Tuesday, June 18, 2013

My breastfeeding journey & Why I don't want to do it again

When I was pregnant with A. I had no doubt that I would breastfeed. I read from cover to cover The Womanly Art of Breastfeeding, watched numerous videos about all aspects of breastfeeding, read forum after forum about hints and tips and spoke at length with My Mom who breastfed me until 15 months and My Brother until well past the age of two. I felt I was well prepared.

I knew breastfeeding was a skill, a difficult one, with a harsh learning curve. I knew it wouldn't be easy and prepared myself to be frustrated but I knew that there was no way I was ever letting my baby drink formula. Breast was best, period. I brought all the samples into work and left the coupons for formula on the shelves.

Then I had A. His birth was the exact opposite of what I had planned for - PROM followed by an induction due to it and pre-e, medicated, infection, fever and it all ended in a C-section after 18 hours of back labor and 45 minutes of pushing. I was exhausted and very sick from all the complications I had run into. A. was lethargic and had to have additional testing after birth due to his kidneys not functioning in utero (they checked out fine after all).

I did not see A. until at least 2.5 hours after his birth.  I could not get him to wake up until almost 4 hours after birth. My first attempt at breastfeeding was a blur. It didn't go well to say the least, A. was still sleepy and I was left with a bleeding nipple. A. quickly fell asleep and the rest of that day is blurry at best.

Over the next few days I tried to get A. to latch. Every time it was like electric needles and I knew it was wrong. My Mom helped to reposition me and A. several times, becoming frustrated herself at A.'s latch but reminding me we were both learning and to keep trying. The one LC at the hospital herself unlatched A. at least 10 times during one feeding I remember in particular, before she simply gave up and stated he must not want to nurse at that time. They checked his mouth and declared he wasn't tongue tied, just lazy, so I was to be extra diligent about his latch, breaking it every time it was wrong. I broke every latch.

The LC's seemed frustrated every time they came in, popping him off and changing my hold with him. When I asked why my breasts didn't feel full and I could still wear my same bra from before I was pregnant, or why I couldn't feel this sensation called let down, they said all mother's are different and not to worry about that kind of thing. I also asked why my nipples were flat. They stated simply some women have flatter nipples than others but it was nothing to be concerned about either. I persisted, stating that I couldn't seem to get A. to take the nipple correctly and one got me a nipple shield. A. seemed to latch a bit better with the shield but it still burned every time he latched. I asked why his top lip didn't flare out and why every time I flipped it out for him, it broke his latch. They stated he was learning too, give him time.

We ended up staying for 5 days in the hospital due to my complications. At the end of day 5, despite A. using me as a non-stop pacifier, my milk had still not come in. The LC, each of them, reassured me that I just needed to continue to let him suckle but under no circumstances should I supplement with formula and I should not introduce a bottle until at least 6 weeks. My milk would come in and we would be fine. So A. and I ended up heading home, nipple shield always by my side.

At A.'s check up at 8 days old he has lost over 12% of his body weight, his jaundice was not better and he had orange crystals in his urine. He was however having 6+ wet diapers a day and at least one bowel movement, yellow in color. His doctor recommended I just increase my water and calorie intake to ensure I had enough breast milk. At about a week and a half his bilirubin levels were fine and A. seemed to be getting enough milk, his output increased and his doctor assured me my milk was fine as A. had begun putting weight back on. He explained some babies are just slow and steady gainers but he wasn't concerned.

I continued breastfeeding A., stacks of pillows underneath him, nipple shield always in place and constant re-latching. I cried at the pain every session and found my days consisted of A. nursing on each side for 45 minutes each, to have a 20 minute break before he would want to nurse again. I knew babies liked to suckle at the beginning so I just kept going. I remember thinking things seemed okay until he turned 3.5 weeks and one day he just started screaming. He suddenly began pulling away at every nursing session, arching his back and screaming as I tried desperately to shove as much of my saucer cup sized areola and flat nipple into his mouth.

Soon our new routine started. I would put on the nipple shield, A. would latch, suck-suck-off. I would latch him again and we would repeat this, for 45 minutes on each side. He would fuss and I would cry. I called the LC at the hospital who assured me some babies were just fussy but that it might be something I was eating, so to cut out certain foods and add others in that would promote breast milk. I cut out almost all foods that have been known to cause problems and added in 4 cups of oatmeal a day, a 8oz glass of water during every feeding, the handful of fenugreek pills, mother's milk tea and extra fruits and veggies. I felt like I was starving all the time.

When I called back to report it didn't seem to be my diet, she suggested I might have low milk supply. At the suggestion of the LC, I began a new routine as well. I would nurse A. for a total of 1.5 hours and then pump both sides at the same time for 20 minutes. I never pumped a single ounce out. The LC said that was fine, it was just to stimulate my breasts to produce more milk.

I continued on these new routines, the nursing and pumping and the constant re-latching until A. was 3.5 months old. Then suddenly one day he simply wouldn't latch, no matter what I tried. He missed his morning nursing session, then the next two. Desperate, we brought him to prime care. He weighed 13.5 pounds, or between the 25-50% for weight. The doctor who saw us asked when he has last ate and how much. I explained I nursed so I couldn't tell her how much but at the 6AM feeding; it was now noon. She frowned and looked at his chart. She asked again why I didn't know how much my baby was eating in ounces and I remember looking at her puzzled.

