13 November 2013

When Life Happens Prematurely: Part 2

nipple confusion is real, how I got my son to breastfeed, going from bottle to breastfeeding
How I Taught My Preemie to Breastfeed

This article was originally written for Preemie Resources, a blog and Facebook page I work on. I wanted to share the story of how nipple confusion is real and can develop while your baby is in NICU. Tristan's main issue was remembering to breathe. He'd gulp his food and then his heartrate would dip so low he'd turn colors and/or need stimulation to remember to take that next breath. It was very scary. During his two months in as many NICU's he had to try so many special feeding nipples and bottles that breastfeeding became an issue. What follows is what I wrote at the end of that summer in '11. I made a few edits because I have learned a lot since then and some of my opinions have changed.


I didn't have a birth plan, but I had a breastfeeding plan. That was the only thing I knew for sure. I had researched it and was going to write “do not give my baby formula” on his crib like the books said to do. I don’t have a problem with formula – I’m not a militant LLL EBF RAH RAH sort. It was something I wanted to share with my baby.

Well, I hadn't figured a preemie into the equation. Even when the nurse told me that they could wait for my milk to come in I didn't know what I was getting into. She warned me that breastfeeding might not be an option. She wasn't talking about us!

Except she was, and if you have the same dream with your baby in NICU try to prepare yourself.
Never think for a second that you can’t do it. You might have to let go of that dream because it isn't always possible. If it’s something you want (and you’re really going to have to want it!) you’ll need to start being patient right now
and never stopbut also set limits. There might come a point where the stress becomes too much or you might not make enough milk. That can be a very difficult decision.

In the beginning you can’t try to breastfeed because your baby is too small. You pump. And pump, and pump, and pump. I pumped eight times per day from 20-90 minutes per session. Nobody told me about the power pump method but I had created my own.

When we came home from NICU, though, I wanted to make the switch from bottles to breast. For two months I’d heard, “He’ll get it! He just needs to get stronger/bigger!” It wasn't adding up anymore. Mathematically he could do it, I thought. The very first time we tried he pulled a perfect latch and took an ounce! It was so unheard of several nurses weighed and re-weighed him. But he'd never done that again. By the time we were discharged he'd only take 10 ml at the max. Something wasn't right.

It turned out that my son had nipple confusion. I didn't even know that was a real thing! Most breastfeeding advocates will say it's a myth. My dream had been to feed him for the first time within an hour of his birth, but instead it took 3 months, 3 weeks, and 1 day for him to have his first bottle-free day. ...and that was a lot of luck and even more work.

Breastfeeding wasn't anything like I thought it would be. It was frustrating, upsetting, alienating and often ended with both of us crying. I was so tired of hearing comments from full term mothers when I turned to them for advice: “Well, you must be doing something wrong. Do you know how to latch? You must not. Go see a LC.” We were in NICU for 58 days! I had been swimming in LC's, but it wasn't until I saw a specialist that we realized the problem wasn't me.

My specialist told me that by choosing to EBF I might not be able to go back to bottles – that it was likely we couldn't have it both ways. She was right and now some people make comments about how I've limited myself – I’m tied down to my son’s feeding schedule. That’s also right, but I’m overjoyed! Double features and long shopping trips can wait – I have a son to feed!

I also had the time to commit to this massive project. If I'd returned to work there is no way we could have changed things and that is something I would have had a hard time dealing with. Looking back though, I wish I hadn't put so much pressure on myself. I'd become obsessed with what I thought was the one thing I had left of a natural birth experience.

We had to practice all day & all night; I had to be constantly within his reach. I started watching entire series on Netflix from start to finish to distract myself. It was stressful and tedious.

With nipple confusion often they can latch, but don't know how to suck. They can hang out & look just like they should, nursing away, but not taking in enough milk. It takes time, and a crazy amount of patience. I noticed that if I layed on my side he felt cozier and my arms didn't get tired. I'd let him comfort suck, try, whatever, just hang out.

FINALLY (!!!) he started to suck successfully and we'd skip bottles. That really freaked me out. Then we'd go overnight with him just nursing slowly, getting through the whole night. Then, when we got to a whole day with no bottles, I panicked and gave him one thinking I'd just fill his belly...then I read that that was a mistake (So That's What They're For – best book!). The next day I bit the bullet and didn't cave...............and we did it! We finally did it!

It was really scary when we finally put the bottle down. It was tempting to give him one just to make sure he wasn't hungry. On one of the days that week he lost suction for a feed – he cried, I cried, but we held onto each other and got back on track for the next feed. If their diapers are wet and pooping like usual you are good - and your pediatrician will let you come in and weigh your baby whenever you want to be sure they are gaining. They are there to help and support you!

It’s been over three months since his last bottle. He started sipping from cups this week.

Now, as I edit this, it's been over two and a half years. He is still breastfeeding and self-weaning slowly.

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