Once settled in our room on the ward, we soon set to looking after T1 and T3. T2 was doing fine downstairs in SCBU, getting his extra oxygen and my husband would pop down on a regular basis to see him.
I had decided I wanted to breast feed if I could for as long as possible (I had with my first up to 5 months) but also supplement with formula as imagined I could not keep up a milk supply for three babies, and I could not see how I could feasibly breast feed each baby for a full feed in addition to having a toddler requiring my attention. T1 and T3 were latching on but not really doing much sucking. The sucking reflex is usually ready for extra-uterine life by 36 weeks, so not surprisingly T1 and T3, born at just over 35 weeks, were struggling with this. The midwives suggested that we try feeding formula milk as well. We were provided with ready made up small glass bottles of Aptimil formula milk and also syringes.
The feeding process quickly went downhill overnight (it was agreed that my husband was allowed to stay with me overnight). The nurses were doing ‘heel prick tests’ on T1 and T3 to monitor their blood glucose levels*.
Our boys’ blood sugars were not being maintained. We were trying breast and bottles feeding and were not really sure what was best and what was working.
T1 and T3’s heals were black and blue from the bruising from the heel prick tests every few hours. It got to the point that they would squeal if you went to touch their feet as they pre-empted what was coming. This was heartbreaking. We were desperately trying to feed them milk, willing them to take it so they didn’t have to have their little heals pricked again and it was all bubbling out of their mouths again, or they were sick after. I couldn’t move to pick them up out of their cots due to my stitches and felt absolutely useless. I hadn’t expected to feel this immobile. I couldn’t even change a maternity pad and had to lie there whilst someone did it for me.
I knew from my reading of premature feeding that specific milk is available for premature babies with different teats to help them suck. I even knew from my own experience that milk at room temperature may not go down well, surely better to heat to body temperature. When I questioned the nurses about the premature milk and teats I was met with the reply that they were only available in SCBU and not allowed up to the ward. Right. Doesn’t that tell us something.
The following morning I decided I had enough energy to be loaded into a wheelchair to taken down to see little T2 who I had not seen since the delivery room. Once in the wheelchair (I never expected to be in wheelchair after my c-section but just couldn’t walk), my husband passed me both T1 and T3 so we could take them down to see their brother. I was distraught when the nurses told me I could not do this. I wanted to have them with me and not leave them behind. I completely understand why now – the nurses explained they were responsible for them and they couldn’t let them leave the ward, for safety and infection risks. But it didn’t seem that obvious to me at the time. A nurse said she would sit with the babies whilst I went to see T2.
T2 was in his incubator. I met the SCBU nurses who were looking after him and he seemed to be doing well. My husband had been with him a lot anyway so I was up to date on his progress. In addition to extra oxygen, T2 was also receiving antibiotics through a cannula which is standard practice for a premature baby in the baby unit.
Back up on the ward, the feeding was not getting any better and I asked to see the doctor in charge, who when he appeared really got the brunt of my built up stress, tiredness, worry and hormones. I can see why we ended up on the ward with T1 and T3 as they were well and good weights, but the fact is that they just couldn’t feed consistently off me or the bottle. They were too tired and their sucking reflex wasn’t developed enough. It was agreed that they should be taken to SCBU and be tube fed. A decision we were relieved and happy with as we knew it was the right one. I was to express as often as I could and take the milk down to my boys. The boys were to go down to SCBU at 4pm on Day Two and also have the same antibiotics as T2. They were to be fed a combination of my milk and formula milk by tubes (up their noses).
So my next task was to get the old breasts to maximum efficiency. A lovely nurse sat with me for ages massaging my breasts for milk for me as I just didn’t have the energy to do it. She managed to get the wonderfully nutritious gold stuff and store it in a syringe ready for all babies. This would be fed to them orally by syringe and some would be stored in the fridge for T2 when he was ready for it. This was to be my purpose. To get my milk ready for when my babies needed it.
* Blood glucose levels
A good supply of food energy, particularly glucose, is important for normal activity, growth and development. In rare cases, blood glucose levels can fall too low and a baby may become unwell. The concern is that long periods of low blood glucose in a sick baby may cause brain damage.
According to Paediatrics & Child Heath journal (www.ncbi.nlm.nih.gov/pmc) in healthy babies, blood glucose levels are the lowest one to two hours of age while the baby gets used to being outside of the womb. In most cases, blood glucose levels will rise after this using healthy sugar and fat stores. Healthy babies born at full term do not need blood glucose checks. They have enough stored energy to last them until breastfeeding is well-established, usually by the third day of life. Small and preterm babies may not have enough stores to keep the blood glucose level up without extra feedings. They need routine glucose checks starting at about two hours of age, and then before baby’s feeds, and then after the feed.