Tuesday, February 22, 2011

My Breastfeeding Journey

Ah, breastfeeding. This is a subject that I've become quite educated on in the last three months. It is also a subject that for some reason is still kind of taboo in our society. Let's face it, when someone mentions breastfeeding, a lot of people automatically think BOOBS. And boobs can be an awkward subject. However, breastfeeding should not be.

Breastfeeding is natural. Go to different parts of the world and you will see women breastfeeding their babies (and toddlers) out in the open in public with no insecurities. Not only are the mothers not insecure, the other women and men around them won't even bat an eye at a woman breastfeeding her child in public. Then why is it so socially unacceptable to do that here in the good ol' USA? Why can't I expose my bare breast in the grocery store or at a restaurant or at the mall if and when Lawson gets hungry? Well, maybe I can, but it will offend people. I'm not saying that I would do that because even if it was socially acceptable...as much as I love breastfeeding...I have my limits. But it should be OK for a woman to do so if she chooses.

Breastfeeding is such a hush-hush subject. I can't tell you how many women have asked me since I had Lawson if I am breastfeeding him. However, it doesn't come up as naturally as the other questions I normally get asked: How big is he now? How is he sleeping? Do you just love being a mother? The breastfeeding question usually comes up at the end of the casual conversation and is normally asked in a whisper, close to my ear and almost through gritted teeth, like asking me if I'm breastfeeding is equivalent to asking me if I murdered someone. I smile politely and say that yes, I am breastfeeding. And then, almost always, I get asked, "And how is that going for you?" with a look and a tone that imply that if I'm not failing at breastfeeding now, I will be soon.

I think that breastfeeding is somewhat trendy in our culture. I get the impression that among women that are having babies today, breastfeeding is coming back in style, slowly but surely. But since it has been out of style for so long, that is what makes it uncomfortable for some. Formula was invented some time ago but was extremely popular in the 1970s. Over two-thirds of babies were formla-fed in the 1970s. It was promoted as easy and convenient and women loved it, so the trend was to give your baby formula. Formula isn't poison. Lawson has had formula and he may very well have it again. But formula got to be such a trend that breastfeeding was put on the back burner of the socially acceptable scale and therefore became an awkward subject of conversation. That's too bad.

I made the decision to breastfeed my child(ren) before I even thought about becoming pregnant for the first time. I knew it was something that I wanted to try. I knew the benefits of breastmilk and didn't think twice about giving it a go. However, I went into breastfeeding very blind. My mother was not able to breastfeed my sister or me due to very low milk supply so I never got advice or any kind of experience from her. I had a couple of friends have babies before me but never got into the depths of breastfeeding with them. When I got pregnant with Lawson, I read a lot about breastfeeding. A lot. All of that reading affirmed what I already knew I wanted: to breastfeed and be successful at it. To decide to breastfeed can be easy. To be successful at it can be the difficult part.

I was very lucky in that I was able to breastfeed Lawson for the first time very soon after he was born. Experts say that if you are going to breastfeed, you should do it within an hour after a baby is born to establish a good breastfeeding relationship. I wasn't able to do it quite that soon because of the C-section, but it was pretty soon after. I had an image in my head of what my first breastfeeding session would look like: Me, glowing from the euphoria of motherhood...holding my baby in my arms...the baby latched on perfectly to my breast and fully content as he got his first meal from me. I wish it was that easy. Lawson and I were amateurs at breastfeeding and it showed. Thanks to nature, Lawson knew more about breastfeeding than I did. Newborns have an instinct to open their mouth when a nipple is nearby and know how to suck to obtain milk. I, on the otherhand, felt a tad clueless when it came down to getting him latched on for the first time. No amount of reading could have prepared me enough to really know how to do it. Thankfully the nurses don't just throw you to the breastfeeding wolves and expect you to figure it out on your own. The nurses were very helpful but Lawson and I had latch problems in the beginning. Lawson was also not that hungry because he took a big gulp of amniotic fluid right before he was delivered so his belly was full and he had no interest in milk for several hours. The nurses kept telling me to not be discouraged and that it would happen. I must have been told not to be discouraged about 20 times, if not more, while I was in the hospital. But I was determined and didn't give up.

