breast may be best but it definitely isn’t easiest – our breastfeeding journey

Disclaimer: This post is about breastfeeding.  There will be words like breast, nipple, etc.    If that freaks you out, stop reading now.  But don’t worry, there are no pictures.  I never thought I’d ever write about something so personal, but as I’ve struggled through this journey I’ve talked to so many people who have also had difficulties and I want to share my story so that others can use it to learn or for encouragement.  If you are bothered by that then stop reading now!  Everyone else, read on…

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Breast milk is the perfect food for baby.  It’s natural and the way God designed babies to eat.  I think we can all agree that “breast is best”.  However, breastfeeding is not easy.  Or at least, it wasn’t easy for me.  It was very, very hard.  And as I’ve talked to others it seems like many, many people struggle with breastfeeding.

You think your sweet little baby will be born, you’ll pull him or her to your breast, they’ll latch on and start eating, and all will be well in the world.  I mean, you read the books, you went to two breastfeeding classes.  You got this!  Right?  Wrong.

I was one of the lucky ones that had a fairly easy pregnancy…but I think I’m paying for it now with a ridiculously long and hard labor and a breastfeeding nightmare.  Here’s our story:

My senior year of high school (2005) I had a breast reduction.  My doctor told me that I may or may not be able to breastfeed – his prediction was that I’d have a 50/50 chance.  At 18 breastfeeding wasn’t really something I was thinking about so I took note of the information and decided it wasn’t that big of a deal.

Fast forward eight years.  Breastfeeding is definitely on my radar now.  Over the years I’ve become much more “crunchy” – we eat mostly natural and organic foods, I try to avoid most medicine, I went with a natural childbirth.  Of course it makes sense for me to breastfeed.  I knew going into my pregnancy that breastfeeding might not be possible for me, but I was sure enough going to give it my very best effort and pray that I’d be one of the lucky ones who were able to breastfeed after a reduction (BFAR).

Please know I do not regret my reduction.  It completely improved my quality of life.  If I had to go back and do it over again, knowing what I know now, I think I’d still get the reduction.

During pregnancy I started researching to try to find out what my breastfeeding odds were.  There really wasn’t a lot of information on BFAR, but I did find one book that I bought and read.  I found a little information online, but again, not that much.  I contacted my doctor’s office and was told that the type of surgery I had was the one that would give me the most hope of breastfeeding.  When my reduction was done the doctor left my nipple attached to as many of the ducts and nerves as possible (rather than cutting the nipple and areola completely off and reattaching it later).  I also spoke to a lactation consultant who felt I had a very good chance – the surgery was eight years ago, I had feeling in the majority of my breasts, and my breasts and nipples had changed with pregnancy (signs that they realized I was pregnant and were getting ready to make milk).  I also started leaking a little colostrum in the last few weeks of pregnancy.

So I went into my delivery cautiously hopeful that I would be able to breastfeed.  I figured from the research that I’d done that I would be able to at least breastfeed some, with the possibility that I’d have to also supplement if I didn’t make enough milk.  But I really, really hoped that I’d be able to exclusively breastfeed.  I mean, I even stopped at the store for brown sugar and made lactation cookies while in labor…I was going to do everything I could to make that happen!

That was also one of my main reasons for wanting to have a natural childbirth.  I knew that having drugs in labor would mean there would be drugs in Hudson’s system, and sometimes the medicated babies are sleepy and have a harder time breastfeeding.  I wanted to give us the best possible start, so I opted to go unmedicated (other than that small bit of Pitocin right at the very end, which I don’t think negatively affected his alertness).

Seconds after Hudson was born they placed him on my chest to do skin-to-skin.  After a few minutes the nurses sat me up and helped me get Hudson to breastfeed for the first time.  We fumbled around but finally got latched and Hudson “nursed” (if you can call it that) for maybe a minute.  But I’d read that babies really aren’t that hungry the first day and mostly just sleep so I wasn’t too worried.

