Breastfeeding Part III

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.

Breastfeeding Part II

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.  

next:
Breastfeeding Part III

Breastfeeding Part I

As I held my baby for the first time, I couldn't take my eyes off of him.  The feeling was surreal to say the least.  Once in the recovery room, my mom encouraged me to breastfeed him.  I had no idea of what I was doing and wasn't sure if we were doing it right, but I was thrilled that we were doing it!  


It kind of went downhill from there.  When I was pregnant, I knew that I would breastfeed, but I really didn't know how difficult it could be.  I though that the baby would just know what to do and that would be it.  I realized very quickly that that was not the case for me and my little Monkey.  


During my five day stay at the hospital I saw the lactation consultants every day.  I was also given advice by several nurses who I assumed knew as much as the IBCLCs.  I now know that much of their advice, while well-meaning, did more harm than good.  I was getting so much conflicting advice from so many different people and I didn't know which I should follow.  


On the evening of the third day, a nursery nurse came in and told me and Hubby that Monkey had lost 8.5% of his birth weight and needed to be supplemented with formula since my milk had not yet come in.  I had heard of hospitals pushing formula when it wasn't necessary, and I knew that colostrum was enough for my baby, so I said "NO," and said that I wanted to speak with the pediatrician who was recommending it.  The nurse left and I called my mom in tears.  She went to La Leche League's website and found that 8.5% weight loss was normal and not a cause for concern.  She told me that what they were doing wasn't right and that I had the right to refuse the formula supplementation. 


The nurse came back a short time later with the pediatrician.  He told us that 8.5% was too much weight loss and that we really should "let him have some formula."  He went on to assure me that a little formula would not mean the end of breastfeeding and made it sound like I was starving my baby.  Hubby was worried and told me that I needed to listen to the doctor, but I held my ground.  Through my tears, I said "no" again.  I was scared though.  Was the pediatrician right?  Was I starving him?  


The pediatrician was clearly annoyed that I had not agreed and he said that we could wait till the morning, but if my milk wasn't in by then, we'd have to supplement.  He left and another nurse came in with a pump.  She was very kind and she told me not to worry as she showed me how to use the pump.  I pumped all night and we finger-fed Monkey the colostrum with a syringe.  Sometime in the wee hours of the morning, my milk came in!  Hubby and I were both so relieved, and I thought for sure that the hardest part was over.  


next:
Breastfeeding Part II

Baby!

Well, it was a good thing that we were ready because a few short hours later I woke up with cramps unlike anything I had ever felt before.  I went to the bathroom and felt my mucous plug fall out.  I was surprised and frightened by the amount of blood, so I woke my husband and then called the doctor.  The operator told me that Dr. wallace was on call and she would call me right back.  

Who the hell is Dr. Wallace?!? 

Throughout my pregnancy, I had met with each of the OBs in the practice at least once so that I would be comfortable with whoever happened to be on call when I went into labor, but I had never even heard of Dr. Wallace.  Panic set in.  A few minutes later Dr. Wallace called me back and, after going over my history, told me to come in.  

My husband put my overnight bags in the car and we set off for the hospital.  I was nervous and excited and terrified - I was about to have a baby!
I was 2cm dilated when I arrived at the hospital and 3cm a half an hour later. Dr. Wallace did a sonogram which, of course, revealed that baby was still breach and would have to be born by a c-section.  Even though this was hardly news, it was starting to feel very real and I was starting to feel scared.  Dr. Wallace was really nice, but she wasn't my doctor and I wanted my doctor.  
I had been waiting to call my parents because I didn't want to wake them earlier than necessary, but around 5am I couldn't wait any longer.  Everything was happening so fast, I was afraid that they might not make it in time if I waited too long.  My husband also called his parents.  His mother, who is an anesthesiologist, told him to make sure we insisted on having an anesthesiologist (rather than a nurse anesthetist) do my spinal.  We told Dr. Wallace and she said that we would have to wait for the anesthesiologist.  To be honest, this was a bit of a relief to me.  I was pretty scared and wanted things to slow down a bit.  It turned out that this decision to wait meant that my doctor would be there to do the section - another sigh of relief for me!
Despite all of this relief, by about 8am, I was shaking uncontrollably with fear.  As they walked me into the O.R., the nurses kept offering me blankets because they thought I was shivering from being cold.  I kept telling them that I was really scared.  They were nice, but they didn't help me to feel any better.  
It seemed to take forever for the anesthesiologist to insert the spinal. At one point, a sharp pain ran down my left leg and I cried out.  He assured me that this was normal, but it just made me more afraid.   I was just as scared of this part as I was of the actual operation.  Finally, it was finished and they helped me to lay down.  I was still shaking as they pinned a sheet up below my chin and I asked when my husband could come in.  I was told he would be there soon.  I glanced at the blood pressure monitor and saw that my pressure was soaring at  210/105.  
The anesthesiologist, but something on my chest and asked me if it felt cold.  I told him that it did.  Then he did the same on my stomach.  He continued to do this until I said that it didn't feel cold on my stomach.  I didn't like that I could feel it at all on my stomach because I thought that this would mean that I would feel the scalpel. I was hoping to be more numb than that.  At some point, it became clear to the anesthesiologist that I was terrified.  He told me that most women would be excited and that I was breaking his heart.  He asked me if I would like something to help me relax and I said yes.  He explained to me that it might affect my "memory of the event."  I told him that I didn't care.  I still don't know what it was that he gave me, but it definitely did the trick, and I remember "the event" just fine.  

