Posts Tagged 'breastfeeding problems'

At the End of the Rainbow: My Breastfeeding Story

 

ScaleWhen I was pregnant, there were so many things I was looking forward to.  I remember holding my hands on my stomach, trying to touch the mystery that was my baby moving inside me.  I couldn’t wait to see what he looked like, or breathe in his new baby smell.  I couldn’t wait until I could hold him in my arms, touch his skin.  I wanted to hear his cries and be there to comfort him. 

Of all the things I was looking forward to, I can easily say that breastfeeding was not one of them.

I had made the choice to breastfeed because I knew it was the healthiest choice for both him and I.  I had done some research, I had heard the “Breast is Best,” I knew finding gluten-free formula would be a pain.  The decision was made, but it would be quite the stretch to say I “wanted” to breastfeed.

In fact, I was pretty sure I was going to hate breastfeeding.  For one thing, I don’t enjoy being in shorts or a swimming suit, so the thought of having to expose myself multiple times a day in order to feed my child did not appeal to me.  (And isn’t that what I always saw in the ads, women with their entire breast hanging out?)  For another, all I heard about breastfeeding were negatives:  you can’t drink, or have coffee, or eat certain things, and your. nipples. will. fall. off.  Or at least, you’ll wish they had, because you are going to be in so much pain.  And that’s before they have teeth.  Engorgement.  Chapped nipples.  Plugged milk ducts.  Mastitis.  Sure, it’s healthy, but it’s going to feel like hell.  Breastfeeding seemed like more than an inconvenience, it seemed like some horrible torture for women. 

Even with all that, I was determined.  I would provide my child with the best nutrition I could for one year, and then I would wean him promptly and my breasts would become my own again.  To prepare myself, I read everything I could get my hands on.  I studied every diagram for proper latch, read every tip for success.  I was expecting it to be hard, but I had armed myself with knowledge. 

I had no idea.  With all my planning, I was completely unprepared.

I had planned on nursing him immediately (as I had read was imperative for successful breastfeeding), but because of the breathing issues he had at first, I wasn’t allowed.  It was over three hours after he was born that I was finally given the nurse’s permission to breastfeed him.  While trying to adjust myself more comfortably on the ice mountain I was sitting on and struggling to deal with the gigantic hospital gown, everyone watched me expectantly.  I brought my tiny, exhausted newborn awkwardly towards my breast and… nothing.  There was no latching, there was no instant recognition, there certainly was no amazing crawling towards my breast in search of food.  There was just me, acutely aware of everyone in the room and trying to pretend I didn’t feel horribly awkward.  I wanted everyone to just get out and let me figure it out on my own, but instead I had three nurses hovering over me and family standing just beyond them.  All waiting for the miracle that I apparently was not going to be able to produce.

My concept of time may be a little fuzzy (after all, I had just given birth), but I don’t think I’d been trying for more than a few minutes before one of the nurses swooped in to test his blood sugar.  (This, in case you’re wondering, is the moment we can all point to as the moment when it all started to unravel.)  It came out a little low on their initial testing, which means they have to draw a bigger vial of blood and send it down to the lab to re-check it (since their quick little device is apparently a POS and completely inaccurate).  In the meantime, we are already thrown into PanicMode.  J must have x ml of food immediately, and sugar tests every hour. 

The nurse whips out a little bottle of ready made formula.  There’s arguments from me, there’s no way I’m going to give him a bottle already.  I finally win and a pump is brought in.  (Let me just say here that I was incredibly lucky and had an amazing supply of colostrum from the beginning.)  In the meantime, the nurse is already pouring (gluten-filled) formula down J, topped off with pumped colostrum.

