Saturday, September 8, 2012

Feeding Woes

Feeding has been a struggle for us since Giovanni was born. I knew going into this that breastfeeding would be difficult as I have gestational diabetes, hypothyroidism, asymptomatic PCOS, and infertility working against me, all barriers to successful breastfeeding. I was determined to try my best so I can do what is best for my son. While in the hospital after his birth, I was not producing much colostrum. I was actually siphoning drops of it off of my nipples with a 1ml syringe. The nurses and lactation consultant told me that three drops of colostrum would raise his blood sugar 20 points, so I made an effort to get what I could. I was using the hospital pump as well, and I would only get a few drops with that. It actually became quite frustrating as I would pump for 20 minutes and at times I wouldn't even have enough to suck up with the syringe as it would all just get lost in the chambers of the pump parts. With each pumping session I was only getting 0.1ml. (Yes, you read that right.) By the day of discharge, I was producing .6ml which is considerably more than a few days prior, but not enough where I was comfortable feeding Giovanni. Without going into great detail in this post about all of the problems I had with the hospital regarding my discharge, I will just say that I was in no way comfortable being discharged (another whole long post) as I didn't feel that my son was getting enough to eat. Needless to say, my concerns were ignored and I was discharged against my wishes. Luckily, while I was battling with the hospital to keep him until we knew he was getting enough to eat, I called my pediatrician and setup an appointment for the following day.

The next morning I went to the pediatrician and all I could do was cry. I knew that Giovanni was hungry and there wasn't anything I could do. I had originally asked the hospital about supplementing with formula but they told me not to as it wasn't necessary. By the time we saw the pediatrician it was almost 24 hours since his last wet diaper. I knew something wasn't right. His weight had also dropped from 6lbs12oz down to 6lbs1oz. The pediatrician was quite concerned and had us feed him 2 ounces of formula right in her office. She told us that if he didn't have a wet diaper by 7pm that night, that he would have to be readmitted to the hospital. Needless to say, we never had a wet diaper so Giovanni was readmitted back into the hospital...our local one though, not the medical center. For the next 24 hours we worked with the nurses and lactation consultants to determine what the problem was. They determined that his mouth is unusually small, therefore he wasn't latching properly. Because of this, my breasts were not getting stimulated enough to signal my body to produce milk. I then started a routine of pumping for 20 minutes and then feeding him, and I was doing this every 2 hours. As you can imagine, this left me with very little time to sleep which made recovering from my 3rd degree tear and spinal fluid leak very difficult. Within 24 hours Giovanni was peeing and pooping regularly and put back on 4 ounces.

For the next couple of days I was following this same schedule but I became worried that he would lose interest in the breast. As much as I didn't want to have to use it, I gave into the nipple shield that the hospital gave me. He struggled with it but seems to now be getting the hang of it. While it would seem that this would solve some problems, it actually has created more. Now, instead of pumping and feeding, I am putting him to the breast for 30-40 minutes (using both sides), pumping right after he is done, and then feeding him what I pumped. After all of this is said and done, I have very little time until his next feeding since I can't let him go more than 3 hours and the clock starts when he starts eating, not when he finishes. And to top off this routine from hell, I started having severe stabbing pains in my right breast a couple of days ago. I couldn't stand it any longer so I called my MFM. Since I called on Friday they told me to go to urgent care so I didn't have to suffer through the weekend. Turns out that I have developed mastitis and I am now on antibiotics for 10 days. I am still in a ton of pain but I am trying my best to stick to the routine. While all of this is so much to handle, learning the he was up to 7 pounds as of his last appointment with the pediatrician on Wednesday is making me even more determined to keep this up.  

I never expected things to be easy, but I never expected them to be so difficult. If I could just put him to the breast like most other women do, things would be so much easier. I have to admit that I cave a few times a day. I end up crying my eyes out from a combination of no sleep and seeing how frustrated my son is, and all I want to do is to switch him to formula. It would just be so much easier. While I understand that many women opt for formula and their kids are just fine, I feel like I owe it to him to keep trying. I am working with a lactation consultant at my local hospital, who I go and see again tomorrow, and I am also considering hiring a private consultant but they are just so expensive. I am praying that this gets easier. I am hoping that once he gets a bit bigger that his mouth will be large enough to latch without the nipple shield although I am worried that he won't latch as he only knows how to eat with the shield. One day at a time I guess...

10 comments:

  1. I know it is very discouraging when you can't produce properly; I wasn't able to either. And the feeling of knowing your baby is hungry and giving them a bottle and realizing how hungry they really are is just heart breaking. For me, I felt like I wasn't a good mother because I couldn't produce anything for him after my colostrum was gone. I went through the feeding and nothing coming out, having to supplement with formula because I was only producing 1oz a day between both breasts...it's very frustrating I understand!

