Monday, August 12, 2013

Going Back to the Start (of Breastfeeding)

I have talked a lot about breastfeeding on this little ole' blog, so I thought I would talk about how it was for me at the start. It was a bumpy road, for sure.

While I was pregnant, I knew that I wanted to breast feed Ben when he was born. My reasons were a mix of the following: Expecting moms are practically hit over the head with "breast is best" info these days, so the main reason was for the health benefits to Ben. Financially, it also made sense. Breast milk is free! FREE! Finally, the convenience of being able to breast feed whenever/wherever without have to mix formula/heat bottles, etc. And it just made practical sense for me to try. I have these boobs, let's see if they are functional!

I was pretty much set up for success for a few reasons. I work literally next door to the Breastfeeding Center of D.C. They offer classes for free, so I went to a couple while pregnant. At one of the classes, they recommended the book Breastfeeding Made Simple, so like a good student, I scurried out and bought it. I read it and soaked up all of the info. I discovered that Dan's company had a "lactation benefit" where they gave any employee or employee's spouse a free double electric breast pump (even though we aren't on their insurance) and access to a lactation consultant over the phone for six months. When I first talked to the lactation consultant, I discovered that she was one of the authors of Breastfeeding Made Simple. I felt like I was talking to a celeb. The stars were aligning! I had a awesome friend who gave me a zillion breastfeeding supplies, including her old pump. So I had a ton of knowledge, expert support, two pumps, and a ton of supplies. I was ready to roll. However, I told myself that I was going to give it my best, but I wasn't going to punish myself if it didn't work out. I knew many a mom who couldn't for whatever reason, and their babies were still awesome and healthy.

Then came Ben's birth. I had an emergency c-section, and he was in the NICU. He was born on a Friday at 6:34pm, but I didn't get to meet him for the first time until about an hour or so later. At that point, I couldn't attempt to feed him or even hold him because he was undergoing a special treatment. In fact, I could barely even see him. He was up high on a table, and I was down low in my wheel chair and too numb to stand. So I had Dan take a picture of his face for me. It was a special kind of torture.

The picture that Dan took of Ben's face the first time I got to see him.
When I went back to my room that night, I was overwhelmed, kind of in shock, and not really even thinking about breastfeeding. Then, I woke up with a start in the middle of the night, like around 2 or 3am. Things when into sharp focus, and I wanted to do something dammit! I called the NICU to check on Ben and then I paged my nurse and told her I wanted to pump right then, right there. So, bless her heart, she scurried around and got everything set up for me, and I went to work. And it WAS work! I was prepared for nothing to come out from my classes, reading, and the nurse telling me so. But no matter how much you are prepared for it, it still feels fruitless.

The next morning, I pumped again, and then we went to see Ben. He had made it through the night with no seizures, thank goodness, and was off the specialized treatment. We could pick up him, cuddle, and all of that jazz. She even said he was cleared for me to try breastfeeding! Yay! However, he was on an strict feeding schedule of every three hours and of a certain amount. So, if they felt like he had not received anything from me, they would supplement.

The first session was an exercise in frustration. I still had a catheter and an IV. Ben had an IV and a zillion other wires. I couldn't get a good hold, and I couldn't really get any sort of latch. At some point that day (or the next, I can't remember), a lactation consultant came to help. It was a huge help. She got me set up with a hold. We used the football hold because of all of the crazy wires. She also set me up with a nipple shield. Supposedly, I had a flat nipple, and Ben had a high palate. The nipple shield was to give him something extra to grab onto. She also gave me a needle-nosed syringe to put formula in to use to simultaneously give him formula while he breastfed, so that he would be stimulated/awarded into sucking more. It was also a way to give him the formula that the doctor wanted, while still "nursing" and helping to establish my supply.

The first session. I finally get to hold him!
All of this was NOT easy. This is the routine we got into for nursing. First, I would set up all of the towels and pillows in their correct positions to support the hold. I would make sure I had the nipple shield, syringe, and formula ready. Then, I would pump for a couple of minutes to get me going so that Ben did not have to work as hard. I had someone give Ben to me, get him situated into a football hold, and we would try our damnedest to latch. Inevitably, he wouldn't latch, and I would put on the nipple shield before he would get too frustrated. Then, I would have my assistant (Dan, my mom, my mother-in-law, or a nurse), help inject formula with the syringe under the nipple shield. After we were done, I would hand Ben to my assistant while I pumped again (to make up for the formula that he got as well as the nutrition that he was getting from his IV). The assistant would give Ben any additional formula from a bottle that he needed to meet his "quota."

This whole dance took about an hour and a half at first. Since he was on an "every three hours" schedule, there was almost no in between time. Our rooms were basically on opposite ends of the hospital, so it was a constant back and forth. Since I was still recovering, it would take me forever at first to even get to his room. I daydreamed about how easy it would be if we were in the same room, and he didn't have to get formula.

I didn't have a choice about the formula, by the way, since he was in the NICU. At first, the nurse and I had words. I was very confused. I wanted to breastfeed. They told me that THEY wanted me to breastfeed. But they were also saying that they were going to give him formula. Every three hours. I didn't understand why he needed it, and I was worried that it would make me fail at breastfeeding. Plus, I knew that I would have to pump every time he was supplemented so that it wouldn't negatively affect my supply. One nurse I met for the first time either the afternoon on the day after his birth, or the morning the next day, I can't remember. Anyways, I remember she said - "You seem tense," sort of like an accusation when I was running around getting things set up for the feeding. And I looked straight at her, like she was an idiot, and basically said, "That is because I AM TENSE. My baby almost died yesterday, and now I am fighting an uphill battle just to feed him. Why does he have to get formula anyways?"

