To feed or not to feed, that is the question

That I'm always answering. It seems my nursing routine has been not ideal from the start.
Things would go good for awhile, then be tough.

We've been supplementing since 3 weeks old. We've been using a bottle for supplementing since 4 or 5 weeks old. Then I went back to work part time and of course those days it's all bottle.

A few weeks ago, I just realized how tired I was at fighting Sophia to nurse. Every feeding but the first one of the day I'd jump through all these hoops to try and get her to nurse. She cry, pull away, whimper or just outright scream. Not fun. Sometimes I just couldn't get her to, and then I'd have to drag out the pump instead. And then remember to pump at work. My supply is so little that I could go about 8 hours without nursing and be ok, but that's not good for keeping up the supply. And dragging my pump to work was fairly inconvenient, especially since I don't have a dedicated area to leave my things in.

Anyway, I'd been toying with the idea of stopping. She already gets 80% of her nutrition from formula because I only produce about 20% of what she needs. But, I know some breastmilk is better than none, and I was sad about losing that closeness. But it was so much hassle for the "some" breastmilk. The 6ish ounces a day breastmilk. And after one full day at home fighting at almost every feed, I decided to quit.

So I went about the business of wearing a sports bra with cabbage leaves. For 24 hours. But after a full day and night my boobs were really hurting. So I nursed her for the first feed of the day. Then I put on some more cabbage and added an ace wrap. The next morning things were much more comfortable, and I decided to just nurse once a day, because she usually does well first thing in the morning.

So that's where we are now. I've trained the supply to only make enough for once a day. It's going alright. Because my boobs are no longer about to pop first thing in the morning, I still have to coax her to nursing some. She's also just easily distracted at eating time in general. But, for now I'm willing to beg her into nursing if it's just once a day. I really do want her to have the immunity benefits.

So that's where we are. Don't know how long until I just quit altogether. I do know- if you're planning to stop nursing it's much more comfortable to wean down the amount gradually than go cold turkey. Those can be an uncomfortable 2-3 days!

You make me happy when skies are grey

Today is a gloomy and chilly day here.

But inside my house, I'm feeling optimistic. The bottle makes me happy. Breastfeeding without devices makes me happy. Being more relaxed with Sophie makes me happy.

I know my last few posts have been pretty Debbie Downer. I'm not sorry I posted them, it is really how I felt. But I figured you should all know the good points too, so you don't leave my blog in a funk :)

Thursday with the lactation consultant went ok. The only big problem was they'd forgotten to write down my appointment and had given my time slot to someone else. So I had to wait an entire hour. Thankfully I had a pacifier (even though I'm not "supposed" to, ha!). Otherwise I would've had to feed her and our trip would have been for naught.

Anyway, we are still nursing fine without the shields, and she got an ounce from each side. Her weight is up to 8 pounds 11 ounces. So she gained 7 ounces in a week. We've now surpassed birth weight!

But I wanted to discuss supplementing options. The syringe feeding is really a pain. The syringes get EXTREMELY hard to use after a couple days. Like calluses on our hands from filling and dispensing them. And I only had two syringes.

Since we (were) approaching close to a month old, I'd hoped she'd say it was ok to start using a bottle to supplement. Silly me. She did say that syringe feeding was not a good long-term option. Instead she suggested trying a Supplemental Nursing System (SNS). This way Sophie could meet all of her nutrition needs at the breast. It sounded really good. We tried it out there in the office and she took about an ounce of formula while at one breast. As usual, things went really well in the office. I felt optimistic.

She also suggested Domperidone to try and increase my supply. The Fenugreek should have worked by now if it was going to. Unfortunately, Domperidone is not FDA approved in the US any longer, and the practice my midwife is in doesn't prescribe it. The consultant called our pediatrician, but he has never prescribed it before and is out of town until Tuesday, so he wants to do some research to see if he is comfortable with it. For now I'm still taking the Fenugreek just for the heck of it.

Anyway, after less than 24 hours I wanted to throw the SNS out the window. It seemed to take forever for her to get her normal 2 ounces of formula through it, even with the largest tubing size. Not to mention it taking several tries each breast to get her latched on with the tube in and the formula flowing. I don't need that frustration at 2am. She latches and sucks just fine without any extra contraptions, she just isn't getting enough from my breastmilk alone.

So after a little soul searching, I decided to start using a bottle for her supplementation. She and I enjoy the breastfeeding we can do, and all these extra contraptions were ruining that. Our pediatrician gave us the go ahead for bottles a week ago, but did warn she could develop "nipple preference" but that we could work through it. Now I was willing to risk that.

