Monday, January 14, 2013

August's Breastfeeding Story


Disclaimer: If you are a man, you probably don't want to read this. It might be awkward.  Just sayin'!

I have been wanting to write this for a while, but it seemed so daunting that I kept putting it off.  Breastfeeding has been a huge part of my life for the last 8 months, and I am sad that this chapter with August has closed.  I did not plan for it to end so soon, but I am finally starting to accept it.  I am writing this to record our experience for my own memory and to also encourage other women to press on through the struggles of breastfeeding.  I know reading the stories of other moms online really helped me realize I wasn't alone.  I am also writing this experience so that I can learn from what I did wrong, so that I can correct it with my next baby (coming  August 31st!). 

Prior to August's birth, I had not read any material at all on breastfeeding.  I just assumed since it was a natural thing to do, it would just come naturally.  I did not know a single thing about how milk is made, problems that may arise during breastfeeding, different holds, pumping techniques/output, latch issues, etc.  I did not know a single thing.  Me being the researcher that I am, you would have thought that I would have read up on this.  Honestly I had read so much about labor and pregnancy, that I really hadn't thought much about reading about breastfeeding.  It's just so natural, right?  I highly highly encourage anyone who is planning to breastfeed to read everything you can about it!

Let me start from the beginning.  Minutes after August was born, we discovered that he had a tongue tie.  A tongue tie is where the frenulum (thin layer of skin that attaches your tongue to the bottom of your mouth) reaches all the way to the tip of the tongue.  When a baby has a tongue tie (a severe one like August's), they have no control of their tongue.  Therefore, they cannot effectively nurse.  When they do try to nurse, the tongue gets tired very quickly because it has to work so hard to even move.  One of the lactation consultants told me that it would need to be clipped so that August would be able to nurse, however that was not something that was done in the hospital.  We would need to be referred to an ENT (Ear nose throat specialist).  My labor nurse told me that he could overcome the tongue tie, and that she would help me to nurse him.

The very first time I breastfed August was a couple hours (if not more) after birth.  Unfortunately we did not get that immediate breastfeeding experience right after he was born due to labor complications.  (You can read his birth story HERE).  Two lactation consultants came in to help us with our first time.  I really don't remember much about it.  I was still on Magnesium Sulfate, so I was very weak and very tired.  I remember that I had a lot of trouble holding August because I just did not have any strength.  One of the lactation consultants held him up for me, and the other lactation consultant guided August's head so that he would latch.  August was very sleepy and was not that interested in eating.  After a few minutes, he and I both fell asleep.  I knew I was dozing, and I kept trying really hard to stay awake, but I was just so exhausted.  I apologized that I was so tired, and the consultants told me that I could go to sleep and they would keep trying to get August to nurse.  It sounds like an awkward situation, but I was too out of it to care.  I was exhausted.  The consultants stayed with us for 2 hours straight trying to get him to nurse.  I felt so bad that they spent so much time with us, but it really says a lot for my hospital and how much they value breastfeeding, so I was very grateful. 

Our stay in the hospital was longer than planned due to my blood pressure.  We stayed for a total of 4 days, even though I had only planned for 2.  During that time, breastfeeding seemed to be getting better.  August and I both became much more alert, especially once I was off of the Magnesium.  He started out only nursing off of one side at a time for about 3-5 minutes......every 4 hours or so.  Yep, that's a really long time in between nursing sessions.  I had no idea about how often to feed a newborn.  The hospital had a policy that if the baby hadn't eaten in 5 hours, then the baby would have to be supplemented.  So I always made sure to get the feeding in under that 5 hour mark.  I had no idea how often to feed him!  A couple days after he was born, he was nursing for 30 minutes on each side.  My milk still hadn't come in, but he was getting colostrum.  I had no idea colostrum was so important.  I wish I had read about how good it is for the little babies!  I thought things were looking up.  Then 2 full days after August had been born, a nurse came into the room in the middle of the night to tell me that they had weighed August, and he had lost a full pound since birth.  He was down to 7 pounds.  My heart broke.  I know that babies lose weight, but the nurse said that this was more than 10% of his weight, which meant that August would need to be supplemented until he could get his weight up. The nurse brought me a bottle of formula and showed me how to do it.  Tears rolled down my face as I fed him the formula.  I felt like such a failure.  My little baby was hungry, and I couldn't feed him.  The nurse told me that it was totally normal, and that my milk would come in, and he would be fine.  I still felt useless. 

