Sunday, February 7, 2010

Lactation frustration (or, how I learned to stop feeling guilty and make my own damn decisions)

So. Breastfeeding. I've been wanting to write about it for a while, but my feelings about it change pretty much with every feeding. But I wanted to throw some thoughts out there, because I felt SO ALONE trying to figure things out for the first 2-3 weeks, which coincidentally was also the period of time when I was strapped on the crazy postpartum hormone train. And a disclaimer: these are just my thoughts. I am a pretty judgmental person, but I honestly have NO JUDGEMENT about the choices people make on the feeding front. Not after living through the process myself.

I came to the decision to breastfeed pretty haphazardly. It's encouraged by, well, pretty much everyone, and seemed to me, in the limited amount of time I spent thinking about it, to make sense. The natural order of things and all that. I took the prenatal breastfeeding class, which seemed at the time to be long on evangelizing about the wonders of breastfeeding and short on actual breastfeeding instruction. I read a little bit about it in my library of pregnancy tomes, but basically just thought I would figure it out when I got there. I mean, it's what nature intended, so how complicated could it be, right?

WRONG. Well, at least for me. I think breastfeeding can be pretty easy for some women, but I've only met a handful of these women. Every other new mom I've talked to falls into the "wow, this is way harder than I expected" camp.

Here's how things went for us during the first couple of weeks:

1. My first couple of breastfeeding sessions were completely unsupervised. A nurse basically dropped her off with me about an hour after I gave birth and said "you want to try breastfeeding?" and left. So, I hazily put her to the breast, and figured that even though it didn't feel very good, that probably was because I'd never had someone sucking on my boob that vigorously before.
2. When I finally got some guidance from a couple of different nurses, the message from both was basically "smash her face into your nipple, and she'll latch on eventually." By the end of day one, I had 3 blood blisters on my areolae, due to the Chicklette frantically latching wherever she could, with no meaningful guidance from me.
3. On the second day, a lactation consultant came by. She was appalled that the Chicklette hadn't "eaten" anything, diagnosed her with a "disorganized suck" (you think?) and immediately put us on a schedule of 5 minutes per side, pumping, and finger-feeding formula as a supplement. Which meant that each feeding session took about an hour and fifteen minutes, maybe a little less if the Mr. did the formula feeding.
4. On the third day, we went home, and then ended up back in the pediatric wing 3 hours later (due to a breathing issue completely unrelated to his whole feeding mess). The Chicklette didn't eat for most of that day, since we were in the ER getting ignored for a good chunk of it. We ended up back in the hospital under observation for three days, during which time I slept at home while the Mr. stayed with her at night. We only had time to try and get on the breast a few times during the day. Another lactation consultant visited us there, and pointed out (finally!) that she was only really taking the nipple and not any other part of the breast, and thus wasn't getting milk and was also damaging my nipples. I continued to pump after every "feeding," and my milk finally came in. We were able to finger-feed mostly breastmilk to her after a few days, which was nice.
5. We kept trying once we got back home again. When it got to the point where I had two significant, pus-y cracks on both nipples and my baby had swallowed enough of my blood that she was pooping it out in her diapers, I made an appointment with another lactation consultant, who showed me some techniques for achieving proper latch. She also told us to ditch the finger feeding and just use a bottle. After a few more days, a tube of Polysporin, and one more consult, we seemed to be on the right track. I might only feed her at the breast a couple of times per day, but they were good feeds and weren't damaging my nips any further.

Every day since then has gotten a little easier. I breastfeed her about 4 times per day, and we bottle feed pumped breastmilk the rest of the time. I pump about every 3 hours throughout the day and night, although sometimes I go a bit longer if she's had a good feed at the boob, or it's nighttime and I don't wake up. I'm not planning to try and get her breastfeeding exclusively, as it seems silly to do that, only to have to go back to what we're doing now once I go back to work. I don't really mind the pumping, and my supply seems fine (and seems to be increasing with her growth spurts, which I try to encourage through more frequent pumping during these periods).

Physically, there's no more pain, which has made a big difference. But the bigger difference? My mental and emotional outlook towards the whole thing. Once I was out of the post-partum blues (at about 3.5 weeks), I was able to utilize my own common sense and get over the guilt of not loving breastfeeding and trying to feed her at the breast exclusively. It wasn't enjoyable for me, it didn't seem to be all that for her either, and most importantly, the frustration of struggling with her 8-10x per day was almost completely eliminating any joyful time for us to spend together. And killing my sleep. Now, my husband can feed her once or twice during the night, and I can get a solid block of 5 hours or so, plus other naps between feedings.

