Adventures In Breastfeeding

One of the most amazing things about the birthing process to me is breastfeeding.  This tiny human comes out of you, having spent the last 9 months eating through their stomach, and with a whack on their back, they suddenly are able to eat, breathe, and cry out of their mouths.  Really, the whole system just makes evolution seem more and more ridiculous.  But, anyways...

Though breastfeeding is miraculous, it is far from easy. For me, it was not natural, not instinctual, not easy. When they handed the baby to me a half-hour after the surgery, and told me to feed her, I was so lost as to what to do. If there was any part of the baby process I wasn't ready for, this was it. I hadn't read enough books (or, any books for that matter), and the whole thing seemed so....confusing. I had no idea if I was doing it right, and no idea if she was getting remotely what she needed to survive. I took comfort in the fact that babies don't need a ton of nutrition right after they are born--but was I going to be able to do anything to get her what she needed?

The first night, Nick went home, and Avonlea and I did our best. She would go where she was supposed to, and suck a couple of times in a row, and then be done. It seemed like a victory to me, but I wasn't really sure. Then, she slept like a rock for 6 hours--and subsequently, I did, too--right before we were admitted to the NICU.  I knew I was supposed to be feeding her every 2 hours, but no one came to wake me up, and Avonlea didn't wake me up crying, so I guess she wasn't hungry.

I might have been okay if Avonlea hadn't needed to go to the NICU. Maybe I would've figured out the latching thing (I mean, how do you know what it is, exactly--when you have no context for what it's like in the first place?). Maybe I would've had an amazing lactation consultation the day after her birth, and we would've sailed on with flying colors.

But, it wasn't meant to be that way. Avonlea had to go to the NICU, and I had to tell them exactly how much she was nursing, and for how long she was latched on. The NICU is nothing if not precise in their measurements (they even measure how much each diaper weighs!). I started guessing. "Umm...well, I felt tugging on the left side for a couple of minutes, but it wasn't repeatedly tugging, so I guess maybe 5 minutes on that side?"

This doesn't sit well with NICU nurses. They want to know how high you jumped, and what shoes you jumped with, and what you were wearing at the time, and if your hair was wet or not--oh, and did you poop beforehand, because that might've made a difference in your height?  When they asked me when the last time she ate was, and I had to tell them, "6 hours ago", they looked at me like I was the worst mom ever. Seriously, there were bugged eyes. One of the nurses said, "you should have woken her up to feed her--she's a newborn."  Add to the fact that I was already crying because they were taking my daughter away, and it wasn't a good admission process.

It wasn't but a few hours into the stay at the NICU that they had Avonlea on bottled formula. Inside, I am screaming against it--but what can I really do? She's on antibiotics, so she has to have nutrition going through her system to get the kidneys flowing. And I'm only producing colostrum at this point (I knew that much, at least), so she's not getting that nutrition from me at this point--and I don't even know if she's getting my colostrum in the first place, because I don't wake up often enough, and mostly because I don't know what latching on is.

It was another area where I felt like a failure. Not only did I not get to have the birth experience that I wanted, but now I wasn't going to have the feeding that I wanted. I didn't want her to have sugar water--she got a paci dipped in it right after she was born. I wanted to breastfeed exclusively--I had no idea what I was doing.  I didn't want her to have formula supplements--she was on it as soon as we got to the NICU.

A nurse came and dropped off a pump to me, and told me I needed to pump every couple of hours. I had no idea how long I was supposed to pump, and I wasn't getting anything during the pumping. Is that normal? Or, I would get one or two drops. The NICU nurses told me to bring down anything that I was able to get--did they really mean for me to take down two drops of colostrum?  The NICU nurses seemed to indicate that yes, I should--but then the nurses on my floor rolled their eyes at my pithy little 5 droplets, and told me that they couldn't do anything with it.  The first time I threw away my vial with more than 2 drops in it, I cried.

Over the course of Friday, between running down to the NICU any chance I got, and back up to my room to eat or sign papers or go to the bathroom or get examined, I pumped. I pumped for 15 minutes on the dot, maybe every 3 hours or so.  And slowly, I started to get some production. Not a lot--less than 5cc's each time, and more from one side than the other--but it was a start.  The nurse who told me to throw away my little bottles of colostrum now told me that she was wrong and that I should take down anything and they would make it work--so I started feeling more confident. Friday night, I commented to Nick that I felt like my milk might be coming in, because my breasts felt a lot heavier and fuller.  When I went to bed, I got a raging case of the chills, and then in the middle of the night I had the sweats.

Then, Saturday morning, I woke up and my breasts were as hard as rocks. Like, I thought my skin was going to tear apart. I knew, if I wasn't on my pain medicine, I would probably have woken up screaming in pain.  Yeah, you guessed it. I was completely engorged on both sides.  I called my nurse, who came in and checked me and confirmed that I was engorged. She got me an anti-inflammatory drug (but not a lactation consultant).  I went online and looked up engorgement treatment, and started doing 15 minutes of heat, then pump for 20 minutes (while Nick massaged me), then 15 minutes of ice. My time away from my daughter was getting longer and longer, and now I wasn't getting anything out of my breasts.

