Thursday, April 13, 2006

Adventures in Breastfeeding

Breastfeeding is tough. I knew that other people have struggles with it, but after having the perfect pregnancy and perfect birth (and of course, a perfect baby!), certainly breastfeeding would go smoothly, too... right? Uh...nope.

In retrospect, I wish I had read more about breastfeeding before Max arrived. I guess I figured that I would get help if I needed it, not realy thinking that I could PREVENT problems if only I had learned about achieving the proper latch, etc. Luckily we didn't have any problems with Max wanting to nurse, or with milk production, etc. but our problem was initially with the latch.

I guess I just assumed that it was normal for it to hurt to breastfeed at first. I mean, you would think that having that kind of suction on your breast (and let me tell ya, this boy can SUCK!) for any amount of time would take some getting used to. So I was wincing in pain each time he would latch.

It became unbearable to nurse, my toes would curl, I would grit my teeth...I was in tears. When Ellie came over for a regular check up, she exclaimed, "It's not supposed to hurt!" She watched me nurse, wincing in pain with each suck. By this time my nipples were already cracked and bleeding. She brought over a pump, and said that if we needed to heal up my nipples, it would be ok to pump and then feed max with a tiny tube on my finger. We then called in Amy for some cranial sacral work with Max, since he didn't seem to be opening his mouth very wide. We also called Beyond Birth lactation consulting and scheduled a visit for the next day.

This time was amazingly rough. We were supposed to be bonding, on our babymoon, right? But every afternoon I would get really sad, crying, anticipating the pain of all the nighttime feedings. Because I also had the hematoma, it hurt to sit up, but I had not yet mastered the sidelying baestfeeding position, so every 2 hours I had to get up, turn on the light, sit up (pain number one) and nurse (pain number two). I felt like I was letting Max down by dreading the next time I would have to feed him. It really made me think about how easy it is for people to just give up. I mean, no wonder so many people decide to just use formula after only trying to nurse for a few days... especially if they leave the hospital with samples from formula companies.I feel very lucky (and Max is so fortunate) that we know how imperative breastmilk is to his health -and mine- and his development that we didn't give up. Luckily Max and I had Rons support- we'd had several conversations before Max arrived about breastfeeding, and we both knew that it was the most important thing we could do for Max, and that we wouldn't give up, even if we had problems. Our families knew how strongly we felt, so they never made any comments about "Why not just give him formula?" which would have really been frustrating. We knew that any artificial milk just wouldn't provide all the benefits of breastmilk. But it was really discouraging to feel like this was a cycle that might go on forever... I mean, how do you heal your nipples if you continue to use them in the same way? I was hesitant to pump and finger feed, cause I didn't want anything to cause possible nipple confusion down the road, making it harder to get him back onthe breast.

So, it is great that we have so many resources at our disposal for breastfeeding support. The lactation consultant from Beyond Birth (Lyla) came out to the house, it was great! She weighed Max (he was already over his birth weight!) then checked out my nipples, and asked if I would mind latching him on so she could see what was going on. She showed us what we should be doing, how to get a better latch so that Max was getting a big mouthful, and wasn't breaking suction with each suck. I still was having a hard time, but then she said, "mind if I try?" and she helped to position my breast and insert the nipple into Maxs mouth. Miraculously, there was no pain, even with my nipples still being injured! I fed Max, pain free, and then she weighed him again. He was an ounce heavier, meaning he was getting plenty of milk. It was nice to know that the only problem was with the latch, which we could work on. Combined with his good weight gain, we felt much better knowing that even if I was in pain, Max clearly was doing really well. Lyla assured me that pumping and finger feeding was ok- that many moms do it for a long time for various reasons, and they are able to transition back to the breast eventually. She made me feel better about taking care of myself and letting my nipples heal. I decided that I would still try to feed from my breast a few times a day, just to practice the latch. She also emphasized (as have several other people) that it is not ok to continue nursing with a bad latch. If it hurts, I need to unattach him, and try again. This is hard in the middle of the night when you just want to get back to sleep!

