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Saturday, April 21, 2012

a milk story - Libby!

LOVE this very real, true account of what it was like for this new mom to experience difficulties and ultimately success with breastfeeding. She is an inspiration for sure. 

by Libby Butler

I've chosen to write my milk story now because I feel like I have come full circle. I recently used the last of my frozen breast milk and started supplementing (again) with formula. I don't produce enough milk to provide for my daughter Robyn while she is at daycare. I only pump once at work mainly because pumping more would mean working longer hours and I'd rather spend that time with Robyn. I have no plans to do anything significant to increase my milk Six months ago all I did was work to build my milk 
supply so I could breastfeed my daughter. Here is our story. :)

Before I gave birth, I knew breastfeeding was not easy, although I didn't think too much about it. I figured the nurses at the hospital would help me. I became aware of some anxiety about breastfeeding during one of my first child birth classes. The instructor said, “They will place the baby on your chest and you can start breast feeding right away.” I was anxious and embarrassed at the thought. I admitted to my OBGYN, “Do I even know how to do that?”

Monday September 12
After being spread eagle on a delivery table while 2 doctors and a nurse stitched up my vagina for an hour, and while a flock of NICU staff worked in the corner on my daughter, anxiety regarding breastfeeding was the least of my concerns. I received a brief breastfeeding 101 and off we went. Robyn started sucking...but apparently there is a RIGHT kind of sucking.

Tuesday September 13
I spent a lot of time learning about breastfeeding. I learned to watch my daughter's cheeks, if they collapsed while sucking she was doing it wrong. I learned to listen for a “kah” sound, that meant she was swallowing. My daughter was having a hard time bloody, bruised, cracked nipples were a clear indicator. I had asked to see a lactation consultant MANY times but my nurse never called for one. Finally my husband called them directly and an LC was in my room within the hour. The LC was upset that the nurses hadn't called them sooner because it was obvious we were a mess. I was tired and anxious and embarrassed and SORE. I just wanted the lactation consultant to tell me how to do it right. The LC put what seemed like 47 pillows around my daughter to prop her in a good position, tickled her tongue and cheeks, flipped her lips around, and grabbed my boobs. And we watched and listened. The LC would ask me how it felt, and I kept thinking that my nipples were slowly being tortured, I'm not sure how I could possibly tell if it felt “right”. I cringed and tensed every time she latched, it didn't feel good at all!

On the second visit from the LC that day she checked my daughter's tongue...she was concerned about her frenulum. She didn't have a significant tongue tie but the tight cord under her tongue was prominent enough that it concerned her. She couldn't be sure if this was contributing to our issues but she strongly recommended my husband and I discuss it with the pediatrician.

Wednesday September 14
On our last day in the hospital the pediatrician checked my daughter's tongue, he was not concerned. In my mind I thought everything was fine, tongue was fine, my daughter only lost a small amount of weight which I figured meant she was getting enough to eat. Although my breasts hurt so bad that I winced and cried when she fed... we were going home. Another LC came to visit us and I told her we were fine. I wanted us to be fine. I wanted to go home with my new family. I figured we'd get this breast feeding thing figured out...I was wrong...we were not fine.

Thursday September 15
Robyn was VERY sleepy most of the day, eating only every 4 hours...which part of me knew was not right, but the other part of me thought breastfeeding was just another way to torture me after what had happened during childbirth. I hated how much breastfeeding hurt, so of course I was partly happy she didn't appear to need to eat. The home health nurse was concerned about Robyn and about my milk supply. She recommended I call the pediatrician. She was worried that if I didn't start breastfeeding more I would be at risk of losing my milk supply. After a visit at the pediatrician's office we were sent back to Maine Medical Center for labs to make sure Robyn didn't have an infection. We were also referred back to the lactation consultants. The pediatrician recommended I start pumping. We were to pour one ounce of milk into a small cup, place our pinky in our daughter's mouth to make her suck and then use a pipette to squirt milk into her mouth. We were to do this every 2 hours. This is the most ridiculous thing I have ever done and I am almost insulted that this was the initial recommendation. First of all, I pumped only one ounce the first time off both breasts...second of all we lost half of it down my daughter's face because feeding a baby that way is stupid. I am amazed my husband and I didn't kill each other doing this. We tried this method once. I then continued to attempt to breastfeed. Poor Robyn was a crazy mess that night, none of us slept well. Robyn would wake up to try to eat, she was so frustrated, tired, and hungry. I started having panic attacks and I cried myself to sleep each time after she would fall asleep. My husband told me that getting through this night was worse than watching me in labor.