Fast forward a couple days.  It's the day after we are released from the hospital, and August is 4 days old.  We have his first doctor's appointment, which was a challenge since I was barely even walking the day before due to tons of stitches from the birth.  We had to have a doctor's appointment the day after he was released from the hospital because they wanted to check August's weight again.  August's doctor was not available for an appointment on such short notice, so we had to see another doctor in the practice.  I wasn't very happy that we weren't seeing his actual doctor, since we hadn't seen him the first time since August was born.  (A different doctor also in the practice signed off on August's papers for release from the hospital.)  I told the doctor at the appointment about August's tongue tie.  I told him how August has been losing weight, and that I was starting to have some pain with breastfeeding.  I asked him if he would refer August to an ENT to have the tongue clipped. 

"I don't think that will be necessary.  He will learn to adjust to the tongue tie," the doctor told me.

"But he is losing weight, and won't he have a speech impediment if he doesn't have it clipped?" I asked.  A nurse in the hospital told me that he would.

"Yes, but we will get it clipped before he starts speaking," the doctor said.

????????? I was super confused, as I imagine you are too.  If he does have to have it clipped at some point, why not now?  Why not make nursing easier and get it over with for him?  What's the point in putting it off if he needs it done now?

The following days, I started having some serious pain when I was nursing him.  When he would latch, I would cry out in agony.  I have never felt pain like this in my life. It's hard to describe that kind of pain.  It was a sharp, shooting pain that jolted through my entire body.  It was unbearable to feed my son.  I dreaded feeding him, which I felt terrible about.  I would stare at the clock, and dread the minutes ticking by.  It was awful.  I would cut him off as soon as his 10 minutes on that side were up.  This part might be TMI for some, but my nipples cracked open, bled, and scabbed and would repeat the process every time he nursed.  It was awful.  This was probably the lowest point in my life ever.  I was sobbing every few hours.  We were still supplementing, and sometimes I would skip a nursing session and just supplement.  I couldn't take it.

When he turned 9 days old, I turned 25 years old.  For my birthday, Adam and I went out with August and got some ice cream at Dairy Queen.  I only wanted one present for my birthday.  A breast pump.  I didn't have one because I didn't plan on using one since I would be staying home with August.  Since I was guessing my breast pain was due to August's latch with his tongue tie, I thought the breast pump might help.  We had a gift card and not much money to work with, so we just got one of the cheaper ones.  I also picked up some nipple shields while we were there. 

I began pumping August's bottles, but I wasn't getting much since I didn't know any pumping techniques.  (It is very important to relax during pumping, but I always had a screaming baby, so I was very worked up).  I started getting sore from the breast pump, but it still wasn't as bad as August's latch. August cried every feeding because he was still hungry.  He never seemed satisfied.  The nipple shields didn't help us much because he would get so tired using them.  It was even harder to get the milk out, and he was already struggling enough with his tongue tie. 

After that weekend, I decided I would call and making the appointment myself with the ENT without a referral.  I was his mother, and I could make this decision if I wanted to!  I had had it.  So on Monday morning, I called the ENT and booked the appointment.  It would be a 3 week wait.  I didn't think we would last 3 weeks.  I really didn't know how we would make it that long. 

During those 3 weeks, the pain continued to be unbearable.  I had a lot of encouragement from a friend and my mom during that time.  Without their encouragement, I would have given up.  My mom told me it took her 6 weeks to get the hang of breastfeeding with me.  That is a long, long time to endure that kind of pain.

Finally 3 weeks came.  We didn't have to wait long at the ENT office.  They called us back and briefly explained to me what they would be doing and that I should immediately notice a difference with his latch.  I cried as they took him to another room to perform the procedure.  They told me that it would be painless and quick and that there wouldn't be much bleeding.  They would have to strap him down and then they would use a small pair of scissors to snip the frenulum.  It only took a minute or two, and he was back in the room in my arms.  I was so relieved it was over, and he only had a drop of blood under his tongue.  I immediately nursed him as soon as the doctor left the room, and I could already tell a difference with his latch.  It wasn't painless, but it was a lot different. 

