What does a fertile faith look like in the midst of infertility??? Part 1

I don’t touch on “religious” topics too often. It’s not that I’m ashamed of my faith or trying to shy away from it. On the contrary, my faith centers my life. It gives me hope. It keeps me sane. Call me weak…and I’d probably agree with you. Without my faith, I never would have found the strength to endure the road to becoming a physician, infertility, pregnancy loss, severe preeclampsia, having a premature baby, and dealing with the rest of life’s trials along the way.Woman hiker on a top of a mountain

Don’t get me wrong, many people have suffered greater losses, heartaches, and pains than I can dare imagine. Living in the United States makes most of my problems “First World” inconveniences. But, here and there my heartaches have been and still are significant. I’m often asked how I’ve found the strength to make it through 9 complicated IVF cycles with only one baby to show for it. How do I keep going?  Were does my strength come from? How do I find the endurance? What’s the key to making it through?  As I’ve opened up about my infertility journey these questions have continued to ping my inbox. What’s the secret?Closeup On Hands Of Stressed Young Woman

I’ve decided that it isn’t a secret at all. And, while some won’t like my answer, it is still my answer. Feel free to disagree. That’s the beauty of living in a country with freedom of speech and religion. If you don’t have a faith base and find this annoying, that’s fine too. I’m not offended by you, and it’s not my intention to offend you. I’m simply sharing from my own world in life view what I’ve found to be most helpful. Here goes…

Stay tuned for Part 2



When Pregnancy Swelling Becomes Something More…


After years of trying to get pregnant, our dream finally came true. God had finally answered our heart wrenching prayers for a baby. Getting pregnant had been the hard part-being pregnant was a breeze in comparison. That is, until everything went wrong.

Because we had conceived with the help of IVF, I was already a paranoid pregnant lady. Even though I followed all of the recommendations, I still feared a miscarriage, a physical deformity, or a genetic anomaly. I had thought of most potential complications, and every little ting or pain alarmed my fragile state of mind. Knowing too much as a physician didn’t help. I reminded myself that it was normal to be overly concerned considering all that we had been through. It wasn’t like getting pregnant was a walk in the park for us. All forces of nature had conspired against us for years. Now that we had finally gotten a positive pregnancy test, I was a little leery that it was too good to be true. But, as months passed and our baby continued to be a perfect patient, the hypochondriac in me started to lessen. I resolved that I was going to have a happy and healthy baby.Love and new life concept. A woman's hands forming a heart symbo

Around 26 weeks of pregnancy, I suffered the worst headache of my life. My husband and I had recently moved states, and I had just established care with a new OB/GYN. I didn’t want to be the annoying patient who called about every little complaint, but when loads of Tylenol and sleep just didn’t cut it, I began to worry. Knowing that headaches can be linked with pregnancy induced hypertension and preeclampsia, I quickly checked my blood pressure. It was normal, but the pain in my head was not. With tears streaming down my cheeks, I asked my husband to call the doctor.

The physician on call recommended that I come into the hospital for blood work, to monitor the baby, and to get me something stronger for the headache. I couldn’t have agreed more. Thankfully, my blood pressure and blood work were fine, the baby was active, and the Percocet took the edge off.

After that episode, pregnancy life returned to normal. My follow-up blood pressures were fine. I hadn’t had another headache, and my only real complaint was the swelling in my feet. By swelling, I mean absolutely NO shoes fit my feet. I questioned, joked, and complained about my elephant feet, but I just assumed that it was part of the beauty of getting pregnant.

Since we had just moved to a new state without any family nearby, I knew that I needed to establish a support system before the baby arrived. This gave me the bright idea to join a Mom’s group while still only 32 weeks pregnant-I like to think outside of the box sometimes! I loved my “Real Mom’s” group from the moment that I met them. They applauded my assertiveness in joining the group while pregnant and welcomed me wholeheartedly. They didn’t, however, welcome my swollen feet! Instead, they insisted that I prop them up and have someone take a look at them. I reassured them all that I had a doctor’s appointment later that day, and that I didn’t have preeclampsia. It was simply swelling from pregnancy. I had noticed just the night before, however, that my glasses seemed a little tighter on my face, and my rings were even tighter than usual. I voiced my concern to my husband but then brushed it off as paranoia.

Fetus 7 Month In The Womb. Visible Head And Arms

At my 32-week prenatal visit, my blood pressure checked out fine. The Ob/GYN examined my belly and listen to the baby’s heartbeat. After measuring my belly, she recommended that we get a quick ultrasound of the baby since I hadn’t grown much since the last visit.

I waddled off to ultrasound, my feet aching with each step. The ultrasound confirmed that my baby’s growth had decreased to the 10th percentile from the 40th. Something was making her very unhappy inside of me. When I returned to the exam room, my doctor asked for a urine sample (which being pregnant I was easily able to give.) She reexamined my feet and decided to confirm my “normal” blood pressure. On recheck, my pressure wasn’t just a little high; it was stroke worthy! My urine dip screamed protein. And, when my doctor asked if I had been seeing any floaters, I dumbly responded that I had been having a weird, spotty kind of dizziness for months, but it seemed to be positional. Duh! Floaters! Wow, sometimes being a physician really doesn’t prepare you to be a good patient.

