Tuesday, October 5, 2010

Adventures in Babysitting Breastfeeding

Yup - here is the long awaited breastfeeding post. If you don't want to know all the dirty details, don't read it. Trust me - I get pretty candid with this one.

Among my friends with babies or my friends who are preggers, breastfeeding always comes up as a topic. I know I had plenty of questions about it when I was pregnant. Breastfeeding was the one thing I felt very strongly about doing, provided that I had a good supply and was able to. Other things (e.g. cloth diapers) I took more of a we'll try it out and see attitude. Back in my grad school days, my friend MB (who also recently gave birth) and I took a class through the nursing school on breastfeeding. Not how to personally breastfeed, but how to help people (from a nursing perspective) with breastfeeding. Given that we were public health students, we naturally saw a connection between public health and breastfeeding. This was when I was toying with the idea of doing maternal and child health for a career as well. So we took the class. I thought it was a great class and we had to shadow some lactation consultants (LC) for it. I was all about becoming a LC. Yeah - that went no where.

Fast forward a couple years (5 to be exact) and I was taking another breastfeeding class - only this time it WAS of the "how to breastfeed" variety. Nate even went with me. We registered for the breast pump, for the nipple cream, the milk saver bags, the nursing pads, the Boppy...etc.

Then I gave birth to Maggie and they encouraged me to try to get her to latch right in labor and delivery. She did it the first time!!! Hooray! We gave birth to a breastfeeding champion! Who needs a LC?!

Then, as I like to tell it, she forgot everything on the wheelchair ride up to the mom & baby floor. 2 AM came and she was screaming with hunger. I put her to my boob. I thought she was sucking. We paged the LC on duty, R. R came and basically looked at us like we were idiots. "THAT is not a nutritive suck - that is not going to do anything or get milk into her. She is a lazy sucker." I don't remember much about my days shadowing the LCs, but I thought that chastising new parents and insulting their baby probably wasn't the best bedside manner. R immediately grabbed my boob and literally started milking me. Then she asked, "Is this ok?" "Um..yes. Do what you gotta do," was my reply. She said that we were going to have to train Maggie to suck.

"Training and infant to suck" sounds all cute. It is not. What this meant was that R had to teach me how to hand express my colostrum (aka milk myself). Given that colostrum doesn't just readily flow from your boob, it is hard work. Since I did not have any sleep in about 48 hours, I readily tired from squeezing the hell out of my boob. While I was squeezing the drops from my boob, Nate was sitting there, gathering them in a plastic measuring cup. When I literally got too tired to continue, Nate took over the milking. No questions asked. We didn't even really think about it until days later when Nate would tell his friends, "I had to milk my wife." Go ahead. Laugh. It is funny. It wasn't funny that first night in the hospital, but it is now.

After we gathered a whole shot glass of the colostrum, we again paged R. Holy toledo. The woman looked at me as if I were a celebrity - "Look at how much you got!!! That is amazing!!". We then got these tiny syringes that we had to fill with the colostrum and Nate would put his pinky in Maggie's mouth and when she sucked, we would have to syringe in some milk. This is how we fed her for the first 24 hours.

THEN, this method was passe. The other LC, W, said we had to graduate to a syringe with a long thin tube on it that we would have to tape to my boob. This would give Maggie practice at sucking at my boob and then getting "rewarded" with milk when she sucked appropriately. Like she was a little puppy. Seeing that I could hand express a ton of colostrum, they graduated me to the hospital breast pump, which was much easier than milking myself. So I would try to feed her every 2 hours and have to pump every 3 hours. It was exhausting. And let me tell you - trying to fit your giant boob in a tiny baby's mouth along with a little tube is NOT easy. However, W was way nicer and more encouraging than R. She was very nice and made it sound like every newborn has some sort of problem and that she was confident that once my milk actually came in, Maggie would be a champ.

Then Day 3 came and we were going to be sent home. W sent us home with a SNS device, which is basically the fancy version of the syringe with a tube attached. So I was still going to have to pump round the clock so we could fill the bottle and tape it to my boob for our first day home.

During the day, this wasn't too big of an issue. But at night, when Maggie would get up to eat every two hours, it was a circus. Nate would have to get up, fill the bottle with breastmilk, come up with the device and the medical tape and tape the tube to my boob and then hold the bottle. We were taught that we would see little bubbles in the bottle when she was sucking appropriately. So as I tiredly would shove my boob into Maggie's mouth, I would ask, desperately, "Are there bubbles? Are there bubbles?". We did not get any sleep that first night.

The SNS device was only good for 24 hours because the tube was so thin that it wouldn't hold up longer than that. We were thinking she was latching pretty well after that so we threw it away and hoped for the best. The whole time, I worked with the cradle hold, which is basically like how all the pictures of breastfeeding moms are - you cradle the baby in your arms. Due to a stroke of genius, one night Nate mentioned, "Why don't you try using the football hold?". That man WAS paying attention in that class!! Bless him! Maybe HE should think about becoming an LC!! ha ha ha I arranged the Boppy to my side, laid her on her back, and the magic happened. It was like that episode of the office when Pam excitedly proclaimed "Jim, she latched!" (only we didn't breastfeed the wrong baby!).

