breastfeeding: my story (part 1)

I’ve recently been inspired by the Fearless Formula Feeder to share my story.  My hope is it will encourage a more open dialogue about the struggles that often come with breastfeeding and the challenges of being a formula feeding family in a “breast is best” culture.  I have a lot to say so I’ll be writing a few posts about it.  This one is about the first week of Gretchen’s life and my initial experience with breastfeeding.

our first family photo taken a few hours after Gretchen was born at 35 weeks and 5 days

I had always planned to breastfeed, but in the back of my mind I knew it wouldn’t be easy, as so many friends have so openly shared their struggles with me.  I read books, took the breastfeeding class offered at our hospital, and had the name and number of a highly recommended lactation consultant programmed into my phone just in case.  I didn’t register for or buy any bottles, and I threw away any formula samples that I received in the mail or at the doctor’s office.  I’d read that having it in the house was a black mark against one’s chances for successfully breastfeeding, and I wanted to do everything I could to make breastfeeding successful.

Sunday:  Gretchen came into the world just shy of 36 weeks at 5lbs 13 oz and we did immediate skin to skin contact just like all the books recommend.  She latched right away and had “crazy eyes” as we like to call it.  Like “HOLY COW WHAT IS GOING ON THIS IS AWESOME!”  I gave birth in the middle of the night on a Sunday and all the nurses were extremely helpful in getting her positioned and latched as it became more difficult to do after that first time.  Since Gretchen was born so early they were watching her blood sugar and temperature very closely.  Both were low and I was encouraged to feed her every 3 hours.  Because Gretchen was so sleepy and not sucking very well the nurse brought me a pump to see if I could express some colostrum to give Gretchen through a cup or a syringe.  I got nothing from the pump so we started supplementing with ready to feed formula via cup feeding, thinking we’d only need to do it for a day or so until my milk came in and the baby was over her sleepiness and then we’d be set.

Monday: A lactation consultant came by my room to observe a feeding. She said we had a good latch, handed me a folder of info, and said we’d be well on our way once my milk was in.  No mention of renting a pump or any information about the breastfeeding support group they had weekly.  There was a flier for the support group in the folder but it did not state where or when it met, simply that it existed.  Gretchen’s temperature and blood sugar were improving by the middle of the day and even though she was always asleep, we knew that was a normal and figured she’d wake up and get more interested in eating soon.

Tuesday:   Gretchen’s blood sugar and temperature regulated and we were discharged from the hospital with instructions to keep breastfeeding every 3 hours and supplement via cup feeding after she nursed until my milk came in.  We took all the formula samples we could fit in our bag home in hopes we wouldn’t have to buy any formula ourselves.  I was still running pretty high on adrenaline at this point but the lack of sleep was catching up with me.  We knew we were fortunate that Gretchen had spent zero time in the NICU despite being a late term preemie, but we were so nervous about taking home such a small baby and having to care for her ourselves.  She was just so tiny and fragile.  Tyler was immediately over protective (and still is to this day).

Wednesday:  We saw Gretchen’s doctor in the office and learned she was quickly losing weight (down from 5 lbs 13oz to 5lbs 6 oz) and becoming jaundiced, so we had to come in daily that week for blood draws and were told to breastfeed/supplement every 2-2.5 hours around the clock.  Gretchen had plenty of wet diapers but hadn’t pooped since birth.  I scheduled an appointment with the LC I’d heard good things about for that Friday.   Gretchen’s doctor encouraged us to go to the breastfeeding support group for a weighed feeding and told us where and when it took place (turns out it was held in a room in the maternity ward where I delivered Gretchen.)  At one point I thought my milk had come in, not really sure why, I think it was wishful thinking.  My breasts felt fuller but I wasn’t getting anything when I tried to hand express and Gretchen was growing increasingly frustrated at the breast.

Thursday:  We were back in the doctor’s office for more bloodwork to check Gretchen’s billi levels.  She was turning a nice shade of orange by this point and Tyler was in full on freak out mode.  He’d never heard of jaundice and was googling all kinds of things and freaking himself out.  I was much calmer about it, knowing that many of my friends had gone through it with their babies and everything had been just fine.  Getting Gretchen to eat and poop were key in getting her billi levels up, so we fed her and fed her often.  I had consulted with many of my friends online about our breastfeeding issues at this point and they were so incredibly helpful and encouraging.

