Saturday, January 14, 2012

Breastfeeding: The Road So Far

Warning: This post is extremely long.

Early in pregnancy, I was asked if I was planning on breastfeeding, or formula feeding. I assumed I would do both at the time, having no concept of exclusive breastfeeding, and it's benefits. Honestly, I had no idea it was even possible. I had never known anybody to exclusively breastfeed.
Then I began reading forums, articles, blogs... And I realized that breastfeeding was important to me. I hoped I wouldn't be one of the few who was unable to breastfeed exclusively, or at all.

Then, when my niece was born, 6 months before I was due, I decided to take a frozen homemade three-cheese lasagna over to my brother and his girlfriend. His girlfriend's mom was staying with them, and cooking for them at the time, but she would soon go home, and I knew my brother didn't cook.
Eddie and I are close with my brother and his girlfriend. There are a lot of things that we about, and we have a lot of common interests.
So we took the lasagna over, and spent some time with them and their new baby, Lily. They lived about an hour from us, so we decidedly made the most of the trip.
Toward the end of the evening, my brother's future mother-in-law asked if I was planning on breastfeeding.
"Yeah, if I can," was my response. I mean, how could I know at 3 months pregnant if it was going to work out? Everybody told me that I couldn't possibly know. I had even read that people shouldn't buy a pump before they form a good breastfeeding relationship post partum and are positive that it's going to work out.
"Everyone can breastfeed," was her response. Um, I'm sorry, but no. I didn't voice my strongly opposite opinion at the time, but I sure thought it. Most women can breastfeed. Some with problems, some with none. But there are also people who can't breastfeed, at all.
I took a class on breastfeeding through WIC, and didn't learn much - I had already read it all. But I did get to meet their lactation consultant. I liked her, and hoped I wouldn't need her much as she said due to budget constraints, she was only allowed one home visit now.

