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Breastfeeding a Preemie
by Lenette S. Moses
One of the funniest things I have ever had to do in my entire life was to learn how to feed my first child.  Tim was a 28-week preemie, which in itself was not funny.  But getting food into him was.  Being the resolute, young mother I was, I was determined to do it right.  Little did I know this involved a machine called a breast pump.

I approached the machine with an attitude of "how hard can it be?" and ended with a feeling of "very hard - especially on my nipples!"  With the aid of the reduce-pressure switch and some cream, that problem was rather easily resolved.  Nevertheless, I soon gained the nickname of "bossy" (the cow), and I had to admit I didn't feel much different from a bovine mother while attached to the pump appendages!

Mothers-of-the-field, however, do not have to carefully pour their milk into tiny little plastic bags (a trick in itself), label each bag with a name, date, rank, serial number and mother's maiden name, and refrigerate each bag like we preemie moms do.  I began to feel like a human assembly line.  Every morsel of food or glass of milk that went into me I pictured as raw material for breastmilk.

What a shock it was to see yellow, blue, and finally thin, white milk being produced!  (Should I expect green after asparagus?)  I suppose I had mentally aligned myself with my cow counterparts too much, and expected my milk to look like theirs, which it definitely did not.  Not only was it the wrong color and consistency (I thought) - it wasn't homogenized!  Should I be drinking stabilizers?  It was a great relief to discover that my milk was normal for my species and especially for my baby!

I was a dedicated pumping mother.  I went according to my lactation consultant's suggestion, and on the dot of three hours, I would pull out my pump and start "expressing myself."  No one thought to ask how much milk I was pumping, since most pumping mothers get little to none at first.  I was getting eight ounces a shot - one morning I pumped twelve!  I felt like a real pro, although once Timmie came home, it took some time to reduce this output to match his actual needs.  I eventually threw a lot away.

As the weeks wore on, I got teased about my "traveling buddy."  Wherever I went, my trusty pump went.  I'd set up anywhere and start the production line.  (I had lost all modesty in the delivery room, where it seemed that everyone and the janitor were checking for dilation!)  It was a great feeling to be making this milk, despite all the hassles and teasing involved.

One day, Tim's nurse said, "Do you want to try to breastfeed"?  Wow!  Being hooked up to the real thing!  I was thrilled.  I sat with Tim in my lap and proceeded to "breastfeed."  Unfortunately, Tim didn't begin automatically to suck.  And I couldn't find the "on" button.  I had so much milk in my breasts that he was able to lick the drops that came out, but he did little else that morning.  I was crushed.  I was sure I'd be attached to that machine forever.

The next few times we breastfed, Tim didn't learn much, but I did.  I learned not to give up that easily.  I figured out that he had to be fully awake first, so I'd change his diaper, take him for a walk around the unit and talk to him until he really had his eyes open.  Sometimes I'd even give him a bath.  Then we'd sit down to nurse.  In the very beginning, I also used a bottle nipple to get his mouth open, stroking his upper palate to get the sucking and swallowing reflexes going, and then I'd quickly switch to my nipple.  Sometimes I'd have to express first to reduce the size of my breast (each was larger than his head) and hold the nipple between my fingers so he could hold it in his little mouth.  Eventually we became a nursing team, but it didn't happen right away.

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Even after Timmie came home, we continued to struggle.  He could suck much better at that point, but he still had no cheek muscles and the nursings wouldn't last very long.  I felt like I was constantly "on tap," nursing every two hours for twenty to thirty minutes at a time.  For some reason, he wouldn't nurse lying down, so I would have to sit up during the middle-of-the-night feedings and prop pillows behind him so he wouldn't roll off my lap if I fell asleep.  More than once I awoke in that position to discover that we'd slept from one nursing to the next.  I was exhausted, and Timmie refused bottles.  But even as I felt myself slipping toward the edge of sanity, (or because of it?) I was ultra sensitive in those early morning moments.  I still have sweet memories (dimmed by passage of time) of that little face looking up at me, and then closing his eyes as he immersed himself in the bliss of nursing.  Even at three in the morning, that made it all worthwhile.

This article was reprinted with permission from the September/October 1991 issue of Intensive Caring Unlimited Newsletter.

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