February 9, 2017

A (Not So Successful) Breastfeeding Journey

Forgive me in advance as this is a lengthy post. I didn’t realize how much I had to say, and how traumatic the experience was until I started writing it all down. I share this in hopes that others who experienced the same will realize they are not alone.

I also need and want to give a really big thank you to Shiraz who was there by my side and supported me every single step of the way through this journey, and continues to do so today.

TO BREASTFEED OR NOT, THAT IS THE QUESTION

Prior to getting pregnant I never really gave any thought as to whether babies were fed via breastfeeding or formula. I felt (and still do feel) that how a parent feeds their newborn is not my business. As long as the baby is fed that’s all that matters. For the first few months after that positive pregnancy test I continued to live in ignorance and not think about this subject. However, as the pregnancy progressed and we started prepping his nursery, buying all the adorable baby clothes, and thinking about what else we would need for those first few months of his life, the subject of breastfeeding vs. formula become unavoidable.

Shiraz expressed that he would like me to at least try to breastfeed (because he wanted the baby to receive the immunity that comes with breastmilk) and my mother gave her two cents in the form of “so you are going to breastfeed, right?”.  While I was not enthusiastic about the idea of a baby attached to my breast, being the baby’s only source of food, and the potential difficulties around making it work, I had read all the literature about the positive benefits of breastmilk so I committed to at least trying (plus breastfeeding is the cheaper option). When we checked into the hospital we reaffirmed this intent.

THE FIRST 48 HOURS

Immediately after Kian was born and they had cleaned him up they handed him to me and we did the first latch. While the sensation was weird I wouldn’t describe it as painful or uncomfortable. He ate for only a few minutes and then immediately drifted off to sleep. Over the next 24 hours he spent most of the time sleeping and periodically nursing for that little bit of colostrum. As the day progressed I became more and more uncomfortable with the breastfeeding. He wasn’t staying latched, I couldn’t get the proper positioning/hold, and it started to become painful. I was reassured that this was all normal and that we would eventually find our rhythm. In the meantime, until my milk started coming in, I would need to keep at it as even just letting him suckle would stimulate the milk. Since newborns don’t need much to eat in that first 24 hours we managed to make it through the first 24 hours. And then everything went to hell.

Because babies do nothing but sleep that first 24 hours you get lulled into this false sense of “oh hey this won’t be too hard” (on a side note I highly recommend you don’t let any visitors come that first 24 hours so that you can rest, I wish we had done this). At about 36 hours of life our angelic newborn suddenly woke up and would not stop crying for food. For approximately 9 hours he cluster-fed. He’d nurse for 10-15 minutes, then be ok for 15-30 minutes, and then would start wailing for more. By about the 3rd hour of this my nipples had started to feel dry and chapped. By the 5th hour every time he latched on it would send sharp shooting pains up through my chest that I would have to fight through for the first couple of minutes. By the 7th hour I was at my breaking point and cried, a lot. By the 9th hour I was pretty much going crazy, not able to understand what was going wrong, and wishing the nurses would just take him out of the room for a little while so I could sleep (at that point I think I had only slept 4-5 hours over a 72 hour period, including labor). The nurses reassured me that this was all normal; that most babies have a period of time on the second day where they are ravenous and non-stop feed, that eventually my nipples would become stronger, and that once my milk came in everything would be ok. When the nurse finally took him for his next set of newborn tests I was so relieved that it was finally quiet. When she brought him back (after only 45 minutes or so) I was so exhausted at this point and couldn’t think straight so I had Shiraz take the baby and walk around the ward with him just so I could close my eyes for a little while. At some point while I was half asleep my Dad stopped by and left a cup of coffee for Shiraz and a pint of raspberries for me. I was so grateful that I nearly started to cry.

Right after Kian was born and the first latch.

GOING HOME

Before we left the pediatrician came by to check Kian. Because he had already lost over 10% of his birth weight (7-10% is generally considered normal) and was showing signs of jaundice (not uncommon for newborns) a follow up appointment was scheduled for the next day. When we left the hospital later that morning (around 10:30 am), I was still determined to make breastfeeding work. The first 24 hours at home continued the trend of the previous two days at the hospital, only this time we were in the comfort of our own bed. I sent Shiraz out to get lanolin nipple cream and a nipple shield to help make the experience easier. Armed with those items I continued to try and breastfeed while fighting through the extreme pain. At about 4 am Kian became inconsolable and I finally reached my breaking point and became despondent. The baby cried, clearly wanting food but unable to get enough from me, until we left for the pediatrician at about 8:15 am.


The day we went home. Looking back on this picture it’s so obvious how yellow (jaundiced) he is.

As we were driving to the pediatrician I had a feeling we were going to have to supplement with formula because he wasn’t getting enough and my milk still hadn’t come in. Part of me also wanted to just switch over to formula for good and give up any attempts at breastfeeding. At his appointment the doctor told us he had now dropped over 12% of his weight and he was looking fairly jaundiced. I meekly told him if he thought it was a good idea that we would supplement with formula until my milk came in. He agreed that supplementing was a good idea and gave us some samples. We gave one of the two ounce bottles to Kian right there in his office. He drank it down so quickly, as though he was starving. The minute the food was in his belly he immediately became a different baby. He was content and calm. I wanted to cry with relief. I think Shiraz did too. The doctor also confirmed that Kian had a tongue tie, something that I noticed in the hospital but the nurses didn’t, and that this likely impacted his ability to properly latch (and thus the reason he was wasn’t getting enough food). Before we left he gave us a referral for a ENT that could do a frenectomy (releasing the tongue tie).

