Wednesday, March 3, 2010

Breastfeeding Blues

Breastfeeding is so hard for me. It just is.

This might sound surprising, since I'm such an advocate for natural childbirth. It would usually follow that I have a very optimistic outlook on breastfeeding. Indeed, I think that breastfeeding is a wonderful thing and something that every mom should give a concerted effort toward (or at least consider trying). That doesn't mean that I think it's easy.

When my daughter was born, I had two big challenges that arose in connection to my birth experience and breastfeeding: placental remains and having received antibiotics during labor. Actually, a third challenge that I attributed for years to the epidural was a sleep baby. Alas, I've had three unmedicated births now (yes, my 4th birth, which I promise to describe soon, was also a natural birth), and all of my babies have been somewhat sleepy eaters (though one was less than the others).

Anyway, after the baby came, I was very stressed, had inadequate (and pretty starchy and sugary) nutrition, and I quickly started to experience symptoms of yeast, though I was undiagnosed until the baby was 4 weeks old.

Wait. There is one more challenge which I've not admitted yet - I was extremely uneducated about breastfeeding. Even after having 4 children, I still feel like a novice. But I digress...

Anyway, I came down with yeast in my milk, and that made my already sore nipples even more painful. My daughter didn't actually latch on until day 2, and I didn't realize that it would have been wise to pump a lot in the first day. So I only pumped a few times. Then I didn't bring a pump home, which would have been wise as well, as my sleepy eater of a daughter wasn't so hot at stimulating my breasts to produce milk.

So the milk came in - not a ton, I'm sure, but a start. I nursed my daughter until she fell asleep, called it a feeding, and when she would quickly fuss for more, I would hesitate to feed her again. It was hurting.

Oh, I could go on and on, but it's a really depressing story, and I don't need depressing right now. Suffice it to say, I knew little, made a lot of mistakes, learned more, made fewer mistakes, and by the time I really understood what it would take to get my milk supply where it needed to be and to get my daughter nursing well enough to be nourished by me, it was too late. Having tried a supplemental nursing system for several days and ending up with my daughter and me in tears each time, I finally began to offer my daughter supplemental bottles to keep her gaining well. When she was six weeks old, she realized that she could be nourished by a bottle and no longer needed to latch on. At 8 weeks postpartum, my bleeding had continued, and it was discovered that, in delivering my placenta for me, the doctor had left some placental remains in my uterus. My body had never fully figured out that it wasn't pregnant anymore, and the prolactin levels had been insufficient for me to produce an adequate supply. Ironically, I still got a little bit of satisfaction in pumping what milk I until my daughter was 3 months old and adding it to her formula bottles. At 3 months, we had a family gathering that threw off my pumping schedule, and my milk never came out again. I had about a half a day of engorgement.

That first experience was painful, so when my second baby came and needed a quick transfer to the NICU, I immediately requested a pump. Until I was allowed to put my son on the breast, I pumped at least every two hours with one 4 hour stretch at night, and I gave myself an incredible start with a milk supply. Happily, my son was less sleepy than his siblings have all turned out to be, and he nursed pretty well. I still had soreness, but I passed quicker. We did have yeast, but it was quickly taken care of.

The hardest challenges I faced with my handsome son was that 1) he was very sensitive to any dairy I ate - so much so that his stools literally had blood in them, and 2) he was not a great sleeper. I was so determined to nurse him that I kept him in a swing for months to make his sleep schedule "bareable" for me, and by 4 months had never exceeded a 5 or 6 hour stretch of sleep in a night. He also usually followed a good night with two or three rough nights of nursing every two hours. It seemed that my body was so time sensitive that getting extra sleep and going too long was poison to my supply. But I could be wrong. It might just have been that his sleep quality in the swing was very poor, and he was accustomed to frequent night-time nursings.

Anyway, at 4 months I reluctantly weaned my boy, and my emotional and physical health changed literally overnight. It was a sad choice, but it was a blessing to my family.

With our third child, I had a sleepy eater on my hands. And though I had nursed frequently in the beginning, I had forgotten to do breast compressions and work hard to wake my son to feed well enough. My right breast immediately shrunk to half-sized as soon as engorement ended - the letdown was too slow for my little guy, so he hadn't drained the breast well. We eventually showed strong signs of yeast again, and this time I found it more difficult to erradicate (having 3 kids is really hard, by the way). Happily, or unhappily, he was a great sleeper, and I was so anxious at all times about my milk just going away, that I was wearing myself out with nighttime feedings (I would literally go in and feed my son in his sleep just to keep my milk up).

At about 8 weeks, my husband had a three day business trip. Right around that time, my son stopped napping well during the day and was demanding feedings every 90 minutes during the day. By the second day, I started offering him supplemental bottles. He loved it. Then I panicked and wanted to go back to just the breast again. So I tried to pump after each feeding to stimulate my supply back up. After less than a day of pumping, I was exhausted. My husband came home, and after some prayer and consideration (I was still fighting yeast, by the way), we decided to fully wean him to a bottle. He was happy, slept like a dream, and fussed very little. It took a few tries of formula (we didn't just start with the normal stuff, which turned out to be the best for him) to keep him regular. But - viola - he was a happy formula fed baby.

Here we are now with our 4th and final baby. I have milk for her, and I think she's doing alright. But I'm a little discouraged. Well, a lot discouraged, actually. I have cried me a river already. Her output has been great - at least 8 or more wets and 4-6 messy diapers a day. She lost at least 9 or 10 ounces (so many poopy diapers) in the hospital, and her weight gain quota was pretty big - at least 9 or 10 ounces in 12 days. Well, she hasn't hit her birth-weight yet, and she's 2 weeks old today. Sometimes I weigh her, and it looks like she's almost there, but then she'll have a wet diaper or a big bowel movement, or it'll be a couple of hours after a feeding, and she'll be a few ounces behind again. (I have a scale - I don't know that it's amazing, but it seems to work).

So, my point to all of this is, even if you've had a successful nursing experience before (I consider my handsome son's experience to be the most successful, and I attribute it largely to the great milk supply and his active nursing from the beginning), there is a lot to know.

So here's a link I found to a very helpful website. The information is so much better than that idiotic little booklet they give you at the hospital. I would encourage all to not make the mistake I made this time - which was to wait until after the baby came - to educate or reeducate myself on the breastfeeding. Read up on things now and learn how to get the best start you can so that you don't have to "fix" problems later on. If you can get your baby gaining and nursing well in those first few weeks, you have such a great start.

I haven't given up. She's gaining - more slowly than I'd like, but still gaining I think. We'll have to see what her doctor says. I believe we can do it (if I can just get enough calories and not DIE of stress!!). I wish you the best!!

P.S. I'll have to skip editing and let this be it's grammatically messy self. Must rest (or pick up a crying toddler).

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