Within minutes I was loaded into a wheel chair and whisked to the OB floor for overnight observation. I voiced my concern that my mom was coming from Michigan to pick me up and take me back for a wedding shower. My Ob politely but firmly replied, “Emma, you aren’t going anywhere. First we have to make sure that you and the baby are safe.” By the time I made it to the OB floor, my blood pressure was sky-high, my head was pounding, and I was starting to get very scared. The nurse poked and re-poked me to start the IVs for the blood pressure medications and the dreaded magnesium. In what seemed like minutes, I had developed sudden and severe onset preeclampsia.

I called my mom to let her know the change of events. Knowing nothing about preeclampsia, she asked, “Emma, is this serious?” That’s when I broke down sobbing. Yes, it was serious. I was getting sicker by the minute, and I knew that my baby needed to be delivered soon…TOO SOON.

For more about preeclampsia head to The Preeclampsia Foundation or March of Dimes. Both have their annual walks all across the country in May and June. Sign up to raise awareness and support women who have had pregnancy complications, and help prevent complications for others.



Can a Pregnant Mom Trust Modern Medicine?

Pregnant Woman Belly. Pregnancy Concept

The beauty of medicine is that it can fix most things. No, it’s not perfect, but modern medicine saves countless lives. In addition to saving lives, it dramatically improves the quality of the lives we live. Without modern medicine, my 18 month-old daughter and I would not be here today. After sailing through 32 weeks of a healthy pregnancy, I developed sudden and severe onset preeclampsia. I’m a high achiever, so my body decided it needed to start setting records. My blood pressure soared to stroke high levels. The protein in my urine topped the charts at 12 grams (5 grams is considered severe preeclampsia), and I gained over thirty pounds of fluid, becoming the Michelin man overnight. A simple tap on my arm or leg would send my limbs flying into the air. My nervous system and reflexes were in overdrive. The pounding headache, spotty vision, and abdominal discomfort were icing on the cake.Pregnant woman sitting on sofa looking at her unborn baby's ultr

Overnight, I became one sick mamma to a 3 lb. 2 oz preemie. As soon as my daughter was cut from my belly, she required urgent resuscitation. A tiny tube was placed in her airway, and she was whisked away to the neonatal intensive care unit. It took me two days to even make it up to the NICU to see her. Even then, I was hooked up to IVs, countless medications and could only manage to hold her for a few minutes. Although the textbook answer to treating preeclampsia is to deliver the baby, for some women this doesn’t solve the problem immediately. My blood pressure continued to top the charts, my reflexes remained in hyperactive mode, my mind was very confused, and I was pretty sure I had, or was going to have a stroke. My concerned OB/GYN consulted a cardiologist to manage my unimproved condition. She was amazing. She listened, investigated, and made the necessary changes (mega doses of several blood pressure medications), which eventually helped normalize my blood pressure. But, even she didn’t have all of the answers. It wasn’t until three weeks after I delivered that I was able to cancel home nursing and stop my blood pressure medications.Close up of doctor writing on a medical chart with patient lying

Through this experience I started asking questions about why this was happening. What was the physiology behind this crazy multisystem condition affecting my nervous system, cardiovascular system, kidneys, liver, and reproductive system? What caused preeclampsia? What could I do to prevent it in the future? What was my chance of having it happen again? Why couldn’t we prevent it or at least treat it more effectively? I didn’t like any of the answers that I was hearing or reading. They were all just theories, nothing concrete. This condition, which landed me in the hospital for eight days, forced me to have an emergency c-section at thirty-two weeks, placed my tiny baby in the NICU for nine weeks, and which put me at risk for having high blood pressure and a stroke later in life was still not understood.Care For A Sick Child In The Pediatric Icu

One out of every twelve pregnant women will develop preeclampsia according to data from the Preeclampsia Foundation. One in twelve! I don’t like those odds. How is it possible for a condition that is so common and potentially life threatening to mom and baby to continue to mystify us? We have mapped the human genome. We have eradicated small pox. We can identify breast cancer at its earliest stages, ensuring early treatment and amazing survival rates. Why haven’t we identified the true cause of preeclampsia and developed earlier and more efficient and effective screening tests for this condition? If prevention and earlier identification are not yet possible, then why haven’t we developed more effective treatments that will allow for a continued healthy pregnancy?

I have a fifty percent chance of developing preeclampsia again and at an earlier gestation in future pregnancies. I’m not a fan of my chances. I did everything right during my pregnancy. For goodness sake, I was the crazy lady who gave up all caffeine even though it probably wasn’t necessary. I didn’t drink a single soda, and I verified that every item entering my mouth was pasteurized. I was a paranoid pregnant mama! And, although following all of the recommendations probably prevented me from having other complications, it didn’t protect me from preeclampsia.

