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My Daughter's Dedicated Commitment

Janis L. Frazee, RNC, MSN, WHNP-BC
Cedar, Michigan, USA
From New Beginnings, Vol. 28 No. 3, 2009, pp. 12-13

When Kira Grace was born, her mother, Chrisamy, expected to breastfeed. Little did she know what her dedication to feeding her baby mother's milk might require.

Chrisamy had successfully breastfed her first son, Chad, after overcoming a variety of problems. Chad had gastric reflux, a hyperactive nervous system, and would cry inconsolably for hours on end. Despite all these issues, she successfully breastfed Chad until he was a year old. Even with a rocky first experience, there was no question she would breastfeed her second baby. With all this preparation and experience it seemed inconceivable that this second child's struggles could present an even greater challenge, but they did.

Moments after birth, Kira took to the breast really well. During her first week of life Kira had some minor choking episodes during her feedings. As these episodes increased it became apparent she was in distress and the feedings became more stressful. Her pediatrician diagnosed reflux and gave medication to alleviate the choking. It did not. The very astute pediatrician acted quickly with a referral to a pediatric gastroenterologist. This prompted an upper gastrointestinal test. Alarmingly, the barium flowed into her lungs instead of her stomach. Kira was immediately admitted to a local children's hospital for evaluation. A laryngeal cleft (a small opening between the larynx and the esophagus) was discovered. Laryngeal cleft carries a very high infant mortality rate as it is often not discovered until life threatening events occur. Everyone is grateful to the pediatrician who made the speedy referral before disaster struck.

Kira was admitted to hospital for monitoring, where she stayed for five days. The only way to feed her until the cleft could be surgically repaired was with a naso-gastric feeding tube. This tiny tube inserted through her nose and extending to her stomach was now her lifeline. At this point, Kira needed to be fed every three hours so she could regain the weight she had lost. Chrisamy stayed with her around the clock, pumping her breastmilk, then infusing it into Kira via the feeding tube.

Kira was discharged with the feeding tube and pump, which would remain with her until her corrective surgery. Surgery could not take place until the gastric reflux was controlled and the stomach acid studies revealed it would be safe to operate. Kira's needs required Chrisamy to pump both breasts every three hours around the clock. Three times a day, 15 minutes prior to the feeding, medication was administered through the feeding tube. The breastmilk was then poured into a bag attached to the pump and the feeding tube, and the milk was infused in the correct amount. Kira's feed would last another 45 minutes to an hour, plus clean-up time for the pumps, tubes, milk bags, and medicine syringes after every feeding. Life revolved around pumping breastmilk and feeding the baby. Little time was left for even the simplest life activities such as bathing, eating, and sleeping.

It was a challenge for Chrisamy to maintain an adequate milk supply. At times she added the herb fenugreek and milk tea to her daily routine to try to boost her supply. She applied cabbage leaves to her breasts when they were sore. Fatigue and worry were two of the biggest issues. Fatigue from the complications with feedings, looking after a four-year-old child, three large dogs, a home, and a husband who works away for days at a time multiplied the exhaustion and stress.

Kira had other compounding health issues. She was born with a small heart defect, an atrial septal defect, that we hope will close without surgical repair, as well as one extra digit on her left hand. She had to undergo additional screening to rule out potential genetic syndromes. Fortunately, these tests all came back normal, but it took nearly three and a half months to receive the welcome news.

Many wondered why a mother faced with a sick infant, around the clock feedings, and such family commitments would continue to pump her milk rather than simply opening a can of formula and pouring that into the feeding apparatus. Chrisamy believes in the long-lasting health benefits that children and their mothers gain from breastfeeding. Her dedication was exceptional in the face of her situation. She never lost hope that when the feeding tube was removed she could resume feeding her baby directly from her breast.

A baby's fascination with her fingers and mouth caused more than one feeding tube to be pulled out and finger mittens were added to Kira's wardrobe. When a feeding tube would come out (usually late at night) a trip to the hospital ER ensued, where a wait would begin while personnel trained in the reinsertion technique were found. These outings were four-hour ordeals on six occasions.

Weekends seemed to be the preferred time for the pump to fail (a time when it was almost impossible to locate someone to troubleshoot or bring another pump to the house). Power outages require an even greater creative solution; especially when the back-up battery does not function. Did you know you can use your car cigarette lighter outlet to power a breast pump? During a rainstorm, mom, Kira, and brother Chad with a load of toys sat in the driveway, while Kira had lunch and the workman repaired downed power lines.

The much-anticipated surgical repair was a success although the feeding tube remained in place for another three weeks to allow the surgical site to heal. During the entire period the tube was in place, Kira was given a pacifier to suck during her tube feedings. Her sucking instinct remained strong. When the big day arrived for her to be offered the breast she was interested, latched on well, and was able to tolerate increasing amounts of breastmilk. Now, at four months, she is totally fed at the breast. Both she and her exceptional mother are delighted and are once again sharing the joys and physical contact of breastfeeding.

We all face challenges in life. Our priorities and the choices we make in those times define what is most important to us. Chrisamy never swayed from her decision to breastfeed Kira. She was fortunate to have a loving, supportive husband, a patient four-year-old, and helpful friends and family but nothing equaled Chrisamy's minute-by-minute commitment to breastfeeding. This is what inspires me most. I am not sure that I could have done what she has, while faced with all the obstacles in her path.

I find her to be a most remarkable woman and one that I am proud and honored to have known since her birth. Chrisamy is my only child. Her love and devotion to her children's welfare is exemplary and has been tested and re-tested. Her kindness, patience, and unconditional love have been displayed on a daily basis. Thank you, Chrisamy, for being a shining example to us all. You are truly an inspiration!

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