She asked if his doctor was aware he was gaining weight very slowly. I shrugged and said he was regularly seen at his doctor and his doctor said his weight was slow but steady. She then stated that we should bring him home and try to nurse again. If he refused, feed him water from a spoon. When I expressed the concern that water was not recommended for infants that young she sighed and stated, "well you clearly do think your opinion is better, after all this baby is completely unvaccinated". I sat there stunned. It was true, but I hadn't come here looking to discuss his vaccinations. I went to open my mouth and The Husband broke in, telling her we hadn't come here for her bullshit and he picked up the diaper bag and we left rather suddenly. We went home and around 2PM A. finally, exhausted and crying, latched. This would be the 1st of at least a dozen nursing strikes. I never did figure them out.

The trip to prime care turned into a trip to his doctor the next day where they evaluated him for reflux. I asked about his weight gain and his doctor, who is actually a family doctor who has been practicing for 30+ years, said if he was worried, he would have said so. None the less, he patted my knee and told me if I wanted to stop nursing, formula was okay and sometimes breastfeeding just doesn't work, no matter the effort. I nodded, thinking he had lost his mind and asked for a referral to the children's hospital for reflux.

In the mean time, we began giving A. reflux medication and he seemed to fuss less at the breast. He still screamed almost every second of the day. By the time we saw the specialists he was 4.5 months old, which only happened because they called with a cancelation, his original appointment was for when he was nearly 8 months old! His weight gain had slowed down and his growth curve started to drop.

The specialist who saw us went over his birth and our breastfeeding till now. He jotted down notes and then asked how much milk A. was getting. I said I simply didn't know because I never could pump anything to put in a bottle, the most I had ever pumped was 1/2 an ounce. He frowned and jotted down another note. He warned me A. was close to the failure to thrive mark and I was sent home with a new routine and homework.

I was to begin supplementing immediately, that day, with double scooped formula after I nursed him, 2 ounces at a time to begin with. I went home and latched A. who arched, flared and screamed. I cried. I made My Mom feed that first bottle of formula to A. He gulped it down quickly and fell asleep. I bawled even more. I entered in the length of the nursing session, how many ounces and when,  and then stared at the sheet. At the bottom of the chart were helpful feeding tips at the bottom. All the hints I had already tried or were still doing.

I then sat down to begin my homework. I was to track how much I pumped in one day while A. received formula. I don't remember the actual number, but even without nursing A. for a day, I never pumped more than 1 ounce off each breast. They figured I was pumping less than a third of what he needed. I argued with the nurse, stating that pumping was not an adequate indicator of supply but they were more concerned now than before. I was then told to start weekly weight checks on him with my local doctor and call that information in as well while increasing the amount of formula he received. They told me I needed to drink more water, continue the pumping and let A. nurse anytime he wanted. I was told I just needed to nurse more often and my supply would increase.

So began our third new set of routines. I would nurse A. in the latch-suck-suck-off,  latch-suck-suck-off, repeat for the 45 minute pattern, for each side. Then I would feed him a 4 ounce bottle, double scooped with formula. I would put him in his bouncer or swing and pump both sides for 20 minutes. I would then have 10-30 minutes before I started again. I did this until A. was 7.5 months old and I finally gave up. By that point A. was drinking 8oz bottles of normal scooped formula every four hours and eating solids. I doubt he received any breast milk at all at that point. I just simply stopped one day.

I never once leaked. I never once felt encouraged, no matter how long I went between feedings or pumping. I never once felt the sensation of a let down. I burned through the motor on my first pump. I never had any milk to freeze.

I felt trapped and isolated. I resented my breasts and their clear failure to feed and keep my son alive. I hated breastfeeding. I cried every day over my failure to breastfeed my child and the poison I was sure I was feeding him. I became consumed with his weight, my output, diet and routines. I became mentally unstable over breastfeeding.

Now, four years later, I am sad that A. and I struggled for so long. I am mad because it was my fault for being so stubborn. I should have realized despite my efforts, providing my son's nutritional needs on my own just wasn't something I could do.

I won't ever know why, not truly, why we couldn't breastfeed successfully.
  • Was it A.'s colic and constant screaming?
  • Was it his reflux?
  • Was it because at the age of 2 we were told by his speech pathologist that the underside of his tongue was incorrect?
  • Or was it the fact that at 3 his dentist showed us that he has a frenum muscle that makes it hard for his upper lip to flare out?
  • Is it because at age 4 he was diagnosed with poor motor control planning in general?
  • Was it is because I was told by my RE just this past year I have PCOS?
  • Was it my flat nipples?
  • Was it my severe PPD?
I don't know, but I suspect all of the above. And now I'm left with the realization that I'm half way done with this pregnancy and in just a short few months I will have to feed this baby.

But... I don't want to breastfeed. Not really.

The very thought of trying to breastfeed this baby causes my breathing to quicken and my pulse to race. I have to close my eyes and mentally calm myself down. Trying to write this all down alone caused me to have to stop multiple times due to anxiety. I just don't want too again.

But I still feel guilty. Like I should give it a good college try and see. Maybe this baby will be a better nurser? Maybe I won't have supply issues? Maybe I'll love nursing this time?

But what if this baby isn't? And what if I still hate it? I can't be as insane as I was with A. I can't. I have a little boy who needs his mommy to function and not cry every day. I have a baby who needs not only food but a mother who doesn't dread having to feed her. The Husband deserve a wife who is mentally stable. I deserve to be mentally healthy.

That being said, I know that I will at least nurse in the hospital. I will try it again but I don't truly want to. I will try to nurse but my heart just isn't there this time.

I feel guilty that I'm not willing to put as much effort into nursing this baby as I did her brother.

I feel guilty I'm letting one bad experience influence my decision for this baby.

I feel guilty I don't want to breastfeed.

After all, isn't breast best?

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