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Sophie’s first baby was diagnosed with Intrauterine Growth Restriction (IUGR) because of placental insufficiency at 25 weeks. Little Tilly was born at 29 weeks and weighed only 534 grams so she was tube-fed for 10 weeks in NICU before being discharged. Sophie takes us through her breastfeeding journey - controlling the controllable, triple-feeding and eventually an exclusive breastfeeding journey that ended at 22 months. When asked if she would triple-feed again to ensure she could breastfeed, she admits she would 1000 percent do it. “It’s so worth it!”
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Just a note, Sophie also discusses her experience with mastitis and the extra pumping and feeding she did to recover. Advice regarding mastitis treatment has changed in recent years and extra pumping and feeding is no longer recommended as it contributes to inflammation.
“We had an interesting start to Tllie’s life; she was born preemie at 29+4 weeks and was only 534 grams. An amniotic band was found on my 20 week scan and at the 25 scan to check on it we found out the placenta was insufficient and she had stopped growing at 22 weeks. We were told that she wouldn’t survive but we made it to 28 weeks and she was 500 grams which was the baseline for survival so from there it was full-steam ahead or termination for medical reasons (TFMR). The NICU and breastfeeding journey was the easy part compared to the waiting in pregnancy to see if she’d survive.
“She was tube-fed right up until her due date. I had a caesarean birth and so I felt like I had to really work at getting colostrum and to top it all off, I had covid so I couldn’t see her for eight days. Getting my milk in was a really big challenge and so difficult being in hospital in isolation. I had a fairy godmother of a midwife who would sit with me and encourage me and help me with pumping.
“We introduced breastfeeding at 35 weeks. You really have to advocate for yourself in NICU, especially when it comes to maternal, enjoyable things because breastfeeding at that stage wasn’t life-sustaining for her. I was really focussed on giving her a dummy after tube-feeding so she would associated sucking with being full and I introduced an ISOC which is a q-tip dipped in breastmilk so when she was being tube-fed she also experienced the taste of the milk in her mouth. It gave me a sense of control; it was the one thing I could do – pump and give her the ISOC when she was tube-feeding.
“I introduced the nipple at every tube feed that she was awake for and at 37 weeks they switched the tube from down her mouth to down her nose. She was medically stable most of the time; it was just her size that was the concern. The staff told me that one day she’d just get it and she did but because she was so tiny and sleepy, weight gain was our biggest challenge. I was lucky with supply; I had oversupply if anything, I had a freezer-full of milk.
“When the tube came out we were doing alternate breast and bottle feeds and offering a bottle top-up after every feed. Once we were discharged she was on three-hourly feeds but we went to feeding on demand which was roughly 2-3 hours. I had so much milk in the freezer so I didn’t have the stress of low supply; I could have a bottle set-up ready to go,I’d breast or bottle feed her, give her to Ben or whoever was visiting and then I’d pump and freeze that. I did that every 2-3 hours around the clock and I really focussed on bottle feeding overnight.
“For five months after being discharged, we had to have weekly and then fortnightly weigh-ins. It’s hard not to be consumed by it and although we’d have bad weeks, the curve was always trending in the right direction. There was a lot of appointment burden early on which is the experience of all preemie babies. I would try and get to appointments and try to time feeding and pumping and having fresh milk that’s warm…I wouldn’t wish it upon anybody but of course it’s worth it.
“We got to the point of exclusively breastfeeding when she was 5kg, which was five months after she got home. I never considered not breastfeeding. In NICU seeing other babies coming through, the feeding preferences from all the doctors was breastmilk because it’s more suited to the babies underdeveloped digestive system so they would use the mother’s milk and if she didn’t have enough that’s when they would use donated milk. I always just presumed I’d breastfeed but I never realised how challenging it could be. I would 1000 percent triple-feed again to make sure I could breastfeed.”
exclusive breastfeeding, Mastitis, NICU, Premature birth, triple-feeding, tube-feeding
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