Going from TPN to Feeding Success in the NICU

August 29, 2019

How one mom found feeding success in the NICU after her baby was born with a rare condition.

by Faith Wilson

NICU baby feeding, NICU baby, TPN, Gastroschisis
Photo courtesy Faith Wilson

My son Calvin was born at 32 weeks gestation via C-section after he went into distress and stopped moving. His delivery was further complicated due to his diagnosis of Gastroschisis. Gastroschisis is a congenital anomaly that occurs early in gestation. Basically, he had a hole in his abdomen which led to his small and large intestine developing on the outside of his body. Because his gastrointestinal system was so compromised, I had a pretty strong determination to breastfeed from the beginning.

Calvin was on total parenteral nutrition (TPN) for several weeks, in which he received fluids directly into his vein to provide his nutrition. After that he received bottles containing very small quantities of milk. So I was unsure he would even know what to do when it came to nursing. When we finally got the go ahead to try putting him to breast, I had a mixture of emotions. I was so excited to try; it was a monumental step towards going home. But I was also dreading it. What if he didn’t latch on? What if he spent more calories trying to nurse than he received from my milk? I was able to control expressing my milk, but there was no way I could determine how he did direct nursing. It felt like a leap of faith in a way. Thankfully our breastfeeding journey would continue out of the NICU and well after that. 

The greatest challenge that I faced was developing mastitis a few weeks after delivering. I slept through one alarm and that’s all it took. Recovering from that took a lot out of me. I felt awful. After that I made it a point to get up and pump every two hours. You’re sort of in this survival mode when your baby is in the NICU. There’s really nothing a NICU mama can’t do. 

The time commitment for protecting your milk supply is no easy matter. But in a way pumping became this very empowering thing for me. I was relatively young when I had my son, and I really felt lost. All I saw were people that seemed way more qualified in every way taking care of my baby. Even though I felt helpless at times, I thought to myself, “This is one thing that only I can do. This is the one thing I can have control over. This is something only I can do that will help my little boy.” It was kind of cathartic. 

My advice as you begin this journey? Be kind to yourself. It’s absolutely okay to not be okay when you’re going through this. As far as pumping goes, I absolutely encourage every mom who is expressing milk for her NICU baby to seek help early on, even if it’s just to hear someone tell you you’re doing everything right.