May 15, 2006

No One Ever Said It Was Easy

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This entry is going to be about breasts and breastfeeding, and what has been going on with me and Sam. If you don't want to read about things like my boobs, breast pumps, and latching on, you should probably skip this entry.

First off, I want to preface this by saying that Sam is the best baby in the whole world. He sleeps enough that I've been getting 6-8 hours at least every night, which is freaking awesome. When he's awake, he's alert and loves to sit in your lap and listen to you talk. He doesn't fuss unless he's in the bath or very hungry. Everything is actually easier than I expected except for this whole breastfeeding thing. Moms all around me are breastfeeding. You assume that it just comes naturally, that it's easy, that the baby comes out, you put him to the breast and he just eats and automatically gets all of the nutrition he needs. But no one ever SAID it was easy... and it's not for a lot of women, myself included. This is the story of what's been going on with our struggle with breastfeeding, and how I'm feeling about it right now.

I have not been able to sucessfully breastfeed up until now. My milk supply is quite low, and we've had a few other challenges. When Sam was born, he was put to the breast within 2 hours of birth. That's when the challenges started, since Sam could not properly latch on to my breast. I have pretty small breasts, and there was not a lot of change during the pregnancy. My breast tissue is soft and my nipples are not all that prominent. So, we tried breastfeeding. Then we got a nipple shield, and Sam was able to latch on with that some of the time, but it was already becoming a little frustrating when he couldn't. The first day he did not want to feed at all, and started spitting up because he'd swallowed amniotic fluid and was still trying to get it out of his system.

On Wednesday and Thursday after we were home from the hospital, I had trouble getting Sam to latch on, but he would do it. However, once he was latched on, he would suck for a couple of minutes then start to fall asleep. He would only eat for 5-10 minutes at most, and then drift off. When he woke again, he would be fussy and hungry and we'd start again.

On Friday after he was born, we went back to the hospital for our appointment at the postpartum & breastfeeding center and met with a lactation consultant nurse. Sam was weighed and we tried breastfeeding there and learned that he was not getting enough food from me. In short, he was really getting almost nothing. Sam was down to 6 lbs 8 oz, which means he lost more than 10% of his birth weight, and that's supposed to be the limit/normal amount. I was so sad to learn that my baby had not really been able to eat for those first couple of days. The nurse recommended supplementing with an ounce of formula each time Sam ate, and gave us a tube and syringe and taught us how to supplement Sam at the breast. Basically, this works by the baby latching on, then you put a tiny tube in his mouth so he gets formula & nutrition WHILE he is sucking at the breast as if he's breastfeeding. Once Sam was actually getting the food he needed, he was much less fussy and started sleeping more and being more alert when he was awake.

Saturday we were back at the hospital for a followup appointment. Sam gained 3 ounces from the food he was eating. They had me breastfeed Sam again and weighed him after each breast. From my right breast, he only got about 5 grams, and nothing measurable from the left. It had only been 4 days since Sam was born, so I felt that it was "normal" that my milk hadn't come in yet, although most women get their milk in by 4-5 days after birth. That day, the nurse recommended that we rent an electric pump from the hospital and pump for 10-15 minutes after each feeding to try and get my milk supply to come in. We went to the store at the hospital and rented the pump. That day I started pumping after every time that I fed Sam. The pumping is a very weird experience, and honestly it does feel a lot like you are hooked up to some farm milking machine. Very strange. When I pumped, I would get maybe 1/8 of an ounce from the right side, and drops from the left.

We continued the supplementing and pumping for the next few days. We did some finger feeding, which is basically feeding Sam with the syringe but by letting him suck on a finger instead of a nipple. This allowed Justin to feed him when I was sleeping. Sam seemed okay, but also got hungrier and wanted to eat more.

Wednesday, 8 days after Sam was born, we had our final appointment at the hospital with another of their lactation consultants. We did not breastfeed Sam at the appointment. We talked to the nurse about many things. She told me that they expect most women's milk supply to come in fully by about 10 days after birth. She recommended Fenugreek, which is an herbal supplement that can sometimes help to increase milk supply. We looked at my breasts and discussed the idea that I may have insufficient breast tissue. This make sense especially on the left side, which had almost zero increase in size during my pregnancy and the period after Sam was born. At one of my appoinments, I spoke to the nurse about my medication, and found out that Wellbutrin, which I was on throughout my pregnancy, could possibly affect milk supply. I called my doctor and had him switch me to Zoloft, which has better indications for nursing mothers. The nurse recommended that we stop finger feeding and supplement at the breast or start using bottles so that the baby would not get used to the finger and have trouble with bottles latler if we needed to use them. At this point I asked the nurse if there was a point at which if it didn't happen, it just was not going to happen. She said usually by 3-4 weeks. Also, she said that most women can't handle keeping up with all of the pumping and the stress of trying to get things to work for much longer than that.

We also found out at this appointment that Sam should be eating twice as much, which explains why, again, he had been acting hungry. I was unhappy because no one had explained how and how much to increase his food amount, and again hated the idea that he'd been hungry because I had not been feeding him enough. Sam now needed 2 oz every 3 hours or so.

