It sat there, next to my hospital bed, staring at me.

My breastpump.

(Google image courtesy of http://www.medelaimages.com/product_images/lrg/Symptroll-02-002.jpg)

My daughter had just been born, four weeks and two days early, and had been whisked off to the NICU.  The nurses had rolled the pump in, and told me it was there when I was ready to use it.  I knew I needed to, but I was too busy being on an emotional high and scrolling back and forth through the few pictures we had of her to bother much with the pump.

If only I had known just how necessary that pump was going to become.

After finally being able to go down to the NICU to see Haven, and after moving to a recovery room, the nurses asked if I had begun pumping yet.

“No, not really,” I told them.  They reminded me of the importance of beginning to pump, since I wanted to breastfeed and Haven was in the NICU.  They showed me how to use it, and I began pumping.

The first several times, I got maybe a drop or two.  It was pretty discouraging at first, but my Mom encouraged me that my milk would come in; I just needed to keep pumping.

So, those first few days in the hospital, I pumped every two hours, and walked the few drops I was getting down to the NICU.  Because she was on a CPAP for breathing help for the first few days, we were not able to attempt nursing until she was breathing room air.  She was receiving IV fluids, so all of her nutrition was coming from the fluids, so it wasn’t a problem that she was not receiving colostrum or breastmilk yet.

My first time holding Haven

The first time I attempted to nurse her, she was a few days old.  The nurse set up the privacy screen around us, and showed me how to hold Haven to help her latch on.  She latched right away, but was just sitting there.  We let her stay there for comfort, until it was time for her to go back in her isolette.  Each time over the next few days it was the same story-she would latch on, but fall asleep despite our attempts to wake her.

Once she finished her IV fluids, it was critical that she take in milk, whether from nursing or being bottle fed pumped milk.  The nurses would help me to position and latch her, and asked me to time how long she actively nursed.  If she was actively nursing for 20 minutes, it was considered a full feed and she didn’t need a bottle afterward.  If it was any less, she would receive a bottle.  They did not want her to attempt to nurse for longer than 20 minutes, because the calories she would expend would be more than she was taking in.

I would sit and watch the clock, hoping and praying that she would start nursing.  There were a few times when she nursed 5 or 10 minutes, and once when she nursed the full 20, but most of the time she wouldn’t nurse at all.  It always felt like somewhat of a defeat when I would give her the bottle.  I wanted SO badly to be able to nurse Haven, and every time she didn’t, that dream felt farther and farther away.  Even though the bottle nipples were “slow flow”, the milk would pour out of the sides of her tiny mouth, so we had to tuck a washcloth under her chin to catch all of the milk.

Josh giving Haven a bottle in the NICU

After our nursing attempt and subsequent bottle, I would send Haven back out with the nurses to be hooked back up to the monitors, and I would pump.  By this point, I was starting to develop a love/hate relationship with the pump.  I loved that I was able to provide the best possible nourishment for my baby, but I hated the process of pumping.

It takes a few minutes to unpack all of your pump parts, put on a pumping bra, and hook up to the pump.  The feeling of pumping is not a particularly enjoyable one, either.  It’s not painful, but just not enjoyable.  Then, you have to wash all of your pump parts, and since I was only bringing one set back and forth to the hospital, I had to dry them with paper towels every time.

While at home, I had to pump overnight.  I would usually get a set of pump parts ready, place them in a plastic mixing bowl by my bed, and when my alarm went off, I would sit bleary eyed on the edge of the bed while I pumped.

