Tag Archives: NICU

Breastfeeding Part 3: PTSD, PPD, Panic, and the End of Nursing

I honestly don’t remember what day in the hospital it was, but somewhere around Day of Life 4, as the doctors call it, things started to crumble quickly for me.

My baby was continuing in the NICU because she had what is called “apnea of prematurity.” Basically, she would randomly stop breathing, mostly while in a deep sleep, and would have to be picked up and patted awake, after which she was fine again.

Even after I started nursing my daughter, she got one bottle with vitamins in it each day. This was to make sure she drank it.

I was giving her this bottle when suddenly, she went limp in my arms. The NICU nurse with me grabbed her and flipped her over and patted her back until she started breathing again. While I was feeding her, she forgot to suck, swallow, breathe.

Sometimes, though, I’m not sure I’ve ever started breathing again from that moment.

Simultaneously with this, my milk came in. At each pumping and each feeding, I started to feel like I was having a panic attack with each let down. I know now that this is actually a “thing,” called dysphoric milk ejection reflex. However, as I was exhausted, and guilty, and overall in a bad space, I didn’t mention it to anyone.

Besides, breast is best, right? How could something so “natural” do this?

I kept on trucking, and after ten days in the NICU, we were sent home.

Once home, anxiety started to take over all my days and nights. I started having panic attacks multiple times per day, and combined with the bad feelings I got with each milk letdown, I was afraid to be alone with my baby. One of the few non-negotiables of breastfeeding is that you have to eat and drink to make milk. I was so anxious I could barely eat, and my supply was not that great. My baby was constantly nursing for hours at a time, day and night.

Finally, after a day where I slept for 20 minutes in 24 hours, I broke down and finally started the process of getting help. That is another story for another time, but that resulted in my needing medication, first to sleep, then to get the panic attacks under control, and finally, long term to treat the anxiety. I had post-partum depression and anxiety, along with PTSD from my premature birth and my baby stopping breathing in my arms. I was not in good shape.

No doctor I met with could inform me about medication transmission in my breast milk. I was exhausted and scared. And so, when my baby was three weeks old, I stopped breastfeeding her.

The guilt that I felt at what I perceived to be yet another way I was failing as a mom was incredible. Looking back, it was the best decision I could have made with the supports and information I had available at the time.

But it didn’t feel that way.

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Breastfeeding: Part 2: The NICU

This is where the hard stuff begins.

When I became pregnant with my first child, I was determined to feed the baby breast milk. Since this was all pre the Obama-care free breast pump days, I researched pumps, I had my IBCLC-to-be/doula friend on speed-dial, I got all psyched up for the whole kit and kaboodle. My baby registry was stocked with breastfeeding items. I was ready!

Then, at 35 weeks gestation, my daughter made a completely unexpected entry into the world. She came out of my womb, stopped briefly in my arms, and went into the neonatal intensive care unit (NICU).

I was completely unprepared. I hadn’t even had my baby shower.

But, after she was deemed pretty ok, just small and yellow, I went up to the NICU to try and feed her for the first time.

Premature infants are born without the layers of fat that make babies all roly-poly and keep them satiated with small feedings until a mother’s milk comes in. They also often experience difficulty self-regulating their own body temperature, and having unstable blood sugar levels. Mothers of premature babies often experience a longer wait time for milk to come in because your body has to catch up with your baby. Also, you have just experienced a majorly stressful event, which also is difficult for the body.

Therefore, you have to feed them something. The protocol for feeding premature infants address all of these issues. At the NICU I was at, and at most NICUs, that something is what I call “milkshake formula,” pumped up with extra calories preemies need to compensate for their early arrival.

There are NICU programs now that only feed preemies pasteurized donor breast milk. This is a good thing, but it was not an option for me the night my daughter was born.

To help with making the milk come in, lactation meets you at the NICU immediately. My IBCLC was brusque, but incredibly helpful. She hooked me up to a syringe system where I could simultaneously breastfeed and formula feed until my milk came in. A little hose was taped to my nipple and my baby sucked while I slowly let formula down the tube.

This went okay. At that time, however, like with many preemies, “suck, swallow, breathe,” was not a strength for my baby.

This is an important fact that comes up later, so remember it.

Then, I got schooled in The Pumping.

When your baby is in the NICU, you are told to pump at least 8 times per day if you are intending on breastfeeding. Also, your baby is fed on-demand, or woken up after 3 hours to feed. To increase supply, and to make sure the nursing staff has breast milk when you are not there (sometimes you have to shower, and you often can’t sleep over,) you are instructed to pump about 15 minutes after each feeding. Feeding my daughter took at least 30 minutes at a stretch, because I had to wake her up, keep her awake, and slowly dispense the formula while she nursed on what colostrum I had. Then I waited 15 minutes and went to pump for 20 minutes. Then, I had to wash everything, because the NICU is sterile, and turn in my tiny bottles of almost nothing. When I was at home, I set my alarm for every three hours through the night (not that I could really sleep) and hooked myself up to my hospital-grade free rental pump (oh, the perks of preemie birth) and pumped away.

When my milk finally came in, we stopped the formula, but I gave permission for it to be used if I wasn’t there and she drank more breast milk than I had provided. As suck, swallow, breathe continued to be a challenge, the IBCLC gave me a nipple shield to use until her latch became more powerful.

This helped.

But it was rough. I spent 12 hours a day sitting in a grey room basically naked from the top down holding my baby on my chest and watching my baby sleep, and feeding, pumping, washing-labeling-rinse-repeat.
Then I went home and woke myself up every three hours for more pumping-washing-labeling.

And this was my breastfeeding life. Not exactly the pillows-snuggles-and Enya experience I had pictured.

And that’s what I can give today. More tomorrow.

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