My Breastfeeding Journey

img_0624This week is #WorldBreastfeedingWeek and I thought it was the perfect opportunity to share my journey and celebrate the achievement that I’ve made it 6 months and counting. It’s a long one, but I needed to write it all down, if not just for me to process.

I did everything I could to prepare for breastfeeding.  I had heard from so many friends who struggled with it, how painful it was, and some who switched to formula because it was just too much.  I really wanted to give my daughter the benefits of breast milk and was determined to make it work. During pregnancy, I read the book The Womanly Art of Breastfeeding and several blogs about nursing, read the KellyMom website, started following La Leche League on Facebook and took a breastfeeding class from a IBCLC (Lactation Specialist).  Even with all that, nothing could have prepared me for how hard this breastfeeding journey would be, both physically and emotionally.

When my baby girl was born, we did skin to skin immediately and for the first few hours of her life.  She breastfeed for the first time about 45 minutes after birth.  It did not feel comfortable, but according to the nurse and midwife, her latch looked great. I noticed immediately when she cried that her tongue was connected to the very front and the midwife confirmed it did look like she had a “tie.”  She said that it could cause problems, and that if it did, we should look into getting it fixed.  I fed her a couple more times at the birth center before going home, each time experiencing the same discomfort, but thought I was just sore from the nearly 5 hours of pumping I did during labor to help encourage contractions during the pushing phase. Ugh!! (read my birth story here)

She slept a lot in those first 12ish hours after birth.. I think we were both just exhausted from the labor… and the amount of feedings seemed “normal.”  After that, she started nursing constantly.  When she wasn’t feeding, she was awake and usually quite fussy.

A nurse came to our home the next day to do a check up.  Her weight had only dropped 1% (though I now believe that scale reading was likely incorrect).  By this time, I was in a lot of pain when I was nursing and (TMI!) was already cracked/bleeding.  She observed me breastfeeding and confirmed once again that the latch looked “perfect” and I was doing everything right.  The nurse encouraged me to get a nipple shield to use until I “got used to it,” so I did and continued on.  The teacher in my breastfeeding class did emphasize that it shouldn’t hurt, but that is may be uncomfortable at first; being a first time mom, I wasn’t sure of the difference.

As the awake time and fussiness continued, I began to wonder why I didn’t have a typical sleepy newborn.  You always hear that newborns sleep, eat and poop; we were having a lot of eating, but not a lot of sleep or diapers. After the first 24 hours, she was not meeting the dirty/wet diaper count they tell you to look for.  Something told me something was not right.

As I’ve learned far too often before in my own health journey, we cannot always trust medical professionals to really know what’s going on.  You have to be your own health advocate at all costs. If you ever feel like there is something wrong and you aren’t getting answers, keep asking questions.  I’m also truly a believer in mother’s intuition… we know our children better than anyone, including nurses and doctors.  Trust your gut.  So, I decided to push for more answers and seek further help.

The following day, at 48 hours old, we made a trip to see the midwife for a weight check. She confirmed that Juliette had already lost 7% of her weight and that we should see an ENT to evaluate/fix her tongue tie.  She also prescribed me some triple nipple cream to help with the pain (which slightly helped). We were able to get in with a pediatric ENT the next morning.  He immediately confirmed her tongue tie and clipped it with scissors right then and there in the office. The procedure was super quick and she didn’t cry long, but it’s certainly heartbreaking to watch your newborn held down while someone cuts their mouth with scissors! He said it would immediately help.

It didn’t.  I continued having to use a nipple shield. It was still painful. And she was still nursing constantly.  My milk came in on Day 4 and I thought that would help, but it didn’t.  I would nurse her for a total of 30-50 minutes each time (both sides). Most times, she would fall asleep for a few minutes at the end of the session and sleep in my arms for a bit.  In between nursing sessions, we might take a break for 15-30 minutes to change diaper and play a bit.  The longest break I ever got in between was 1 hour, except for one 4-5 hour stretch at night before the schedule returned.  Evenings were the worst- she would nurse constantly from 4 or 5 pm to 10 pm at night.  Any breaks were filled with crying.

Typing this now, it seems SO obvious that things were not right.  And, I knew that in the moment, but of all the people I talked to and internet research I did, everyone would just say “well, she’s just cluster feeding before bedtime.”  Let me tell you, cluster feeding is NOT that.