In a world where I count on modern medicine to fix most things, I have decided that modern medicine has failed to meet my expectations. Yes, it definitely saved my life and my daughter’s, but not all women are as fortunate as I was. Globally, preeclampsia is listed as one of the leading causes of mother and infant morbidity and mortality (illness and death). Worldwide, the United Nations reports that more than 500,000 women die each year due to pregnancy related causes. In the United States alone, preeclampsia causes 18% of maternal deaths. In short, preeclampsia is a killer.

As with any horrific and life threatening disease, the way to beat it is to study it. Research and clinical studies require interest, money, mental power (the scientists), and patients willing to participate. In most cases, it takes years before the results of clinical trials can be used in every day medicine. With only a short window left for my childbearing years, I’m hoping that new preventions and treatments will be available quickly. In the meantime, I’m doing my best to raise awareness and money, educate other women, and save the lives of women and their future babies (myself included). Join me by putting on your tennis shoes for the Promise Walk for Preeclampsia in your area. Or, take a look at the Preeclampsia Foundation or the March of Dimes for other ways to get involved. Push modern medicine to meet our expectations as women, mothers, and future mothers.

Both March Of Dimes and the Preeclampsia Foundation have their annual walks in May! Head to either of their websites to sign up and get involved.



Little Babies Matter Too!

Every woman dreams of a healthy pregnancy. Every woman also dreams of an easy one…one lacking swollen feet, excessive weight gain, countless stretch marks, and negligible energy. But if you were to ask any mother if she had to choose between healthy and easy, I guarantee you that she would choose HEALTHY any and every time.

Yes, we all have a tendency to complain when our waddles get a little to wide (a consequence of water buffalo breadth hips), our bellies block any reasonable effort at shaving, and our swollen feet refuse to fit into anything but granny shoes-all legitimate complaints in my book. But, what would we trade for a healthy baby? What would we give to deliver on-time without any complications? What would we vow if we could keep our infant out of the neonatal intensive care unit, tube and wire free?

Maybe you’ve never thought about it, but lately this has been weighing heavily on my mind. Every year about 450,000 babies are born too early. That’s 1 in 9 babies. Unfortunately, that was my baby! I admit, a premature delivery wasn’t on my “worry list,” and it’s not because my list was short! Santa Clause would have even had trouble keeping up. No, for some reason everything else landed on my irrational, OCD, hypochondriac list; then preeclampsia took me by surprise, and my body and my baby’s life by storm. If I could have done something differently I would have. 3 pounds and two ounces is too tiny for any little one to make a grand entrance into the world. Intubation tubes, heart rate monitor lines, feeding tubes, incubators…these life saving interventions brought both comfort and terror.Care For A Sick Child In The Pediatric Icu

Could my emergent c-section at 32 weeks have been prevented? No one knows. Even in today’s medically advanced world, preeclampsia is still a mystery. My risk for developing sudden and severe onset preeclampsia in future pregnancies is literally the flip of a coin. 50:50. It’s a chance I’m willing to take, but not one that I take lightly. After 9 weeks spent in the NICU with my daughter, I know the fear, exhaustion, and grief that prematurity brings. When the tiny twin next door doesn’t make it, or the micro-preemie down the hall is whispered one last loving farewell from his devastated mommy…it’s all too much to bear.

If I don’t know what to do…what can I do? Of course, there are known contributors to premature deliveries such as tobacco use, alcohol and illicit drug consumption, and a lack of prenatal care; but, none of these apply to me. I don’t drink, smoke, pop pills, or shoot up with anything other than infertility medications. And, since In Vitro Fertilization is our ticket to parenthood, my prenatal care starts at day zero. I take prenatal vitamins, exercise, try to eat healthy, and limit my stress. Yet, none of these have been shown to reduce the risk of preeclampsia.Birth

So, in an effort to protect my future pregnancies I’ve decided to look beyond myself. Now, I’m pushing researchers and the health care community for answers by partnering with The March of Dimes. I want to know what causes preeclampsia. I want to know if there is anything that I can do to prevent it; and if not, what can be done to treat it more effectively? If I am destined for another preterm delivery (one that could happen at an even earlier gestation) I want my preemie to have the best chance not just at survival, but at a healthy life free from neurological complications, breathing problems, visual and hearing disturbances, and developmental delays.

My desires may seem unrealistic, but I know them to be possible. Just 60 years ago my grandmother whispered goodbye to her preemie son only moments after he was born. 60 years ago she was told that there was nothing that they could do to save his life. 60 years later, my healthy 2-year-old daughter is living proof of the life saving advancements developed by the medical research community and largely funded by March of Dimes. All I’m asking for are more answers…quickly!Girls Kissing Mom's Belly

I can’t do it on my own. Please join me in making a difference for pregnant mothers, unborn babies (my own included), and preemies by walking with me this May 9th, 2015 in the March for Babies or by sponsoring me. Start your own team. Be a corporate sponsor, or sign up to raise awareness in your community. My dream is that 60 years down the road preeclampsia and preterm deliveries will simply be a thing of the past.

