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Five Weeks and a Day - A NICU Story - Day 18

Updated: Sep 19, 2022

Day 18 - August 31, 2014

Over the last few days, LoLa and I have been diligently working on feeding. I have had the good fortune of understanding nurses who have been very supportive of my strong conviction to nurse. From the beginning, I've received tips and motivation to continue pumping and deal with the occasional snags pumping moms run into: engorgement, clogs, fatigue... They've educated me on the difference between the waterier, less calorically dense foremilk, and the fattier hind milk to help me maximize LoLa's calorie intake to support her growth. Even with my abundant supply, my breastmilk is fortified with an additive used to boost calories without increasing volume because preemies increase their feed volumes very slowly, especially in the presence of issues with reflux.

Currently, breastfeeding is mainly for practice. Staff aren't convinced she is efficient enough to actually count it as a feed. Once she appears to "get it" we will do weighted feeds (weigh her pre-feed, feed, then weigh post-feed to estimate how much milk she transferred from the breast) but for now, we let her suckle and simultaneously administer a gavage feeding of my breastmilk through the feeding tube in her nose. When I am not present for feedings, the nurses initiate bottle feeds for practice as well.

Sean and I also take turns practicing bottle feeding. It is a cautious task. LoLa lacks the innate ability to regulate the timing of drinking. A preemie has to work extra hard to coordinate suck-swallow-breathe-repeat, something most term babies don't always struggle with. She also severely lacks stamina. While attempting to feed she often fatigues quickly, fails to coordinate the sequence, choking and sputtering, and turning red or even grayish. The dreaded alarms sound and we do our best to calmly and slowly sit her up, gently patting her back to elicit a burp or help her collect herself, holding our breath until the numbers on the monitor return to normal ranges. Eating is still such a chore, sapping her energy and quickly ending in a deep sleep.

Sweet dreams, little Lionheart.

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