Her entrance was quiet…sterile. Anticipation engaged in a forced dance with anxiety. Clanging instruments, safety checks, drapes…then, a frantic voice, “Damn it. I can’t get a hold of her.” Swirling nausea melting into raw, wordless prayers. A hush. Then only her; the sweet and supple blushing skin of this soul that I had borne. But she was so far away from me. After some time, I watched her chest wall rise and fall with irregularity, and somewhere in my self-preserving mind, the Mother in me stepped quietly aside…sobbing. The nurse in me…specifically, the exact specialty that the circumstance required…stepped to the front. No time to comfort the Mother in me.
I watched her wheeled away unceremoniously in that Plexiglas incubator; no adequate haven for a soul…a daughter…a child. My child. The hours to get to her are a blur of loneliness and ache. And, my body responded. I could feel the fullness in my chest…the familiar sparking of pathways reawakening. Milk…waiting to break through the surface in its’ own way, weeping with me.
Fresh from an operating table, where the choice was made to stitch at the close the sacred avenue, which leads to the glorious mixing of life. Oh, that decision was made with good information, and it was the right decision in my case, but it complicated my emotional footing. I was frightfully sick for years before I became a mother. And, I am already bound for surgery to repair what stretched too far in carrying these two lives within my womb. ::Ah, a story for another time:: So, this was my last chance. She is my second and my last.
The ambulance ride was frenzied. I was whisked away at nightfall in a downpour. Apropos down to the very detail.
When I arrived, all of the necessary rules were checked and balanced. But, I couldn’t focus…my whole body was crying out; my reckless need for my daughter was so loud.
Several hours later, I coerced my nurse with a smile, and I finally beheld her- my darling Fern. The CPAP equipment could not hide her loveliness in all of its’ clumsy attire. I finally felt her skin to mine…and my milk dripped between us, mixing with my tears in a sort of joyfulness.
While this story is not specifically about what my daughter overcame in her own diagnosis, I will touch briefly on it, because it weaves into our story of breastfeeding. She was diagnosed with Persistent Pulmonary Hypertension of the Newborn. She declined in stability on her second day of life…required mechanical ventilation and was intubated. Her peripheral blood pressure had to be forcibly increased in order to oxygenate her tender body. She received nitric oxide piped into her ventilator that helped to facilitate that. Her right lung tore amidst the weight of the effort afforded for her life. She required a sedation IV drip as well as a continuous Morphine IV drip for pain. One night, we watched helplessly numb at the door to her NICU room while a flurry of staff members were huddled around her bedside working to save her life. All of the trappings of my profession became the wallpaper to welcoming my daughter into the world. A wallpaper I knew by memory; now hated so bitterly. Chest tubes and umbilical artery lines, frequent blood gas measurements, umbilical venous lines, urinary catheters, ET tubes, ventilators and nitric machines whirring in tune to each other as they danced; animating my daughter’s chest wall movement into a perfectly synchronized metronome’s beat. So, there was no suckling…no gazing eyes upwards to facilitate that singular attachment; the glory of breastfeeding. No cascading oxytocin waves of euphoria for us in that time. That I knew the weight of what we were missing…was cruel. We had to find another way to each other until our skin could kiss the other’s again.
I mostly sobbed through each pumping attempt from the time she was born until over a month later. With my first child, I didn’t have to pump until I returned to work…and, that made a big difference. Those first few days when your breasts are so full and new and tender; even a soft palate and puckered pink lips can sting and ache. Even more so when you add the depths of an emotional ache that ends every day in a cliffhanger. That mechanical meeting every 3 hours seemed a ticking clock that mocked my pain. Once I was discharged from the postpartum unit, I was able to set up camp in Fern’s NICU room. I remember the first moment she knew my scent distinctly. One night as I was pumping and trying to distract my mind, I noticed she had gotten agitated. She was arching her back and reaching in my direction. It occurred to me that she might be calmed by the smell of me…the scent that beckons her uniquely; mother to daughter. She must have known I was there. She struggled against the heavy medications holding her will down, but she made a way…to gaze at me. It was the first time she looked at me. Her eyes flickered open and shut for what felt like an eternity. I can return to the very moment even now. Pumping became laced with a bit more purpose from that point on.
By day 8, my daughter was finally extubated. As she was still sleepy and weaning off of her morphine drip, there would be no oral feedings for several days to come. So, I relegated myself to that pump in between long-awaited skin on skin meetings with my daughter.
One thing that struck me as powerful in this process…was that my body went into some sort of hyper-drive. It took me 8 days to get my milk supply established with my firstborn. I fought for it. But, here…though surely my body had done this before…my supply immediately flourished. It flourished despite my poor nutrition, the multitude of distractions, skipped pumping sessions every day, my cup running over with emotional stress, and our inability to melt into skin-on-skin time. It was as if my body was fighting for her the only way it knew how. The connection, the link….the nurturing cells all huddled together in the pouring forth of liquid love. I attribute it to the connection of our souls…but, also, to the way I pumped. Because it was such a stinging reminder of what it was not, I oftentimes began those sessions with tears…and in that time, I would unconsciously soothe myself with gentle hand expression massage prior to pumping. I was woefully notorious as skipping pump sessions during heightened stress, and therefore would be full to the brim. I’d draw that NICU curtain around me, because I craved some sort of veil from the nurses and RTs that would come and go through that hushed room. As I mouthed prayers through tears, my face turned upwards to staunch the flow…I would inevitably always be met with peace at the end of the suggested 5-10 minutes of hand expression before pumping. Suddenly, I’d be startled by the milk freely trickling down my fingers; tickling awake the need to be present for her.
