I originally wrote this post in August on www.hdydi.com for the World Breastfeeding Week 2013 Blog Carnival. I wrote these tips based on my real life experiences of breastfeeding my three little guys during my time in and after their NICU graduations. We aim to promote community support and to normalize breastfeeding for today's and the future's parent. Find more posts that were included by visiting the main carnival page.
This week it is Breastfeeding Awareness Week here in Canada (October 1 - 7.)
A special note I want to make is that although I am pro-BF'ing and I tried very hard to be successful, I do believe each mother has the choice and I hope that mothers will consider and try breastfeeding, and if it doesn't work, seek some help and if still doesn't work, well then, it doesn't work. On another note, many premature babies have difficulty in gaining weight and struggle and in these cases premature babies often benefit greatly from receiving fortified milk or supplemental formula feeds to increase caloric intake. If you are reading this, in a NICU and want to solely breastfeed your babies, but the doctors are advising to fortify, it is important for you to understand the rationale behind it and be on the same page as your baby's specialists.
We all hear it. We all know it. “Breast is best.” Being able to breastfeed babies is something to strive for and many new mothers are bound and determined to be successful breastfeeding mommies. But it’s not always that easy.
What happens when you have more than one baby at a time, each demanding to be fed as newborn babies do? How do you balance the needs of twins, ensuring they are being well-nourished? How do you handle your own needs as a mom, such as getting enough sleep, managing your own diet when you are trying to balance the needs of multiple babies? How do you learn to nurse your babies if they are born premature and are living in a NICU? Each situation is challenging, but each of these needs can be achieved. I am telling you, because I have done it for three premature babies, including twins while in a NICU. I’m not going to lie. It’s not easy. You might shed a few tears. You might want to give up. People might try to talk you out of it. But I’m telling you now, it can be done!
While in the NICU for over three months with twins, I learned to nurse each of my babies when they were ready. Unfortunately we found ourselves in contact isolation for about 9 weeks of this time, all the while trying to learn to breastfeed and nourish my babies enough to be able to go home when they were ready and continue on with breastfeeding for as long as possible. Wearing gloves and gown while in isolation, I learned to work through the awkwardness of breastfeeding while in my isolation “get-up,” along with dealing with numerous wires and sticky things about my babies’ bodies. It truly was awkward, yet I wasn’t going to give up because of a rash of a bit of bad luck. The one thing that was natural and I could do for my babies, I was going to do.
Here are my 5 tips for you to try with the hopes that you will be successful while breastfeeding in a NICU and beyond.
Why Do You Want to Breastfeed?
First things first, ask yourself why you want to breastfeed. Is it for your own personal satisfaction and goal of providing for your children? Is it because you feel it is best for your children? Or is it because someone else told you that you should? If it is because you either want to gain something out of it such as the feeling of satisfaction of knowing you are providing nourishment for your babies or because you feel in your heart it is what needs to be done and you’re going to do it, then you’re on the right track. To be successful at breastfeeding babies, who are living in a NICU, when you are already under an enormous amount of strain and potential mental, physical and emotional stress, you have to be sure breastfeeding is important to you and you’re not doing it because someone else said so. If you are not mentally prepared to breastfeed, you’re headed for a rocky road.
Communicate Your Breastfeeding Goals to Others
Make sure you tell your babies’ NICU nurses, lactation consultant, and medical team your goal to breastfeed your babies when they are ready. Remember, because your babies have arrived early, they may not be able to start nursing immediately due to their size or health situation. Give it time and be patient. Begin using a breast pump as soon as possible and on a regular schedule, which you will expect to follow when the babies are ready to begin breastfeeding. Most hospitals will have you begin to get accustomed to an every three hour pumping and eventually breastfeeding schedule. Now is a great time to allow your body to what it was designed to do, which is produce milk for your newborn babies. If you find you are experiencing challenges with producing, consider being in a NICU a blessing in disguise. If you are struggling in the early days, you will have a bit of time to investigate and figure out how to have your milk come in. By being in the NICU you have access to the nursing team, as well as lactation consultants, which you wouldn’t have if you went directly home after the birth of your babies.
Use the NICU Resources
No one wants to be in the NICU. I know that. The way I looked at it though, is that it was a chance situation that put me in the NICU, surrounded by medical experts and a team of lactation consultants, occupational therapists and dieticians, so I was going to make full use of the medical team there to support me and my babies. Each of these experts has a different way of looking at the breastfeeding process. Your lactation consultant can discuss tips and tricks for positioning yourself and your babies for optimal comfort and breastfeeding success. An occupational therapist can also be brought into the picture to assess how babies are handling the “suck, swallow, breathe” process and make any necessary adjustments needed for your breastfeeding technique. The dietician may discuss your dietary needs, what’s best to eat while breastfeeding, as well as possibly discuss your infants’ dietary needs and possibility of higher caloric intake, which may depend on weight and rate of growth. These people are a quick phone call away and they will come to help you when you ask. Where else can you get a team of experts like this practically at your fingertips?
Find Your Comfort Zone
Each mother is different and thankfully there are different ways to breastfeed your babies. Figure out what works best for you by trying things out. Once again, since you are in the NICU, now is the best time to hammer out the best approach for feeding your babies. Having premature babies often means they are very small in size. It can be very uncomfortable in the early days when it comes to figuring out how to handle their little bodies and having the confidence that you are not actually hurting them as you move them around getting settled to breastfeed. It will take some time to get comfortable with these things. Ask the lactation consultant if they have a variety of nursing pillows for you to try. One mom of multiples might swear by nursing pillows made specifically for twins, while another mother might prefer a different style which fits her small premature babies on it. Some moms are quite content layering a few pillows across their lap and adjusting based on the babies’ needs for positioning. You may find your babies also have a preference for a certain breastfeeding hold over another. Once again, your time in the NICU allows you the unique opportunity for “practice,” as well as bedside coaching from the nurses and other staff involved in your babies’ care.
Before Discharge from NICU
The day you get to take your babies home will eventually arrive. Make sure you plan how you will transition yourselves from the NICU with constant access to experts to your own household, which will not have a 24 hour staff on call. How will you and your partner handle your breastfeeding schedule once you have brought your babies home? Will your partner be able to support your goal of breastfeeding by helping you keep on top of your feeding schedule and by helping you get up in the wee hours of the night to feed them? These are all important points to consider and prepare for before being discharged from the hospital. To help make a smooth transition from NICU to home, consider contacting your local multiples organization to see if they have a breastfeeding support person, or your local public health office and even your children’s pediatrician’s office. All of these organizations will know how to put you in touch with a lactation consultant or formal breastfeeding supports. Knowing that you can build your own “team” outside the hospital will hopefully help you keep on track with breastfeeding your babies until you are ready to wean them, whenever that day may be.
Landing in a NICU with your premature babies is not ideal, but take it is a chance to accept help you would not have received otherwise. Consider this your opportunity to get breastfeeding right. You are in a place with some amazing experts that you never would have had access to if you’d had your babies and went directly home. The NICU is likely a whole new world to you, so take the time to explore it and the unexpected opportunities it has available to you. I am confident I was able to successfully breastfeed my three children for 13 months and 9 months based on the fact I had supportive experts rooting for me and showing me the way from day one.