Thursday, January 31, 2008

breastfeeding craziness- long post!

When I did my 2007 year in review I briefly touched on the challenge of breastfeeding.  I wanted to write more about it when I had time to elaborate fully...because I want people to understand what I went through and how I feel.  And maybe it will change how other people feel about it too.  

I decided long before I was even pregnant that I wanted to breastfeed.  My goal was to do it for at least a year.  It's a commonly accepted fact that breastmilk is the best food for babies, providing all the needed nutrients for them until they are one year old- and is even beneficial beyond one year.   My sister breastfed with no problems (that I know of).  My mom didn't BF us (that I know of) because she was returning to work right after maternity leave- which is why she was able to retire so young!  I had just decided that I WOULD breastfeed because it is what I wanted to do.  If I went back to work I was going to pump so that the baby would still get breastmilk.  And once I make my mind up about something there has to be a major reason for me to change it.

I talked to people about it.  I took the breastfeeding course at Rex to prepare for it, so I'd know all about latches, how long to do it, positioning, etc.  I read books loaned to me by other people, and purchased some of my own.  In other words- I would say that I educated myself more than the average bear...because I KNEW that it was what I was going to do.  Plus- since I wasn't returning back to work immediately- the cost savings alone was motivating even beyond the convenience and nutritional benefits.

I had heard from a few people and read more than once that it was important to try and nurse the baby as soon as possible after delivery.  Meaning- a matter of minutes after birth.  Even if the baby didn't really get anything to eat it was just to begin the process and stimulate their nursing instincts and start the milk production process.  For me- that wasn't really possible.  I didn't explicitly state that it was my intention, so it was assumed that it wasn't.  After she was born (8 lbs 6 oz-much bigger than we thought she'd be!!) she was whisked away by the nurses to start cleaning her up (she was in the same room as me, just about 10 feet away)...and I was bleeding....Enough to concern the OB who tried a few different meds and ultimately gave me a shot of something to stop it.  But it took a while.  By that time she was cleaned and already being held by Marshall.  

Then she was given to me and it seemed like 30 seconds later all of our family came in!  (of course it probably wasn't that fast- but I remember it as one big blur).  So- no nursing going on then!  I wasn't even thinking about it.  When we were wheeled into the postpartum room and everyone had finally left, the nurse asked me if I was ready to feed the baby.  Oh yeah!!!  The baby needs to be fed!!  Crap!

So she helped me get Mdx latched on and watched her eat for a while.  Everything seemed great.  I was exhausted but couldn't sleep because of adrenaline and excitement.  I maybe slept a hour that night.  The LC came in to talk with me the next day and was very pleased at how prepared I was, and how well things were going.  My milk came in (finally!) 3 days later.  That was an amazing feeling-having these new big boobs full of milk (I thought).  At that point I thought everything was going great.

The first tiny inkling of trouble was at Mdx's first check-up- 3 days after she was born (the day my milk came in).  She had lost more weight than normal- she was down to 7 lbs 8 oz. - a loss of almost a pound.  The pediatrician said he wasn't worried- to just keep charting her feedings and diapers, and to come back for her 2 week check-up.  He said by then she'd probably be back to her birth weight.  One thing I had never heard anyone talk about was how sore my nipples would get.  It literally felt like she was stabbing me when she'd first latch on!  It brought tears to my eyes and made me curse ("Son of a biscuit! Mother forker!").  Once she was drinking it was fine.

We continued on as normal.  Feeding pretty much every 2 hours- I had to wake Mdx up to eat, because she'd just sleep and sleep and sleep.  She didn't act hungry much at all.  Even at night I had to set an alarm and wake her to eat.  Marshall left to go back to Korea- and I became a single parent.  I was so tired at that point that I was either sleeping or nursing pretty much all the time.  I tried to stay in bed as much as possible!  :)  At her 2 week check up she had only gained 2 oz!!!  She was 7-10.  A big disappointment.  We were put on weekly weight checks to make sure she was gaining appropriately.  I made sure to feed her every two hours and let her nurse as long as she wanted.  I fed her from both sides every time until they felt empty and soft.  But I had noticed that I never felt a let-down.  Not even once.  Whether pumping or nursing, I could see milk coming out (never very fast) but couldn't feel it.  It never sprayed in streams- like I had heard other people describe.  I began to be concerned.

At her 3 week check-up she had LOST weight and was at her lowest- 7 lbs. 7 oz.  The pediatrician said she looked great, very alert and good color....but we really needed to get her weight up.  So she recommended that I start supplementing after nursing by offering her 2 oz of formula after each feeding.  Or course I followed the recommendation...I didn't want to hurt my child! Sometimes Mdx drank it all, sometimes not.  I thought it was just a temporary thing until she got the hang of it.  I took people's advice to make sure I was eating enough, make sure I was drinking enough, make sure I was sleeping enough (yeah right), eat oatmeal every day, etc.

At her 4 week check-up she was 8-2.  A decent gain but still not up to her birth weight.  The ped. said that we must be over the hump- so she'd see us in 2 weeks.  We continued the supplementing- and I was starting to think that I wasn't making enough milk.  But- I knew that my insurance didn't cover a LC- and money was tight, so I just kept doing what I was doing hoping that it would all work itself out.

At her 6 week appt. she finally was back to her birthweight of 8-6.  Which was not good enough...she had only gained 4 oz in 2 weeks.  The ped said she really wanted to see weight gain of 4-8 oz. a week minimum.  So she recommended that I up the supplementation to 4 oz after every other feeding, instead of 2 oz.  That was when I decided to call the Lactation Consultant.  I knew that if I kept it up my baby would be a formula baby in no time.