After this appointment, I continued pumping. I bought the Fenugreek and started taking it. I kept trying to put Sam to the breast, and have him suck for a bit before supplementing, but he would get upset when he sucked and there was not a good flow of milk right away. We started using bottles when supplementing him. If I supplemented at the breast, it now required two full syringes full of formula, and switching the feeding tube from one syringe to the other in mid feeding.

The last 2 days Sam has been almost completely bottle fed. I haven't been making him latch on. He doesn't usually want to latch on. If he's hungry, he will get frustrated when there isn't a rush of milk. If he's sleepy, he'll fall asleep. Half the time he pulls his head away and pushes at my breast with his hands. It has now been 13 days since he was born and I feel that since I started the Fenugreek my milk will flow better when I'm pumping, and my supply has increased some, but not to the level of having any changes in my breast size. Inside, I do not feel that my milk supply is going to increase much more than this, and it's nothing like the stories I've heard from other moms about their milk coming in and suddenly having gigantic breasts that are flowing with milk and soaking all of their shirts.

Throughout the process I've had the nurses telling me that it's my choice, telling me how many women have trouble, at the last appointment telling me that whatever I decide to do it okay. If I want to keep trying, I can. If I want to go to bottle feeding and stop, that's okay too. That it doesn't matter what anyone thinks and that my baby will be fine either way.

It has now been 13 days since Sam was born. I don't feel like the breastfeeding is going much better than it was in the beginning, and I am struggling with a decision that I need to make. Should I keep trying to get Sam to breastfeed? Is it worth it for him to get a half ounce or an ounce of mothers milk every once in a while? Is it worth trying to figure out the exact right time to get him to nurse when he's not too hungry, but not too sleepy either? Will anything change? After the last appointment at the hospital, I thought about my history. We conceived this baby with fertility treatment. I was on Clomid for almost the entire 20 months we were trying to conceive, which is a drug that works with your pituitary gland to help it communicate with the reproductive system. We conceived the baby with IUI. I haven't had my hormone levels tested, but I suspect they may not quite be normal. Before I got the positive pregnancy test, I was starting to think that we would never be able to conceive and we were starting to think about adoption. I don't seem to ovulate regularly without medication, at least not before I had this baby. My family has had some hormonal problems as well. My mother had breastfeeding challenges too. Maybe it makes sense that I'm having trouble with this, but for some reason I never expected it.

I read stories about women who used supplemental nursing (like the tube & syringe at the breast) for 8 months. I read about women who kept pumping for months, who took prescription drugs, who put the baby to the breast every chance they got to try and increase their milk supply. I read about women who have almost zero milk when pumping, but they say that pumping is not the same as breastfeeding and that some women's breasts just don't respond to the pump. I read about women who got their babies to latch on after months of refusing the breast. I have friends who were not able to breastfeed as successfully as they wanted. One stopped after four months. My Mom was not able to breastfeed very well either, she supplemented us with formula and her milk dried up after 4 months with both me and my sister. But four months seems like such a long time compared to the 2 weeks I've been at this and been thinking about it.

If I decide to stop now, am I giving up too soon? Should I keep trying? I don't think there is a "right" answer here. I'm afraid of what people will think of me if I stop. I may seem well put together writing about this now, but I cry about it at least once every day. On Mother's Day I finally talked to my Mom about what's been going on, and how I'm feeling. I tear up almost immediately when I start talking about it. I cry thinking about this at least once every day. I feel like I'm failing my baby because I can't feed him the "normal" way. I'm afraid he's going to get sick because he didn't get enough breastmilk. I'm afraid that people are going to think I'm a bad mom, and that I didn't try hard enough, and that I don't want the best thing for my little baby. I'm trying to make a decision based on how I feel and what is best for me and Sam physically and emotionally. It's easy to say "who cares what other people think", but harder to put that into practice and actually stop caring. Mom pointed out that this is just the beginning - as a parent, people are going to judge me all the time, and that it's my child and I'll do what is best for him and it really doesn't matter how other people want to raise their children.

Sam is happy when he gets his bottle. He looks up at me with his big blue eyes and sucks away and gets all the nutrition he needs. The funniest thing about all of this is that he doesn't care where his food comes from. He only cares that he's getting food. He cares that he's well taken care of. He's surrounded by love. He's relaxed and trusting, and gets a ton of attention from me and Justin. He gets frustrated too when I try to put him to the breast and he doesn't want it. He surely doesn't understand why I'm trying to make him do it. But then there is a moment like this afternoon when he's awake, not too hungry, and I put him to the breast and he actually gets something from me and cuddles up to me, content. It's soothing and calming, and it feels so wonderful.

I still haven't made any decisions. The bottle of Fenugreek still sits on the coffee table. The breast pump is rented through the 22nd. I have my nipple shields ready to use, and extra syringes if I want to supplement at the breast instead of using the bottle every time. The not knowing and not deciding may be the hardest part. If I make a decision to stop, maybe I can grieve the loss of that relationship with baby and move on so I can concentrate on how wonderful he is. But maybe I don't have to lose it, at least not all the way. It may not work out the way I planned, but I do feel better today about just letting things go how they're going to go. Maybe he can still nurse, but I know it's not going to be how he gets his nutrition. We'll see how it goes.

All I know right now is that I will NEVER judge another mom for her decision to breastfeed, or not breastfeed. Looking at someone, you don't know what they've been through, and I could not ever have imagined how hard this would be.

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