On Breastfeeding

If you don't want to read my long personal story, scroll down to the bottom for my list of advice on breastfeeding.

A couple weeks ago, I wouldn't have been able to predict if this entry would be called "On Breastfeeding" or "On Bottles." I was pretty close to giving up on doing things the "natural" way.
Funny, how misleading the word "natural" can be. Yes, breastfeeding is natural. But so is walking...and it takes a lot of time and development and strength to be able to do it. Babies have to learn how to walk. They have to take small steps with a lot of help. They have to fall down many times before they can do it properly. Yet there is no denying that it is, in fact, natural.


Breastfeeding...ahhhh...breastfeeding. How confident I was telling people, "Yes, I'm going to breastfeed." Just saying it seemed natural. I heard it was painful at first, but most accounts seemed to limit the discomfort to the first few days. No problem.



How cute I was with that confidence. LIttle did I know what was ahead.







As you know, my daughter was born a month early. The hospital had a "protocol" for premature babies. They offered her my breast right away, but she was too small and sleepy to nurse. The pattern was this: Breast, bottle, pump. Offer her the breast. Supplement with the bottle. Pump for 15 minutes to stimulate your milk supply. Let me tell you: 15 minutes is a long time to have something tugging at your knockers.







While we were in the hospital, Aleida didn't do much with my breasts. So, we started off giving her formula (I heard the collective gasp from all the La Leche Leaguers out there). It was nice because both Dave and I could feed her. Daddy liked that. Not what I wanted or expected, but I knew she needed nourishment. And the nurses assured me that she would be able to breastfeed eventually.







I used to see breasts as a feminine, sexual thing. That's why women wear necklaces and low-slung tops, right? To flaunt the boobage. To showcase the tatas?







Cue the breast pump. If you've never seen one, it's like this: A funnel shaped piece of plastic is placed over each breast. You have to hold it there- no handsfree contraptions. I've heard they exist, but the hospital did not offer... These funnels are connected to a splitter. One end goes to a collecting bottle. The other end connects to a tube which runs to the pump. Turn it on and you get a nice "whirrr, slump, whirrr, slump, whirrr."







In essence, I became a cow. Hook me up to a milker and collect. At first, it's a painful tug that for me brought not a drop for almost 24 hours. Once the milk started, the yield was little drops and trickles of milk. After a couple days, I was getting a stream. I had extra milk. More than AJ needed. By day 3, she was on nothing but breast milk, but not from the breast. Had I been more informed, I would've been more proactive in getting her to latch. But I had lots of other things on my mind, and the lactation consultant was clearly not aggressive.




Jump ahead 7 weeks. Today I'm going to my 4th appointment with a lacation consultant. These appointments will outline for you the general points of difficulty that I've encountered on the journey.



1st Visit: Aleida 1 week old. Routine Visit to Kaiser's Mother-Baby program. She was weighed. Lactation consultant watched her try to latch. She gave us a "nipple shield." It's a plastic dome that covers your nipple. It's usually used for flat or inverted nipples. I don't have this problem, so I think she gave it to us as a transition from bottle to nipple. I was advised to try the shield, but continue to pump and supplement with the bottle.



2nd Visit: Aleida 3.5 weeks old. Back to Kaiser's Lactation Specialist. Originally, I made the appt b/c we were really struggling at the breast. Aleida would cry and pull away from my breast, but happily finish off a bottle. Feedings often ended in frustration, sometimes tears. Aleida was still small, still premie, so my expectations might have been a bit unrealistic. Still, I just wanted to breastfeed her. I didn't want to struggle with it. Between making the appointment and going to it, things improved dramatically. Aleida was taking more from the breast. We were still using the nipple shield, but I was okay with it b/c it was better than the bottle. At this appt, Aleida was again weighed and still gaining like a champ. We also did a before and after weight. Weigh her. Feed her. Weigh her again to see how much she was getting. AJ proved to be efficient. In about 14 minutes of nursing, she took in close to 3 ounces- more than her nutritional need. Everyone was happy and I thought the worst was over.



3rd Visit: Aleida 5.5 weeks old. I wanted to wean off the nipple shield. Though my husband continues to warn me away from the blogosphere, I continue to turn to it for advice. I saw that nipple shields have been shown to decrease milk supply and can be very hard to wean off. So, I started nursing without the nipple shield, and started having some pretty major pain. I'd heard breastfeeding caused pain in the early days, so I suffered through, thinking that this was my equivalent of the early days. I started to have anxiety associated with breastfeeding, b/c I wasn't sure how she was going to latch on, and I anticipated pain. I would often have to give myself breaks from nursing. Even when I wasn't nursing, I would have intense soreness and even acute pain in my breasts. I started to worry about infection and I had no idea if this was normal. I called a different lactation consultant under my new insurance, and made an appointment. I was skeptical that anything could be done, and worried that I would be giving up shortly after the visit.