I was tired, I was frustrated, and I was wishing I had some clue as to what was going on.

After reading some more, I went to only a few minutes of heat, then pump with massage, then ice. And again, slowly I started to get some production, and some relief from the stretching and the painful knots and lumps.

As my milk production grew (about 10cc's a day), I got more and more happy that I was able to provide some better nutrition for my daughter. Downstairs, she was not doing well with the formula. Yeah, enough of it was staying down for her to be doing fine health-wise, but she was getting a reputation as the pukiest, poopiest kid on the block.  There were 2 nurses who literally had to change their scrubs from top to bottom because Avonlea puked so violently on them.

She was also POUNDING her food. She would drink an entire bottle of formula in 2 minutes.

I was so excited to take down this bottle one morning:

Only to watch in dismay as she ate it in 35 seconds.  It took me all night to get that, girl!

Finally, on Saturday, a lactation consultant came to my room. She asked me a bunch of questions and handed me a bunch of flyers. When I told her that I wanted someone to come to the NICU and help me with Avonlea hands-on, she made an appointment for me the next day.

On Sunday afternoon, I finally had my first lactation appointment.  And it was hellish.  I stayed pretty cool the whole time--more than I can say for the lactation nurse--she was frustrated!  See, since Avonlea had gone so many days on the bottle, she was used to eating the easy way. Also, in the NICU, they feed "ad lib". So, basically whenever she started crying, they would feed her--so by Sunday, whenever she didn't get fed, she screamed bloody murder.  I mean, outrageous, purple-in-the-face ridiculous screaming.  Surprisingly, the screaming doesn't really bother me--but it did bother the NICU nurses. I learned this on one of the first days down there trying to breastfeed her. She started to cry, and 3 different nurses came to check on me to see what was wrong. (I felt really pressured to get the feeding thing right from them, and so when it wasn't going well, I felt really pressured to give in to the formula thing quickly--mommy guilt at its finest.)

We ended up feeding her the bottle, but the lactation nurse said we would try again. She had a couple of things she wanted to do.

Well, when we finally got together on Tuesday, it worked, and I finally learned what REAL latching on feels like! We used a breast shield to help us, and I think it really helped Avonlea to get hooked on right. I was excited and happy, and Avonlea actually ate from me for 15 minutes on both sides! Victory! She was only doing 5 or 6 sucks at a time, and she would stop every 5 minutes or so to fuss, but she was doing it!  Tuesday was the first day that she had enough milk (from a bottle) from me to last all day--and she didn't vomit at all the whole day.

I had a lingering doubt, though. Nick tried to help me put the nipple shield on the other side, and it was really hard to do. And I was thinking, "what am I going to do when the nurse isn't here? I'm not going to be able to put this thing on by myself."

In fact, today when I went in, I didn't think I would be breastfeeding, because I couldn't do it by myself.

And that's when God sent Vicki.  I have had a different nurse every day with Avonlea--but today's nurse also spent 27 years with her own lactation consultation business. She graciously stepped in to help me. A no-nonsense Hispanic lady, she quickly took charge and told me exactly what we were going to do. She told me to put the nipple shield away. She helped me to hold her the right way, to calm her before feeding, to talk quietly to her, to lead her nose-first to the breast. All things that the other consultant had told me, but this time it really clicked. I was doing it on my own--and Avonlea took to it like a charm. It took maybe 5 minutes of re-working my hold, and guiding my nipple to her correctly, but she totally got it.  She latched on to me sans nipple shield, and ate for 20 minutes without stopping. She went up to 10-20 sucks in a row, and not once did she let go of me.

Vicki actually suggested only feeding Avonlea on one side for a while, that way she can get used to the hold, get used to opening her mouth wide, and get used to working a little harder for the food. Vicki explained what I needed to be doing while pumping in a language I could understand, using her hands to demonstrate what she meant. She didn't come in and take over what I was doing, but she guided me to the right technique. She was a fabulous teacher.

When Nick came to pick me up, I wasn't ready--I wanted to stay and feed her again! This time, Vicki didn't help me at all. In fact, I didn't even know she was watching--until I had gotten Avonlea latched on, and I heard her praise me from the side of Avonlea's bed, telling me I had gotten an A+.

Tonight, when Nick and I went back for our evening with Avonlea, I couldn't wait to show him what I had learned. And Avonlea stepped up like a champ. She ate for 25 minutes on one side, and then used the bottle for the rest (which we'll do until I feel like I can take her to my other side). I was so proud to see her little Momma's Milk Mustache:

Breastfeeding has been a struggle, but I am loving where I am at now. I know that there will be hard times ahead still--but now I know that I can do it by myself, without any tricks or special tools. Just her and me, the way it's supposed to be.

(I left out a few details of this story, I am sure, but I am tired and I need to go and pump.)