Click this link to donate/sponsor The Mom in Me, MD or to learn more about the March for Babies:






When You Lose What’s Most Precious…the baby that should be in your arms

It is all more painful than words can express. And, yet, I write. I write in REMEMBERANCE of pregnancy loss, infant loss, and infertility-the lost hope of ever becoming a mother for the first time, or the shattering disappointment of losing what would have been a precious and treasured addition to your family.Concept Of Love And Family. Hands Of Mother And Baby

I first felt the twinge of longing for a baby when I was still just a baby myself. For many women, the desire for motherhood starts as early as our toddler years. Even now I am reminded of this innate longing as I watch my two-year old daughter feed, change, and rock her baby dolls. It is all so natural, and yet for many of us, getting pregnant, staying pregnant, or carrying a baby to full term delivery are far from natural.  Even many of the seemingly “fertile” moms among us have been touched by the devastation of miscarriage and stillbirth-countless times over. In my own neighborhood moms have been touched by stillbirths, miscarriages, infertility, and premature delivery. According to statistics from the CDC, the history of your street is probably similar to mine with 1,003,000 pregnancies ending in either stillbirth or miscarriage and 27,500 infants not making it to their first birthday each year in the United States.Melancholy And Sad Young  Woman  At The Window In The Rain

And, while the WHYS and WHAT TO DO’s are incredibly important, taking the time to reflect, remember, and grieve is also important. As I head back into infertility treatments, I am blessed to say that my diagnosis has changed from primary infertility to secondary! After years of trying to conceive naturally, and 5 cycles of complicated IVF with numerous failed embryo transfers, I am blessed to be called “mama” by the sweetest little girl in the world. And, while already being a mother has changed my infertility outlook, secondary infertility is still painful and challenging. My frozen embryo transfer is only several weeks away, but instead of excitement, I am reminded of the grief that comes with each failed cycle. The catch phrase in the infertility and pregnancy complication world is always “cautious optimism.” Oh, how I would love to replace that phrase with ECSTATIC ENTHUSIASM for something that is guaranteed to work!Love and new life concept. A woman's hands forming a heart symbo

Even though my previous embryos were tiny clusters of 8 cells, they were still my “babies.” With each transfer I saw a glimmer of hope. I had new life inside of me. That life would grow into an amazing person! But, when nausea turned into spotting and cramping time and time again, the devastation and disappointment was almost too much to bear. I’m not sure how to prepare myself this time for the possibility of a failed transfer, the cruel tease of a miscarriage (where hope is given and then snatched), or my overwhelming fear of once again delivering a preterm baby who this time may not survive.Divided couple are separated by white wall but holding hands

I should be a pro at coping with infertility and preterm delivery grief and loss, but this time around I’ve decided to FEEL rather than just cope. Life is made to be felt. The beautiful things are made to be seen, the horrific to be despised, and the devastating to be endured with strength. I refuse to become cold to my pain. Instead, I will remember my losses with a heavy heart but look to my blessings with overwhelming gratitude. I have found an inner strength, stronger than anything I could muster alone, fostered by friends, strangers, my faith, and a desire to inspire others enduring similar journeys.

Join me by raising awareness, giving a voice to loss, and sharing your story. Encourage others to donate to cutting edge research that could establish healthy pregnancies, prevent miscarriages and preterm deliveries, and save the lives of preemies. I recently decided to partner with March of Dimes as a local Ambassador. Check out their website for more details, for resources on dealing with grief, and for ways that you can get involved. For additional resources on pregnancy loss, miscarriage, still birth, and infertility, take a look at these amazing sites. If your grief has turned into lasting depression it may be time to seek professional help.

The American Pregnancy Association

Resolve: The National Infertility Association

The Mayo Clinic on Pregnancy Loss

In the spirit of remembrance, click HERE to enter to win a memorial bracelet or necklace of your choosing from Fertile Gems. Crystal, the designer and Etsy shop owner has graciously offered to give away a piece of her Always & Forever jewelry line to a mom who has suffered loss. This small token may take you one step closer to healing along your journey.