Fortunately, Aleida was still gaining weight. And this consultant was much more knowledgeable than the last. She showed me that with some very minor technique changes, I could get AJ to take more of the breast in her mouth. Before, she was really just nursing off my nipple and I thought "latching on" referred to her grip on my nipple. What "latching on" really means is that the baby's lower lip is latched on below the nipple, towards the bottom of the areola, taking much more into her mouth. She again did the before and after weight, and again we saw that Aleida is an efficient sucker. I felt good. I was equiped with good information.



I asked about the pain. My consultant did suggest that I might have Reynaud's Syndrome. This is the same syndrome that causes people's fingers to turn white when they are cold. Apparently, you can have it just in the breast, and that could be a cause for pain, especially when your nipple is already traumatized. The blood vessels in the area actually constrict, so it feels like a spasm. Yep, I was having nipple spasms. I often referred to these episodes as "nipple attacks" and affectionately described them as "cheese-grater nipples." Lovely, no? Don't worry, this is an outlier symptom- not among the scope of "normal" breast-feeding adjustment.

**24 hours have elapsed since I started this entry**

4th Visit: Aleida 7.5 weeks old I made this appointment because while my pain has greatly diminished, Aleida is inconsistent with nursing. Sometimes she will be on and off in 5 minutes and I can't convince her to go back on. In the last few days, she's been fussy at the breast, squirming around like she's uncomfortable and sometimes crying. Since she's not a fussy baby by nature, I'm worried that something's wrong. And I'm worried that she might not be getting enough milk with her quick feeds. Again, the blogosphere has me worried about foremilk/hindmilk inbalance, insufficient weight gain, etc.

Good news from the visit- Aleida now weighs 8 lbs 14 oz which means she's been gaining about an ounce a day since birth--over an ounce a day since my last appt. She's also a total Hoover- sucks down 2 ounces in about 5 minutes on my boobage. The consultant said I'm doing everything right. She said AJ's latch is great, I make it look easy, I'm a good mother. Shucks...I thought...keep going... The only question is the fussiness. 6-8 weeks is one of the more fussy periods across the board- so it could be that. She also said the buzz word in lactation circles is acid reflux in babies and they are actually treating babies with antacids. She isn't buying into it, and neither am I. I checked the blogosphere and most babies suffering with reflux have many more and much worse symptoms than my AJ.

So, I'm trying new positions and just in the last few feedings, I've noticed a big improvement. Part of the problem could be my overabundance of milk and therefore my fast let down. I think it's probably just creating gas. So, I'm trying more upright nursing positions. I prop AJ up beside me- almost in a sitting position, and offer her the breast that way. She hasn't fussed this morning, so I think it's working. And there's validation in her weight gain and the words of the consultant. So this time...fingers crossed...I do feel like the hard part is over, though I still hope to get more consistent feedings, and I want my milk to regulate so I don't feel so swollen.

In summary...here's my advice to anyone attempting to breastfeed:

1. Lower your expectations. This is a difficult process for a lot of moms. Some lucky people transition w/out much trouble, but from what I'm hearing, it is totally normal to have a bumpy start.

2. Do what's best for you! For me, pushing through was the right decision. The disappointment of not breast-feeding would've outweighed all the pain and frustration. On the other end, I'm glad I suffered through. But this is not true for everyone. If you need to pump and bottle, pump and bottle. If you need to go to formula, go to formula. Don't let frustration hurt your relationship with your baby, or your body. In the end, a happy bottle-feeding mom is going to be much better for a baby than a miserable breast-feeding one.

3. Forget your cans as anything but functional milk-makers. They are as big and pretty as they are going to be, but they are not your boobs anymore. Nor are they your partner's. They are your baby's. It's temporary.

4. Use lactation consultants. The minute you feel frustrated, call and schedule an appointment. I wouldn't be breastfeeding now if it wasn't for the help I got.

5. Beware the blogosphere. Keep reading my blog...of course...but watch out for the info out there. Every baby is totally different. So when I was reading that babies should nurse for at least 15 minutes on each breast, I was totally insecure. My baby gets what she needs in under 10 minutes (that's right, suckas). But advising others to stop at 10 minutes could be harmful. You will learn what works for you and yours.

Breastfeeding is hard, but I must say, there are few things more precious than my daughter nursing. It's a beautiful, amazing thing that our bodies can be the sole producers for our offspring. Oh yeah, and you burn 500-800 calories a day breastfeeding- that's more than during pregnancy- so eat away!

Final piece of advice: Be gentle and patient with yourself, your baby, and the process. Remember, it's all temporary.