I Had To Do Something
Breastfeeding in a Neonatal Intensive Care
by Martine Engel, Thunder Bay,
The morning of the first day of my 33rd week of
pregnancy, I reminded my husband we had an appointment with the midwife. He went
up to get ready for work and I went to the kitchen to get some breakfast. First
a trickle, then a gush of water. My waters had broken. I called the midwife and
she met us at the hospital.
Five hours later I gave birth to a 5 lb. 13 oz.
baby girl. I held her about two seconds and she was whisked away to Neonatal
Intensive Care Unit. Although a good size for her gestational age, she was too
young and struggled for every breath. She was quickly intubated and given
surfactant to help her lungs develop more quickly. The pediatrician was relieved
I was planning to breastfeed.
As my skinny little baby lay crying soundlessly
because of the tubes down her throat, I knew I had to do something for her. The
nurses were all too busy to show me how the breast pump worked but through my
tears I figured it out and pumped a tiny bit of colostrum that I proudly brought
Fortunately the surfactant worked quickly and by
next morning she was breathing on her own with a small amount of oxygen through
nose prongs. Her jaundice was high, so she was moved to an isolette and put
under lights. She was fed my milk only, through a gavage tube inserted in her
mouth or nose.
I was so excited when I could put her to my
breast the second day, but I had no idea what I was doing. I felt a little
engorged but nobody suggested I express a little milk to soften my breasts.
After carefully arranging all the tubes and wires attached to my little daughterís
body, I put her mouth to my nipple. She didnít do anything at first but after
a couple of minutes she licked the end of my nipple and drifted off to sleep. We
decided on her name: Rachel. Itís a good strong name, and she needed all the
help she could get.
I was allowed to try nursing her just once a day
for that first week, and all she did was lick and kiss my nipple ever so
lightly. She remained hooked up to oxygen and other monitors and stayed in the
isolette. I sat by her all day and evening, talked to her and caressed her
gently through the portholes. The
nurses were good about letting us feed her my
milk through the gavage tube. Usually she slept right through these feedings but
at least we could hold her and she could hear our voices.
I pumped milk every three hours. Nursesí
information varied; some said five minutes each side, some said fifteen. I
decided to pump as much as I could before switching to the other side. The
electric pump at the hospital was good pretty good but made a terrible ďmooingĒ
sound each time it sucked. At home I set my alarm clock and got up once or twice
in the night to pump. (Some wonderful friends chipped in and rented us an
electric pump, but it was mean and really sucked my nipples hard. Within a few
uses of it my nipples were cracked and bleeding. I gave up on it and used a hand
pump my sister gave me.)
Night pumping was most draining, emotionally. I
pumped in the room we had fixed up for Rachel, and often I watched a video of
her we had taken. Although this always brought tears to my eyes, my milk flowed
quickly. Before long, I had enough milk to feed the entire NICU. I was so proud
By Rachelís eighth day she was breathing on her
own. During the day I was allowed to take her across the hall to the ďparenting
roomĒ, a place exclusively for parents whose babies were in the NICU. I was
able to put her to the breast twice a day, but at first she had to go back to
NICU for feedings to she could be monitored. She held her own and I was able to
nurse her without monitors and machines.
I had a terrible time keeping her awake for
feedings at my breast: she would mouth the nipple, lick it, and doze off to
sleep. I tickled her feet and palms to no avail. Her latch was terrible because
she had no suction and didnít open her mouth wide enough. I was virtually
expressing milk into her. The nurses were helpful. A midwife and lactation
consultant checked on us and her positioning was good. She was just too little
and to weak to nurse well. The pediatrician didnít want her at the breast for
more than 20 minutes at a time for fear she would spend more energy than she
would gain. She was a pound less than her low birth weight
4 lbs. 13 oz, it was a slow climb up.
After a week of barely noticeable improvement, I
felt discouraged. Would I ever get Rachel home? Her inability to nurse
efficiently was keeping her tube-fed in the hospital. Another mother told me
bottle fed babies go home sooner than breastfed babies...My husband strongly
encouraged me not to give up. My dream of a peaceful birth at the birthing
center without bright lights or drugs had been blown apart. I had to
Around day 22, Rachel started to stay awake for
longer periods of time and although still only mouthing my breasts, she did it
more vigorously. By this time I was putting her to my breast at least three
times a day, more often depending on what nurse was one. This was great; the
more often she sucked, the less I had to pump, and I was beginning to hate the
On day 24 the nurse suggested I stay overnight
and feed her for all the feedings. I was excited! After the midnight nursing she
gained 65 grams! Incredibly, she no longer needed to be supplemented by tube. I
stayed a second night and she gained weight again. Twenty six days after her
birth, we finally took our 5 lbs. 2 oz. baby home.
At home we had to wake every four hours. A couple
of days later she was waking on her own every two hours. She still only mouthed
my nipples. There really was no feeling of suction. If I didnít hold my breast
in her mouth, it would fall out. She usually nursed an hour, then was wide awake
for an hour. I tried to nurse her lying down, but since she couldnít hold the
nipple at all, it didnít work. I wasnít worried about her weight-gain since
there were lots of wet diapers.
A couple of weeks after we got home a friend
encouraged me to attend a La Leche League meeting. It was our first outing and I
was happy to get out, but once I got there I felt horrible. All the moms and
babies seemed to be nursing so effortlessly, and they could have a cup of tea
with their free arm. I broke down and cried. The leader and some moms reassured
me it would get better.
Two days before Rachelís official birth date,
seven weeks after her birth, when I sat down to nurse, I felt a tug at my
nipple. She was actually sucking! Over the next few days the pull increased and
I could actually have one free hand too. When she was 11 weeks old she finally
managed to nurse lying down and we started getting some sleep at
She cried often, and when she cried I always
offered her a breast, but it wasnít always the answer. I wore her in a sling,
danced with her, (she still like Stevie Ray Vaughn) slept with her, changed my
diet for her, but I guess she just needed to cry. Maybe it was our cruel early
separation. She had breastmilk only until seven months. At that time she was
already 24 pounds.
Now Rachel is 17 months and nurses like a pro.
She sleeps in our bed and nurses every two hours, which drives me crazy but I
believe will stop eventually. Sheís pretty clever.
I still get mad when I read about wonderful
birthing stories. Establishing a good breastfeeding relationship was the most
challenging thing Iíve ever done, and the best thing Iíve ever done.
If you have a premature baby, my advice to you is
If your baby is hospitalized, make sure the
nurses know you want to do as much as possible. You can change diapers, bathe
baby, give your milk through the tube, touch your baby as much as possible. Be
sure the pumped milk your baby is receiving is given in chronological order.
Surround yourself with people who believe breast
is best. Find La Leche League. They can help.
Know you will be able to nurse this child. It
will be worth it.