Over the next few days I pumped and Ron and I finger fed Max. It was hard at night, because taking 30 minutes to feed, then 30 more minutes to pump made there less time to sleep. But with Ron being able to help feed Max, we made things work. The one good thing that came from this time was Ron being able to feed Max. It took some weight off my shoulders at a time when I was already feeling bad about not being able to nurse Max. Also, when he first stuck his finger in Maxs mouth he exclaimed, "Man, he's a sucking machine!" he was amazed at the strength with which Max was sucking. He understood how much pain I must be in to continue to breastfeed even after my nipples were cracked and bleeding. It was good for me to have his understanding and reassurance that it is ok to heal myself, and that we will be ok going back to regular breastfeeding in a few days. I swear, I would rather give birth to Max all over again than to relive those first weeks of nipple pain!

My nipples healed well, and the latch got better. I noticed that he was fussing at the breast a bit, and that I had a new pain, more in the main breast tissue. Ellie thought it might be thrush, and after reading the symptoms, it seemed an accurate diagnosis. I started treating it with Gentian Violet, Grapefruit Seed Extract, and rinsing with vinegar. The Gentian Violet is bright purple, you paint it on moms nipples and areola, then let the baby nurse. It turns the mouth of the baby bright purple for a few days. We later switched from Gentian Violet to Tincture of Myrrh, and added garlic tablets and probiotic (acidophalis) for Max. The thrush got better, but then Max had an allergic reaction to something we had added, and he got a painful rash on his bottom. We thought it was from either the Myrrh or the garlic, so we discontinued those two things, and his rash has gotten better. There was also a bloocked milk duct in there somewhere, but compared to the other pains, this was nothing! I used warm compresses and nursed Max in the area of the blocked duct, and it got better. Luckily it didn't get infected, as can often happen.

The thrush is now gone, and we are back on track now. The latch is still hit and miss. It always hurts right when he latches, but then the pain subsides after about 5 seconds. About 30% of the time we get a good latch right away, but most of the time I have to re-latch him a few times to get it right. We are progressing, though! It doesn't hurt nearly as much to re-latch him now that my breasts are healed.

I am also learning about engorgement, and how hard it can be to get him to latch properly when I am swollen and engorged... plus it hurts to be engorged! I have learned to just bite the bullet and wake him up if I am feeling engorged- although it's hard to do at 2:00 am when I really want to just let him sleep another hour! I know I'll pay for it if I don't nurse.

I went to a La Leche League meeting on Monday, it was really nice to meet other breastfeeding moms and hear about their experiences. I think I will continue to go. I wish I'd gone before Max was born, maybe I wouldn't have had so many problems!

I also highly recommend The Womanly Art of Breastfeeding, it has been invaluable to me over the last 4 weeks! Another great book is The Ultimate Breastfeeding Book of Answers. I know that this is a personal issue to be writing about publicly, but perhaps if more people did talk about it, more women would be aware of the challenges involved and more educated about the importance of getting off to a good start. I wish I had payed more attention to this issue before birth- I thought it would just come naturally, but it isn't always that easy!

Cabbage Leaves can help with the pain of engorgement...It really works!

Ron feeding Max

Purple mouth Max. And this was after it had cleared up for a day or two! How many fun nicknames do you think we came up with? Grape Ape, Little Boy Blue...


Breana said...

I'm so glad you wrote about your experience...people need to talk about breastfeeding more! :-) What an amazing gift you have given Max. And, I love the cabbage picture!

kyouell said...

Good for you for getting help!

I had read that it takes an average of 6 weeks for mom & baby to become good at breastfeeding, so not to quit before then. It took us 10 weeks.

And, you know, there is biting to come. So don't give away those books!!!

Melanie said...

Melanie from the newlyweds list again. I had a HORRIBLE time with breastfeeding at first--though different problems from yours. Max's mouth is unusually small and my nipples are very large and very inverted, so he just couldn't latch. We tried a SNS (supplemental) but since I wasn't producing milk well at first, it just was a lot of work. We ended up having to supplement because Max was losing weight like crazy and then getting him BACK on the breast was a nightmare. But we did it-- and 5.5 months later he's exclusively breastfeeding and doing great. I agree with you though-- no one tells you just how hard it can be. I was frustrated by both sides--folks who said to give him formula (including my husband!!!) and the "boob nazis" who felt I was failing by using a bottle at all. I'm so glad that awful time is over and I can nurse w/o problems. Glad you made it through as well!! So sorry about all the pain.