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When we think of parenthood we imagine a perfect family life. Smiling, laughing cherubic babies, full of joy and cuddles, playing happily together, enjoying the admiring glances at your beautiful child and sharing secret smiles with your partner as you watch your child try valiantly to achieve their next milestone (ahead of time, naturally).
In real life, while there is a huge amount of enjoyment and satisfaction from having children, it’s also full of times of stress, disappointment and even occasionally resentment. When you have a child who is premature, these pleasant dreams of perfect family life can feel out of reach entirely.
Premature babies are often fed via tube, and although this is a good, life saving measure; as a parent you can have a mixed emotional reaction to the tube and feeding. Here are a few questions and emotions experienced by parents we have helped during the tube weaning process.
Why does my baby seem to fear even the sight of food when all the other babies seem happy to eat?
It can sometimes feel like your baby is the only one who is reluctant to eat and this can make you feel very alone. Be reassured that you are not alone in having your child do this, and when seen from your baby’s point of view, it’s really a logical and intelligent response.
All babies born between 23 and 30 weeks gestation are given an NG tube to feed as they are too little to have developed a sucking reflex. Gradually as they grow the aim is to gently transition them onto oral feeding as long as they are doing well medically and developmentally.
Your baby at this point will not have experienced any oral feeding or stimulation; the staff on the baby unit will try to expose your baby to sucking and tiny drops of sweetened water and milk to help encourage development of a sucking response.
Despite the best efforts of the caring staff your baby will have been exposed to many painful, scary but necessary procedures during their time in special care, they may well have had reflux, a painful condition that can be made worse by tube feeding. So your bright little baby has unfortunately learned to associate feeding with pain or unhappiness, and naturally avoids it. They were also fed frequently and never experienced hunger.
A good tube weaning program works on changing these negative associations to positive ones with the aim of producing a child who enjoys a natural appetite.
Why are my partner and I always arguing about this?
Becoming parents is a major change in the dynamics of your partnership. No matter how much u loved and knew your partner, you may find you have completely different opinions on raising a child and arguments are frequent, especially during the first couple of sleep-deprived years.
When you have a baby who was born prematurely, this can add a huge amount of additional strain. The constant hospital trips and stays, unexpected financial strains and worries about your child often bring out the worst in both of you. There’s nothing in all the lovely pregnancy books to prepare you for this time.
When it comes to feeding there is a huge range of opinions, you may well find you get differing advice depending on what book you read and that even the advice from health professionals varies. It’s also a highly emotive area, having a baby who doesn’t feed can make you feel like a failure (you are not) and worry about being judged by other parents. Any comment from your partner can feel like an unwanted and unjustified criticism and easily blow up into an argument.
HOW CAN YOU SUPPORT EACH OTHER THROUGH THIS TIME?
This is a time where you need a lot of empathy, patience and forgiveness. You will both probably say things you don’t mean after a sleepless night or stressful day. Try to bite back any criticisms and aim to work together to find ways to help your child.
If possible discuss getting psychological support from your hospital. This can help you work in increasing insight, relieving feelings of guilt and help with prioritizing the essentials.
The psychology team for tube weaning will help you look at the behavioral and psychoanalytical approaches to changing your child’s feeding behavior. The behavioral side will help to empower you as parents, increase your confidence in your ability to help your child and give you pointers on how to act in various situations.
The psychoanalytical side looks at your child’s personality traits and point of view to adjust the weaning program to best suit your child. It helps you as parents to stop blaming yourselves for any medical problems or delay in development and to keep an emotionally neutral attitude towards your child’s eating.
Why am I obsessed with weight, milliliters and calories?
When your child was on the special care unit its feed and fluid intake was closely monitored. Your child would have been weighed each day, then the day’s fluid intake would be calculated and divided into hourly amounts. No doubt you would have heard from a nurse at some point that its feed had increased to a certain point and this was a very positive progress.
Not only that but everything else was monitored: heart rate, oxygen levels, breathing rate, temperature, blood sugars. All observed and carefully recorded on charts.
In a situation that can feel so out of your control, being able to record numbers can help you feel in control and let you monitor progress. With premature babies it is important that they are not over- or underfed, so it was useful and meaningful to monitor these numbers.
Tracking a baby’s weight is still a very useful indicator of any underlying problem. If you faced any infections or heart problems you may recall that failure to gain weight was an early indicator that trouble was brewing.
You may find yourself comparing your child with other babies born at the same time, a natural response although not very helpful. Premature babies can often lag behind other babies, even when allowing for the age difference, but they do catch up eventually.
Why do I hate the tube even though it is helping my baby?
Your baby was fitted with a tube because it was an essential part of their treatment. Despite its lifesaving work, you can easily start to resent or even hate the tube.
That’s a natural response and one we frequently hear. No parent dreams of having a sick child, and the tube is a very visible, intrusive indicator of your child’s illness. Not only that but it can feel like it interferes with much wanted contact, prevents you from bathing your baby easily, gets in the way when dressing them and causes inquiring looks from passersby.
Your child may also be one of the unfortunate children who get reflux or pain on feeding. Seeing a visible cause of pain, no matter how essential, brings out your protective instinct.
You can help reduce this hatred by having a clear plan and targets for when tube feeding will no longer be necessary, and knowing that the time will soon come when you will be able to be rid of the tube for good.