The next few weeks, my nipples had to get used to his new latch, so we went through the crack, bleed, scab process all over again.  I had started getting used to his old (bad) latch, and now I had to get used to a more correct latch.  It was a lot for me to endure.  I will have to say that God showed me more mercy and forgiveness in those weeks than ever.  I was constantly praying for forgiveness for my sinful thoughts.  I'm sure I thought a few choice words that shouldn't be in my brain at all.  Thankfully, they never came out of my mouth.

Things slowly but surely started getting better.  I decided to completely cut out supplementing with formula and pumping and just go for it.  I knew if we were going to do this breastfeeding thing, then I needed to full out commit to it no matter what.  So I began nursing August every 2 hours.  He would nurse for about 20 minutes per side, making our sessions 40 minutes long.  So I would have an hour and 20 minutes in between feedings.  It was a busy time, but I was determined to make it work.   

August began growing and putting on weight.  By 2 months old, he was in the 98th percentile for height.  He was in the 20th something percentile for weight, but neither Adam nor I were chunky babies.  He continued to grow and put on weight.  Our breastfeeding relationship was wonderful at this point.  It became really convenient to feed him while I was out, and he also began sleeping through the night.  It was no longer painful, but felt completely natural and pain-free.  We even took a trip to Dollywood when he was 4 months old.  I highly recommend Dollywood for breastfeeding moms.  They have very nice nursing stations all over the park.  Each station has comfortable rocking chairs, a little reading area with books for older children, and they also have changing stations with a private restroom for moms.  It was wonderful. 

During the time that he was 2-3 months old, I got up and pumped once during the night just to have some extra milk on hand so that I could leave him with my mom some.  I would pump about 4-5 ounces per session.  I only did this 2-3 weeks because I really wanted to just enjoy my sleep. :)

When August turned 4 months old, I decided to start a strenuous exercise program.  I had been walking up until this point, but I still had about 14 pounds (out of 51) left to lose, and it just wasn't coming off.  I began working out doing the Insanity program.  I also reduced the amount of calories I was eating, but I was not counting calories.  I had no idea how many calories I was taking in, but I was afraid that if I started counting them, then I wouldn't take in enough for August.  The weight started to drop off, and the inches dropped off even faster. 

When August turned about 4 and 1/2 months old, he went from taking 20-30 minutes per session in total to about 10 minutes total per session.  I assumed he was getting more efficient at getting the milk out.  Then he started waking up at night.  I started wondering if he was hungry.  I paid close attention to his hunger cues during the day.  We decided to start him on rice cereal right around 5 months old.  He looooooved the rice cereal.  I worried that he seemed so hungry for it.

Over the next few weeks, he began taking a shorter and shorter amount of time to nurse.  He got down to 5 minutes (to complete both sides).  I knew he couldn't be getting enough, but he would pull off and be done.  He never cried or tried to nurse more.  I continued to make him nurse every 2 hours, but welcomed him to nurse more often if he chose.  He didn't want to though.  We continued with the rice cereal and even began introduced apples and pumpkin.  He loved it.

At the age of 6 months, he developed a really bad diaper rash.  I put all kinds of rash cream on it as well as cornstarch, and nothing was helping.  It turned into an awful dry, scabbed rash.  I didn't know what to do, so I made an appointment with the doctor.  When they weighed him, I thought his weight was kind of low.  But I wasn't that focused on it.  We saw the nurse practitioner since his doctor was not there.  She told me that August had eczema.  As she looked as his chart, she noticed something. 

He had lost weight since the last time he was there, at 4 months. 

An infant should never lose weight, for any reason.  I began crying.  I had noticed over the last few days that he hadn't really changed much in the last couple months.  He was about the same size he had been for a while.  However, he hadn't cried at all to tell me he was hungry.  He was sleeping through the night since starting solids.  I never cut him off while he was nursing, and he never went more than 2 hours in between feeding.  I didn't understand why this was happening.

"Is your supply low?" the nurse asked me.

