From the NICU to Nursing: Our Breastfeeding Journey + How We’ve Made it This Far

This post is kindly sponsored by Ultima Replenisher: my absolute favorite electrolyte drink mix that I drink every single day. But, all of the info and opinions here are my own! I hope this is helpful to someone in the thick of it.

When my baby girl was born at 36 weeks with an unexplained inability to suck, swallow or gag, I thought my breastfeeding journey was over before it had even started.

Preparing to become a mom, I heard all about things like immediate “skin-to-skin”, “golden hour” + cluster feeding. I had prepared to be a normal breastfeeding mom.

But what about those of us who’s stories don’t look like that?

My baby spent 6 weeks in the NICU. We fed her into her intestines through a tube. She didn’t even attempt a latch until 5+ weeks old. Could there still be breastfeeding hope for someone like me?

I’m here to share my story + pull back the curtain on just how hard, but equally worthwhile, the road to breastfeeding has been for us + also to share some of the SIMPLE tips + tricks that made it feel just a little bit more doable. Because we moms have to stick together, right?

Preparing for Breastfeeding

I know some women aren’t interested in breastfeeding + I think there really should be no shame regardless of how a woman chooses to nourish her baby. If I’ve learned anything over the last year + a half of pregnancy + breastfeeding it’s that all of us are living through unique circumstances that most of us can’t understand unless we’re one of the people IN them. So please, don’t hear any of this post as condemnation for making a choice that was different than mine + please have grace for me even if you don’t agree with my choices.

That being said, I knew I wanted to breastfeed from the moment I had a positive pregnancy test. I don’t know why, but there was some internal, guttural driving force that just knew that was our way. It didn’t even cross my mind that this wasn’t always a CHOICE for some women.

I am so lucky that I had so many female friends really pour into me in the season of pregnancy + share their very real experiences with breastfeeding – stories of oversupplies, postpartum anxiety and depression, mastitis and clogs, painful latches, etc.

I KNEW that it wasn’t as easy as popping a baby on your boob (even if it looked that way sometimes) + so I wanted to be equipped.

I took a breastfeeding course by Karrie Locher + I can’t recommend it enough. I learned all about breastfeeding (as much as you can before you actually try it, ha!), but also all about pumping, which you’ll see came really in handy later 😉

Day 1

Poppy’s birthday – Christmas Day – was simultaneously the most transformative + traumatic day of my entire life. (You can read more about that here.)

I didn’t get to experience any of the new mom/baby stuff mentioned earlier. We didn’t share a “golden hour”, I didn’t even meet her until hours after she was born. I didn’t hold her, I held her hand through the wall of an incubator. I didn’t latch my hungry baby – I sat in a wheelchair next to her and cried.

Because Poppy’s birth was traumatic + left both of us in need of serious medical care, I actually spent the first night (and the next 6 weeks of nights, I’d learn) away from her. I was on a ward with 4 other women separated by curtains.

I couldn’t get out of bed + my husband couldn’t spend the night with me, so I relied on a catheter and the nurses, who frequently checked on me and brought me egg salad sandwiches to try to encourage me to eat. I only really remember 2 things about my first night as a mom:

I remember I cried. I cried more than I knew it was possible to cry. I just wept + wept + wept.

But I also remember a nurse came in to encourage me to start harvesting some colostrum to help my sweet baby in the only way I could at that moment. It felt really powerful to have something practical to do in a situation that felt so out of my control. She handed me some syringes and tried to instruct me on how to massage my breasts to get out the golden liquid. I could barely see through my tears to try to suck up the drops. And I will never forget this – she took my hands in hers + asked if she could do it for me. It was so compassionate and caring. I was so fragile + this sweet nurse expressed my colostrum with her own hands and collected it for my baby even when I couldn’t.

And thus, that broken + beautiful moment began my breastfeeding journey.

