Friday, April 10, 2015

The Rocky Road of Breastfeeding – My Breastfeeding Trials & Triumph

Lil’ Chica is now eight months – eight months! – and through some strong determination, coupled with the grace of God, I am still breastfeeding her. It has been far from easy, but she and I persevered. If I’ve learned anything from this, it’s that stubbornness can sometimes be a virtue. My crazy goal was to breastfeed her for six months. We’re already passed that, so everything now is bonus.

Sometimes struggles turn into personal journeys. We persevere, we grow, we learn.

My VBAC with Lil' Chica felt victorious, maybe because it was a confined event with a clear ending that thankfully had the end result I’d hoped and prepared so much to achieve. On the other end of the emotional spectrum, breastfeeding has felt like a long trek, going mostly uphill. It’s only recently, now that I’ve surpassed my six month goal, that I’ve started to feel any sense of victory.

Some background: Nursing Lil’ O fell flat after two weeks. It hurt and I wasn’t producing enough. After a week of daily weigh-ins, we were told he had to gain weight over the weekend or be admitted to the hospital. They had to be sure he COULD gain weight. So, we put aside the breastfeeding and tube supplementing we’d been fumbling through (it was definitely a team effort!) and bottle fed him around the clock for one very stressful weekend. He never looked back and my dreams of nursing died. I still pumped for four months, but my production never matched his ravenous demand. He got about half breastmilk and half formula. Thank God we have easy access to formula! Sometimes, even with grand intentions, we need the extra resource. I have been so grateful for it!

With this history of pumping for Lil’ O and being tied to a pump, I was DETERMINED to make breastfeeding work with Lil’ Chica. The main benefit of breastfeeding that entices me is the passing of immunities to the baby, so they’re less likely to get sick in those early months when they have no immune system of their own. I was nervous about low production, but exclusively breastfed for the first couple weeks. I booked a private at-home visit with a lactation consultant and went to a breastfeeding support group, since I’d heard they were so wonderful. I got Lil’ Chica weighed there and all my fears were realized. She wasn’t gaining enough. The nurses handed me a tube to help with supplementation. They gave me a hospital-grade pump to use after every nursing session. The at-home lactation consultation the next day further confirmed the diagnosis that I needed to start supplementing for Lil’ Chica to gain weight. My supply was again too low for the necessary weight gain. I was crushed, but I also wasn’t yet ready to accept defeat. Lil’ Chica is perhaps our last baby and I really felt that I had to give it everything I had, largely to prove to myself that I could do it. My goal was to get to six months. Lil’ Chica and I had already proved the doctors wrong with the VBAC. How hard could it be? Very, very hard it turns out.

From making the decision to do everything possible to stick with nursing, as much as my body would allow – it really was one day at a time in the beginning – it became a choose-your-own adventure of the challenges that can come with breastfeeding. I think moms are told how beautiful it is and how wonderful it is for their babies, but rarely do they hear about the struggles until they’re living it. At least, that was my experience. So, from my own journey, here are some of the things that can go awry. Any and all should be shared with a licensed lactation consultant for support and guidance. They’re life savers!