(Oh, and my husband actually likes to be able to participate with feeding. Which is great for him, but also, in my opinion, fair. One of the other little things they don't tell you about the exclusively breastfeeding route is that it means that mom essentially has a baby tethered to her boob for half of the day and night. Which some women love, but it's not for everyone.)

Some of the women (including the lactation consultant) who facilitates one of my mom's groups discreetly roll their eyes at my feeding arrangement. Why am I not willing to go that extra mile to breastfeed her at every feeding? It's what's best for my baby!

To which I respectfully disagree. The Chicklette is gaining weight, occasionally sleeping through the night, and eating exclusively breastmilk. And even if she had to have a couple of formula supplements, that would be fine with me as well. She is thriving. And so am I. We enjoy our days together, and I'm able to focus on the parts of raising her that aren't just about feeding. And now that I'm sleeping more and feeling more rational and sane, I know that this balance is just as important as all of the other stuff. My daughter needs a mom who is not constantly at the end of her rope.

So, anyway. There it is. My breastfeeding manifesto. My advice for anyone getting ready to embark on this journey: do the best you can, use your common sense, digest the information that's out there (no pun intended), and make the decision that is right for you and your baby.

Oh, and invest in some Soothies.


Jen said...

Hi there...I'm not quite sure how I happened upon your blog, but I just wanted to pipe in with my two cents on breastfeeding guilt. Oh, and our IF timelines look similar, except mine was more like 3.5 years...only to finally learn it was MF and IVF/ICSI worked the very first time! :) We also transferred two on day 5, had one implant and have one frozen. Our Caroline was born in 8/08.

Anyway, I put SOOO much pressure on myself about breastfeeding, that when I ended up basically have a "dry well" (as I like to call it), it just TORE me up! I couldn't ever pump more than about an ounce at a time and I fear the sight of a breast pump. My daughter latched on perfectly, I just didn't have much to give her. I drank special tea and took herbal supplements recommended by the lactation consultant. I drew the line at a prescription drug, though, because they said it could cause depression. I was already depressed enough. I really feel like I missed out on a lot of joy in the first month of my daughter's life. I will NOT (hopefully) put that much pressure on myself next time around. I nursed her for about 3 months, morning and bedtime, always followed by a formula bottle. If it works next time, great...if not, I hope I'll just enjoy my girly (or boy)! :)

Hope you don't mind my rambling here! Stop by and "visit" me sometime if you have time...

La Generalissimo said...

I've been following you for quite some time, since our IVF and subsequent pregnancy schedules were within days of each other (my daughter was born on Boxing Day). I have to say I couldn't agree with you more on the whole breastfeeding thing and on finding your own rythmn. I fully disagree with any lactation consultant who pushes that your breast milk has to come directly from the breast. What a crock. The breast milk itself is what is important, not the method of the delivery.

We had issues because I have an abundant letdown - which I had never heard of from classes, nurses or consultants - and was choking my daughter while feeding her in the ways I had been shown. The forced latch and positions were causing so many problems for her she was clamping down and tearing my nips to shreds. I finally let the baby determine her own latch and wouldn't you just know it worked out fine.

I also found it a blessing when at 3.5 - 4 weeks my husband figured we had found our stride and suggested taking over evening feeds with bottled breast milk. The extra sleep and relaxation has done wonders for me and has strengthened his bond with his little girl.

You are doing everything right and I commend you for being open about it because it can be quite a polarizing subject!

Carrie said...

So glad you are in a place you feel good! Your baby is so lucky to have a mommy who works hard for her and gives her wonderful breastmilk, regardless of the delivery system. :)

Glad the blues have passed for you- it feels like the fog lifts more and more, I promise!


Amber said...

Great post! I never attended a breast feeding class and hardly spent any time with a lactation consultant in the hospital. I figured that I'd worry about it when the time came. Some feedings come easy and he eats like a champ while others have been frustrating (like right now when he is sleeping and won't wake up to eat after more than 3 hours!!). Your post brings about some great perspective. Glad to hear you have figured out what works for you.

K said...

Great post. Thanks for taking the time to share. I already have feelings of anxiety about the whole thing before nuggets even get here. And while I admire people who can nurse 2 or more (or one for that matter!), I'm not even going to try to be a hero. I've pretty much made up my mind to try to pump exclusively and bottle feed. If pumping doesn't work, then I will do formula. I've seen all these little gadgets and charts to fill out about which twin got which breast at what time and alternating and blah blah blah. No thank you.
Cheers to you for finding what works.

ana said...

