Adventures in Breastfeeding (The First Chapter)

Here are some things I have learned so far in my journey:

• Drops of Breastmilk spot your clothes
• Lanolin can leak through your bra and onto your favorite T-Shirt
• Lanolin is tough to get out of clothes
• Breastmilk is a lot stickier than you would imagine it would be
• My breasts might actually see more action/be felt up more during breastfeeding than my hoo-ha did during our infertility treatments
• 15 ML is not as much as you would THINK it is
• Not all Lactation Consultants are created equally, nor are their suggestions
• There is such a thing as information overload
• The sound of a woman pumping breastmilk sounds JUST like a dairy
• Nipple shields will not hold up to doggie teeth, nor are they chew toys
• There is a substance called Magic Nipple Cream, and it is Magic
• I have a lot more determination to breastfeed than I realized

 

 

I had my heart set on breastfeeding Carder.  I knew that this might be a rough road since I had a reduction in 1999.  I had planned to research BFAR a bit more prior to his birth, but my plan was foiled by his early arrival.  My vision of how this would be though?  Perfection.  After a vaginal delivery that would go super smoothly, the sweet babe would be laid on my bare chest and we would commence breastfeeding and bonding.

The reality was much different.  After the C-section, recovery room time, and a brief visit to the NICU, I returned to my hospital room, crossed my fingers, and pumped.  I was totally psyched to see that I had pumped 5ML of colostrum.  At the suggestion of the Lactation Consultant (LC), I set my alarm and I pumped 4 hours later at 4 am.  And then again at 8am...etc,  My first 4 pumpings were all at 5 ML.  And then my production began to drop.  My lowest pumping was a measly 1ML.  I began to worry that my milk wasn't going to come in.  (Read:  hormonally cried hysterically because this was the only thing I could do for my baby - as we had yet to figure out how to actually hold our baby and weren't allowed to change or feed him yet -  and I was failing miserably).  After watching a video online and another visit from the LC later and Derek started helping to massage my breasts while I pumped.  The amount pumped increased  to 6ML.  I learned how to massage and pump at the same time - and due to this, I was single pumping.

 

We had found out that our insurance would only cover the rental fee for a hospital grade pump if mother and child were separated due to illness (which we would qualify for).  However, after debating on the best course of action, we determined we would be buying a pump anyway, so we purchased a pump for me to use at home.  We ended up going with the Medela Pump In Style Advanced.

 

The LC suggested that once I was released from the hospital that I should stop waking to pump and should get as much rest as possible during the night hours, so I took her advice.

 

On day 4, my milk began to come in.  On Day 5, I had a pumping that was equivalent to one of Carder's feedings.  I was so psyched that I had to take a picture to share with you all.  At the time, he was eating about 40 ML each feeding.

Got Milk?

 

Now, I felt excellent about my supply - UNTIL - Derek made some pancakes and informed me that 15ML was actually just 1 Tablespoon.  So, what you see above?  Just over 2 Tablespoons.  Or, just about the amount of oil it takes to make pancakes.  Yeah, I know.  Kind of takes the excitement out of it, don't you think?

Over the next several days, my milk supply gradually increased.  Since I was skipping the night time pumpings to rest, I was never fully ahead of his eating schedule at the NICU, but he was getting very little formula.

 

Now, you may ask if we attempted breastfeeding while he was in the NICU.  The answer to this is that we did.  However, this caused me HUGE amounts of stress.  What you may not realize about the NICU is that they have a goal of a specific ML amount based on the weight of the baby for each feeding.  When we attempted to breastfeed, certain nurses would give him credit for his attempt at feeding and wouldn't expect for him to eat his entire bottle in addition to his time at breast.  Others would expect for him to eat the whole thing and would use the gravage tube for any that he didn't eat.  Since him finishing his feedings without the tube was a prerequisite to his release from the hospital, I felt very unnerved every time we attempted to put him to breast at the hospital.