The rest of the hospital stay

I’m not going to go into intensive detail about Poppy’s issues or what our time in hospital looked like. I’ll be including all of those details in Part 2 of Poppy’s birth story, which I’ll be sure to link here when it’s finished. Instead, let’s jump into a brief overview of our timeline:

• Poppy was fed my breastmilk via an NG tube (feeding tube to her stomach) for nearly a week after she was born. While we waited for my milk to come in, she was fed colostrum + also donor breastmilk from the hospital. A few days into her hospital stay, she suffered a cardiac arrest episode + was taken off of all food for a few days and put onto a ventilator. She was “nourished” with sugar water into her veins.
• After the ventilator came out + Poppy stabilised, she was fed my breastmilk via an NJ (feeding tube that bypasses her stomach into her intestines) for nearly 4 weeks due to a suspected risk of reflux and aspiration of milk into her lungs, which could trigger a dangerous infection.
• The last 2 weeks that we were in hospital, Poppy was fed my breastmilk via BOTH an NJ + an NG tube in varying amounts as her stomach adjusted to food + the doctors monitored her ability to safely keep food down as her ability to swallow naturally improved.

During this journey of tube feeding, I was continuing my portion of the “breastfeeding” journey, which in this season, meant pumping. I started pumping the day after she was born, and friends, exclusively pumping is HARD. It has the same time and energy demands as breastfeeding (every 2ish hours, around the clock even WITHOUT your baby close), but with the additional pressures of cleaning and sterilising parts after every pump. Not to mention the emotional toll of seeing every single drop of milk that did or did not come out of your breast. Those weeks were measured in mls and ounces + they were so hard.

My milk came in on day 3 + I really struggled to navigate how to pump on my own. I heard different recommendations on how long to pump or what size flanges I needed + I struggled hugely with engorgement. (For the record, pumping as a nursing mom + exclusively pumping are VERY different things.) I remember walking down the hall to the NICU at 3am absolutely sobbing because my breasts were rock hard, red + hot, but I couldn’t get any milk to come out.

These initial weeks are SO hard. (But please know if you’re in them, they DO get better.)

At week 5, Poppy had made HUGE progress + the speech and language therapist gave us the okay to try to get Poppy to latch for the first time + to see what she would do. We had no idea if she had the ability to draw out any milk, but she was showing signs of interest + we were desperate to try.

Poppy Starts Breastfeeding

Poppy latched right on the first day that we attempted to feed via the breast. She was 5 weeks old. She suckled + got tired, but she definitely tried. It was incredible. I spent the next week and a half in hospital all day, every day trying to get her to breastfeed while also managing her continuous tube feeds. The hospital even graciously offered a room for Poppy and I to stay in together for a weekend before I brought her home to try around the clock nursing. It was exhausting, but it was my dream, so we did.

Poppy was released from the hospital at just over 6 weeks old + miraculously, came home without a single tube. In fact, her NG tube was removed THE day we brought her home. What a gift. Our goal was to continue breastfeeding as her main source of food + weigh her once a week with someone from the hospital team.

Sadly, after a week at home, it was obvious that sweet girl wasn’t getting enough milk. She maintained her weight, but didn’t gain anything. We were encouraged to start triple feeding + to also seek additional help from a feeding specialist to navigate what came next.

Triple Feeding

Triple feeding is the most exhausting thing I have done for my baby. Triple feeding is often used in circumstances where babies aren’t strong enough to solely breastfeed. Because the baby isn’t emptying the breast on their own, not only is the baby still hungry, but mom’s breastmilk supply WILL dip due to the leftover milk in the breast. (Breastfeeding is all about supply + demand! The body learns how much milk to make based on how much milk is removed throughout the day. I definitely saw this in action as my supply ebbed based on Poppy’s weak feeding versus pumping.) Triple feeding looks like:

• baby is fed at the breast until tired
• mom hooks up to a breast pump to express all of the remaining milk that baby couldn’t get
• baby is then fed a bottle of the expressed breastmilk

This sort of feeding is meant to be used short-term, but we ended up doing it for nearly 9 weeks. It was gruelling + draining, but it also was the only way that I saw to potentially successfully continue on our breastfeeding journey while we navigated what was still going on with Poppy’s ability to feed.*

*Just a note to say that my husband and I had frequent conversations during this season about mental health + whether or not I could/should keep going. Triple feeding is especially isolating + is not for everyone. I am in no way advocating for you to take this same route – it’s just what is true about ours.