    Something my mother reminded me helped me cope. There are millions of formula fed babies, my mom was, as were both of my siblings and my niece/nephew and you know what...we/they all turned out perfect! I know breast milk is the best for them, but Giovanni will still be perfectly healthy :) if formula is the only option.

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  2. There is absolutely nothing wrong with switching to formula. But you might also consider exclusively pumping and not bothering with the breastfeeding until he's a bit bigger. My son didn't latch on for 8 weeks, and life got a whole lot better when I stopped trying regularly.

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  3. My son was born prematurely at 32 weeks, so I can relate to the small mouth thing. It wasn't until he was at least at his due date that he could latch on without the use of the nipple shield. And I don't think you have to worry about him rejecting the breast because he used a nipple shield. My son definitely knew what to do once we stopped using the nipple shield! Also, I pumped and gave him breastmilk in a bottle along with breastfeeding and he didn't get "nipple confusion" at all. And he was a preemie. I know how it feels to feel like you're constantly either pumping or breastfeeding, but trust me your strong-will and tenacity WILL pay off! I persevered with the breastfeeding and my son was exclusively nursing until he was a year old, then went on to periodically nurse until the day before he turned 3! And everyone says what an extremely intelligent little boy he is! (He's 5 now and just started kindergarten.) You can do this! I know you can! Just look at all you've accomplished so far! But on the other hand, don't feel like you've failed if you have to supplement. I had to briefly, but got right back in there with the breastfeeding. What's the saying? "You're not a failure until you've failed to try." And I know you haven't failed to try! Good luck! : )

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  4. Just why is it that you're so terrified of giving formula? Even if breastfeeding IS an option, there is absolutely nothing wrong with giving formula. I'm a wholehearted believer in attachment parenting. we partially bed-share, eat predominantly organic and home-made goods. I also formula feed my 6 week old. It allows me the ability to actually take care of myself. Which, as a mother, is one of those things that often gets forgotten/neglected/just doesn't seem important. But believe me, it is so very very important. When my oldest (now 11) was 2, she broke her leg. She had to spend some time in the hospital and her ortho specialist said something to me that has stuck through all these years- he told me that in order to be the best mom I could be, I needed to take care of myself FIRST. Not second, third, or last. FIRST. Because if I was taking care of myself, then I would be better able to take care of her. That means I need to sleep, eat, bathe, and take a few minutes for myself every once in a while. Being the best mom you can be doesn't mean you breastfed- it means you were the best YOU you can be. And if that means you hand your hubby a bottle of formula and take six solid hours of sleep, then breast-is-best be damned. When your kid is in high school and an honour student, they aren't going to remember or care how you fed them for the early years of their life.

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  5. Similar story here. I took various galactagogues, etc. I am getting ready for work, but will send you a long email tonight when I get the chance.

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  6. Just had my neupogen baby too! He's now 3months and he doesn't latch well. We supplement a little..i can TOTALLY relate!! In the hospital, he didn't eat enough and was screaming his head off for like 40 minutes. I called my husband sobbing and he thought something was wrong with the baby...I was like choking/crying his name. (I hadn't slept in a cpl days so I was a mess/hormonal/sleepless/just had c-section etc.) The nurse recommended the formula. I hadn't read anything about breastfeeding and nobody had warned me about how hard it can be.
    i thought you stick the baby on the boob and voila! he/she eats...NOT!
    anywho...then i left the hospital, a few days later got post partum pre-exclampsia and was readmitted to the the hosp...cldn't move barely so cldn't pump much..was separate from my baby AWFUL.....of course he was at home being fed formula..got back home a wk later and my boobs were all blocked up. luckily didn't get mastitis...kept pumping and b'fing. He was latched on so-so. Then I hired a lactation consultant to come to my house and she thought he was fine..I said can you just check to see if he's tongue-tied (it's a little extra piece of tissue or smth under the tongue that holds it in place) so she said "i doubt it" but checked anyway and low n behold he was. SO we had the post partum pre-e, then the tongue-tie. (had the ear nose throat clip it --painless quickie procedure)2 wks later as i had to have the pediatrician "confirm" it and then make the appt...
    after they clipped the tongue tie he latched WORSE than before. which is VERY unusual! but we somehow work around it. a lot of milk spills out while he's eating but he gets enough based on his diapers and weight. UGH WHO KNEW it cld be this hard????!!! i was in shock!!!
    so i totally get your frustration but i 2nd what other women say YOU NEED YOUR SANITY. if you are not sleeping/eating taking care of yourself, you can't take care of your baby so well. i was 100% formula fed and have not had any major issues knock on wood.
    i know how you feel. you went through HELL and back to make this baby..now you want to do what's best for this little miracle! i get it BUT you have to be good to yourself too so you can care for him. GOOD LUCK to you!!! i know it's hard as hell and you feel like guilty if you don't give him breastmilk. but don't! hugs, jen

