The United States has one of the highest rates to preterm births in the world. Each year approximately 1 in 10 U.S. babies are born too early — before 37 weeks. The moment they are born, these babies begin their journeys in the NICU (Neonatal Intensive Care Unit). For preemies, breast milk can be critically important to their progress, however, for the mothers of premature babies initiating milk production and breastfeeding can be extremely difficult.
September is NICU Awareness Month. As we close the month, we are happy to be able to share our friend and MotherShop partner, Lauren Stuart’s breastfeeding story. We hope that her NICU pumping and breastfeeding experiences bring comfort to those facing similar journeys.
Lauren is mom to twins, Elodie and Owen, and the co-founder and CMO of bӧkee.
Breastfeeding is natural, right? So, it must come naturally to all new moms and babies too, right? Wrong!
My perception that breastfeeding and pumping was that it would be easy was a far cry from my reality, and for most of my friends too.
As a first time mom and pregnant with twins, I was going to need a lot of milk! So, I knew I wanted to meet with a lactation consultant prior to having them. I was on full bed rest starting around 28 weeks. Since I didn’t have much going on, I made an appointment with an International Board Certified Lactation Consultant (IBCLC) that was recommended to me. At our first meeting, she provided me with a bunch of literature on why breast milk was important and tips for increasing milk supply. She also taught me how to stimulate the glands and self express, and why this would be crucial for generating colostrum in the first few hours after giving birth. I’m so glad that I had that consultation on that day, because later that night my doctor told me that I needed to go to the hospital and I wouldn’t be coming home until the twins were born.
Fast forward to 32w+0d and they had arrived. After recovery, back in my hospital room, it was time to start trying to produce some milk. I asked the nurse for a lactation consultant to come talk to me about what I needed to start doing and when – and to bring me a pump. I was dumbfounded when the response I got was, “there’s no rush, you just had the babies”. Typically, in a birth without complications, if a mom plans to nurse, her child is placed in her arms right away. In my case, it would be weeks before I’d have a chance to put one of my babies to the breast.
Breast milk is important for immune development in preemies, especially within the first 6 months, so I was determined to make it work and to get them as much of my milk as possible. Thanks to my prenatal lactation consultation, I knew I could hand express. So I did, into a cup. I didn’t get much, but I knew that even swabbing a little bit of milk into their mouths would be something, so I kept trying.
When I was discharged from the hospital 5 days later, I was pumping every 3 hours around the clock trying to get my milk to come in. I went to the NICU like it was a full-time job, I was there for the first feed in the morning and there for the last in the evening. To pump in the NICU, I’d sit between the isolettes and try to “relax” – I’d look at the twins and every time I’d pray for more milk. Maybe, if I had gone into labor, my milk would have come in faster and my supply would’ve been higher, I’ll never know. Unfortunately, all of the pumping wasn’t generating much milk. In a good session I was lucky to get 3 oz. combined. As someone who is well-endowed, I never imagined my boobs could “fail” me like I felt they were! I ate dozens of lactation cookies, drank high-yeast beer, took fenugreek, stimulated, power pumped, all of the things you read about to increase supply. I would watch videos of the babies crying to try to stimulate my body into producing more while at the pump, I also tried distraction (watching Friends) and warm compress, but no matter what I tried, the same amount seemed to come each time. Most of the time, when I’d hand over the milk to the nurse, it was met with a “more will come” look or sentiment.
Four weeks after having the twins, I was finally able to try to put my daughter to the breast. She was getting ready to come home and had mastered drinking from the bottle. You see, suck, swallow, breathe doesn’t come naturally for a severely premature baby, she had to learn this as she grew. In the NICU, preemies usually start with an NG (nose) tube for nutrients, then move to a bottle and then to the breast, if that’s what the mother wants. At five weeks, she was nursing like a champ and she continued to breastfeed for 20 months.
My son didn’t come home until eight weeks and had a lot of trouble at the breast. While I was able to nurse my daughter, I was still pumping around the clock for my son. What’s crazy is that I was producing enough at the breast for my daughter (and she was growing as expected without supplementation) but on the pump, I could still barely produce milk for my son. I continued to work with my lactation consultant multiple times a week for several months to try to increase my supply. I also never felt a let down – ever. My lactation consultant explained that a baby at the breast is much different than what a pump simulates. So, I kept on with the nursing and tried two different kinds of hospital grade pumps with hopes of a better supply.
Pumping was taking a massive toll on me – physically and emotionally. I was blessed to find a milk donor for my son which relieved me from the relentless pumping. I felt guilty when I stopped, but I knew it was the best thing for me. At first, the concept of giving him someone else’s milk felt weird, however, I immediately had to put those feelings aside because I knew that with his prematurity, size, and GI issues, breast milk would benefit him. When I mailed that pump back I was so happy to be done! I was finally free of the mental load I was carrying – the guilt and the feelings of not being enough.
I share this story because breastfeeding outcomes may not match your desires or expectations. You might fail at the pump but produce enough for your child at the breast. You might not produce anything at all. You might decide to stop breastfeeding sooner than you had expected, or not at all.
The most important thing is that you need to do what’s best for you. Your mental health is important and maintaining it may involve tough choices. Breast milk is great — so is formula.
As a new mom, providing safety, sustenance and love to your child are the most important nourishment you can provide them, not how you feed them.
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How can you help NICU families?
These wonderful organizations provide critical services, support and guidance to NICU families.