Right there, before I’d even left the delivery room, I felt like I had failed.  I had promised myself, my unborn baby, that I would breastfeed.  I had promised that I would not give him formula.  I was trying not to show how incredibly disappointed I was, but the fact is I was heartbroken.  This wasn’t something I had expected, not something I had prepared for.  I certainly hadn’t expected to be so crushed by not being able to breastfeed as planned.

nurseThe results came back from the lab: his blood sugar was fine.  It was completely understandable if it had been low–after all, he had not eaten for over three hours after birth, and the labor was a long and stressful one.  However, the hospital had already put us in this emergency mode, so we were stuck in this cycle of forcing x mls into J every hour and blood tests and stress.  (I can’t remember how much it was, but I know it was more than the average newborn would be getting from the breast.)  Every initial blood test came back low, the results from the lab came back normal.  He never actually had a blood sugar issue, but we were treated as if he did.  He was monitored, poked, re-poked, force fed.  And of course his vitals weren’t done at the same time, so there was a constant stream of nurses and undressing and poking and crying.  I would no more get settled down to try to nurse him again, and another nurse would walk in.  It was incredibly frustrating, although I know the nurses were just doing their job. 

You see, because he was born pre-term, J did not have the fat stores that full-term babies are born with.  He had nothing to fall back on for energy, which is why the nurses were so concerned with his blood sugar.  Also, he had no suck reflex.  Zero.  You could gag the boy with your finger, and he still wouldn’t latch on.  So instead, I fed him with a syringe.  I fell into a cycle of pump and feed where I was constantly doing one or the other, determined to get enough colostrum that I wouldn’t need to give him any formula to meet the dictated amount for the hour.  Following the nurses advice, in between all of this, I would try to get him to latch on.  It was complete chaos.

Some time in the middle of the night, when it was quiet and the interruptions were fewer, J started to actually suck a little bit.  I wouldn’t say he was getting a whole lot, but he was trying, and that was an improvement.  .  I held him in that darkened room, and for the first time it really connected with me that he was mine.  It was in that moment that breastfeeding became something I passionately wanted to do, not just because it was  healthy for my baby, but because I had this fierce desire to keep him close and protected. 

I knew the hospital provided a meeting with a lactation consultant, and I could not wait until my turn came.  I just needed someone to help me figure out how to latch him properly, and we would be fine.  I knew it.

The lady that blew into my room was not what I was expecting at all.  She was curt, impatient, and more than a little condescending.  I had nurses and family watching (once again) while the consultant informed me loudly that I was doing it WRONG and then proceeded to manhandle my baby and my body.  I was using the wrong hand to bring him to the breast, I was holding him wrong, I was sitting wrong, no not like that!  The other hand the other hand!!  Then she was shaking her head and talking to the nurse about how my baby had no suck reflex and oh my god look at her nipples they’re huge and then a nipple shield was slapped over my nipple and my baby shoved back into place.  I was mortified.  I was in shock.  I don’t know how I managed not to cry. 

There was quite a debate about whether or not I was going to be allowed to go home.  They threatened to put J in the NICU repeatedly (although once again I point out that his blood sugar was never actually low).  The consultant informed my doctor that she was not happy with how J was feeding.  She would really like to see me stay in the hospital another day to get breastfeeding right. I wanted to go home where everyone would leave me alone so I could feed him in peace.  I won.

At home, things went a little better.  He still didn’t latch on, but he made efforts.  I continued to pump and feed him with a syringe and a tube to make sure he was getting what he needed.  I hated using the nipple shield they gave me, but they told me it was the only way I’d get him to suck.  I was pumping enough within the first day home that I no longer had to supplement with formula.  We can do this, I thought.  We’ll make it.

The following day was our appointment with the pediatrician. Before I even knew what was happening, I was ushered into a room with my (ex)partner, six year old stepson, and another lactation consultant and ordered to remove my shirt.  She was going to show me a trick.  She then pulled out a Similac bottle nipple and stuck it over mine (totally not making this up) and took my baby from me.  She pushed J onto the bottle nipple repeatedly while he screamed and gagged (“No, don’t touch him!”).  Over his cries, she told me how sometimes you have to use unconventional methods, it’s all about whatever gets the food into the baby.  She completely ignored my protests that he was actually improving, that I already didn’t like using the nipple shield, that I wanted my baby back.  I was so completely exhausted, upset, and confused by that point that I couldn’t find the words to tell her to back off.  I left the room with a bag full of Similac bottle nipples.

