Lact-Aid Nursing System: Goodbye, Frenemy

_{Preview: My experience and feelings about using a Lact-Aid nursing system for breastfeeding my 27-weeker preemie. I review the Lact-Aid versus the Medela SNS, and share my thoughts on both.}

Yesterday I got an email from the mother of a preemie. She had just taken her baby home from the hospital and sounded desperate.

She asked about exclusively breastfeeding her preemie, whether she should listen to the doctors who insist she give her son a formula supplement.

It’s odd.

Like so many other things that happened around my son’s birth and NICU stay, I forgot until that moment that I used a Lact-Aid nursing supplementer for months.

My Frenemy The Lact-Aid

I hated it and was deeply grateful for it all at the same time.

I resented it and fought it and was ashamed of it, yet I may not still be breastfeeding my son at age two, if it weren’t for the simple technology of a nursing supplementer.

My brain lovingly forgot about the stress, fear and anxiety I went through – par for the course for the mom of a preemie.

Randomly, something brings it all back for me. It could be a smell (that astringent odor of alcohol in hand sanitizer), walking down a long corridor, or even the ring tone that was my pumping alarm.

Every so often I meet another mom who tells me her preemie story, and I share mine. It’s a secret club with a secret handshake or door knock.

We carry this little bit of scar tissue around our hearts, and when we recognize the wide-eyed look of another mom who knows how birth and death can get all wrapped up in each other, we can’t help it – our stories spill out.

So when this mom emailed me yesterday, I realized that I’d never written about the Lact-Aid nursing system. The critical role it served in being the breastfeeding mom of a preemie. I’d been one too eager to forget it.

Breastfeeding: Before The Preemie

I’d breastfed my first six babies without a hitch. For several years, I was a volunteer breastfeeding counselor a la La Leche League. Known amongst my girlfriends as “the Boob Lady”, my number got passed around to moms who were struggling to nurse.

With all that, I never imagined I’d watch my vulnerable preemie struggle to gain weight on my milk. Breastfeeding was a crucial part of my mothering identity. I didn’t know how to mother without tit.

Talk about adding insult to injury.

First my body was inadequate at the task of safeguarding my baby in the womb long enough until he could safely be born (on a bad day that’s how I’d see it, on good days I felt proud that I kept baby alive and stayed pregnant for months without amniotic fluid).

But then to fail at nourishing him?

What a kick in the gut. The guilt and shame were overwhelming.

When my son came home from the hospital, he gained 9 ounces in just a few days. I sent a text to the nurse who corresponded with me after he was discharged from the NICU. I was so proud and so happy. I didn’t have to give my son formula, something I didn’t want to do.

Why Nursing a Preemie Without a Supplementer is so Difficult

But then something changed.

He stopped gaining. There are few things more frightening than watching an already tiny, vulnerable baby lose weight.

Nobody told me that once baby came home, I should continue to pump even though Josiah seemed to be latching well at the breast.

Preemies have a weak suck, and they sleep more than a term newborn. They can’t stimulate the milk supply as well as termies.

Not to mention, everything about a preemie pregnancy and birth are fubar, making it doubly hard for a woman’s body to respond properly to the correct stimuli in the first place.

Hormonally, everything is whacked.

The breasts didn’t have 9 months of the correct balance of hormonal stimulation to promote re-growth of milk-making plumbing, the fear and anxiety around the delivery and baby’s well-being in the NICU aren’t compatible with the operation of breastfeeding hormones… I could go on.

Secondly, my son had a tongue-tie. He had a frenectomy procedure to correct it. But afterwards, he went on a nursing strike and refused to eat anything at all, whether from breast or bottle, for 24 hours. Talk about panic.

Once we got over that hump, I thought things would improve, but they didn’t. He wasn’t gaining weight. Despite taking galactagogues, including prescription medication, a visit from a Lactation Consultant who assured me that we were doing everything right, and cranio-sacral therapy sessions and chiropractic adjustments to help his mild torticollis.

I started pumping again and gave Josiah supplemental breastmilk via a plastic fingertip syringe.

This was not fun. I was either nursing or pumping or finger-feeding him every moment of the day, it seemed.

Researching for hours every day, I found nothing assuring me that preemies can thrive on breastmilk alone. There were a few anecdotal experiences on message forums by individual women, but no medical studies or research.

In fact, I found the opposite: the reason doctors universally recommend supplementing breastfed babies with preemie formula is because they don’t gain well on breastmilk alone (especially very early preemie).

This fact didn’t exactly boost my confidence.

I cried. I raged. I screamed at my husband once. I’m not proud of that, but when one is being awakened by a heart/oxygen monitor every few minutes all night long, one is not in their right mind.

Making Peace with the Lact-Aid Nursing System

Finally, I gave up the dream of the ideal. I decided that perfect was the enemy of good.

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Initially, I used a starter Medela supplemental nurser (SNS). It’s marketed for temporary use, but you can easily wash and reuse it indefinitely.

It served my needs for awhile, but then I decided to purchase the Lact-Aid. I didn’t like how the bulky Medela bottle holding the supplement felt on my chest.

Lact-Aid Versus Medela SNS

I found the Medela SNS more difficult to use than the Lact-Aid. It was also less discreet. The SNS would sometimes explode and leak formula or pumped milk all over me. This only happened a couple of times with the Lact-Aid, and it was due to a wiggly, grabby-hands baby, not a flaw of the system itself.

The Lact-Aid was easier to use, far less likely to leak, and easy to hide. Because the supplemental milk is in a bag, it has very little bulk. I was able to use it while nursing in public and noone was ever the wiser. (This was important to me then. I didn’t want to field questions from other moms who saw it. That felt like too much for me to handle.)

It’s a Marathon, Not a Sprint

Thing that helped me make peace with giving my son supplemental formula was taking a long-range view. I wanted to breastfeed my son for years, not months, and if a little formula was going to help us get there, it was an acceptable compromise.

Still, I struggled emotionally.

Giving a baby formula was something I had never done, and I had to rework my vocabulary around it. Learning to use the supplementer was easy, but overcoming the emotional hurdle was painful. I had to overcome the feeling that I was harming my son.

Nothing about having a preemie is easy, but the pain, anxiety, guilt, grief and fear do slowly fade.

I post a picture on Instagram of some new accomplishment of my son’s, and every once in a while someone comments “remember when he was so little and we were all so scared?“.

Yes, yes I do.

I cannot look at pictures of the first few months of my son’s life.

My Lact-Aid supplementer retire permanently a few months ago. I fantasized about burning it with great ceremony, but it didn’t happen that way after all. In fact I found it a couple of days ago in my refrigerator, empty and stuck to the bottom of a shelf. I peeled it off and tossed it in the trash without fanfare.

Having a preemie has changed me in ways I’m still unpacking. Nothing can ever be taken for granted. Nothing is normal. Every little normal thing is a miracle.

Including having a 27-weeker preemie who is still breastfeeding at 21 months. Looking back on the experience, my only regret is not starting with the Lact-Aid supplementer earlier.