I started writing this post two weeks ago, but taking care of a baby and having lots and lots of visitors hasn't left me with much time to blog. So I'll just post now what I written before and write an update at the end. (After this, I think I'm going to have to stop writing such long essays that take me weeks to post!)
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Today was Lucas' fourth doctor's appointment to check whether he's gaining enough weight. He's now 7 lb 15 oz - at six weeks old he has reached what was my weight at birth! But although he's small (5th percentile for both height and weight), he's growing along the curve that the doctors look for so he's doing well. This is good news and feels like a much needed little pat on the back for a breastfeeding job well done.
I've been meaning to write about my experience breastfeeding for a while now, but it's felt like things kept changing every day. Plus, it's been tiring and time consuming and is the main reason I haven't gotten much else done since Lucas was born. So keep reading if you're interested, but as with Lucas' birth story, I will warn you to stop reading here if you don't want to read all of the gory details. (Also, I'm partly writing this out for my own memories of this experience, so it's really, really long.)
Before Lucas was born I was already worrying about how breastfeeding would go because... well, I have what I will call "shy" nipples. Actually, shy is a bit too generous; these nipples were terrified of the light of day. I'd read that babies don't nipple feed (or well, they shouldn't, if you want to avoid pain), they breast feed and so I reasoned that I might have no problems at all, but at the same time, I also wondered what's the point of nipples if you don't need them? And really, having now tried breastfeed, I can say that it's not really true that the nipple is superfluous.
I had read some things about how to prepare your nipples for breastfeeding - things like trying to pull them out by wearing breast shells or starting to chafe them early with a washcloth. But I didn't try these things because, well, first of all I'd read that they don't necessarily work. And secondly, if breastfeeding was going to hurt, I didn't really want to tack on an additional one to two months of pain.
Happily, when Lucas was born, he seemed to know what to do. I did have some problems getting him to latch on correctly, but it wasn't impossible. We kept working at it in the hospital and on the third day a lactation specialist came by and offered a lot of help. However, what ultimately turned out to save the day was a nipple shield that a friend had lent me and which the lactation specialist showed me how to use. (Actually, the lactation specialist seemed sort of conflicted about it. On the one hand, she seemed to want to avoid resorting to accessories and wouldn't have suggested it if I hadn't brought it up, but at the same time I think she could see that it worked. In the end, she made sure I had one in a small size since Lucas was so small.) Once I had that nipple shield and once my milk started to come in, I was definitely in business.
However, just because I was now "successfully" breastfeeding doesn't mean that it was going particularly well. For one thing, the way the shield worked on me (and maybe this is how it works on other women, but I don't know) is that Lucas would suck and draw the nipple out of my body and up into the plastic shield. Does that sound painful to you? It really, really was. Every breastfeeding session started out with a screaming baby, and as soon as he stopped screaming and started sucking, I would start crying out in pain. But once past the initial sucks, the pain would subside and I was able to let him feed. And then, after every feeding, I would slap a whole bunch of lanolin on. This stuff is truly amazing. Within an hour, my nipples both looked and felt much better. It kept them from being dry and it helped them to heal when they started bleeding. (Yes, bleeding. It's gross.) I have no idea how women ever managed to breastfeed before they discovered lanolin - it must have been brutal.
Soon after my milk came in, I got a clogged duct. It showed up as a hard spot that was inflamed and painful. I looked it up online and discovered that the only way to fix it is to nurse (or pump) through it and keep trying to work it out, because if you don't get rid of the clog it can get infected and you can get a fever and you might even get an abcess that needs to be drained by a doctor. Eek! So I spent the day trying to work out the clog and when Lucas wasn't feeding, I tried to use a hand pump to work it out. Well, the hand pump felt so unnatural and I couldn't get the rhythm right and I only got a few drops out. By that night it still wasn't gone, so I just kept nursing Lucas for hours hoping that eventually it would clear and it did.
Some time after this I got another clogged duct. This one actually started out as a fever that had me feeling really sick. My doctor told me she thought it was the flu, but a few hours later I saw the tell tale redness. Once I finally nursed that clog out, the fever mercifully faded away.
Unfortunately, for all the effort I was putting into breastfeeding, on his first weight check we discovered that he had lost about 20% of his birth weight - he now weighed only 5 lb 5 oz! (And we discovered later than he'd been weighed with his diaper on, so he probably weighed even less than this.) Our doctor looked a little shocked and told us that we should start supplementing his feedings by giving him an ounce of formula after every feeding.
This was very hard for me to hear because I was convinced I was producing enough milk. I could see milk in the nipple shield whenever Lucas would pull away and sometimes there was enough that it would drip down his cheek. Also, I'd been working so hard at breastfeeding and I really didn't want to start doing something that would interfere with that. Breastfeeding is a perfect supply and demand system - the body produces milk to replace whatever is taken out. That is, every time Lucas nurses, my body resupplies about the same amount of milk. If he really drains it, there will be more next time, and if he leaves some behind, then I'll produce a little bit less next time. And if he keeps suckline even if there's no milk, my body gets the message that it needs to produce more. So what formula feedings do is that every time Lucas drinks any formula my body doesn't know it and so it doesn't work to make more milk to meed this new demand. And since newborns feed 8 to 12 times per day, that's 8 to 12 oz that my body should be producing, but doesn't know to do! So I really didn't want to supplement with formula.
