Sunday, February 15, 2009

Breastfeeding

I tried to put Annalise up to my breast in the first hour after her birth (before she was weighed, even), but she never quite understood what I was hoping for, and she didn't latch on. That evening, I was transferred up to the post-partum ward and our nurse tried to help out. Here, Annalise would seem to latch on with a big, open mouth, but wouldn't agree to suck, even a little bit. The nurse even tried putting a few drops of sugar-water on my nipple, but this didn't tempt her, either.

The next morning (Tuesday), a lactation consultant came in and tried to help, but we found the same latch-on-but-no-sucking routine occurring most of the time. At this point I was producing just a few droplets of thick, golden-yellow or white colostrum. By later that evening, she was finally agreeing to latch on and suck a little bit. Frequently, however, her latch was "off" and I was left with a whitish ridge across my nipple, intense pain, and even a droplet or two of blood under the surface of the nipple. We tried basically all of the positions including cradle, cross-cradle, and football. By Wednesday morning, she seemed to be getting the hang of it, but her weight had dropped from 7 lbs 15 oz at birth, to 7 lbs 6 oz only a bit over 24 hours later. We were told that we would need to go to the pediatrician for a weight check on Thursday morning. Also, before we left, our very nice nurse told us about giving a bit of formula by tube (either alongside the nipple or a finger), "just in case it is 2AM and you get desperate). She gave us two tiny bottles of ready-mixed formula along with a syringe and tiny tube for a feeding.

We went home on Wednesday afternoon. Feedings immediately seemed a bit harder as my left upper arm developed an intense pain, which I attributed to my weak muscles and lifting the baby. The pain made it much more difficult to get into certain nursing positions without S's help. A few hours later I realized that it was actually painful because of a tetanus/pertussis vaccine that I had received before hospital discharge. (Apparently this vaccine is recommended for people who have frequent contact with infants under age 12 months. S needs to get one, too). Poor Annalise seemed increasingly fussy, which I attributed to her suddenly getting hungry, but I just didn't have enough colostrum to satisfy her appetite. S was great in that he got up with me throughout the night, providing moral support and other assistance. Sometime around 4 AM, we figured out that maybe she was hungry and gave her some of the formula by tube-feeding. She couldn't seem to latch with the tube fastened to my breast, but she latched onto our fingers and eagerly drank it from there. That night, we actually only gave her 20 mL, which I believe is 2/3 oz. However, this seemed to help a lot and she was finally able to sleep.

Thursday morning, she went to the pediatrician and was weighed. She was down to 7 lbs 3.2 oz at this point, so we were told to return again in 4-5 days. Meanwhile, I think it was this day that I finally noticed some increase in milk production. However, Annalise's frantic suckling had meanwhile left me with scabs on both breasts. Between my left arm, my grade 2 tear, (TMI) hemorrhoids, this intense nipple pain with feeding, AND the general breast pain as they filled with milk, I was (physically) pretty miserable!

By Friday morning, I woke up feeling like I had gotten enormous breast implants. They were as hard as rocks, stuck straight out, and well...I have watched a lot of Dr. 90210 in my life, and I definitely looked like an "after" picture. (This was a novelty to me as I am usually a 34/36 A or B. Within the next several days, my milk seemed to be in oversupply. Annalise would latch on and be surprised by a flood of milk filling her little mouth before she even started sucking. My breasts were extremely uncomfortable after just a few hours and I would need to express some milk even before she latched to allow the nipple to protrude a bit. There were occasions when a "jet" of milk would spray milk up to 12 inches into the air... sort of entertaining, but messy! I quickly developed a new vocabulary, talking to Annalise about breastfeeding, too. My nipple is sometimes called my "nursie," the flannel blankets that we use to clean up the spraying/dripping milk are the "milky towels," and a nursie that is gives out a lot of milk without any real effort on Annalise's part is termed "juicy."

One week after Annalise's birth, we had a home visit from a nurse. A state-funded program sends a nurse to the home of all first-time moms in our county. It was sort of helpful, but definitely aimed more at moms who hadn't read every parenting/newborn care book out there. I was pretty familiar with most of the things that she reviewed with me ("back to sleep" and the like). Anyway, the nurse did weigh Annalise and we found that she had started gaining again and was 7 lbs 12 oz on that date. Thus, I cancelled the followup at the Pediatrician's office. Apparently our next visit there is now at two months! I have weighed her once (at a hospital-based nursing store, where I went in search of a sling/wrap). At that point (last Wednesday, age 2 weeks, 2 days), she was 8 lbs 12 oz, diapered and fully clothed. I think she is growing well and seems very healthy.