Any mom who has pumped long-term with an electric pump will tell you that her pump “talks”.  Especially in the middle of the night, when your brain is SO tired, and is trying to make sense of the rhythmic whir of the pump.  I swore my pump said, “Diego, diego, diego…”.  I tried to make my brain hear, “Haven, Haven, Haven…”, to help me remember why, in the middle of the night, I was attached to a machine that repeatedly pulled my nipples into a tube.  It seemed like that would make it better.  But alas, I still heard Diego. 😉

I did love the satisfaction of pouring one bottle into the other after finishing a pumping session, and seeing what my total was.  Even if it was just 30 mL (or one ounce), I was elated.  After pumping in the NICU, I would apply the ID sticker to the bottle, record my times and amounts in my pumping log, and head back out to Haven’s isolette.  If a family member was there that day, I would proudly show them the little bottle and tell them how much I was able to pump.  I couldn’t do much in those early days, but providing milk was something I could do, so I did it proudly.

The last few days in the NICU, Haven just needed to get on a weight gaining trend.  She had been losing weight for a few days, which was concerning.  After a few days of gaining weight, she was given the green light to go home!  She was still not nursing, and was actually screaming at the breast, until I would give up and give her a bottle.

The car ride home

This feeding process continued every 3-4 hours at home: she would wake and scream while I tried to latch her, I would cry and give up after trying for 15 or 20 minutes, we would feed her a bottle, and I would pump.

Bottle feeding at home

This went on for weeks.  It was draining, heartbreaking, frustrating, and every other difficult emotion you can throw in there, topped with the inevitable sleep deprivation that comes with being a new parent.  I felt like I was making my newborn baby cry it out every three hours.  As she screamed and pushed off of me, I would cry and ask, “Why??? Why won’t you nurse?”

Eventually, I realized that a few things were happening.

First, I was not catching her hunger cues early enough.  The feeding process was becoming such an emotionally difficult process that I dreaded, so when she first began to wake up, I would sit there for a few minutes and think about how much I did NOT want to start everything all over. By the time I got her to the breast, she had enough time to realize how hungry she was, and was not happy about it.

She also had bottle/flow preference.  This was a big one.  She was used to the milk coming fast and easy, and not having to work for it.  If I could get her to latch on, she would get frustrated that the milk was not dripping into her mouth, and everything would spiral downward from there.  She did not know how to or really have the strength to pull the milk out of the breast, especially considering that for much of this time, she had not yet reached her due date.

Because she kept having these stressful experiences every 3-4 hours, she started to associate being at the breast with stress.  I would place her in the cradle position, and even before attempting to latch her, she would start screaming.  As a mom, that breaks your heart.  Even though I knew it wasn’t true, I couldn’t help but feel like she hated me.

Pumping and bottle feeding was also becoming super stressful.  We blew through the extra milk I had pumped while she was in the NICU, and I was pumping each time for the next feeding.  She would finish a bottle, and still be hungry, and I didn’t know what to do.  I felt like I wasn’t pumping enough to satisfy her.  Every pumping session, I would pray for enough, and either triumphantly pour it into the bottle and put it on the nightstand for the next feeding, or I would cry with stress and worry that I was starving her.

At around 6 weeks old, I called my mom, crying. “It just isn’t working,” I told her, through my tears. “She is never going to nurse.  Maybe I just need to give up and switch to formula.”

“If that’s what you need to do, there is nothing wrong with that,” she said.  “I don’t know anyone that has tried breastfeeding harder than you have.  Giving her formula doesn’t mean you love her any less.”

So, with a tremendous amount of guilt, despite my mom’s reassurances, I found myself on the formula aisle in Target.  I felt like a failure. (Side note: In no way do I mean that moms who use formula are failures.  This is just me being real about my sleep deprived, emotionally exhausted mental state at the time. Formula has fed countless babies whose mothers could not or choose not to breastfeed, and in the end, FED is best.)  I picked out one that was formulated as a supplement for breastfed babies, and headed to the checkout.

The first formula bottle I mixed up was done so with tears.  A tiny voice crept into my head: I’m a bad mom. (Again, not formula bashing.  Remember, trying to breastfeed had been my life-almost an obsession-around the clock for weeks.  And because, sleep deprivation.)  You know what?  NO. I told the voice. I’m a GREAT mom.  I’m putting Haven’s needs above my own desire for her to breastfeed.  And that is what a good mom does.

