Between 10-15% of babies in the US end up with a stay in the Neonatal Intensive Care Unit, with prematurity being the most common reason. Breastfeeding a NICU baby often comes with challenges on a whole other level. In honor of NICU Awareness Month, one of our treasured lactation consultants, Jenna, decided to share her NICU journey, and the gifts she found from navigating those challenging weeks.
I was well into my second trimester and joyfully anticipating the end of my pregnancy with my second daughter. I had a previous preterm delivery, so when contractions began suddenly at 33 weeks of gestation, I was scared. And sad. It was too early, yet my sweet baby Cora Joy would be born today.
As a then postpartum nurse and aspiring lactation consultant, I knew my hope for easy breastfeeding, newborn snuggles, and hospital sibling introduction was gone and, in its place, lay an emotionally and physically challenging journey ahead.
The very first thing I did in the recovery room after my c-section was ask for a breast pump. I used a hand pump and got an amazing 6 mLs of colostrum! I was confident that my body would make perfect life-saving milk, tailor made for her exact needs at that exact time, and I was determined to get it to my baby.
Cora required extra support to breathe initially, so she was not stable enough to breastfeed until her third day of life. When she was stable enough to suckle at the breast, the NICU lactation consultant helped me to set my expectations for what a successful feeding looked like in these early days. Cora’s breastfeeding durations were short; she suckled, hardly swallowed, and was easily exhausted. Aside from the regular learning curve of proper body alignment and positioning of a newborn, breastfeeding in the NICU brought new logistical challenges of wires, tubes, and alarms sounding all around us.
Cora could only tolerate trying to latch a few times a day, so I relied on the pump to stimulate my milk production. I needed to cling to something I could control during this uncertain time—so I pumped 8 times a day, religiously, and celebrated every drop! In the weeks ahead, I visited the NICU regularly and was able to be present for a couple of feedings a day.
Cora and I snuggled skin to skin, letting my heart help regulate hers. I talked and sang to my baby, so she heard my voice and knew she was not alone. I prayed for her and her care team. I asked lots of questions and looked forward to their updates every day. I accepted help from my family and friends—rides to the NICU because I could not drive myself after my c-section, meals, and babysitting my toddler. I was humbled and grateful for so much unexpected kindness. I cried a lot and grieved the loss of my expectations for this time. I pumped—this was the hardest, yet most empowering, labor of love; I was able to own the incredible gift that I could give my baby…my breastmilk.
Breastfeeding slowly improved as Cora got stronger. We set little goals that felt so big. We had to take one feeding at a time, one day at a time. Cora slowly gained strength and endurance to maintain her heart rate and breathing while tolerating more volume by mouth; she grew into staying active at the breast for longer durations, and not require a feeding tube for the difference. It seemed whenever we took one step forward, we took two steps back. I longed to bring my baby home with me, and for her to meet her big sister. The days in the NICU were slow and long, defeating and victorious, sad and hopeful.
The struggle of breastfeeding a preemie did not end with NICU discharge; in fact, feelings of uncertainty were magnified as I had little guidance from here.
I wish I had known about outpatient lactation services for this specific issue because I would not have felt so alone. Triple feeding continued: Breast, bottle, pump, repeat.
I was hoping for positive weight gain at her next weight check. I was exhausted and trying to still be a present Mom for my toddler, too. Cora continued to gain strength and ultimately required less supplement and worked her way to exclusive breastfeeding.
Today, Cora is healthy, strong, spunky, and full of life. Today, I appreciate the growth that happened during our NICU stay and the gifts that remain:
The gift of finding beauty in a reality that is different than my plan,
The gift of slowing down to celebrate little victories, because baby steps can be big steps too,
The gift of allowing myself to be cared for by my support people,
And, most importantly, the gift of finding unexpected joy in the hard places.
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