felt it. It’s really mind-blowing having to get up every three hours to either breastfeed or pump. It was challenging, especially with Emmi waking up every three hours on the dot from when she started breastfeeding! It would have been easier had it been from the point where she had stopped but no! It was from the point that she had started. So, I would breastfeed Emmi because she was crying. Andy was too weak to cry at the beginning. So I would breastfeed Emmi, then breastfeed Andy, and then I would have to pump.

And it was a challenge! I mean, on a good night or a good session, I would be getting around forty-five minutes of sleep. And trust me, this wasn’t “I need a few minutes to fall asleep.” 

I was so exhausted as soon as I put both kids down, I was out! But of course, I’m an extremely light sleeper, and every time the baby moved or the baby fussed, I was awake. So, I guess maybe not even forty-five minutes, maybe if I was lucky, thirty minutes. I looked and felt like an absolute zombie! So, I can totally understand a mom saying, “I can’t do this!” 

There were many times when I said it. And I think had it not been for the support, the cajoling of my husband. I couldn’t have continued doing it. It was just an extraordinarily challenging period in our babies’ lives.

My Andy Loved the Feeling of Being Comforted while Nursing!

So, the challenges did eventually get to me. Eighteen months later, I was done pumping. I had started a new job. And even though I had a private office and I couldn’t pump. For some reason, the cleaning lady would constantly open the door on me when I was pumping my breast milk.  She would just not give me a heads up that she was coming. She would just open it! So, then I tried turning around to pump, but I couldn’t work while I was pumping. 

I also noticed that my milk started to change. The milk started getting raspy. It wasn’t as sweet. Yes, I did try my own breast milk. I couldn’t help it. I just took a tap and tasted it to see why the girls loved it and preferred it. It’s incredibly sweet! I could not believe how sweet it was and how mild it was. Now, I understand why the nurses called it the “golden liquid.” In any case, I noticed that the kids didn’t want to take it anymore, and that’s when I did the tap test the second time, and its consistency had changed. I could still produce as much. It just was like “chalky.” It’s a good way to describe it.

So, I stopped at eighteen months. I didn’t make it to twenty-four. And that’s when I realized how exhausting it had been. I felt like I had awoken from a fog! I instantly felt so much more energetic after stopping. But, I have to tell you that I wouldn’t change it for anything in the world. It was a wonderfully validating experience. I felt great as a mom. I felt great that I had been able to last as long as I had breastfed, and I really bonded with my babies. My babies and I have always been extremely, extremely close. I always knew when they were fussy, what was going on, and I always could tell the difference between their cries. Now, I know you’re going to say a lot of us can tell that. 

But it just went when I talked to other mothers, the bond between my babies and I was just, we understood each other’s language better—body language, the cries, the smiles. Everything! We understood each other better. And when the girls were sick, it was a lot easier for them to fall asleep if I held them. We could synchronize with each other. In fact, Andy, who has ADHD, struggled to take naps when she was a little girl. The only way she could fall asleep was if she had her head on my breast to take a nap. And that nap kept her and me both sane. So, we needed that. 

So, it was an incredibly validating experience, but that doesn’t diminish the challenge. Had I had another child would I go through the process again? Would I breastfeed for eighteen months? To be honest with you, I think if I had a full-term baby, I would have gone twelve months. Preemies? I would have felt guilty had I not tried to do the same thing for my first children. I just would have done it. And if they had been even more premature than my twins, I would have probably tried to stick it out even longer. But I decided not to have more babies, and I’ve discussed that in previous episodes, so you can go check it out if you want to hear about that.

So again, that was my personal experience. I hope you find it encouraging, and please, no judgment. Breastfeeding is hard. breastfeeding a full-term baby is hard. Breastfeeding preemies is even more challenging. So I totally, absolutely get it if you feel that you cannot do it, and I 100% support you in your decision. We all have to do what we think is best for ourselves and our kids. And remember, it’s more important to preserve our sanity to be the best moms that we can be than to breastfeed and be so exhausted that we can’t take good care of our babies. So whatever you decide, I send you a big hug. Don’t let anyone judge you, and know that there are many moms out there that understand your choice.

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Dr B.

I began my journey into motherhood at the age of 40 when I became a mother of twins! Today I am a mother of 4! Being an older mom might be a growing trend, but we are still a minority with our own unique blessings and challenges. Join me in this journey! To contact me directly, email me at oldermoms@entrepreneurialdreamers.com