Our plan all along had been for Hudson to room in with us, something that “they” all say is very important in order to establish a breastfeeding relationship.  However, at our hospital either mom or dad has to be awake at all times when baby is in the room, I guess to make sure no baddies come in and snatch him.  After we finally got settled into our room and our families left around midnight, we were exhausted.  We tried to sleep in shifts so that we could keep Hudson with us but after a 32 hour labor and running on no sleep in two days, we just couldn’t do it.  I tried taking the first shift but couldn’t stay awake.  We called the nursery and asked them to take Hudson.  It was definitely the right decision because I don’t think we could have safely stayed awake and cared for him.  They were wonderful – they put a big sign on his bassinet that said “no pacifier” and they brought him back to me in the middle of the night so I could feed him.  I didn’t worry that they were going to give him a paci or a bottle to make him stop crying.  We were able to get some much needed sleep, too.

The next day he didn’t eat much and mostly just slept, which is apparently pretty typical for newborns.  Several nursery nurses were wonderful and helped me try to get him latched.  We didn’t have tons of luck, though.  My nipples had totally flattened out so there wasn’t much for him to latch on to, but they said that was very normal – the fluids from labor had caused my nipples to flatten out but they should go back to normal soon.  In the meantime they gave me a set of breast shells; these dome-like things that you wear between feedings that help to pull your nipple out so that baby will have something to latch on to.

That afternoon I requested to meet with a lactation consultant.  She was pretty helpful trying to teach me how to get a good latch.  However, she said I needed to use a nipple shield until he could latch on well himself.  I really didn’t want to use an artificial nipple because I was afraid that would cause nipple confusion later, or that he would get so dependent on the shield that he would never latch on my nipple.  It was also very hard for me to use and he never really got a good latch with it either, so I quit using it pretty quickly.

I didn’t mention the breast reduction at first, but when it came up awhile into the consultation the LC totally changed her demeanor.  She went from casually helping me as she would any mom to acting like that was a huge game changer and that my chances of breastfeeding had just tanked.  She went on and on about how I probably wouldn’t have enough milk and instructed us to rent a hospital grade breast pump, like, yesterday.  She said I needed to start pumping after every feeding to build up my supply.  So Michael went and picked up a rental pump right away.

I was really discouraged after she left.  I know I shouldn’t have let her get to me, but I guess the postpartum hormones had me out of whack.  I was very shook up and not at all confident in my abilities to breastfeed.

The rest of that day and the next the nurses were great – not only did they continue helping me with my latch when it was time for Hudson to eat, they also helped me set up my pump, told me how to store the milk and wash the pump, and even sterilized the pump parts for me.  It took me awhile after my meeting with the lactation consultant, but my confidence returned and I was even more determined to breastfeed.

We went home Saturday evening, and sometime over night my milk came in.  However, Hudson just wasn’t all that interested in eating.  I had always heard “never wake a sleeping baby” so I just let him sleep as much as he wanted and wasn’t waking him up for feedings.  I didn’t realize that was a bad idea and that he wasn’t eating enough.  We knew his jaundice numbers were high (although no one would tell us what they actually meant) but I didn’t know that I needed to be feeding him as much as I could to flush that jaundice out.  I did pump occasionally during those first few days but not very frequently.

On Monday we went in for a routine check up with the pediatrician and shortly after getting back home got a call that we needed to go back to the hospital immediately because his bilirubin numbers were so high.  Our pediatrician started saying thing about supplementing with formula and doing an IV in order to flush him out, as well as putting him under the bilirubin lights.  I was so upset and did not want to give him any formula.  On our way to the hospital we stopped at Babies R Us and bought a couple of bottles that were supposed to be most like the breast (to prevent nipple confusion) and I took the milk that I had pumped so far.  I really wanted to get a supplemental nursing system, which you wear around our neck and a thin tube goes to your nipple – that way the baby is still latched on to you and you don’t have to use a bottle.  However, we couldn’t find one in town fast enough.

When we got to the hospital I made it clear that I wanted to breastfeed first, then if we had to supplement I wanted to supplement with my pumped breast milk before we used formula.  They brought a pack of formula to our room anyway and left it but I was determined not to use it.

Shortly after we got there, two of the nurses came in to check on me and noticed that the tops of my breasts were very red.  I had briefly noticed it before but thought it was from where Hudson had been laying on my chest and made my skin hot.  One of the nurses really freaked out about how that was an indication of clogged ducts and that I was on my way to having mastitis.  She just really kept going on about how had I not noticed? and it would be really, really bad to get mastitis.

