My preemie milk journey
By Ashleigh Holmes
The traumatic start
I woke up to a breast pump being placed on my boobs. Not a suckling newborn. I had just delivered my baby 2 months too early at 32 weeks’ gestation under general anaesthesia c-section and I had no idea what was going on. I hadn’t seen, met or held my baby. I had to ask my husband if we had a boy or girl because I didn’t know. We had a girl. She wasn’t next to me or on my chest though, she was across the hall in NICU and I was in maternity ward with breast pumps on. This was my first breastfeeding experience, the first latch, the golden hour….and it was all with a pump.
I remember the nurses being pleased with the amount of milk they got that night. They were shocked. They said usually preemie moms don’t have much milk because their bodies aren’t ready. I remember feeling proud. I had drank litres and litres of water for 48 hours before to try and increase my amniotic fluid and delay delivery. That obviously didn’t work. But hey, at least I had milk.
I thought to myself “thank goodness my body is doing one thing right, it’s the least I can do for my baby” but the Dairy Queen didn’t last long. My body was in shock, I was stressed and it was showing. After being told by doctor “we need more milk mommy” I agreed to take Clopamon, an anti-nausea drug with lactation side effects to help bring milk in. However, this drug also drops dopamine levels and left me feeling uncontrollably sad. So I stopped taking it and felt immediately better. I also signed for Donor Breastmilk to be given to my baby should I not be able to make enough in time. A backup plan of sorts. As an anxious new mom, a Preemie mom, this was a heart breaking moment. It felt like yet another failure, another thing I couldn’t give to my baby. I started wondering if this whole motherhood thing was for me. And so the infamous mom guilt began.
The next morning came and I begged for the nurses to take the catheter out so I could get up and walk to see my baby. 24 hours later I met my baby girl, we named her Summer. She was a tiny 1,4kg and 37cm long. She had far too many wires and monitors on her to be comfortable but she was beautiful. I saw a tube in her mouth, I asked what it was. They said it was a feeding tube. And it was in that moment that I unknowingly met my fiercest competitor…the feeding tube.
Boobs VS feeding tube
Once Summer was strong enough to breastfeed our journey started. Many of the NICU nurses were lactation consultants and they helped me immensely with all their tips and tricks. We mostly hand expressed into her mouth as her sucking reflex wasn’t the strongest. But we were doing it, we were breastfeeding, struggling, but breastfeeding!!! I was proud of us and happy, until the results came in…boobs vs feeding tube, and the feeding tube had won.
What do I mean by this? Every day in NICU, your baby is weighed. On the days that I breastfed, Summer would gain 40grams. But on the days she was tube fed, she put on over 100grams. The results spoke for themselves, my boobs were not as good as the feeding tube and I was failing my baby.
The ONLY reason our baby was in NICU was to put on weight and by me selfishly wanting to breastfeed I was hindering and slowing down her growth and inadvertently extending her stay in NICU.
You see, there is no room to play, no leeway when you are feeding a 1,4kg underweight baby. They can’t afford to lose weight. And the guessing game of breastfeeding, for us, was a dangerous road. The feeding tube was obviously the better option. We had the numbers and figures. We couldn’t argue with facts.
Milk was measured out, we knew how much she was getting and she didn’t have to expel any energy getting it. I quickly realised the feeding tube wasn’t my fiercest competitor at all but rather it was saving my baby’s life. So I decided to surrender to the feeding tube for the benefit of our baby. It was the best decision for our baby given our circumstances.
I didn’t want to let go of breastfeeding all together though, so decided I would just do “fun feeds/top ups” through breastfeeding, but still pump for the main feeds.
Every 3 hours I pumped milk for my baby. All through the night at home and during the day at NICU. I had hospital grade pumps set up at both locations. My milk came in hard and fast. I was constantly engorged, sore, having to massage blocked ducts out but we had milk. WE HAD MILK! Every day I would catch an Uber to the NICU with my bottles of liquid gold in a little cooler bag on my lap (I couldn’t drive because of C-section) I was sleep deprived and emotionally exhausted but I was grateful I had milk. So so grateful.
Our girl very quickly upgraded from feeding tube to bottle and once she was weighing 2kg and taking all feeds orally (without feeding tube) we were able to take her home. It had been 32 days in NICU.
It was tough at home. It’s true when they say pumping and feeding is double the amount of work. We weren’t allowed to let her sleep longer than 3 hours without feeding because of her weight. So every 3 hours it was running to the fridge to get the expressed milk out, boiling the kettle to heat the milk up while baby is screaming at you, feeding baby with the slowest teat ever because of reflux , burping baby, settling baby back to sleep and then sitting on a couch alone in the dark with my pump to express milk. By the time I had done all of the above, it was almost time for the next feed. Dad helped as much as he could, but we were exhausted.