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  7. I had to use a nipple shield with my daughter and I was afraid she would never be able to give it up. I was on a simliar schedule of pumping and breasfeeding and I know how hard it is. I would always try to get her to latch without the nipple shield and when she would get frustrated (which was every time) I would put it back on When she was about 4 weeks she was suddenly able to latch without the shield, and that stuck! That was in the middle of two bad nights where she was up almost all night, but it was totally worth it! At 12 weeks now she now prefers the boob the bottle and I am having to make her practice with bottles again to get ready for my return to work. Don't give up hope. Also, I had a few days where I did give her about 2 ounces of formula out of exhaustion and frustration and it was fine nad did not affect my supply. I think were about 3 or 4 days early on when I did that and didn't have to do it again. Long time reader---Beth

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  8. With Roo being a preemie, she and I had a lot of problems with nursing. It is so tough but it does get better. I've struggled with forcing my body to produce breast milk when the baby wasn't even supposed to be here; I had terrible engorgement problems; the list goes on. I promise it will get easier even when it doesn't feel like it will. I pumped and fed every three hours for two months. It sucks but is worth it for the little one. Hang in there and big hugs!

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  9. hi there, I also had lots of trouble getting my son to latch. He was born 2 weeks early- not small, 8 lbs 11 oz, but early- and maybe that was part of it. I was unable to see the lactation consultant at my center because she was too busy. The nurses tried to help but we weren't figuring it out that well. In the end, they couldn't let me leave until he was nursing so they gave me the nipple shield. In retrospect, I was really unhappy that I did that because, like you said, it solved the immediate problem but created a new one. My son could eventually nurse with shield but he was a sleepy and lazy nurser- he would fall asleep a lot at the breast and wasn't getting much milk. I was taking him to the pediatrician to do a weigh-in every other day because he was dropping weight. I cried and struggled a lot every day. I wanted to give up EVERY day. My husband helped me through this and I had a lactation consultant visit me several times. Every time she came, she evaluated our nursing and we came up with a new plan. I almost crumpled the third time (when baby was about 2 weeks old) because she said that I really needed to do ALL the feedings, and not let my husband give bottles of expressed milk (which he'd been doing to let me rest sometimes.) She said if I let my husband do a bottle, then I really needed to pump at the same time or my body wouldn't get the signal to make more milk. Also, I rented a hospital grade scale and learned that my son was nursing but wasn't actually suckling- he was just moving his mouth and pacifying. So I started nursing him with only his diaper on and tickling his feet a bit to keep him awake, and I learned to see if his jaw was moving (nursing) or just mouth (pacifying, getting no milk.) In the end, our routine was me nursing him about 12 times a day- like you experienced- it was nursing for 15-20 minutes and then pumping (if I could- hard to do in the middle of the night).
    My husband helped me like this: I would do my last nursing at about 10 pm and then I'd go to bed. My husband would take our son and get him to sleep. When he woke up a few hours later, my husband would give 1 bottle of expressed milk and then wake me up and give him to me. This allowed me about 3 hours straight sleep every night. All the other feedings- I did. And my son was colicky which meant we were up, walking, swinging, singing, all night between about 1 - 5 am, when he finally would have a bowel movement and then would usually sleep (on me) for a few hours. He spit up a lot, was colicky... it was awful and the longest 3 weeks of my life. I'm glad I stuck with the breastfeeding though it was so hard. It was really important that I had my husband to support me when I was exhausted. My son finally regained his birthweight at 3 weeks old and shortly after, began to nurse well and turned into a super-chub. At 4 months old he was 19 lbs and at 6 months old, just over 22 lbs. Total michelin baby. I didn't mention that we did some supplemental nursing through a tube taped to my finger (or my husband's) after I pumped milk. Weaning of the nipple shield also was an ordeal. It was a lot of tears for sure. I did the weaning after about 3-4 weeks I think- I had to get him nursing and back to birthweigh.

    Later on, after 8 months or so, I did supplement occasionally with formula because my supply declined when he started solids. I exclusively breastfed to about 8 months and then with the supplement of formula, he went to mostly formula by 9 months (that 1 month just spiraled my supply!) I was able to nurse in the morning and at night until a bit over 1 year but he decided he wanted to stop...

    This is a really tough time for some of us moms and your medical history might complicate your efforts. I highly recommend trying different routines with your lac consultant and trying to do the most breastfeeding you can, without killing yourself. Getting even one 3 hour block of sleep each night is really great for you and your son.

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  10. As you know, my little one was a premie and he had a tough time eating. We kept at the breastfeeding and, in the end, he would take from the breast sometimes and the rest of the time he just had to drink from the bottle what I had pumped (an arrangement he liked much better anyways). We had started with a nipple shield because of his little mouth and my inverted nipples, but we both just knew when he didn't need them anymore. I agree with the sentiments of the ladies above. Keep at it. It was one of the biggest pains in the butt I ever went through and it lasted (for me) for 6 months, but I am not sorry for a second that I did it. Givoanni is really lucky to have such an awesome mommy looking out for him.

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