My wife and I are both determined to give Baby Benjamin the best possible care, and that includes breastmilk during his early stages. However, breastfeeding presents a ton of challenges for new mothers, especially those with preterm babies.
Benjamin may have only been 4 weeks early, but that has still caused extra difficulties due to his diminutive stature and lesser coordination - being a month behind on the developmental curve.
INITIAL STRUGGLES WITH FEEDING
Our first three days were spent in the hospital, and BY FAR the most stressful part of our time was feeding him. It usually went like this:
1) Marie would try, to no avail, to get him to latch. All the while, he'd be fussing out of frustration and hunger. Even with a nipple shield, it was virtually impossible. His mouth was simply too small.
2) We would resort to the alternative - formula (Similac Neosure 22 - more on that in a later post) administered via syringe. The goal was actually to attach a narrow feeding tube to the end of the syringe, and put that in the side of the mouth while he was on a nipple. Again, that usually proved too difficult.
3) A lactation specialist would stop by and try to help. Most of them were truly wonderful - a couple of the floor nurses and a couple of the lactation specialists really stand out as heroes of Benjamin's first few days. In the end, we typically resorted to having him suck on a finger while taking food through the small tube from the syringe.
INITIAL STRUGGLES WITH PUMPING
In the meantime, there was all the consternation over breast milk. Just like the preterm baby itself, milk production sometimes isn't quite ready for the big leagues when the birth happens ahead of schedule.
Marie's first pumping, shortly after birth, went exceptionally well. We got our hopes up, but the next couple days she was producing so little that we got worried. If you're in a similar situation, be patient, stay positive, and keep trying.
A couple things that worked for Marie...
1) Manipulation of the breasts, especially when the milk truly came in "full force" on about Day 3. Her breasts were so swollen and tender at that point. It was truly excruciating. Remember when I said we had some heroes of our hospital time? One of the lactation specialists showed up randomly in the middle of the night, gave her advice and helped her overcome some of the pain. Thankfully, it passed after 24-36 hours, during which time she used ice, warm water, and massage.
2) Having Benjamin on or near the breast, prior to or during the pumping session. There is a huge psychological aspect to the whole thing. Positivity is really key. When she is stressed, at work or at home, her production is markedly lower. If you can't have your baby nearby, at least look at pictures on your phone. Talking to others who've been through it can really help your mindset. Marie participated in a couple Facebook chats with a local chapter of La Leche League, and found it very informative.
3) This is easier to discuss than to execute, but some of the obvious things like rest, hydration and diet have a huge effect on production as well. Keep tabs on your physiology and make the necessary adjustments.
SETTLING INTO A ROUTINE
All along, we've fed him approximately every 3 hours. That's roughly when he starts chirping for it again. As his demand for volume has increased, Marie has continued to prepare bottles with a 50/50 mixture of her own milk and the Similac formula. In our first few days in the hospital, he was only getting 20-30 mL per feeding. As of 2 months, he's getting about 100 mL total. Although he started small, his weight has progressed nicely.
She tries to pump at least six times per day. The goal was 7-8 during her six weeks off from work (post-birth), but now that she's back in the OR, she has to settle for two pumping sessions during the workday. Plus, on average, 1 in the early morning, 1 right before work, and 2 between work and bedtime. For a total of 6.
I do my best to help by feeding him while she pumps, or feeding him in the middle of the night so she can rest up for a better pumping in the early morning. While I called it a "routine" in the subheader, every day is its own battle and things change quite a bit from the plan.
I'll update this post with more details, and also expand more on the topic in future posts. Feel free to comment or even email us with questions!
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