The neonatal unit staff support the WHO/UNICEF Babyfriendly Iniative to promote and encourage breast feeding. Tiny preterm babies and babies who are very ill may not be able to breast feed initially, however they will be able to have your expressed breast milk. Help and advice on expressing milk is available from all staff on the neonatal unit. There are specialist feeding advisors within the parenthood department at the maternity hospital, contact details available from neonatal staff. There are breast pumps available on the unit for your use whilst your baby is in hospital and there are pumps available for hire. Details available from staff in the neonatal unit. Expressing milk for your baby can seem such an uphill struggle.
Sometimes a tiny baby just cannot manage to stay on the breast long enough to enable them to receive enough breastmilk. They may not be able to get a wide enough mouth to get enough of your breast tissue and will therefore keep sliding off. Perhaps your nipples are a little large for their tiny mouth or your nipples are flatter. But you really would like them to receive your breastmilk!
Each does have their own issues that you need to consider to make the right choice for you.
Your baby may have been with us in the unit for a period of time already. Offering the breast then topping up by tube until you are confident, they are strong enough and able to breastfeed efficiently, may take some time. Not all staff are trained in cup feeding as this takes time in a busy unit, so there may not be anyone allocated to your room that could assist you with this every shift. Also cup feeding is not recommended for large amounts and not all babies like or can cope with this method of feeding.
Sucking by bottle and breast are totally different ways of sucking and your baby MAY decide that he prefers to feed by bottle then not feed effectively when on the breast. Some babies find no problem feeding from dad or grandparents in a different way from mum BUT no one can assure you this will be the case. You might end up expressing and bottlefeeding which is time consuming.
Using a nipple shield does allow the baby to realise that feeding at the breast is the way he is to feed and often it does make it easier to latch on and stay there. This is not a long-term option. You should continue to try offering without the shield. Nipple shields come in limited sizes so it may not be a good fit and you have to hold on whilst latching. Because there is a barrier between you and the baby your supply may be slightly affected.
We hope these points have helped you make the best decision but if you’re still unsure what to do please do discuss this with any of the nursing staff or contact someone in the list of numbers that we can provide you with, here or on the ward.
When you don’t have your baby with you, expressing milk can be such an uphill struggle. In the beginning, tiny amounts are all you can offer and it can be a frustrating and lonely experience. Holding Claire close on my front, her skin directly next to mine made all the difference to my attempts to express. Gradually, 10ml (15ml on a good day!) became 60-80 ml and I could walk tall to the fridge with my bottles feeling that at last I had turned a corner. It’s great when lactation really does take off but keep in mind that those initial tiny amounts are still so beneficial and of no less value.
I was still reeling from the shock of early delivery and then trying to cope with the reality and enormity of the situation that my baby was in special care. I had never felt so out of control emotionally. I remember one morning at the 6 am feed, feeling particularly fragile, I held Claire skin to skin. It felt so warm and peaceful and served as healing time, for both of us. That very basic need – to hold your baby close – is possible even if only for a few moments. For me, it made all the difference.
We are home now and still do skin to skin – especially in early morning time. If this is something you wish to do ask the nurses and they will assist you when this is possible.
January 2006 my twin boys arrived into the world a whole 10 weeks too early. They started their lives in ITU on drips and CPAP. I sat in the expressing room many a time and met mums like you. Some were quite resigned to just milking themselves as a chore of the day. Me.. well I looked upon it as I was doing my bit. My boys were in incubators and the staff were doing their bit and as I couldn’t hold or feed them, then all I could do was really sit here and do the best I could.
Some mums sat here and worried that their milk was drying up when they struggled to collect more than 20mls. I was in pain after putting nearly 2 litres in the freezer a day!
I sat here and shed a few tears with other mums. I remember one saying “why on earth am I bothering”. Her baby had been here for months. I wanted to respond with “because you can” but my boys had only been in for a few weeks at that point.
I too did feel like her at times and after sitting expressing I would then go and visit the boys with the nurses and doctors all around them. I realised that we all had our own part to play and for that moment in time I was doing mine. I couldn’t do anything apart from look at them, touch them, talk to them and express my milk for when they were ready.
So “Why Bother?” Because you can! It is something very special that ONLY we can do for their babies. Whether it be a day, a week or months…. Do it because you can say to yourself “I’m doing my best I can for the here and now”
And “Why Bother?” Because you Can!
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