Friday September 16
We met with the lactation consultant, she finally gave us hope. She told me to stop breastfeeding altogether and to start pumping and bottle feeding every 2 hours...I did not expect this at all. I was grateful she gave us a strategy that would work (at least in theory). Our goal was to make sure Robyn was eating and gaining weight (she had lost more weight since our discharge from the hospital), we could focus on breastfeeding again when it was safer. She showed us how to pump and gave us instructions on how to bottle feed. Robyn gulped down what seemed like a miniscule amount of milk that I had pumped in the lactation consultant's office. She was still concerned about Robyn's tongue-tie and highly recommended we demand a referral to an ENT. I was VERY disappointed about not breastfeeding but at the same time felt relieved because I could feed my daughter.

Saturday September 17
My daughter was still hungry. We would feed her the pumped breast milk but she wanted and needed more. I was crying, she was crying. I was feeling pretty much like a failure because I still couldn't feed my daughter. I don't know if I started out with a low supply or if the lack of breastfeeding created a low supply, but whatever the reason, I did not make enough milk. I was exhausted and my post pregnancy hormones were raging. Everything I read said I had to rest to make more milk...although it was impossible to really rest when I was up pumping all night. I had a teary text conversation with one of my favorite moms, Angela Avery, who told me that I was a good mom and I needed to do what was right for my baby. It was the support that I needed in order to do what I already knew I should do. We started adding formula to Robyn's bottles. She stopped being hungry. I think it is silly now that I AGONIZED about giving her formula. The kid was hungry, I should have fed her! I did the best I could with the milk I had but I just didn't have enough milk.

Tuesday September 20
We had a weigh-in at the pediatrician's office. We discussed our concerns about Robyn's eating and told him we were pumping every 2 hours. He said we were working way too hard...but luckily Robyn had gained 6.5 ounces in 5 days since we started bottle feeding so even though we were working hard, it was working. We admitted we were supplementing with formula (he of course totally approved). He wanted to know what the LCs thought of us doing that and our answer was, “We didn't tell them” haha. :) We asked about Robyn's frenulum (tongue-tie). He again wasn't too concerned but we wanted a consult with an ENT so he gave us a referral.

The ENT was able to see us later that day. He determined, that while not severe, her tongue-tie likely was contributing to her poor latching since no other reason could be identified as to why we were struggling so much with breastfeeding. He recommended we have her frenulum clipped. I knew about the procedure. I didn't need to think about it. My niece had had her frenulum clipped at 12 weeks, by that point my sister was never able to get a full milk supply and had to pump in addition to breastfeed and supplement with formula. I did not want to do all that. I was already exhausted from pumping for the previous 5 days. I knew the procedure wasn't supposed to be painful. I read a lot online and a few things that compared the procedure's level of controversy to circumcision...I already knew I was in favor of the procedure, but that comparison sealed the deal for me. I wanted it done ASAP. My husband was not entirely convinced...but I wanted to breastfeed and I knew if she never latched well I would always wonder if this could have been the easy fix. Robyn handled the procedure well, she cried as soon as the tools were put in her mouth (mostly out of irritation I'm sure because the snip hadn't even happened yet) and was done crying before we left the building. It was quick and mostly painful for my husband. We called the LC on the way home from the doctor's office to schedule another appointment. She told me to start breastfeeding again as soon as I got home. I thought that this would be a magic fix but we still had 2 major issues. My milk supply was low and my daughter still didn't know HOW to latch even if now she was able.

Wednesday September 21
And I thought the hard part was over. We met with the lactation consultant who worked with us to start reteaching Robyn how to breastfeed. We were instructed to massage her hips to loosen her jaw and to tickle her lips and tongue to teach her that her tongue was no longer attached to the bottom of her mouth. I learned how to power pump (an hour long session of pumping for 10 mins, rest for 10 mins, repeat). I learned about herbs and foods to increase milk supply. I was told to breastfeed first, then pump after every other feeding, then feed back what I just pumped at the next feeding. So if you do the math...that is a lot of time spent totally dedicated to emptying my breasts.