And, then. The day came. We had a whole day of practicing breastfeeding. I had advocated that I didn’t want to complicate any of her needs for energy conservation on trying to learn two things at once; breast and bottle. SO…we spent the entire day blissfully in each other’s embrace. The day quietly ended with tears and some dashed hopes. She was unable to latch well; she slipped off as quickly as she latched…she was frantic for it, and therefore even more frantic that she couldn’t settle into it’s warmth. I blamed her late-preterm status; paired with the weak suck and sleepiness…and resolved that I would focus our fight on getting discharged within the week. Nestled in at home, we could begin the journey of finding our way back to each other; to the breast. It would seem to me at the time that I gave up a big portion of my deepest wishes in my ‘plan’ for my daughter, but I hoped that if we could prove that she could eat enough by bottle, we’d be able to quietly steal away from that place. The following day was controlled depression, though I would not know it at the time. I had insisted that I be the only soul to feed my daughter. I used every ‘trick’ and technique that I’ve stored away in my 10 year NICU career. She worked for it. She started with vigor but labored her way to the end…only to melt into my arms, too exhausted for a burp. I remember crying and pleading with her while she ate, “Fern…oh please, my darling. I need this, sweet daughter. I need you to do this for mama. You can do this, my love.” I constantly fought myself from pushing her to finish. And, somehow she knew. She knew what I needed. She remained steady and full of fight. A spark of fire and soulfulness is my darling Fern. And, we made it. She inched by…sweetly suckling the very minimum amounts of breast milk that was required. We were discharged on the 13th day of our NICU stay. And so we began to learn each other.
Our days were oftentimes a battle. As family had come to help us in our great need, there were more arms that craved her presence. And, that made it difficult to carve out little corners of time for just her and I…without guilt. I fought exhaustion and the wings of sleep…just to be present for those hallowed 15-20 minutes that we were able to ‘practice’ breastfeeding…gazing at her, before we would begin the ‘work’ to finish a bottle. She was difficult to bottle feed, and because of that, I insisted on being the main bearer of the task to nourish her entirely. Which is rarely all-consuming if you’re breastfeeding exclusively, on demand. But, I had triple the tasks. I practiced breastfeeding with her every 3 hours, then bottle fed her 2 ounces of my pumped breast milk for those long 30 minutes, and then painfully handed her off to another’s arms to drift off to sleep…while I snuck away to my room to pump in drowning loneliness. In retrospect, I was trudging through postpartum depression during this time, but had no idea.
It wasn’t until almost a week after our discharge from the NICU that I learned why Fern struggled so. She was posteriorly tongue-tied with an exaggerated arch in her palate…making it doubly difficult to latch effectively. ::sigh:: Another mountain to climb. But, we were fit for the journey. We changed our nipple system and our type of pacifier, so that she could minimize her air intake from a poor latch. We had to step back from practicing breastfeeding during that next week because Fern had lost even more weight. Every day felt my abilities as a Mother and a NICU nurse were being challenged…with medical professionals looking over my charts and schedules. Strangely, the procedure to fix her tongue-tie was talked about as a “possibility some day”, and was treated with no urgency. After only a few more days at home, I recognized her need, and I immediately made an appointment with my Pediatrician, advocating that she put in for a referral to fix it expediently. It took weeks and weeks to get an appointment. I counted the hours and the minutes; my way back to her. Those days were grey…gloomy. Exclusive breastfeeding was just a fuzzy hope on the horizon that only shined a light on the distance I felt from her then. She still took in excess air at the breast despite all of my techniques…which made her squirm in discomfort; waking in a startle from the gas pain. She was restless at night, and I swore every night was going to be the very end of me. I couldn’t have made it without my family’s arms that replaced mine in those long, weary hours.
I broke down sobbing on the phone with the representative that called to tell me that that elusive appointment had to be cancelled only 24 hours before my countdown was coming to a close. I laid bare my desperation in a way I’ve never before to that stranger on the only end of a telephone. 30 minutes later and a frenzied car ride to that ENT appointment, we had finally arrived. He, too, tried to talk me out of this procedure’s necessity. But, I had done my research. I knew that this was our last avenue to breastfeeding. I could not go on pumping and bottle-feeding. I was ready to eliminate any unnecessary time apart from her no matter what dreams I was throwing out with my hope.
The snipping of her tongue-tie was rather gory for a total of 20 minutes…but, then life slowly flickered it’s dawning light. And, I started to wake. Waking to her was both glorious and shattering at the same time. It shattered me that I had lost so much time with this sweet soul. That I had been regarding her with only 1 eye open (so fearful of not meeting her needs, not gaining weight, etc.)…which was missing out on so much beauty. Despite what every medical professional told me, I stopped pumping within 12 hours of her tongue-tie correction. It was clear…that she was fighting for this. That she had found her home there. She greedily gulped and sighed and nestled into me.
My darling Fern is mighty. She transferred 100 ml of breast milk within the first few feedings after that tongue-tie was fixed. It was magic.
She still had to fight to regulate my supply to her needs, which meant that she dealt with reflux and gas. However, she was hearty. She flourished with ease there. My heart soared as we packed up bottles and pumping supplies. I know we will return to these tools someday, but for now…we heal. And, that powerful healing is at home here at my breasts. This fragile dance we believe should be so innate; so easy…is not always so. Sometimes you do everything just as they say, and it slips away into the night. I’m eternally grateful that it let me grasp hold and rest in its intimacy; with my Fern. To all those mothers and daughters and sons still fighting: I see you. Though I didn’t get it myself…in my frenzy to control…you should know…you are enough.