Gone Coastal

Thursday, October 05, 2006

The Epic - abridged

I tried to write an abridged version of this already, but if you read my blog regularly you know brevity is not one of my strengths. This is a second attempt to follow what has been a seemingly endless journey around the feeding of T without requiring years to read.
My purpose is not to complain, though I must admit writing this has been somewhat cathartic. But it seemed the best way to explain my overall experience with breastfeeding, and to a lesser extent motherhood in general so far. It has struck me, in different ways at different times from frustration to detached curiosity to depression, how often the choice we make or the action we take now to deal with one issue leads to another issue down the line. And the need to intervene with another choice or action. And so on.
And then every so often you do something seemingly insignificant in the moment that the Lord uses to turn the whole thing around for the better.

Here's the story so far

Day 1

After birth, she was mucousy, and it took a few days to clear all that out, so less drive to feed initially.

She also had a very cute, but none too efficient, receding chin, which might be adding an extra challenge to latching. She might grow out of that, but if she doesn't it'll be my genes (and my dad's before me) to blame.

Days 2-3?

Pumped colostrum in a glucose solution at the hospital to get something in her and minimize the waste of what would be left on the pump or spoon. Possibly resulting in a sugar crash later.

Days 3-4

Previous delays lead to milk coming in late, too. Received several suggestions of beer to help encourage letdown. It apparently contains an enzyme useful for such purposes, though after 10+ dry months, it didn't take too much encouragement to try. Hindsight says it may well have helped bring the milk in but it no doubt also made her sleepier, and thus less eager to feed.

Day 5

Doctor's checkup shows she's lost more weight since leaving hospital, and she's sleepy and yellow with jaundice. We need to enforce a frequent feeding schedule, waking to feed and supplementing with formula. Say goodbye to sleeping more than thirty minutes at a time with maybe a two-hour stretch at night if you cheat.

Day 6

Public health nurse #1 visits, and talks our ear off for nearly an hour and a half, but otherwise finds that she's made a little weight gain. Woohoo! Progress! Some payback for the first sleepless nights.
In the afternoon I talk to my doula at the store because I'm thinking part of her latch issues are because she can't find my nipple in all that swollen breast. A few demos and experiments, and I come home with a nipple shield. First time I've seen her really feed!

Day 7

I cheated. Based on the progress reported the day before, I relaxed my vigil and allowed myself to sleep a few extra hours overnight. Felt physically a bit better, but soon lost that to the realization that I was struggling once again just to get her to take the bottle. Doctor's appointment confirmed she was as yellow as ever, and even lower in weight.

Days 8-10

Worked extra hard over the weekwnd to get her to the breast often, pump every last drop of milk into a bottle for her, and supplement with formula as needed to keep her full.

Day 11

Public health nurse #2 - our correctly assigned district nurse - visits. I like her much better and she answers some of our questions with useful suggestions and resources. Her weight is up a little, and she's a little less yellow.

Day 15

Another checkup. While she's still pretty sleepy, she's had reasonable gain over the previous week and most of the yellow's gone.
Stopped in to a staff party with her in the afternoon. She slept through the whole thing - speeches, clapping, even the live band. Had to explain more often than I wanted that her being so quiet and 'easy' wasn't always such a good thing.
Last few days she's been getting lazier at the breast. I suspect all the feeding that's coming so easily from the bottle is part of the problem. The Bear who's out of town for four days, suggests trying the orthodontic nipples we had bought.

Day 16

'Helpful' suggestions from family that don't know the full story saying my doctor is wrong and there's no reason to enforce a schedule or wake her up if she's not asking
to be fed. Fortunately, I now know enough to ignore them.

Day 18

The Bear is back with his mom. The special nipples seem to have helped, so I send his mom to the store for more. The breasts have come down a bit in size, so I've started putting her to the breast without the shield initially, with some success. The shield doesn't seem to be working quite as well for her as it was.
Lots of milk now, so I rarely need to supplement anymore.

Day 19

Took her down to the health unit to get a weight on her. Gaining slowly. Got a few more breastfeeding tips from our nurse. She's pretty much fully pink now, and I stop at the store to visit our doula and buy a sling.

Day 20

She's been fussing and pushing off the breast, and now every time I try to latch her on she's chomping on me. I've got a great big blister dead center on my left nipple.

Day 21

The chomping continues and the pain is excruciating. The doesn't ease the pain either. Several smaller blisters have appeared around the nipple.

