Tuesday, April 30, 2013

Breastfeeding Issues

**warning:  lots of boobie talk ahead.  If breastfeeding or boobie talk isn't your thing, feel free to read this other (benign) post. **

While pregnant with James, I didn't know what to expect regarding breastfeeding.  I wanted to give it the ole college try, but I wasn't willing to lose my mind over trying to make it work.  I talked a little bit about it here and here.  Basically, I breastfed him until he was six months, and then transitioned to formula.  He was always a quick nurser and rarely fell asleep at the breast (instead would usually pop off wailing).

While pregnant with Reese, I didn't give it much thought before she was born.  Been there, done that.  I figured we would figure it out together and it would be no big deal.  I did not anticipate having trouble.  Unfortunately, we did experience some challenges.

When she was weighed for the first time, minutes after her birth, I knew feeding was going to a big, big focus for us since she was a big, big girl!  Bigger babies can have blood sugar issues when they are born, so feeding them as soon as possible is important.

Sometime in the first hour, she latched on well and ate for 15 minutes or so.  It was a good first feeding, in my book.  Her blood sugars were fine, for which I was grateful.

Over the first few days, she was eating well and latching okay, or so I thought.  I met with a lactation consultant while in the hospital just to make sure all was well.  After we went home, two days later, I noticed my nipples were really, really sore.  Other moms warned me about this when I had James, but I never really experienced it.  But this time...WOW.  I also noticed when Reese was done nursing, my nipple would be creased.  A baby that is latched well shouldn't cause this to happen.  On day four, I went back to the hospital with Reese to have another lactation consultant appointment.  Sheri was great.  She helped me try some new positioning techniques to help Reese get more of my nipple in her mouth, hopefully reducing her pinching the bajeebies out of my nipples!  If you asked Reese during this process (which I didn't, but I feel free to speculate), she wouldn't have said anything was wrong.  When she was hungry, she ate until she was full.  End of story.  She seemed to be getting plenty of volume, based on weight checks at the pediatrician, and was sleeping (some, as any newborn does).  It was just ME having trouble with feeding her that was the issue.

After that appointment on day four, I left feeling encouraged that WE COULD DO THIS.  We had to work on positioning and such, but it could be done.  So for the next ten days or so, I tried and tried to get her positioned well, with her chin ever so slightly overextended.  But despite my best efforts, I couldn't consistently get through a feeding without wincing in pain.

I had an idea to try using a nipple shield.  After talking on the phone to lactation consultant Sheri about my brilliant plan, I headed off to the store to find one.  I was so excited to try it out with our next feeding.  Nipple shields can be used for a lot of different reasons (like a mom has very flat nipples that don't give the baby much to latch on to), but I was hoping to take advantage of the SHIELDING properties.  I needed protection from this wee babe that was killing my boobs!  The first feeding that I tried it with was fan.tas.tic.  I was able to relax while Reese nursed.  I wasn't in pain.  She seemed to not mind the shield and ate happily. I thought <cue angelic chorus>  "Aaaaaah!!!  This is it!  We found our solution!"  I felt hopeful again.

It became apparent fairly quickly, however, that when we used the nipple shield, Reese had to eat for a lot longer time period.  Like an hour.  Because of the layer of plastic between us, my body didn't respond to her the same way.  Maybe my milk didn't let down as much, or it didn't flow as easily.  Hard to say.  All I know is she had to eat for a long time to get the same volume that she was getting pre-nipple shield.  Hmmm...perhaps not the miracle cure I thought it was...  I tried using the shield every other feeding to see if that would help my nipples heal a little bit, while still regularly giving Reese an unencumbered feeding.  This worked okay, but it still practically brought tears to my eyes when she would nurse without the shield.  We needed another solution.

When I took her to her two week check-up at the pediatrician, it got ugly.  The sweet, kind, compassionate pediatrician asked me how I was doing and I started sobbing.  (side note--I'll bet they deal with a lot of weeping moms in the peds office.  If I were the doctor, I would've been thinking "Aw geez...we've got another crier...")  I told her I was really, really, freakin' tired.  Reese was eating all the time because we were using the nipple shield because I couldn't get her to latch well (or tolerate her latched) without it.  She had their lactaction consultant come in right away to work with Reese and I.  After examining Reese, this lactation consultant speculated that maybe Reese was slightly tongue tied.  She said her frenulum looked a little bit tight.  She recommended making an appointment with an ENT, so we did.  She also helped me work on positioning using a brest friend pillow.  Up until this point I'd been using a boppy.  I left that pediatrician appointment feeling hopeful once again that this will work out for us!

