Tuesday, September 20, 2011

Our breastfeeding journey

Warning: If you are a male who knows me in real life, I'm gonna talk bluntly about many things you probably don't and really shouldn't know about me. I'm saying don't read this post.

It seemed to be off to a great start. We were in our room within an hour of delivery and Naomi latched on beautifully. We were nursing about every three to four hours. A lactation consultant visited right away and made sure we were on the right track. I should stop here and warn you, I'm gonna give the long version. You might think it's too much information. I need to remember this so I'm putting it in writing so as not to make the same mistakes again.Hey, if someone else learns just one thing here that'd be great too. Anyway, by day two I developed a crack/sore on one side. I believe that is why at one point a nurse asked me if I wanted to use a shield. This however came about after a different nurse suggested I just not nurse on that side at all until I healed- the advice to which I was following. Now I don't remember clearly why she said I needed the shield, but she showed me how to use it and it reduced the soreness overall so I obliged. Though it was not effective on the scab side as I still bled when Naomi latched on. That was disgusting by the way.  Imagine seeing your baby's mouth with your blood coming out of it! So as much as that shield was an inconvenience, I continued to use it, without questioning. As the third day rolled around a nurse mentioned that Naomi was losing a lot of weight. Normal, I thought. She seemed to be crying more. I tried to remedy this with waking her to feed more often, but many times she would just cry. Another nurse said I should wait for her to wake up, follow her cues.I tried that approach as well. This was the more peaceful approach, because she slept a lot. At some point late the second day someone mentioned starting on a pump to speed up the milk production. A nurse got me all set up- with the actual machine that is.As far as the what and how I was on my own. Some of you are probably thinking, "What is there to know? Just do it." Right? So there I was pumping away for twenty minutes a side several times over those last 18ish hours of the hospital stay. Nothing but a few drops would appear. How discouraging to spend all that time to get no pay off. By the last day in the hospital Naomi's weight had really dropped ( to what I was told ) a dangerous 8%. Feeling defeated by my efforts, Exhausted. Disappointed. Green. I agreed to start supplementing with formula. By that time she had had a few more crying-at-the-breast episodes.I thought she might be starving and felt terribly guilty for it. We nursed then topped her off with half ounce of formula only when she woke up on her own hungry.Which turned out to be every 3-4 hours.Those of you who know anything about breastfeeding already see the problems don't you? Off we go on the fourth day with baby and formula in hand. I diligently set up my own pump at home, continued pumping only to have a drop roll out here and there. We had an appointment on the fifth day to follow up on her weight,which was at a stand still.  The professionals seemed so concerned. In turn I was concerned.Another appointment was made for 5 days later, to closely monitor her weight. Before we left the hospital a nurse went over the reasons why I would need to call or get Naomi back to the hospital. This included not urinating, and diarrhea. Both of which I believed was happening on the sixth day. I called the nurse, talked to a doctor and they told us to bring her into the ER. The first Ped. bagged her to catch her urine.Yep, we were to sit there until she did go so they could find out why she wasn't going. Logical right? (hint of sarcasm here) After an hour (Thank God) Another Ped. came on duty. Within minutes she started asking me the right questions about our breastfeeding. She said so matter-of-factually that Naomi did not have diarrhea, she had normal breast fed runny poop. Which also made it hard to tell whether or not she had peed. The doc guessed that she was peeing just fine. There were no signs of dehydration.I would have been more excited had I not been exhausted and a little humiliated. I was a wreak, thinking I couldn't provide for my baby and that was ALL I wanted! To just nurse my baby and have something come out in the damn pump. Anyway, she said she wasn't going to keep us there, removed the bag, and told me she was referring me to a Lactation Consultant. This wonderful Ped. was a breastfeeding mother to three children, she knew what was up.By the time we saw the LC it was day eight. In the meantime though, I developed a major section of plugged milk ducts,( about the size of a dollar bill folded in half) on the side I wasn't able to nurse on which started developing into Mastitis. After an unsympathetic phone conversation with the OB on duty, luckily I was able to reduce my fever and nurse on that side, though I cried each time and stomped my foot on the floor wincing to get through it. After about 24 hours of feeling flu-ish it dissipated without any antibiotics.

