Feeding Jack.

Alright, this is a more personal post than I’m used to sharing, but 1) Writing has helped me heal, and 2) Keeping it in when the media is swamped with the opposite doesn’t help another Mom whose story relates to ours. I share with the intention of helping, as a Mom and a dietitian. This post about feeding my baby would have saved me a lot of anxiety and worry to read because it isn’t straight from a textbook and doesn’t follow a plan, and it isn’t what I see everyone else doing. It’s been doing what we need today, and then tomorrow doing the same thing.

So, I guess I can laugh at the fact now that I had a solid plan for feeding Jack, that plan only included breastfeeding and baby-led weaning. This was to follow a vaginal birth and lots of skin-to-skin and bonding, of course, because that is what’s best for a new baby’s immune system. As a dietitian, the nutrition and feeding of my child was something I looked forward to and daydreamed about; I knew how to give him the best start to good health and that’s what I was going to do. It was easy to find (a lot of) information on what is best to do when everything goes smoothly.

Well, what about when things do not go smoothly and the best option is not an option? I’m sharing our journey up to this point, the reality of feeding Jack doesn’t have a title and I didn’t buy a step-by-step program to learn how to feed him. It has been doing what we have to do and trusting Jack, trusting the process, trusting myself, and trusting Zach – This is how I’ve been nourishing Jack, part science and part soul. <3 Motherhood is the best ongoing church sermon I didn’t know I needed, feeding your baby is feeding your baby, and nourishing a child and life entails a lot more than how your relationship started and the source of their food.

Jack was born at 34 weeks 0 days via c-section because I had a complete placenta previa. Prior to the bleeding episode that landed us in the hospital, I was very caught up in the products and what everyone else was doing in motherhood. My priorities were mostly superficial, but it stemmed from excitement. I just didn’t know. I was making my lists and checking them twice, or more like ten times…

Fast forward to laying in a hospital bed for a month just praying I don’t have a life-threatening bleed, harm my unborn son, or lose my uterus, to nearly bleeding to death after his birth, and then sitting in the NICU for a month watching my son have to learn how to breathe. Needless to say, my priorities quickly shifted to necessity. Like all I want is life and breath kind of necessity. You cannot empathize with this feeling if you’ve never been there, but if you have you know it changes your outlook on parenting… Well, and life.

Breastfeeding and being able to give him enough of my breast milk was a challenge because of many factors. It was eye-opening that I only prepared to breastfeed. I didn’t expect to not see him, hear him, or feel him the day he was born, or to be on an OR table under anesthesia for hours when I should have been meeting my son and establishing breastfeeding. I didn’t expect to be separated from him for 25 nights. I didn’t expect to be terrified to feed him. I didn’t expect to have to be taught by a nurse how to feed, burp, pace, and handle my tiny baby. I didn’t expect him to need to be fed through an IV or an NG tube, or to have to rely on donor breast milk because I wasn’t ok and therefore not being able to feed him by myself, and I most definitely didn’t look into options for formula beforehand. Who thinks about formula when they’re pregnant?! *Eye roll* There was a lot that I didn’t expect… Obviously this experience has changed me. It has definitely shaped me to have more grace and empathy, especially with motherhood and nourishing a child.

I say all this as a preview to this blog post because I was very excited to feed Jack and do it all the simple, natural, and beautiful way. I spent so much time thinking about and planning for this, before I was even pregnant. I was very excited to breastfeed… Yes, I know I sound crazy. I was excited to be carefree with it all. I was excited to do baby-led weaning. I was excited to make all his food and start introducing solids and allergens as soon as possible. Those are all great and helpful for a baby, but I naively thought choosing and preparing was all it took. The reality is, he has been fed nearly every way a baby can be fed and it has been far from what the books described, what everyone else is doing on Instagram, or the simple, natural, and beautiful way. However, it all helped him thrive and grow from a once 4 lb. baby to where he is now and that was the sole purpose, as simple as that is.