Breastfeeding Challenges and Solutions
  • Supply: It’s critical to the whole breastfeeding enterprise that momma has the right amount of milk for her baby. Usually, once milk comes in, as there’s demand from the babe, mom’s production jumps to accommodate that demand. Some women can overproduce, but it seems that can be corrected with some adjustments such as feeding from just one side and not adding in pumping sessions. On the other end, some women can’t seem to produce enough. That’s been my fate. At one point I was feeding Lil’ Chica every hour and a half for at least a half hour at a time. Around the clock. That doesn’t leave much time for sleep, or anything else. It was exhausting. Then, with the news that I simply wasn’t producing enough for her to gain appropriately, we began supplementing nursing sessions with tubes at breast. These lovely concoctions, sometimes called a supplemental nursing system, allow breastmilk or formula to be available directly alongside the milk from mama. No matter how much I tried pumping, we inevitably went with formula supplementation. Note that I intentionally say WE here, because Husby was critical in making this happen for the duration of his paternity leave. Husby and I did this as a team and then I did it solo. It was torture and stretched out nursing sessions to be 45 minutes to an hour. But, I was downright fearful of introducing a bottle too soon since that’s what tripped me up with Lil’ O. Then, I got the joy of pumping after each feeding to simulate additional demand, theoretically stimulating additional supply. When that, coupled with supplements, still didn’t make a noticeable difference, I went to prescription meds, which thankfully really amped up supply, though it’s still not quite enough. Where we’ve netted out is that Lil’ Chica gets whatever she can at breast, followed by a supplement of 1.5-2 ounces. So, she’s at 75% breastmilk and 25% formula. Not what I’d initially wanted, but I’m learning to roll with the punches of life. So, I’ll still take this is a win!
  • Lip Tie: This is the lesser-known sibling of tongue tie. (Check here for resources on both.) In the midst of addressing Lil’ Chica latch concerns, one of my two LCs noticed she had a possible lip tie that was keeping her upper lip curled under when nursing, a big no no. So, Husby and I went to the recommended pediatric dentist and surgeon for an assessment, which confirmed a pretty sever lip tie. Some professionals simply cut the tie, but this specialist was recommended as a leader in the field and because she uses a laser, which helps everything heal more cleanly. We went ahead with the laser outpatient surgery and two weeks of stretching to be sure the skin didn’t reattach. This helped with Lil’ Chica’s latch, but the journey wasn’t done yet.
  • Latch Technique: If the latch isn’t complete, as in it’s too shallow, nipple cracking and bleeding ensue. Not pretty, but super common. No amount of reading, and I did plenty, can substitute for hands-on knowledge. In the first few days and weeks with Lil’ Chica, she and I were definitely figuring out how baby ought to be held/positioned, how to latch her on once at breast, and how to get her off with minimal agony. I wish I was exaggerating about the agony, but the truth is that breastfeeding is hard. It’s not something most of us grew up seeing, so we’ve not been taught this practical knowledge and have no idea what we’re doing at first, even if it is “beautiful,” “natural,” and “best for baby.” This is where a lactation consultant (LC) comes in. They will check for quite a few things, and the couple LCs I was seeing had me try a variety! First, I was given hydrogel pads, basically for wound care. They’re amazing and made the pain bearable in between feedings. Then, when we introduced a bottle at six weeks and it seemed that Lil’ Chica was choking, we saw an occupational therapist. She evaluated how Lil’ Chica ate and said she looked great. We were given some exercises to do at home, but pain persisted. Then, desperate, I got a recommendation from one of my LCs to see a craniosacral therapist. Lil’ Chica and I went to two sessions and there was a marked difference! Everything finally healed and the toe-curling, scream-aloud pain went away. What a difference!
  • Rash: Beyond the damage that can happen from a poor latch, a variety of skin irritations can also occur from having your babe at breast on and off throughout the day. In my case, I learned the hard way that wearing hydrogels for months on end can have repercussions. In my case, it seemed to just be a rash, though we treated it as if it were both a simple rash and thrush.

Everyone’s experience is different, and thankfully the moms that stick out the first few weeks often get really good at nursing their babes. Like, really, really good. And, even those of us that struggle can still persevere. Lil’ Chica and I have made it! Sure, I’ve had to supplement every feeding, but we made it! I met the six month goal and surpassed it. Hallelujah.

Of course, this is just one side of the story. I repeat, thank God we have easy access to safe, reliable formula. Lil’ O needed it and thrived. I refuse to believe he’s at a disadvantage because he didn’t have breastmilk for the first year of his life and beyond. Ultimately, in the end, each mom needs to decide what works best for her and her baby. Maybe like me, it’ll be something different for each child. So, be prepared for the twists and turns, be as educated as you need, then decide for yourself and don’t look back.

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