 

There were 4 LCs on staff at the hospital.  Each one of them had a different suggestion on how to transition him to breast.  One LC gave me a book on Breastfeeding after a Reduction to read.  One LC had suggested that I check out these Stanford Breastfeeding Videos and I found some great information there to increase my milk supply.  I began massaging during the pumping AND manually expressing milk after I thought I was done and then pumped some more.  And as I read the book, I picked up a few other tricks.  However, I found that there was a lot of conflicting information out there.

 

Once he came home, I was so concerned about the amount that he was eating and ensuring that he ate enough, it took me 2 days to even attempt to put him to breast - and that was AFTER his pediatrician suggested that switching to all feedings straight from breast would be best.  So, for a couple of days I put him to breast once a day and then supplemented what he ate with a bottle.  I also pumped after every attempt to breastfeed to see what I had left in the breast vs. what I normally pumped to gauge how much he may have eaten.  Each time I did this took about an hour and a half for each feeding.  It was at this time that I began to double pump. 

 

It wasn't until he had been home for a week that I began attempting to put him to breast twice per day.  From there, I increased to 3 - 4 times per day.  Each time I breastfed, I would offer him a supplemental bottle afterwards and then pump.

Now, let me interject here that due to the reduction, I have flat nipples.  This has made latching without a nipple shield tough.  Typically, I can only achieve a non-shielded latch either after pumping or after he has been latched with the shield and has pulled the nipple out a bit.

 

Last Wednesday (his 20th day of life), a home nurse came to visit and weighed him.  He weighed 6 lbs 14 ounces - up over a pound from birth and gaining an average of an ounce a day since he had come home.  This home nurse (another LC) suggested that we move to straight breastfeeding.  I finally felt ready to take this step and jumped in with both feet.

 

The first few hours went great.  I was feeling confident.  Great, actually.  This was going to simplify my life.  UNTIL the span between feedings got shorter and shorter.  And then, for one of the nightly feedings, I realized my nipple shield was missing.  A quick look around and we deduced that Murfy decided it was meant to be a chew toy for him.  The shield did not survive the attack.  Derek had to run out at 10 at night to buy a replacement shield.

The first night, I think the longest he slept was an hour.  I was exhausted.  He would suckle for at least 30 minutes and then fall asleep, waking shortly thereafter to be hungry again.  By the middle of the second day, I decided to pump afterwards to see what he was leaving behind - and it turns out that he wasn't really getting a lot at breast.  I don't know if this is due to some nipple confusion (which could NOT have been avoided due to the stay in the NICU) or if it is because he is a preemie and wasn't quite ready to be able to drain my breasts yet.  Regardless, after a couple of days, my resolve to complete breastfeed at the breast had dwindled and I was, once again, in tears.  And, I was spending my days pumping the side he didn't eat on.

Over the 4th of July weekend, I noticed that my supply on the right side had dropped drastically and I was having pain on that side.  I think it might have been a clogged duct, but even after it drained, my production was still down.  When he did latch, it was extremely painful.  I told Derek that if it wasn't such a good thing for Carder, I would be ready to throw in the towel - I am exhausted.  Time that I should be able to spend snuggling with my baby has been spent filled with anxiety and pumping.

After a tear filled visit to my OBGYN, I walked away with a prescription to increase my milk production and some Magic Nipple Cream for some small cracks in my nipples.  And a renewed resolve.  My current plan is to go back to square one - exclusively pump with the exception of a few feedings occasionally by breast to keep him interested and to bond.  Hopefully, the increased milk supply will provide him with enough easy access milk that he can eat at the breast easily OR as he gets closer to the Gestational age of 40 weeks, perhaps he will be strong enough to feed directly from the breast.  And if not, hopefully the increased supply will let me build up some reserves.

Perhaps some day he can switch to the breast.  Perhaps not.  Perhaps one day I will just give up and switch to formula.  I don't know.  My commitment to breastfeeding is renewed each morning and my resolve to stick with it is the lowest during the nighttime pumpings when all I want to do is sleep.  But this has been my breastfeeding saga thus far.

And if you read all of this, you deserve some sort of award yourself!