I felt like a complete failure, but I later realized I was alive and so was he and so this was an opportunity to grow and learn… And to NEVER (EVER!!!) make plans written in ink again. 😉

Breast Milk

When I was pregnant, I read that lack of education was the number one reason more babies weren’t breastfed. I understood why so many organizations, books, professionals, and social media accounts discussed and encouraged breastfeeding. I’ve had someone look at me and say, “So, why did you stop breastfeeding?”

I know it is the #1 source of nutrition for infants and reaps many benefits. Honestly, at times I was mad that I knew this. I wished I didn’t care because it would’ve been easier on my heart. After his birth, while I was hemorrhaging, the nurse was able to get drops of colostrum from me to send up to Jack. A NICU nurse swabbed his mouth with my drops of colostrum to help his gut and immune system. I was out of it and not able to make decisions, but Zach knew my desire to breastfeed and chose for Jack to receive some donor breast milk until I was able to provide. Zach was with Jack that first day+ when I couldn’t be, and he fed Jack before I even saw him.

Jack’s dad fed him with someone else’s breast milk through a tube in his nose. He was fed.

It was day three when we tried to breastfeed for the first time. I do remember he had an IV in his head and an NG tube in his nose, but his tiny mouth latched successfully from the start. I loved it because I finally felt like, “Yes! I’m your Mom! I’m here!” When a baby is born prematurely they get exhausted quickly from feeding. The handful of times that we successfully breastfed in the NICU were very bad evenings for him; it maybe wasn’t the reason, but it happened enough that I made a correlation and I didn’t want to push him or do anything that may set him back. He didn’t need anything else working against him. My desire to breastfeed didn’t trump his need to rest and learn how to breathe. He just needed fed and I wanted him to get the calories and nourishment he needed, however he needed.

From day two on, I pumped and pumped. Every morning I put one foot infront of the other and walked my broken body and a big bag with my pump, pump parts, and last night’s pumped milk into the NICU. I liked pumping when I could gain the strength to look away from watching his monitor and hook myself up. The nurses supported me and Zach got there every evening after work and took care of the both of us. For me, pumping was a way to hold onto a pregnancy that should still be and use my body to help him, and it was a way to feel like I was with him when we were apart at night. Jack got as much breast milk as he could get in the NICU, from a donor, from my breast, and pumped into a bottle, and for that I’m thankful. I would now tell another Mom, “At the very beginning, a little is better than none!” Whatever you can give is good.

After we got home I continued pumping and I kept trying breastfeeding, but it wasn’t working. I could not nourish him with only my milk. We had to supplement with formula more because his appetite increased. I wanted to keep going, and I was going to until I couldn’t anymore. I felt like a failure because of how he was born and what the start of his life was like, so I wanted to make up for this by providing him my breast milk. Eventually I was only pumping around 2 oz. for a whole day. Some women pump 8+ oz. per pumping session.

I did all the things to increase milk supply that people kept telling me would work if I kept with it. But it got to a point where I was a Mombie who was only pumping 0.5 oz. per day. It wasn’t ideal, but I had it in my head that I was helping his immune system and protecting him from COVID with my antibodies because I had since gotten vaccinated. I was terrified of him getting sick and not being able to breathe again, and that was my reason to keep pumping drops.

I decided to stop, or more like just stopped collecting my drops in a syringe, when he was continually getting less than 0.5 oz. per day of breast milk. This was after I learned that in order to help his immune system with my antibodies he really would need to be consuming breast milk for the majority of his feeds. He was getting drops. We switched to full formula and it really helped me begin to heal. Looking back, I was not ok during this time and a healthy Mom for Jack outweighs the benefits of continuing breast milk.

Jack kept growing. I started processing what happened and healing my mind and body.

Formula

The more advanced technology gets and the more that is learned, then the more infant formula is made to model breast milk. Formula is not breast milk, but I am extremely thankful for formula because without it Jack would not have thrived. The irony.

I had a few factors that were important to me with formula, and I chose his formula based on this. At first, I used a formula that had hydrolyzed (partially digested) proteins to be more gentle on his immature digestive tract. Choosing a formula is overwhelming because there are many options, I would suggest making a list of your top concerns and your baby’s needs and then choose one that best fits. Talk to your child’s pediatrician if you have questions! The FDA has requirements for infant formula that must be met, it is regulated. It is nutritious. It is a safe food source for infants.