Finally, my husband came in and they gave him a seat near my head.  He knew that I was scared and did his best to talk to me to keep my mind off of what was happening.  It wasn't long before I heard a commotion and my husband said that he could see the baby.  The doctor held him up above the sheet, but I couldn't see him.  My husband took a couple of pictures for me.  
I asked why he wasn't crying, but almost as soon as I had asked, I heard him cry.  It was not the moment that I thought it would be.  It felt like someone else's baby was crying, not mine.  
Someone asked my husband if he would like to cut the cord and he walked away out of my view.  Unable to move, I desperately waited for him to come back.  When he returned, I saw my baby for the first time.  He was an amazing sight, but still did not feel like my baby.  I was very aware of this disconnect and hoped that it would go away when I got to hold him. 
It seemed to take forever for the doctors to finish closing me up and I did my best not to listen to what was happening below that sheet.  The anesthesiologist took a few pictures of the three of us together.  Finally, they lifted me onto a bed and, just before they wheeled me out, they handed me my baby.  
  

next:
Breastfeeding Part I

Complications

The first two trimesters of my pregnancy were fairly uneventful. All of my check-ups went well and my greatest concern was finding maternity clothes that didn't make me look like a whale. Around 32 weeks, during a sonogram to check my amniotic fluid level, I learned that my baby hadn’t turned yet. My doctor assured me that some babies turn later and that I shouldn’t be concerned. Of course, I had to look it up when I got home and I was relieved to read, “Twenty five percent of fetuses are in the breech position at 32 weeks gestation; this drops to three percent at term.” (Wikipedia) Three percent? No problem! This baby was going to turn himself around.


As the weeks went on, I continued to feel those little feet kicking my bladder instead of my ribs, but I knew that there was no way we would be a part of that tiny three percent. In my childbirth classes, we spent 5 weeks learning about vaginal births and one week was dedicated to c-sections. I was sure that I was going to have a vaginal birth, and although I was pretty sure I wanted an epidural, I practiced my breathing techniques. I was nervous, but excited.


Around 36 weeks, I was ready to be done with being pregnant. The record-breaking heat and humidity in Washington DC was like my own personal hell. Family and friends talked about how hot it was, but they had no idea what it was like to work in a building with no central air while 8 months pregnant. People kept asking me how I was feeling and telling me “how awful it must be to be pregnant in this heat!” I smiled as sweetly as I could, but secretly hated everyone around me who wasn’t miserable. My feet and ankles swelled up to capacity and even my oversized Crocs were so tight they left imprints all over my feet.


The day after my last childbirth class, I went in for a routine check-up and my doctor was immediately concerned about my blood pressure. When she told me that I would need to go straight to the hospital, the blood drained from my face. I felt sick as she told me that I might have to have the baby that night and I tried to hold back the tears as she explained to me the dangers of preeclampsia.


I had only been to the hospital once before and I couldn’t remember how to get there. I called my husband sobbing and he gave me the address to enter into the GPS. He assured me that he would meet me there just as soon as he could but, unfortunately, he was at least an hour and a half away in rush hour traffic, so I called my mom and asked her to meet me there as well. As I drove to the hospital, I kept thinking about how I hadn’t packed my bags and the car seat wasn’t installed. I wasn't ready and I was scared.


Upon arrival at the hospital, I peed in a cup and had blood drawn. The nurses hooked me up to machines that monitored my blood pressure, contractions, and the baby’s heart rate. After a sonogram showed that the baby was still breech, the doctor explained that if we had to deliver that night, I would have to have a c-section. I looked around the room and saw posters showing the difference in a baby’s brain size from 36 to 40 weeks. Was that supposed to help me relax? How could they expect my blood pressure to go back to normal now?


After several hours, I was surprised and relieved to hear that the test results were normal, my blood pressure had gone down enough, and they were going to send me home on modified bed rest. As my husband drove me home, I felt so grateful to have more time to prepare for my baby.


About a week later, another sonogram confirmed that this baby had still not turned and my doctor told me that, at this point, he probably wouldn’t. My heart sank as I realized that I was, in fact, going to have a c-section. We scheduled it for the following Thursday.


That weekend my husband and I finished getting the house and ourselves ready for our baby’s arrival. As I got into bed on Sunday night, I felt a wave of calm wash over me. We were ready!


next:
Baby!

This Moment

This Moment as inspired by The Leaky B@@b

So, I'm blogging now

In August 2010, Monkey was born and our breastfeeding journey began.  Throughout our ups and downs, I spent a lot of time learning about breastfeeding everywhere I could: I met with lactation consultants - lots of them.  I attended La Leche League meetings.  I read all of the breastfeeding books, blogs, and websites I could find.  I began talking to other breastfeeding mothers, some in person, and many online.  Each of these resources contributed to our breastfeeding success story in some way.  When his latch was so painful that I cried, when I was worried that I wasn't making enough milk, when he screamed and pulled away from the breast, when I felt like I was developing a stronger bond with my pump than with my baby, I found comfort in knowing that I was not alone.


So, I'm blogging now.  I'm not really sure exactly what direction this blog will take, but I want to share my story with other mamas out there.