WARNING! There are pictures of boobs in this blog. And if you just got a little excited by that, here's a second warning. These are not sexy pictures of boobs. These are pictures of baby feeding machines, or soon to be baby feeding machines at least. I also have to warn you that this story is not finished so if you need a breastfeeding adventure with a tidy ending, come back in a few weeks and hopefully it will be updated!
I'll also say that this blog post will probably not be interesting at all if you are not, have not, or are not anticipating ever breastfeeding. I wrote this to help me sort through a few things and to hopefully help other moms going through the same thing. It is quite wordy and potentially boring. Consider yourself warned.
The media has convinced us that breastfeeding is beautiful and natural and easy much like they have convinced us that we are all fat (neither of which is true for the majority of women). Chances are, when you see an image of breastfeeding you see a peaceful image like this one:
That is me and sweet Emma Jean at our first skin to skin the day after she was born. I was so excited and relieved not only to be holding her against my skin but that she started to root and latch on immediately. The nurses said it looked like I was a natural and for a moment we were both caught up in the bliss that only a mother holding her new baby for the first time can understand.
As the days went on I began to realize that breastfeeding was going to be more like this:
That is me and sweet Emma Jean a few days ago. That is what it is often like when we are trying to latch on. And you can't see my face but it is doing pretty much the same thing except in pain instead of hunger frustration.
So as it turns out there are a lot of potential barriers to that beautiful nursing experience we all assume we are going to have with our new babies. Barriers like having a c-section or having a premature baby (check and check).
If you read my first blog post you know that Emma Jean was born via emergency c-section and took us by surprise. Because the little peanut came early, my body and brain were not in sync about when I should start producing milk so we had to trick my body into realizing that a baby was here and needs milk. How? With a modern torture device known as a breast pump. I was advised to start pumping as soon as I could as often as I could as well as to nurse (well, practice nurse at least) as much as possible because being close to baby helps stimulate milk production. Oh, and by the way, don't forget that "you just had major surgery and you need to rest and recuperate." I was conflicted and quickly realized that no matter how much my body needed to heal my new full time job was feeding my baby.
After the docs decided Emma Jean's IV could come out began the very serious job of getting her to eat enough food by mouth. We started off with breast and gavage (or tube feeding). The tube ran through her nose and down into her belly. It honestly did not seem to bother her too much, even when they put it in, so I tried not to let it bother me too much.
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| Emma Jean with feeding tube in her nose. |
After about 48 hours with the feeding tube I was informed that the only thing keeping Emma Jean in the NICU at this point was that she needed to be able to take in all of her food by mouth for 48 hours. The choice we were given was either leave in the tube and continue to only offer her the breast, thereby keeping her in the hospital, or introduce her to a bottle for her supplemental feeding, potentially making breastfeeding more difficult for her in the long run. I know it sounds like a simple solution but I will admit I struggled with it. The idea of giving her a bottle, that I was not able to provide what my daughter needed all on my own, was incredibly and surprisingly emotional for me. I felt that my body was a little broken. Sometime that night Emma Jean pulled the tube out of her nose and I decided to take that as her helping me make that decision. Bottom line was that we had to get her out of the hospital and the only option they were offering to make that happen was a bottle. Fine. We'll give her a bottle but I am still the only person that gets to feed her. I cried.
So, Emma Jean wants to eat about every three hours. My first couple of weeks of feeding sessions consisted of attempting to feed her at breast for about 20 minutes, finishing her meal with a bottle of what breast milk I was able to pump and supplemental formula (the hospital would not let my very generous friend donate any of her breast milk to us) which took another 30 minutes or so, changing her, soothing her back to sleep, then pumping for 20 - 30 minutes depending on the most recent advice from nurses and lactation consultants (oh, there was and is no shortage of advice). By the time I was done I had about an hour or so to do whatever...sleep, eat, shower, pee, my choice really but generally speaking I could only manage one of those things before it was time to do it all over again. One of the first things I realized after we got Emma Jean home from the NICU was that this schedule was not going to be sustainable for me. So now AJ and the grandmothers are allowed to feed Emma Jean a bottle so I can have extra time for pumping and sleeping and eating etc.
Alright, so we have a better handle on the feeding schedule but we still have more barriers to face. One of our biggest barriers is that my milk supply is low. I can manage to produce enough milk for about half of her diet and that is when I am pumping like crazy. I am currently pumping every 2 - 3 hours (I did a few days of "power pumping" as well when I pumped closer to every hour), taking an herbal milk enhancer, taking a prescription milk enhancer, and eating oatmeal and walnuts every day since they are considered galactagogues (your word of the day, look it up). Emma Jean and I still try to nurse occasionally but...
