From Breastfeeding Today 2013 Issue 20
Julia Lehman Caldwell, N Hubbard, WI, USA
翻译|Chris
审核|Daisy、Shiuh-jane
呜哧、呜哧、呜哧
我的夏天是在一间漆黑的屋子里度过的。那里仅能容纳一个水槽，一把摇椅和一台整天呼呼作响的机器。那台机器是一个浅黄色的圆筒挂在一根三英尺长的杆子顶端。而房门外是一个已清洁消毒的、让人感觉冰冷的世界——新生儿重症监护室。
弱小的早产儿睡在透明的保温箱里，里面塞满了模拟子宫环境用的白色羊绒织物。报警器的鸣响声日夜不休，监测着各种微弱的生命征兆。
呜哧、呜哧、呜哧。在这间呼呼作响的屋子里，这台不停发出闷响的医用电动双泵吸奶器成了我忠实的伙伴，不论白天黑夜，每隔两小时吸一次奶。甚至是在睡梦中，我依然能够听到呼呼的吸奶声。
我怀孕27周的一天晚上，我正坐在分娩球上，上我的第一堂生产课，突然我感觉到一股热流涌出。在随后的短短几分钟内，我被抬上直升机送到了一家大型医院。我们的孩子提前12周降临了。
生产前，一个男人出现在我身边，手上托着一块蓝色的毛巾，解释道：“我要将您的宝宝放在这块温热的毛巾上，带他去另一个房间。”随后他走开了。差不多两小时后，他们把Wesley宝贝带进我的病房，他浑身插着管子，被固定和安全地放入了一个手推车上的小保温箱，准备进入新生儿重症监护室。
我只能通过手推车上的小窗子看看他，不能摸他。Wesley体重1磅15盎司（注：约879克），12.9英寸（注：33cm）长，只比我的手掌大一些。他的头像只小桃子那么大，表面覆盖着一层薄薄的金色绒毛。
我曾经期盼着喂养一个足月的宝宝，像普通妈妈一样表达爱意——给他喂奶、抱着他、帮他洗澡。但是这一切在一段相当长的时间内都无法实现了。Wesley不能自主调整体温和呼吸，也不能自己进食。
“早产儿需要母乳”一位儿科专家这样给我们解释道。他说早产儿不能消化配方奶，而我的母乳是为早产儿量身定制的。虽然我不能像普通妈妈那样表达爱意，但是我能够提供他人无法取代的营养食物给我的小宝宝，以满足其生存和生长需要。
Wesley出生的那天，护士把一台呼呼作响的机器推进我的房间。跟机器连在一起的还有一袋子设备——橡胶管子、塑料连接器、阀门和瓣膜以及不同型号的瓶子。她给我演示如何将这么零件与机器装配在一起，形成一个泵，模拟宝宝吸吮乳房的动作来吸奶。
早产儿的母亲往往存在没奶的风险，因为他们的宝宝吸吮力不足，不能直接亲喂，甚至连最高级的电动吸奶器都不如宝宝的嘴那样有效地吸奶，它也不能复制宝宝吃奶时释放荷尔蒙的情况。“立刻启动”，护士边鼓励我边冲那台机器比划着。
我的初乳来了，一开始只是几滴金黄的粘稠液体，又称为“液体黄金”，因为它富含养分。随着每次增加一些乳汁，乳汁分泌越来越多，很快就装满了1盎司(注：约20克)的初乳奶瓶。我亲手将奶送给住在NICU的Wesley，在那里，乳汁会通过经嘴插入他胃里的饲管喂给他。
这间狭小黑暗的房间成了我的避难所，远离那些没完没了的各种治疗、做艰难的抉择和可能出现的风险。B超监测着他的脑出血情况。超生心动仪对他心脏上的洞进行评估。呼吸管、抽血、输血、胸透……我试图把精力集中到能为他做的唯一一件事上，那就是持续走进那间狭小黑暗的房间——像一项永恒的仪式，不分昼夜——我才能为他提供一些乳汁。
在我初次能肌肤相亲地抱着Wesley前，等待两名护士摘除与他相连的那些监测仪器的管线，比如监测心脏、呼吸、氧气水平的仪器，再加上脐静脉滴注管、饲管和呼吸管。当她们终于把他抱到我怀里、包裹在我雪白的病号服里时，他只穿着尿布，小小的、粉嘟嘟的、轻飘飘的没什么份量。但是这一切已经让我感到无比震撼。
直到那时我才意识到情况是多么的紧要。我不仅仅是为他提供乳汁这么简单，我是在为一个虚弱到不能自己进食、甚至不能自主呼吸的宝宝维持母乳的供应。经受母子分离的煎熬，不能以寻常方式表达爱意，母乳成了我和他之间维系情感的生命线。当时我幻想着用早产的乳汁滋养着他，以我体内的活性抗体保护着他，于是我继续坚持不懈地走入那间狭小黑暗的房间。
两个月过去了，Wesley就这么一盎司一盎司地积攒着体重，逐渐接近6磅时，他再也不需要使用呼吸机了，并且进步到从保温箱里搬出、挪到普通的婴儿床上。我们的小沉睡宝宝开始醒过来观察四周找奶吃了。他已经准备好大吃一顿了。
我们试着母乳喂养了几星期。他的啼哭令我倍感挫败。我致电给哺乳顾问。她们对我说，继续尝试。我担心会回奶，因此尝试了所有能做的事情：喝草药、胸部按摩、用手挤奶、放松、肌肤相亲，吸奶、吸奶、不停地吸奶。她们鼓励我说，奶量通常在宝宝开始吃奶后增加。我开始反感与那台吸奶机的定期“约会”。我想自己喂孩子，并开始相信这只是众多计划外事件的其中一件而已。
恰巧在又一次母乳喂养尝试失败的时候，一个护士问我：“你试用过乳头保护罩吗？”[1]她向我展示如何使用这小小的、透明薄硅胶做的乳头保护罩。此后不一样的事情发生了。他衔住乳头，下巴开始有节奏地颤动，并不时停顿伴随深呼吸。我感觉到一股刺痛穿过我的胸部和身体。我看到他的嘴角有溢奶，顺着流入他的脖子和耳后。后来他闭上眼睛仍继续有节奏地吮吸、呼吸和吞咽。吃完后他推开乳房，张开的嘴里满是乳汁，流到下巴上。在我轻柔地为他拍嗝时，他带着竭力之后的满足与放松，在我的怀里沉沉地睡去。
