Premature babies like the Captain are born before they develop the ability to eat on their own. It isn’t that they just don’t know how to breastfeed, it’s that his brain has not developed the advanced motor skill of sucking, swallowing and breathing in coordination. Generally this skill is developed between 34-36 weeks gestation.

Take a moment and drink some water. Think about all the coordination that must take place in your body to simply to do that. You need to be able to suck, which requires muscles in your lips, cheeks and mouth to work in unison, and  swallow, which requires your tongue and throat to work together, and finally pay attention to your breathe. Notice how when you swallow you hold your breath for a split second. Now imagine you were born with Respiratory Distress Syndrome like Captain and imagine how confusing it is to have to stop breathing while eating.

A whole symphony of muscles and organs and breathing must work together in perfect harmony to feed a baby who was also born underweight and whose body must also grow to catch up. It’s a lot of work and it’s why the Captain’s intake is watched very carefully. It’s why there is a special newborn dietitian on the floor who make decisions about adding 2 or 4 calories per feed to the Captain’s breast milk tube feeds. It’s why each wet diaper is weighed, why he is weighed every night, it’s why everyone is very interested in my milk production, it’s why each tube (and now bottle) feed is measured out very precisely based on his birth weight.

So for the Captain it isn’t just that he and I must learn to breastfeed together, it’s that his brain has to learn to coordinate parts of his body, its that he must learn to eat, period. When he learns how to eat by mouth (oral feeds) and not a tube, and does so for 48 hours in a row, then he is ready to come home. He has been doing extraordinarily well at his oral feeds. He has surpassed 50% oral feeds (meaning 4 our of 8 of his meals are done via breast or breast milk in a bottle). So the captain’s time in the NICU may be coming to a quick end, or he may plateau at his current rate and we may be here for some time to come.

As most parents of newborns find, I am sure, it’s the Captain’s world and we are just living in it.