The LC was wonderful.  Expensive, but great!  At that point I was so discouraged I had decided that I was going to pay whatever I had to in order to figure out what was wrong with me.  She checked Mdx's latch (only issue is a very high palate- hard to suck very hard), helped me work on positioning her better (I was doing it well already) showed me how to do breast compression, got me taking fenugreek supplements, called my OB to get a domperidone prescription, rented me a scale to use before and after feedings, and showed me how to use a SNS.  She also told me to pump after I nursed her every two hours which would stimulate me to make more milk.  I told her I'd do my best, but only managed to pump about half that amount.  The problem was I couldn't hold Mdx and pump at the same if she was happy I could pump.  If not, I had to take care of her.

At this point I hoped the fenugreek would be enough and I wouldn't really need the medication.  In my opinion if something can be solved herbally it's a much better choice than a man-made chemical.  However- it didn't work.  I smelled like licorice, but didn't make much more milk.  I got the medicine from a compounding pharmacy (not covered by insurance!!) and it was $1/pill!! I was supposed to take 6 a day!!  This was very discouraging. We already were tight on money, and I was blowing it on medicine that MIGHT or MIGHT NOT work.

It ended up the domperidone worked a little- but not enough.  I bought some online from a pharmacy overseas- it was much cheaper (don't turn me in), but still had to supplement.  At her 2 month old appt. she was up to 9 lbs. 4 oz.  Finally a decent weight gain.  The pediatrician said she didn't need to see us until the 4 month check up.  Great news! I ended up using the SNS to supplement with liquid formula (more expensive than powdered, but the powdered clogged the supplementer) and nursed Mdx until right around 4 months old.  At night she exclusively nursed, I think because she was too tired to protest...and could just sleep and drink at the same time.  Finally after a lot of soul-searching, stressing, feeling guilty, draining the bank account, and generally feeling like a failure- I decided to stop nursing her right after Christmas.

It doesn't matter how many people tell me it's fine, she'll get what she needs from formula, good for me for nursing her as long as I did...blah, blah, blah.  I listen to all of that, and I HEAR it, but I don't FEEL it.  The fact of the matter is that I couldn't provide what my child needed.  My body let me down.  I physically was not able to make enough milk to sustain her.  Perhaps it was stress related.  I may not have enough milk ducts in my breast tissue to ever make enough.  A hundred years ago before formula- what?  Would Mdx have just died because I couldn't feed her?  How am I supposed to feel about that?

And on TOP of that is knowing how judgmental people are- people who don't even know me.  Because I used to be one of them.  I had heard the statistic that it was really only 1% of women who actually physically CAN'T make enough milk.  Most of the women who quit because they say they "can't make enough" actually gave up because they didn't have the right information or support, or truly weren't dedicated enough.  I remember seeing people feeding their babies formula and thinking that they sure must be selfish- to deny their child breastmilk, which they know is better for them!!  But me??  Certainly that didn't apply to me, right?  Karma came back to bite me in the ass big time.  Amazingly I must be in that 1% of women who just can't.  No matter how hard other people might be on me though, I'm much harder on myself.

For pretty much the first time in my life I CAN'T do something, no matter how hard I try, or want to, or see a doctor, or read or study.

I can play the violin, viola, cello, guitar, mandolin, a little piano, and a few other things...I can sing in musicals....I can be a lifeguard, babysitter, swimming teacher, camp counselor, and Elem Music teacher...I can get scholarships to college and do study abroad in an off-the-beaten-path country...I can break the Conference strike out record for our high school softball team...I can run a marathon to raise money for the Leukemia Society, and grow my hair for Locks of Love...I can pick up and drive from NC to TX to be with by hubby!...I can get a full scholarship to grad school and get a Masters degree in one year while pregnant.

But I CAN'T FEED MY OWN BABY.  And you know what, it makes the rest of that stuff seem pretty insignificant.


Em said...

You're a great Mom, Mary - don't beat yourself up over something you couldn't control. I know it is frustrating, but you have a beautiful daughter who loves you and a supportive and sweet husband (who also loves you). It sucks when things don't go the way you planned and I know you tried your darndest! Em

Rocketgirl said...

My heart breaks to read this entry!! I wasn't anywhere near as prepared to breastfeed as you were, but I had the same attitude - "I can do it! Women have been doing this for years! This statistices don't apply to ME!" But it didn't go well at all. Solei couldn't latch on because my nipples were totally inverted, and the nurses traumatized her by forcing her little head onto me - she was so hysterical she could only really nurse when she was asleep and not aware of what was happening. I did have letdown, but the horrible thing was, it exasurbated my post-partum depression and I would have intense pain and desire to kill my baby every time she'd latch on. I heard you got feel-good hormones, but I'd never heard of anyone getting the reverse!! I've since found out it isn't common, but it does happen. I had to stop after 3 months when my therapist agreed that this wasn't healthy for either of us. I was shocked, my mom had done it, my friends were doing it, and hey, tons of Basilian women were doing it right in front of me everywhere I went (4 year olds - that was a trip!!). People who didn't know me would be so disappointed in me and tell me how selfish I was being, and I felt guilty for so long. I've finally told myself that I can give my daughter so much more than breastmilk. I will give her music, I will give her love and everything she needs. And then, my mom told me that she got sick after I was born and she'd only been able to nurse me for 6 weeks, and I'm healthy as an ox. So, I'll focus on what I CAN give her, not what I can't. Your little girl is so blasted lucky to have such a talented mom to show her all the wonderful things this world has to offer. I could make a huge list for you, but then I'd just get jealous for my little girl:)