Fast forward 6 months to December. I had decided that I would breastfeed no matter what. I had been leaking colostrum for months already (in the future, I will find a way to store the leaked colostrum), and had no doubt that my milk would come in.
Evan was born, and already things weren't going as planned. He wasn't placed on my stomach immediately, and they instead took him off to the table to do the APGAR. I was confused, but exhausted so it didn't really hit me right away, except as disappointment. I wondered when I would get my baby back, figuring that it would only be a matter of moments. I hadn't even caught a glimpse of him yet, as he was taken that quickly, and I didn't have my glasses on so I couldn't see across the room.
I have no idea how long it was, but I was told that they were going to take him to the "Special Care Nursery" (read: NICU) to monitor his breathing. Something was wrong. I asked if I could see him, and they said of course (although I have a feeling I wouldn't have had a chance if I didn't ask). They held him just barely in my reach, and I touched his face before they took him away. I was told he would only be gone for an hour.
I told Eddie to go with them, and I texted my mom in the waiting room saying that they were taking him for an hour, and then I wanted a little bit of time with him before she, my brother and his girlfriend could come back and meet him.
I was in and out of sleep for that hour, waking multiple times to find myself alone in the room. It was these moments that it hit me what had happened, but I was honestly too tired to care much at the time. At one point, a friendly nurse from the NICU came in and asked if I wanted my husband with me, or in the NICU because he wasn't sure. I told her to tell him to stay. Somebody had to be with our son, and I was sleeping anyway.
The hour came and went, and my son wasn't back. I had read that those first moments, and that first hour, were crucial when it came to breastfeeding. Multiple times nurses would come to check something in the room, and when they first came in, I hoped they were bringing Evan to me. They weren't.
Then the same NICU nurse that had come to ask if Eddie should stay came back, and she wasn't alone. Evan was handed to me, and she helped direct me in how to begin breastfeeding. It was easy and natural. She made a comment about how I had more grace than some mothers who had done it before. We were given a few minutes, and then told that they were going to take him back while I moved out of the birthing room. I was assured that it would only be an hour tops, and also Eddie couldn't go with them because of something going on in the NICU.
We went to our new room, where I discovered that my phone had died. It was late now, and I couldn't update my family in the waiting room. Not long after settling into the new, much comfier bed (at the time it seemed that way), my mother found her way back to us. She wasn't supposed to be there, but a nurse allowed an exception. I asked how long she could stay, and was told about 20 minutes. I asked if she would see the baby, and the nurse said she could wait for the baby to be brought back, but she wouldn't get long.
We waited, and waited. Meanwhile my brother and his girlfriend had already left because they had a long day. It had definitely been over an hour, again. Frustrated, my mom took Eddie out to get food, and check on our pets. I filled out paperwork, until finally around 3am, Evan was brought back to me. At this point, we had been separated so much. My plan to never let him wear a disposable diaper had already been foiled.
I attempted breastfeeding, and I held him. I didn't feel right. There was no sudden click, I didn't feel that wave of love and completion that most people claimed. There was no attachment. Just a desire to sleep, and wishing that my mom would bring Eddie back already. But, my phone was dead.
They were gone for what seemed like forever. And I didn't know what I was doing. I knew that he should eat every 2-3 hours, but that was it. So that night, we slept. All three of us. And five hours later, I woke up to a nurse coming to take Evan for some tests. I was panicked. "But I haven't fed him, I slept 5 hours straight!" They acted like it was no big deal and took him for his tests. An hour later, he was brought back, and another nurse came to check me. Later that day, I was given a sheet to fill out with the times he ate, along with a diaper count. They wanted me to rate how well he fed, but I had no idea how to do that either, so I guessed.
Later that day, a nurse told me that if he didn't eat well soon, we would have to supplement. Say what? No, I knew it took awhile for milk to come in. But they were worried he wasn't even getting colostrum.
Another nurse said I could just hand-express and we could spoonfeed or something so that we saw how much he was getting. She clearly "got" breastfeeding moreso than the other nurse who jumped to formula.
My mom thought I was being hysterical about it all.
The best part was that it was Sunday, and apparently there is no lactation consultant on Sunday. And I was being discharged Monday.
Monday came around, I avoided having to supplement by getting one "good" feeding in (actually courtesy of the soothie pacifier - it helped him get a stronger suck). A lactation consultant came by, but she couldn't stay long. She promised she would  come back, but must have gotten tied up because she didn't come back before we were discharged. Meanwhile, we almost didn't get to take Evan home because his jaundice (usually normal in newborns) was still getting worse. Instead, they let us take him home, but we had to bring him back the next day to get checked.
When we came home from the hospital, I sat down on the couch with Evan and fed him. I would doze off, feed him, doze off... I was there until bed time, and then I realized he wouldn't sleep without me. He slept fine at the hospital though. So I ended up in the nursery rocker all night, at first crying because I had no idea what I was doing, then sleeping, nursing, sleeping... Until finally he stopped nursing. Evan was screaming, and would wake up, scream, half-nurse, sleep, repeat. In the morning, we took him to get his biliruben levels checked, and they were 16. Still getting worse. The nurse said that we shouldn't have been able to take him home until they were improving. Insert worry. Evan slept so well while we were there, probably exhausted from all that screaming at home!
They ordered us a bili-blanket, and said that we would need to supplement for now. I asked if that could be why he was so horribly fussy and inconsolable all morning, and they said probably. At that moment, I didn't mind that they were going to give him formula. I just wanted my baby to be happy, and healthy.
After that bottle, he wouldn't latch at all. So I called the WIC lactation consultant that I had met a couple months previously. She was going on vacation for the holidays, but could come see how things were going before she left. That would be my one home visit, which I desperately needed. I was losing confidence with breastfeeding every time I tried, and every time Evan screamed, fought, and rejected me. Formula was just so easy, and tempting. But, luckily I had begun pumping with my "occasional use" electric pump. It was a cheap Evenflo pump, but it worked. It took a lot of work, but I started to get 1 ounce per feeding for him, while he was taking 2 ounces.
So I had her come Thursday before she left, and when she came, I could get him to latch - for about two seconds. She said that it looked like a decent latch, but he was just impatient for letdown. Denise, the lactation consultant, referred me to one of the hospital lactation consultants, Julia. She said they sell some things that could help - one of which was a supplemental system that would allow him to drink his needed formula from the breast. Denise also wondered why they bottle-fed Evan, knowing that I was breastfeeding. She said they should have used a syringe or something, and that I could ask about that as well.
I regained some of that confidence.