But at the same time, Lucas' weight was a real concern and so we took the doctor's words seriously. The first time we gave Lucas formula, J gave him the bottle and I cried. But over the next week, it got easier to watch, even as I dreaded every bottle feeding.
By the next week, Lucas had gained a little bit of weight - he was now 5 lb 10 oz - but it wasn't enough. That is still 15% less than he weighed at birth and by this time he should have regained the weight lost immediately after birth and then gained some more.
So we kept giving Lucas what J was beginning to call the "evil brew". Of course formula itself isn't evil, but I regarded it as evil because of what it meant to my breastfeeding efforts. To make things more difficult, we hadn't bought a breastpump up front for reasons I hadn't really thought through. A couple of people had suggested that I wouldn't need a pump at first and so it didn't make sense to buy one, but I'm not really sure I understand that argument. If I'm going to need it eventually, why not have it on hand right away for as soon as it is needed? So J and I soon ordered this one and, even without paying the outrageous fast shipping fee, it still came within a couple of days. (Let me reiterate that if you're going to buy a pump, buy it from Hackley. Mine was $80 cheaper than at Babies R Us.)
I was a little nervous about using the breastpump after having already discovered how difficult the manual pump was. I'd also heard from a friend that she had had trouble with hers when she first used it and even thought it might be broken. So I was very happily surprised that when I first used it, milk started flowing right away! I was so relieved because now I had a solution to the milk supply problem. The idea was that every time Lucas was fed formula, then I should pump and that way my body would get the message that milk was being drained and more needed to be produced. However, this has ended up being more difficult that it sounds. After a feeding session, I felt like I didn't have more milk to give so what was the point of pumping right away. And if I waited to pump, then within the hour, it seemed like it was time to nurse Lucas again.
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Update April 22: Getting back to this post two weeks later... At today's doctor's appointment, Lucas weighed 8 lb 15 oz. This still puts him on the lowest growth curve they have on the chart, but as long as it lines up with any curve, the doctor is happy.
Unfortunately, we're still supplementing him with formula. Some days we only need to give him an extra couple of ounces, but other days it's as much as 6 oz. It has just been so hard for me to keep up. There are pretty much only two ways I can get my milk supply up to match what we're giving him with the supplemental formula - either I can just keep nursing Lucas as much as he's willing to do, even if he's not really getting very much, or I can use the breastpump to eke out whatever last drops might be left and encourage my body to produce more milk. The first one is difficult because Lucas sometimes gets frustrated when he's trying to nurse but there isn't any milk. (The sole exception to this was two days ago when Lucas was nursing almost the entire day, starting at 5:30 am and going until around midnight. I almost lost my mind in the process, but kept trying to remind myself that it could only help my milk supply.) As for pumping as a way of increasing my milk supply, this is difficult just because it's hard to find the time to do it. For one thing, Lucas doesn't sleep much during the day and isn't exactly self-entertaining at this point, so I don't have the chance to go hook myself up to a pump whenever I want. J isn't home during the day, so it's not like I can hand Lucas over to him. Also, we've had a steady stream of guests ever since Lucas was born, so that has also left me with less time to pump.
But I'll just keep trying. Either I'm determined and optimistic that it will work, or I'm just too overtired to see that I'm fighting a losing battle, but I'll just keep trying and I have to believe that at some point I'll be able to catch up. It would be so nice to finish nursing him and have him be happy and full afterwards. It's no fun dealing with a baby who's crying for more and then having to hold him or put him somewhere while I try to prepare a bottle.
But, I am actually optimistic about it because so much else is changing every day. Breastfeeding itself is almost painless now. I can hardly believe it! And I no longer need to sit propped up with multiple pillows for myself or Lucas. (Bonus: I got a glider and absolutely love it. As much as a person can love a chair, I love this glider.) I can even now walk around nursing Lucas if I have to. In fact, there are two instances I'm particularly proud of. Once, about a week ago, I was nursing Lucas while lying down on the couch, but wanted to go to bed. So I stood up, walked across the apartment, and laid down in the bed, all while Lucas continued to nurse. The second feat was this past weekend when J went across the street to check out an apartment in case we want to move. I'd stayed home to nurse Lucas, but J called me from the apartment to tell me that I might want to get a look at the place. So, all while Lucas remained latched on and nursing, I put on a nursing cover, got up from my chair, walked out of the apartment, down the building stairs, went out to the street, went into the other building and up their stairs, and checked out the two-floor apartment. (Although the apartment was really beautiful, we're probably not going to pursue it because the rent is the same as ours and there would be additional moving costs, plus it would be a huge hassle to move.)
So I'm thinking that if nursing has changed this much over the past two months, then probably it will just keep changing and I shouldn't worry so much when we have "bad" days and need to feed him more formula than I would like. (At least, that's what I say now while Lucas is taking a rare nap and, for the first time in weeks, I actually had the time to pump in the afternoon. Ask me on a day when Lucas has been awake and hungry all day and I won't be quite so Pollyanna about it.)
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