I’ve been promising a post about breastfeeding for a while now, so I’m finally attempting it. On one hand I want to answer the questions you’ve had, but on the other hand I hesitate to share because I feel like it’s pretty personal, and I think there’s also a part of me that wants to avoid any judgement. But as usual, I do want to share in case there’s anyone who can relate or if my experience can help anyone in a similar situation.
As most of you already know, the girls were born extremely early and spent a lot of time in the NICU. In the beginning they needed help breathing and with a few other things, but the reason we were kept there so long in the end was because they were having such a hard time feeding. So, here’s how it went down…
The hospital that the girls were born at really encourages Mom’s to breastfeed (as I’m sure many hospitals do these days). So the same day/night that the girls were born, after they were settled in the NICU and I was back in my hospital room waiting to see them, they sent a lactation consultant with a pump kit and a hospital-grade pump to teach me how to pump. We all knew that the babies were’t going to be able to latch for a really long time but that they would need my milk, so pumping was going to be my only option. I was lucky that my milk came in fast, and I actually had a lot of milk in the beginning, so I learned to pump and got on a schedule with it. As weird/hard/painful as it was I loved feeling like I could do something for the girls. The doctors and nurses told me how valuable and vital my breastmilk was for them in the beginning. Apparently my body knew that the babies were born at 30 weeks, and would therefore make breastmilk perfectly formulated for a 30-week baby. How crazy cool is that?
So I pumped and pumped and pumped. I was proud in the beginning, and Blake was, too. He loved to run my milk down to the NICU for the girls. They were getting small amounts of milk through their feeding tubes, which in the beginning went in their mouths. Then I was discharged from the hospital, and had to figure out how to manage my pumping schedule with my time in the NICU. The nurses in the NICU were so helpful – they had a pump for me there, and were all trained in lactation. They stored milk for me in a freezer there. At home, I’d save up milk from pumping and bring it in to the NICU when my supply there ran low. I set my alarm to wake up every three hours at night and pump. They had cameras there for me to see the babies when I was away from them, which is also supposed to help you keep up your supply. (When people told me I was lucky to be getting sleep at night away from my babies I felt like rolling my eyes. Not only because I felt like I was pumping all night, but because you tell me how well you’d sleep with your newborn babies in the hospital!!!)
During Piper’s early days in the NICU, before she was able to eat, we were able to swab her mouth with breast milk.
I felt like I had a lot of milk in the beginning. At one point, I even asked one of my nurses how I could donate milk. (Romy had received a tiny bit of donor breastmilk – just one time before my milk had come in – and I was really grateful for that.) My nurse looked at me like I was crazy and told me that there’s no way I was donating milk, that I should just keep saving up my milk because I was going to need it. Um, she was right…
After the girls had been in the NICU for about 6 weeks, I got sick. It was just a bad cold but it was horrible – one of my worst fears had come true. I couldn’t see the girls for a couple of days, because for them catching a cold could be fatal. Through the sickness and the stress of not being able to see them, my supply singificantly dropped. I think from that point on I started to really battle my dropping supply, trying different tricks to improve it. I had a lot of milk saved up, but the girls were starting to eat more and more.
Over the next month we tore through the milk I had saved, and soon it was all I could do to keep enough at the hospital for them. We started making runs to the hospital in the middle of the night to make sure they’d have enough breast milk to get them to the morning. I finally realized one night when the girls were about 2 months old that I just couldn’t keep up, and the nurse explained to me how we could mix formula with my breast milk to supplement. I agreed that was what we needed to do, but I cried and cried that first time we had to do it. I’m crying now even writing about it! There were lots of emotions mixed in – I knew breastmilk was best for my babies and wanted them to have it, but I also felt like I was failing at the one thing I’d been able to do for them that nobody else could – giving them my breast milk.
After that first time we supplemented with formula, I started to feel ok about it. I told myself that there were good nutrients in formula, too, so maybe they were getting the best of both worlds? I still struggled with my supply but just got as much milk as I could and then asked the nurses to evenly divide the breast milk with the formula needed throughout the day and night so that the babies were at least getting consistency in their feedings.
Side note – at this point the girls still weren’t allowed to actually breast feed. We were allowed to do what the hospital called “non-nutritive”, which is where the girls could practice latching/sucking without really feeding. This was supposed to help them practice for when they were allowed to start bottle feeding and also hopefully help my supply. The girls seemed to take well to this, which gave us lots of hope that they would pick up feeding quickly when it came time.
Things got complicated again when the girls were allowed to start bottle feeding. They’d been getting all of their feedings through a tube, but when they started bottle feeding we realized that they hated the taste of formula. The kicker is that bottle feeding was the last thing they needed to learn before they came home, so you can imagine the new added pressure I felt to get my supply up.
