Prepare for a confident birth – The Birth Class

Episode 501

Sarah – PPROM, NICU, antenatal expressing, nipple shield, triple-feeding, lactation consultant

If you need to hear a positive NICU breastfeeding story, this is it! Sarah shares her experience with premature prelabour rupture of membranes (PPROM) and the NICU journey that followed the birth of her baby at 32 weeks. She started antenatal expressing in labour and continued hand-expressing in the days after before switching to a hospital-grade pump. She had plenty of milk, triple-fed and used a nipple-shield alongside navigating an oversupply (she could pump 400ml in a single session!). She saw a variety of lactation consultants in the first few months and emphasises how important it is to find the right person for you who also has the right level of expertise for your situation.

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“Jack was born at 32 weeks. At my 20 week scan they noticed my cervix was quite short but I was also horse riding everyday so once I stopped, my cervix stayed stable the whole time. At 31+5 I felt a really strong kick and noticed my waters had broken so I went straight to hospital and they admitted me and monitored me for a week. I had two rounds of steroids to help his lung development and luckily I never spiked a temperature and neither did he.

“My labour ended up stalling when I was 5 cm and I was in the birth suite so my midwife showed me how to hand express. We got some colostrum throughout labour and once I was back on the ward after birth, the midwives helped me hand express and then I started using the pump.

“Jack weighed 2 kg which was a really good weight for 32 weeks but he lost 400g throughout his first four days. My husband and I really committed to being at the hospital for every feed for the first two days so I pumped every two hours in the day and every three hours overnight. As soon as they wanted to double his feeds on the second day, I was able to supply enough because my milk came in really quickly so we didn’t have to use formula top-ups. He actually did the breast crawl from the first go and he latched too which amazed the lactation consultant as she said they often don’t develop that reflex till later.

“He was in NICU for five days and then moved to special care for three weeks. He came home doing a mix of breast and bottle feeds. I had a massive oversupply – I responded really well to the hospital-grade pump – but what that meant is that Jack would stop breathing as the milk came so quickly. We figured out that the best way to feed him was to express a bit off the right side, feed him on the left and then the right. We did that on the guidance of a lactation consultant.

“I shopped around for a lactation consultant and I think that’s an important point; you’ve got to find the right person for you who has the right level of expertise for your situation. I saw a few in the community who all taught me something, the maternal child health nurse also offered a free session and then I saw Dr Amber Hart at Maternal and Child Infant Wellbeing in Carlton and she’s fabulous, an amazing resource. Jack has a tongue-tie and my osteo suggested getting it revised but my gut feeling was to not do it, mostly because he was feeding well and he’d caught up in terms of weight. Amber reiterated that she didn’t see it as an issue and was really happy to support me in my decision.”

Topics Discussed

Antenatal expressing, Lactation consultant, NICU, Nipple shield, PPROM, triple-feeding

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