Feeding: the first 48 hours

One of the biggest challenges with having a baby with cleft lip and palate is initially establishing a good feeding routine. While we have known about Ben's cleft lip for the last 20 weeks, we have not been sure about his palate. That is the difference between being able to nurse and not. As soon as he was born (and came screaming healthily into the world) we were able to see his palate was indeed cleft as well. (FYI- cleft means gap, or open)

Although I was not able to nurse Spencer, they were my only children at the time they were born so I was able to pump for both twins for the first 8 months of their life (until I returned to work and couldn't keep my supply adequate). I am not sure what it will look like this time around, since I have 4 other children at home and not really sure how I can pump around the clock. But we will address that when it gets here. 

In Ben's first 12 hours, lactation told me that he was fine with drops of colostrum (protein-rich first breast milk) that I hand expressed and put in his mouth with my finger. It is absorbed through mucas membranes so anything I could get in there would be good. I also put him to the breast and allowed him to try and eat, which man he did! He tried. I would hand express for him to encourage sucking, and he would and was comforted in that way. It is just that he couldn't create the suction he needed to be his primary form of food. They checked his blood sugar after every feeding for the first 12 hours and as long as he was fine, we were good to do that. So we did. After the first 12 hours I added pumping to my feeding regime and my colostrum production slowed way down. So we had to supplement with formula (given through syringe at this point, 3 mL at a time) because my body is not yet producing enough for him. I struggled with this at every feeding - not because I am against formula, but because I could feel myself grieving his cleft all over again. Just the weariness of this road that I am familiar with. 

In his second 24 hours of life, I have pumped every 3 hours (after every feeding) and given him whatever I can get, which his amount is increasing and I'm still not making much - like only drops after a 15 minute pumping session. But I know that it takes days for milk to come in and I am doing all I can for him. In the meantime, his belly is full and satisfied with formula. Later this morning we tried the Haberman feeder for the first time after feeding him by syringe for the first 30 hours or so. We have another bottle we can try that some cleft babies like called the Pigeon valve, but Spencer had great success with the Haberman and we are used to it so we thought we would start here and see how Ben did. 

Daddy introducing Ben to the Haberman for the first time!

The Haberman is a special-needs feeder that attaches to a regular bottle and is long. It allows the baby to experience some suckling reward (getting milk) as the person feeding squeezes and helps that along. Ben took to it right away and is consistently eating a full amount each time. 

Feeding right now looks like starting out with a syringe of mommy's milk (now starting to transition from colostrum) from my last pumping, finishing off a meal with formula with a haberman, and then I pump to be ready for the next time he is ready to eat. It takes a while...but I know it will get better. He will get more efficient at eating and needless to say, it doesn't take as long as when Spencer was learning the Haberman and there was another baby to feed as well. (Those early on feedings with the twins took f-o-r-e-v-e-r!) 

A closer look at Ben eating from the Haberman:

There are 3 lines on there to help control flow rate depending on baby's success. He is doing well on medium flow already - able to pull the milk out himself and it's not coming too fast it chokes him. 

He is doing great. His weight loss is small and steady (babies always lose weight in the hospital) and he is pretty content between feedings. He is doing exactly what he is supposed to. I am hopeful that my milk production will come in quickly and I will be able to pump for him while I have the opportunity to do it. After my help leaves in a couple weeks I don't know what feeding will look like, so I'm taking it a day at a time !