Monday, June 9, 2008

My Nursing Saga

For those of you not interested in the details of lactation (I'm thinking of the male readers here), feel free to skip this post. For those of you who decide to read on, beware that I may use some graphic references and possibly borderline crude language (I'm OK with it, but you never know whose sensibilities I might offend). Also, this is going to be a long post.
**End of Disclaimer**

I nursed twins for a year. Twins. TWO babies. Simultaneously (for the most part). For a YEAR. When I think back on that experience, it is hard to believe that I was able to do that. I want to beat my chest (except that I'm lactating now and that would hurt) in triumph. I must be SuperMom! Of course I feel that is nothing compared to some friends I know who nursed during pregnancies and THEN ended up nursing two (a toddler and a newborn). I don't think I could have ever done that. Especially not while pregnant. Anyway.

It was not easy. The first six weeks were downright brutal. For one thing, I was recovering from major surgery. We had to work through issues like bleeding, cracking, blisters...and that was just the nipple trauma. When my milk first came in, George couldn't handle it. He had been doing fine with the colostrum, but had trouble latching once the jugs got really full of milk. He would just scream in frustration because he was really hungry and it was too much work to get the milk. It took some very heartbreaking sessions with him and finally some consultations from a lactation specialist to get him to where he could manage it well (we had to "prime" him with a tiny bit in a bottle first to take the edge off and that seemed to do the trick). Then there was the issue of Joshua wanting to nurse for an hour at a time or more. That was killing me, time-wise and pain-wise. I was advised to cut them off at 20 minutes, and that completely changed my life! They did great, and I remained sane. The babies became very effecient, and it was way easier than having to deal with bottles all the time (though they didn't have a problem with taking bottled breastmilk either, until they refused it at 9 months). It saved us a fortune, as I was blessed with an ample milk supply. I never had to struggle for milk - when I pumped I got plenty to store up in the freezer, and the boys nursed what they needed and grew very well. They never had a drop of formula (even though I tried a couple of times when they were older babies - just out of curiousity and since I had a ton of sample cans - but they wouldn't touch it). I knew if I had any more babies, they would be nursed. Period.

I was excited during my pregnancy with Blake at the idea of only nursing one baby. Imagine! It will be a breeze! Plus I've done this before, so I know what I'm doing, right?

Blake came into the world, and immediately had trouble nursing. The nurse said he had "tongue incoordination." What?? He also has a short frenulum (but is not tongue tied). He also has a high palette. And he had jaundice, so I could barely rouse him to eat. I would try for an hour and a half sometimes just to get him and keep him awake to eat. They tried sugar water to no avail. They tried feeding him formula (while I cried because my baby was having so much trouble getting the milk I HAD available), but he wouldn't take that either.

I tried pumping, but only a few drops of colostrum would come out (I never was able to pump that stuff). The lactation nurses worked with me again and again to get him to latch properly. And my milk came in with a vengeance on the 3rd day post-partum, and he seemed to be getting the hang of it. Then we went home, and his jaundice got worse. We had to do the bili-blanket for a few days, and that cleared it up. We went back for his 2-week checkup, and he had not gained ANY weight. I had a feeling things weren't all hunky dory, as my breasts stopped feeling really full before a feeding. But I also had friends who said that their breasts never felt as full with the second child and everything was fine and normal. So I chalked it up to that. But he was pretty colicky, especially in the middle of the night. Gripe water seemed to help some, but not a lot.

I didn't mention the pain I was enduring. He was causing creases, blisters, cracks...stuff I had been through before. No less painful the second time around.

It turned out that he was dehydrated (in my mind: starving). Oh, the guilt. The heartbreak. How could this happen to such an experienced nurser as myself? My baby had no energy to eat, but because he wasn't eating, he could not get the energy he needed to eat. See my dilemma? So I started pumping and we supplemented. I would nurse him for 20 minutes (about all I could handle pain-wise), then give him breastmilk (or formula if breastmilk was not available) out of a bottle. And he started plumping right up. And he was so much happier! And he slept so much better! And I had severe guilt about starving my poor child for two weeks. Now my dilemma became an issue of whether or not bottle feeding him would get in the way of nursing successfully.