I know what mastitis is and what clogged ducts are, and even that I’m more at risk for clogged ducts because of my surgery (if a duct was cut during surgery and doesn’t go all the way to the nipple then the milk that is made in that duct will have no where to go and get blocked).  However, my milk had come in just barely over 24 hours earlier.  I didn’t realize the blocked ducts and/or mastitis could manifest so very quickly.  I didn’t appreciate being treated like an idiot (however that seemed to be the running theme during much of our hospital experience, but that’s not the point here…).  I am glad that the nurses noticed so we could take care of it before it got too bad.  There were so many lumps that it seemed like I was just one big clogged duct.  I also had some brown scabby-ish things on my nipples that apparently were cracked nipples.

Our night nurse was fantastic.  She truly went above and beyond her duties as our nurse.  Every single time it was time to feed Hudson she would come to our room and help me get him latched on. Then after I fed him I would pump, and while I pumped she and Michael would massage the hard lumps my breasts (think deep tissue painful massage, not nice relaxing massage).  By the time we went home the next evening most of the lumps were gone and the redness had gone away.

We tried feeding Hudson a bottle of pumped milk when we first got readmitted but he refused.  I had requested a supplemental nursing system that I could wear to supplement him while I nursed him (the milk runs out of a bottle into a thin tube, you run the tube down to your nipple so that when the baby latches they get the nipple and the tube in their mouth), but they said they didn’t have any and couldn’t get one for me.  The nurse brought us some syringes and we used that to squirt little bits of pumped milk into his mouth after he had nursed for a while.  You can read more about our whole jaundice experience here, but the short story is that we never had to use the formula.  Between my nursing, the syringe with the pumped milk, and the IV they gave him, we were able to flush him out enough to get the numbers down and go home.

Before we left, I requested to meet with a lactation consultant because things were just not going as well as they should and I figured while I was at the hospital I might as well get some help.  One of the LC’s (not the one I had met with during our post-partum stay) came to meet with me.  I was very disappointed because the first thing she told us to do was to give Hudson a bottle.  Granted, she did teach Michael how to feed him the bottle in a way that would best prevent nipple confusion, but I was very surprised that someone who you would think would do everything possible to promote breastfeeding was having us turn to the bottle first!  She assured us that he would still breastfeed, even though he was going to be getting a bottle now, but that the number one priority was to get the jaundice under control and let my cracked nipples heal.  I agreed that we needed to deal with the jaundice and nipple issues, but I just don’t think we needed to jump on the bottle so very quickly.

After she left, I sat on the edge of the bed and pumped with tears pouring down my face while Michael fed Hudson his first bottle.  It’s not that I didn’t want Michael to get to feed him, and we completely planned on introducing a bottle after a month or so when breastfeeding was established, but to have it pushed on us and to not get to do it in our own time was really hard for me.  Yet again I felt like I’d failed my baby, that I wasn’t “good enough” to feed him enough milk.

We got to go home Tuesday evening and I continued to try to nurse and then we’d give a bottle with a very small amount of pumped milk afterward if he still seemed hungry.  It was a huge struggle though because he’d just scream and scream when I’d try to get him to latch.  I wasn’t sure if it was a bad latch or he couldn’t get the milk out or what, but it definitely wasn’t working for us.  I was concerned that maybe he had a lip tie but after some more investigating it seemed like that wasn’t an issue (I was almost hoping it was because that is something fixable).  There were a few times that I was just so very exhausted that I couldn’t face fighting him again to get him to latch, so I’d have Michael give him a little bit more in a bottle or with a syringe.  It was very frustrating because I was pumping plenty after each feeding, so I knew the milk was in there, he just wasn’t doing a very good job getting it out!

Thursday morning (when he was one week old) we went back to see our pediatrician.  Hudson’s bilirubin levels were fine and he was almost back to his birth weight so she seemed pleased.  She just said she wanted him to be back at birth weight by his two week visit.