However, over and over I was hearing  from them and reading online that I should be pumping if I was supplementing, and moms that had been in a similar situation as myself had been sent home with a pump and instructed to pump every time they supplemented with formula so that their supply would not suffer.  The helpful LC at the hospital never mentioned that.  They’d sent me home with the pump flanges and tubing from my one failed attempt at pumping in the hospital but I was given no info on pump rentals.  When I called the information desk at the hospital to inquire I found out I could rent a pump at the BF support group where we were headed that afternoon.

Gretchen would.not.wake.up. during the group so I didn’t get to do a weighed feeding (I did however get to whip my boobs out in front of a group of total strangers, lol.)  Gretchen had dropped another 2 oz, down to 5lbs 4oz.   I did get my pump but no instructions on how to use it.  Thankfully youtube filled in the gaps for me!  I started pumping right away (after every feeding) but just got a few drops of colostrom as my milk still wasn’t in yet.  I got a call at the end of the day that Gretchen’s billi levels were leveling off and we breathed a sigh of relief.  Goodbye jaundice!

Friday: 5 days after her birth my milk still hadn’t come in and Gretchen was screaming and crying when I brought her to the breast (and by that point I was crying too!)  When she wasn’t screaming and crying she was fast asleep and difficult to arouse for feedings, typical of late term preemies.   I got so tense and filled with dread before every feeding.  I was letting her breastfeed for 10-15 minutes per side (although I had to pull her off and wake her up every 2-3 minutes since she kept falling asleep) and then we’d supplement with the cup.  15-20 ccs after every feeding.  She gulped it right down.

I remember going to the LC that Friday and Gretchen was inconsolable in the car, I was trying to time it so she’d be due for a feeding at the LC’s office but she had woken up early and was hungry.  Tyler missed our exit and I was pissed that we were running late and the baby was upset.  We had read so much about “nipple confusion” that we were afraid to introduce a pacifier, for fear it would ruin our chance of being able to breastfeed.  So we were using our pinky fingers to soothe her when she needed something to suck on.  I remember sitting in the waiting room with my pinky in her mouth.

The LC was amazing.  We met with her for 90 minutes and she helped me improve our latch, gave us tricks for keeping our sleepy baby awake and sucking, and taught us about doing compressions to bring the fatty hind milk forward.  I felt so encouraged during that one feeding in her office.  It was a weighed feeding but at the end when we weighed her she had gained nothing.  Nothing.at.all.  She hit her lowest weight yet: 5lbs 2 oz.  I was armed with information and new techniques to try but no milk, the key ingredient to breastfeeding!

During our consultation the LC asked lots of questions about my medical history including a question about whether or not we’d had difficulty getting pregnant.  As a matter of fact, we had.  After going off birth control in early 2011 I never ovulated on my own and I needed Clomid to get pregnant.  The doctor suspected PCOS but while I had some of the classic signs, I didn’t have any cysts on my ovaries or irregular labwork, so it was never an official diagnosis.  The LC informed me that many women with PCOS have problems with low milk supply.   Other issues she noted were that my breasts never changed in size while I was pregnant  and I’d had zero leaking of colostrum during my third trimester.   Both of these things can be normal and not indicative of one’s ability to breastfeed, but sometimes they are a clue that difficulties are ahead.   She gave me some mother’s milk special blend supplements and detailed instructions on how much to take and how often.  She also fitted me with a hands free pumping bra and told us it was okay to use bottles instead of cup feeding.  Less messy and unlikely to cause nipple confusion if we used the right kind of bottles (we went with Tommee Tippees, they are very boob like!)  I can honestly say if we hadn’t met with this LC we would have given up breastfeeding before the end of that first week.  She armed us with enough strategies and confidence to persevere until Gretchen reached her due date, the first goal we set for ourselves.

That was the first week of Gretchen’s life and it had been a complete roller coaster.  I thought we’d been through the worst of it with her premature birth and jaundice, but the next few weeks proved much more difficult as the adrenaline wore off and hormones and sleeplessness set in.

click for part 2