Little Giraffe and my Tiny Preemie: Discount Code Included for your own Little Giraffe Shopping Spree

Newborn baby boy covered in vertix inside incubatorI have mentioned before that Little Giraffe is one of my favorite baby/child luxury lines. From their stuffed animals to their bath towels…they are the best! My daughter, Ayla’s, very first stuffed animal was the GIANT (not Little as the company name implies) plush pink, grey, and white giraffe. My husband bought her for our preemie daughter while we were living in the hospital neonatal intensive care unit. Sophie (that is what we lovingly named our pet giraffe) stayed in the NICU with us for those trying nine long weeks. She moved around the room, sometimes even stealing the nurses’ work station seat at the computer, adding beauty and laughter to an otherwise stressful situation.Iphone 1944

When our daughter was able to safely be held outside of her incubator, one of her early pictures taken by one of our AMAZING night shift nurses (Chelsea you rock!) was in the arms of her Little Giraffe. At 3 lbs. 2 ounces, our daughter’s tiny size was even more profound in comparison to her plush friend. Over the past two years we have continued to take pictures of Ayla in the arms of her Little Giraffe. I am blessed to say that she is now almost as big as Sophie! I never thought a stuffed animal could be so sentimental…but, our Little Giraffe is more than just the cutest plush you’ve ever seen. To this day, Sophie still sits beside my daughter’s crib as a reminder of all of our answered prayers.994389_627788507281149_541333443_n

So, yes, I have a soft spot for the Little Giraffe company, and I tend to agree with the Company of the Year Earnie Award that they just received. Since they are so excited about their award they decided to invite us to the party!!! Yep, you guessed it, they have a special discount code offering 15% off of their entire online store until November 1, 2014. This never happens! Simply enter LOVEWINS14 at checkout to get the discount.

If you missed my previous review of their bath products…click HERE to get up to splashing speed! Happy shopping…even if it is just window shopping (that’s what I do most of the time:)

From the Mom in Me, MD


Our Preemie Journey: Holding My Dream Come True for the First Time

I couldn’t do it. I hadn’t been able to get out of bed with my soaring blood pressure, pounding headache, and magnesium clouded confusion. I desperately wanted to hold HER; but, it had been two days, and I had yet to see my baby. Today was the day! I willed my body, forcing my legs to carry me just one step toward the wheel chair. Un-showered, unrecognizably swollen from the preeclampsia, connected to several IV lines and a foley catheter bag…I was far from a picture, perfect new mother. Actually, I was a wreck! I was trying to hold it together, but it was all too much. My body continued to suffer the side effects of preeclampsia, unresponsive to the blood pressure medications being loaded into my veins. I was terrified for myself and my tiny newborn. But, I had to see her! I had to hold her! I had to touch her!Iphone 1634

Iphone 1729Every tiny bump, even the elevator’s gentle thumping felt like foot-high speed bumps. My head bobbed and my body swayed as though I was on a tiny fishing boat weathering rough seas. Although Dave was probably only moving at a turtle speed, I begging him to slow down. The nurse at his side, there to make sure that my blood pressure didn’t jump any higher and that my IV lines were running appropriately, assured me that we would be to the NICU in moments. I reminded myself to take deep breaths. I could make it. I would make it.

The NICU was a whole new world. Small rooms filled with even smaller babies. IV’s, feeding tubes, heart rate monitors, ventilators, incubators…all in an effort to save these precious little lives. My wheel chair stopped in front of HER room. It wasn’t the perfect pink room with a white crib and velvet curtains that I had planned but hadn’t had the time to decorate. Instead, it was a hospital room with a tiny incubator, purple walls, heart rate monitors, and a hospital curtain.Iphone 1653Iphone 1764

I barely noticed the room. All that I saw was HER. So tiny…so fragile…so transparent. Again, I was terrified. I didn’t see a beautiful, healthy, chubby baby that I could snuggle and kiss. Instead, what I saw resembled a frail, baby bird that had fallen from its nest. Her skin was translucent, covered in downy hair. Her features were far too fine and underdeveloped, lacking the fullness and health that fat brings. Her skin was wrinkly, and her arms and legs almost looked skeletal from the lack of fat. Some may be appalled to read that I didn’t find her beautiful at first sight. I loved her desperately, but her appearance was shocking…even to me, a physician.Iphone 1693

I was afraid to hold her. Would I break her? Her weight had dropped into the 2 pound range-down a little from her birth weight of 3 pounds 2 ounces. The nurse reassured me that SHE would be fine. It took some time to get her out of the incubator and untangled from all of her iv and monitor lines. Just as she was placed in my arms I began to feel waves of nausea. My blood pressure had jumped, and my medications were making the room spin. I had made it this far. I had to hold her.Iphone 1661IMG_2042Iphone 1703

After only a few moments, with tears streaming down my face I asked for someone to take her from my arms. I had to close my eyes. I had to lay down. My body was my enemy. It was preventing me from being the mother that I longed to be. But, I had seen her. I had held her-even if just for a moment. In that moment, in my sick and terrified state, I was in love with a little life that had been gifted to me. She was tiny, but she was precious…the most priceless gift my arms had ever held.Iphone 1832

From The Mom in Me, MDIphone 1738

Breastfeeding a Preemie: thoughts from a mom who has been there!

