Feeding a full-term baby in NICU – Katy’s Story

Katy describes her experience of hand expressing, using a breast pump, formula and breast feeding as she did whatever she could to help her baby put on weight.

Our baby boy Finn was born by caesarean section at 37+1 weeks due to placenta previa (where the placenta partially or totally covers the cervix).

We were allowed to have some cuddles when he was born but because he needed some help with his breathing, he was taken to the NICU. My midwife was quite confident that he would only be there for a few hours, so naively I just assumed he would be back down to see me later that day.

But then I was told that they had no more room in the special care unit for Finn so he would need to be transferred to another hospital, St Mary’s in Manchester. I cannot describe how it felt to be told I was being separated from my baby on the day he was born. My husband went to St Mary’s as we couldn’t have Finn being on his own. But that left me, recovering from surgery, on my own. The hospital was extremely busy that day and I honestly felt like I had been forgotten about. I had no baby and no partner. I felt helpless.

Luckily my parents and my sister arrived to support me. My mum is a recently retired midwife and I cannot put into words the relief I felt when she turned up. She got me some food and drink and immediately told me I needed to start hand expressing. I was still in shock from what had just happened that I had completely ‘forgotten’ that I needed to feed my baby even though he wasn’t with me.

We watched a YouTube video on how to hand express and mum knew that we would need syringes, bungs and name labels. So I began hand expressing, using a “C” shaped hand around the breast and squeezing into the syringe with a bung attached to the end. Sure enough, the liquid gold colostrum began to appear! It took 30 minutes to produce about 5ml of colostrum, but I knew that anything I could do to help Finn was worth it.

I’ll never forget the moment we had the wrong-sized bung attached to the syringe and all my hard work drained out of the bottom of the syringe. I could have cried but I remember just laughing and thinking, “right, I need to try and do it again.”

That night, I was on a postnatal ward with other new mums and their babies. It was utterly heart-breaking to not have Finn with me, but the hand expressing gave me a purpose, a job to do, a goal to help my baby. I hand expressed on my own three or four times that night, only asking for help when I needed it to be stored in the fridge. I felt proud of myself that I had in some way been helping my baby without being physically with him. My amazing husband, Ciaran, was with Finn all night, so I knew he had one parent with him giving him lots of love and cuddles.

The next day I was discharged and my family took me to St Mary’s. I immediately felt a huge sense of relief to just be in the same room as my baby. The nurses were so kind: as soon as I arrived, they closed the curtains around his incubator and helped me to have skin-to-skin. Words cannot describe the feeling of being physically reunited with my baby. When I held him I felt complete.

One nurse spent a long time giving me some more tips for hand expressing. She suggested pumping the breast rather than squeezing it - this made more of a flow which really helped. But my milk still hadn’t come in fully so the nurses asked about giving Finn formula milk. I immediately said yes as my baby was hungry and I wanted to do anything that would make him stronger and better quicker. I think this could be upsetting for mums who have long hoped to breastfeed their baby. But having a baby in NICU is nobody’s ideal scenario, and what you may have had planned or dreamt of whilst you were pregnant is not the reality you are faced with.

When my milk did come in that day, I was able to use the breast pump at the hospital. I was lucky because I seemed to have a good supply. I was pumping around six times a day and it gave me a real focus during the long days at hospital. My daily routine became: cuddling Finn, pumping milk, sterilising breast pump equipment and repeat. Each day, we tried to breastfeed him but he found it difficult to latch because of his breathing tubes. By the fourth or fifth day of Finn being in hospital, I had enough milk stored for him to exclusively have breast milk through his feeding tube. I felt proud of myself that I had been able to do this for him.

A week after he was born, Finn came off the breathing equipment and I gave him his first breastfeed. I will never forget the toe-curling pain - I thought that pumping had been uncomfortable but nothing compared to a baby latching on for the first time! At the same time, it felt wonderful to be so connected to him.

Finn lost a bit of weight over the time he was hospital. So, after I was discharged, my mum helped me come up with a feeding plan. We decided that, because he was tiny, I would feed him every 3 hours. I would try breastfeeding each time and if he didn’t have much or stay on for long, we would give him expressed breast milk and if he still seemed hungry, we would top him up with formula.

I read an interesting article on how to feed underweight babies which said that although you might have to do all this at the start, your baby might go on to breastfeed exclusively eventually, which is what I had wanted to do. Sure enough, after roughly three weeks of doing the three types of feeding (breastfeeding, expressed milk and formula) Finn gradually became more confident with breastfeeding and strong enough to just have this.

I am very lucky that I had a team of us feeding Finn. As well as having my mum’s advice and support, Ciaran was constantly sterilising, getting the next bottle ready, and getting up in the night to help me express.

Finn is now approaching his first birthday. He is still breastfeeding and enjoying weaning and lots of different foods! My advice to any parent of a NICU baby with regards to feeding is to just go with whatever your baby needs or wants. A fed baby is a happy baby no matter how you do it and if you want to do it in a particular way, let the NICU nurses know and they’ll support you with your feeding choices.