After that, Maggie took off with the breastfeeding. And the more I talked with friends the more it seemed "normal" that there are some issues at first. I am thankful ours only lasted 4 days. In the grand scheme of things, that is nothing but at the time I was thinking "THIS is why people give up on breastfeeding."

One of Nate's biggest fears about being a father was poopy diapers. Not losing sleep - not being able to care for a small baby - but Poop. He quickly got over that fear and became a cheerleader for poop. When you initially start breastfeeding, you can't magically see through your boob to see how much (if any) milk the baby is getting so you have to count dirty diapers. For real - they give you a chart to count the poop and pee diapers. Those early days, we would literally high five when she had a poopy diaper. Now there is not turning off the poop! Let's just say the girl is getting PLENTY to eat.

Speaking of plenty to eat, I definitely have no supply issues. Quite the opposite really. Since I started pumping early on, I sort of had to wean myself from the pumping. Your breast literally works on supply and demand - so if you keep removing milk from it, it will keep producing more. Thus, while it may seem like a good idea to keep pumping to empty your really engorged breast, that will just signal them to keep making more. I went through about 2 weeks of no pumping. It was nice - I already had quite the nice supply built up in our chest freezer. However, I did return to pumping last week once a day. Five minutes of pumping each morning gives me 4 oz for the freezer, which will come in handy when I go back to work.

The breast pump was something I was quite afraid of before having a baby. When my friends CD & AH were here for a baby shower, they both were pumping and they gave me demonstrations and answered tons of my questions. I felt better about pumping after that. And despite the fact that we didn't have the easiest entry into the world of breastfeeding, having to pump in the hospital, where there were nurses and LCs around to help, definitely made me an old pro at pumping. I was very thankful we bought the Medela Pump In Style Advanced BEFORE having the baby so that we didn't have to make any emergency trips to Babies R Us to buy it that first day home. The hospital also gave us a Medela pumping kit with a manual pump, duplicate pump parts, etc which was very nice. During those early days of engorgement, it was easier to "take the edge off" with the manual pump rather than hook up the electric.

If I heard or read "breastfeeding is not suppossed to hurt if you are doing it right" one more time, I was going to combust from insanity. If it wasn't suppossed to hurt, then why were my friend HC and I trading stories about the cringe we did every time our babies would latch for the first few weeks. In reality, breastfeeding IS a bit uncomfortable the first few weeks. The nurses with kids in the hospital confirmed this. That is why there are things like Lansinoh Soothies (thanks AB!) and lanolin nipple cream. I would have BATHED in nipple cream that first week if I could. But then, one day, the first cringe goes away and it's no big deal. I felt very lucky as some of my friends had blistering and such. I had minor discomfort that went away around week 2 or 3.

I was hoping I would be like some of my friends and have no issues with leakage. Yeah that dream did not come true. I might buy stock in Avent given how many boxes of nursing pads I might go through! Again, remember in the episode of The Office where Jim & Pam have thier baby and Kevin is always making crying sounds around Pam hoping to get her breasts to leak? Yup - I can attest that that does really happen.

As I said, Mags and I had the football hold down pat. However, I had wanted to try to switch back to the cradle hold because the football made me a slave to the Boppy. At home, this wasn't awful but when we would go someplace, I would have to drag the Boppy along. Sometimes, the only place to feed Maggie would be the car and squeezing into the seat with the Boppy and baby would not exactly make for a comfortable time.

Then last week, Maggie started having gas and spit up. Things I read said that the cradle hold might be better for this, particularly in my case where I definitely don't have any let down reflex - milk just streams out of my boob causing her to gulp the first few minutes of feeding. The football hold worked with gravity - something I did not need! So we tried the cradle hold and voila! Less gas and instant trasportability. No more Boppy necessary for feeding!!!!!!

Now we use the Boppy more as an infant lounger and for modified tummy time, as pictured above. (Note the use of burp rag in case of any spit up!).

I once heard my boss tell a colleague that had just given birth, "Breastfeeding starts out being sort of a pain, but with time, it is easier than formula". In my case, this was very true. Nate & I have commented many times that it is so nice being able to go somewhere and not have to lug around bottles and formula and worry if they will have a heat source to warm the bottle. And now that we have mastered the cradle hold, I can basically feed Maggie on demand without any props, prep time, or any drama. Clearly she is getting enough - the girl didn't hit the 10.0 lb. mark before week 4 by NOT eating. NICE!


CRICKET said...

Good job! What a great post. I could relate on so many levels. I am a bit sad my breastfeeding days are over.

Old MD Girl said...

The first 4 days sounded like HELL!!!! What a b*tchy first LC you had! So glad it's working out for you now.

Also, thanks for educating me!

Emily said...

Thanks for the candid info...hoping all goes well for me in a few weeks. It will be nice to know if I do have issues that I'm not alone and to stick with it!!

Amy Badler said...

Wow! You should be so proud of yourself. I am sure that most people wouldn't have made it through all of that and still be successfully breast feeding. I'm glad to hear the soothies came in handy! (your thank you note cracked me up)

Mary Hinkle said...
This comment has been removed by the author.
Mary Hinkle said...

I think having a nanny is such a great option when you need childcare. If you get a good one they really do become part of the family. And it is so nice that you still see your previous one, and you seem to have found another good one! For more see you can Click Here.