Don’t be fooled by the title. This blog is helpful for all breastfeeding moms! I have been asked on several occasions now to touch on breastfeeding a preemie or a baby who is in the NICU. Mommies ask…I answer! While I’m not a lactation consultant, my role as breastfeeding mom to a preemie has given me quite an education. I’ve decided to address some of the common challenges that go along with breastfeeding a preemie. Some of these challenges also exist for non-preemie babies…so, all of you nursing moms may want to keep reading.Newborn baby boy covered in vertix inside incubator

1. Not Yet Ready To Breastfeed

Many moms with preemies have a sense of helplessness. They want to protect and take care of their newborn, but this is incredibly challenging in the NICU setting. Breastfeeding is one significant way for moms to impact their preemie’s health. But, one of the major challenges of having a preemie or sick infant in the NICU is that they are not yet physically ready to breastfeed. Many little ones require a feeding tube and IV nutrition for their early meals. Eventually, many preemies will be ready to breastfeed, but in the meantime, moms can have an incredible impact on their preemie’s health by pumping breast milk to be given through the feeding tube. Research tells us that infants (specifically preemies) that receive breast milk have better outcomes. Since preemies are already at a disadvantage from day one, giving them any extra health benefits is MAJOR!

That being said, pumping often feels like a task rather than an opportunity. Having your breasts hooked up to a suction machine for thirty minutes, twelve times a day is far from pleasant. It doesn’t afford the same bonding that actual nursing creates, but don’t give up. Eventually your baby will be at the breast, and you will be able to pump much less frequently.

This is often a slow process and starts with nonnutritive feedings, where your preemie is simply put to the breast but not expected to actually transfer milk. Be patient. With time, your preemie will figure things out. In the meantime, I can’t say this too many times, pump, pump, pump. Be diligent in establishing a good milk supply from day one. Pumping every several hours for at least 20 minutes to start will help ensure a good supply. Being in the room with your preemie while pumping can also increase the amount of milk that you produce. The times that I sat looking at my preemie while pumping I often was able to pump at least an extra ounce of milk.

Getting enough sleep is also an important part of milk production. Once your milk supply has been established, allow yourself to go one somewhat longer stretch at night (not more than 6 hours-you don’t want to get engorged) without pumping. This extra sleep may help keep your supply up. Drinking enough water is another important component to an adequate supply. Water…Water…Water! Keep refilling your bottle.Mother breast feeding her baby with closed eyes

2. Small Mouth

Most preemies have tiny mouths, making it difficult for them to latch correctly. Make sure that you are using the help of a lactation consultant when teaching your baby how to latch. They have amazing tricks for helping the little one open widely and latch deeply. If your baby is latched too shallowly not only will they be unable to get milk efficiently, they will also cause you incredible pain! You are not going to gag your baby! Sandwich your breast with your hand and shove your baby’s mouth as deeply as possible onto your breast. The angle of their mouth should line up as though they are taking a bite from a sandwich. If you are in extreme pain, simply slide your finger into the corner of your infants mouth to break the suction. Unlatch and try again. Don’t let your baby feed with an incorrect latch! Sometimes a nipple shield may be necessary as well.

3. Lazy Feeder/Tired

Many preemies are tired. They don’t have much of an energy reserve due to their small size and lack of body fat. Overdoing it can definitely tire them out. Don’t expect your new preemie to eat efficiently at the breast for some time. It will come eventually. Some tips to help your little one stay awake to feed include stripping them down to a diaper and tapping the soles of their feet or stroking them.Mother Breastfeeding her newborn

4. Bradys

Many preemies will have bradycardic events (drop in heart rate) while breastfeeding. This is incredibly common. If this happens, take the baby off of the breast and stimulate them either by rubbing their back or the soles of their feet. Eating takes a lot of energy and sometimes if they are not yet efficient at handling milk flow, they may “choke” or “gag” resulting in a brady. Your nursing staff will help you know how to look for the warning signs before it happens. I always knew when I was nursing when my daughter was going to have a dip in her heart rate before it showed up on the monitor. She had the same tell every time where she acted like I was water boarding her with milk. If a very fast flow is an issue for your baby, you may need to pump for just a couple of minutes first to get the fast let down out of the way. This may benefit your preemie anyway, because they will be getting more of the hind milk which is richer in fat. If you notice that your baby is starting to struggle or gag, it may be a good idea to remove them from the breast for a moment and let them recover.

5. Poor Suck-Swallow-Breath reflex

Preemies have a lot to learn. Unlike other infants, they are expected to be high achievers before they were even supposed to enter the world. They shouldn’t have to breath air, suck a breast, or swallow milk yet. Expecting them to put all three of these activities together in a coordinated fashion is incredibly demanding. Most full-term infants are born with a suck-swallow-breath reflex. It happens naturally. For most preemies this is not the case. Give your baby time. Eventually they will figure this out. I was incredibly frustrated because I thought that my daughter would figure it out immediately. It took her nine weeks before this became natural.