  On to the Lactation Consultant, first things first, she got rid of the shield. She helped us with her latch, it was too shallow. And suggested we strip her down to her diaper, as she would fall asleep a lot. We also did what is called switch nursing, to keep her awake. She also told me to nurse then pump every two hours, never go longer than two hours except once during the night for no longer than 5. We talked about my frustration with pumping. She said that I needed to hold Naomi or look at her while I pumped to have an emotional response, leading to let down. She also encouraged me to check out the hospital pump as it was stronger and should really "get the job done". Reluctantly we took it home, it didn't get the job done whilst in the hospital, but I was desperate to get milk, so I would try again. I never wanted anything so badly as to breastfeed, aside from having a healthy living baby. On our way out she said, "Oh, by the way what shield are you using on your pump?"
"What shield?"
"Yeah, there are sizes, is it the 24 or 27, it has a number on it.You'll need the larger one I believe." She proceeds to explain how my nipple should appear in the shield, how it should feel and look before, during, and after pumping.
"Wow, I have no idea what I have, the nurses nor any of the three LC's who saw me in the hospital said a word of it." I hadn't looked in the box of parts they sent me home with.
When I got home and started pumping with the properly fitting large shield I got one ounce on the right and 1/2 ounce on the left!!! YAY! But I was also pissed! Someone should have helped me with this before I left the hospital! I was already fuming because before leaving the hospital my breast became a rock and I asked the advice of a LC, who hurriedly spouted out that I could massage it. When I got home, I thought, "How? What direction? For how long?" I had no specific direction, so I looked that up on the internet.
So there I sat pumping, and pumping. I pumped for 20 minutes each side after each feeding. Allow me to break this down. It took Naomi anywhere from 30 to50 minutes to nurse. Then I would pump for an additional 40 minutes. That would leave me about 30 minutes to wash the pump parts, go to the bathroom, eat, study the subject online, then change a diaper and start the cycle all over again. All for no more than 3 ounces of milk. I did this for 2 weeks. For three ounces of milk. We continued supplementing with formula, and eventually increased the amount of formula we gave her after each nursing session per LC's advice.
At three and four weeks out I had no more milk than the first day I successfully pumped. This was incredibly discouraging. I felt like a failure. I don't see other moms who aren't able to breastfeed as failures, but I sure felt like one. Someone asked me, why I was trying so hard, was there pressure from family, or was I trying to please someone by breastfeeding. No. Just me, it's what I wanted, no outside pressure. I wanted to give up especially late at night. I was exhausted. But I figured some breast milk is better than none so I kept going. Meanwhile Naomi was slowly gaining weight and her diapers told us that she was getting enough to eat.

Experts say many things can affect supply, stress being one of them, lack of sleep another and not enough calories another. I was overwhelmed by this, I was getting no sleep by trying to make more milk. I had little time to de-stress with all the pumping. And calories? Forget eating, I had a baby to care for, milk to stimulate and no appetite. Naomi would sleep as much as 6 hours at night if I let her. So, I found myself setting an alarm to wake her every 2 hours, then when that wasn't increasing my supply, I did every hour and a half.  Every hour and a half. For about a week. Looking back I see so clearly how obsessed I really was!
Another visit to the Lactation Consultant later, with her lack of hope and recommendation to give Naomi more formula, I got smart. I decided to order a scale and I decided that supplementing with formula was the cause behind my perpetual low supply. I also started taking fenugreek at  maximum dosage. I read website after website on breastfeeding.As I was realizing the folly, Naomi started refusing the "top off" of formula after most feedings.And finally at about 4 months she was no longer on any formula. I quit pumping cold turkey, I just gave up, I was losing precious time with her!  I was doing everything right, eating foods that promote supply, drinking the appropriate amount of water, nursing on cue.I wasn't enjoying all that comes with being a mommy to a new baby. It was all about the milk!
In the midst of all of this striving Naomi wasn't a real happy camper. She was fussy, she was gassy, and the older she got the less she would sleep. Sometimes she would cry at the breast, and cry at the bottle.I would cry too. We never considered her colicky, just a few degrees from it. We discovered that she has a dairy/soy protein allergy and a bit of reflux. Unfortunately, it took her having blood in her stools before I woke up and took serious notice to the thing I suspected from the very start. Both were easily remedied by changing my diet and having her sleep elevated- aka in the Pikkolo or by waiting 30 minutes after eating to lay her down. She decided on her own to only nurse on one side per session about 90% of the time, which resulted in no more spitting up. We also had a lovely bought of Thrush, which also contributed to her fussiness & gas.Poor baby, she was so uncomfortable! Yes, all of this in the first 4 months! It was SO hard on all of us!

What did they do before pumps? What if I had her vaginally and hadn't stayed an extra day? They never would have known she lost one percentage point higher than they deem healthy. Who says it's not okay for some babies to lose a little more than others? She was always thriving. Though it was lonely and frustrating and maybe took me longer than it should have, I'm glad I took matters into my own hands. If it were up to the professionals in our hospital we would still be on formula and who knows about breastfeeding at all. It was in the letting go of my dreams, in the giving up in some regards that my supply kept up with her demand. I wish I could say exactly what it was that increased my milk, but there were so many variables. I can say this, I learned A LOT from Kellymom and Jack Newman. If I could do it all over again I would have read more about HOW to breastfeed while pregnant rather than all the facts that support why breastfeeding is so good for mom and baby. When the rubber met the road those facts did me no good. I think, through reading evidence based research and listening to other moms that the c-section posed the first problem, and supplementing with formula and using a shield were secondary.

 Despite all the challenges; including another very bad episode with the red- eyed-breastfeeding- monster- on my birthday by the way- and ongoing vasospasms due to poor latching, and having flat nipples, I am proud to say that 10 months later we are still at it! She is a very happy and healthy nursing baby! She still  has a shallow latch, but effective. And in turn I am a happy momma!

1 comment:

  1. Oh, Michelle! You are a better woman than I! For all of the above reasons, I didn't even TRY breastfeeding. I know I probably missed out on what you are no experiencing, but I could never be that strong to endure all that you just wrote about! Whoa!

    I'm glad you found out about Naomi's allergy. Beth had blood in her stool as well when she was little - that's how we found out she was lactose intollerant. She had to be on the soy formula.

    Congrats on 10 months with your rainbow! You are a GREAT momma!!!