Thursday, October 20, 2011

The Battle of the Breast

 I am mainly recording this for my own benefit. I want to record these experiences so when the guilt hits me 3 months later when I read some other study about why breast is best, I can assure myself that yes it is, IF IT WORKS. So if anyone is reading this, I apologize for the hastily & poorly written style.

While pregnant with BB (big brother), I was 100% planning to breastfeed. So smug was I that we did not even unpack the bottles that someone had given us at a baby shower. We didn't need all that crap! I was going to nourish my baby at my bosom, the way nature intended and pediatricians have suggested! It started off OK. Numerous nurses at the hospital told me he was latching fine & it was supposed to hurt. He was born over the holidays so there wasn't really a lactation consultant readily available; we made an appointment to see one at our pediatrician 10 days later. Our second night home from the hospital, we were faced with screaming infant fighting and clawing at my bloody cracked nipples, not pooping or peeing, and just freaking out every time I tried to get him to feed. We boiled those bottles, mixed up the Simi.lac that the evil hospital snuck into my take-home bag, and the little devil happily chugged it down, burped, smiled, and slept! I continued to try to get him to latch on and feed, we spent tons of money on a lactation consultant, and tried every trick I could. 3 weeks later I gave up and exclusively pumped 8 times a day for over 5 months. So he got breastmilk for nearly 6 months, but in the roundabout way, via Medela & Dr Brown's.

For the past year and a half, when I think back on why I didn't breastfeed, all I could come up with was that I was lazy & weak, couldn't take the pain & hassle, and gave up.

It has been eating at me all this time. The guilt. The failure. The fact that I clearly DID NOT LOVE my son enough to make this sacrifice.

This time around was GOING to be different. No caving in the middle of the night. I would ask for help right away in the hospital. If we needed multiple visits to the LC, we would suck it up and pay for it. The bottles stayed, packed away and unwashed. I did not want to make it easy to give up.

Welcome to the world LB (little bro). He latched on soon after birth and it HURT immediately. Knew where this was headed so insisted on help from nurses and LC at the hospital. Again, was assured that he was doing fine. He lost less than 10% of weight at 24 hours, and was pooping (meconium) and peeing. He wanted to feed CONSTANTLY after the first 24 hours of sleepiness, and I gritted my teeth and let him. I couldn't really tell if he was getting anything, since the milk hadn't come in yet.

Day of life 5: Baby hadn't pooped for over 48 hours, only peed 3 times and was very minimal, concentrated, and with those red crystals. Went to see Ped and had lost more weight. He suggested supplementing 1/2 oz after each breastfeed. I ignored this. I could feel my milk coming in, I figured it'd be all good by the evening.

That evening: suddenly the boy was FREAKING OUT. He refused to latch on. Just fought & clawed & arched away. I was hugely engorged and hurting. Thought maybe the rock-hard-boobs were making it hard for him, so I broke out the pump and pumped several oz of milk. Tried again. Nothing. He fought until he got tired and fell asleep, still starving. Decided to feed him the pumped milk but to use an "alternative system" to avoid the bottle---used a syringe (so messy!) and got 1.5 oz into him. He burped, smiled, and slept. I cried for hours.

DOL 6: Same story. Fighting, clawing, hands in the face, arching away from the breast. We got tired of the syringe and went to the bottles, but I tried each feed for over 30 minutes to get him to latch.
I pumped after each feed and got barely enough for the next feed (1.5 oz) each time. Lots and LOTS of crying.

We saw the LC. She got him to latch...OF COURSE he didn't fight & scream in her office! But after 45 minutes of switching positions and waking him & all that jazz the kid took in 5 MLS. That is ONE TEASPOON people! He needed 60 mls per feeding. DO THE MATH.

Had a long chat with the LC about why he was doing this. I revealed my secret fear that there was something wrong with me. The fact that this happened BOTH TIMES cannot be a coincident. She kind of agreed that it is very rare for infants NOT to take the breast (makes sense, of course) and for it to happen twice in one family is exceedingly unlikely. She was very kind about it, posing it as a positive thing---nothing is wrong with the baby or with my milk supply---I just need to experiment with positioning, technique, etc... She did reassure me that it is unlikely my anxiety or ambivalence transferring to the baby---they aren't that smart at this point, and their primitive urges to feed themselves and NOT DIE are the main things they are working off of at this age. So I didn't need to FEEL calm, as long as I could physically handle him & position him correctly, he should catch on. She also gave me a nipple shield. It gave me enormous confidence that he wouldn't shred up my nipples which helped me actually WANT to keep trying. Self-preservation is powerful.