I will say, formula does bring its own challenges. On top of that, you have other Moms who act like because you are formula feeding you don’t have to wake up in the night or give your time and energy to feed your baby. That’s not helpful or supportive. Like I said, any way you feed a baby brings its own, but different, challenges and uses your time, energy, and body in some way. Babies eat a lot. We’re all doing the work.

The goal of breast milk and formula is to help nourish and grow during the first year of life, and to get them to the next step… Solid food!

Supplementation with Formula Feeding For Immune Support

Did I mention my main reason for wanting to continue giving my breast milk was to try and help his immune system? #PandemicPregnancy #NICUMom #PrematurePandemicBaby #FirstTimeMom #TryingToStaySane 😉

From what I read about supporting gut microbiome development and an infant’s immune system, the best way to help is with vaginal birth, a delayed bath and lots of initial skin-to-skin, and exclusively breastfeeding. He didn’t get any of that sooo Momma needed to find some other ways.

I did a lot of reading on infant’s immunity and decided to implement what I could to help support a healthy development of his gut microbiome.

I am not suggesting everyone start their baby on a multivitamin + iron or a probiotic, please talk to your child’s pediatrician first if this is something you are interested in!

I enjoyed reading this book and I learned a lot: Dirt is Good by Jack Gilber, PhD and Rob Knight, PhD

• Get outdoors (Take daily walks, lay on a blanket in the grass, etc.) – Fresh air, vitamin D, and walking are good for Momma, too!
• Skin-to-skin, hold him, love on him (both parents) – Of course, we couldn’t do this in the NICU, but once we were home and able we made up for lost time. You have lots of microorganisms on your skin, this is a good thing!
• Jack came home with a daily dose of a multivitamin that contains iron, I continued this regimen per his pediatrician’s recommendations. He started on Poly-Vi-Sol, then after we ran out I switched to Mommy’s Bliss (both with iron because he was anemic).
• A daily probiotic – This is something breast milk has that formula does not, and I have read it’s very important for the development of their gut microbiome. I chose this probiotic because it contains Bifidobacterium and Lactobacillus, two prominent strains in breast milk: Mary Ruth’s Infant Probiotic Drops. I will say I was scared of adding this (shocker!), so I started with 1/5 of the daily recommended dose, then slowly increased as I saw he was tolerating it well.
  P.S. After a c-section, probiotics are beneficial for Moms, too: Postnatal Probiotic.
• He has now received all recommended vaccines for his age!

Introducing Food

This has been… messy… scary… and now, fun! I waited until his 6-month appointment (he was 4.5-months adjusted) to get the green light from his pediatrician that he was developmentally ready for some pureed food.

I started out with very thin baby oatmeal mixed with formula, then moved on to stage 1 jarred vegetables, then fruits. Yes, I had dreams of making my own from the start, but at this point I was still terrified about hurting him. Having pasteurized food that reduced risk of foodborne illness and a consistently smooth texture was best for us at that time. Now, I have done a mixture of jarred baby food, and also making homemade food with a simple steamer basket and mini food prep. It is fun throwing together new mixtures and seeing if he likes it, but the smooth consistency of jarred food is also convenient and comforting. This is where we are now, but tomorrow may bring something new!

Setting up a solid foundation for eating and a good relationship with food entails more than the method of starting solids. They are their own, unique person. You can mix together some principles of baby-led weaning with pureed foods, the idea is that they are experiencing food and developing skills to improve their eating behavior down the road. Some points to consider for a well-rounded food foundation, with purees and beyond:

• Showing appropriate swallowing
• Interested in food and feeding
• Grasping the spoon
• Putting spoon to mouth and eating food off the spoon
• Feeling different textures with mouth (This extends out of the kitchen… Momma’s hair, chins, his toes, and blankets are some of Jack’s favorites lol)
• Touching pureed food on tray and putting hand in mouth
• Different flavors
• Practice gumming (“chewing”) with thicker, more textured purees
• Self-regulation: Babies have an innate ability to self-regulate with eating, this doesn’t need to be taught. Our job is to not suppress what they already do and know! They are still in control with feeding pureed food, you must just learn and pay attention to their cues. Some common signs of fullness: Turns head away, closes mouth when spoon comes close to mouth, disinterest in the food…
• All the lovely smells with food while I’m eating, cooking, or with his food
• Getting used to meal times and eating at the table in his high chair
• Togetherness and bonding with food
• Modeling good eating behaviors as parents (!!!)

