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Saturday, August 22, 2009

Breast is Best!

For something as natural as breastfeeding, it sure can get tough to get right. We've had some issues with Eddie's feeding, but luckily most of them are resolved.

He didn't move from my chest for the first hours after birth and I tried to feed him only a few minutes after he popped out. The doctor, midwives, and nurses were all very supportive and helpful. Each of them personally assisted me, helping me choose the best way to hold him (football hold) and how to get him to root. But my little stinker would have none of it. He wouldn't root, wouldn't open his mouth, wouldn't really stay awake. Not even when I expressed some colostrum did he perk up.
Since newborns are full of liquid and aren't really hungry for the first day or so anyway, we decided to try but not to push it. He'd been through a lot during that long delivery. His head was swollen and very bruised--the doctor suggested the football hold so I wouldn't have to handle his head because he said it was likely painful.

By Friday we really wanted him to start nursing because we were concerned that he needed the water, if not the other nutrients. After what seemed like a million attempts to get him to latch on and stay awake to suckle, a nurse named Paula suggested that I pump my colostrum and feed it to him using my finger and a syringe.

So I learned to use a breast pump while still in the hospital. The nurse warned me not to be disappointed if I only got a few drops of colostrum on my first attempt. Dave and I were so pleased (or was it proud??) that I got like 6 mL right off the bat. Clearly, my production was not a problem.

That thick, golden liquid became our prize possession, other than Eddie. After each finger feeding we watched each drop fall to the bottom of the collection bottle as I pumped again. Six tiny millileters seemed like such a small amount of food to sustain an 8lb baby for 3 hours. I knew it was all that he needed, but it just didn't seem adequate. At one point, a nurse's aide came in to our room, saw the full syringe on top of the mini fridge, picked it up, and waved it around as she said, "Oooh, is that yours? It looks like liquid gold!" Both Dave and I gasped and reached out for the syringe in a panic. We were scared she'd drop it and then we'd have nothing for our baby. FYI: Don't mess with a stressed-out, exhausted, new mother's colostrum. She just might kill you.

Our first finger feeding attempt worked perfectly. It was clear that his sucking reflex was working--he could really chow down on my finger! The nurse showed me how far to put my finger into his mouth to prompt him to suck and then she slowly squeezed the colostrum into his mouth.

So for the rest of our stay in the hospital, every 2 or 3 hours we'd try to wake Eddie up enough to latch on (as best as he would given how sleepy he was), play with his hands and cheeks to try to get him to suckle, then finger feed him. Then I'd have to pump again, then suck it up into the syringe and then wash all the pump parts. It was quite an ordeal.

Most of the nurses and midwives agreed that Eddie was just super sleepy and that's why he wasn't able to nurse--but that he would learn as he matured a little and became more alert. I knew they were probably right, but it was still so stressful to NOT be able to feed my baby. It had become my ONLY pupose in life and I couldn't do it. (My mother-in-law suggested that my epidural caused him to be overly sleepy--which made me feel guilty--but I asked the doctor since then and he said that since epidurals are only in your spinal column and not in your blood they medication doesn't affect the baby at all. That's the beauty of an epidural, I guess.)

Another nurse suggested that I had "flat nipples" and that's why he couldn't latch on. She offered no other advice so that bummed me out since there seemed to be nothing I could do to fix it. (We've since learned that my nipples are just fine and not flat at all, thankyouverymuch.)

Dave and I were so anxious to get out of the hospital and go home by Saturday. They offered to let us stay another day since we were having such issues breastfeeding (I declined supplementing him with formula since we knew we could keep him nourished with expressed milk). I'm lucky to have been given a Medela double pump by one of my professors who just weaned her own baby boy. I got all new parts for it before Eddie arrived so it was ready and waiting at home. I never thought I'd be using it so soon! If I didn't have that pump at home, I'm sure we'd have stayed in the hospital longer. But we felt ready and able (and super uncomfortable because of the terrible beds and chairs in the room--I'm sure the bad furniture was part of the problem with our nursing attempts because with the discomfort that comes with a vaginal delivery, pretty much any position I could get into in that bed was ackward).

