Wednesday, August 26, 2009

Our breastfeeding story

My breastfeeding story begins much like my cloth diapering story. The only other moms I knew breastfed their babies, it was healthy and cheap, and it felt like a natural choice. The main difference is that whereas the choices in cloth diapers were overwhelming at first – types, materials, new or used, etc. – I actually felt VERY prepared for breastfeeding, and like it was a straightforward decision. I had read books about it, attended seminars on it, and watched several people breastfeed for the first time, as a doula. I was a little nervous about what it would feel like and if I would be comfortable doing it around other people, but I didn't worry about it much. To my surprise, it turns out that breastfeeding is THE most challenging thing I've experienced as a new parent so far.

Before I go any further, I feel like I should let you know that at 6 months old, Sweet Pea is an exclusively breast-fed (EBF) baby. So, we have had success, but it was hard-won. Perhaps it is especially important to me because it was hard?

I was and am very committed to breastfeeding my baby. There are numerous benefits that I know about, and I tend to look for the most economical, natural way to parent - so as I said, breastfeeding is the natural choice for me. During my pregnancy, I read a few books (The Breastfeeding Book: Everything You Need to Know About Nursing Your Child from Birth Through Weaning by Martha Sears and William Sears is my top recommendation - thanks Jen!!), had a nursing cover made, got a good breast pump (I have the Medela Pump in Style - thanks in-laws!), and confirmed with my midwives that they could help me initiate breastfeeding (they remain on call for 6 weeks after the birth for any questions or help). I felt like I was as prepared as I could be. And yet...

Sweet Pea was born at home, in the morning, and I put her to the breast just a few minutes after she was born. Her cord wasn't clamped and cut until after I delivered the placenta, and she was in my or her father's arms for most of the first hours. She didn't have any painful tests or blood draws. All of this is supposed to help a baby be ready to nurse. In those first hours, she seemed hungry at times, and would suck on a finger, but didn't do great at latching on to my breast. My midwives helped me get into a good position for nursing and reminded me of the principles of a good latch, stuck around until she had sucked a few times for a few minutes, and said we were off to a fine start and to keep trying every time she seemed interested. For many mother-baby pairs, this is enough. We were not so lucky.

The next few days are mostly a blur for me. I wasn't sleeping much, and had a very very sore bottom so it was pretty uncomfortable to sit in the proper position for nursing. I kept trying every couple of hours, but continued to struggle to get her latched on for more than a minute or so at the most. My nipples were also growing more and more raw and painful from her style of latching on the end, then pulling away. I was in daily phone or in-person contact with my midwives, talking about nursing, my sutures, my mood, how much rest I was getting, and anything else on my mind. After two days of struggling to nurse, I had a visit from one of my midwives focused just on breastfeeding. For nearly an hour, she coached and encouraged me, and I felt like we made some progress. I started a schedule of attempting to nurse every 2 hours during the day, and every 3-4 hours at night, for up to an hour at a time. This meant that all day long, about every other hour was devoted to trying to nurse. On the fourth day, my milk came in, so not only were my nipples sore, but my entire chest was swollen and painful. On that day, I had one nursing session where Sweet Pea actually latched for more than 5 minutes straight, and I felt like maybe I was over the hump, but then it reverted to on for a few seconds, then back off and rooting. By this time, Sweet Pea was getting visibly frustrated every time I put her in the position to nurse. She would cry, arch, and flail her arms around. This was not the beautiful bonding experience I had hoped for. I was feeling very low, but still determined. My midwives had told me one option would be to pump and dropper-feed her if I continued to struggle, so at 1:00 AM on the fourth day I finally did that. It was a huge relief to get the milk out of my engorged breasts, and then thrilling to see Sweet Pea actually drinking milk. For the first time since her birth, I cried. The first day or two I hadn't been too concerned about her not getting much milk, because I know that babies have fat reserves that help them get through that time, but by the fourth day she was visibly skinnier and had a dry mouth at times. I wasn't really consciously acknowledging it, but I was full of anxiety about not being able to nourish her. When I called and told my midwives that I'd pumped, they encouraged me that I was doing the right thing for our situation. They counseled to me to try just pumping for two days, to help the negative association with the position of nursing fade, and then try bringing her to the breast again, but this time with a nipple shield.