But it didn't get easier right away. We were starting to get the hang of breastfeeding when we left the hospital, but Lawson was pretty jaundice. I know that some of the nurses were nervous he wasn't getting enough calories to make the jaundice go away. Basically the more calories he took in, the lower his bilirubin levels would be and the jaundice would go away. However, my peanut was more concerned with sleeping rather than breastfeeding and that posed several problems. A sleepy baby is not a good eater, and boy did we have a sleepy baby. The jaundice was making him exhausted, especially when his bilirubin level was its highest at 18.6 (I think a level around 25 is when there starts to become real concern of harmful effects to the baby). He was a very sleepy and lethargic baby, which made breastfeeding him extremely difficult. He was perfectly content on sleeping and not eating. He was also content on not being full when he did eat. He would eat enough to not be hungry, but not be full, which was not making the jaundice go away. Justin and I struggled to get him to stay awake during each feeding. We would strip him down to his diaper before each feeding, hoping that him being cold would keep him awake. While he was eating we would pull at his limbs (not hard, of course), tickle his back and his feet, rub his head, poke at him, massage his neck, and basically do everything we could to get him to stay awake and eat. Since he was so sleepy while eating, feedings could take an hour to an hour and a half. Since he was eating every three hours (and that's every three hours from the start of one feeding to the start of another...not three hours from when he ended one feeding to the start of another), sometimes I would only get an hour break between feedings and I began to really understand what women meant when they said that breastfeeding is hard. And that was just from being exhausted...don't forget to factor in the sore, cracked nipples and pain from being engorged when my milk came in.

Lawson's pediatrician and the lactation consultants suggested that I pump after each feeding to get my supply to stay up and to use that extra milk to supplement him. Basically they wanted him packed with calories so we could get the bilirubin levels under control. So I thought he was eating around 2-3 oz. at every feeding and then I was pumping 2-3 oz., which would have been an awesome milk supply. However, my little man was only taking in about an ounce or so at each feeding and the extra milk I thought I had, was really just the milk that he should have been taking in but wasn't. We knew this because he was not gaining weight and his bilirubin levels were not decreasing for awhile. So on to plan B.

What was plan B? Hell. Instead of supplementing him (giving him extra breastmilk after a feeding) once or twice a day, we were now to supplement him at every feeding, at least an ounce each time and feed him every hour and a half to two hours. Since we were to supplement at every feeding, I was worried about having enough milk and about Lawson getting too used to a bottle and losing interest in breastfeeding. To combat the latter problem, we decided to use an SNS system to give Lawson his supplement. This means that I would breastfeed him and at the same time a tiny tube would go into the corner of his mouth that was connected to a syringe that held more milk. As he sucked to eat off of the breast, he would also suck the milk out of the syringe. We could have given him a bottle, but this system was recommended to us by both his pediatrician and the lactation consultants at the hospital. So we decided that was best. And I say we because it took two people to complete each feeding. I would focus on Lawson and Justin would help with the SNS. While the SNS helped with Lawson not getting used to a bottle, I was still worried about having enough milk for all of these feedings, and I didn't. We had to use formula for a lot of the supplement we gave him. The hardest part during this time was the exhaustion. A feeding would take 45 minutes to an hour, I would pump for 15 minutes and then I would get about 45 minutes to an hour break, and then we would start all over again. We did that around the clock for about four days. Justin nor I slept much at all and only for about 45 minutes to an hour at a time. Now that I look back, perhaps the word exhausted doesn't even begin to explain how tired we were.

