My experience of establishing breastfeeding with my premature baby

by

Tosan Adjene for Black Breastfeeding Week 2024

My pregnancy was a sickly one; several hospital admissions and lots of medication to treat the symptoms and effects of gestational diabetes. After a long battle with the National Health Service, and their overzealous wielding of the caesarean scalpel, I was induced at 34+6, and my son, Tobi was born at 35+2weeks. He was whisked off to the NICU without so much as a sniff of his hair. All my hopes of hours of skin to skin, being drunk on oxytocin, Tobi crawling up to the nipple and camping there forever – out of the window. Five hours passed before I got to hold him for the first time.

In the NICU, the main priority is, rightly, the intensive care of the most vulnerable of babies. All hands were constantly on deck incubating the tiniest humans arriving from the labour ward, having been born at twenty-something weeks. Breastfeeding support was far from being top of the agenda. My 1.9kg boy was on IV antibiotics, dressed in tubes, wires and a mask to protect him from the rays of the UV lamp helping to manage his jaundice. I was only permitted to hold him a few minutes at a time, when I was able to get the attention of a busy nurse. There was one designated breastfeeding ‘expert’ and she only worked two and a half days per week. 

I started attempting to express colostrum. After a few inexperienced attempts, I proudly harvested tiny drops of golden serum which I desperately wanted to feed to my baby. As I collected this into a syringe, I was so focussed on catching every drop, I scraped a speck of nipple skin in with it – a nurse later told me my colostrum was ‘dirty’ and advised me not to give it to my baby – I ignored her advice.

The hospital tried to send me home, but I fought for a room in the NICU so I could be close to my baby and maximise the opportunity to establish our breastfeeding relationship. Every time I had a chance to hold my baby, I would attempt to put him to the breast - a few investigative licks, but no latch. Another nurse commented that my nipples were flat, and I would need nipple shields. As my milk came in, I was eventually given a hospital grade breast pump and on advice from Cordelia Uys (forever to be known as my breastfeeding godmother) I began a cycle of expressing every 3 hours, 8 times a day –  round the clock. I set alarms to wake me for the all-important night expresses, as the vital hormones in breastmilk (particularly prolactin) are higher at nighttime. My expressed milk was given to my baby via feeding tube.

When Tobi was 4 days old, the NICU team advised that he was to come off the glucose IV. The doctors said my milk quantities were not sufficient for Tobi’s development, and there was no other choice but to top him up with premixed cartons of formula milk. After consulting with Cordelia, I was able to contact the Hearts Milk Bank. The team at the milk bank were amazingly supportive. Within a few hours, they arranged for a courier to deliver a 24 hour supply of frozen breast milk. Over the next 24 hours, my milk rushed in with purpose, as though in affirmative response to the solidarity I had experience from the Hearts Milk Bank, and by this point, my growing relationship with Cordelia and the NWL Breastfeeding Facebook group which I had joined.

As the days went on, Tobi gained weight, and was soon well enough to come out of the incubator. I established a routine of putting him to the breast to practice his latch, then expressing. As his latch became stronger, he was able to feed longer. Then the routine evolved to me putting him to the breast to feed, followed by a titrated top up of expressed milk through a feeding tube. The top up gradually became less as he learned to latch and feed for longer periods of time. Tobi was discharged from the NICU at 21 days old. 

When Tobi was 4 weeks, a visiting midwife noticed a 100% tongue tie which was confirmed and removed by the wonderful team at the drop-in Cordelia used to run at her house. The lactation consultants there marvelled at the fact that Tobi had been feeding and gaining weight despite this tongue tie. This encouraged me to persevere with our nursing journey as it confirmed to me that we were truly in it together. At the drop-in, I was encouraged by the other mums and experts who became my community of breastfeeding advocates.

I continued to exclusively breastfeed with the aid of nipple shields. There were challenges - feeding in public, looks and comments. One health visitor told me nipple shields were effectively the same as a bottle teat. There were unsuccessful latches where Tobi would cry himself to sleep hungry. I would share anecdotes about our breastfeeding exploits with the NWL Breastfeeding Facebook group. In response, I received countless messages of encouragement and support. This network became the overarching backbone of my entire breastfeeding experience. 

It would be 7 months and 4 days before Tobi would latch successfully without a nipple shield – I was faffing around trying to position the shield, and he suddenly latched on to the naked nipple, never to need a nipple shield again. It felt as though our breastfeeding journey began afresh at this point. I had a newfound enjoyment of nursing, It was the best feeling. I got more confident feeding in public, I felt proud and powerful. I felt like the spirits of the first mothers were surrounding me, smiling at me, protecting me from those ever-present stares and sneers. Every feed now transported me into a realm of superwoman. Here, I was invincible, and I could achieve anything. 

Tobi and I started and ended each day with a breastfeed. This journey lasted for a glorious 3 years 4 months and 6ish days, and would see us through snotty noses, tummy bugs and a chest infection. I wear these memories with immense pride, and I hold on tight to that feeling of fortitude, the rousing of a resilience like I never imagined. This chapter of my life continues to carry me through the endless adventures of motherhood and I am grateful to have had the honour of being amongst the far too few black breastfeeding mothers. 

Happy Black Breastfeeding Week.