Surprised by a Preemie
By Sherri McInnis
Statesville, North Carolina, USA
From NEW BEGINNINGS, Vol. 13 No. 2, March-April 1996, p. 46
We provide articles from our publications from previous years for reference for our Leaders and members. Readers are cautioned to remember that research and medical information change over time
I thought I had breastfeeding all figured out until I found myself with a premature infant in the NICU of a large medical center forty miles from my home. Jillian, our third baby, was born twelve weeks prematurely and weighed only two pounds and six ounces at birth. She spent the first seven weeks of her life in the hospital. Fortunately, she was strong and healthy and adapted more quickly than I imagined possible to life outside of my womb.
Shortly after the birth, a friend commented that someone had said to her, "Too bad Sherri won't be able to nurse the baby." My friend replied that of course I would breastfeed. If anyone could do it, she knew I would! This vote of confidence carried me through many dark hours, when I wasn't sure I knew what I was doing. The one thing I did know was that breastfeeding had been an integral part of my relationship with my other children, and I simply could not imagine mothering any other way.
I enlisted the support of my LLL friends and ordered all of the information that applied to premature babies. Even before the baby was born I requested a visit from the NICU lactation consultant so that she could help me devise a plan. I explained to every nurse and doctor who would listen that my goal was long-term breastfeeding, that I did not plan to pump my milk just for a little while and mix it with formula. It was important to me that everyone who had contact with my baby knew how serious I was and what breastfeeding meant to us as a family.
There are other valuable resources available to families of premature babies. I read Kangaroo Care by Susan M. Ludington-Hoe and Susan Golant and began sharing skin to skin contact with Jillian as soon as she was stable. I considered this time as "breastfeeding orientation." Even before she could suckle, Jillian found great comfort in the warmth and scent of my body, and she was able to hear my familiar heartbeat. Many of the nurses in NICU had heard about the benefits of "kangarooing," and they were always helpful in providing a rocking chair, a privacy screen, warm blankets, and words of encouragement.
As part of my experience, I was introduced to some of the breastfeeding equipment which can benefit mothers in special situations. The day of Jillian's birth I began using a double electric breast pump every two hours. This regimen helped me establish a good milk supply and provided lots of fresh milk for Jillian. I later learned to use an SNS feeding system and rented a gram scale for home use for about a month. Using all this equipment was sometimes stressful, but it made the transition to full-time nursing possible for us.
Aside from all the information and devices I had at my disposal, I believe the thing that made the difference between my giving up or following my dream to breastfeed my new tiny baby was my attitude. I always thought of myself as a nursing mother. I never gave up the vision of being able to fully nourish my baby at the breast and enjoy all the closeness of a long-term nursing relationship.
It was not always easy. The hospital's policy was that the baby must be able to take all feedings by nipple before being allowed to come home. Because of the distance and other children at home to care for, it was impossible for me to be with Jillian for more than one or two feedings each day. Jillian was four weeks old when the nurse called, so excited to report that Jillian had taken her first bottle-feeding. I cried. This was not how I wanted it to be. I worried she would never learn to breastfeed. But I continued to do the thing a nursing mother does best--I put my baby to the breast every chance I had.
My relationship with the breast pump went on for four months. At times I despised that machine. But thinking like a nursing mother, it never occurred to me to miss a "feeding."
Perhaps my greatest and most joyful challenge began with Jillian's homecoming. When we brought her home she was still five weeks from her due date and weighed only three pounds thirteen ounces. It was a matter of life and death that she take in a certain amount of milk every twenty-four hours. Now I had the awesome responsibility of not only producing the milk, but making sure she drank it. I made temporary peace with the idea of giving bottles and using the SNS, faithfully recording the amount Jillian took at each feeding. And because I still held fast to my dream of being able to breastfeed without all the cumbersome equipment, I continued to think like a nursing mother, and I put my baby to the breast often.
As Jillian grew, I found time between feeding and pumping to offer her my breast for comfort. These were sweet moments that inspired me to keep going.
There came a point, around the time of Jillian's due date, when the pumping/feeding regimen began to totally exhaust me. She didn't always fall asleep after a feeding, so by the time I had a chance to pump, she was ready to nurse again. I realized that it wasn't making sense to offer her my breasts right after pumping if I wanted her to learn how to get full by nursing. So with the help of a lactation consultant I was able to make the transition to complete nursing almost overnight.
By using a gram scale, I could measure the amount of milk that Jillian took in at the breast. Often she showed an immature pattern of taking only about 20 ccs, then resting for a short period and waking hungry again. Because I was feeling more and more like a nursing mother, I embraced every opportunity to feed my baby. For us, the frequency of her nursing was a victory, not a hardship. By keeping Jillian in bed with me at night, I could offer her lots of time to nurse while at last getting some much needed rest for myself.
Jillian is now nine months old, very plump and healthy, and completely breastfed. From this perspective, the trials we endured seem minimal. When she takes a break from nursing to look up at me and smile, I have no doubt that the struggle we had to face to become a happy nursing couple was worth it all.