I tried the Dr. Brown's bottles that we'd actually used twice before in the first week of life, but she didn't seem to want to take it, and the flow was way too fast. I think they aren't newborn nipples. I also tried the free bottle Avent sent. She didn't want it either. But she wasn't really hungry when I tried, so that could have been it. Anyway, my fabulous friend Hannah who has a 7 month old brought over her Tommee Tippee bottles for us to try. At the next feeding she took to it like a charm. I think the nipple design more closely resembles my anatomy. I still want to get some newborn Dr. Brown nipples and try that, but our last store trip they were out and I'm kinda afraid to mess with a good thing at this point. Their shape is much different than the Tommee Tippee.

I also noticed that my breasts feel more full between feedings, and she seems more satisfied and nurses better. I pumped a feeding yesterday just to see, and I got 3 ounces. So that's a little better. We're now feeding 10-20 minutes each side, then supplement from the bottle. She usually takes 2 ounces, but it varies from 1-3 depending on how she feels. So she is probably about half breast and half formula fed. And as the Lactation Consultant (LC) told me, "some breastmilk is better than no breastmilk". And I still really enjoy the bonding of breastfeeding.

I don't know if my body will ever produce enough milk to breastfeed exclusively. And if not that's just the hand we've been dealt. But I do know that the feeding routine is now SO much easier and I'm experiencing a lot less anxiety. It's hard to do something 6-12 times a day that's so frustrating. Now it's not.

I also want to thank everyone for all the sweet and helpful comments. I really appreciate it. I haven't tried the Mother's Milk tea yet. To be honest, I hate hot tea. Isn't that so selfish of me? LOL. I also tried to find donor breastmilk in our area, no luck yet. I do have a request in on a milk sharing group on Facebook. I asked the LC and she wasn't aware of any donor programs in our area.
But if I can't get the Domperidone then maybe I'll give it a shot.

And now I'm gonna write a more fun post...

In the trenches of rookie parenting- breastfeeding

So while I'm on hold with our health insurance, figured I'd try to punch one of these out.

I probably can't relate all that has happened since my last update, but here's what I remember.

Sophia had her first episode of gas. Only I didn't realize that was the problem until the middle of the night. And we were in Tampa. And I didn't bring any medications with us. But at 7am a trip to CVS cured that problem. Thank you generic Mylicon. That was the only horrific night. I maybe slept an hour altogether, and she mostly screamed. It must have been something I ate, but I sure don't know what it was.

She had her frenulum under her tongue snipped in order to try and facilitate better breastfeeding and weight gain. At 2.5 weeks she was still 4 ounces shy of birth weight, eating all the time, and irritating my breasts even with the nipple shields. In fact I had a small crack on one side that was really making it painful.

Two days after the snipping, we visited the lactation consultant again to see about training her to feed without the shields. She actually did pretty well with that. However, I was concerned because she was still eating so much. Like 12 times in 24 hours for 30 minutes to an hour at a time. And she was still underweight at 3 weeks. I'd tried pumping twice, once after a feeding where I got like 5ml and once in place of a feeding where I was able to get 2 ounces. But it seemed my pump was really slow and not very forceful.

They tested my pump, and it was dead. At this point I was ready to rent one, to try and give my cracked side a chance to heal, and also to see what I was getting and to be able to let someone else do a feeding or two, because I was tired and tearful all the time. Sophie was sleeping for two 3-4 hour stretches at night, but it was during the day she would wear me out.

So the lactation consultant gave a plan. Start Fenugreek supplements to try and increase my supply. She said to only keep her at the breast for active feeding where I can hear her swallowing. No more hanging out for 30 minutes doing "tickle" sucking. I didn't realize she wasn't swallowing for so much of the feeding. It was just for comfort. Which is ok if my breasts weren't so worn out and irritated. So feed 15 minutes each side, then pump for 15 minutes both sides. Give pumped milk via syringe feeding to try and get in extra calories. Repeat process every 3 hours. Also massage the area around her mouth a few times a day to re-train the muscles and play "tug of war" with a pacifier to build mouth strength. But of course don't give the paci any other time.

So off I went to another area of the hospital to rent my pump. Only to find out they were out. They expected a shipment "hopefully sometime next week". Are you kidding me? Everything hinged on that! I was so upset. I called for their recommendation on purchasing a pump, since they said the rental pump is not great for taking to work anyway, too heavy. Only after three attempts at paging the on call Lac Cons, no one ever called back. Not until the next day. Turns out the pager died.

Anyway, I called the other hospital in town about a pump, but by that point it was 4:30 on the Friday before Christmas. I left a message but no one has ever called me back about that. There's a reason I didn't deliver there.

So I went to Craigslist and found a Pump In Style Advanced in the backpack that someone purchased in August from Target and only used for 3 weeks. For $100. Like 2 months of pump rental. Only they couldn't meet me til Saturday.