Introducing Allergens

I am allergic to peanuts, so I wanted to introduce this as soon as possible in hopes of preventing an allergy from developing. Before, I was all about early introduction at 4-6 months and offering it often. Now, I was avoiding it and did not want to rock our now steady boat with a potential hazard.

He is now 8.5 months old, and just this month I decided to give it a go. Holding off on introducing peanut butter just because I was scared of the worst scenario was not helping him. I was prepared for if the worst happened, and I stood with a pit in my stomach while he was fed peanut butter. He was given a tiny amount of peanut butter stirred into his oatmeal, mixed with formula so it wasn’t too thick. He did not have a reaction and I am so thankful!

This is a great resource for learning about food allergies: FARE

One of my Master’s courses was on food allergies and intolerances, this book was also helpful in helping me learn how to try to prevent and handle introducing: The Health Professional’s Guide to Food Allergies and Intolerances

For peanut allergies in specific, the LEAP study provides great information: Learning Early About Peanut Allergy (LEAP) study

All in all, feeding Jack is the opposite of what I planned on doing, but maybe that’s the point. If you care and you’re trying, then I think whatever you’re doing is great (in all areas of parenting). Now, I’m all for just trusting more, taking your time, learning your child, and arming yourself with a good support system. I could’ve benefit from reading this, so I hope it helps someone out there. It doesn’t have to be one or the other, you don’t have to have a name or title for your method of feeding or parenting, you don’t have to have a strict plan, you can do a combination of it all and maybe that is what’s best. In a world telling you to “do this!”, I hope you take the time to learn what’s best for your little family and “do that!” Just nourish your baby how they need it today, and then tomorrow do the same thing. That’s the goal, for forever. <3

My Recommended Must Have Items for Expecting Moms and Dads:

• Love & communication
• Freakin’ pray a lot… Or make 11:11 wishes, send good vibes, just whatever you do for soul food!
• An OB/GYN that you trust and feel comfortable with (!!!)
• A pediatrician that you trust and feel comfortable with (!!!)
• Meal train or gift cards to order food (Especially if new parents are in the NICU!)
• Support with however you choose to or have to feed that sweet baby!

Cheers (NG tubes, breastmilk, formula, pureed carrots, broccoli spears, coffee, wine, water…),

Meredith Wellman, MS, RD, LD / Jack’s Momma

Other credible resources that I found helpful:

• Dirt is Good: The Advantage of Germs for Your Child’s Developing Immune System
• Peer-reviewed journals published within the last ten years, like this one: Click
• Nutrition Through The Lifecycle
• Feeding Littles

I read the obituary of an 107-year-old woman the other day; oddly, I met her by chance years ago and she left an impression on me then. I was comforted reading her life story. Her biggest achievement was raising her five children. The day in and day out little tasks that end up making up your life. She made it sound beautiful, not easy, but beautiful. Her days were full, and true. Her life was full, and honest. She got more years than many, many people, but she sure made them count.

It was the gentle reminder I needed to keep my eye on what is true and look past the distractions of our generation; that hard does not equal bad, it may actually be the opposite.

“You could say that Pearl, like the Biblical Paul, ran the race and kept the faith. In looking back she says she wouldn’t change anything, not that it was all rosy, but she looked at the harder side of life as an opportunity to learn. Neither Pearl nor her mother needed to read self-help books to learn this. It was just what they did. And so it was.” – Her Obituary

I want to run the race and keep my faith!

If you want to read her full page: Click