The recommendation:
Step 1: try bf for no more than 30 minutes total---try both sides, both positions (football hold & cross-cradle hold), stop unless baby is "productive" (swallowing milk)
Step 2: Then give bottle using "pause method": hold bottle so that milk influx is horizontal. Make baby open wide before giving bottle. Allow a few good swallows and then remove bottle & make baby suck on your finger for a few seconds, then start again---this will teach him that he needs to work a bit for food. It should take approx 15 minutes to give a bottle.
Step 3: pump for 10-15 minutes, until breasts are empty
additional stuff: skin to skin with baby as often as possible. try feeding when kind of sleepy. if freaking out hungry, give little bit of bottle before putting on breast. Try herbs & hand expression to increase supply.
Give it 7-10 days & then re-assess.

DOL 6-12: I faithfully tried the tactics suggested by the LC. I tried to latch him on each side, in different positions, awake or asleep, before any bottle, after 0.5 oz, after 1 oz, after the whole thing. Once or twice he did it---but always took himself off before really taking in any milk, despite feeling a letdown & leaking. Started getting severe pains in my wrists from trying to hold him. Ended up ditching the nipple shields because he kept batting them off onto the ground whereby they became covered in dust and dog hair, necessitating getting up to wash it off---baby in tow. REally wasn't seeing an improvement. Tears for both of us (I KNOW they aren't supposed to make tears yet but he IS!)

Had a panic attack one day and just couldn't face another feeding. Was in the shower and just couldn't catch my breath and didn't want to get out of the shower in case baby was hungry again. The whole thing felt familiar---I had this same anxiety/panic with feeding BB. In fact, that was a big reason I decided to stop trying to breastfeed---it was interfering with my mental health and my husband was really really worried about me. Last time it had a lot to do with physical pain from the feedings; this time more psychological pain from the disappointment that I would never ever successfully breastfeed a child (this likely being our last one) due to my own incompetence.

DOL 13-now. The lack of any improvement is getting to me, and I'm starting to lose my resolve. It started with the nighttime feedings. I had husband give the bottle while I pumped so that I didn't have to be up for over an hour doing the whole shebang---and then not be able to sleep anyways because the whole thing was so discouraging. Then the "30 minutes" became a little less. And a little less. And now sometimes I just flash him the boob and stick it in his face---if he doesn't attempt to open his mouth after a few seconds I whip out the bottle. LB seems to have gotten wise to the whole charade. He screams and cries until that bottle is in his mouth, and he is losing patience for the whole suck-on-finger game, too. He knows where the good stuff is, and he wants it NOW. Is it too late?

I called the LC again earlier this week & she is coming for a home visit tomorrow. I am hoping that just the act of going through the consultation (and shelling out big bucks for it!) will re-energize me to continue trying. I have set a personal goal of keeping at it for 4 weeks.We shall see how it goes!


  1. Congrats on LB's birth and welcome to blogging!

    I really feel for you, having had all sorts of breastfeeding disasters myself which you probably remember. One thing you didn't mention is a supplemental nursing system, SNS -- less messy than the syringe, for sure. This would let him get either breastmilk or formula (or both) while going through the motions of nursing, so that he starts to associate the breast with eating rather than with not eating.

    Nipple shields are the only way I could ever get anything to work at all. But mostly I just exclusively pumped for months and months.

    Hope the LC visit went well. Good luck! No matter what, you will both be okay.

  2. Ana -- I am really impressed with your resolve. My friend told me that she used some tube thing taped to her breast and that seemed to teach her daughter to work to eat.... but it took her 2-3 weeks to really get the hang of things. It also kind of sounds to me like you've already done everything you can, and your mental health is important too! I really feel for you.

    I am also taking notes on this for my future reference.

    Even if you end up pumping / using formula everything will be fine. You are not a failure, and you are not missing out on some earth moving experience. It's ok to use technology to make things easier on yourself, and plus if you bottle feed, your husband will have greater opportunity to feed your baby, which can only be good for your family. The moral superiority of "natural is better" is mostly a cultural phenomenon. We both know that all that matters is that you and your family are healthy and happy, regardless of how you get there. And you WILL get there.

    Keep us posted on how things are going.

  3. This was like reading my own story towards the I'm a pump dependent mom. I have found a way to make it work for me now, but sometimes I think breast feeding isn't as natural as "THEY" make it out to me.

    Thanks for sharing this with PAIL!