The list of concerns and complications goes on and on when dealing with feeding a preemie. I have only touched on a few of the common issues. Please feel free to comment with questions, concerns, and your experiences.baby near mother's breast

From The Mom in Me, MD



When breastfeeding doesn’t go your way…

Seeing other moms discretely breastfeed their babies while sipping lattes, answering text messages, and having in-depth conversations with their friends left me wondering what I was doing wrong. Why couldn’t I make breast-feeding look this easy? I wanted to sit at Starbucks perfectly covered by a pretty, Petunia Pickle Bottom nursing cover! Instead, I was still working on getting my baby to latch correctly without biting off my boob in the process. Would it ever get easier?SCARSDALE, NY - SEPTEMBER 15, 2013: A tall Starbucks coffee in f

I know that you are all expecting me to say, “Yes, my daughter became a model breastfeeder! I was sipping my own lattes at Starbucks in no time.” But, the reality of the situation was that breastfeeding was always a challenge for me. My daughter eventually figured out how to latch correctly, but then she decided to start biting me! YES, BITING! After we had a pretty heated chat about how naughty it was to bite mommy, she then decided that home was the only place she liked to nurse. Each month it seemed like a new breastfeeding challenge arose. Each month, we muddled our way through.Mother breast feeding her baby with closed eyes

I was determined to breastfeed for at least a year. And, although I loved the bonding that breastfeeding brought, I couldn’t help counting down the days until her first birthday. Because she was a preemie, I still had to pump in order to give her fortified bottles with breast milk. The extra step of pumping several times a day in addition to nursing left me feeling akin to a dairy cow. I was exhausted, moody, and sometimes downright irritable.Cute Baby At Hands Of The Mother In An Embrace, Monochrome

Would I do it all over again? Absolutely! Reminiscing about my love-hate relationship with breastfeeding reminds me that most things worth doing are challenging. Although breastfeeding doesn’t always get easier for some of us, neither does motherhood! Poopy diapers, skinned knees, toddler melt-downs, teenage rebellion…as moms, we are in it for the tough stuff. Although I love the beautiful moments that motherhood brings such as cuddle time, kisses on my nose, and a little hand to hold; I’m also grateful for the challenges. These remind me of what I’m made of…or at least what I’m becoming…someone a little less selfish, a little more genuine, and a lot more determined to be the best at my biggest title…MOMMY!

From The Mom in Me, MD



Breastfeeding Musts: 10 tips to make nursing easier

Although breastfeeding is “natural,” it can also pose some pretty great challenges for new and established moms. If you are determined to give it a try (which I strongly suggest) here are a few items, ideas, and resources that I found helpful for my boobs, my baby, and my sanity!baby near mother's breast

1. Get Some Help Sooner than Later

Several of my friends had struggled with breastfeeding, and their experiences clued me into the absolute necessity of lactation consultants, breastfeeding support groups, and breastfeeding friends. While breastfeeding is “natural” many babies have to learn how to feed. They may not want to latch correctly, they may be lazy eaters, or they may have medical issues that complicate effective nursing. On the other hand, breastfeeding challenges often stem from mommy related issues-difficulty positioning, low milk supply, flat or inverted nipples, exhaustion from every 2 hour feeds, and the list goes on! Getting help early on can reduce a whole host of potential frustrations. While lactation consultants may not be able to “fix” every problem, they can offer the encouragement and support that every tired mom needs.

2. Invest in a Good Pump or Borrow One


Medela Symphony Pump-image from Medela website

-Although you many not want to start out with any bottles, pumping can give you the opportunity to go on a date with your husband, get to the gym, or even have a spa evening at home while your partner watches the baby. Most babies have established nursing after 4 weeks. Once they have figured it out, introducing a bottle with pumped breast milk is an option. Another benefit of pumping is that it allows your partner to have the special experience of feeding the baby. Although I nursed my daughter most of the time, my husband loved the opportunity to feed our daughter. If you aren’t interested in doing any bottles or in pumping…no worries…simply skip this section. I had to pump since my baby was a preemie.

-I decided to spend the money on the best Medela Pump that Buy Buy Baby carried. It was portable with a battery so that I could travel with it. It was worth the money! I’ve now loaned it to a friend who simply had to change out the tubing (for sanitary reasons of course). Since we spent some time in the NICU, I also used a hospital grade pump by Medela. These pumps have a different type of suction mechanism, and I actually felt that it was the best at getting the most milk. I ended up renting this pump from the NICU. I couldn’t travel easily with it (no battery and very bulky), but for women who feel like pumping “doesn’t work!” this might be a good option to try. It is pricy as well, but many insurance companies are now covering pump purchases and rentals. Make sure that you save your receipt to submit to insurance! If insurance won’t cover it, you can still count it as a non-reimbursed medical expense…this is a tax deduction! Supplies are a deduction too!

-If you feel like your pump all of the sudden doesn’t have good suction, check the tubing to make sure that it is pushed in completely. If that doesn’t solve the problem, next check the “membranes”. Not all pumps have these, but these small white flaps can get tiny tears from being frequently removed for washing. You can find replacements at most Targets and Walmarts.