At her two week check up at the pediatrician, she wasn’t yet back to her birth weight as they like babies to be.  But, the amount of her dry and dirty diapers were okay, so they weren’t too concerned.  NOTE: I now know that diaper count can only go so far in telling you that things are okay.  If a baby is feeding that frequently, the amount of diapers they produce may be high, but the amount in the diaper is important too.

We kept going.  I continued sitting in my recliner watching Netflix, nursing her constantly.  I was in pain and exhausted. She was constantly fussy. I am forever grateful for the friends who came to visit and bring us meals.  And for my incredibly supportive husband and parents who encouraged me and prayed over us.

When she was a month old, she had just barely reached her birth weight.  Nothing had changed for us and I decided it was finally time to see an IBCLC.  When she visited us, we did a weighted feed to confirm that only 1-2 oz of milk was getting transferred during a feed, where it should have been more like 3-4 oz.  She immediately noticed that her tongue still looked tied and recommended that we see a pediatric dentist to be evaluated.  She also said that while the latch looked okay from the outside, it was obvious from the amount of milk she was getting / lack of weight gain, and my pain, that it couldn’t be right.  She suggested trying to pump after each feeding and give her a bottle of that milk to supplement.

We made an appointment that afternoon with a pediatric dentist who diagnosed her with a thick posterior tongue tie, which cannot be treated with scissors, only with a laser frenectomy.  A laser is more effective to cut thicker tissue back further, because it cauterizes the wound immediately and with minimal pain.  There is no need to put them under anesthesia for surgery either. We did it right there (again, absolute torture to watch even though it was fast) and I was told, again, that we would see immediate help from the procedure with her latch.

Things slightly improved.  She still wasn’t able to latch without the nipple shield, but seemed less.  She started sleeping a little longer during her first nighttime stretch, and would have longer content times during the day. But the nursing sessions were not all that different: she would still nurse for almost an hour, was nursing very frequently, and would get fussy at the breast.

Days after her procedure, we got thrush.  Thrush is a yeast infection in the mouth of a baby (can spread to the diaper area, but didn’t for us!) and on the nipple of the mom.  In addition to the pain I was already experiencing, this just added to it.  I got an anti-fungal pill prescription for myself and Nyastin (an anti-fungal liquid) for baby.  We used that for the 10 days with zero relief.  Finally, I got some gentian violet, a natural remedy and used that on her – it turned her mouth purple, but the thrush was gone in 4 days!

After the thrush was gone, I was still experiencing pain that would keep me awake at night when I desperately needed sleep.  And even though I was trying to pump to supplement with bottles like the lactation consultant had suggested, my daughter would NOT take a bottle at all.  Most dirty diapers were green, which indicates that she was getting more foremilk than hindmilk (the fatty kind), so I knew she really needed those bottles.  She seemed to be getting more milk, but was still not getting enough.

In addition to the above, I still felt I needed help with spacing out her continued frequent nursing schedule and trying to wean off the nipple shield.  I invited the IBCLC back out for another consultation.  My daughter had quite possibly her worst nursing session ever while she was there, which maybe exaggerated some problems and pushed others under the rug. Unfortunately, I ended up more confused and discouraged.

The lactation consultant felt that her not-tied-but-still-tight tongue, low weight gain, fussiness nursing, painful-sounding swallows and gas indicated one of two problems: possible torticollis/hypertonia or reflux.  We made an appointment to see the pediatrician the next day. The pediatrician prescribed reflux medication to see if it helped (it didn’t) and recommended we visit a craniosacral therapist for body work to loosen the tight neck/face/shoulder/tongue muscles created by months of incorrect nursing.  Unfortunately, insurance doesn’t cover this expensive therapy and having already spent hundreds trying to save breastfeeding, I had to draw a line somewhere.  I took her to a chiropractor for an adjustment and did some light massage I read about online and prayed for the best.

For my own pain, it was suggested that I get my milk cultured for a deep breast infection. I decided to try essential oils before resorting to an antibiotic and thankfully, again, the natural remedy worked!  I started putting Melrose on and taking oregano oil in capsules and the pain was gone in just a few days.

At 10 weeks, we were still struggling.  And she wouldn’t take a bottle so I felt stuck.  We tried 5 different bottles and 5 different people.  One day, my friend Emily was over for a playdate and offered to try- she stood up, rocking her in front of the tv and she finally took the bottle!  Nursing was still very difficult and I began, reluctantly, considering formula.  I am team #fedisbest, but I had worked SO hard, that I was struggling with feelings of failure.  One night, during a late night nursing session, I saw a mom on a mom’s Facebook group I’m in offer up her extra milk bank donor milk she no longer needed. I arranged to pick it up the next morning and was shocked to receive over 200 ounces of donor milk for free. I was so thankful I cried!