I carried on with “fun feeds” (breastfeeding in between main bottle feeds) but to be honest, they were not fun. Every time Summer would latch I would feel resentment, anxiousness and sadness. I was not enjoying it. As soon as she unlatched, those feelings disappeared. So i decided to film our last feed and stop breastfeeding all together. I now know that I was actually suffering from a condition called DMER (Dysphoric Milk Ejection Reflex). If you are experiencing the same, definitely look it up and chat to your doctor about it.
The switch to formula and feelings around it
We managed to bottle feed breastmilk for 4 months through expressing and freezer storage. It was the longest four months of my life. I hated every second of it, but I also remember the dread and anxiety knowing I had to switch to formula soon.
I remember standing in that formula aisle with all the tins shouting “BREASTMILK IS THE BEST FOR YOUR BABY” at me. Like rub salt in my wounds why don’t you. I felt like such a failure I wanted to cry. I felt like I was about to poison my child. The anxiety was unreal. UNREAL!
The funny thing is though, our baby THRIVED on formula and still does to this day at now 2 years old. Why hadn’t we switched sooner?
I understand why we didn’t, but looking back now, I WISH I had started formula sooner. We had so many battles to fight with premature birth, a low weight baby and NICU, why make breastfeeding another one!? We should have picked our battles and just started with formula from the get go. We would have been happier (and better rested) for it.
But I do need to be kind to my previous self. I know she wanted to do everything she could for her prem baby. I know she thought “The least I can do is produce milk for my baby after not being able to carry full term safely” I know she was scared, dealing with mom guilt and searching for any means of control. And I just want to tell her, you did the absolute best you could. Your situation was not easy and I’m so proud of you.
Ashleigh's tips and tricks for other preemie parents
- Sing or read to your baby while they are in the incubator. It’s sometimes feels overwhelming visiting your little one in NICU. What are you supposed to do? Sing or read. Remember, they have been listening to your voice for months now and even though they are sleepy, hearing your voices will bring them comfort
- Practice skin on skin kangaroo care whenever possible. Both mom and dad. Preemie babies first experience with human touch is negative: being poked by needles, feeding tubes stuck down their throat, monitors everywhere. Skin on skin kangaroo care counteracts the negative touch and tries to override that negative experience so baby learns to not only trust human touch but also to enjoy it.
- Take photos and videos. I know it feels weird in the moment and that’s probably not where your head is at, but I promise you, you will be glad you documented your journey. Even film the tough parts. Or ask your partner to. I promise you, you will be so grateful you did in the future.
- Try and buy a knitted octopus to leave with baby. The tentacles feel like the umbilical cord and distracts baby from pulling their monitor wires/drips.
- Try and leave something with your scent on in the incubator. You can buy little fabric hearts or a reusable breast pad, place it in your bra for a while and then leave it with baby.
- Places like Little Little Prem are a great one stop shop for tiny nappies, clothing etc. The stuff sold at the shops will probably still be too big.
- If you can’t afford to buy a pump, you can ask the nurses about hiring a pump. Especially until you find your feet in how you want to feed etc.
- Celebrate the small NICU milestones like “off oxygen” or “in an open crib” or “first outfit” to keep your spirits up.
- Most preemie parents didn’t make it to their antenatal course because they gave birth before it started. The good thing is that you are surrounded by the most qualified NICU nurses who are there to help you with everything. Think of your NICU stay as a hands-on antenatal crash course. Be sure to ask the nurses for all the tips and tricks with burping, feeding, diaper changes, bathing and sleeping.
- Try and buy a breathing monitor that clips onto baby’s nappy for when you go home. Remember your baby has been monitored 24/7. It’s tough to wean yourself off of the security of the monitors. So having one at home might make that transition easier. Also know that certain thing like wearing beanies, sleeping under blankets and on sleep positions are only done in NICU because the babies are monitored. You shouldn’t do these things at home without supervising your baby.
Ashleigh shares her life as mama, wife and content creator based in Port Elizabeth. Her Instagram has an authentic flare and boho charm. You can follow her over at IG: @ashleighholmes_
MyMilkClub is about sharing experiences and supporting each other. We launched the #mymilkjourney series to share stories from other mamas about their experiences on their milk journey. If you have a flair for writing and would like to share your story get in touch
Disclaimer: This is not a sponsored post. MyMilkClub reserves the right to its opinions and fully supports the notion of promotion that breast is best in line with the World Health Organisation (WHO) infant feeding guidelines. The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of an infant’s life, and continued breastfeeding with complementary foods for up to two years of age. Breast milk is the best food for infants. Good maternal nutrition is essential to prepare and maintain breastfeeding. If breastfeeding is not possible, an infant formula may be used according to the advice of registered health professionals. Preparation and storage of any infant formula should be performed as directed on the tin in order not to pose any health hazards.