那天的晚些时候，一位护士从冰箱里拿出一些我的乳汁。“你的奶太好了”她指着一瓶装有我乳汁的瓶子说道。我的美妙的乳汁啊！
在医院住了三个月后，我们把他带回家，正好是预产期之前的两周，他的体重刚好超过了6磅重。经过了几周的过渡，我们再也不用乳头保护罩了。这三个月来的每隔两小时日夜吸奶的历程，让我终于能够母乳喂养我的宝宝了，一直到他一岁大。
我的小宝宝教会我生命的意义并不是以常规的方式来表达爱，而是以不平凡、非计划的方式来表达爱，甚至当事情不在计划中时，如何表达和展现你能做的一切。如今我能以平常方式来表达爱，然而最初的三个月，日日夜夜，我的爱就是呆在那间狭小黑暗的房间，用那呼呼作响的机器生产源源不断的乳汁，提供给我那极度虚弱而无法自主进食的小宝宝。
编者注1: 不是所有的宝宝都需要使用乳头保护罩，乳头保护罩也不是解决宝宝吸吮问题的唯一方法。如果您在考虑自己和宝宝是否需要使用乳头保护罩，请咨询身边的国际母乳会的哺乳辅导或者其他母乳喂养专业人士。
Whoosh, whoosh, whoosh.
I spent the summer in adark room, barely large enough to hold a sink, a rocking chair, and thewhooshing machine: a canary-yellow cylinder perched on a three-foot pole. Justoutside the door was a chilled, sanitized world: a neonatal intensive care unit(NICU), where tiny, premature babies slept on pods of white fleece insidemakeshift wombs—transparent boxes known as isolettes. The dinging of alarms couldbe heard day and night, monitoring delicate vital signs.
Whoosh, whoosh, whoosh. In thewhooshing room, the muffled, repetitive suctioning of a hospital-grade electricdouble breast pump became my constant companion, every two hours, day andnight. Eventually I heard the whoosh even in my sleep.
One evening, 27 weeks into mypregnancy, I had been sitting on a birthing ball in our first labor and deliveryclass. Suddenly I felt a warm gush. Within minutes I was on a helicopter to alarge hospital. Our baby was coming 12 weeks early.
Before the delivery, a manappeared next to me, cupping a small blue towel in his hands, “I will placeyour baby in this warm towel and take him to another room,” he explained, andthen he disappeared. Almost two hours later, they brought baby Wesley into myhospital room, intubated, stabilized, and secured inside a small isolette on a cart,ready to be transported to the NICU.
I looked at him through a smallwindow in the cart, unable to touch him. Wesley weighed 1 pound and 15 unces,and was 12.9 inches long. He was not much bigger than my hands; his head wasthe size and texture of a small peach with just the thinnest layer of fuzzyblonde hair.
I had expected to nurture afull-term baby, to show my love in the usual ways—nursing, holding, bathing—butnone of that would be possible for a long time.Wesley was unable to regulatehis body temperature, breathe, or eat on his own.
