Over the next four weeks, I continued to meet with three lactation consultants: Ann, Kathleen, and Patty. We tried nursing in different positions to see what would work best. We went back and forth with using the nipple shield - sometimes it worked well, other times it hurt like hell. It always seemed like he latched well when a lactation consultant was watching but then when I was alone, we just couldn't get it together.
My mom and Hubby were both very supportive and did what they could to help, but I still felt really alone. I felt like no one really understood why this was so important to me and I couldn't explain it if I tried. Most people told me that I had tried hard enough and it was time to give up. After all, their kids had had formula and were "just fine."
Monkey's latch steadily improved, but he often got fussy at the breast, especially in the evenings. Okay, he was more than fussy. He would latch on for a couple of minutes and then clamp down and pull back while flailing his arms and legs and finally (after I unlatched him) screaming his lungs out. The LCs couldn't decide if the milk flow was too fast or too slow and the pediatrician was sure it was reflux.
At six weeks, we finally turned a corner. At the breastfeeding drop-in at the hospital, he had been transferring more and more milk each week and this time, Patty said she thought I was ready to drop the bottles. She told me to try just nursing him for the next two days and to come back in for a weigh-in in 48 hours. I was so happy! I called Hubby on my way home and told him. He seemed a little bit apprehensive about trying exclusive breastfeeding again after what had happened before. For the rest of the day, we nursed as much as Monkey wanted. That night we went to my first La Leche League meeting and I told my story. I was so excited that I was able to finish the story by saying we were getting rid of the bottles.
But then something awful happened. As I was nursing Monkey towards the end of the LLL meeting, my nipple began to hurt. One of the leaders came over to help me, but when she looked she said his latch looked pretty good. I figured that maybe it was just from nursing more that day than I was used to, but as the night went on the pain just got worse and worse. Around 4am I was in tears as Monkey nursed happily. Hubby finally told me to stop and gave him a bottle while I pumped, but even the pumping hurt. I suffered through the pain as much as I could the next day, only giving Monkey one more bottle.
I was nervous about his weight and couldn't wait until Thursday, so on Wednesday I called Ann (one of the LCs who had been helping me) and she came over with her scale to weigh him. He had not lost any weight, so I was relieved - but I was still in pain. I continued to breastfeed through the excruciating pain for the next twenty four hours. Finally, Thursday rolled around and Monkey and I went to see Patty. I was elated to see that he had gained two ounces! Patty was excited too, but she was concerned when I told her about the nipple pain. I sat down to nurse him so that she could see his latch and she said it was perfect. On the verge of tears, I told her that it felt like he had razorblades in his mouth.
"You just said the magic words!" She explained that the pain I was describing was classic yeast/thrush and told me to get a prescription for "triple-nipple-cream" (also known as APNO). I called my OB immediately and had the ointment about an hour later. Within a few hours, I began to feel relief and by the next day I was breastfeeding pain-free.
Monkey is now 22 weeks old and has been exclusively breastfed since he was 7 weeks old. We still go to the breastfeeding drop-in to see Patty and to help other nursing moms who are struggling.
Tuesday, December 7, 2010
For the next couple of weeks, we worked hard to nurse every two hours, day and night. It hurt a little bit, but it was not that bad so I wasn't worried. I figured I just needed to get used to it.
At the beginning of the third week, things started to get bad. My nipples were bruised and so very sore. Something had drastically changed, but I couldn't figure out what it was. One desperate night, Hubby and I wound up supplementing with the milk that I had pumped in the hospital. We used a tiny 5cc syringe because I was sure that using a bottle would forever doom our breastfeeding relationship. I met with two lactation consultants that week, one at the hospital and one who came to my home. They were both helpful, and a before and after weighing showed that Monkey transferred about an ounce, but the pain continued.
That Saturday, my husband had to go to a party with his parents and my mom was having dinner with friends, leaving me alone with Monkey for the first time ever. A few minutes after Hubby left, Monkey started crying and didn't stop. I tried everything I could think of, but (other than one short 30 minute nap) the crying continued. About four hours later, after several tearful phone calls, my mom came over to help me. We determined that Monkey did not have a fever, but still I couldn't soothe him.
I called the pediatrician on-call, and she went over a list of things for me to check to figure out why he was crying. She finally told me to drive him around for twenty minutes and, if that didn't work, to take him to the emergency room. We tried the driving and it didn't work, so we took him to the hospital. They weighed him and ran a bunch of blood tests and then they told me that he was malnourished and dehydrated. Needless to say, I was crushed (and then I was the one crying for hours). At 5lbs 15oz, he was 3 ounces below his birth weight and his bilirubin levels were 13.5 (which I later found out was not as high as the doctor had suggested, but still not great).
The ER doctor said that we had to supplement Monkey with formula, which I had never wanted to do. As I watched Hubby feed him that bottle of formula, I thought about his "virgin gut" and how we were ruining it. It broke my heart that we were no longer exclusively breastfeeding. I had heard the stories and I knew that supplementing with formula could destroy our chances for successful breastfeeding. They almost admitted Monkey into the hospital that night, but, after talking to our pediatrician, they finally decided to let us take him home. They gave us strict instructions for feeding him: every two hours, breastfeed for no more than twenty minutes (so that he wouldn't "waste" too much energy on it) and then give him pumped breast-milk and then formula.
Monkey sleeping with Hubby after returning from the hospital
That Monday, we took him to see his pediatrician. He weighed 6lbs 5oz, so he was finally over his birth weight (by 3oz) at three weeks old. The pediatrician agreed with what the ER doctor had said and wanted us to continue supplementing. I asked him if I could just give pumped milk and eliminate the formula, but he said that we should continue with the formula in case my breast-milk "didn't have enough calories."
The day after meeting with the pediatrician, I went back to the hospital to meet with Kathleen, one of the lactation consultants who had helped me after my delivery. She did a before and after weighing and told me that Monkey was doing non-nutritive sucking and only transferred about a tablespoon of milk. We discussed the possibility of a posterior tongue-tie and I made an appointment to meet with an oral surgeon. Kathleen also watched him drinking from the bottle and was concerned with how much time it took him to finish it. She recommended using different bottles to minimize nipple confusion since his latch had gotten worse and she gave me a new nipple shield to use.
I left feeling so discouraged. I couldn't tell when Monkey was getting milk and when he was doing non-nutritive sucking. Feeding him had turned into a nightmare. The entire process took at least an hour and between the nursing and the pumping, my nipples were in bad shape. I was pumping as much as I could after every feeding to maintain my supply and I was beginning to feel like I was developing a closer relationship with my pump than with my baby. This just wasn't the breastfeeding experience that I wanted. I hated seeing him drinking from a bottle, but I hated even more to think that I had been starving him before! I really wanted to go back to exclusive breastfeeding, but it seemed that I was unable to adequately nourish him that way.
I felt broken.
Breastfeeding Part III