3 under 3

Despite my fears about having a premature baby, Tiernan turned out to be quite a good size – 2900g, or about 6 lb, 6 oz. Apparently there’s ‘premature’ and there’s ‘premature‘ (as we later found out…) Being a 36-weeker, he was admitted to what was called the ‘Cub House’, which was a mini special-care nursery for babies who needed extra monitoring, but weren’t sick enough for the NICU. It was up on the maternity ward, across the hall from where my room was. Being separated from my brand new baby was hard. Even though he was only steps away, this small distance felt like too much. I was allowed to go and see him whenever I wanted, but still it felt like I was only borrowing him.

He had to be in there, though, because his sucking reflex sucked! I was determined to breastfeed, but it was very, very difficult, as Tiernan didn’t have the strength to attach properly, and stay attached. He also had a habit of falling asleep after one or two sucks. Despite his good size, it became obvious that my poor, sweet baby just wasn’t ready to be born yet, as he was completely incapable of feeding this way. I ended up having to express tiny amounts of colostrum for him (like 2 or 3ml) into a syringe so that it could be squirted into his mouth. Things didn’t improve much over the next couple of days, even though I sat for hours and hours trying to coax him onto the breast – he was just so sleepy (and a little bit hopeless!)

Actually, the sleepiness was due to him being very jaundiced, and eventually (on day 2, I think), he ended up being put under phototherapy lights (to help break down the bilirubin in his blood faster – there is some debate about whether this actually does anything at all). I was so sad when they did this, as it really did feel like he was ‘off limits’ to me, except at feeding times. Actually, I was so sad about it that I didn’t even take a photo of him in his little tanning salon, with his cute little eye mask protecting his eyes. I regret that now. As hard as it was to deal with at the time, it was a part of his journey and I should have recorded it.

Back at home, and still a bit yellow!

Tiernan began his 48-hours under the phototherapy lights, and I began my ridiculously exhausting, 3-hourly feeding cycle: first I would attempt to wake him up to feed – this usually took at least 10 minutes, but he never really woke up properly; then I would attempt to attach him to breastfeed – he might get one or two good sucks in the hour that I sat trying, which was enough to give me sore nipples, but not enough to get any milk into him at all; then I would bottle feed him the colostrum (or milk, after his third day) that I had expressed last feed; then I would mix up a small amount of formula to ‘complement’ his breastfeed (the doctors wanted him to drink plenty of milk to help flush the bilirubin from his system) – I would then attempt to feed him this, but he was usually too full to drink it; then I would change his nappy (and usually his clothes after he spewed all over them, from drinking too much), give him a cuddle and put him back under his lights; next, I would drag myself over to the ‘pumping room’ to express whatever milk I had for the next feed; then I would either go back and sit with Tiernan and just be near him / or stumble back to bed for an hour’s sleep / or try and be alert and responsive to any visitors we had, before starting the whole process all over again! And this went around the clock. I was spending so much time on my feet, running around from one errand to the next that my legs ballooned for a couple of days, filled with all of the fluid that was supposed to be draining from my body but couldn’t because I was so busy.

After 3 or 4 days of this, Tiernan was still absolutely hopeless at breastfeeding, despite my saint-like patience! My Mum was with me through much of this crazy routine (during the day, anyway), keeping me company and providing moral support. I think she was beginning to wonder why I was so determined to breastfeed this baby who just couldn’t do it, worrying that maybe I was feeling pressured into doing the ‘right’* thing. But, she could see that I wanted to this, so she just kept on supporting me, encouraging me, and not expressing the doubts that she had, which is exactly what I needed at the time. If it had became obvious that this was never going to work, then I think she would have gently encouraged me to think about other options (such as exclusively bottle feeding with either expressed breast milk or formula), but as it was, it never came to that. I will be forever grateful for her support during this very challenging time. I hope I have her wisdom (and ability to hold me tongue!) one day. I don’t even really know why I was so stubborn about it. I was feeling pretty guilty for not being able to carry him until he was actually ready to be born, so maybe I thought breastfeeding him would somehow make up for this. Or maybe I was just being stubborn (not unusual for me!)

Despite my Mum’s helpful presence, I was beginning to get pretty disheartened. While I wasn’t ready to give up trying to breastfeed yet, I was starting to wonder how much more of this I was going to put up with – there seemed to be no end in sight. Then a wonderful midwife, who usually worked down in the NICU but was filling in for someone in the Cub House, suggested I try a nipple shield, as they can sometimes help premmie babies who have trouble attaching, or who have a weak sucking reflex. She went and found me one, and it worked. Tiernan attached, sucked and fed for almost an hour! Major breakthrough!! This meant I could just relax and feed my baby, change him, give him a cuddle, and forget the whole stupid business of complementing with formula and expressing for the next feed. I was so much happier, even if only a little more rested, after this development.

Things started to come together after that – not long after this breakthrough, the midwives brought Tiernan into my room and I was allowed to keep him. He was finally mine! And then, about half an hour later, they came and asked me if I would like to go home today. Just like that. My verbal response was, “Yes please!” My internal response was: Wait a minute, half an hour ago I wasn’t allowed to touch him without asking permission, and now you’re kicking me out? I’ve never even slept in the same room as him. I don’t know shit about babies! Oh crap, now he’s really mine!

But we went home, anyway. For two days. We were soon back, when Tiernan’s jaundice took another turn for the worse. Catherine, the midwife who came to visit us at home each day after we were discharged, wasn’t happy with Tiernan’s ‘golden’ appearance on the second day, so she took a blood sample and then rang back later to confirm that he would need further phototherapy. I was devastated. I was just getting used to having him belong to me, and now I had to go and hand him back! That was so hard. I cried and cried! However, Catherine was very kind, and made sure I was given a bed on the ward again so I could be close to him. So, back to hospital we went. The next 48 hours went without incident, and we were discharged, for real this time, when Tiernan was 8 days old.

I’ve realised that I haven’t mentioned Tom much in all of this. He was there, too, supporting me and getting to know his son. But he was also at home, doing all the things that we hadn’t had time for, like building the cot, decorating the ‘nursery’, washing the baby clothes, installing the car seat, and painting baby furniture. He and Mum took turns to sit with me at the hospital in that first week, and both of them helped me immensely.

Tiernan and his Daddy

So, there is the entire story (or novel) of how our precious Tiernan came to be. By the way, I was eventually able to wean Tiernan off the nipple shield at 5 weeks, which is much longer than some doctors or lactation consultants would recommend they be used for. However, my milk supply was not affected by its extended use, and Tiernan simply could not have been breastfed without it. So which better, to feed with a nipple shield, or not at all? Tiernan and I went on to have a good breastfeeding relationship, which lasted 12 months before he weaned himself. So, thank goodness for nipple shields.

On reading over this again, I’ve just realised that it could be read as a ‘How I managed to breastfeed despite the odds’ sort of story, which really wasn’t my intention. It was my choice to breastfeed my son, based on my instincts and my own needs as much as on his. Mothers have always been judged for the decisions they make, especially in regards to breastfeeding, and it is not my intention to imply that not breastfeeding my son would have been a ‘bad’ choice. Of course, if breastfeeding had not worked out, I would have bottle fed him. I would have been disappointed, not because I think bottle feeding is bad, but because I wanted to have the experience of breastfeeding.