Good for you for finding a working scenario, and thank you for posting about the difficulties...I also had no idea things would be so difficult (for some reason, no one--and I mean NO ONE--mentioned that things even COULD get this difficult). I found out the hard way in the past six weeks & actually, I am now only pumping and feeding bottles of breast milk. Despite lactation consultation, etc... I couldn't get my son to latch on properly & I was in so much pain & just miserable. Additionally, because one boob makes a LOT less milk than the other, he refused the "bad" side & I got clogged ducts & mastitis repeatedly. I was told by the nurses in the hospital that it "should hurt", so I tried to just power through, but it got to where just looking at him or hearing him move brought fear to my heart because of the painful experience that was coming up. I too was hard-core "encouraged" by family/friends/health-care professionals, to basically just woman up and do it, but I realized I was seriously depressed & wasn't enjoying my hard-earned motherhood, and ended up quitting after 3 1/2 weeks. Despite how annoying the pump is, I am keeping at it, the freezer is filling up with extra, little guy is sucking down his bottles & gaining weight, and daddy can give some bottles & I am not chained by the boob to the baby.
Its weird how many people came out of the woodworks AFTERwards when I was sharing my woes & mentioned that they too had issues---I think pregnant women need to be given a more realistic expectation, so we are not disappointed when the "natural & beautiful" experience we were told about does not go so smoothly! Though "breast is best", most pediatricians will agree that formula these days is pretty darn close, and there are NO studies to suggest long-term ill effects of formula feeding your child.

Kerri said...

I can't believe they just handed you the baby and left you to "try" breastfeeding at the hospital! I would've been lost if they'd done that to me. Camden was in the special care nursery for a couple of days and the nurses there were fantastic. They helped me get him latched every single time for 2 days. Then after he got out and was allowed to stay in our room, I had to page a nurse to come help me get him latched on in the middle of the night when he was screaming his head off. It was a rough start! It's crazy how no one really tells you that BF'ing isn't easy. No one talks about the pain, the bleeding and cracked nipples, the overactive letdown, the engorged boobs, and being the only one who can get up with the baby in the middle of the night. Having said that, I do still BF and it has gotten a great deal easier with time. But I will never, ever judge anyone else's choices when it comes to feeding their baby. As long as the baby is growing and healthy, who cares if it's due to a boob or the bottle?!

kdactyl said...

Hear Hear! Yay for you for taking what works and throwing the rest away. It sounds very similar. I actually had a tough time in the beginning too....blood blisters etc and my baby was getting more jaundiced and screaming from hunger. It was the nurses at the hospital that kept pushing the breast feeding. The lactation consultant saved us by introducing the breast us permission to supplement with a little formula...and yes...use a bottle. She explained that going from breast to bottle is no big deal as long as you use the right worked and pretty much from day 4 our son did both and my husband LOVED it. He often saved my sanity in the night. I also had a very strong let down and it wasn't helpful to our son's reflux so I ended up pumping and bottle feeding exclusively for about 6 weeks. It all worked out fine and he got only breast milk (with a few formula supplements) for 7 months...he is healthy and perfect and I can look back on our experience with wiser and happier thoughts. We are embarking on pregnancy number two soon and we actually PLAN to do it the same way...combo breast/bottle. My husband says he would feel left out otherwise and I also think our son will love to feed his baby brother/sister to feel included.

Keep on enjoying your baby.


Becky said...

I am not sure how I found your blog, but here I am. Just wanted to encourage you and say I am glad you have found something that works for you! I am a nurse in the NICU and have breastfeed my own kiddos. I was lucky enough to have my kids figure it out right away, but it was definitely one of the hardest things I have ever done.

As a nurse and a mother who has breastfed, i hate it when new moms get bullied into feeling guilty about their feeding choice! You are doing what works best for you and your baby and that is all that matters. Like you said, your little one is growing, gaining weight, and you are happier. That is what matters! And way to go for even trying breastfeeding and pumping and bottle feeding too. It is very easy to throw the towel in and call it quits.

Your baby is very lucky to have such a wonderful mommy! Keep up the great work and don't let anyone tell you otherwise!

tomi said...

I am in the same boat. Last week was so stressful because of the breastfeeding issues (babette won't latch on) and the midwife that came out to see us made me feel like a failure because I couldn't BF.