Because Emma Jean was early, her mouth, along with the rest of her body, is tiny. Combo that with a lip and tongue tie and the fact that my nipples are apparently flat (which is why I have the shield on in the photograph above) and we've got some more pretty big nursing issues to conquer. The lip and tongue tie required a minor surgery which taught us the difference between a hunger cry and a pain cry (in case you aren't familiar with the difference, the hunger cry instills a sense of urgency in the parent to meet the need of the child. The pain cry, because the parent cannot simply meet a need to stop it, steals the parent's soul). As it made no immediate difference in our nursing situation, and I was expecting it to based on things I had heard/read from others, I am not sure I could be convinced to do it again. My experience with this procedure was not a very positive one but I seem to be in the minority on that. I'm not sure if we will ever know if that procedure made a difference in our nursing situation therefore I do not want to pass judgement. However, if you are interested in hearing specifics about our experience with this please feel free to get in touch with us.
Now apparently my milk supply and Emma Jean's difficulty with nursing go hand in hand. The nurses in the NICU kept saying Emma Jean was a "smart baby," meaning that because she wasn't getting a good milk flow she wasn't trying very hard to nurse. Normally I would be ecstatic to hear someone say my baby is a smart one, but in this case it seems possible that it is causing yet more set backs. Nothing stimulates a mother's milk to come in quite like her baby nursing at her breast (I know I know, shocking that plastic flanges attached to an electric pump do not have the same hormonal effect as a warm cooing baby). Now because Emma Jean mostly cries or falls asleep at my breast that stimulation for me is rather low. You see the cyclical nature of this problem, the Catch 22? If I'm not producing enough milk, Emma Jean will not be so interested in nursing. If Emma Jean is not so interested in nursing, it will be more difficult for me to produce enough milk.
Emma Jean's tiny mouth, lip/tongue tie, my flat nipples and low milk supply, the (I'm going to go ahead and say it)
evil breast pump all equal one thing when we try to nurse like "normal" baby/mommy pairs: PAIN. My nipples are so sensitive now that when Emma Jean (or the pump) don't manage to get a comfortable latch (which is usually) I stomp my feet, curl my toes, and sometimes call out in pain. I can't come up with an appropriate analogy to describe this pain to someone who has never experienced it so just pinch your nipples really hard with the boniest part of your fingers over and over and see how that feels. There are many causes of nipple pain while breastfeeding but the most common one is poor latch, which after much research I do think is the case for us. Now normally when you are in pain you take a break, let the affected body part do some healing and try not to overuse it. Unfortunately, if I am committed to feeding my daughter breast milk I cannot give my nipples a break. If Emma Jean and I stop practicing the perfect latch, she is likely to become dependent on the bottle and not return to my nipple (breast nipples and bottle nipples generally require the use of different muscles in the mouth with bottle nipples being the easier of the two; many times, though not always, if a child becomes very used to the bottle it can be difficult to convince them to do the work necessary to get the same results from the breast). If I stop pumping and am not nursing full time, my milk supply will suffer. So once again I am faced with the task of trying to heal my body while focusing on feeding my child what I believe to be the best thing for her, her mother's milk.
Am I passing judgement on moms who feed their babies formula by choice? No. If I am learning nothing else from this Emma Jean Experience it is that raising a baby, much like being in a relationship, is a very individual thing that nobody has the right to judge unless they are the parties involved. What works for me and Emma Jean may be a complete failure for someone else. I suppose that is part of the reason breastfeeding is such hard work. It isn't simply a matter of learning the facts and applying them, you have to figure out the methods that make your milk come in and the latch that works for you and your baby. And I'm starting to think that much like the birthing experience, you have to
let go. Let go of your preconceived notions of what feeding your child looks like and figure out what works best for you. If what works best for you turns out to not be what you initially thought you wanted, let go. The bottom line is that you must feed your child something and get it into them somehow. The methods for doing that are nearly endless but if you do the work and the research you will find the one that suits you best. Once you get there you will feel it and be content as long as you are able to let go of what you think others expect of you.
Emma Jean and I are currently doing a combo of breast/bottle feeding my milk supplemented by formula. I am hoping to replace the formula with my breast milk entirely in the coming weeks and am exploring the idea of donated breast milk in the meantime although I have not yet made that decision. I still have a goal of being able to actually feed her straight from the tap most of the time but will not be giving up the bottle entirely, although I was very resistant to it at first. Providing food is one of the major ways moms bond with their newborns and it is beautiful to be able to see AJ participating directly in that bonding experience. Emma Jean has surprised me over the last few days by naturally latching on to me while I was simply holding her close to me. And this is another place where learning to let go is serving us. Emma Jean, like most babies, instinctively knows how to do this. If I can let go of all the learning I've been doing about how to get my child to achieve the proper latch, she will do it all on her own if I simply give her the opportunity. I am amazed once again at how mother and baby work so well together as a unit if they can forget everything they are being taught for a moment and just simply be together.