I contacted another lactation consultant – this one wasn’t associated with the hospital.  She even comes to your house which was amazing!  I was so tried of hauling Hudson to the doctor that it was nice to have someone come to you.  Anyway, she came out Friday morning and did a weighed feeding where she weighed him before I fed him and again after so we could see about how much milk he was getting.  From that feeding we guessed that he was getting about an ounce and a half, but he probably needed to be getting about two ounces.  She said we still needed to supplement, but she recommended getting rid of the bottle and syringes completely (exactly what I would expect a LC to recommend…unlike what I experienced in the hospital!).  She gave us a supplemental nursing system and showed us how to use that so I could supplement but still keep him at the breast.

Basically, he was just a lazy little nurser.  He took forever and kept falling asleep.  The LC said that he would get better as he got older, we just had to keep working with him.  She said he also had probably gotten used to getting so little milk that we needed to re-teach him what it felt like to get a full feeding using the SNS and then hopefully he’d wake up and realize that he needed to do a little work in order to keep his tummy full.  Also, him sucking at the breast (even if the milk was coming through the SNS instead of me) would stimulate my breasts to produce more.  She helped me with my latch and had me start taking some supplements (fenugreek and alfalfa) to try to boost my supply a little bit to make it easier for him to get the milk out.

For the next few days we nursed, pumped, and supplemented.  The LC wanted me to feed him every two hours, meaning two hours from the start of one feeding to the start of the next.  We tried to keep the feeding sessions to under an hour, but they usually lasted longer than that and then I had to pump (usually about ten-ish minutes) after he finished.  All in all, it ended up being about an hour and a half spent nursing and then getting a very short 30 minute break before starting over again.  I could only get about one thing done per break (shower or hair dried or eat a meal…).  Using the supplementer was way harder than I thought it was going to be.  Getting him latched was hard enough, getting him to latch and get a tiny tube in his mouth was a nightmare.  We’d have to latch over and over again each feeding just to get a semi-decent latch.  It was all so difficult.  Not to mention very painful.  The nights were horrible because as soon as we got to sleep it was time to get up and feed him again.

Back when we took our Bradley classes we had a discussion question about what could dad do to be involved with baby since they can’t really help with breastfeeding.  I look back and laugh now because Michael was so very involved with breastfeed.  He had to be – it took multiple hands to hold the supplementer and get Hudson latched (man, that sounds so easy when I type it…when you’re doing it in person it’s so much more complicated!).  Not to mentioned pump parts to be washed, milk to be stored, the SNS to be set up at each feeding, and the moral support.  Breastfeeding was definitely a team effort for a while there and it took me, Michael, and Mom working around the clock to make it happen.  We all slept very little those first few weeks.

The LC came back on Wednesday of the next week.  Hudson hadn’t lost any weight but he hadn’t gained any either.  She did another weighed feeding and that time he only got a half an ounce from me – less than our first weighed feeding!  I was so disappointed.  She told us to just keep doing what we were doing and supplement a little more.

She left her baby scale with us so that we could do weighed feedings each time and see how much he was getting from me and then supplement with my pumped milk whatever we needed to get him up to that two ounce mark.

It was nice having the baby scale so I could see exactly how much he was getting, but it was also very disappointing because he would nurse for a while and then when we weighed him he would have only gotten 4 mL or maybe 9 mL.  Guys, an ounce is about 30 mL so we’re talking a negligible amount of milk here.  Yet I was pumping and able to get enough pumped milk for him to drink.  I just couldn’t understand why he wasn’t extracting the milk on his own!  He would sit there and suck and suck but obviously nothing was coming out.

That next day, right at the two week mark since he’d been born, was my low point.  I was so frustrated and ready to give up.  Everyone had said, “give it two weeks, it gets better after two weeks”.  It had been two weeks and things weren’t getting better at all.  I had been struggling and struggling with that SNS and the pump, thinking we we’d get to ditch them soon only to find out he was getting next to nothing from me when he nursed.  I was beyond exhausted since I was getting almost no sleep.  I felt like I wasn’t getting to enjoy my sweet boy at all because I spent an hour or so fighting him to try to get him to latch and then to stay awake to suck, then I had to hand him off to someone else so I could pump and maybe get one small thing done then it was time to fight him all over again.  Instead of gazing at my precious boy’s face and oohing and aahing over how adorable he was, we were struggling and I just felt frustrated all the time.

