When infant feeding means bottles, boobs and tubes
Tube feeding; two words I did not come across a single time during my entire pregnancy. No midwife or doctor ever uttered them in my presence; they did not appear in any sentence in any information I was given or in any infant feeding book or website I had eagerly consumed during the 8 months I was baking my bun. The concept that a newborn baby may need to be tube fed was alien to me and not something I gave a single second thought.
Until my newborn baby needed to be tube fed.
He arrived at just 36 weeks and didn’t hang about! Just a few hours after the first twinge, I was holding him in my arms as he appeared to have a first breastfeed. Appearances can be deceiving though, as it turned out not to be the case. He was admitted to NICU shortly after with low blood sugar (hypoglycaemia). Once there, we discovered that he had a poor suckling reflex. This is one of five reflexes babies are born with and it enables them to remove milk from the breast or bottle and swallow it properly. Without a good suck, babies find it difficult to feed which puts them at risk of feeding related complications, including the low blood sugar that had already been identified.
As he was unable to feed himself, a nasogastric (NG) feeding tube was placed so we could deliver milk straight into his wee stomach. Thankfully this had been done before I got to the NICU ward as, when the tube had to be re-inserted a few days later, it was not a pleasant experience to witness. By then I had gotten used to the NICU, the tube and the monitors attached to his wee body, beeping regularly. I’m sure it would have been much harder for me to deal with on day one, having the shock of both a quick, unexpected preterm birth, and then him being transferred to NICU to process.
Learning how to feed
In the days that followed, both of us had to learn how to feed. It turned out that he was much better at it than me! So began the torture of triple feeding. Putting baby to the breast to try to stimulate both my milk supply and his suck reflex, trying with a bottle of formula or breast milk, and then me pumping for further stimulation. I continued this hellish cycle for three months, gaining nothing but a few measly ounces of breastmilk, chronic sleep deprivation, and postpartum anxiety. When I look back at this experience I wish I had just stuck with the formula from day one and saved us all a lot of hassle and heartbreak.
At first, the wee one took no milk from me and very little, if any, from the bottle so we gave him what he was unable to drink on his own via the NG tube. My husband and I learned how to slowly feed him through the tube. Our days in NICU were stressful, happy, sad, scary, and lonely. We became focused on milk volumes; how much was I producing (very little), how much was he drinking (not enough). We would have a good few feeds and start to feel optimistic about going home, and then he wouldn’t feed and we’d be back to square one.
The lowest point for me as a Mum was being discharged home without him. I can’t write about it in detail as it still upsets me. A close second was him having to have his NG tube reinserted after initially improving and having it removed. It was a real setback, and as I mentioned earlier, really hard to watch as his wee body fought against it.
Ultimately, after perseverance at every feed, trying to stimulate his suckling by rubbing the bottle teat against the roof of his mouth, and painstakingly monitoring how much milk he drank, he was ready to come home without the tube. I will forever be indebted to the amazing staff who looked after not just him, but me too, during those early, hormonal, and unexpected days.
The days and weeks afterwards were no picnic. We were both on a massive learning curve. He lost a lot of weight and we were very close to being readmitted and despite months of trying, he never, ever, managed to latch on to the breast. Thankfully, he took to bottle feeding and although it often took hours in the early days, we managed to provide him with all of the nutrition he needed. After around 12 weeks, when I ditched the pump and switched to exclusive formula feeding, we both hit our stride with a lot of help from Dad too.
Today, he’s a strong, healthy 6-year-old, tearing around the place like a tornado and with a good healthy appetite. Those early days were a shock, and ones I wish I had been prepared for. It’s not uncommon for babies to require a bit of help feeding in the early days and often a tube can be a Mums best friend, helping us to feed our babies with love while they catch up on their own. For some babies, a feeding tube is a longer term, or even permanent companion, requiring a whole new set of skills and knowledge to deal with.
The one thing that tube feeding has in common with other feeding methods is that it enables us to feed our babies with love. Tube feeding is infant feeding in the same way that breastfeeding or formula feeding is. It will touch more of us than many realise and we owe it to women and their babies to prepare, support and celebrate our tiny tubies.