Oral Restrictions

While Poppy was still in the hospital, I remember watching someone on instagram share about their baby’s tongue tie. I had never heard of one before, so I watched them share + I did some research. A tongue tie is when the frenulum (skin that joins the tongue to the bottom of the mouth) restricts the tongue’s moment. It can cause all sorts of feeding issues in babies including poor, painful latches, ineffective feeding, misshapen nipples, suck blisters on baby’s lips, etc.

Poppy had all of the signs.

At 8 weeks, 2 weeks after Poppy came home, I asked our pediatrician about it – thinking it could be causing our issue, but was quickly dismissed and told to call a breastfeeding hotline. Because I had a lot of experience advocating for my baby after weeks + weeks on the NICU, I did NOT let this go. I contacted the SLP from the hospital + eventually got connected with a local breastfeeding clinic run by a feeding specialist licensed in diagnosing + releasing tongue ties.

Upon reviewing Poppy, she immediately identified a lack of side to side tongue movement + suggested we see a cranial sacral osteopath and also look into a release of Poppy’s tongue tie.

It took us 6 more weeks to finally have her ties (I say ties because she was also diagnosed with a lip tie) released, but it was SO worth it!

Post Tie Release

We saw a pediatric oral surgeon to have Poppy’s ties released at 14 weeks old. They used a laser and it took less than 30 seconds. Once they’re released, mom or dad have to continue to do “stretches” in the baby’s mouth 6x a day for 3 weeks to ensure that the skin doesn’t heal in the same place + re-restrict the tongue. The stretches are rough, but I’d do it all again. SO worthwhile.

Poppy’s tongue movement immediately improved. Like, shockingly so. We saw her stick out her tongue for the first time ever + she just really didn’t stop. It was as if she was discovering her tongue for the first time!

As far as nursing is concerned, it did not get better right away. In fact, it got worse. For the first week after her release, she sometimes didn’t want to latch AT ALL + when she did, she would nurse longer than she did before, but still wanted a full bottle top-up as we’d been doing. My supply couldn’t keep up + we had to supplement her with a bottle of formula each day for a few weeks. It was so demoralising, but we kept going.

Weaning off the Bottle

One of the hardest parts of our nursing journey has been figuring out when and how to wean her off of her supplemental bottles. As a mom, you are so desperate for your baby to get what they need + to not be hungry. But when you’re breastfeeding, you can’t SEE how much milk baby is drinking. So, here’s what we did + when:

• As her nursing sessions got stronger/longer, I noticed the amount I pumped after she breastfed was getting to be less + less. This indicated that she was draining my breasts more successfully on her own!
• Once we suspected she was drinking more, rather than immediately offering her a bottle post breast, we began to wait for her to “ask” for it.
• We then started decreasing the amounts in the bottles we offered her. If she finished a smaller bottle + asked for more, we’d give it. But only if she really asked.

Our feeding specialist gave me an incredible tidbit that really, really helped in this part of our nursing journey. She said, “You can’t distract a baby from hunger.” So, during these weeks of weaning off the bottle, but also in the months since as an exclusive breastfeeder, I take HUGE comfort in knowing that even if she’s fussy when she pops off, if she quickly regulates herself, she isn’t truly hungry. A hungry baby will keep asking for food until they get it. (Just a note: this doesn’t mean I didn’t stress over it in the moment, ha!)

Exclusively Breastfeeding

At 4 months old, we suddenly had a day where Poppy didn’t ask for any more bottles. And then another. And another. And just like that we were done with triple feeding. I couldn’t believe it.

Poppy has been fully fed from the breast for nearly 2 months now (with a bottle at bedtime because she still loves it + dad can help feed her, so I still pump once a day) and it has been worth every ounce of effort that it took to get here.