I had been attending the breastfeeding support group at the hospital where Haven was born, as well as joining a local breastfeeding support group Facebook page.  Somewhere along the way, I heard the very best piece of advice.  To the new mom who is reading this and is struggling with breastfeeding: let this sentence soak in and remember it in those moments that you want to quit.

Never give up on your hardest day.

That day that I called my mom in tears, I figured that was my hardest day, so I knew I couldn’t quit.  Even though I was getting some formula to supplement, I wouldn’t let myself give up that day.  I couldn’t.

In hindsight, that was my hardest day.  It only got better from there.

I started watching her while she slept, and would scoop her up as soon as she started stirring.  This gave me time to try to get her latched before she realized she was hungry and completely lost it.

Haven napped in her Rock ‘n Play while I waited for her to wake up

At the suggestion of a friend, we switched to the Munchkin Latch bottles.  They are made for breastfed babies, and they don’t drip out when turned over like many other bottles do.  This helped Haven to learn how to draw the milk out, instead of waiting for it to drip in.

We also began to practice paced feeding when giving her bottles.  With paced feeding, you hold the baby more upright instead of reclined, hold the bottle horizontally, and take it out every couple of minutes for 30 second pauses.  This slows the baby down to more of a nursing pace, and taught her that eating from a bottle was just as slow as nursing.

Josh giving Haven a bottle at the park

I also started using a nipple shield-a silicone nipple that is worn over the mother’s nipple. Its intended use is to assist with latching when a mother has flat or inverted nipples, but is also sometimes used for preemies, because it gives them a little more to anchor onto.  I had tried the shield a couple of times in the NICU, but hated it because Haven would just knock it off in her flailing, and milk would spill everywhere.  But I decided to try it again, because it would at least get her back to the breast, rather than eating from only a bottle.  In an effort to keep the shield on while she was flailing, I started taping it on with medical tape.  I ended up with red rings on my breasts from pulling the tape off every few hours, but it kept the shield in place, and she was nursing with it, so the discomfort was worth it.  I was also making sure to pump after every feeding, to protect my supply.  Nipple shields are very useful tools, but should be used with caution, and under lactation consultant guidance, because it can be hard to maintain supply with them.

Nursing with the nipple shield

At one point, I realized that she was getting frustrated with the inefficiency of the shield, so I started trying without it.  Sometimes she would latch without it, and sometimes she wouldn’t.  If she did, I felt like I couldn’t move a muscle because I didn’t want to mess it up.  Without fail, every time she would successfully latch, my nose would start itching.  I often asked Josh to scratch my nose for me so I wouldn’t have to move.

We eventually got to the point where we were using the shield less and less.  Those times that she directly nursed, my heart soared.  I suspect the oxytocin released while nursing also had something to do with it, but I was SO excited and thankful that my baby was finally nursing.  I think the day when I was able to leave the house with no pumped milk, no shield, and no breastpump was the day when I felt like we had finally arrived at a successful nursing relationship.

Kicked back after a successful nursing session

It was an incredibly long, difficult, emotional road, but now 10.5 months later, Haven is still nursing like a champ.  She eats solids for all three meals a day, and has recently moved to mostly nursing before and after sleeps, and several times overnight.  Sometimes, when I look back at the beginning of the journey, I can’t believe the obstacles we overcame.  We are incredibly lucky that it all worked out for us-many moms and babies aren’t able to overcome those challenges, but we did.  I was extremely determined (read: stubborn) to make it work, and in the end, I think that that is what made all the difference for us.  Determination and support.

To the mom who is struggling with breastfeeding right now: don’t give up.  You can do this.  It gets better.

Thank you for reading about our journey, and I encourage you, if you are struggling with breastfeeding, feel free to comment or email me at jen.r.mendenhall@gmail.com .  I would love to chat, give you some resources, and pray for you and your baby.

Nurse on, mommas!