Feeding Strike! Again! Ugh!

When Carder isn't feeling well, the first thing he does is slow down on his bottle feedings.  This had been happening and Carder just wasn't acting himself.  He was fussy and pulling at his ears a lot.  He also was suffering from a very stuffy nose that was filled with bloody boogies every morning.  (Reading between the lines, sleep also deteriorated at this point).  So, on Monday 4/16/12, I took him to the Pediatrician to see if perhaps he had an ear infection or if he was suffering from allergies or another virus.

The Ped looked him over and said that his ears were fine.  He didn't rule out allergies and suggested children's Zyr.tec.  He also suggested that perhaps we were working on some teeth and that would explain the ear tugging.

By Wednesday 4/18/12, Carder was flat out refusing the bottle again.  And when I say refusing, I don't mean that he just turns his nose up at the bottle when it is offered.  I am talking back arching, screaming, wiggling to get out of Mommy's arms refusal.  After struggling to see inside his mouth and almost losing an eye to see it a quick glance at his gums, it was apparent that he was working on getting his upper left Maxillary tooth.  A few google searches later and Dr. Mommy had concluded that since this tooth was much bigger than the bottom, it could be the culprit for our refusal to eat.  After all, the bottom teeth caused the bottle rejection issue - for a week at a time.

But this time, he was refusing to let us get fluids into him through our normal means of a straw or syringe.  At least he was taking a water from sippy cup.  So we upped his solids feedings to 4 times a day with larger servings.  We had gone to my in-laws for a visit with them, Derek's sister, and Derek's grandfather for the weekend. But Carder was too interested in the new surroundings and all the people to drink anything.  We left shortly after arriving for fear that another trip to the ER for fluids was in our future. (Luckily, we have avoided that so far.)

Since he didn't do well with his sippy cup at Day Care, we were afraid to send him.  My MIL came to stay with him while I went to work.  After 7 days of refusing the bottle, we had also added waking up SCREAMING to our list of symptoms.  On Wednesday (4/25/12) we returned to the Pediatricians office.  This time he was diagnosed with a double ear infection on top of the teething.  Carder got some antibiotics and some ear drops. *

Thankfully, the screaming at night has stopped.  But, he still is sleeping like absolute shit.  And even worse?  He used to go down for bed at around 8ish at night.  Since Sunday (4/29/12), he has been fighting bedtime terribly.  He will fall asleep in my arms and when I go to lie him in the crib, he wakes up, flips over, and stands up in his crib.  Sunday night it was 10:00 before he finally went down for the night.  Monday was a little better with him finally drifting off at 9:30.  Tuesday night was another 9:30 night.  And once he reaches that “overtired” point, he is clingy and wired.  We tried lying him down to see if he just needed some alone time.  Nope - he stands in his crib and jumps up and down.  He squeals with delight when you open the door to check on him.  It is like he is all hyped up on sugar or something.  I broke down and bought some room darkening curtains for his room to see if that would help (no such luck yet). 
Once he finally goes down, his nighttime sleeping has recently involved waking up as frequently as hourly.  Usually I get things taken care of (laundry, eating dinner, spending time with Derek, having a few minutes of “me” time) after he goes to bed.  The last few nights, after hours of rocking and soothing my sweet little boy to sleep, I plop down and stare into space like a zombie – absolutely spent.

But sleeping isn’t our only problem.  In addition, he is still refusing the bottle (that is for 2 weeks straight now, just in case you lost count).  I absolutely abhor, detest, cringe at the thought of offering him the bottle right now - the screaming and throwing himself around to avoid the bottle is terrible.  Maddening, even.  I am so afraid that he is going to throw himself back and slam his head into the arm of the chair or fall to the floor.  It totally stresses me out and I dread every bottle offered.  It’s just a waste of formula at this point.  (And that crap is too expensive to waste!)  And making sure he gets enough fluid is like an all day marathon.  And you have to make sure you don't let him know you are stressed about how much he is drinking (or the lack thereof) or he will refuse to take the sippy. **

I am taking him back to the pediatrician this evening to see if his ears are cleared up or if we are still battling both ear infections and teething at the same time.  Hopefully this will end soon.***

Needless to say, I am – once again – exhausted.  This explains my blogging/commenting absence.  (And why his 10 month post was posted today.  Without any pictures.) 

*We have tried Tyle.nol and Ibupro.phen for the pain.  Ora.jel, too.  None seem to help a bit.  At least the stuffy nose/bloody boogies has cleared up.

**We have also tried small plastic cups, ped.ialyte, juice, and all temperatures of formula in the sippy cup.  The only thing he is "drinking" is water.

***I am afraid that due to his age, this is "the end" of our bottle feeding days and that he may never pick up the bottle again.  If only I had known, I would have savored that last bottle.  Every last second of it...

Lip Smacking Good

Even though Breastfeeding is supposed to provide me with so much joy, I prefer to watch Carder drink a bottle.   In addition to getting to hear him gulp and grunt in excitement, I get to see this when you take the bottle from his mouth.  Melts my heart...

(This video was taken over a week ago, but I have just been too busy/tired/lazy to upload it to my blog until now...)

Adventures in Breastfeeding (Part Deux)

Thanks for the comments on the previous post about breastfeeding.  My saga is not over yet.

In answer to questions/statements from the previous post -
Martha - Thanks for commenting.  I love to get feedback!
Lau - I have missed you, girlfriend!  Hope you are doing well!  I did try the breast pads for the lanolin - AFTER I ruined my favorite T-shirt and they work fantastically.  I just want that T-shirt back.
Alie-Yes there is a medication for increasing milk production.  It is called Reglan and is often used to treat pediatric digestive issues.  I haven't seen much increase (i.e. the doubling that was suggested), but it was worth the try.  It apparently works very well on people with hormonal issues with milk production.
Ellie  - So glad you posted.  I have thought of you many times during my dramatic ordeal and knowing you made it through has made me feel like I can too.  You are my BFing hero.
EOE - Thanks so much for the supportive comments!

And now the second installment - where did I leave off...Oh yes, I got the prescription and was hoping for increased milk production.

Prior to starting the medication, my OBs office had me pump every 2 hours on that side.  I am not sure if the increased pumping or the medication made the difference, but shortly after beginning the meds, I was back at the level of production I was seeing prior to the drop.  By day 3 or 4 on the meds, I was up slightly from that mark.  Is the medication helping?  I don't know.  But I wouldn't have NOT tried it.

The most recent and most AWESOME development?  Due to a BFing session yesterday morning (which was because I was so damned tired that I didn't feel like getting up to warm the bottle or pump afterwards) with an incorrect latch, I now have blisters on my right nipple.  You read that right.  Blisters.  As in hurts like a mo-fo.  And looks pretty rank, too.

I have consulted Dr. Google with how to treat this and then verified with my OB office.  I am also going to meet with my favorite LC from the hospital tomorrow regarding my difficulty getting a correct latch.  And before anyone says it - I know that a correct latch shouldn't hurt.  But EVERY latch hurts me.  And from what one LC told me, this is probably due to the reduction.  So, yeah, great.

So now I am not BFing at all, just pumping.  And it may just stay that way.  My friend Ellie did it and she made out just fine.  And, even though I have been saying for days now that switching to formula wouldn't be a cop out, I am beginning to buy what I was selling and I am coming more to terms with the fact that breastfeeding may not work out for me.  (You must be wondering what kind of a bumbling idiot I am to just now be coming to this realization...)

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!