And then the pediatrician gave me bad news:  J had already lost over 10% of his birth weight.  I had five days to get his weight up or we would go back into the hospital.  (Unless, of course, there were complications, and then we would go immediately.)  The order was two ounces, every two hours, whatever it took to get it in him.

I went home and cried.  And then pumped, and force fed him, and shook him awake, and repeated.  Pumping took twenty minutes, feeding him took at least an hour.  With cleaning, I had at most thirty minutes in between feedings that I could go to the bathroom, eat, or sleep.  Feedings meant syringes and a tube and a nipple shield and constant efforts keep him awake enough to swallow.  I refused any visitors.  I didn’t shower.  It was a horrendous week.  To say that I was exhausted would be complete understatement.  And through it all, there was a constant paralyzing fear that I was not going to ever be able to breastfeed my baby.

The next trip to the pediatrician ended with a beaming doctor and the declaration that he was “incredibly pleased with this baby!”  J had gained enough that he not only would stay out of the hospital, but I could ease off the schedule.  Yes, I thought, I’ll finally be able to just feed him.  

Well, not quite.  It took another week before tube feedings were out, and another week before he could latch on for more than a minute at a time.  I had so much milk that I had to pump a little every feeding in order to keep from being so engorged that he couldn’t latch at all.  Even after he could manage to latch fairly decently during the day, during the night he was too tired to manage.  He still wanted to feed every two hours, and often because of the latching problems the night feedings lasted for hours at a time.   It was a constant struggle to get him latched and keep him latched, with long stretches of him crying and struggling in between.  The only position I could get him to nurse in was the football hold, which was not in any way comfortable for me.  It seemed my life was consumed with simply trying to feed this child.

But I persisted, and it got easier.  He figured out how to latch on by three months, and night time feedings (although still every two hours) were shorter and much more relaxing.  Eventually he gave up the two hour schedule I had forced upon him (which was a happy day for me).  And somewhere in there I fell completely in love with breastfeeding.  It’s a part of my day that I look forward to, not only for the nourishment that it brings my child but also the relaxation it brings to me.  I wouldn’t trade the quiet moments I’ve spent nursing him for the world.  The one year mark has come and gone, and I have no intention of weaning him any time soon.  I am surprised to say that it is something I will miss terribly when the time comes to end that part of my relationship with my baby.

Looking back, I am incredibly angry at the people who made things harder than they had to be.  If the lactation consultant at the hospital had been kinder or more informative, I would not have had all the problems I did.  If the nurses hadn’t insisted on measuring and cleaning J before handing him to me to breastfeed for the first time, things may have been easier.  And we won’t even go into the consultant at the pediatrician’s office–that was beyond unhelpful, that was a little crazy.  What I needed was a little support, a little compassion, and a little kindness.  Not to mention correct information.  We overcame the hard times in spite of the people who were supposed to help us get started, not because of them.

My story had a happy ending.  What about yours?

basketbaby

my little pot of gold

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The Flipside-When Breastfeeding Doesn’t Work

Guest post by Katie Bowman

Wink

The adorable Miss Suzie

I was born in 1971 and I was raised a family woman; extremely few are the times in my life when I ever considered NOT being a mom. My earliest memories include various nurturing activities with my dolls and stuffed animals, which later translated quite smoothly into a very handy helpfulness when my twin cousins arrived. I was four and a half years old, and they were quite premature fraternal twins, named Kevin and Melanie. The import of this detail here is only this: Because they were so premature, they spent the first 4 weeks of their lives in neo-natal intensive care. It isn’t by any means impossible to breastfeed in that situation, but it is quite hard, and they were so small and weak that by the time the efforts could usefully begin, their mother had nothing to give. In the early-to-mid 1970’s, breastfeeding was still looked at as the less preferable option to bottle-feeding, so no one told her how to keep her production up, or even asked her if she wanted to provide breast milk to be given to her new babies when they could be taken off IV feeding. All parties just naturally assumed that bottle feeding meant formula, and that was the way it went. Hence, I always bottle-fed my dollies and my cousins, and didn’t even learn what breastfeeding was until I was pubescent and learning about human biology. . .I believe I was in 5th or 6th grade.