We went to the hospital for his bili-check, again. While they tested his blood, we got to meet with a lactation consultant - Julia. She had us attempt to feed him at the breast, and she pointed out that he wasn't latching correctly. His tongue was going to the roof of his mouth while he was latching. No matter what I did, it wasn't working, and so we couldn't have the supplemental system. She tried a nipple shield, and it still didn't help. Finally, she tried the Haberman bottle. It required a good latch to work, and thus would "teach" him to latch correctly. So we bought it for $24. She also had me pump with the hospital pump. I got 1 ounce from both sides, which is what I got at home too, just it didn't take as long with the Medela.
I left with a follow-up appointment for the next week.
Within a couple days, one of our cats found the Haberman bottle, and tore the nipple up. I ordered a replacement from Amazon (which wasn't cheap), and was forced to give him normal bottles until then. I worried that it would set him back. Meanwhile, I stopped having the heart to attempt breastfeeding him directly. He acted like it was torture, and I just couldn't do it. I also wasn't good about pumping religiously. I noticed in the following days that my pump wasn't sounding quite right, but it still worked, so I still used it.
Meanwhile, I was told we didn't have to supplement once he was back to birth weight because his jaundice was improving.
Two days before our follow-up appointment with the lactation consultant, I tried breastfeeding and he suddenly latched. It finally clicked. And then we had a weight check. He was up to 8lbs 10oz. Evan surpassed his birth weight, and I said goodbye to the formula.

A few weeks went by, and I thought that everything was going well. Evan was having more and more awake time. He would look around, even smile at me and Eddie. I thought it was normal for him to want to nurse almost all the time.
We went to his one month weight check this past Thursday (Jan. 12th), and he was 8lb 15oz. It had been 20 days since his last weight check, and he only gained 5oz. If he was gaining the minimum healthy amount (1/2 oz per day) then he would have gained 10oz, but he didn't even meet that. The nurse told us that we would have to supplement every 3 hours with formula. I asked how much, and she said 2-3 ounces. I asked if we had to do it at night and she responded, "If he's hungry."
I left that appointment pissed. I had gone through so much, and he seemed fine! Why should I have to supplement, again?!? At least he was, in fact, gaining weight. Plus, there are other factors. He hadn't been pooping regularly at his first weight check, for one. For two, I knew for a fact he had grown. I clothe him, I put diapers on him... he's bigger. He smiles. He's attentive.

When we got home, I first posted a complaint on a facebook group that I'm a part of. They validated my opinion, and assured me to wait until I talk to my lactation consultant, because supplementing formula would hurt my supply.
Then I posted on the wall for my local chapter of Eats on Feets, a mother-to-mother milksharing group. Then I began reading about what a breastfed baby should be gaining. He definitely wasn't gaining enough. Meanwhile, I kept track of how often he was eating. 5:40-6:15. Then again at 6:55. Then again around an hour later. Every hour? No wonder I was going crazy, I thought this was normal! I left a voicemail for my lactation consultant from WIC and went on with my night.
We gave him one bottle of formula that night, and I pumped, reassuring myself that it was only temporary.
He slept better than usual that night, and by the morning, I had a message on facebook. A stay-at-home mother of three wanted to donate to us.

The lactation consultant hasn't called back, but she should after the weekend. Melissa, the donor mom, and I have spoken on facebook and on the phone. She's also given me advice to help get my supply up. We're going to get together in the spring.
And of course, my mother was disapproving at first, but she got over it. Now, my brother's girlfriend is voicing her opinion as well. But you know what? I'm happy with this situation, finally.
I'm finally comfortable supplementing. I know that it's not forever, and I finally have support, something that I've been lacking until now.

Eddie and I are happy in our decision to receive donor milk, and that's all that matters.

Next time around, I will save leaky colostrum from pregnancy. I will pump from day one (which I was advised not to do by a nurse at the hospital). I will set an alarm those first nights in the hospital. And hopefully, things will go better. Hopefully, I'll be the one with milk to spare.

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