Boob Juice

I’ll have to admit, of all the things about having a kid I thought would be difficult, I never imagined that breastfeeding would be one of my biggest challenges.

Before I gave birth (hell, before I ever became pregnant!), I had made the decision to try to breastfeed. Okay, let me be real here: I was judgmental. I couldn’t understand why someone would choose NOT to breastfeed, and was probably more than a little rudely outspoken on the subject. The idea of feeding my child in any other way never even crossed my mind, let alone the prospect that I might have any difficulties with it. In the months leading up to Clare’s birth, I watched as my friend and baby-guru Alicia’s breastfeeding relationship with her daughter flourished, and I WANTED IN ON THAT. I was excited to flex my boob power.

Then I gave birth, and figured out that an anatomical quirk of mine can make breastfeeding really fucking hard, unless you’ve got proper support and guidance. I was able to put her to breast almost right away when she was born, but she had problems latching right away, and so my L&D nurse was quick to offer me a nipple shield. This was a surprise to me, but it seemed to work a little better, so I didn’t think much of it. During our two-day stay in the hospital, I got the same spiel from staff about making sure to pump after every feeding to make sure my milk supply was stimulated, and trying to get rid of the shield within a few weeks of going home. Even the lactation consultant was pretty nonchalant about the shield, repeating the same thing about pumping and getting rid of it.

Speaking of lactation consultants, mine was crap. I gave birth at a large Level I trauma teaching hospital, and for some reason, they only employ ONE LACTATION CONSULTANT for the entire Labor and Delivery Unit. ONE. That is ridiculous, especially with the increased focus on breastfeeding that has happened culturally in our country. Figuring out breastfeeding can be a difficult, harrowing process (especially if you have complications like I did), and new mothers really need a strong support system in those early days. The LC at my hospital was not that support system, unfortunately. She spent about 5 minutes in my room, noting that I looked like I was doing well, demonstrating a few nursing holds with a babydoll, and asking me, in my sleep-deprived state, if I had any questions. She gave me her business card on the way out the door, but I’d heard from other mothers that she’s basically impossible to get a hold of once you’ve left the hospital, so I never bothered to follow up with her. Sigh.

We had a rough few days in the hospital, learning how to use the shield, learning how to deal with a new baby, not sleeping at all because I was all jangly from giving birth, and then the nurses getting on my case about Clare not eating enough, since she wasn’t dirtying as many diapers as they thought she should. She eventually peed enough to make them quit worrying and we were able to go home on time. Only one nurse, our last one before we left, seemed discouraging about the nipple shield. She advised me to get rid of it as soon as I could, that C would learn to nurse my type of nipple, and that continuing with it could spell problems for my supply and breastfeeding relationship. I wish I’d listened more closely to her!

At our first pediatrician appointment two days later, she was down to 5lbs 15oz, which meant she had lost 10% of her body weight at birth, the top end of normal for newborns. We were scheduled for another appointment a week later, to make sure she’d started gaining weight back by then. When we went back, she’d gotten back up to her birth weight, and the doctor was pleased.

During this time, Kevin and I both realized that Clare was a very, very fussy baby. She’d fight with me at the breast, arching her back and screaming into my boob. She basically cried at every waking moment, sometimes even sounding like she was in pain. She cried through diaper changes, through baths, through Kevin dancing around the living room and beatboxing in her ear. We had come up with some tricks that would calm her down enough to breastfeed, like squirting gripe water or gas drops into her mouth to distract her from crying so that I could get her to latch on. I had been doing my reading, frantic internet searching on my phone, trying to figure out if she was just a “high needs” baby or if there was something physically wrong. We decided to go back to the doctor, to see if maybe she had reflux or some other issue. When we got there, the doctor immediately ignored the fussing and was worried about her weight again. She had gained, but not the 1oz/day that the doctor wanted. That’s when he first mentioned the dreaded word: FORMULA. He gave us some sample cans (one of which contained “corn syrup solids”, blech) and told us to try giving her some to help bulk her up. He scheduled us for another weight check a week later to see if it made a difference.

We got her home and she immediately refused the formula in a bottle. I can’t deny that I was pleased with this, as I didn’t want to supplement at all. And according to the World Health Organization’s standards for newborn weight gain, C was within normal limits (although her Ped probably wasn’t going by that scale). So, I wasn’t concerned. Even so, I made more of an effort to get her to eat, by waking her up often during her feedings, burping her and switching sides, etc. I was sure that she’d gain more weight by the next appointment, and I’d be able to let the doctor know it was through breastmilk alone. Unfortunately, over the course of that week, she only gained 2oz, half of the low end of the range for her. The doctor insisted that we supplement, and had us try soy formula in case the milk-based one was hurting her digestive system. I was crushed.

We managed to get her to eat it, although I was determined not to have her drinking only formula, so I started pumping in earnest. I had been really lazy about pumping because it was such an ordeal, but I was still using the nipple shield. I finally figured out that this was really hurting my supply. Because Clare wasn’t latching directly onto my breast, she wasn’t stimulating my milk supply enough, which meant she was hungry. I’m almost totally sure this was the source of her extreme fussiness in her early days, which tears up my heart, knowing that she was suffering and I didn’t realize it. After checking her weight again and seeing that it was okay, C and I settled into a pattern of me pumping, giving her two 4oz. bottles of formula and two 4oz. bottles of pumped breastmilk every day, and letting her feed freely from the breast in between bottles and overnight. Thankfully, she settled down a lot, temperament-wise, and was gaining enough to satisfy her pediatrician.

I’d been toying with weaning her from the nipple shield on and off for a few weeks, although she’d get frustrated eventually each time, so we’d always go back to it. Suddenly a few weeks ago, she stopped tolerating it and wanted my bare breast. VICTORY! My supply has come up by a lot since then, and by the end of my maternity leave, I was able to forgo the pumped milk bottles and just let her breastfeed directly between formula bottles. MORE VICTORY!

She’ll be heading back to the Ped next week for a 3-month weight check, and I plan on discussing dropping one of her two formula bottles each day, in favor of breastmilk. Eventually, I’d like to cut out formula altogether, and I think we’re well on our way.