But it worked. Lawson's bilirubin levels came down and we got rid of the jaundice. You would think that the SNS and the frequent feedings and the lack of sleep would have been my lowest point in breastfeeding, but that came about a week later. After Lawson's jaundice was pretty much gone, his pediatrician told me that I no longer needed to pump after each feeding since I didn't need to supplement Lawson with extra milk. I trusted her as she was a) a doctor and b) currently breastfeeding her daughter. So I stopped pumping. I was so ready to put that pump away and not think about it for a couple of months until I needed to stock the freezer for going back to work. But when I stopped pumping, my milk supply dropped drastically. Until then I hadn't been making a ton of milk, but I was making enough for him (except when we had to supplement at each feeding). Milk production works on a supply/demand basis--the baby demands it, the body makes it. Since pumping mimics (as best it can) breastfeeding, I was asking my body for a lot of milk between feeding Lawson and pumping, and my body was responding by making it. When I stopped pumping (stopped demanding) my body stopped making as much milk. This was a problem. The bigger a baby gets, the more milk he wants. Since Lawson's jaundice was gone and he was awake and alert during feedings and growing, he wanted more milk, and I simply wasn't making enough for him. I hit my breastfeeding rock-bottom when Lawson was three weeks old. He was hungry and I didn't have enough milk for him. He was crying and crying at the breast because he had completely drained it and was still starving. I felt like the biggest failure. I don't know why. It's not like I would be a failure of a mother if I couldn't breastfeed. But I was exhausted and overwhelmed and I completely lost it. I remember laying him on the couch, screaming with hunger, and standing in the kitchen and crying because I didn't have enough milk for him. Enter Justin. He came home from work at that point, calmed me down, calmed Lawson down and off we went to the breastfeeding support group at the hospital. Thank goodness for lactation consultants. They reassured me that I was not a breastfeeding failure. They suggested that I do some things to increase my milk supply and that if I had to give Lawson a little formula in the meantime, then it would be fine.

I started the slow climb back up the sanity ladder and took measures to increase my supply. On the way home from the hospital that evening we stopped at GNC to get Fenugreek pills. Fenugreek is an herb used for several different reasons but commonly used to increase milk supply. I'm not sure exactly how it works, but it does! I saw a difference within a few days and was very relieved. Only downside about taking Fenugreek? It makes you smell like maple syrup. In fact, if you don't smell like maple syrup, you aren't taking enough to have an effect on your milk supply. So I was taking nine pills a day...and I smelled like a nice big stack of pancakes for six weeks. After six weeks I was able to stop taking it as your body keeps up your supply without the pill after that amount of time.

The second major measure I took to increase my supply was to pump at least four or five times a day. Even if I didn't get any milk when I pumped, I was trying to trick my body into thinking that even though I was empty, I still wanted it to give me more milk so it should produce milk. It helped and I slowly weaned myself off of pumping so much. Finally, I started drinking more water. I think this is one of the most important measures to take when increasing and keeping a milk supply. You have to drink enough water and eat enough calories to achieve a good supply since you lose so much water through breastfeeding and burn about 500 calories a day as well. Now I think I drink about 125-150 oz. of water a day. I may not be a slave to my pump anymore but I'm definitely a slave to my water bottle!

Now, as Lawson approaches three months of age on Thursday, we are breastfeeding pros. He is eating six times a day and gaining weight like a champ. I am able to pump 4-5 oz. of milk each morning after his first feeding and I have a nice supply in the freezer. I'm insanely jealous of women that can pump 20 oz. in one sitting, but I have to remind myself that it is my job to feed my baby, not the freezer.

I've come to love breastfeeding. It was extremely difficult in the beginning. It was physcially draining since I was exhausted and sore and emotionally draining due to all of my frustration and stress. But now I love feeding Lawson. He is a much more efficient eater so feedings don't take quite as long. And while he is getting bigger everyday, I know that at least six times a day I get to have him snuggled up to me.

I've become passionate about breastfeeding. I still read almost anything I can get my hands on about it. I can't educate myself enough about it. It is one of the most rewarding and selfless things I've ever done because I did it and still do it for Lawson. My goal is to breastfeed him (or at least give him breastmilk through pumping) for a year and then make the decision if I want to continue longer. However, if that doesn't work out I won't beat myself up about it since I know I've truly given my best try at breastfeeding.

I'm glad I wrote this post as most of it was for myself to document my breastfeeding journey, but I also think it was beneficial to say that breastfeeding does not have to be such an off-limits topic. It doesn't have to be a secret. I'm not going to breastfeed Lawson in the middle of Olive Garden  (mmmm...breadsticks) anytime soon, but if I want to, I shouldn't be thrown dirty looks or feel frowned upon. Nor should I feel like a failure if I have to stop breastfeeding and give Lawson formula. At the end of the day a mother that does her job and feeds her baby so that he or she grows and thrives is a good mother.

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