Day 22

Another checkup. She's gaining well and clear of the jaundice, so no need for another appointment next week. Discussed the current state of feeding routine and how much I'm pumping. I've suspected and Doc agrees that though she's sometimes at the breast for quite awhile she's not getting a lot out on her own. Doc says most women would have given up by now. Doesn't want to discourage me from trying but if it's too much, maybe strictly pumping is an option to consider.
That comment, by the way, is the nicest way anyone has ever told me that I'm stubborn ;) It was encouraging, too, to have someone who oughtta know validate how hard I'd been working, that 'I dun good'.
T allowed me a bit of time in the afternoon to search online for clues to her chomping on me, I found some articles on the La Leche League site on milk oversupply that seemed to line up with some of what I was seeing. Babies clamp down on the breast in an effort to slow the milk flow down. They'll also fuss and push off the breast franticly, because it's coming faster than they can swallow.

Day 23-24

Tried to adjust the milkflow down somewhat by pumping only a little more than she drank each time. Gave myself the weekend mostly off from direct breastfeeding, to let the nipples heal a bit. Breasts were a little sore from not being drained.

Day 24

It seems I'm picking up the cold the Bear brought back with him.

Day 25

Having brought the milk supply down, T suddenly seems to be entering a little growth spurt, and pump as I might, I can't keep her satisfied. Had to go back to a supplement. Pumps are apparently not very effective at signalling demand increase to the body. Wanted to get to the health unit to find out about the brastfeeding clinic and get another weight, but I just couldn't make it happen between frantic feedings.

Day 26

She's now showing signs of the Bear's cold. Stuffed up, feeding in short bursts because she can't breathe and suck at the same time. Made it to the health unit, I get signed up for the clinic in the other location the next morning.

Day 27

The nurse at the clinic agrees with the oversupply theory, though I now seem to be under-supplied. Gives me some tips to help deal with the clamping.

Day 28

Another frantic day of many small feedings. End the day with a big supplement around one in the morning.

Day 29

A brief cry right on schedule at five gets me up. I check on her, and she's quiet so I opt to get everything set up and down some breakfast while she wakes up. A rare treat to eat cereal before it's soggy. I check in and out on her, getting little things done 'while I can', expecting her to start running again any minute. By nine I'm really worried and have to resort to the old 'force' feeding techniques. I pump some milk out, but she shows no interest. Eventually, I get her to take some, then I pump some more as she starts to wake a bit. By the third pumping, she's resuming her previous day's relentless pace of feeding.

Day 30

She won't stop crying, except sometimes when I hold her. Trying to keep up with the milk but the supply seems to be low. Left breast is very sore, as are both nipples. My cold is mostly gone but I start to feel flushed in the afternoon. When I have a chance, I check my temperature, and confirm I have a slight fever.
Mastitis. I eventually call the doctor on call. Best way to get the infection out is for T to nurse on the infected breast. Good luck, but I'll try.
The stupid pump bit me again. Pumping on the right after getting her to nurse for at least a few good sucks. Looked down after a couple of minutes and what's in the bottle is dark pink with blood from a new tear in my nipple. T was still crying franticly, awaiting more food. I wasn't going to pump anymore, and didn't like the idea of feeding her that much of my blood, so mix up a bottle of formula, of which she took maybe a quarter of an ounce and then settled down. I retreated to the bedroom with atowel and hand expressed the rest from that breast.

Day 31

Some progress in the pain part of the mastitis overnight, through massage around the affected ducts and pumping (very little success getting T to latch). A little dizzy overnight, may still get some antibiotics for the infection.
A few pleasant surprises. Her stuffiness seems to have cleared up, so she's calm and quiet this morning. And the hand expression on the right breast seems to have done the trick to get the supply back up.

Happy one month birthday!

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3 Comments:

  • Still praying for you. I agree with your doc. Every woman I know would have (or did) give up far before now.

    By Blogger Coralie Cowan, at 1:10 PM  

  • My goodness Coastal. You must have the patience of a saint or the stubborness of ?? Hopefully month 2 will be much better for you. Just remember that it's just as important that you are healthy. T will need mommy to take care of herself as much as mommy takes care of T. We love you and will keep praying that things settle out for you both and the Bear too! Hugs.

    By Anonymous jem, at 2:05 PM  

  • That's the stubbornness of a viking, I think. Something you may know a bit about :)

    By Blogger Coastal, at 2:10 PM  

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