Breastfeeding a premature baby: my story

Photo by Wes Hicks on Unsplash

Five months in and I only now really feel ready to talk about breastfeeding. It’s such an emotional subject for many women and I don’t think the realities of it are talked about enough. It is hard. It is one of the most difficult things I have done in my entire life and I know I’m not alone in that feeling.

Before giving birth

Laying my cards on the table here, I am very much pro-breastfeeding. I believe breast milk is the best thing to feed your baby with and I personally can’t imagine not wanting to breastfeed. A Mummy’s milk is specially designed to give her baby what it needs and it is amazing.

Before we had a baby, I would say I was anti-formula. I never wanted to give it to our baby, but then I never thought we would have to. It’s safe to say I was pretty naive. Everything I learnt before giving birth assumed that I would be able to breastfeed, I just might need a bit of practical help doing it; it was all about tongue tie or how to hold the baby so you’re comfortable. No one talked about how to establish feeding or what to do if you struggled. No one mentioned cluster feeding, how to check milk transfer, let down, nipple pain, how to get a good latch if your baby can’t do it, skin to skin etc. etc. – the list of things I didn’t know I needed to know is endless.

I went to an NCT class, where we were taught positioning and attachment; I went to a talk by an IBCLC (Independent Board Certified Lactation Consultant) who told me that most women can breastfeed, or rather, there’s no biological reason why they can’t. That won’t be me, I thought. I was looking forward to it.

I was completely and utterly unprepared for what was to come.

Trying to establish breastfeeding

After a traumatic labour (read my birth story here), my premature baby boy was taken to SCBU whilst I recovered. We were separated immediately. When I next saw him (hours later), he was in an incubator hooked up to machines. He was bruised, unwell and sleepy. Because he was in an incubator and repeatedly treated for jaundice, we had very limited contact. I felt scared to get him out of there and when we did get him out, we were told to put him back after not too long so he could stay warm. We were completely deprived of enough contact during this time and, with hindsight, I completely believe this contributed to my lack of supply.

I expressed using a hospital grade pump from the day after he was born but never felt like my milk came in as I was repeatedly told it would. I was tired and anaemic from the blood loss and I don’t think I truly realised what needed to happen to get breastfeeding going. I just kind of thought I’d wake up one day with rock hard, leaking boobs, but with every day that passed it started to seem less and less likely to happen. And from that point on, I was clueless.

I could get small amounts of colostrum when I was expressing but it soon became apparent that my supply wasn’t enough to satisfy Sebastian – he needed more food.

In the middle of the night, on my own (without my husband) I was asked which formula I wanted to start him on because I wasn’t producing enough milk. I had done zero research about this and just picked one of the three on offer. We still tried putting Sebastian to the breast but not nearly often enough. He was small, lethargic and struggled to stay awake to feed and to latch strongly. He had a tube down to his stomach that we fed him with, but I didn’t know how to coordinate this with breastfeeding – if he feels satisfied and full without having to suck because the food is being put in his tummy, then why would he latch? But obviously he needed sustenance to thrive. It felt like a catch 22.

Over time, he started to become stronger and after two weeks, he pulled his own feeding tube out and we tried exclusively breastfeeding to avoid the tube going back in. It seemed to work and we were discharged from hospital with Sebastian classed as “exclusively breastfeeding”, even though we had only been doing it for 24 hours or so.

Trying to breastfeed at home

We were told someone would visit us at home on day one after discharge. No one came until day five, after I had made two calls to the hospital to ask for someone to come and help. We didn’t really know what we were doing – we thought feeding for just a few minutes was enough, but it wasn’t. Sebastian was always hungry, crying, wouldn’t be put down, would only sleep if being held. We were all wrecked, completely exhausted.

When the midwife finally came on day five, we were told that all seemed OK. She recommended nipple shields because of a difficult latch on one side. A few days later when our health visitor came, she weighed our baby and he had lost more weight. He’d lost so much we needed to go back into hospital. Despite me telling her I was determined to breastfeed, she told me to give him 90ml of formula every three hours. I got very upset – I couldn’t provide for my son, I had failed, I had been starving him.

A trip back into hospital

We went in to A&E and a midwife came to observe a feed. She asked me to express to work out how much milk my baby was taking. She told me to make sure baby feeds for at least 20 minutes per breast to ensure both fore and hind milk transfer. They calculated he should have 35ml top up after every feed and told us to feed every three hours, express during feeding and then top up with expressed breast milk (EBM) and formula.

We got home and started this regime, meaning I was sat there topless every three hours, with Andrew holding the pump while I got Sebastian to latch. Sebastian was a slow feeder and very sleepy. It was difficult to leave the house – by the time we would be ready to leave, it would be time for another feed and there was no way I could feed in public.