A nipple shield is a very thin piece of silicone, in the shape of a large nipple and areola with holes in the end, worn over the top of the nipple. If you wash it with warm water and turn it halfway inside-out, it will stick to the skin. Apparently, nipple shields have been over-used in hospital settings for some time. I know one woman who was advised to use one for her first nursing attempt after a hospital birth, and felt like it damaged her nursing relationship with her baby. Some warn that using a nipple shield prevents the breast from getting the same stimulation as direct contact with the baby's mouth, and can therefore reduce the milk production of the mother. For these reasons and more, nipple shields are quite controversial in some circles. However, for me, the existence of the nipple shield was a blessing. Average went to Target and bought one, and I began using it at the end of the two days of dropper feeding. Sweet Pea had put on some weight by this time, and was no longer lethargic. Our first nursing session with the nipple shield was an incredible difference. It seemed to help Sweet Pea get enough of the breast into her mouth to stimulate a let-down, and the nipple shield was substantially longer than my actual nipples so it taught her the proper mouth position with the end of the nipple towards the back of her palate. It also did exactly as you would guess from the name, and "shielded" my nipples from the rubbing of her tongue. The soreness began to dissipate, and we were actually having longer, more satisfying (for her and me!) nursing sessions! I felt such relief that the entire world seemed to me to be a bright and happy place where everyone was kind and generous and I loved my baby, my husband, my entire family, and everyone around me. I had the opposite of the baby blues – the baby rosys? What an incredible feeling to be able to feed her directly from my body!
Breastfeeding at one week old.

I knew that I didn't want to rely on the nipple shield forever, so at two weeks, with the wise counsel of my midwives, and with the support of my husband, my mom and sister (staying with us at the time), and online friends at diaperswappers.com breastfeeding forums, I attempted the 48-hour cure for weaning from the nipple shield. We started out by trying each breastfeeding session without the shield, and then using it if she started to seem overly frustrated or upset. My only focus for those two days was nursing and skin-to-skin contact. I literally did nothing else besides nurse and hold her all day long, mostly in bed. Within about one day, I was almost exclusively nursing "bare." For the next several months, I continued to nurse with the shield at night, because it made side-lying nursing much easier for me, but rarely any other time. On our cross-country trip, I accidentally left the shield at my aunt and uncle's house, and so have been without it for about three weeks now, and we are now able to side-lie nurse fine without it.
Breastfeeding at six weeks old. That's not very polite, Sweet Pea!

For the first month or so of Sweet Pea's life, nursing was my main occupation. She needed to eat often, and successful nursing took a lot of effort and concentration from me to get her properly latched. At about the 10-12 week mark, it finally started to feel natural, and like I could do it and do something else at the same time. Before that, nursing was something I had to prepare mentally and physically for. It took a lot of effort to get everything to go smoothly. Now, at nearly six months old, she is nursing "like a pro" most of the time but we still have difficult sessions occasionally. My short nipples have been drawn out longer over time (I hear that they can just get longer and longer, the longer you nurse), but that wasn't such a painful process, thanks to the nipple shield I think. I went through a period of a month or two where I experienced some pain at let-down, but that's gone now. Breastfeeding has become a source of food and comfort for Sweet Pea, and is often relaxing for me.
Breastfeeding at five months old.

I am so grateful to my midwives and my family for supporting me through our struggles, never questioning whether breastfeeding was the right choice. I am a part of the minority of moms who make it this long, and I'm very glad that I stuck it out through the tough times and was able to make it work for us.

This may be the most personal thing I post about on here. I feel strongly about the importance of sharing this experience because since Sweet Pea's birth I've talked to so many moms who struggled and thought they were the exception, that there was something wrong with them, not realizing how very common these problems are!

Coming soon: an update on where we are now, advice for pregnant or breastfeeding moms, milk vs. cow's milk, and more!

6 comments:

  1. Good for you!
    We also used the shield at birth. I was having bleeding problems and my midwife wanted to get us nursing quickly to help. We used it until 2 months and are still going strong at 8 months!
    It makes me sad that moms quick nursing because of lack of support. Thanks for posting this to let others know they can do it!

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  2. Thanks for commenting and sharing, Melissa! I have heard lots of stories of the shield really helping, so don't fully understand why many people are so against them? Even using one forever would be better than not bfing at all, right?

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  3. I had no idea it could be so difficult. I wonder what people used to do if there was trouble breastfeeding? Do you think your experience was common or rare? Kudos to you for sticking to your decision!!

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  4. Ann,
    Luckily it is not that difficult for many people. But, I'd say that of the people I personally know, only about 2 out of 15 have had an easy time of it. The rest struggled at one time or another, with one issue or another. I think that in the distant past, people saw their mothers, aunts, sisters, neighbors, etc. nursing and had a lot more common knowledge of it, which helps some. But still remember there have been wet nurses around for a long time, and some babies used a "sugar teat" (basically sugar water sucked from a cloth) or some other animal milk, and some women used a makeshift nipple shield I have read. So, it seems that breastfeeding has always been challenging for some. I do know that with the right information and support nearly every woman can breastfeed, but many who struggle don't make it past the first few weeks. I have another post in the works addressing barriers to success and the national stats on breastfeeding in this decade.

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  5. I think people don't want to use a shield because of the fear they will always have to use it. I tryed getting him off it sooner and we both would end up crying! It wasn't until I told myself and my dh that we would do it when he was ready and not stress out about it. We got off it just like you, a little at a time.
    And I think you are right about the support. I've heard family memebers of friends say" why don't you just give him/her some formula? It would be easier" Without support how does anyone get through a tough situation?

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  6. And yes, it would be better to always use the shield then not bf at all!

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