The nurse and I began a "discussion," and Dan hid in the corner silently until it was over. Something turned a corner in the middle of the discussion though, and by the end, we were best buds. We came to a mutual respect, and she became my favorite nurse. I can't really explain all of the details, but she realized that I felt like I was getting mixed signals between what the doctor was telling me (which was - please breastfeed!) and what he was actually ordering (which was copious amounts of formula). She tracked him down and got answers for me. And on my end, I realized that she (of course), like me, wanted what was best for Ben, and also had orders to follow. Her main goal was to get him as healthy as possible, as quickly as possible. The better he ate, the quicker he could get off of the IV and get home. We all wanted that. Medically, it was important for his blood sugar level to stay high to nourish his brain because he had been without oxygen so long at birth (I realize there is probably a million things wrong medically with that sentence, but that was basically the gist). He wasn't a regular baby, and it was important to stay on the "safe side" of him be over-nourished basically. Once I understood all of this, I was on board. Breastfeeding is important, but all of that other stuff was necessary and even more important.

We got into a routine for the next few days where I would do the crazy breastfeeding/nipple shield/formula dance with Ben at the 9am, 12pm, 3pm, and 6pm feedings during the day. Dan would feed Ben a bottle at 9pm before he left for the night. Then the NICU night nurse would feed him a bottle at 12am, 3am, and 6am. I would pump each time Ben got fed (so at 9pm, 12am, 3am, and 6am). Whoever was giving him a bottle would give him whatever I had pumped first, and then any formula that was needed to top him off. I was VERY protective over whatever I pumped. At first, it was tiny amounts of colostrum that would fit into a one milliliter syringe. Slowly, but surely, it became more. I would call my nurse when I was done pumping, and she would walk it over to the NICU where they would refrigerate it until it was given to Ben. I would call the NICU nurse during the night to check on Ben and let them know that my "stuff" was on its way over.

On Monday night, I pumped an unprecedented amount of 40 mL while watching The Bachelor (Sean's Women Tell All). I didn't realize it then (because I am sort of dumb), but my milk had come in. I was excited about it and feeling good, so I ran (hobbled) over to the NICU to deliver it myself and to catch Dan before he left. He was just finishing giving Ben a bottle, with the nurse helping him. They were both so sweet and happy for me. I attributed part of my awesome "production" to watching the Bachelor, and the nurse thought that was hilarious. She later told other nurses about the Bachelor's magical powers. Since I made the trip over, and the feeding was already done, I got to just spend time with Ben. It was pretty much one of the first times I actually was able to just enjoy him without being stressed about latching, syringe-ing, football holding, etc. It was the sweetest moment. I imagine it was comparable to the moment that other moms have when they hold their babies for the first time after they are born. It was just Ben and me in the darkened room. I cried, and I tear up now just thinking about it. When I got back to my room later, Dan had left me a note that said - Congrats on the 40ccs. I love you!

I still have that note, and it reminds me of that night. It was just great.  

My guys.
I was discharged on Tuesday, and Ben was discharged on Wednesday. We rented one of the hospital's breast pumps, so I wouldn't have to worry about "learning" mine right when we got home. Doing the whole pumping/football holding/nipple shield/syringe with formula dance on the first night home was HARD. The next morning, I realized that if I had to keep all that up, I wouldn't be able to keep breastfeeding. It took ridiculous amounts of time, so much paraphernalia, and I always had to have someone on hand to help me the whole time. I knew at that point that I had done everything I could. I had tried my best. If I couldn't get it to work how it was supposed to soon, that would be the time to call it quits. 

I decided that morning that my only goal for the whole day would be to figure out/master a new "hold." Most of the reason I had to have someone helping me the whole time was because of using the damn football hold. That hold made sense at the hospital with all of the wires, etc., but it was time for something new. Dan and his mom went to Target to get supplies, and I sat down on the couch prepared to breastfeed on my own. I had the nipple shield, the formula, and the syringe all ready. I managed to get him into a cross-cradle hold, and magic happened. He latched without the shield. And because he latched without the shield, I didn't use the syringe to give him formula, because I didn't want to mess with the latch or accidentally poke him with it. He "quality" nursed for such a good amount of time, I didn't end up giving him any formula afterwards either.

And that is how it was from there on out. He hasn't had formula since. I was so sick of pumping, that I didn't pump again until the next month, when I started building my freezer supply. It was AMAZING how "easy" it seemed after that first magical session. Yes, I dealt with bleeding and cracked sore nipples. Yes, I was nursing him around the clock. Yes, I was never sure if he was hungry or tired or what. But it was still "easy" compared to all of that rigmarole before. However, I think all of that rigmarole was probably necessary at the time to get everything set up for success later because of our situation.

I couldn't have done it without the help of Dan, my family, the lactation consultants (one visited me everyday at the hospital), and all of the nurses. And Ben, of course. I feel like I am at a podium accepting an award, giving thanks ;) But honestly, the support was crucial. I know that Ben would have been fine drinking formula, but I am happy and thankful that breastfeeding worked for me.

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