It is amazing the comfort that a measured bottle brings. If I put 2 ounces of milk in a bottle, I knew Robyn ate 2 ounces. If I put Robyn on my breast for 45 minutes, I had NO IDEA how much she was eating. Psychologically I had to wrap my mind around being comfortable with breastfeeding which was hard since I worried that Robyn would be hungry and wouldn't be getting enough milk. I had to start making small goals to force myself to breastfeed more often instead of solely pumping. I started by making myself breastfeed at least 3 times a day, then I would pump for every other meal and after breastfeeding. Then I tried to increase breastfeeding sessions to every other feeding. My family would check in on me and try to encourage me to breastfeed more. I felt so anxious solely breastfeeding. It was SO hard to trust my body to know it was producing what she needed. I couldn't see it in a nicely measured bottle. It was hard to let go of the pumping and make myself breastfeed. The lactation consultant told me over and over that breastfeeding would increase my supply because I loved my baby more than my pump. While true, I hated pumping, I hated not knowing even more.

For the rest of September through October I started slowly worked on my breastfeeding plan. It started well. I was tired and hated pumping but I had my husband home with me and it was tolerable. Then my husband went back to work and I had to do it all by myself. I was lonely. I couldn't get help for this...making my breasts produce more milk was my job only. I had to figure out how to breastfeed and pump and wash god damn pumps and cuddle and eat and go to the bathroom and I was all alone. I couldn't nap when the baby napped because by the time I fed her and got her down to sleep I had to pump and then she was awake and needed to eat again. Then I felt guilty because I'd pumped all the milk out and she'd have to work really hard to get more milk. Which was good because I knew I had to empty my breasts as many times as possible to stimulate my body to produce more. I felt like a feeding machine. I hated breastfeeding and pumping. I'd sit on the couch and stare at my living room and cry while my little love would eat, and then cry herself because she was still hungry. I spoke on the phone numerous times with the lactation consultants. They were very supportive of my efforts and encouraged me to continue pumping. They must have kept good records because they were impressed when my output increased by almost one ounce in one week. I suppose that was good but it still wasn't enough.

When Robyn was 3 weeks old I decided I needed to go to a breast feeding support group. I barely got myself out the door because I needed to do all the things I normally did, which felt practically impossible, in addition to making sure I had pumped milk to bring with me. The group seemed like a silly idea because what I really wanted was someone to tell me I could stop breastfeeding. It was so hard and exhausting to both breastfeed and pump. I just wanted permission to stop. I felt so GUILTY because I still did not like breastfeeding. I told the group my story. I thought for sure someone would have advice for me. They didn't. I was pretty much already doing EVERYTHING I could to boost my milk supply. The LC checked us out during a feeding session, I was grateful that my daughter was latching well. It was one hurdle accomplished. The LC was so kind and encouraging and kept telling me I was doing the right thing and to keep it up if my goal was to continue to breastfeed. Oddly I left feeling better although with no change in my strategies.

Very slowly I was able to continue to drop pumping sessions and add breastfeeding sessions. Then I was able to stop supplementing with formula. Later I settled on breastfeeding during the day and pumping at night...I did this until my daughter was 10 weeks old. When I finally decided I could breastfeed Robyn for every meal it was a HUGE weight off my shoulders. Not only was I feeding my daughter exclusively by breastfeeding but I had been so much in the habit of pumping I managed to build up a 200 ounce supply of milk in my freezer by the time I went back to work. I never thought that could have been possible. I became somewhat of a crazy person though. I would track the number of times my breasts were emptied. I obsessed on the statistic that you have to empty your breasts 8-12x a day. I wondered for a long time when I would be able to stop worrying about my milk supply. I still wonder that sometimes.

Looking back, making myself breastfeed was so incredibly hard. Would I do the same thing again? Absolutely. But now as my daughter is in her sixth month of life, I will not work to affect my milk supply. My goal was to exclusively breastfeed for 6 months. Even though we used a few cans of formula I consider that goal met. I'm proud of myself for persevering. The days of looking at my sweet baby with tears in my eyes while I attempted to feed her are long in the past. Although now I do get tearful with the prospect of weaning someday. Today I am feeding Robyn the milk I have and know that I am doing the absolute best for her. I miss the days of 45 minute long feeding sessions cuddling on the couch. I miss the quiet relaxing moments. Now she is so busy, grabbing at my hair, mouth, necklace, bra strap, rolling over looking's like taming a wild monkey trying to feed her sometimes. But I am feeding her and for me that is what counts. 

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