Saturday at noon we got the pump. By the time we made it home from shopping it was 3. I took my first dose of Fenugreek, fed her and then pumped. I got one ounce after she was done. One measly ounce.
And then 2 hours later she was hungry again. So we fed each side, pumped, then gave her the 1 ounce from before. She GULPED that ounce down. Got her settled and asleep. Only this time I had 5 ml from pumping. Like 1/6th of an ounce. So sad. She woke up 1.5 hours later, crying, head bobbing and hungry. I broke. I knew she'd be sorely disappointed with breastfeeding and then only like 2 sips from the syringe. I also knew I couldn't do this process every 1.5 hours. It's an hour plus with 30 minutes breastfeeding, 15 minutes pumping and 15-20 minutes to syringe feed. Add in burping, diaper change, swaddling and soothing and you could be at it 90 minutes or longer if she can't be soothed right away.

I was a crying, anxious, hopeless mess. I wanted to give her something to satiate her. I was said that my body was failing me yet again. So we called the pediatrician (he'd told us to call if I felt like giving up). After a 20 minute conversation with lots of crying, he gave the go ahead to start supplementing her. He agreed I needed the break and so did my poor boobs. He even suggested pumping only and bottle feeding for a few days. I didn't want to regress that far, so I decided to keep the consultant's regimen, except adding in formula via syringe so that she could be satisfied and I could have 3 hours between each feeding ordeal.

I can't tell you how much I didn't want to give formula. I hate the ingredient list. But, I also hate googling postpartum depression because I'm afraid I have it I cry so much. I hate thoughts of our pre-baby days being so nice in my mind. Believe me, I love Sophie and never had thoughts of hurting her or myself, but I did feel the thread I was hanging on by slipping. I was having trouble coping. I couldn't keep up our feeding routine for another three weeks (they keep telling me it gets better at 6 weeks).

So, after getting recommendations from the doc, John went off to the store to buy the formula. Enfamil or Similac was recommended. He came home with Enfamil because they were out of regular Similac. I did the feeding, pumping, and then syringe feeding. And she gulped down like 3 ounces of formula. She was soothed easily and slept for 4 hours. It was awesome.

I decided to give the left breast a chance to heal, so I would pump from the left while feeding on the right, then pump both, then syringe feed. It's still a 60+ minute process. And I was still only getting like an ounce of breastmilk from pumping. But then she'd get an additional 1-3 ounces formula. She would suck it down and scream while we loaded up the next syringe full. We'd know she was full when she was quiet once you stopped feeding. Poor little thing has basically never been full for all her 3 little weeks of life.

And I started to feel human again. I smiled more. John sent me out for a few hours with a friend. I left Sophie for the first time and didn't have to worry about her the whole time. Someone else could feed her if needed.

Today I see the lactation consultant again. She'll be weighed. Our home scale says she's now 3 ounces over birth weight. We have some things to address still. Despite 4 days of Fenugreek I'm still only getting an ounce to an ounce and a half when pumping after feeding. And only 2.5-3 ounces when pumping instead of feeding. That just isn't meeting Sophie's needs. And the syringe feeding is really an ordeal. Especially for John. It's frustrating and time consuming for him. And time consuming for me. It looks like we are going to need to continue to supplement for awhile, and I don't think we can keep doing it via syringe. Since she'll be a month old Saturday, we are probably going to start using a bottle to supplement.

I also want to know if there is anything else I can do to increase supply. I'd love it if we didn't have to supplement. But I also want to keep my sanity. It's essential to Sophie's well being too.

There's good to the story also. We are not having to use the nipple shields anymore. And after 2 days of exclusive pumping on the left the crack has healed and it's back in service :) So yay for that!

But more areas of concern- Sophie get sleepy at the breast really easily. Even when she's naked. Then there are also times she gets squirmy and frustrated. It's a struggle to get 30 minutes of good quality sucking. To be honest, she probably only gets 15 minutes of good solid feeding each time. BUT- when I pump insteading of putting her to breast, I'm emptied in about 7-10 minutes. I've tried putting the pump back into letdown mode to see if I can get more, but it seems I only am able to have 1 letdown per session.

So it's been a wild ride here. I'm beginning to think Sophie is here to teach me to let go of my fierce grip on having it my way. And to empathize with those who do things that in the past I didn't "approve" of. I still want a natural birth and exclusive breastfeeding. Maybe next time around that's what I'll get. But that's not the hand I've been dealt this time. And all I can do about that is put it in God's hands and John and I make the best decisions we know how.

And kudos to all the women out there who overcome obstacles to keep breastfeeding. The pediatrician says it's supposed to be easier than a bottle after the initial break in period. I'm glad for those women that it is. But our pedi says I've "climbed Mt. Olympus" trying to solve our feeding issues, and all that's required is that I feel I've done everything I could. And I know that's subjective. I know there are women who've pushed through even more obstacles than me. But I've done what I can do and still be mentally healthy.

I'll try to update ya'll again if we make any changes or progress.

Until then- pray for us and specifically for my boobs! Those udders need to step up the production BIG time!