I wanted to share our "Nursing Story" for anyone else in the same boat.
Recap: baby born at 30 weeks gestation, I pumped breastmilk for her in NICU and she was fed by bottle. We had a few breastfeeding attempts in NICU, but nothing successful.
The baby came home from NICU at 34.5 weeks gestation. At first, I attempted breastfeeding before every feeding during the daytime hours. This quickly grew exhausting and disheartening, and so I cut down to once or twice per day. Every attempt seemed futile. Then, one evening, the baby was very fussy. I kept trying the bottle, and she'd eat 5-10 mL, and then fuss some more. She seemed discontent with the pacifier as well. So I thought, "what the heck?" and tried breastfeeding. She latched on perfectly and had a strong suck. I don't think she got any milk out of that exchange, but it seemed to be exactly what she wanted. I thought maybe this was our turning point, but it wasn't really...not yet. After that, she acted like she had never latched before and returned to using a bottle & pacifier for her nutritive and sucking needs.
I continued expressing breastmilk with a hospital grade pump (Medela Symphony). It became more and more of a challenge to be Mom and to pump every 3 hours. I found that the middle of the night was my most productive pump times, because no family members were around to interrupt the schedule. Daytime was different - it seemed impossible at times to pump even 4-5 hrs after my last pumping. I began to think more about ending this. I had plenty of milk stored in the freezer for the next few months, and then I could switch to formula. I felt guilty: I expressed breastmilk exclusively for my second daughter for 8+ months, and yet, I wasn't sure I could last longer than 2 months for our third daughter!
The hospital Lactation Consultant called periodically and offered advice. She advised that I use a nipple shield. She also thought that I should go to using the nipple shield 100% around the time of baby's due date, to build up her stamina for breastfeeding. I had some major doubts about this. One thing I noticed - after using the nipple shield before every bottle feeding, she seemed gassy the next day. Also, she didn't seem to be getting much at the shield, because she was still ravenously hungry for her bottle, and would eat the same amount as usual from her bottle afterwards.
I also attempted to switch to a slow flow bottle nipple. I found that 30 minutes into a feeding, the baby had only eaten 10-15mL at most from the slow flow nipple. This was not encouraging! If she couldn't even eat from a slow flow bottle nipple, how was she ever going to nurse at the breast? This was my last straw. She had reached her estimated due date by this point, and I didn't see how she was going to breastfeed.
I went to my local LLL (Le Leche League) meeting, but I'm not sure why. Part of me had given up. Another part of me thought I would at least listen to what they had to offer. At the meeting, I met someone that had had several problems starting to nurse, and her advice was to nurse 24/7. I wasn't sure if I could handle that! I was already working overtime with pumping and bottlefeeding. My husband had a new job position that was high stress and long hours. I had had his support during the whole birth and NICU experience, but now he was needing my support. I wasn't sure how much more I could put into this whole breastfeeding thing. At the meeting, one of the leaders watched what we do with latch and suck. The baby latched on beautifully and sucked just as she needed to. The leader believed that she was getting milk just fine and encouraged me to keep going. During that meeting, the baby latched, sucked, unlatched, acted hungry again, and latched again. I wasn't sure I could handle that all day and all night, glued to a chair. That night, I was at a crossroads, and I wasn't sure what I was going to do. I bottle fed her all through that night. I woke up at 5am and did major house cleaning, still unsure what I was going to do. Then, around 10 am, I decided to try nursing again. She latched and sucked. I did breast compressions to help her get milk. After 30 minutes, she was done nursing. Shortly thereafter, she spit up. This baby has been a big spitter, which normally is a bad thing. But here was proof that she had gotten milk from the breast. She spit up quite a bit, so apparently she had gotten quite a bit of milk! I continued to nurse her during the day, followed up with a few bottles (about 4 bottles in all). The next day was her doctor appointment. I nursed at the appt and followed up with a bottle. I offered 2 bottles total that day, but she really only drank the one bottle (the second one, she only drank 10mL from after a full nursing session). My husband encouraged me to stop bottles altogether, so I did. She appeared to be breastfeeding!
The next big hurdle was my milk production. I was producing milk in overtime. I was able to pump about double what the baby actually needed. It was hard to find the time to pump, so I began only pumping when I had gotten very full and it was uncomfortable. I pumped for 5 mins only, and at first, this was enough to fill a 6oz bottle! After about 2 weeks, I stopped pumping. I am only full and uncomfortable during the night, but the baby seems to nurse enough during the day to eventually catch up on the fullness leftover from the night hours.
I really doubted that my body would respond to the gentle sucking of a tiny newborn, when it was used to the full double breasted pressure of the hospital grade pump. At first, my body didn't respond, and I needed to use breast compression to help things along. Within a few days, however, my body's response was immediate, and responded far better to the baby's gentle irregular sucking than the mechanically sucking of the pump.
I hope this post is able to offer some encouragement and some help to someone else trying to overcome nursing difficulties. I love not having bottles to wash, and I love being able to leave my house without a host of bottle gear. I also love a snuggly baby wrapped around me nursing directly from the source. And I love being able to sort of nod off to sleep on the couch while the baby is nursing during the night.