That was a turning point.  Once I was able to start supplementing her with a few bottles each day, she finally started to gain weight and get the fatty hindmilk she needed to keep her satisfied longer in between feedings.  And having the donor milk to use allowed me to keep what I pumped and start building a freezer stash.

When I first started adding in bottles, I was tending towards exclusive pumping. Having each nursing session be such a struggle and never being confident in how much she was getting, I thought it would be the best option.  But my daughter had a really strong emotional reaction to what was essentially weaning, and it was heartbreaking. So, I continued to nurse and just use a couple bottles a day as a supplement to that nursing.  Eventually, over time, the nursing became less of a struggle. Maybe because she wasn’t so hungry all the time or her mouth was big enough to be more effective. I’ll never really know.

Then it was time for me to go back to work at 12 weeks… My maternity leave had been, if I’m being honest, horrible.  Then, when we were finally getting into somewhat of a groove, I had to leave her. Thankfully, I was able to work from home two days a week to continue breastfeeding as much as possible.  While I was at work, I would pump 3 times each day, but couldn’t get enough for the bottles she drank while I was gone. I had to pump each morning after her 3-4am feed to get the extra milk for bottles during the day.  I was working full time, barely sleeping and exhausted.  Two months in, I decided to cut that morning pumping session to get some more sleep (even though I was waking to nurse her, pumping woke me up so much more so it was hard to fall back asleep). I hoped my supply had stabilized enough to get that milk in later pumps, but I quickly learned that wasn’t the case.

A couple weeks after I stopped that early morning pumping session, I started to notice that it was, unfortunately, causing my overall supply to decrease. Then, I got sick and my supply tanked even more.  So, I added that early morning pump back in.  I don’t get anywhere near the amount of milk I used to at that time, so I am thankful for my freezer stash that I have to dig into each work day. But, it has helped keep my supply up for the rest of the day to keep her satisfied while nursing.

On keeping up a milk supply: I’ve found that drinking lots of water and having a diet high in protein and good fats (like olive oil, coconut oil, avocado, red meat) is absolutely crucial.  Early morning pumping sessions (your hormones produce more milk at the 3am hour) and frequent nursing on-demand throughout the day.  And I have recently tried a few supplements that have helped a lot: Moringa, Legendairy Milk’s Liquid Gold and Pump Princess.

So here I am, 6.5 months in.  I’m still breastfeeding and it feels like a miracle.  I can’t believe what we have both overcome to make it here and I’m thankful for how the Lord has provided.  In the end, the tear-inducing pain with nursing lasted 2.5 months for me.  I’ve had some pain on and off since then because she still has a narrow latch, but nothing consistent. She’s still hungry every 1.5-2 hours, so we will likely never follow that ideal 3 hour schedule everyone recommends. I still stress about my supply and worry my freezer stash won’t last.  I’m still using the shield, which is annoying, but ultimately I’m okay with it because it saved breastfeeding for us. And while we are saving money by not using formula, there is a certainly a cost to breastfeeding.

I don’t love breastfeeding, but I cherish it. I cherish the connection with my sweet baby each moment she is in my arms (especially now that she’s always on the move!), the ability to calm her by nursing when nothing else will, and the fact that I’m able to provide for her health and nutrition- what an incredible thing!

For those of you soon-to-be mamas reading this, I want to say: You can do it! Check out your local La Leche League group in person or on Facebook- tons of very knowledgeable people on there that can provide you with evidence-based support, not just anecdotal. And don’t be concerned about supply now or in the first few days… there is such a stress out there of comparison with how much people can pump and the size of stash they can build, when a big stash is often not necessary. As long as you are feeding on demand, as often as the baby wants, your supply should be just fine.

Work with a lactation consultant from the very beginning to make sure your baby is latching correctly, and if you are in pain, seek out answers.  Don’t let it go too long, like I did. Even though my IBCLC visits didn’t result in a whole lot of answers or help, I still believe they can help with most issues.  I would certainly try to see one before giving up on breastfeeding. Plus, your insurance has to cover it, according to the Affordable Care Act.  My insurance denied the claim (because insurance companies are dumb), but I submitted an appeal that was accepted- I would be happy to share my letter and back up documentation with anyone!