Without going in to too much detail, we went through a lot of ups and downs (mostly downs!) with our feeding/breastmilk/formula situation in the hospital. It’s hard to explain it on here, but we switched hospitals to meet with a renowned feeding specialists, fought with a doctor’s order to switch formula, tried different types of bottles and nipples, etc. etc. etc. Every mL was tracked, the girls were carefully weighed everyday and every milligram gain or loss carefully tracked. I was allowed to try and breastfeed them, but in order for that to count towards their daily feeding minimum we had to weigh them before and after feeding. Sometimes the scale would show no weight gain or even show that they’d lost weight during feeding, even when I knew they’d gotten a lot of milk! So although I wanted them to breast feed, I wanted them to come home more and I worried that it would take away from them hitting their requirements to make that happen.
When they were finally able to come home, they were still considered fragile feeders. We still struggled with them to finish every bottle. I started trying to breastfeed them each a couple of times a day, but that came with complications all over again (the cracked/bleeding nipples, clogged ducts, and mastitis). In the hospital they said that my supply would go up when I got home and had the babies with me more. But that actually wasn’t the case – I think figuring out my pumping/feeding schedule with them at home was a lot harder and it actually seemed to keep declining. Breastfeeding seemed to take so much time, and so did pumping. Sometimes I felt bitter (and maybe a little jealous) that Blake was enjoying time with the girls while I was stuck pumping. It was hard to remember that pumping was providing something so valuable for the girls when I felt like it ate up all the time I could have been playing with the girls and the time that they were napping where I could have been getting other things done.
This went on for months, with my supply still slowly declining. When the girls were about 8 months old, they stopped wanting to latch. Even though they liked the taste of breastmilk better, they started to get frustrated with how much more effort it took than their bottles. At this point we were up to a level 3 nipple, so they could feed much easier/faster from bottles. I should also note that by 8 months old the girls each had 8 teeth! Crazy, right? I still can’t believe that my little 8 month old preemies had 8 teeth, when a normally a baby would have 1 or 2. And that many teeth bring a new terrifying and painful element to breastfeeding, especially when a baby is feeling frustrated!!
So, for a couple more months I pumped, but slowly weaned myself off. And when the girls were about 10 months old, I stopped altogether. That was a really hard few weeks for me – I immediately felt so much sadness and regret. At one point I even tried to start pumping again to see if I could get my milk back! I felt so guilty when I would think about the nutrition my girls would no longer be getting from breastmilk, and sad that the act of breastfeeding never felt special, or beautiful, or bonding for me. And aside from that, the hormone shift was horrible! Aside from adding to the sadness/depression I felt, I instantly gained weight and my face broke out like crazy.
Now that I’m a little further out, I’m doing much better. I still have some regret, but there’s also relief that I have more time to spend actually playing with my girls. We are working hard on getting them to eat solids, and they still drink bottles totaling anywhere from 30-40 ounces/day. We are still on the same formula that worked best for them in the NICU, partly because I’ve been too terrified to change it because of what happened when they changed it in the NICU, and partly because the doctors have told us that they still need the added benefits of something formulate for preemies.
As I’ve been writing this post, I’m facing out the window where Blake just put up a hummingbird feeder. He’s been wanting to get one forever, and he will be so excited when I tell him that there are two hummingbirds that keep coming to feed from it. Watching these two beautiful little birds as I sit here thinking about Romy and Piper’s feeding journey along with my breastfeeding journey gives me so much peace for some reason. Everyone’s journey is going to look different, and that’s ok. My babies are alive and healthy and have surpassed so many expectations for what their situation was. They have chunky thighs, and (most often) big smiles on their faces!
Now as we tackle solids I hope I can remember that it’s all going to be ok…;)
I tried to cover most of your questions in the body of this post, but here are a few more answers to questions I get a lot:
What formula do you feed the babies?
The babies are on Similac NeoSure Infant Formula with Iron, For Babies Born Prematurely. For several reasons, this was the best option for us. Until very recently, we’ve mixed it specially to be 24 calories instead of 22.
Did you ever tandem feed the babies (breast feed them at the same time)?
Yes, I did. And it was so hard. The nurses would help me do it in the hospital (“for fun”) and it was always chaos. I felt like I always needed two hands to feed one baby, so you can imagine how hard it was to feed two babies with two hands! Once I got home a tried it a few times, but mostly I would breastfeed one while bottle feeding the other.
How did you wean off pumping?
By this point the girls stopped latching all together, so I only had to wean off of pumping. I slowly let myself go longer and longer in between sessions – I was so afraid of more clogged ducts and mastitis! It took almost a month to totally stop.
Which pump did you use?
In the beginning I was able to borrow the hospital-grade pump from the NICU – the Medela Symphony. I loved that pump, and then when they needed me to return it for other moms to use I switched to the pump I talk about in this post.