Wednesday, January 29, 2014

Breastfeeding Sucks: A Painful Start

I didn't have much of a birth plan for you (and it was a good thing I didn't), but there was one plan I was set on: I was going to breastfeed for the first year of your life. Yes, breastfeeding has some wonderful benefits for babies, but my motivation was mostly selfish. I knew that breastfeeding would get me back to my usual self faster. More importantly, there's some research (though controversial) that breastfeeding can reduce the mom's risk of breast cancer. Given our extensive family history, I figured I should do everything within my power to decrease my risk! I told myself that it wasn't the end of the world if I couldn't do it (after all, I wasn't breastfed and I think I turned out fairly well), but I was going to give it my all before giving up.

Giving it "my all" turned out to be quite a lot.

Before you were born, I took a lactation class. I knew that although this was supposed to be a natural process, there was a great deal of skill involved and I wanted to learn as much about it as possible beforehand. As informative as the class was, it had some inevitable limitations. You see, I'm what we call a kinesthetic learner. I learn by doing. And there is absolutely no way to do that when pregnant! First of all, I had a giant belly in the way. Secondly, if a real baby had the rigidity of the baby dolls we were practicing with, I would get them to a pediatric PT stat. And to keep things PG, we used these things instead of actual breasts:

So yeah, I felt like a pro when it came to holding a plush boobie up to my chest and holding a baby doll up to that boobie. Then you were born, and I realized how unrealistic that setup was.

As soon as you got here, you had trouble latching. I had a lactation consultant see us every day that we were there, and it still got us nowhere. The first one seemed to be helpful, but at that point we hadn't practiced enough to determine where exactly we were having problems. The second one seemed busy and flustered. The third one spent a lot of time with us, but she was terrible. Instead of answering a couple of simple questions, she provided a great deal of tangental information (which is never well-received by someone who is still trying to come out of anesthesia), and handed me some formula and a nipple shield. WHAT LACTATION CONSULTANT GIVES A NEW MOM FORMULA?! AND WHAT THE HECK IS A NIPPLE SHIELD?! I had no idea what was going on, but I figured we'd keep trying and see what happened.

When we got home, I quickly learned that you having a poor latch meant me having a lot of pain. My nipples are pretty flat, so there wasn't much for you to grab onto, so your shallow suck left me with squished up nipples and eventually blisters. I decided to try that nipple shield. I had to google how to use it since no one taught me, and that was pretty much the worst thing ever. Everything that popped up kept talking about how horrible they were. They reduce milk supply! They cause nipple confusion! They should only be used under the constant direct supervision of a lactation consultant! Great. At this point, though, I was desperate. Even if you were using a nipple shield, at least you were still breastfeeding. So, I slapped that baby on and we got to work.

I noticed something almost immediately: even with the nipple shield, breastfeeding sure looked like an awful lot of work for you. You took frequent breaks, often just to catch your breath. Occasionally, you'd fall asleep at the breast. I initially assumed that this meant you were satisfied and sleepy, but as soon as I took you off, you screamed bloody murder. So I let you keep eating, but it was still inefficient. Feedings took up to 90 minutes, and you were demanding them every two hours. This combination made for a very tired baby and a very grumpy mommy.

We had your first pediatrician appointment when you were three days old. At this appointment, we found out that you had lost a good 10% of your body weight. It's normal to lose about 7-10%, but since you were at the high end of this range, Dr. Cooper asked us to come back later that week for a weight check. Four days later, you had only gained one ounce. This was a little concerning. Dr. Cooper explained to us that even though I was probably making enough milk, for some reason eating was really inefficient for you. This caused you to burn more calories than you were taking in, which is a great way for grown-ups to lose weight, but it's pretty awful for newborns. She asked us to supplement with formula, meaning that after each feeding, we needed to offer you an ounce or two in a bottle. Bottles are much easier to eat from, so this meant easy calories for you. I felt like I had let you down, but I was glad that we had a (hopefully) temporary solution to bring your weight up.

The next week, you had gained another two ounces. A few days later, another three ounces. Dr. Cooper cleared us from weight checks and told us to keep up the good work. But "the good work" meant supplementing with formula, something I did not want to do long-term. I felt as though we needed a bit more support, so I found a lactation consultant who made home visits. Her name was Ann Grider, and she reminded me of Mrs. Doubtfire.

Her demeanor was patient, warm, and gentle. She asked lots of great questions and really listened to my very detailed answers. I told her that though we were breastfeeding, I had two goals: I wanted to get off of the nipple shield completely and I wanted to wean off of formula supplements. She taught me a lot, and she had me try lots of different things with you. She also gave you a thorough examination, including weight checks after feeding to see just how much you were taking in (which was nice, because otherwise there's really no way for me to measure how much you're eating). Her exam included a thorough assessment of your oral anatomy. She informed me that you were severely lip-tied and possibly tongue-tied as well. This meant that the labial frenulum (that little strip of tissue that connects your upper lip to your gums) was really tight and the lingual frenulum (that little strip of tissue that connects your tongue to the floor of your mouth) was kind of tight, too. This was prohibiting you from getting a deep latch, and it also wasn't allowing you to swallow appropriately, which resulted in really inefficient eating. She recommended a pediatric ENT and suggested that we make an appointment to have this tissue clipped. In the meantime, she assured me that any breastfeeding is still breastfeeding, and reminded me that priority #1 is for you to thrive (gain weight).

I felt relieved to have a plan in place, but the pediatric ENT couldn't see us for several more weeks. In the meantime, we kept working at it. I tried to use the nipple shield less and less, but every time I went without it, that same pain returned. I eventually gave up and decided to use it for every feeding. It was like Ann said: at least you were breastfeeding.

This post has become quite lengthy and I'm only halfway there sooo I think I'll split this into two posts. Stay tuned for the exhilarating conclusion!

1 comment:

  1. So grateful for the support and knowledge of that lactation consultant! Your mommy, Ellie, is a very determined person!