Around the gestational age of 34 weeks (6 weeks prior to due date), babies are capable of the "suck-swallow-and breath" pattern enabling them to take feeds more normally. The goal at this point is to get them use to the bottle and get them off of tube feedings. It was around this age and shortly after Natalie had returned to work that she gave him his first bottle. He went from being exclusively tube fed, to receiving milk through the bottle every so many feedings.
After having mastered bottle feeding, it eventually became time for Thomas to take on a bigger challenge -- breast feeding directly from mom. Please welcome Thomas' mother's description of that experience:
"Soon after delivery, the possibility of breast feeding was discussed. Although Thomas would be unable to feed directly from the breast at first, the milk could be expressed and frozen for use as necessary. It was strongly encouraged for mothers to provide breast milk to the premature babies. This being the case and knowing I couldn't do much else for Thomas, I decided to give it a try.
After being attached to a mechanical breast pump for 2-1/2 months, I looked forward to the day when I could feed Thomas naturally.
Before Thomas and I made our first attempt at breast feeding, we experimented with a little 'skin to skin' contact. Thomas' father and I had read about the concept of 'kangaroo care,' which is the practice of the mother kangaroo holding her baby (called a joey) next to her bare chest in her pouch. Kangaroo care has been found to help nurture premature babies through the NICU experience. It was our experimentation with skin to skin kangaroo care that led up to our first try at breast feeding.
The first time Thomas latched on to my breast was by accident during a skin to skin experience. Thomas latched on and ended up with a mouthful of milk he didn't expect and wasn't prepared for! Although we had a lot of ground to cover, it was wonderful to finally be approaching this milestone.
The first time I actually tried to feed Thomas, it was quite a struggle. He wanted the instant gratification of the bottle and didn't have the patience to wait for me to let down. That time, and many a time thereafter, I left the NICU feeling disappointed, that he didn't want me and that I wasn't a good mother.
These trials and tribulations frustrated both of us. He had mastered the bottle and was apparently confused and frustrated when we asked him to try something different. Fortunately, the NICU nurses were fantastic with their persistence and coaching efforts and helped us to be successful much of the time. Once I resigned myself to the fact that it would get better when I fed Thomas all the time, I felt I wasn't failing him in some way.
It was a time of learning for both of us."
--Natalie M. King, aka "Mom"
Most mothers and babies don't have to learn breast feeding behind a screen in a busy NICU. Natalie deserves credit for her persistence which continued even when Thomas refused the breast in favor of the bottle. Eventually, he overcame his "nipple confusion" and became an effective breast feeder. However, that didn't and couldn't happen until he was released from the NICU.