Breastfeeding in the NICU: When Things Don’t Go as Expected

We had it all planned out.  We were expecting our first child and had made the perfect birth plan. We had done our research and knew the best practices for birth and the immediate postnatal period.

Everything was going to be perfect for us and for our new little baby. We were going to have a natural, unmedicated birth in a private birth center. I was going to breastfeed the baby immediately after birth. Within a few hours of becoming parents, we were going to be back at our own house cuddling our new little baby. We were going to exclusively breastfeed for at least six months and continue breastfeeding for a minimum of a year. Our baby was only going to have a bottle when we chose to give one to her, but she would never need to have formula.

We were so excited to become parents and were confident that we had everything figured out.

So much for our perfect plan

Then, I developed pregnancy induced hypertension and my midwife naturally induced my labor. Eventually, I was transferred to the hospital due to the fact that my labor was not progressing. A few hours, a lot of Pitocin, and an epideural later, our beautiful little baby girl was born. It was the most amazing moment—becoming a Mommy was a dream come true!

Soon, we had another change in our perfect birth plan—our daughter was placed in the NICU. Among other things, she had an immature latch and could not breastfeed. She had an IV to ensure that she was receiving enough fluids and nutrients and was given a bottle of milk every three hours.

During the first few days when my body was only producing colostrum, she had to have formula in addition to breast milk. Knowing that I had to give my child formula, which I swore that I would never do, was devastating! I believed with all of my heart that my body was created to care for a child and was angry that I was unable to do so.  I had fears that giving her formula would stunt her growth.  The hospital’s lactation consultant was gone that week, the nurses had little knowledge about breastfeeding, and I did not have any experienced breastfeeding friends, so I had no support.

The stress of breastfeeding in the NICU

During the five days that she was in the NICU, I kept a crazy schedule while trying to ensure that my baby was receiving the best possible nutrition.  Every three hours, I went to the NICU to feed her. For thirty minutes, we would let her attempt to breastfeed.  While she loved cuddling with me and seemed to enjoy being latched on, she was unable to actually get any milk. So, I would spend the next thirty minutes feeding her a small bottle of pumped milk.  Then, I would leave the NICU and go pump milk for the next feeding.

Each time that I pumped, I prayed that my body would produce enough milk so that we would not need to supplement at the next feeding. Then, I would take the bottle of milk to the NICU nurses, who would often make comments about how little I pumped and spend the next hour and a half waiting around the hospital for the next feeding and hoping that I had pumped enough milk.  Breastfeeding in the NICU was a stressful and emotionally painful experience.

Breastfeeding our preemie at home

When we finally left the hospital, we rented a fancy hospital grade pump because we knew the regular pumping and bottle-feeding was going to continue for a period of time. Initially, my fears of not producing enough milk and my stress over the situation continued. However, after a few days in our own home, with our own routines, things quickly improved.

Over the course of the next month, my daughter’s sucking reflex developed. Slowly, she was able to actually get some milk during the breastfeeding sessions. After about three weeks, she was getting more milk from breastfeeding than from bottles and by the time we had been out of the hospital for five weeks, we were only using bottles by choice.

Before becoming a mother, I read about breastfeeding and asked questions about it in our Bradley Birthing class. Nobody told me how difficult it could be. Breastfeeding a preemie was hard.

Many times that first month, I wanted to quit. But each time that I felt that temptation, I looked at the beautiful baby in my arms and remembered that I wanted the very best for her, so I kept working at breastfeeding. And I am glad I did.

After just five difficult weeks, we developed a fabulous breastfeeding relationship that last until she was 22 months old. I was able to produce not only enough milk for her, but enough to donate as well. I am so thankful that I decided to stick with breastfeeding!

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Marla is a former special education teacher and current PhD student and stay-at-home, homeschooling mom of two little girls (ages 2 and 4).  She blogs about homeschooling at Marla’s Motherhood Musings and her family’s experiences living in Zambia at Our Life in Lusaka.