Throw in another one who insists we finger feed her, AND pump both breasts at the same time (what the?!)

I just wish some people won't try to force their opinions on new mums, no wonder some get so stressed and depressed - I was crying almost daily last week until I decided enough was enough.

*HUGS* oops sorry about the rant

Gabby said...

so glad you posted about this - people do NOT talk abotu it enough. we just went to a BF class last week, and I learned abotu breastfeeding twins.. I was really planning on having my husband help, and to find out that the LC said, no pumping for the first 4 weeks in order to have the best milk supply.

I say, we'll see how it goes... and then decided. no expectations.. and no regrets.

my mom didn't nurse me for one day, and I turned out just fine. (i think!)

you go mama.. do what you need to do!

bdmaggs said...

Ahh, the guilts. My daughter is 7weeks and since she was born I have been having breastfeeding guilts. I am also not a fan of actual breasfeeding for a few reasons. My experience in the hospital with bf was pretty terrible. A nurse was smooshing her tiny face at my nipple and the image still haunts me. Then they labeled my nipples as flat and her tongue as short. Labels, bad. They stick in your head and you feel hopeless to get it to work.

Anyway, I have breastfed pretty exclusively till a few days ago. After much beating up of myself and going back and forth, I am weaning her off the breastmilk. It is a very hard decision and I have to keep telling myself that I am not a bad mom but I have to do what I feel is right for us. Too much frustration with feeding and I want feeding to be a better experience for both of us.

Oh ya, weaning is very very painful. My breasts feel like they could burst off my chest they are so full :).

SS said...

YOu're doing great! i am so jealous of the occasional sleeping through the night. Nights are honestly still HUGE disaster for me! I am weaning currently and go about 6 hours betweens pumps (decided to switch to pumping to have more control over the weaning given my mastitis episode). So at elast I am getting a good chunk of sleep from 9:30 to about 3. The the baby will be cry off and on fron 3 until his next feeding, mostly from small amounts of gas. He's not hungry because he never really wakes up, and often doesn't finish the bottle I've given him. ANyhoo, enough about me you are doing fantastic with all of this! My first wouldn't take the boob and I could barely pump anything and I beat myself up for months over it, and I pumped a measly 7 or 8 ounces a day for over a month before I decided to quit. This time around I successfully fed at teh breast for one month and I don't really feel that it is that big of deal, when last time around I thought all would eb right with the world if I could just get to that point. Goof for you for having such a great perspective. And 4 times a day is fantastic.

Michele said...

Hon, you have to do what is best for your baby, you, and hubs. If this is it, then this is it and that is great and just how it should be!

You are doing a fantastic job!

Anonymous said...

The secret to breastfeeding is to ignore the vast majority of 'helpful' advice, and just do what works for you. Glad to hear that you're doing just that! I battled through cracked and blistered nipples and breasts too engorged for my baby to latch on, and only made it through due to the use of nipple shields - which anyone in authority will tell you are a bad idea... But for me were the difference between breastfeeding and not. We're now 3 months along and doing just fine without them now. I did what you're doing and slowly weaned myself off them (similar to your partial breast partial express). But even if that doesn't work, sounds like Chicklette is doing really well as things stand. Yay for you!

Aisha said...

Wow thank you SO much for this honest post. Why on earth she rolled our eyes just because the babe isn't on the actual nipple despite getting breastmilk either way baffles me. Breastfeeding is important I agree, but some people are so vigilant about it, its frightening and can make you just want to NOT do it becaues the pressure is SO strong.

Mary Louis Quinn said...

I just came across your blog this morning, and thought this was a great post! I have a 6 1/2 month old, and she has been on breastmilk exclusively thus far (well plus solids as of a few weeks ago). I was very determined to breastfeed exclusively (and give pumped bottles once I returned to work), so I read up on it a ton while I was pregnant (and I'm also a nurse, so that helped, too). I just knew I was going to be beyond devastated if it didn't work out. And so far things have gone great! But now knowing what I know, I will certainly not put that much pressure on myself the next go 'round. And I was less than pleased with the lactation services in the hospital. They came by the room on the 2nd day (why they wait that long is beyond me) and asked if it was going ok. I wanted to say, "How in the world am I supposed to know? I've never done this before!" Luckily we haven't had any problems (besides some minor frustrations in the beginning), but it can still be a trying process for both mother and baby. And like you said, when you are breastfeeding exclusively your husband can't do much to help out, and there were definitely times where the weight of that responsibility felt like too much, and it about made me crazy. But luckily I survived. :)