Trials & Tribulations of Breastfeeding

After successfully breastfeeding Meredith for 16 months, I thought I'd be a pro at breastfeeding Sean if I decided to go that route. I was on the fence about whether to nurse him or feed him formula because I really didn't enjoy breastfeeding with Meredith.

For 16 months I waited for the moment when the lightbulb would flash & I'd love nursing Meredith. It never came. By the 2nd week of painful & raw nipples, waking up to nurse every 1.5 - 2 hours night and nursing every 2-4 hours during the day I cried. I broke down & cried that I just wasn't cut out to breastfeed. It was to taxing on my psyche. Then Meredith decided she didn't want to take a bottle and because I never wanted her to cry & fight to be fed, I made the decision to stop trying to give her a once in a while bottle and exclusively breastfeed her. I dealt with the agony of flaming nips and lack of sleep so bad I was delusional.

From the start we had some issues with latch and position. I had an oversupply and Meredith never had a yellow, seedy mustard colored poop. EVER! Every time we'd goto babies r us, she'd poop so much she needed a change of clothes & more than once she left naked because I had forgotten to pack extra clothes. Granted I could've bought them, but it was the point that I didn't want anyone else to see my ineptness at packing a diaper bag. Did I mention she didn't ever have a mustard yellow poop? Oh how I tried to get her to have a yellow poop. I was always told that's the mark of a well fed breastfed baby. "That's how you'll know she's getting enough hindmilk." Sure.

I felt like such a failure that it took me so long to figure out nursing her. I couldn't believe that something that every other mammal in the world was able to do, but me. What the hell was I doing wrong that I couldn't figure out all these issues?

Slowly, I started to figure it out. I took all the information I was receiving & piecemealed it together. I finally put Meredith in a cockeyed football hold, held her all sorts of crooked and balanced myself on one butt cheek to get her latched on properly. And by properly I mean with a good seal on the breast. She nursed for 10 minutes, popped off & promptly fell asleep. We repeated this scenario over & over until I finally had enough. I finally said to myself this is a relationship and it has to be 2 way. I won't make her fight for the bottle, but damn it she better let me be comfy.

I was so worried that by only nursing for 5 minutes from one breast that she wasn't getting enough to eat, but apparently I was wrong. She grew consistently and always seemed satisfied. We also had the added complication of her having GERD. Fun times. Now Meredith didn't have all of the classic signs of GERD. But she had some. And I had to fight with the pediatrician for 3 months before he finally listened to me.  Before I switched drs in the practice to get a 2nd opinion & some results. I was assured that babies with gerd try to regulate themselves by wanting to sleep in certain positions (the side & belly for Meredith), eating more frequently so they're able to empty the stomach faster, etc.

As soon as Meredith was put on zantac she was a different baby. She ate better, was more content, she stopped spitting up for hours, etc.

What did I learn from all of our trials & tribulations? I learned to think outside the box when it came to breastfeeding correctly. No amount of information can prepare you for a baby that doesn't follow the breastfeeding "rules". But once we figured out our niche, she nursed like a champ. For 13 out of the 16 she nursed, she nursed everywhere & anywhere she wanted. Even a NYC subway. And she'd latch on & stay on. Woohoo!! I'm good at this. I don't like it, but damn it..... I'm good at it. By the time Meredith was 12 months old, I was done with breastfeeding. I felt like I had paid my dues and reached my goal of nursing to at least 1 year old. But Meredith was still nursing every 2-4 hours and showed no signed of stopping. I opted to slowly wean instead of going cold turkey. I weaned from night feedings first. It was so hard for her. Rob & I decided that he'd take over going into her when she woke. Then I eliminated daytime nursing. I offered her sippies & snacks in place of nursing. Some days it worked. Others it didn't. Slowly I eliminated them. She was only nursing 2x a day. Nap time & bedtime. After a week of that (at 16 months old) I just cut her off. She never looked back.

When I got pregnant with Sean I wavered back & forth about breastfeeding him. I was still nursing Meredith and it was just a constant reminder of how much I didn't care for breastfeeding. I always knew though that if I did breastfeed he'd get a bottle right from the start. I wouldn't wait to recommended 6 weeks to introduce one "to avoid nipple confusion" or whatever it is they're recommending now. There would be no way I was going to have an exclusive breast kid on my hands again. I just couldn't face the thought of it ever again. It was to daunting. I knew I wanted Sean to have the health benefits of breast milk, but quite frankly the thought of pumping night & day for him was a lot to bear as well. My little brain just couldn't handle that kind of stress. So if in the end I did formula..... then that's what it would be.

