Breastfeeding - As A Premie Mother

As Breastfeeding Awareness Week comes to a close. I reflect more on the challenges I faced as a mother of a Premie.  

My son was born at 27 weeks and he is my third child. I breastfed my daughters prior to him so I would say that I was quite experienced in breastfeeding and was already aware of the usual things to watch out for within my body and the usual How Tos with bub. 

With my son arriving so early I didn’t realise that I would need to start expressing as soon as he was born. From when my milk came in, I was expressing milk every three hours on the dot, even through the night. This was then stored in the NICU freezer for when my son could tolerate breastmilk. When expressing at home I was traveling back and forth with a cooler bag topping up the NICU freezer. 

Until he grew big enough to breastfeed, he would be fed through a feeding tube and a syringe filled with my breast milk. The amount to give him is a delicate balance of enough to nurture but not too much to affect his breathing. My son would desat almost every time he was fed in the initial stages and then the ringing of the monitor alarms started. A sound which rings in my memory almost six years later. 

The beautiful imagery of a new mother cuddling her baby to her chest and feeding would have to wait. For a mother of a premie, it will have to wait months. One of the most common themes of being a premie mother is to let go of the images that you had daydreamed of when pregnant. Of what experiences you will have when bub was born. It won't happen, or intime it might but certainly not as you had imagined or planned.  

In my experience, I was thankful that my milk had come in whilst recovering from a caesarean and I was able to express large amounts. Other mothers are not so lucky and in fact, result to taking medication to try and increase milk supply. The stressful situation of being a premie mother from birthing way too early, having a baby who has round-the-clock care in a NICU and just being physically separated everyday, impacts further on a woman's ability to produce breastmilk.

If you haven't been exposed to breastfeeding before, you are soon introduced to the benefits of breastfeeding by medical staff. So what are they?

For Babies:

• Nutritional Superiority: Breast milk is a perfect mix of vitamins, protein, and fat—everything your baby needs to grow.
• Immune System Boost: It contains antibodies that help babies fight off viruses and bacteria.
• Digestibility: Breast milk is easier to digest than formula, leading to fewer stomach issues.

For Mothers:

• Bonding: This has to wait a few months for mothers of premies - the physical closeness and skin-to-skin contact foster a unique bond.
• Health Benefits: Breastfeeding helps burn extra calories and lowers the risk of breast and ovarian cancer.
• Economic Advantage: It saves money spent on formula and feeding supplies.

The above benefits of breastfeeding are quite well known and expressing is not easy at the best of times. Expressing and having the stress of a sick or tiny baby in a NICU adds varying complexities. As a mother you want to provide the best for your baby so you could imagine how this can increase a mother’s already high anxiety. You feel the pressure to express as much as you can. A pressure which mothers naturally put on themselves. 

If this is you and you are struggling, speak to your local doctor and a lactation consultant in your NICU or in your local area. There is always help available and just know that your best IS good enough. 

Soon when you start your skin to skin breastfeeding journey, you will be in contact with your resident lactation consultant. She helps mum and bub learn to breastfeed specific to a premie baby. Your baby is still so little and may have additional medical complexities, so you will need to understand that latching and feeding takes extra effort and time than a full term baby. 

One memory I have of feeding my little one was quite a traumatic one. I have quite a large and quick milk flow so when starting to feed my little one, he choked, turned blue and alarms were going off. In light of this, my lactation consultant suggested I lay back into the armchair with him on my chest instead of being above him which worked and slowed down my milk flow. 

By this stage of your baby's development, they will be quite strong so watch their feeding tube. The cheeky little monkeys tend to pull on their feeding tube especially when breastfeeding. Their little fingers and arms become quite strong and can pull it out which my little one did a few times. Just another unique challenge for us premie mummas to think about and if you're wondering why they still have feeding tubes, their tubes aren't taken out until they are completely reliant on mother to baby feeding.

For me, this is when breastfeeding became more enjoyable. I had the baby I daydreamed about when pregnant, now in my arms and feeding. 

With very little sleep it can be had to remember which breast you last expressed or breastfed from so a tiny tip from one breastfeeding mum to another. To remember which breast you last fed off I would leave a hair tie on my wrist with the corresponding side. Saves the doubts and overthinking, however you may also notice the tenderness of one breast and firmness of the other.

For a more in depth record, you can document this down in a notebook or journal. Writing down your journey can be therapeutic and offers a cherished record of your baby’s progress and resilience. The Premie Journal contains a section designed just for this so you can review how your expressing is going. It’s called The Milk Diaries and looks like this: 

For mothers who are currently going through this I would say to enjoy the journey you are on. It’s common to ask the ‘why me’ or ‘why us’ questions but the most important thing is that you are okay, bub is okay and you’ll get through it. 

Ask for help when you need it. It is so important to feel supported and in control when you are in a situation that you feel so out of control.