"Not that I know of.  He never complains.  I always nurse him before I offer him solids.  He is also sleeping through the night."

"Well, he will need to be supplemented until he can get back up to a good weight."  She began taking some formula samples out of the cabinet.

I started sobbing.  I felt like such a failure.  Thankfully Adam was off work that day and was able to go with me to the doctor's office.  He comforted me and told me it would be ok.

"When you go home, I want you to pump and call me back to tell me how much you are getting.  Then we will decide how much he needs to be supplemented," the nurse told me.  "No more solids until he gets his weight up.  Solids don't have as many calories as breast milk and formula, but they will fill up his tummy.  So he needs the high calorie milk."

I got a little irritated at this point.  If you know anything about breastfeeding, you know that output while pumping does not equal what the baby gets out during a session.  Babies are much more efficient at getting milk out.  Plus at this point, I hadn't pumped in at least 3 months.  Pumping is something that your body has to learn to do.  I have heard it described as an art.  I knew I wasn't going to get much. The amount you pump is NO indication of your supply.  This much I knew.  But of course I couldn't argue with the numbers.  August was losing weight.

I got an ounce out through pumping.  I called the nurse back, and she told me to continue to breastfeeding him and to supplement him with 4 ounces every 4 hours. 

I know that supplementing will not do anything for your supply.  At this point, I had learned the supply/demand factor with breastfeeding.  However, August had lost weight, and he needed to be supplemented.  That was what we had to do. 

I began taking fenugreek.  Fenugreek is an herb that is used in Indian food, and it has been found to increase your milk production.  It does this by stimulating your sweat glands, and your milk ducts are a form of sweat gland.  It does make you smell like maple syrup, which is good or bad depending on if you like pancakes.  I could tell that I would wake up with a lot more milk, and I would have to nurse him as soon as I woke up.  I'm not sure how much milk I had in the morning, because he was always ready to nurse as soon as he woke up, so I never got to pump it.  However, I would pump some during the day to check my supply, and I was only getting about 2 ounces. 

I continued to supplement him.  He continued to nurse less and less.  He looooved the formula.  I felt so bad for how much he loved it.  He clearly hadn't been getting much from me.  Nursing sessions got down to 2-3 minutes total.  I tried to nurse him more often and for longer periods, but it would only make him mad.  He wanted the bottle.  After a 2-3 weeks, I stopped the fenugreek.  It was useless since August wasn't wanting to nurse anyway. 

A few weeks later, at Thanksgiving, August and I got the flu.  It was horrible.  I was so sick that I could barely nurse him, and he was so sick, he didn't want to even attempt nursing.   He was almost 7 months old.  During this time, he began to rely more and more on the formula.

At this time, August was definitely putting on weight and even started chunking up.  After about a month and a half of formula, I added food back into his diet.  He got to where he only nursed about 3 times a day.  By 7 and 1/2 months, he was nursing twice a day- first thing in the morning and right before bed.  He didn't want it more than that and would get upset when I would offer it to him.

A few days after that, he was only nursing once a day-first thing in the morning.  A few days before he turned 8 months, he refused to nurse in the morning.  He was very eager for the bottle and wanted nothing to do with me.  I decided that when he turned 8 months old, I wasn't going to make him nurse anymore.  If he wanted to, I would, and if he didn't, I wasn't going to force him. 

He may have nursed once after that.  He has now stopped nursing, and he hasn't looked back.  He never roots on me, and the times that I think he might be, I will offer it to him, and all he does is lay his head on me.  He won't even attempt to nurse.  It is really sad for me, and I have shed many many tears over it, but this is what he wants. 

I know a lot of women would disagree with me and say that I should continue to take fenugreek and other herbs and pump all day long and drink tons of water to try to increase my supply.  I did that for 3 weeks, and I was a nervous wreck.  I couldn't tend to August because I was pumping all day long. I was constantly upset that I wasn't able to get anything out, and the fact that I had a cheap pump wasn't helping. 

I am proud of myself for breastfeeding August as long as I did.  My goal was to breastfeed him for at least a year, but he had other plans.  August has always wanted to grow up quickly.  My little man.  I gave him my immunity, and I fed him during the important early months. 