Then we learned that Sean had down syndrome. And I learned that a lot of children with down syndrome have low muscle tone and that nursing helps to improve that. I also learned that children with down syndrome are more prone to upper respiratory infections and ear infections. My first thought was "Damn! Now I'm almost forced to breastfeed." It was almost a challenge from mother nature. "Ha ha!"

I decided to accept her challenge. I read up on issues associated with nursing a child with down syndrome. I read up on nursing positions like the dancer hold to help support Sean's chin & jaw while he was nursing. I felt like all I did was read about all the ways in which to help Sean overcome his low muscle tone (which by the way we had no idea whether he had). I needed to be prepared. I knew Sean would be in the nicu when he was born & everyone had drilled it into my head that he would most certainly have low muscle tone. I was also scared out of my wits when the nicu director told me that unless Sean was eating at least 30cc of milk at a feeding he would not be discharged from the nicu. I was also told that because he would have low tone that it may make sucking from a bottle difficult as well. Crap! Now I needed to figure out how I was going to help this kid eat from every which way. 


I spoke to lactation consultants. One of whom said I should reintroduce the breast to Meredith in order to stimulate the breasts and produce milk before Sean was born. This would ensure that I had a decent milk supply and that he'd have at least 30cc of milk when he was born. Are you kidding me? It took me forever to wean Meredith. There was no way in hell I was going to put Meredith back to the breast. Not to mention that I just couldn't see an almost 2 year old on my breasts. It may work for some women, but once a kid can tell me that it tastes like cookies (M never did that), they have got to get off the breast. 


I had one lactation nazi telling me how horrible the hospital was that I was delivering at. She told me all sorts of horrible things that my ob would do & say and how horrid the nicu was. I would just like to point out that Maimonides actually has a fabulous nicu & my ob was remarkable. Not to mention that he has never done anything, but advocate breastfeeding to me. In fact he's the one who helped me breastfeed Meredith when I delivered her. Without him I never would've nursed her at all. Anyway...... I had so much advice coming at me and none of it fit me. None of it was anything I was willing to do or could do. I had to figure out a way to ensure my baby was released from the nicu & then I could worry about it at home. 


So that's what I did. I nursed Sean while he was in the hospital and I also gave him formula. He ended up having hypoglycemia in the hospital. I needed to make sure his sugars were high enough and I needed to do whatever was necessary to ensure he didn't get an unnecessary IV and make sure he wasn't kept there. I needed my baby home with me where we would figure it out together.


Still under the impression that Sean's problems were all from lack of muscle tone I did what I could to help him. I hired yet another lactation consultant to make sure his latch was good. I thought maybe because I didn't have any sore nipples or pain that maybe it was just his latch. If I could just help him with that. The lactation consultant said his latch was good. Check! I spoke to the cardiologist & pediatrician about his suckling. Everything looked good there. He had a strong suck. Check! Ok so why is he getting so much air? Why couldn't he stay latched for longer than 5 seconds? What was his problem? 


He was diagnosed with reflux at 4 days old. We knew right from the start that he had reflux. It was unmistakable. Not to mention that there is a strong familial tendency for reflux. So he was started on zantac. It worked great for a few days. It hasn't worked since. We've tried prevacid as well & that only made things worse. We're still working on this issue. 


We were told his palate was short, but he had good muscle tone in his mouth. "Massage the roof of his mouth & gums with your pinky. Push the gums out with gentle force. Because the gums & bones are still soft we can stretch them some." Ok started that. It would also help him be more aware of his mouth and he'd suck less air. OK..... 


Nothing helped him. He still sucked in so much air whether it was the bottle or the breast. He continued to come off the breast after a few seconds during an entire feed. Feeding was taking a lifetime. 


Well now what? We've already confirmed that his suck is strong. We've already confirmed that the muscle tone in his jaw is good. So I had to think and think and think. I came up with nothing. This was not like anything I encountered with Meredith. She had a great latch and never came off once she was latched properly. 


I went through all the tricks I had learned while nursing Meredith anyway just in case there was something I was missing. I held him upright so that he controlled the flow. Didn't help. I propped him up on 2 pillows, on a pillow on the arm of the chair. I laid down & nursed him, rested him on the boppy leaned into me with my knee behind the boppy while nursing. 