“Premature babies needbreastmilk,” a neonatologist explained to us. He said premature babies have troubledigesting formula, and that my breastmilk would be custom-made for my prematurebaby. Although I couldn’t show my love in the usual ways, I could providesomething that no one else could: the nourishment that my tinybaby boy neededto survive and thrive.
The day after Wesley was born, anurse wheeled the whooshing machine into my room, along with a bag ofequipment—rubber tubing, plastic flanges, valves and membranes, bottles ofvarious sizes—and showed me how to hook all the pieces together with the machine,to create a pump that mimics a baby’s suctioning.
Mothers of premature babies areoften at risk of losing their milk supply, because their babies are not able tobreastfeed and even the highest quality electric pump cannot remove milk fromthe breast as efficiently as a baby, or replicate the release of hormones thatoccurs when a baby nurses. “Start right away,” the nurse encouraged me,gesturing toward the whooshing machine.
My milk began as a few tiny dropsof a golden, thick liquid known as colostrum, sometimes referred to as “liquidgold” for its rich nutritional properties. A few more drops each time, and soonI was filling one-ounce colostrum bottles. I hand-delivered milk to Wesley inthe NICU, where the milk was fed to him through a feeding tube inserted intohis mouth and stomach.
The small, dark room became myrefuge from endless procedures, decisions, and risks. Ultrasounds to check forbleeding in his brain. Echocardiograms to evaluate a hole in his heart. Breathingtubes. Blood draws. Blood transfusions. Chest x-rays. I tried to focus on theonly thing I felt I could do for him. I kept going into that small,dark room—anendless ritual, day and night—so I could provide a few tiny bottles of milk.
Before I held Wesley skin to skinfor the first time, I waited while two nurses untangled and redirected thecords for machines that monitored his heart, respiration, and oxygen levels,plus his umbilical IV line, feeding tube, and breathing tube. When they finallyset him on my chest, tucked inside my white hospital robe, he was tiny and pinkand naked except for his diaper, and it was the absence of weight, of anysubstantial mass, that was so shocking to me.
I hadn’t understood how seriousthe situation was until then. I wasn’t just providing breastmilk. I was maintainingmy milk supply for a baby who was not strong enough to eat or even breathe onhis own. With so much separation, unable to show my love in the usual ways,milk was my lifeline as well as his. I imagined my special preterm milk nourishinghim, my lifetime of antibodies protecting him, and I kept going into thatsmall, dark room.
Two months passed, and ounce byounce, Wesley approached six pounds, shed his breathing support, and graduatedfrom his isolette into a bassinette. Our tiny, sleepy baby began to wake, lookaround, and suck. He was ready to eat.
We tried breastfeeding for severalweeks. He would cry and I would get frustrated. I called lactation consultants.Keep trying, they said. I worried about losing my milk supply. I triedeverything. Herbs. Breast massage. Hand expression. Relaxation. Skin-to-skintime. Pumping, pumping, and more pumping. They encouraged me, saying that milk supplyoften increases on its own after the baby starts nursing. I began to resent myround-theclock appointments with the whooshing machine. I wantedto feed my baby, and I began to believe that this was just one more thing thatwouldn’t go as planned.
“Have you tried a nipple shield?”[1]a nurse asked me one day, during another failed attempt at breastfeeding. Sheshowed me how to use the shield, a small, disc-shaped object made of clear, thinsilicone. Then something different happened. He latched on. His jaw beganmoving in a rhythmic pattern, punctuated by pauses for big, deep breaths. Ifelt a tingling sensation through my chest and body. I saw milk surface aroundthe cornersof his mouth, sometimes running in small streams down hisneck and behind his ears. Eventually his eyes closed yet he continued hisrhythmic sucking, breathing, and swallowing. When he was done he pulled away,his open mouth full of milk, running down his chin. He collapsed in satisfiedexhaustion, sleeping deeply on my chest as I gently patted the burps out ofhim.
Later that day, a nurse was takingsome of my milk out of the refrigerator. “You have beautiful milk,” she said,holding a bottle of my milk and pointing to it. My beautiful milk!
After three months in thehospital, we brought home our baby boy, two weeks before his due date, weighingjust over six pounds. Within a few weeks we didn’t need the nipple shield atall. After three months of pumping every two hours, day and night, I was ableto nurse my baby and provide breastmilk for the first year of his life.
My tiny baby boy taught me that life isn’t aboutshowing your love in the usual ways. It’s about showing your love in unusualand unexpected ways. It’s about showing up and doing what you can, even whenthings don’t go as planned. Today I can show my love in the usual ways, but forthree months, day and night, love was the whooshing machine and the small, darkroom; love was protecting my milk supply for a baby who was too weak to eat onhis own.
Editor’s note[1]：Not all of the babies need to use nipple shield，and nipple shield is not the only way to solve sucking problems. Please consult a La Leche League leader or other professional breastfeeding helpers to know if the nipple shield is suitable for your baby or not.