I went to a lactation specialist. She discovered that I have a condition called "nipple vasospasm." This condition causes me pain while nursing or pumping (like an irritation - a burning/stinging sort of sensation). I had this the entire time I nursed the twins too, but it was never so bad that I thought there was something wrong. I just assumed that it just came with the territory. I have since found out that many women nurse completely pain free. She gave me many tips and tricks to try. I bought a special nursing pillow. I started taking supplements to help increase my supply. And more supplements to help with the vasospasm. We had multiple appointments with the doctor (to monitor weight gain and the jaundice) and the lactation consultant. And we seemed to do a bit better. And for about a month, my baby nursed pretty well. And pretty much exclusively. I knew I had it figured out. Because again, it was once we crossed that 6-week threshold that things seemed to fall into place. I knew if I just hung in there for the first 6 weeks, we could make it work. Though I was ready to throw in the towel SO many times. But I made it.

Then, for whatever reason, he started to nurse less. But he would scream for more. So I started supplementing him again. And he began to refuse the breast more and more. I was at my wit's end. I did NOT want to go backwards - I have two toddlers to care for. At least during the first 6 weeks, I could devote myself to nursing - my mom was living with us and helping out with the big boys and everything else.

After a lot of wrestling with myself, I finally decided to pump exclusively. For a while he would still take the breast in the middle of the night (he liked it to be calm and quiet, which only happens in this house at night - another obstacle in our nursing path), so I'd nurse him then plus I offered it to him here and there. But over time he pretty much rejected it entirely. And I had to work really hard to get my milk supply to a point where I could pump enough, because of his lazy sucking habits.

For a little over 3 months, I gave it my all and then some. I am gradually getting over the guilt of not nursing him (could I have done more?). But then I remember that it wasn't my fault, and he's still getting the good stuff, so that is what matters. And I did try - more than most would, I imagine. And it is working out really well for us this way. He is a very distracted eater as it is anyway, which does not bode well for nursing. Plus he can be a snacker at times, just eating a couple of ounces here and there. And I don't have time to sit down and nurse him every time he needs a snack (and I don't think he would nurse while being worn, as we had positioning issues as well - hence the purchase of the special pillow). But with bottle feeding, anyone can do it. So Christopher can help me with the overnights (to my everlasting gratitude), and I don't have to worry about leaving him with anyone because they can feed him too! So I will say it is more convenient for us, overall. But I do have to deal with washing/sterilizing bottles and pump accessories. I think it's a small price to pay to ensure that my baby gets his mommy's milk.

I never dreamed that nursing a single child could be more difficult than nursing twins, but that has been my experience. Nothing like a baby unwilling to do what he's "asked" to humble a gal.

I will post another day about the reality of exclusive pumping. For now I have to wrap it up, because my baby needs his bottle.


Beth @ The Natural Mommy said...

Hey, you are a SUPER STAR in my book. Sure, I took the time and grinned and bore it and worked on nursing w/ Olivia for 9 months (that's how long we WORKED on it - it got easier after that), but I DIDN'T HAVE TODDLER BOYS running around my house at the time. I had all the time to spare to work on nursing w/ her.

And pumping exclusively? You deserve a badge of honor. Especially with above-mentioned toddler boys running around. It would be so much easier to just mix some powder w/ water and call it a day, but you care so much about giving your baby the best, you make this sacrifice.

So don't feel that you're not doing enough, and don't feel guilty. :-) You're my hero!

Jes said...

I had a preemie who had jaundice and wouldn't wake up to eat and all that good stuff too. I know you're pain of feeling like you starved your baby and had no clue.

At first I had to pump and nurse and supplement and nurse and pump. Finally I started using a nipple shield- did you try those? It worked great with my daughter.

But seriously, you are amazing for making the way to give your baby breast milk! I don't know if I could have handled pumping and feeding exclusively. That is a lot of work.

Don't feel bad about it! your baby is getting what he needs. :)

3BoyMommy said...

First of all - I'm amazed you made it all the way through that monster post - LOL. But thanks for that. It has been easier to let go of the guilt as time as gone on, and I find myself saying pretty frequently "I'm glad I'm not nursing." He still is a pretty difficult eater, even on the bottle, and it would be way worse if we were trying to nurse. Anyway, I so appreciate the supportive comments. Thanks!!!