When I found out what breasts were for, I was fascinated, amazed, and mystified. Why on earth would bottles be employed when they were so unnecessary? And how had I gone so long NOT knowing that human babies can and do get milk from their mothers just the same way all the animals most familiar to me at the time did? Calves, piglets, puppies, kittens, foals, ALL the adorable and fuzzy baby creatures took milk from their mothers till they were big enough to chew solid food. . .and people could do that, too!? But if they could, why had I never seen it happening? If it was in our biology to do this, why was it NOT being done?

My mother didn’t take long to explain the why’s and wherefores, and I don’t think I need to run them down here.  Boil it down to prudishness, body shame, squeamishness, and lack of honest information on the subject. Throw in a hint of selfishness, and give it a side of legitimate biological issues that went unexplained, and that’s what I got in the way of justification for fighting the natural biological imperative that causes human lactation.

Fast forward to 2006.  At last, I was ready to be a mom. My husband and I were blessed quickly, and I had long since made certain decisions. Among them, of course, was the decision to breast feed my child. By this time, I’d had LOADS of friends that took it in their strides as well to breast feed their babies, with only one that had total lack of success. In that woman’s case, her pain tolerances simply weren’t what they needed to be; she was in tears from the sensations of having her baby latched on to her nipples from the start.  I knew I wouldn’t have that problem, so I took it for granted that I’d have more or less smooth sailing.

I gave full-term birth to my 8lb 4oz daughter in mid-September.  .  . and here began my road to tribulation, frustration, exhaustion above and beyond the pale, and ultimate disappointment from my lack of ability to successfully breast feed, despite receiving all possible help and advice.

It all began at the hospital, of course. Textbook smooth-sailing natural birth was quite soon followed by a very promising first attempt to nurse. My daughter plainly had the appetite, and the natural urge to suck. No problem there. On our second attempt, I had observation from my obstetric nurse that reassured me that all looked well and sounded the way it should; all signs pointed to that I’d have all the success that I could hope for. I was feeling great. . .except for the dreadfully uncomfortable hospital bed. For that reason I wanted to go home as soon as my doctors would let me, and since everything checked out fine with dd, I went home the very next day. That was my first mistake, and as I process this presentation, I come to view it as the only one I really made.

By the time I took dd to her first pediatric appointment, three days after we went home, my precious angel had lost almost a pound and was looking decidedly yellow. She’d not had a bowel movement, and it was decided that we needed an ultra-violet light blanket straight away. It was further recommended that I start pumping to get my production up and to supplement with formula, to get her digestive up and running the way it should to process the overload of bilirubin in her blood. I was given small-gauge flexible tubing that I was supposed to use to try to avoid using a bottle, minimizing the nipple confusion, but it didn’t work at all; she was unable to latch on in any way with the tube to contend with, so I had to give in and use a bottle to get my precious thing fed. At each feeding, I’d start and finish with an attempt at the breast, and her latch on seemed to maintain as well as it had ever been. It was about another week before her jaundice cleared, and once her weight was back up to where it should have been, I went back to concentrated efforts to breastfeed exclusively.

In just a few days, I realized something was wrong. Nursing was new to me still and naturally the sensations took some getting used to, but quickly the discomfort increased to pain, and my nipples started showing signs of trauma. I knew it for what it was, and made an appointment with the lactation specialist at the maternity ward where I delivered my girl. I went with high hopes, and was reassured that I was doing everything right. After some observation time, I was told that there were a couple of things that should be kept in mind as I went forward with my attempts to be my daughter’s source of nutrition.

