Sunday, November 17, 2013

The Breastfeeding Saga :: Part II - Nipple Shields

Hey, remember months ago when I started telling you all about our Breastfeeding Saga?  Well, probably not because I really dropped the ball.  So, without further ado, I'm just going to jump back in here with Part II.


The next two days at home with the baby were difficult.  My milk had come in, but she was constantly in distress, difficult to settle, and never satisfied with the amount we were told to feed her.  I think we were both relieved to visit the pediatrician and see what they had to say.

The doctor asked about breastfeeding, and I confessed our difficulties.  She reviewed the amount we were feeding Baby and said it was not nearly enough.  The baby was screaming because she was hungry!  It all seems very "Duh!" now, but you have to realize that it was the first two days of our parenthood.  We followed the instruction sheet to a T, and I still have no idea why the LCs thought she needed so little.

Once I described our latching issues, the pediatrician sent in their own LC to do an evaluation.  The LC watched me attempt to feed baby, looked at her mouth, and said she wanted the doctor to come in and evaluate her for a tongue tie.  The doctor returned and they examined her together.  The doctor explained to me that she was fighting against her anatomy and that she would, in time, be able to breastfeed (Missed Diagnosis #6).  She pointed out her very strong suck, and explained to me that she was gumming and tongue thrusting.  "Even if you could get her to latch," she told me, "it would be incredibly painful for you." The LC suggested a nipple shield, and the doctor concurred.  They also told me to ditch the pacifier.

Come with me if you want to breastfeed.

Moments later, we were breastfeeding for the first time.  Tears flooded to my eyes as baby latched easily and began to nurse contently.  I thanked the LC over and over again.  She warned me that a lot of folks don't like nipple shields--they used to be a thick plastic that would slow the milk follow and eventually decrease your supply.  She said they had since been redesigned and offered some moms their only chance at breastfeeding.  She told me that most moms could eventually wean off of them, and that she only had one mom still using them even though her baby was several months old.  I was hardly listening... we were breastfeeding!  My heart was full of hope.  I was finally feeding my daughter the way I always thought I would. (Well, not exactly the way I always thought I would...)

The next several weeks I continued to feed Baby with the help of the nipple shield.  Hubby bought us several of them, so we could always have a clean one ready to go in the middle of the night.  I was glad they were helping us breastfeed, but I also hated them.  It felt strange to know that if I was caught somewhere without one, there was nothing I could do to feed my baby.  I carried them with me everywhere I went.  I had a pair in every diaper bag.  I had two containers at home: one with the clean ones and one with the ones that needed to be cleaned.  Hubby and I were constantly washing and cycling them out.  And to make things even more complicated, the edges stopped sealing after a couple of uses, and they would leak milk everywhere during her feeds.  I had to slather my breast and the shield with lanolin just to keep them in place.  It was a nuisance, but it was better than nothing.

Baby's feeds were epic.  She ate on both sides, taking over an hour for every feed.  Because of her weight loss, I had to keep Baby on a strict every two hours feeding schedule, which meant I spent very little time not feeding the baby. Though I was happy for the nipple shield's help, I felt self conscious about needing it, so I never fed her publicly, around family, or friends.  As you can imagine, that started to feel a bit isolating...

It's worth noting that, at this time, Baby would sleep 4 -6 hours when given the opportunity.  I accidentally slept through my alarm a few times and woke up several hours later.  Of course, at the time I felt like a HORRIBLE mother.  You can bet that I'm laughing at that now.  Laughing, crying, whatever--it's a fine line when you are sleep deprived.

We had many, many doctors visits to monitor her weight gain, and the fact of the matter is, she was not gaining weight the way any of us would have liked.  The LC said she thought she wasn't getting everything she needed in my milk.  They started talking about exclusively pumping and fortifying my milk, or just plain switching to formula.  I was not giving up now, so we started with the fortifier.  I would pump, add it to the bottle, then feed her the bottle.  When she finished, I would let her nurse on the other side.  It was exhausting. I don't know how people find time to pump frequently when they are home with a baby... I really don't.

(Side Note: when we ran out of Similac Human Milk Fortifier, we found that you can't actually buy it ANYWHERE.  The doctor had us create a "high calorie mix" of formula and breast milk to continue fattening her up.)

With each step forward came a new obstacle, and with the frequent bottles, Baby would no longer latch well.  She got flustered with the shields, knocked them off, wouldn't latch completely, and the whole production was getting very struggled and very NOISY.  I was frustrated that the bottles had caused this issue. I was frustrated at the sheer noise.  Desperate for some semblance of normal, I pulled the nipple shield off and... SHE LATCHED!  It was amazing.  And painful.  But I was convinced I could power through it.  She wouldn't latch without the shield consistently, though.  It was frustrating for both of us.  Sometimes the lack thereof would just make her angry, but I kept trying, and after a few days, we were off the shields completely.

Her latch was still sub-par.  Her lower lip (and frequently her upper lip as well) were usually turned in.  She would slip off while she was eating, and she would click during letdown.  I hoped that she was just learning.  I corrected her latch as much as I could without making her angry, at which point she would refuse to latch at all.  Despite all my efforts, and after only a full day of being shield-less, I was leaping off the chair in pain during every feed.

The doctor was shocked I had been able to wean her from the shield at all.  Everyone was so excited about that, they didn't pay much attention to my desperate pleas for help.  I was in excruciating pain, and it wasn't improving.  The doctor said Baby was still tongue thrusting a bit, and her gums were still getting involved, but her suck was improving.

"You've worked so hard, no one would blame you if you wanted to throw in the towel."  That is the sound of breastfeeding support in my neighborhood.  I know she meant well, but I wish I had felt like she had my back.  But, I had fought this hard, and I surely wasn't about to throw in the towel now.

I met with the LC again.  She had me latch baby in front of her, and for the first time it didn't hurt.  I was esatatic, but confused... I hadn't done anything differently!  The LC pointed out that Baby's lips were turned in, and encouraged me to try to keep flipping them out.  I was trying--all the time--but sometimes it just wouldn't work.  Even Hubby would help me by holding her lip out while she latched on--what a production breastfeeding was for us, it involved a whole crew! She told me to hang in there, give it two weeks and see if it still hurts.  But I didn't think I could handle two weeks of this pain.  I was crying while she was nursing.  I was anxious at the idea of her next feed.  A growth spurt arrived, and I just wanted to run down the street.

I needed a PLAN. I need to feel like someone understood the level of pain I was experiencing, and I wanted to know for certain it would improve.  I didn't want to "hang in there" for two weeks and still be suffering.  I called the La Leche League. Though I had heard most of her suggestions before, the woman I spoke with was supportive and listened to my entire story.  She encouraged me.  I felt lifted up.  I kept going.

After three weeks of breastfeeding without the shields, the feeds had reduced to 20 - 30 minutes split between both sides.  The pain had improved, but never really ceased.  I would have a few good days, and then a few very painful days.  Overall, it was better than before, but still not what I had expected from breastfeeding.  However, I could handle it, and I did.  The good days were enjoyable, and the bad days were survivable.  We were breastfeeding, and I will still grateful for that small miracle.

I wish this period of successful breastfeeding and 3 - 6 hour blocks of sleep had lasted more than a few days, but just as we were finding our footing... the shot hit the fan.

Coming Soon The Breastfeeding Saga :: Part III - MSPI

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