Estimated reading time: 5 minutes
Julia Lehman Caldwell, N Hubbard, WI, USA
Whoosh, whoosh, whoosh.
I spent the summer in a dark room, barely large enough to hold a sink, a rocking chair, and the whooshing machine: a canary-yellow cylinder perched on a three-foot pole. Just outside the door was a chilled, sanitized world: a neonatal intensive care unit (NICU), where tiny, premature babies slept on pods of white fleece inside makeshift wombs—transparent boxes known as isolettes. The dinging of alarms could be heard day and night, monitoring delicate vital signs.
Whoosh, whoosh, whoosh. In the whooshing room, the muffled, repetitive suctioning of a hospital-grade electric double breast pump became my constant companion, every two hours, day and night. Eventually I heard the whoosh even in my sleep.
One evening, 27 weeks into my pregnancy, I had been sitting on a birthing ball in our first labor and delivery class. Suddenly I felt a warm gush. Within minutes I was on a helicopter to a large hospital. Our baby was coming 12 weeks early.
Before the delivery, a man appeared next to me, cupping a small blue towel in his hands, “I will place your baby in this warm towel and take him to another room,” he explained, and then he disappeared. Almost two hours later, they brought baby Wesley into my hospital room, intubated, stabilized, and secured inside a small isolette on a cart, ready to be transported to the NICU.
I looked at him through a small window in the cart, unable to touch him. Wesley weighed 1 pound and 15 ounces, and was 12.9 inches long. He was not much bigger than my hands; his head was the size and texture of a small peach with just the thinnest layer of fuzzy blonde hair.
I had expected to nurture a full-term baby, to show my love in the usual ways—nursing, holding, bathing—but none of that would be possible for a long time. Wesley was unable to regulate his body temperature, breathe, or eat on his own.
“Premature babies need breast milk,” a neonatologist explained to us. He said premature babies have trouble digesting formula, and that my breast milk would be custom-made for my premature baby. Although I couldn’t show my love in the usual ways, I could provide something that no one else could: the nourishment that my tiny baby boy needed to survive and thrive.
The day after Wesley was born, a nurse wheeled the whooshing machine into my room, along with a bag of equipment—rubber tubing, plastic flanges, valves and membranes, bottles of various sizes—and showed me how to hook all the pieces together with the machine, to create a pump that mimics a baby’s suctioning.
Mothers of premature babies are often at risk of losing their milk supply, because their babies are not able to breastfeed and even the highest quality electric pump cannot remove milk from the breast as efficiently as a baby, or replicate the release of hormones that occurs when a baby nurses. “Start right away,” the nurse encouraged me, gesturing toward the whooshing machine.
My milk began as a few tiny drops of a golden, thick liquid known as colostrum, sometimes referred to as “liquid gold” for its rich nutritional properties. A few more drops each time, and soon I was filling one-ounce colostrum bottles. I hand-delivered milk to Wesley in the NICU, where the milk was fed to him through a feeding tube inserted into his mouth and stomach.
The small, dark room became my refuge from endless procedures, decisions, and risks. Ultrasounds to check for bleeding in his brain. Echocardiograms to evaluate a hole in his heart. Breathing tubes. Blood draws. Blood transfusions. Chest x-rays. I tried to focus on the only thing I felt I could do for him. I kept going into that small, dark room—an endless ritual, day and night—so I could provide a few tiny bottles of milk.
Before I held Wesley skin to skin for the first time, I waited while two nurses untangled and redirected the cords for machines that monitored his heart, respiration, and oxygen levels, plus his umbilical IV line, feeding tube, and breathing tube. When they finally set him on my chest, tucked inside my white hospital robe, he was tiny and pink and naked except for his diaper, and it was the absence of weight, of any substantial mass, that was so shocking to me.
I hadn’t understood how serious the situation was until then. I wasn’t just providing breast milk. I was maintaining my milk supply for a baby who was not strong enough to eat or even breathe on his own. With so much separation, unable to show my love in the usual ways, milk was my lifeline as well as his. I imagined my special preterm milk nourishing him, my lifetime of antibodies protecting him, and I kept going into that small, dark room.
Two months passed, and ounce by ounce, Wesley approached six pounds, shed his breathing support, and graduated from his isolette into a bassinette. Our tiny, sleepy baby began to wake, look around, and suck. He was ready to eat.
We tried breastfeeding for several weeks. He would cry and I would get frustrated. I called lactation consultants. Keep trying, they said. I worried about losing my milk supply. I tried everything. Herbs. Breast massage. Hand expression. Relaxation. Skin-to-skin time. Pumping, pumping, and more pumping. They encouraged me, saying that milk supply often increases on its own after the baby starts nursing. I began to resent my round-the-clock appointments with the whooshing machine. I wanted to feed my baby, and I began to believe that this was just one more thing that wouldn’t go as planned.
“Have you tried a nipple shield?” a nurse asked me one day, during another failed attempt at breastfeeding. She showed me how to use the shield, a small, disc-shaped object made of clear, thin silicone. Then something different happened. He latched on. His jaw began moving in a rhythmic pattern, punctuated by pauses for big, deep breaths. I felt a tingling sensation through my chest and body. I saw milk surface around the corners of his mouth, sometimes running in small streams down his neck and behind his ears. Eventually his eyes closed yet he continued his rhythmic sucking, breathing, and swallowing. When he was done he pulled away, his open mouth full of milk, running down his chin. He collapsed in satisfied exhaustion, sleeping deeply on my chest as I gently patted the burps out of him.
Later that day, a nurse was taking some of my milk out of the refrigerator. “You have beautiful milk,” she said, holding a bottle of my milk and pointing to it. My beautiful milk!
After three months in the hospital, we brought home our baby boy, two weeks before his due date, weighing just over six pounds. Within a few weeks we didn’t need the nipple shield at all. After three months of pumping every two hours, day and night, I was able to nurse my baby and provide breast milk for the first year of his life.
My tiny baby boy taught me that life isn’t about showing your love in the usual ways. It’s about showing your love in unusual and unexpected ways. It’s about showing up and doing what you can, even when things don’t go as planned. Today I can show my love in the usual ways, but for three months, day and night, love was the whooshing machine and the small, dark room; love was protecting my milk supply for a baby who was too weak to eat on his own.