By the middle of last week, my milk supply was decreasing to better match her demands, and Annalise started to get frustrated when confronted by "nursies" which were not dripping with milk when presented to her. Her almost inconsolable crying caused a lot of stress on my part that I'll get to in another post. On several occasions, Annalise would be frantically searching for milk, wailing and crying, even as I was literally putting the nipple into her mouth and aiming it right to her palate. Just yesterday, S reminded me that the lactation consultant had suggested priming the nipple by squeezing and getting milk onto the tip before giving it to her. I had been focused on aiming the nipple toward her palate, but I had forgotten about that other suggestion! I started doing it last night and already things have improved... a lot!

I purchased my Medela PISA (Pump in Style Advanced) in the backpack version about a week and a half ago, but I haven't even opened the box yet. Somehow I am intimidated by the thought of breastfeeding AND pumping. However, apparently 3 weeks is the optimal age to introduce bottles (unlikely to reject either breast or bottle at this point), so I need to get started ASAP. I am very surprised about how expensive the breastmilk storage bags are...something like $10 for 20 of the Medela ones...that's 50 cents each! Sheesh! I will post on Ovusoft to find out whether there are other options.

We've abandoned the football hold altogether (she is too tall) and we usually do some sort of cradle hold with the help of the Boppy or another pillow. Side-lying is a new favorite. I just have a feeling that she is working toward being a co-sleeping baby, though. More on that later, too, I think.

I know that breastfeeding is supposed to be this magical bonding time, and sometimes it is. I murmur loving words and admire her, sing silly songs, or sometimes (especially at night) we both just fall asleep. At other times, I lean back in my chair with Annalise content on the Boppy, and I read... I've read many magazines, skimmed a bunch of childbirth and parenting books, and now I'm finishing up my second novel. It feels good to have books back into my life. I haven't read anything at all about breast cancer (my profession), and at this point it feels good to escape that.

4 comments:

alison said...

Thanks for the honest evaluation of how things are going. My sister and nephew took to it like they'd been doing it for decades (ok, weird visual...nevermind) but I can't imagine it's always so easy. I'm glad she's picking it up though, I imagine it does get easier with time.

I've been recommended the Lansinoh bags - I think they're $6 here for 25 bags, I just bought some at target yesterday. They're thicker than the Medela ones (I have the Pump in Style too). But the kicker is - we're using the Playtex Drop Ins for bottle feeding (because I know we'll have to do bottles eventually and those are the ones that everyone said to get). But they obviously take their own liners, and using the Playtex storage system to freeze the milk is mega expensive by the time you get enough rings for what you need. Anyway, someone told me you can use the Lansinoh bags in the drop ins bottles, so that's what I'm going to try - kill 2 birds with one stone that way. I also want to try the freezer trays for milk storage to see if they work well. They just keep the milk in 1 oz. sticks that you pop out when you need. Anyway, too much advice from a girl who still has the kid in her belly. ;o) Let me know what you come up with.

Hilary (Maya Papaya) said...

You are doing great. Breastfeeding was really difficult for us too, at first. I remember crying because every time Maya would nurse, my nipples would bleed profusely (in addition to the excruciating pain) and the blood in the milk would make my kiddo throw up what seemed like the entire feed. Oh it was hard. To see the product of the last hour of painful nursing go right down the tubes. Not to mention Maya looked like a scary little vampire baby with bloody milk dripping down her face. It was awful.

Fast forward to a month later - Nursing not only got a lot easier (the nips healed, and we figured each other out) but at some point it even became....are you ready for this....pleasurable. You're laughing right now but it's true. It must have been the oxytocin but it started feeling really good. I almost kinda craved it. Seriously!

And now Maya is nearly six months old, has never taken a bottle and we both love the breastfeeding. It has been so awesome, so rewarding, so wonderful. There is an amazing intimacy that you get to experience, it's just magic. You'll see! Now that we're just starting solids, there is a part of me that is sad that the breastfeeding will become less and less in the months to come.

It does get easier. Keep at it, it will actually start feeling good, like really good. I can't wait to read about how it all comes together. Hang in there!!!

Jill said...

Thanks for your candid breastfeeding description. A friend of mine had a similar experience to yours. I'm going to try to BF both babies, but I also am not going to feel bad if I have to switch to formula at any point. I think sometimes the lactation consultants, etc place too much guilt on new Mommies who choose formula when a BF problem arises. Glad she is doing well!!

La La said...

You are so, SO lucky that you were able to make breastfeeding work and KUDOS, BTW,for not giving up through the tough beginning!

I tried and tried with the girls, but after getting bottles in the NICU for almost 2 months they were just NOT interested. Lennon finally got the hang of it, and then Evy started to, but by then my milk had almost dried up. A few weeks after that I started getting mad migranese and had to start meds, so, no more BFing for us. =(

I'm really broken hearted about it.