My first child was born at only 33 weeks gestation. However, he was growth restricted which resulted in he being the size of only a 30 week gestation baby. He was my adorably tiny little man! Because he was a preemie and required care in the NICU, we had a rather different and difficult breastfeeding experience. (I later learned that practically no one successfully directly nurses a preemie. I was determined, and we did it though!). I learned that NICU care is supportive of nourishing babies with breastmilk, but not necessarily through breastfeeding. Some of the care posed challenges for directly breastfeeding. For instance, breastfeeding isn't necessarily measurable which is not ideal for numbers-driven care. They disregarded that he was actually taking in adequate milk from nursing and calling it mere exposure and practice. Regardless of our nursing session, he would be fed their desired amount (via NG tube). His little belly did not tolerate the large amounts of milk. I made quite a fuss and thought then that I'd not breastfeed and not contribute to he being made sick. Fortunately, our wonderful neonatologist changed the care plan and allowed Tennyson to nurse as desired and only take that which he desired from a bottle. (Preemies aren't strong enough to nurse without getting overly fatigued and so a bottle is also used). One really nice takeaway from the NICU was that he had always been on a feeding schedule. We continued that schedule, and it was wonderful to have that predictability!
So, that became our breastfeeding routine- breastfeeding preemie style. I would nurse him directly with a shield (he was too small to go without it for the first month), then try him without the shield for him to practice without the plastic, pump, bottle feed some of that pumped milk, store the remainder of the milk, wash the pump parts and bottle, and then get it all ready for the next session. It took me about two hours to complete the entire process! That went on around the clock for several months. It was exhausting to say the least.
(Tennyson after a feed. His poor belly really had a hard time in the early days)
We continued to directly breastfeed until Tennyson was about seven months old. At that time, my milk began to change a bit and we discovered that we were expecting our second child. We continued to nurse directly, but would also supplement with frozen breastmilk in a cup. My OB later instructed me to wean Tennyson completely by the time I was 16 weeks in the pregnancy due to the level of risk I am for preterm labor. (Nursing can cause cramps/contractions, which is concerning for someone who is at such high risk for preterm labor). By that time, though, he was well adjusted to a cup and really didn't have any issues no longer nursing. By the time he as 10 months old, the freezer supply of breastmilk began running really low. We then began offering half breastmilk and half infant formula. By 11 months, he was receiving all infant formula. For a few months after he turned a year old we continued to offer toddler formula instead of cow's milk. I wanted him to have that extra bit of nutrition up to close to his original due date. Then, we offered him half formula and half cow's milk. Finally, we began giving him all cow's milk. Phew, we've done about it all when it comes to milk feedings! He's taken to each form easily and never had any issues. He loves his milk cups still!
Our second child was born to term (actually 2 days over the due date!). Our experience with her has been drastically different mainly because she's a term baby, not a preemie. I have felt like I was a first time mom breastfeeding and had to relearn about it (all I knew was breastfeeding preemie style!). I quickly discovered (and favored) that breastfeeding a term baby is much easier. Yet, we still encountered our problems. Once again, my milk supply was plentiful. She, too, has gotten to experience "drink or drown" breastfeeding. Though my goal was to not use the pump, I found myself needing to pump fpr comfort several times a day or else I would be painfully full.
I was given the guidelines of nursing on each side for 10-15 minutes every three hours. We tried and tried to meet these marks for weeks. She has never nursed well for 10-15 minutes and will only on occasion take both sides.
She has also nursed on demand instead of per feeding schedule. A predictable schedule had been so nice last time, and I had looked forward to doing the same this time as well. However, we struggled for feeding schedule success without the initial establishment and use of a bottle.
The entire experience up to that point was wearing me out. I cried out of frustration and stress, and considered just bottle feeding pumped breastmilk or formula. However, I just couldn't justify doing so, especially when I have an ample supply.
Will we continue to exclusively breastfeed for all twelve months? I don't know. I consider how messy, uncomfortable, and time consuming breastfeeding is. I miss having the predictability of a feeding schedule like that which was established with my first child. I look forward to being able to prepare milk in a cup, and thereby give us both that moment of independence, but that's not something I could do as easily if I exclusively breastfed for a year. But then, I consider the alternatives. Exclusively pumping leaves me tied to the machine, something I was not in favor of in my previous breastfeeding experience. We would also be limited in going out or traveling. Even if I could take the pump with me (which I'd rather not) I'd still need to have a way to clean the pump parts. The third option would be formula. Formula is certainly convenient. But, it's harder for babies' bellies to digest. (And we have enough trouble with gassy or upset baby bellies). It's also expensive. We averaged about $100-125 per month during those few months when we used it for Tennyson. There are a lot of other purposes I can think of for that amount of money each month! Presently, we're pressing on in breastfeeding. Some days I want to throw in the towel, but I know that we'll keep going for as long as possible. (I'm too stubborn to just give up without a valid reason).
Prior to my first child, I was adamant that I would only exclusively breastfeed. Now, I'm a little more considerate of different options and situations. I've learned through our two breastfeeding experiences that sometimes things don't go precisely as planned, and that's okay. You have to do what's best for you and your family.