So for the first few days at home we did the pumping/finger feeding routine. I loathed having to sit there in the middle of the night, cold and nodding off so much I nearly let go of the breast shields, while I pumped for 15 minutes. The whole routine took a good 1.5 hours since I wanted to give Eddie adequate time before/after each finger feeding session to try to nurse. Each time he'd suckle a little more. But with him waking every 2-3 hours to eat, I got pretty much no sleep at all. It was rough. This is the point at which I think most people would draw the line with trying to nurse and would just pop a bottle of formula into the baby's mouth and call it a day. We REALLY wanted to breastfeed (for his health and our pocketbook) and didn't even want to put a bottle in his mouth, lest he get "nipple confusion."

On Sunday afternoon, his third day, he FINALLY nursed long enough to be satisfied. While I was struggling to get him to stop fighting the breast (literally, he'd rear his head back and flail his little arms away from the breast) I was so tired all I could think about was getting that feeding over so I could try to sleep. But then he actually latched on and nursed for like 15 solid minutes. I was so elated that I got all my energy back and went to find Dave outside where he was working on the shade structure with my dad to celebrate. Needless to say I didn't take a nap because I was so happy!

Since then it's only been getting better and better. For a few days we were supplementing his nursing sessions with finger feeding, just to ensure he was getting enough food. His bilirubin level was getting high and the doctor said the best way to knock it down was food, food, food and poop, poop, poop.

We used shot glasses to store the small amounts of colostrum and colostrum-milk that I expressed. We'd microwave little bowls of water to warm them up. You can see here that my milk had started to come in since it looking more milky. Isn't it pretty? It is the exact color of the Medela pump parts, sort of a daffodil yellow.
I'm taking part in a year-long lactation study at UC Davis and part of the compensation is access to lactation consultants. Ours is named Samantha and she's awesome. Her first visit was the day we retuned from the hospital. She observed our struggle and basically said he needed to stay awake longer so he could figure out how to latch on and suck on his own. She said it was "all in his court" and that he'd likely come around in a few days. By the time she came back the following Thursday he'd gotten it down pretty good. She said she'd been thinking about us all week since she knew how much work our other method was.

On Thursday she observed again (by this time Eddie had to get pretty hot and bothered and yell a lot before he'd latch on) and made TONS of great suggestions. She taught how to listen for "nutritive sucks" (those that are followed by an audible swallow) and what a lot of his body language meant. I think Eddie was actually listening to her, too, because since that night he's been so much calmer and just eats without fussing first.

The best thing she showed us was that a baby's arm will remain tense and close to his face when he's first started to nurse. As he gets full and satisfied, his arm will become limp, eventually to the point that it becomes completely limp and you can move it around however you want without bothering the baby. This has become our favorite method to get him to continue sucking once it looks like he's fallen asleep--you just pull down on his little arm and he'll usually snap to attention and suck again. He's like a slot machine...just pull the handle and something happens. Haha!

So now I'm only pumping the few millileters needed each day for the lactation study and/or whatever I need to so my breasts aren't engorged and painful. I LOVE being able to feed him without having to pump every time. My next goal is to get him to feed in the traditional cradle position rather than the football hold...but that's just a selfish desire for me since I think it'd be easier to feed him in public that way. At this point I'm anything but modest when it comes to feeding Eddie. I've only had to nurse him once away from home and that was at least in the back seat of the car where no one could see me fumble around or see my stray boob. I really want to be one of those savvy moms who can throw a blanket over her shoulder and feed without making a fuss...or better yet just hook the baby on while keeping her shirt over the top of her breast without needing a blanket. Sigh...I've only been doing this for 9 days so hopefully I'll get there soon.

1 comment:

mu rye uh said...

pumping is a pain, glad he gets the boob now! ANd so glad you are producing what he needs!