Sticking With It
From NEW BEGINNINGS, Vol. 24 No. 3, May-June 2007, pp. 107-108
I had a healthy and uneventful pregnancy. So you can imagine my surprise when my water broke in the middle of the night when I was just 33 weeks pregnant. We drove to the hospital expecting to be checked out and sent home (my cramps were not intense and I wasn't even sure that my water had broken at that point), but to my even greater surprise, my daughter, Anna Victoria Larsen, was born less than six hours later.
I had been planning to breastfeed, but because of the prematurity, Anna was whisked away to the neonatal intensive care unit (NICU) for close observation shortly after her birth. As a result, I wasn't able to put her to the breast right away or at all during her first day of life. Anna was given formula for her first few days, but before I left the hospital, I had generated some milk for the nurses to bottle-feed her. Within a few days, I was generating way more milk than my little five-pound premie could consume!
The doctors told us that most premies at Anna's gestational age need to learn how to coordinate eating and breathing at the same time before they can be discharged from the hospital. Anna was able to bottle-feed from her first feeding, though she sometimes got too tired and required a feeding tube to ensure she got enough to eat. At that age, doctors have concerns that infants will burn more calories than they consume in the effort to eat.
The NICU staff at Bryn Mawr Hospital allowed and encouraged lots of parental contact with the infants under their care. I was encouraged to let Anna try to breastfeed at least once a day. More often than not, she screamed her head off—a flat out rejection of the breast. Although I had lots of help from nurses and lactation consultants, I wasn't able to get Anna to latch on during her two-week stay at the hospital.
While this was discouraging, I was not deterred. I was determined to breastfeed, and I was convinced that all Anna needed was a little maturity to be able to do it. Moreover, it was important to me that Anna consume my milk because I knew that, as a premie, she needed any advantage she could get.
I had great success with an electric breast pump and continued to feed Anna my milk in bottles when she came home from the hospital, still five weeks before her due date. The doctors recommended that we "fortify" my milk with a special human milk fortifier designed for premature babies. This gave the milk a 10 percent boost in calories so Anna would gain weight faster. Anna was consuming 100 percent human milk, although none of it came directly from my breast.
Weeks passed and she was still not latching onto the breast. I had read about "nipple confusion," and I worried that Anna would never learn to breastfeed simply because drinking from a bottle is easier to do. But I kept trying, at least once a day, to get her to latch on and feed directly from the breast.
When we found out that our insurance coverage included visitations from a lactation nurse, we set up a visit. The lactation nurse suggested a nipple shield, a small silicone device that attaches to the breast and provides a larger nipple for the baby to latch onto, similar to a bottle nipple. I tried this and had success. This method was a little messy, so it was not ideal, but it sure beat pumping and then feeding. Within two to three weeks, Anna didn't need the shield any more and she was latching directly onto my breast.
Anna overcame some serious odds to be a breastfed baby. From what I understand, many women have a tough time generating a milk supply when their babies are born so prematurely. And many of them find that an electric pump does not stimulate their breasts to produce milk the way a baby's sucking would.
I am proud to say that I nursed Anna until she was 18 months old. Despite weighing just under five pounds at birth, Anna's weight and size increased quickly. She made it to the 50th percentile for weight by the time she was nine months old. Today, she's healthy, happy, and headed for her second birthday!