In the special care nursery....and breastfeeding woes

Zoe spent four and a half days in the special care nursery and its an amazing little world. Unlike the post-natal ward, where babies screaming pierces the air on a regular basis, in the SCN, it is very calm and peaceful.

These babies are usually preterm or small and sleeping, not wailing loudly, is the main thing on their agenda. There were two babies in humidicribs while we were there, one on CPAP for breathing, another having his temperature monitored and several in normal cribs but hooked up to heart monitors.

Every baby has their 'station' to park at, with a full set of nappies, wipes, hand sanitiser and numerous other things, plus a breastfeeding chair positioned opposite.

Parents are encouraged to come and go as they please, and to breastfeed as often as possible if the bub is up to it. In our case, we actually wheeled Zoe over there for every feed 4 hourly, and then took her back to our room in between. This was optional and there was no need to take her back to the room, since all she did there was sleep, but it made us happier to be able to see her and hold her whenever we wanted.

On that first day, the midwife who had taken our antenatal class was working and she helped me on getting Zoe's attachment and positioning right. We are extremely lucky that this worked right from the start and according to the lactation consultant I've just seen this morning, its perfect.

We learned how to tickle her and stroke under her chin to get her to suck. Nappy changes were Lovely Husband's responsibility, and she was about 3 days old before I changed one of her nappies :-) Basically breastfeeding Zoe in the first week involved a huge amount of coaxing to keep her awake and sucking. She can do the sucking and swallowing just fine, but it really tires her.

So every 4 hours, I fed her as best I could and then some formula was put down the feeding tube through her nose to top her up. The midwives were keen for her to get most of her milk from me and not the feeding tube, so they really encouraged me to come over for every feed and they reduced the volume down the tube accordingly.

On Monday, we weighed her and the news wasn't good. Her weight had dropped to 2.660 kg, a loss of 13% of her body weight. All babies lose weight at birth while their mother's milk comes in and its fine in a term baby because they have a nice layer of brown fat they have accumulated during the last 4 weeks.

But for a premmie, this is bad news. From then on, 30 ml formula was put down the feeding tube every 4 hours regardless of how the breastfeed had gone. Fortunately, 48 hours later, she'd gained about 50 gms, which was good.

The best thing about being in the SCN was all the attention I got from the midwives. I probably had far more advice and people watching me for positioning and attachment than I would have had we stayed on the ward. But although most of the middies were incredibly helpful and sympathetic, there's always one to prove the exception to the rule.

It happened at the 10pm feed on my third night, the one notorious for the 'baby blues'. I'd been feeling fine all day and not sad. There was a new MW in charge that night and as soon as she saw me with Zoe, she criticised the way I was holding her and said I wasn't looking after her little neck.

Then as I attached her, she took my shoulder and literally slammed it to the back of the chair and said I needed to relax more! Then she took my breast and rammed it into Zoe's mouth. The last straw was when she did something to Zoe's feet to make her wake up, which instead made her scream.

By this stage, I was in tears and utterly distraught. For once, lovely husband had stayed in the room to get some rest, so he wasn't there to console me. We finished up as fast as we could and I got her out of there.

Back in the room, I was inconsolable. I just couldn't believe someone had been so mean and insensitive. Under other circumstances, I would have told her to back the hell off, but the baby blues chose just that moment to descend and I was completely undone.

I think Lovely husband must have called in the MW's from the desk because two of them were soon in the room, as I lay on the bed sobbing my heart out. We didn't tell them what had set me off, but I said the main cause of my distress was that my milk hadn't come in and I wondered if it ever would.

All week, everyone had been asking me if my milk had 'come in'. According to the textbooks, this happens on Day 3, and you are supposed to wake up with rock hard breasts and a feeling they are about to burst, then wonderously release copious quantities of milk.

Well, at some point in the last 1o days my milk did 'come in' because I've just expressed 30 mls, but I sure as hell never felt it - never had the rock hard feeling or any other feeling for that matter.

So the moral is that everyone is different, and things do sort themselves out eventually, which is basically what the middies told me that night.

I was so upset at having to deal with the horrible midwife in the SCN, that I tried to BF Zoe in our room at the 2am feed, and then sent LH off to the SCN with her for the top up through the tube. In her notes, it says that 'breastfeeding was not observed'. Basically, if they don't see you do it in the nursery, it doesn't count.

He told the midwife how she had upset me, and she was taken aback that she had made me feel that way. From then on, she completely avoided me.

Next post...taking Zoe home.