CurlsFirstly, there was my breast structure to consider. As it turns out, I was quite right to have been concerned that my exceedingly large breasts would add to the challenge. Also, while they aren’t inverted per se, my nipples are quite flat in their relaxed state, and do not distend much even at their most aroused. Secondly, there was an unforeseen challenge with my daughter’s oral structure. In the process of working with us, the lactation specialist noted that my daughter’s tongue was “tethered.” This means the little strip of skin that connects the underside of the tongue to the soft palate was not very stretchy and came all the way to the tip of her tongue, making it harder for her to maintain latch-on or even establish latch-on at all. The specialist recommended that I speak to dd’s pediatrician about the matter.

At the very next well-baby check-up, I shared with Dr. Rosenbloom what I’d learned, and what a struggle nursing had become. I don’t know what I’d expected. In fact, I was by that time so rest-deprived that I was all but running on auto-pilot; I don’t think I expected anything. But what I got was more bad news. I was assured that, while the lactation specialist was certainly well-meaning and not precisely wrong in her observation, dd’s tethering was not acute enough to be a significant factor in our problems with nursing. According to Dr. Rosenbloom, if the baby is capable of extending the tip of his tongue past his lower gum line, then that is well enough to establish a latch. Tethering can be remedied, but is only recommended as a last resort for the most extreme cases.  My daughter was not an extreme case, and the idea of cutting on my daughter was not one I found I could entertain. I was assured that, ultimately, the chances that an untethering procedure would help were quite small.

After another week of painful attempts to nurse, full of frustrating and unsuccessful efforts to help dd open her mouth wider to accommodate more breast tissue, only to find her grip slipping nonetheless in mere moments. . .after another week’s worth of accumulating nipple trauma for me and nipple confusion for her. . .after another well-baby visit that weighed her in lighter than the week before rather than heavier. . .having tried everything I was told to try. . .I had to give it up. I was exhausted, scraping by on an average of two and a half hours of sleep per day. My nipples were split and raw, on the verge of bloody. Nipple covers hadn’t helped, nothing had helped. I was realizing that this incomparable bond that was touted as the most important reason for nursing, (after the nutrition factor, of course,) was not happening for us anyway; both of us were too stressed out from trying to make nursing work to receive that bonding benefit. It wracked me emotionally; I felt like a failure. I felt like I was letting us all down. So I made a compromise for as long as I could. I decided bottles wouldn’t have to mean formula, and embarked on a schedule of expressing and bottle-feeding that gave the best of both worlds; my girl got all the breast milk she could handle, and I got the pleasure of feeding her without physical agony.

The challenges in an all breast milk bottle feeding schedule are few, but they are great. Expression takes time, and needs to be done every 3 hours. Cleaning bottles and pump parts takes time. Add in the time it takes to feed the baby, and you’ll see it makes for a full day that doesn’t leave much room for anything else. But the peace of mind that I retained as a result of continuing to give my daughter breast milk was well worth it.

After a couple of weeks, I found that I could improve efficiency a bit by hand expressing rather than using the electric pump; sure, the pump expresses both sides at once, but it doesn’t have as strong a draw, and I had to finish by hand anyway. If I never got the pump out, I didn’t have to clean and sterilize it. I started getting a little more sleep, which was more of a factor than I’d known; as it turns out, if you don’t give your body the rest it needs, your milk production can and probably will drop off. Still, the moments I had that weren’t centered on feeding and production of milk were few, and I still wasn’t getting enough rest to have enough energy for anything else during those moments. For this reason, we made the switch to formula when my daughter was four months old. Another heart-breaker, particularly when the switch brought with it a constipation issue for my girl that persists to this day. . .but she’s also thriving. Off the charts for weight and head circumference, and in the high percentiles for height. She has a wonderfully diverse palate, loves her veggies and fruits, takes a pass on sugary drinks, and is in every way I could have hoped a mommy’s girl.

American GirlOn that last point in particular I was given by my friends little hope. “Girls are daddy’s girls when they can be. When have you ever heard of a momma’s girl?” I thought for sure that, without nursing, I’d be left on the sidelines in favor of daddy by now. HAH! No way, my friends. Even without that “incomparable bonding experience,” . . .I TOTALLY win!