SO NOW WHAT?

When we got home we talked about still trying to get my milk to come in and breastfeed. Before the baby was born, knowing that I would eventually be going back to work and would have to pump, we had bought a breast pump. We decided that I would would pump until my milk came in, supplement in the meantime, and then go back to breastfeeding after Kian had his tongue tie released (which did happen that Monday). Within the next 24 hours my milk slowly started to come in and we were able to stop feeding the formula and instead feed breastmilk from a bottle. Worried about my supply I began taking Fenugreek and Milk Thistle (both of which are galactagogues) and continued to pump 7-8 times per day. Over the next week or so we established a good pumping and feeding rhythm in which I would pump and Shiraz or my parents would feed the baby. Kian started rapidly gaining weight, we began getting some decent sleep, my milk supply increased, and peace returned to the house. Kian never ate directly from the breast again.

Eleven weeks later and Kian continues to exclusively consume breastmilk via a bottle. I attempted to breastfeed a couple times after his tongue tie was released but he had ZERO interest in getting his food via the breast (a bottle is so much quicker to him). I also like that other people can feed him when needed so the responsibility does not only fall to me. Additionally after the trauma my nipples suffered I am extremely hesitant to go through that kind of pain again (which would be necessary to reestablish a good nursing rhythm and latch post tongue tie).

I AM A DAIRY FARM

While it was a slow start I have been extremely lucky that my supply has been fantastic; in fact it is so good that so far I have been able to freeze over 1000 ounces (I pump 45-50 ounces a day and the baby only eats 24-30 per day). Basically I am a dairy farm (I use these for storage and freezing). As I was establishing my supply I was pumping 7-8 times before dropping it to 5 times a day for the last month. The last few days I recently started cutting out the middle of the night pumping and one pumping in the middle of the work day so I am now pumping three times a day (about every 8 hours, my max time between pumping for it to not feel painful). Despite only pumping three times a day I am still generating 45-50 ounces in a 24 hour period (about 15-17 ounces each time I pump for 20 minutes). I will likely continue to pump until he starts eating solids at which time I will slowly start decreasing the volume I produce and use the frozen breastmilk (for which we had to buy a small chest freezer after filling up TWO freezers in our current refrigerators). By the time he hits one year old I hope to have weaned from pumping completely, though we will likely still have leftover frozen breastmilk which we will continue to feed him until it runs out.

A couple days worth of “excess” pumped milk.

WOULD I DO IT AGAIN?

There were likely many things that led to the inability to breastfeed. It certainly didn’t help that even before he was born I wasn’t enthusiastic about the experience and that I had gotten it in my head that it was going to be difficult. Additionally the nurse that was responsible for us the night that Kian decided to cluster-feed (and when I was the most vulnerable and desperately needed guidance and assistance) was less than helpful and actually scolded me at one point for not holding him properly while attempting to feed. And then of course there was Kian’s tongue tie that prevented him from properly latching, thus causing me excruciating pain, and the fact that my milk took a full 4-5 days after giving birth to come in (this is normal for a first child, but combined with the above made it very difficult). By the time all of the above had resolved it had already been one week since his birth, he was used to a bottle, and I was irreversibly emotionally scarred.

If we were to have another child I am honestly not sure if I would even attempt to breastfeed. It’s likely that I would do the first latch immediately birth and then exclusively pump from there on out. Even though Kian is not fed directly via the breast he still receives breastmilk, and we still have a strong bond (we did a lot of skin to skin those first few weeks). However, if I were to get over my fears and give it a try there are many things I would do a lot differently. Before giving birth I would take a breastfeeding class (I did not do so this time), I would inform the hospital of my unease and inability to successfully breastfeed the first time, I would reach out to La Leche League for assistance and guidance, I would immediately have them check the baby for a tongue tie after birth, and I would ask for formula in the hospital if I am not able to provide enough and the baby is starving. But even if I did all this and the baby and I were unable to successfully breastfeed I would have ZERO qualms or guilt about pumping or even formula feeding.

SO WHAT ADVICE WOULD I GIVE?

Don’t be afraid to ask for help; whether that is help from the hospital staff, your significant other, your parents, or another group or individual. If something doesn’t feel right (physically or emotionally) say so immediately. If you need a break so you can get a couple hours of sleep while still in the hospital ask someone to wheel the baby around the birth center or have them take them to the nursery so you can get some peace. If you feel like your baby isn’t getting enough food and you are ok with it, ask them to provide a little bit of formula (many hospitals won’t offer, you have to explicitly ask). Formula won’t hurt your baby, but being extremely stressed can ultimately impact your supply and make breastfeeding less likely to be successful. Don’t every let anyone judge you for the decisions you make about how to feed your child; not the doctors, your family, your friends, or even yourself. And whatever you do, try not to feel guilty if you aren’t able to make breastfeeding, or exclusively pumping, work for you. At the end of the day, no matter what all the articles and studies say, FED IS BEST.

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