That same night in the middle of the night I dumped a full pumped ounce in my lap.  I completely lost it and cried hysterically.  Dumping pumped milk is always upsetting from what I hear, but I was so very tried and discouraged that it was magnified.  I was just barely keeping up with him by pumping enough at one session to give him at the next to make it a full two ounce feeding, so to lose an ounce was devastating.

I felt guilty because I couldn’t really have people over to visit.  I felt like people thought I was being selfish by not having visitor, but reality was I just couldn’t.  It stressed me out more than anything to try to think about timing a visit in that perfect little 30 minute window when he wasn’t eating or I wasn’t pumping.  I’m sure they understood but that guilt and fear weighed on me on top of all the other issues.

I had a wonderful support system between Michael and my mom there with me, as well as friends who I texted and Facebook messaged almost constantly.  However, at this point they could all see how horrible this was, and while no one was telling me to quit I think they were all supportive of me quitting if that was what I wanted to do and would have completely understood.  It really was a nightmare and I was pretty miserable.

However, I’m a bit stubborn (some might say stupid) and just couldn’t give up yet.  I kept pushing on.  My LC really encouraged me to try to give it just one more week until he was three weeks old so I decided I could probably make it until then.

The next day things actually started to look up a little.  We finally figured out the SNS, so even though I was still having to pump and supplement, at least I wasn’t having to fight to get him latched with the SNS each time.  It only took three or four tries each time to get him latched (believe me, that was a big improvement).

I also contacted a friend of mine who had mentioned that she made an herbal tincture that really helped milk production.  I honestly thought I was doing okay on milk since I was pumping enough, but I figured it couldn’t hurt to increase it some and maybe if I had a little extra milk it would be easier for my lazy guy to get out.

Over the next few days I continued feeding, weighing, pumping, and supplementing.  And watching the Olympics.  Honestly, if it hadn’t been for the Winter Olympics I think I would have gone crazy.  I’m not even a sports fan but it gave me something to do, and since I was sitting in my recliner nursing nearly all day every day I needed a distraction to keep me busy and take my mind off the pain.  I also Googled a lot.  Probably more than in my whole entire life up to that point, but I was constantly trying to figure out what on earth with going on with my little guy.

That Sunday, when Hudson was two and a half weeks old, I got the tincture from my friend.  I took my first dose that night.

wow.

WOW.

That was it.  That was what I needed.  For whatever reason the lactation cookies, the fenugreek, the barley tea, the alfalfa…none of it had made a significant increase in my milk.  But this tincture definitely did.

That very next morning, less than 24 hours after taking my first dose, Hudson went from getting about half an ounce from me at a feeding to a full ounce.  The next day, after my second dose, he was getting two ounces from me at a feeding!  TWO OUNCES!  Apparently it was a milk production issue even though it didn’t seem like that was the problem at the time.

From that point on (the second day of taking the tincture) I didn’t have to pump or supplement a single time.  I kept weighing him before and after feedings just to make sure, but after a while it was apparent that he was getting all he needed from me.  That was a huge, HUGE relief!

I am so, SOOOO glad that I stuck with it a few more days (although I really wish I had known that “magic” tincture was going to make such a difference because I would have gotten it much earlier).

The big problem of him not getting enough milk was solved, but we still weren’t having a easy time.  Breastfeeding was so very painful.  Because of the pain in my nipples I thought we had thrush and started using gentian violet to treat it.  After some more reading I decided that probably wasn’t the problem, but went ahead and finished the four day treatment just in case so I could rule it out.

purple mouth from the thrush treatment

It hurt every time he latched.  It hurt while he nursed.  It hurt when he wasn’t nursing.  After going my whole pregnancy with almost no medicine (two Tums the whole pregnancy) and delivering a baby with no pain medication, I now found myself popping ibuprofen right and left.  I hated that (I really don’t like to take medicine), but that was the only way I could keep feeding him without crying in pain time after time.

His latch wasn’t great and he was crimping my nipple while he ate.  Literally my nipple had a crease in it  after each feeding like when you bite down on the end of a straw.  I tried working with his latch but something just wasn’t working.

