Breastfeeding a preemie, fighting jaundice, low weight gain, and the whole nine yards

My baby was born at 34 weeks and 2 days, so everything was new and unexpected for me. Though I was quite positive about breastfeeding, many things came a surprise!

I remember being present for my cousin’s first nursing session, where couple of aunts kept squeezing her breast, and she kept screaming in pain and crying. I felt so helpless, my tummy churned inside as I walked out.

Now that experience kind of scared me for many years while I was single, about the whole nightmare of breastfeeding, plus reports of moms in pain and agony. However, ever since I got pregnant, I was quite hopeful and full of joy, as I was holding on to a promise from God which read, “she will nurse and be satisfied at your breasts.”

Also, I realised that babies are so instinctively wired to suck, they actually develop the sucking instinct in the womb itself. I discovered that in a beautiful video by National Geographic, In the Womb, which I think every pregnant woman should see.

Now having said that, I got a call from the NICU to come and feed Zara – I was longing to look at her after the hurried glance soon after delivery. I wiped my breasts and just ran in, and thankfully, they kept all relatives out, and only allowed the mother in. I still remember the look on the faces of some of my friends and relatives – really scared!

Zara, at the NICU, has some rashes, just woke up, hungry.

Tell everyone it is your first time!

The nurse did not know and I did not know that she did not know that it is my first time. So when they placed Zara on my lap, I looked up at them as if, now what? Then she asked me, “Madam, first time?”

She pulled my aeorola out and squeezed gently and the colostrum oozed out. I was so excited. I couldn’t believe I was carrying milk all this while! When did it from? How did the body know that I went into preterm labor? Of course it knew.

It was uncomfortable but not painful. My Zara was so tiny, but such an animal when she smelt milk. She immediately opened her mouth and the nurse dragged my breast right into her mouth. 15 min on one side, then they burped her, and 15 on the other. I loved those nurses for helping me out. First time was a breeze.

Then came the storm!

As long as I had help, I was fine. For the life of me, I could not squeeze my own breast. It got frustrating as she could not latch on! And soon, my nipples became the subject of public debate.

My gynaec came for her regular check-up, and then asked, “Are you able to feed well?”and I said, “not really. They say the nipple is not coming out.”

“Ok, show me your breasts. Oh why is it not coming out? These nipples look great to me,” and she gave a rude look to the nurses, guessing one of them was the “they” I mentioned.

So, I was all ‘lets-do-this’ and this time one of those Mallu nurses came to help me. “Forst time? No probe-lem.” She tried and tried, and then suggested I use a nipple shield. By now, the pressure to feed her was building up, since she got jaundice already. And man, no one prepared me for this one. Breastmilk is like a wonder drug, the more the baby gets it, the faster jaundice leaves. Breastmilk plus phototherapy – winning combination. Except it looked like I was not winning. After a lot of prayers, somehow it worked and the jaundice levels came down.

When the jaundice shot back

I was home, happily feeding Zara repeatedly, every two hours, plus doing KMC (Kangaroo Mother Care), plus oil massage and sponge bath, and what not. Totally stressed out.

Mark left for the U.S. for a shoot, right after we celebrated my birthday on Sept. 23. And the same week, we went for a regular check up to the paediatrician. I was so not prepared for this. Zara’s jaundice shot up to 21 mg/dl on the 14th day of her life. She had to be admitted immediately.

I was beside myself. I just could not take another separation – and the anxiety of seeing her under the lights, with her eyes masked, and constantly checking the bilirubin levels … madness. I just cried and cried. Though I was told it was normal in premature infants, nothing could comfort me.

I spoke to Mark. He asked me to stay strong, but I felt so weak, absolutely weak. To add to my sorrow, they wanted to take her blood sample and she would not let them, because it was her feeding time. I told them to take it after the feed but they were so scared, they wanted to do it immediately, and they kept poking her, and could not get the blood they required. The blood is sucked out drop by drop, and I went mad during this procedure. Finally, they gave her back to me, and once she had some milk, she was so cooperative … my little princess.

Again, she was admitted. This time, what it made it so hard was I already got very attached to her. Yes, it was just 14 days, but I was touching her, feeling her, feeding her, loving her, and enjoying her drunken-face after every feed. I was so in love with her, I could not bare the separation. Thankfully, at the hospital, they believed in keeping her close to the mother, so that was the only solace – not more than 24 hours and she was treated right next to me.

Just nursed her, putting her to sleep; she was kept under phototherapy right beside me. Here, they took her cannula out, and gave her into my arms.

Is my supply low?

I really wondered. Nurses would rush in and ask me for expressed milk, and the hospital did not have a breast pump that we could use, like some other hospitals had. We had to hunt for a pump at 10 pm in the night. My closest friend, Preethi, managed to get me one and we immediately tried to pump. … only to be disappointed, there wasn’t much coming out. When the nurses expressed milk from my breast directly into the pallada, they did get adequate milk. Somehow, it was still on the lower side.

I’m telling you – all I knew was to pray and speak to my breasts to provide an abundance for my daughter. And when medical staff says those words “low supply” it really pierces your heart as a mother. I felt helpless. I was doing everything I could.

A nurse, feeding expressed milk, using pallada.

The lioness awakens!

I was like a weakling for the first 10-12 hours. Just sobbing and feeling miserable, and terribly missing my greatest strength, my husband. My mother was with me the entire time, praying and believing and my parents and Preeti were my strong support.

Mark told me he spoke to pastor Zack, and Zack said that it was very normal, nothing to worry, the jaundice is coming down and they were praying for me.

