Our NICU Story
by Diane DeJesus, RD, CLC, IBCLC
Trigger Warning: Traumatic Birth, NICU
Diane de Jesus is a board member of Global MilCom and an IBCLC. In 2015, she and her partner moved from Brooklyn, NY to London, UK. A couple of years later, she experienced pregnancy and birth in her new country. Ultimately, the family all became British citizens and Diane became a Lactation Consultant in 2021. This is the first of a muliti-installment series of Diane’s lactation journey, beginning with her experience of breastfeeding through a stay in a neonatal intensive care unit (NICU).
Our son was born with a pneumothorax (collapsed lung) after a forceps delivery. He spent five days in the NICU. I was grateful that, soon after he was whisked off, a nurse came over and helped me to hand express my colostrum (the first milk) for him. She encouraged me to get my husband–who was in the NICU with our son–to send a photo of our baby. Seeing a picture of my son might help the release of oxytocin (the ‘love’ hormone) and in turn help with expressing. The nurse showed me how to massage my breast before I started to squeeze tiny amounts of the thick golden liquid. I scooped up the first few drops with a syringe that was taken straight to my baby. I felt relieved that I could still feed my son, even from a different part of the hospital.
Later, in the maternity ward, I was still reeling–and coming back into the present–after a traumatic birth experience. Only curtains separated me from the other mums (and their newborns) and it was really triggering to hear the cries of the other babies. Even though I hadn’t really met my son yet, I’d frantically wake up to the cries, wondering if my baby was hungry or just needed me. Someone came in and said they needed to collect my information (name, address, things like that). I started giving my details before realizing this person wasn’t hospital staff. This person was a representative from a company bringing bags of promotional samples to new parents. I suddenly felt exposed, vulnerable, and like someone was taking advantage of the position I was in. I told this person I was not interested in giving my information or receiving the samples, and asked them to leave. It wasn’t exactly easy to do this while alone, still with labor drugs in my system, and still recovering. Later, my partner wheeled me (I still didn’t have use of my legs) down to the NICU. A nurse asked me, “where are you going?” “I’m going to see my son.” The nurse stepped aside. My son, I thought; realizing it was the first time I’d said those words aloud.
Around the third day, my milk started to come in. A midwife brought me a hospital-grade breast pump and showed me how to use it. I started pumping, both in my room (by this time they’d moved us) and every time we visited our son in the NICU (while my oxytocin was probably higher from spending time with him). I was given one of his blankets to smell while pumping, to help trigger that milk release.
At some point, NICU staff started asking to give my son a human milk substitute (formula) or a pacifier. I had already started studying lactation and was afraid of starting down a path with either of these options. I wanted to keep giving him only my own milk or donor human milk. Unfortunately, donor milk wasn’t an option. After they asked me a few different times, I finally gave in and let them give my son some formula. It was really hard to advocate for myself and my child when I was feeling so overwhelmed–by both the situation we were in and the status of the doctors and hospital staff. I had many mixed feelings about this decision and found myself working so hard to pump enough of my own milk to replace the amount of formula they were giving.
Around the fifth day, we were able to hold our baby and I got to feed my son for the first time. I felt so awkward, trying to position him across my chest…even with help! Our first feed together was so exhilarating. It helped alleviate some of the challenging feelings I was having about our birth and NICU stay…at least for a little while.
Our son was sent to room-in with us after this. While feeding in my bed, I noticed I had a lipstick shaped nipple and a little bit of discomfort. I knew this was a sign that our latch may need some help. I asked a midwife to watch while I fed my baby. She said everything looked good and we were soon sent home. We didn’t realize that this was the start of a challenging feeding journey.
To be continued…
WHAT TO KNOW:
Hand expressing - Hand expression doesn’t require any special tools and it can help when you’re feeling engorged, want to collect your milk, or want to help stimulate let-down before pumping.
Colostrum - Colostrum is the earliest human milk and is made during pregnancy. It is very thick and very concentrated with loads of properties that help support a newborn’s immune system.
Oxytocin - A hormone released during labor, breastfeeding, and sex. This hormone helps babies and parents to bond.
Human milk substitutes (i.e., formula) - Formula is not inherently bad. It can be good when needed and when parents can make an informed decision. However, companies may take advantage of parents and healthcare professionals may not discuss risks vs. benefits. The World Health Organization recommends not promoting infant formula in hospitals to help protect, promote, and support breastfeeding.
Early introduction of formula and pacifiers - It takes about 6-8 weeks for both milk supply and a breastfeeding relationship to be established. If feeding at chest is going well, it is recommended to hold off on introducing formula, bottles, and pacifiers, if at all possible.
How much to express - Newborns feed about 8-12 times a day. So, if you are pumping in the early days, it is recommended to pump and/or feed from the chest a total of at least 8-12 times per day (to help your milk supply to be established).
Lipstick-shaped nipple - A squashed or lipstick shaped nipple may be a clue that the baby is not getting a deep latch on the breast. Support with latching and position might be helpful.
About Diane
Diane is a Registered Dietitian (RD), Certified Lactation Counselor (CLC), and International Board Certified Lactation Consultant (IBCLC), currently based in Austin, TX.
Originally from Brooklyn, NY, Diane had a first career in marketing, before becoming an RD to align her work with her values and lifestyle. She merged the two with a focus on food & beverage marketing and health communications.
In 2015, Diane and her partner moved to London, UK, where their son was born a couple years later. At this time, Diane began volunteering as a peer supporter with local infant feeding clinics. She also traveled to KMC in Germany, in order to train for, and earn, her CLC credential. This was her first introduction to Global MilCom, then called Mom2Mom.
Diane experienced a number of feeding challenges throughout her breastfeeding journey with her son, including: a NICU stay, tongue-tie, feeding from one breast (after a previous mastectomy), cow's milk protein allergy, and her own postpartum PTSD and anxiety with feeding solids.
While in the UK, Diane also began supporting families with infant feeding through helpline (phone) and webchat support. She became an IBCLC in 2021, as an extension of her passion for nutrition and her love of helping families navigate infant feeding. Shortly thereafter, she returned to the U.S. with her family.
After developing a chronic illness, Diane became a mindfulness teacher and has taken a career break to focus on her health and to support others with the same condition.
Diane is thrilled to join the Global MilCom team in support of military families and their unique feeding journeys, as well as the Military Lactation Counselor program, and overall lactation advocacy.