There are a lot of things I would do differently if I could do it again, but I can't go back.  I can only learn and go on.  These are some of the things that I will change for my next baby.

To Do for next time

- If at all possible, breastfeed immediately after birth.  I think this sets the stage for a good breastfeeding relationship.
-Breastfeed very often, at least every 2 hours immediately after birth.
- Breastfeed with a nursing cover a whole lot more in the beginning.  August was never a fan of the cover, and I really didn't use it much until I needed to.  I should have gotten him used to it so I would have been more confident breastfeeding in public.
- I will read everything I can about breastfeeding.
-If the baby is born with a tongue tie, I will insist that it immediately get clipped.
- I will hold off with solids until 6 months.  (This one isn't set in stone.  I am willing to change this as long as he/she is getting enough breast milk.)
- I will do my best to avoid excessive weight gain in pregnancy.  This way I hopefully won't have to do anything super rigorous to get the weight off.  I believe the rigorous working out and reduced calories may have been one of the main reasons for my supply reduction.  **I do want to say that I don't blame Insanity.  I have a friend who does Insanity, and her milk production was not affected.  I think mine was affected because it was the first time I have ever really done anything that rigorous, and I also dramatically cut calories during that time as well.**
- I also believe that we never really established our breastfeeding relationship.  With such a rocky beginning, I don't think I ever had the supply that I could have had if he had nursed more often in the beginning. My body never knew that I needed that much milk since I didn't demand that much milk in the early days and weeks.


August nursing at 6 and 1/2 months old
So that is our story.  It makes me sad, thinking about it, but August is a very happy, healthy boy.  Now that I am pregnant with our second child, I am trying to enjoy this nursing break so that I can prepare my mind and my body to nurse the next one.  I never thought much of formula before all of this happened, but I am very thankful that we have things like formula when things don't work like they are supposed to.  August and I have closed this chapter together, but I am excited to see what new ones we will open. 
 

 

Photography in this post by Samantha Willis

9 comments:

  1. Amanda, this may not be your "dream" breast feeding story, but it is YOURS! No one should judge you for how it turned out, most importantly you shouldn't. You learned invaluable lessons and you plan to try different things next time. Experience is our best lesson :-) you are a wonderful mommy and thankfully, that is not determined by the length of months you breast feed because there would be some crummy moms out there ;-) I have so much respect for you. For your honesty. For your hard work and diligence. You want what is best for your baby at whatever cost! Beautiful story and this is sure to help so many women out there. I really enjoyed reading it!

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    1. Thank you so much, Abby! You are going to make me cry! I really really appreciate your encouragement. It does make me feel like a bad mom a lot of days that he isn't still breastfed, but like Adam told me, breastfeeding doesn't make you a mom. Thank you so much for reading this and leaving me such a sweet comment!

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  2. I love that you wrote this out. You experienced quite a few trials with August that you can learn for the next baby :) You helped me to realize that even though I did not have an ideal beginning experience with Lillie-Mae that I can use what I learned next time! If you are in need for a lactation consultant, I highly recommend the "Baby Nurse" Shari Hicks. She came to my house when Lil Mae was 2 months old and explained so much that I hadn't read in 4 books and numerous blogs!!! Before her I was spoon feeding and using a nipple shield!

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    1. Thank you, Danielle! It sounds like you and Lillie-Mae experienced a few trials yourself. Those early days and weeks are so hard. Thank you for the recommendation for the Baby Nurse! I wanted to call someone so badly to help us, but I didn't know who to call. I will definitely remember her name!

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  3. Thank you for such a wonderful and detailed post. I am pregnant with my first baby and read all the time, but wasn't sure what to expect about breastfeeding until you shared your story!

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    1. Thank you and congratulations! Every person's breastfeeding story is different, so hopefully you won't have the struggles we had. Whatever happens though, you can do it! Thanks for reading! :)

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  4. so glad to be able to go back and write this. you are so smart, and i'm telling you - it feels like i'm reading my own mind when i read your writing! :) we are so similar. ive been wondering if i should give gracie formula.. ugh.

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    1. i meant, so lad to be able to go back and read* this. haha.

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