Zara was brought into my room. The triple surface phototherapy continued. During one of the feeds, I saw her tiny hands. Transparent skin. And about ten spots – ten pokes on one hand. I kissed that hand and cried, “Lord, no more pokes. I’m done crying. Jaundice, you better leave in Jesus’ name. You have no authority to stay in my baby’s body. She is blood-bought. By the stripes of Jesus, she is completely healed. I uproot jaundice in Jesus’ name. I’m taking my baby out of here.”

That one moment, I moved from lamb to lion, with the Lion of Judah standing by me, with me, for me and in me!

Next day, Zara was discharged. Jaundice dropped to 10.2 mg/dl. Even the doctor was surprised. She thought we would stay for two more days.

And just when I got happy with her health for the next few weeks, with her jaundice going from mild to zero, slowly, now, we had another new problem. Less weight gain.

Low weight gain

Initially, Zara put on some good weight. But I was told we need to hit the 2.5 kg mark and then we can stop worrying.

My doctor knew I wasn’t too keen on formula milk. I felt my baby was puking and gagging. I reduced her intake of formula, and she kept insisting I increase it. I wasn’t convinced. Not yet.

I remember one particular appointment, when she weighed Zara and commented that the weight gain was very low and she was very unhappy. And I was very helpless. As a doctor, she wanted results but she wouldn’t help me get them! What was I to do?

Change my doctor

I would return home each time, with tears in my eyes. I decided to change the doctor. It was great to have her so far, for that season. Now, I needed someone who could help me just increase my milk supply or just solve this whole breastfeeding problem for me.

I went to Vijaya Krishnan from Healthy Mother Wellness and Care, for lactation consulting. That was the best move I made. I am ever thankful and grateful to her. We met her for an hour. She took Zara in her arms, and then did a whole nursing session with me.

I actually did a biological feeding session, with my top off! And my little daughter was latching like crazy! Vijaya taught me what a good latch was, and how to get it. She even taught me to compress my breast and express little milk to provide more satisfaction for my baby. At this point, I was still breastfeeding with a nipple shield. One of the takeaways for me was to see how naturally a baby can actually latch well and drink, instead of just sucking. That’s where my breakthrough was. I confused her comfort sucking for drinking.

Vijaya gave me a list of foods that help in pumping milk supply, plus a new routine to feed my dearest baby. She encouraged me and helped me realise that I am a good mother, and I can do what it takes. I felt awesome after meeting her. This time, I went back home, without tears, but with newfound confidence.

Zara wanted milk every hour and a half. She was enjoying the new cycle: 15 min on right breast, 15 on left, and back to right for 5 min, for some good let down!

Some weeks she put on just 50-60 grams, and others 100 grams! I was getting a little too obsessed weighing her and Vijaya asked me to relax.

After a month, we still did not achieve the weight gain we were looking at. And here’s what worked finally: I would breastfeed her, and top it up with 30-45 ml of formula for every session, though not as a hard and fast rule. It worked like crazy. I shed all my inhibitions about formula milk. I prayed over it and just confidently fed her and she was perfectly in good health. Also, Vijaya encouraged me to breastfeed directly and not pump at all. She knew there was no time for that.

You feed every two hours, or sometimes, one and half – in the interval, what all can you do – take a shower, eat, get a massage, sleep, and now where in the world will I find time to pump and also do KMC?!!!

Finally, we hit 2.5 kg and there was no turning back.

We asked Vijaya to recommend a ped and she straightaway gave me Kiran Krishnamurthy’s number. I remember going to the Topaz Building in Somajiguda, such a horribly maintained place. I wondered what kind of doctor will this lady be. I already had a stand by!

When Kiran called us in, I could not help but smile back at her kindest of smiles! Her first words were, “Tell me about your day – right from you and your baby wake up,” and we went on and on. She measured Zara’s weight and asked us not to worry at all. “Don’t worry about the pace, as long as she is gaining weight and has many wet diapers.”

We just knew, this is Zara’s doctor, as long as she is a kid!

Zara, with her new doctor, Kiran Krishnamurthy.
Zara, with her new doctor, Kiran Krishnamurthy.

She was my doctor too! She told me to relax and not try to do so many things at one go – KMC, oil massage, direct breastfeeding, etcetera. “Just relax, feed and get plenty of rest!”

The first three months, were still tiring and crazy hectic, but this time, we were happier and more confident. We prayed together over our baby. I prayed over her, every single nursing session.

From nipple shield to direct breastfeeding

My sister was encouraging me to breastfeed directly without the nipple shield. Though doctors and articles on the internet held the view that that doesn’t effect milk supply, the desire was strong in me. One day, my baby wanted to feed, and I almost forgot to sterilise the nipple shield. So while it was getting done, she cried and I just popped my breast in her mouth, and bam, she latched on and drank milk directly!

That was it! I think I used the nipple shield only 4-5 times after that. Vijaya was quite impressed that Zara started to breastfeed directly. For me, it was double victory. I can’t tell you how happy I was that my baby was drinking directly without the shield. We celebrated that victory! To God be all the glory, great things he has done.

I read so many articles about how to wean from the nipple shield, and I just prayed that she would do it naturally. My hope and trust and dependence was completely on the Holy Spirit! And he is so faithful, always.

“For you will nurse and be satisfied at her comforting breasts; you will drink deeply and delight in her overflowing abundance” (Is 66:11). 

Today, Zara is 11 months old. And she can feed sleeping, sitting, and even turning, and on her tummy with her head to the side. She’s an expert and loves to feed !

Zara, 11 months old.


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