-Label your breast milk with the date so that you know when you need to use it by. Check out this helpful table for info on breast milk storage. It comes as a magnet (which I kept in my freezer). Make sure NOT to store your milk on the fridge or freezer door. This won’t keep it cold enough.mother breast feeding her child

3. Simplify Your Routine 

-If you are pumping at night or giving bottles of pumped breast milk at night, consider keeping a cooler or mini fridge in your room. This will prevent you from having to run to the kitchen in the middle of the night.

-buy more than one set of pumping equipment so that you don’t have to wash it after every pumping

-Ask your partner to help you get your pumping equipment ready before bed

-Ask your partner to change the baby and hand him to you to breastfeed. This may give you a little extra shut-eye in the middle of the night.

-If you are doing any bottles, ask your partner to do one night-time feeding on a regular basis

4. Relieve Engorgement ASAP

Don’t let yourself get engorged, but if you do…try these tips.

-try taking a hot shower and angle the water toward your chest

-place warm compresses on your breasts

-massaging your breast before nursing or pumping

-place your infant skin to skin on your chest if you are having trouble getting a let-down of milk. This simple solution often does the trick.

Mother and her Newborn Baby. Happy Mother and Baby kissing and h

5. Have Some Soothing Options for Sore Boobs-you will get sore at times!



Hydrogel -these gel pads by Medela are awesome. Because they are a little pricy, you can cut them into smaller sections if you only need to cover a small area.

Young Mother Breastfeeding A Baby In Nature

6. Make Sure You are Comfortable When Nursing

Ways to ensure comfort:

-Have someone help you get positioned early on as you are trying to get the hang of things.

-Make sure that baby is latched correctly so that you won’t be missing a nipple after the feeding-baby needs to have a wide open mouth and needs to latch deeply. You won’t gag her!

-Use a nipple shield if you have to.

-Get a good Boppy or supportive pillow like those from My Best Friend Nursing

-Consider a foot rest if you are sitting in an upright chair

-Buy the most comfy chair that you can find. Make sure that the back of the chair comes high enough for you to be able to lean back with your head supported.


one of my favorite nursing tanks by Pea in a Pod!

-Find a cute nursing cover if you prefer some privacy

7. Wear the Right Clothes

-Nursing tank-these saved my life! You can wear a nursing tank under any loose shirt and then lift the shirt up or pull it down easily without your belly showing!

-Not too many nursing bras-If you are using nursing tanks, you won’t need too many nursing bras. Make sure to get at least one because you may want to wear a dress at some point.

-Nursing sleep wear-having comfortable nursing sleep wear makes middle of the night feedings much easier. Check out Motherhood Maternity for a pretty good selection.

8. Keep the Leaks to Yourself

Although I didn’t have trouble with leaking, many nursing moms do! Here are some suggestions from my friends who leaked.

Lilypadz– I purchased these and liked them, but didn’t end up really needing to use them. I have some friends who swear by them though!

Medela Disposable Nursing Pads-if you don’t want anything extra to wash

Dr. Brown’s Washable Nursing Pads-if you don’t mind throwing these in with the laundry

9. Keep Your Supply Up

-Nurse frequently or pump often! This is the best way to ensure a good supply.

-Fenugreek is a natural supplement that may increase milk supply. This comes as a pill, in lollipops, in drinks etc. Most local vitamin, nutrition, or drug stores will carry this. Talk with your lactation consultant about this option.

-Drink lots of water! Making milk means staying hydrated. Drink, Drink, Drink!Pouring Water Into Glass On Blue Background

-Limit your caffeine

-Oatmeal may do the trick! Oats are thought to increase milk supply as well. By switching to oatmeal for your daily breakfast you may notice an increase in your supply.

-Throw some NUTS into your oatmeal! Nuts may also increase your supply.

10. Be Willing to Admit that Nursing Sucks at Times! 

Although breastfeeding can be an amazing bonding experience with your infant, at times it down right SUCKS…literally! That’s why it’s so important to have a strong support system and to remember WHY you are breastfeeding your baby.

A. It is the best nutrition for your baby with a perfect mix of fats, fluids, carbohydrates, vitamins (minus vitamin D) and protein.

B. You are boosting your baby’s immune system with antibodies now and down the road!

C. You may be increasing your baby’s IQ

D. You are creating a special bonding experience for your baby

E. You may be decreasing your baby’s risk for SUIDS (sudden unexpected infant death syndrome or SIDS)

F. You may be decreasing your child’s risk for obesity later in life.

G. And the list goes on!!!!!

Although breastfeeding can be challenging at times, there are numerous ways to make it a successful experience. Breastfeeding was one of the hardest and best things that I have ever done. Give it a chance…even a fighting chance. If things don’t end up working out the way that you planned, know that you are still a great mother with your baby’s best interest in mind!Mother Playing With Her Baby Boy Son On Bed

From The Mom in Me, MD