15 October 2012

Thoughts on Breastfeeding

The title was your warning. If you're not interested, I'm not offended. Also, this is a long post.

I'm a proponent of breastfeeding. There are the innumerable health and bonding benefits, and also, it is free. Nursing Ike was a breeze. We both picked up on it very quickly. I did have really tender nipples for a few weeks, but other than that I never really had any complications or problems.

I wasn't naive about nursing, though. I knew that it didn't come easily for everyone. Some women's bodies don't do it as well as others. Some babies don't pick up on it as well as others. I've talked to enough women and read enough women's accounts of breastfeeding that I wasn't expecting things with Felix to be a walk in the park just because Ike had been so easy.

The major difference in nursing my two boys is that I was able to nurse Ike within about an hour of his being born, despite the fact that he was taken to the special care nursery for observation right after being born. Felix was under observationfor so much longer than Ike. By the time they brought him to me it had been about 6 hours since he was born. When the nurse first handed me to do skin-to-skin cuddling (right after birth), he was rooting around, but the nurse was fairly concerned about his grunting. I asked if I should nurse him, but she said it was important to get his breathing regulated first. But he didn't get his breathing regulated and had to go to the nursery and be put on a machine that helped dry out his lungs. He was only on the machine for an hour, but then he kept grunting periodically, so even when I finally got to go visit him in the nursery I was still told I couldn't nurse him. I understood why I couldn't but it was still stressful to me.

I wasn't worried that he'd go hungry. I was assured that newborns can go for several hours after birth without eating. I was worried about the bonding we'd missed and chance for him to start nursing and start figuring out nursing right away.

When they finally brought him to me to keep, we immediately tried to nurse. At first he didn't even try. I did the tricks of touching his cheeks and his lips with my fingers and my nipples, and he had no rooting response. The nurse suggested just doing some skin-to-skin cuddling. She said this might get him rooting around, and it did. That was a good first step, but even when I tried to bring his mouth to my nipple, he wouldn't latch on.

And I don't mean that he got a shallow latch or he wouldn't open his mouth wide enough. I mean that he just sort of wiggled his head around and wouldn't close his mouth around my nipple at all. After several minutes of trying we were able to get it worked out.

Which is when the contractions hit. After Ike was born, I had minor cramping when I breastfed him. Nobody had warned me about it, but the nurses explained that it was because breastfeeding releases the hormone oxytocin, which is the same hormone that causes the uterus to contract. Nursing would help my uterus return to normal faster. It was also a great way for me to know whether or not my baby was successfully nursing or just sort of hanging out there without actually getting any nutrition.

There was no cramping with Felix. These were full-on contractions. They were sometimes as bad as the ones I was having when I arrived at the hospital. They lasted pretty much the entire time I nursed, and then usually for a few minutes afterward. I was happy to know Felix was getting milk; I was happy to know my body was doing its job; I was not at all happy about these pains. Every time it was time to nurse I would cringe knowing what was about to happen.

The fact that Felix and I had been separated for several hours in addition to the fact that nursing was so painful to me, I think, made it much harder for us to bond. This lack of bonding made me feel guilty. The feelings of guilt did not help the bonding process.

By Sunday evening we seemed to have gotten things straightened out. He didn't latch on immediately, but for the most part he seemed to do okay with nursing. I decided he was probably okay to have a pacifier. Dumb.

Sunday night, just before Eric left, it was time to nurse Felix before sending him off to the nursery. He absolutely would not latch on. He had reverted back to that same odd behavior we started with of just sort of holding my nipple in his open mouth and wondering what to do with it. He was also getting very hungry and frustrated. I had to call in the nurse to help me. She gave me some great suggestions, like expressing a little bit of colostrum onto my nipple so that Felix would be enticed into sucking enough to get some nutrition. (Colostrum is apparently about as thick as honey and usually takes a baby about 10-15 sucks just to get a small taste. It would certainly be frustrating to deal with that if you were hungry RIGHT THIS SECOND!) Eric was able to get Felix nice and calm, and when he gave Felix back to me he was relaxed enough that he latched on, and patient enough to suck enough that he didn't quit in frustration.

When he was brought to me later that night, it was the same thing. Only this time Eric wasn't there to calm Felix down. And Felix was inconsolable with me, probably because he knew I was the source of the food, and I wasn't giving it to him. (Not for a lack of trying.) I called the nurse in again. She was able to calm him down, but he still would not nurse. We eventually decided to give him a little formula via a syringe attached to a skinny tube. He was given a teensy bit of formula, and it was enough to get him sucking on my nipple, with the tube also in his mouth. This worked, and I figured if we could just keep him in the habit of knowing how to suck, things would get easier when my milk came in.

During the next feeding he wouldn't nurse again. The syringe and tube trick didn't work. The colostrum on the nipple didn't work. Nothing worked. The nurse gave him formula from a bottle. I was too tired to beat myself up about it.

Later in the morning, it was much the same. Only this time the shift change had happened, and I didn't want to call in the new nurse, whom I hadn't even met yet. I ended up just caving and giving Felix a bottle with formula. This time I was too tired not to beat myself up about it.

So I was feeling pretty guilty about this, and then the day nurse came in. She probably had been informed about the nursing problems during the night. (In fact, the night nurse told me I'd be put at the top of the list for the lactation consultant who would come around in the morning.) The nurse recognized that I had given Felix some formula, and she asked what was up. I told her that I had just not been able to nurse, and I was tired, and he was frustrated and hungry, so I gave him some formula. She then warned me about the dangers of nipple confusion and all the reasons to stick with nursing and not give up. She was not attacking me in any way, but I was totally exhausted and very hormonal, and I just burst into tears. And I could not stop crying. I also told her that this meant my milk was coming in.  I did pretty much the same thing when the lactation consultant came in and when I talked to Eric on the phone. It was just not awesome.

The lactation consultant was able to give me some good ideas to help. She told me to call her in the next time I tried to nurse. The next time I started to nurse, I had her paged. By the time she arrived Felix had latched on okay, so she was able to observe his latch and make sure he could do it properly. (He could.) When I switched sides she watched and gave me more tips and pointers. She was really helpful, and she agreed that his impatience would be alleviated when my milk came in because he wouldn't have to work as hard to get some satisfaction. She also said to not use the pacifier anymore, which by that time I had realized was a mistake. She said to give it at least two weeks before introducing it again, which seemed like overkill to me. (He's been fine switching back and forth this weekend.)

Since coming home, Felix's ability to nurse really has improved. He latches readily and nurses thoroughly. I've been pumping as well, which has been helpful with the inevitable engorgement issues. I like the idea that one of these nights I'll be able to have Eric give Felix a bottle while I continue resting. I'm definitely going to wait until I'm 100% confident in his ability to nurse before we bring a bottle into play, though.


Jenn said...

Oh man, I totally sympathize with the stress and frustration of a difficult breastfeeding beginning. I also had a difficult time bonding with Libby because I was just constantly in so much pain...but of course it got better. I'm so glad things were better for y'all this weekend! Good luck!

Jana said...

Ahh, I love this post! (Well, not the parts about you being in pain and such, but the overall message). I love breastfeeding, but it's definitely taken a little bit of work with each of my boys at the beginning. I'm all about the lactation consultants; I think they're such a great resource.