I thought maybe I had an oversupply like I did with Meredith. So I took steps to correct that. I pumped until I felt a let down and then had Sean latch on. That way he wouldn't have to work so hard with such a forceful & fast flow. He still came off the breast constantly. I nursed him while I was leaning back so he'd not only work out his jaw muscles, but my milk wouldn't come out as fast. Didn't help. I nursed him 3 feedings on one breast & then 3 feedings on the other breast. Still nothing. Crap! Well now what? 


When Sean had his first early intervention evaluation it was revealed to us that it wasn't Sean's muscle tone that was an issue because that was pretty good. It was his suck-swallow-breathe coordination. AHA! He couldn't coordinate the three things. That's why he was constantly coming off the breast. He had to come off to not only get a breath, but to right himself. He must've felt that he was off kilter and needed to readjust. We were told that feeding therapy would help us with that. 


Then we had our first therapy (I use the term loosely) session with our first feeding/speech therapist. She did nothing, said nothing and didn't worry about Sean's uncoordination. She was more concerned with Meredith not speaking. We had a couple of weeks with her & then I had enough. We weren't benefitting from her so I found someone else. 


When Rosie first came she did her own assessment of Sean. She said that Sean's muscle tone in his jaw was good, but it could be better. She also pointed out that Sean's right side had less muscle tone than the left. She fed Sean a bottle so that she could see firsthand what his issues were & try different positions to see if they helped at all. She also tried rocking, humming, etc. 


Here's what we have found has helped:


Rocking
Holding his hand or him holding onto my shirt
nursing to classical music with a discernible beat
paying attention to his sucking rhythm. By paying attention we're able to see whether he's pushing the bottle out of his mouth or just having a hard time getting coordinated. When he pushes it out he probably needs to be burped. If he's having a problem we switch positions & try again. 


We have now tried every position known to man short of balancing on one foot while nursing and singing.

Here are some positions that I have found help:

Propping Sean on a boppy with a small throw pillow under his head from added lift & support
Scooping his legs in close to my body
Having him "look up" while he's nursing on his side
Having him propped almost upright with a pillow behind his head while resting on the arm of a chair
Propped up on the boppy with me playing the role of contortionist and almost laying my side

I have also found that even though his muscle tone is good I have to hold my breast while also supporting his jaw/chin somewhat with the same hand. It's almost a dancer hold, but it's more to remind him that he has a bottom to his mouth that has to work as well. It's also to keep him from suffocating since my breast is a lot larger than his head. It just sort of envelopes his whole face.

I have also found that lanolin put on his lips before nursing helps him get a good seal. It also helps him to not suck in his top lip. This works equally as well for bottle as it does the breast.

The bottle I have found that works best for us is the Learning Curve Breastflow bottle http://www.learningcurve.com/breastflow.  We were using the Dr. Browns standard bottles, but I felt that if he got more than 1 bottle using that he would come back to breast & have a shallow latch and we'd have to start all over again.

I would now consider myself successful at breastfeeding Sean. Not because we're so great at it. Not because he's so efficient. Lord knows we're not. I consider myself successful because we're getting there. We've even gotten to the point where I am comfortable nursing him in public. I was hesitant to nurse him in public because he would always come off the breast several times. While I'm not necessarily shy about my breasts or breastfeeding, it's sort of a pain in the ass to constantly be fighting with my kid to stay on the breast. Plus he takes a bottle. Not necessarily happily every time, but he does take one. So it has made it a lot easier for me to ease into nursing in public with him.

It's been a learning process for both of us. He is learning how to plan his motor skills and I am learning how to help him do that.

Will he ever nurse as efficiently as Meredith did? Maybe. Would I change one thing about our breastfeeding journey so far? Probably not. I have learned so much about myself, about Sean, and about nursing that I wouldn't change it for anything.

Some sites I have always found helpful:

www.kellymom.com

http://www.llli.org/FAQ/down.html

http://www.llli.org/FAQ/positioning.html

http://www.llli.org/nb.html

http://www.medelabreastfeedingus.com/for-nursing-mothers

And of course various message boards. Asking other women who are in the same boat as you is always great. You never know what someone else has stumbled on. Maybe they have different positions to try or different holds. Maybe they're just there to offer support at 3am because you're hysterical crying because you've got a 7lb kid attached to your boob constantly. Maybe you just need to hear that it will be alright and that whatever you're feeling will pass.

If you're reading this & you have any questions or concerns with breastfeeding, please feel free to contact me directly. I will do whatever I can to help and hopefully be able to point you in the right direction if I can't.