For me, breastfeeding has meant time freedom away from the house + the pump. It’s meant being able to travel back to the US without all of the extra feeding pressure of packing bottles + expressing milk in an airport. It’s also meant the realisation of a dream of mine for my motherhood journey.

So much of this season of new baby hasn’t looked anything like we’d hoped + yet…it’s been magical in all sorts of unexpected ways. Like hearing Poppy cry for the first time at a week old. Like seeing her suck a pacifier for the first time in the NICU. Like bringing our sweet girl home with NO tubes or wires. And like breastfeeding our miracle when we didn’t know if she’d ever eat through her mouth.

Our journey isn’t over yet + I’m sure there are a million things I don’t know, but I do know that there are some simple things that have helped to make this hard, hard road feel a little bit easier. So in hopes to help even one person who’s struggling along like we did, here are MY tips + tricks that helped us navigate all things baby feeding:

Tips + Tricks that Helped Us

1. Buy some half decent nursing/pumping bras and shirts. If your boobs are going to be out all of the time, might as well make sure they feel nice + are easily accessible. And WAIT until your milk comes in to get sized for bras. Breasts change size so often during pregnancy/birth/postpartum + having some that fit well, are functional and make you feel pretty in this weird season will be so, so helpful. I speak from experience.
2. Eat enough calories. Even more so than during pregnancy, our bodies need extra calories each day to produce nutrient rich breast milk – a minimum of 500 extra according to studies! Prep some food you love + keep it in the freezer (I ate tons of these, these + these) so that you’re able to keep your food intake up even when you’re tired + sore + have a baby attached to you, ha!
3. Drink plenty of water! Not gallons + gallons, but it’s recommended that you drink to thirst as a breastfeeding mom + for me that is WAY more water than I was drinking pre-breastfeeding. And to be honest, I struggle drinking lots of pain water. This is where Ultima comes in!
   
   Ultima is an electrolyte drink mix that I have been drinking for a few years now! It helped me with cramping during my Endo days. It helped keep me hydrated during pregnancy. I drank it every day we were in the NICU + I still have at least one a day while breastfeeding. It helps to promote healthy electrolyte balance, while allowing me to drink ALL of the water my body craves to produce enough milk. And I really do see a dip in my supply day to day if I’m dehydrated, so this is a huge priority for me!
   
   Ultima is sugar-free + tastes SO good that I never forget to have it, ha! Passionfruit + Lemonade are my fave flavours. Get yourself a canister or pouch + a cup you love (I use this one) + drink away!
4. Have some sort of emergency encouragement handy. Some of the best advice I received was: Don’t quit on a bad day. And it’s SUCH good advice because the next day never seems as bad. I also made sure to have some articles + research handy about the benefits of breastmilk to remind myself of WHY I was working so hard on days when I just wanted to give up.
5. Find an emotional support partner. This might be your spouse/partner or it might just be a really good friend who’s okay to listen to you – good or bad. There were many days I just needed to cry or complain for a few minutes + having friends who would listen + not judge felt so life giving. They don’t have to have any answers for you, it just helps so much to have a space to share.
6. Get ALL of the help from professionals. Because Poppy was in the NICU, we had access to a lot of followup care + I wish ALL moms did too. Breastfeeding is HARD + you aren’t going to know everything on your own – you’ve never done this before! Reach out to a Lactation Consultant, the La Leche League, another mom friend who’s done it a bunch: whoever you can! You deserve help in this season, so please, please, please don’t be afraid to ask for it!
7. Have grace! This really is one of the hardest things I’ve ever done + I know that’s true for lots of us. Whatever works for you + your baby is OKAY – even if that ends up not being breastfeeding. I like to remember that my baby has never had to do this before + neither had I, so of COURSE it was going to take time + we were going to make mistakes. That doesn’t mean you’re a bad mom.

Poppy and I are continuing on in our journey in hopes of making it to at least a year of breastfeeding, but with the understanding that so much of these things aren’t in our control. I hope this helps inspire or encourage or empathise with someone who is navigating their own current, or planning for their own future breastfeeding experience!

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