I switched completely over to using the brest friend pillow and ditched the boppy (which I used the whole time with James...different strokes for different folks, I guess.)  Within a couple of days, we went to our ENT appointment.  The doctor was very kind and sympathetic to our latching woes.  After checking out Reese's tongue, however, he said she looked just fine.  No frenulum clipping necessary.  This was both good and bad news.  Good news that Reese didn't need a minor procedure performed.  Bad news that we were right back where we started with no new magical solution on the horizon.

I left that appointment feeling discouraged, disheartened and less than hopeful about our nursing future.  I didn't realize how important breastfeeding was to me until I thought about the prospect of not being able to make it work.  Apparently I cared about it more than I thought I did.  I had to give myself my own "Don't lose your mind over breastfeeding" speech that I give to moms in the NICU where I work all the time. The speech goes something like "You are not a bad mom if you don't breastfeed.  Your self-worth is not tied up in whether or not your baby gets formula.  Nutritionally speaking, breast milk is the best thing for your baby.  But what is best for your baby is a healthy/happy mom.  If your sanity comes into question over breastfeeding, then it no longer becomes what is best for your baby."  Etc, etc, etc.

Unable to decide at that moment to throw in the towel completely, I made an interim decision to pump and feed her expressed milk.  So I pumped.  For a week.  Then another week.  Then another week.  For three weeks.  I didn't even try nursing her in that time.  She took bottles like a champ.  Pumping didn't hurt.  It was a pain in the butt with all the pump parts and bottles to wash, but at least I was pain-free.

Side note:  I remember reading a blog post from another mom (Jessica) where she described her breastfeeding challenges with her second child.  Go read her story.  She pumped for a MONTH and then worked back up to breastfeeding her son.  When I read that in 2011, I thought to myself "There is NO WAY I would do that.  Breastfeeding isn't that important to me that I would exclusively pump and bottle feed for a month."

Well...Fast forward to the end of 2012 and that's almost exactly what I did.  After three weeks of pumping/bottle feeding, I started attempting to nurse her again.  She did great.  I didn't hurt afterwards.  The next day I tried a couple of times to nurse her.  Still did great, no pain.  Over the next week or so, I added in more and more nursing.  We eventually got up to 24 straight hours of nursing and no nipple pain.  Cue the Hallelujah Chorus.  She was about 7 weeks old at that point.

What changed?  Who knows.  Time really did help.  Maybe just the size of her mouth growing a little bit in that time frame made her latch differently.  I don't know.  All I know is I was so.incredibly.grateful. that our challenges seemed to be behind us.  She didn't have any trouble transitioning back to nursing from bottles.  This is partially why it makes me IRATE when lactation consultants preach that if a baby gets one single bottle feed, breastfeeding is RUINED.  Bull$h!t.  Even if my friend Jessica (mentioned earlier) and I are the only ones on the planet with success stories of bottle-to-breastfeeding (which I doubt we are), that's still two cases where it worked.  So people need to quit beating moms over the head about giving their babies bottles.  *stepping down from soap box*

Where are we now?  Reese nurses about 4-5 times per day.  In the evening before bed, she gets a 6-8 ounce bottle of pumped milk.  Before I go to bed, I pump and save whatever I get for the next night's feeding.  Most nights she sleeps through the night.  (glory and hallelujah!)  My plan right now is to breastfeed until she gets teeth.  Based on the drool factor lately, that may be any day now!  I'll transition her over to formula after that.

So.....that's our story!  Thanks for your time!


Unknown said...

That was a fun read!
Oh its Peter by the way

Jessica said...

I had a similar experience with Jude but didn't really know any better to seek help. I powered through for almost 2 months of excruciating pain feeding him. I had no other option, we didn't have money for an electric pump or even formula and I was determined to make it work. Joe will bare witness that I used many unsavory words every time he latched on. But at some point he grew and the latch got better. I tried nipple shields and everything I could think of (and afford) and nothing worked.
The things we do for these crazy kids.

Anonymous said...

add to the list of lies: nipple confusion. my kid bottle and breastfed alternately for a good month, and though it took him a minute to adjust, he was never confused. he's been weaned a month now, but he would latch like a champ if i offered.

Anonymous said...

It's not a lie, nipple confusion does exist. I had one that I had to fight to get back to the boob since she had low blood sugars after she was born. Even when I told the doctor no bottle. So I am sorry you think it is lying, but it actually does exist. Lucky for you and others that didn't have a child with oral motor issues caused by coming 4 weeks early. Don't I wish I didn't have to go through the grief of it!! I also had another one that could go back and forth between bottle and boob, of course he was not early. It is something that commonly affects those born between 34-37 weeks. One small sign is that they can't keep a pacifier in their mouth or milk flows out the corners of their mouth. So if you ever have one like that I wouldn't suggest giving a bottle.