In addition to that, and most painful of all, were the vasospasms.  Vasospasms are when the blood vessels clamp down and restrict blood flow to a specific area…in my case, my nipples.  They would blanch white and the pain was horrible.  From what I read, that is common among people who’ve had breast surgeries.  Also from what I read there really isn’t any treatment other than giving it time (in most people’s cases it went away after several months, yes months) or taking blood pressure medicine which I really, really wanted to avoid.

And on top of everything else were the gas issues.  I think he’d gotten so used to sucking and sucking and no milk coming out that when the milk did start flowing he didn’t know how to deal with it.  He would gulp and choke while he was nursing and I could actually hear the milk gurgling around in his stomach.  That made him really gassy and in pain.  He also started spitting up quite a bit more.  For a week or so I was concerned about oversupply, overactive letdown, acid reflux, food allergy, and/or foremilk-hindmilk imbalance, but things have worked themselves out and I think he just needed an adjustment period.

I took him to the chiropractor to try to help with the latch issues and the gas problems.  We had him adjusted four days in a row and it did seem to help some.  A friend once told us that when you have a baby all scientific reasoning goes out the window – instead of changing one thing at a time and watching to see how that changes things, you just change all kinds of things at once and try everything you can think of.  That is definitely the truth!  We started probiotics for both him and me, we used gas drops and gripe water, we used the Windi (this weird thing that you put in their bottom to help release the gas…it works but it’s kind of gross!), we did tummy massages, you name it, we did it.

He will be eight weeks old on Thursday.  He no longer crimps my nipples.  The vasospasms are much more rare now and he no longer gulps and chokes when he eats.  It is still hurts sometimes when he latches but I have no idea why. I’m hoping that the pain, like all the other issues we’ve dealt with, will correct itself with time.  In light of all the other things we’ve dealt with, that latch pain isn’t really a big deal.  At least he’s not starving, we’re done in 45 minutes or less, and there are no more pumps or supplementers to deal with. (edited later to add…the latching pain lasted until he was 5 months old then finally subsided)

We did it.  We are exclusively breastfeeding.  In spite of a breast reduction, flat nipples, jaundice, clogged ducts, cracked nipples, a lazy eater, low supply, a bad latch, and painful vasospasms, we made it.  And I couldn’t be more proud.  I can now go places or have people over and know that if he gets hungry it’s no big deal.  I can feed him now anytime, anywhere.

So….

That turned out to be a much longer post than I intended (and could have been even longer but I started condensing some details there at the end).  I’m not even sure what the point is other than for me just to write my memories down.  I tried to get this written as soon as I could so I could remember everything, but even just a few weeks out it all seems so hazy.  Some of that I’m sure is because of how sleep deprived I was.  Some of it is probably my body’s way of making me forget the horribleness of it all.

I guess I should try to find some moral or something to my story.  If I could give one piece of advice it would be this: find yourself a really good lactation consultant and a good support system.  I am sure that we would not still be breastfeeding today if it hadn’t been for the LC who worked so hard to get us breastfeeding.  Getting in touch with a LC who could provide me with the SNS, do the weighed feedings, and let me know that others have been in the same place as me made all the difference in the world.  And having Michael and my mom there to basically take care of everything else so that I could do nothing but nurse, nurse, nurse was a lifesaver.

I know this really wasn’t an encouraging story.  I mean, yes, it does have a happy ending but seven nightmarish weeks of breastfeeding is not something anyone wants to deal with.  Please don’t let this deter you from breastfeeding, I’m pretty sure my experience wasn’t the norm.  But understand that if you do struggle that others have been there and there are people out there who can help you.  And know that I won’t judge you in the least if you give up and switch to formula.  I was so close to that point and I completely understand why many people give up breastfeeding.  It is really, really hard.

Breastfeeding was my Mount Everest.  My marathon.  It was something that I felt so very passionate about and was going to do absolutely everything I could to make it happen.  It turned out being much harder than I anticipated but I persevered on and we did it.  I couldn’t be more proud.

my sweet boy growing big thanks to Mommy’s milk

(edited later to add: I was able to breastfeed Hudson until he was almost 17 months old and I got pregnant with our second.  Breastfeeding the second time around has been an absolute breeze; I did struggle with some vasospasms again and some pain just in the first week or two while he was learning how to latch, but other than that it was a night and day difference)