We were getting very little sleep and we were both tearful. Looking back, these first few days are such a blur. Feeding was stressful and we were tracking every ml that he took in a bottle and every minute he spent on the breast. Weigh ins were obsessive – we were desperate for Sebastian to regain his birth weight.

I still never felt like my milk had come in, my boobs never leaked or felt full and I had no idea how much Sebastian was able to transfer from me.

It soon became apparent the regime was impossible to continue once Andrew had to go back to work – I couldn’t feed, express and top up every three hours on my own. It was just impossible, but I still felt like such a failure.

Getting a second opinion

My friend had recommended I join our local La Leche League Facebook group, which was a huge help to me in those early days. I found out about a local meeting and went along with my parents. There, we saw an IBCLC (incidentally, the same lady who had given the breastfeeding talk we went to when pregnant) who was very no nonsense.

She recommended we change the top ups from after every feed to twice a day and freely offer breast in between. She checked for tongue tie, observed me feeding him, checked his latch and milk transfer. She also told me I had been wearing shields incorrectly and told me how to use them properly. I felt momentarily buoyed and we tried this approach with gusto, but Sebastian was still very unsettled, constantly hungry and never satisfied at the breast.

My husband had to go back to work leaving me sitting on the sofa trying to feed him, crying. I began to dread feeding and just wanted to give bottles instead. We were continually exhausted. We questioned every decision we made – do we up the top ups? Do we switch boobs during a feed? Do we feed for a certain amount of time? How often do I express? If I express at the wrong time, will there be any milk left for a breast feed? If I miss expressing, will it affect my supply? I can’t tell you how all-consuming it was. And how utterly miserable – I couldn’t cope with the disappointment after always being so clear on wanting to breastfeed.

I went back to the IBCLC who just told us to give three bottles a day instead of two. I poured my heart out in my message and got a one line response. I didn’t feel supported and I very nearly gave up breastfeeding completely. We had heard conflicting advice from every medical professional we had spoken to and decided we could only trust ourselves and our instincts with our baby. We knew when he was hungry and we didn’t want him to starve, we wanted him to put on weight. We were paranoid about his volumes.

We reverted back to top ups after every feed as we found this easier and Sebastian finally settled. He slept whilst not being held and it was a revelation. Feeds still took a LONG time, but gradually they became more manageable. Sebastian’s weight picked up and we got into a routine that worked for us.

Trying to embrace combination feeding

I started expressing twice a day instead of at every feed and found I was getting the same volume over the day as I had been getting when expressing after every feed. But it wasn’t enough to satisfy Sebastian so we continued to supplement the EBM with formula. I tried to make my peace with combination feeding, but it was so hard. I know I’ve said it before, but I just felt like a complete and utter failure. Every bottle of formula represented milk I couldn’t produce. The use of shields just proved that my baby preferred a plastic bottle than his Mummy’s breast. It went against everything I always believed I wanted for my feeding journey and my relationship with my baby.

Now, just over five months in, I am in a more settled place. Gradually, Sebastian has taken more at the breast and top ups of EBM and formula are down to three or four bottles a day. I express once a day. Yes, we still use shields and that isn’t ideal, but they have enabled us to carry on feeding so I can’t begrudge them too much.

Was it worth it?

Reading this, you might well question whether going through all of that was worth it. Why didn’t I just give him formula and save myself the stress? Well I could have done, and if you want to do that then thats your decision, you do you. But I still believe I did the right thing by not giving up. I love feeding my son – the closeness, the cuddles, but it also satisfies a primal urge I feel to provide for him, to protect him and above all to always makes sure he has the very best he can have.

I also don’t intend for this to put anyone off breastfeeding, I just want to encourage you to reach out for support if it doesn’t come to you. Engage with La Leche League, find a lactation consultant, demand more and better care from your midwives and health visitors. Don’t be ashamed if it doesn’t come easily to you, don’t just quietly give up without a fight if that isn’t what you want to do, don’t be afraid to ask for help. I’m sharing what I went through in the hopes that it helps someone else and to continue the conversation about normalising breastfeeding.

I am so PROUD of the fact that we are still breastfeeding. I could have given up so many times, but I didn’t and Sebastian is still getting breast milk at nearly six months old.

I am so HAPPY that I can now enjoy breastfeeding, it’s the most wonderful bonding experience with my son and it gives both me and him the most amazing comfort.

I am so GRATEFUL for the support from my husband, my family, my friends and even people who I have never met messaging me on social media. Breastfeeding is without a doubt the hardest thing I have ever done and I couldn’t have got to where I am without everyone around me. It really does take a village.

And finally, if you’re struggling with feeding and want some support, please message me. I’ve shared our battles on instagram stories and will continue to do so – find me on there. And the best bit of advice I was given: don’t give up on a bad day. You can do this.

♥ JH

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