My Breastfeeding Journey [Part 2]

It’s been several weeks since the first installment of my breastfeeding journey.  If you missed it, you can catch up here.  

I wrestled with the prospect of going to see my midwife as she offered at the end of her email.  I hated to make the trip—1.5 hours there and back.  But, I was desperate.  So, on Thursday, my Parents drove me & Eden to see my midwife.  She had a completely different approach than my lactation consultant (LC).  She had me pump first to draw my nipple out and try nursing without the nipple shield.  Eden was able to latch if she held my breast flat like a sandwich in her mouth.  She also fashioned a homemade SNS (supplemental nurse system) with a syringe and tube and we inserted that into the corner of Eden’s mouth and gave her supplementation (pumped breast milk) while at the breast.  She also showed me how to finger and cup feed.  I was baffled as to why my LC had not suggested an SNS prior to this.  After this visit, I was so hopeful that we could overcome our obstacles and that perhaps, our problem had just been the nipple shield.  My midwife gave me some free formula samples just in case I needed to supplement with formula.  At that point, I had accepted that we might have to do that.  

Unfortunately, as we drove home, I started to feel engorged and by the time we got there, I was feeling miserable, with a fever, chills, and excruciating breast pain.  I tried to nurse Eden to empty the painful breast but she was not being very cooperative.  I don’t remember every event in great detail because I was quite delirious from the fever and pain but I think that I tried pumping which, unfortunately, did not alleviate much of the pain.  I took some Ibuprofen and laid on the couch covered in blankets and the space heater on full blast at my feet.  I continued to feel utterly horrible for a good little while.  I may or may not have taken a nap.  Many thoughts ran through my head…I needed to go to the hospital, at the least, I needed antibiotics…I couldn’t do this any longer…I would have to give up and all my efforts for the past 11 days would be in vain…I wanted to die.  Finally, I mustered up the strength to go to the bathroom (very unsteady on my feet, I might add) and eat something.  I also fed Eden and pumped again and I started to feel ever so slightly better.  At some point in all of this, I checked my vital signs and my temperature was elevated (can’t remember exactly what it was but something like 102), my pulse was 150 and my blood pressure was low!!!  Why was my heart rate so high?  I figured it was from the fever, dehydration, and perhaps low blood sugar???  I called my midwife but she didn’t answer so I left her a message.  One thing I didn’t mention from my visit with her is that we discussed the idea of drawing some blood to check my thyroid level and a CBC as hypothyroidism and anemia are two possible causes of low milk supply but we decided that there wasn’t any other reason to suspect either of those things other than the low milk supply so we didn’t do it.  Now, there was a concern for anemia!  Hah!  By the time my midwife called me back, I was feeling exponentially better so I didn’t think I needed to go to the ER or anything.  She suggested that I take some supplemental iron just in case I was, indeed, anemic.  Thankfully, none of this lasted long and I was able to continue to nurse Eden all the while pumping and supplementing with pumped breastmilk. 

I brought Eden back to my LC’s house to get her weighed two days later.  I was so nervous but cautiously optimistic that my extra efforts had paid off.  That optimism was crushed to bits when I laid my naked babe on the scale.  She weighed the exact same, if not slightly less.  This is when I realized it was time to supplement with formula.  My LC was out of ideas and agreed that I needed to go the formula route.  To hear her admit this was obviously bad news since she is SO against formula (she has been known to go to great lengths to get donated breastmilk for her clients and has a recipe for homemade formula so infants are not exposed to the ingredients in commercially-made formula).  I felt defeated but I still wasn’t ready to give up completely.  We discussed some vitamins/supplements I could take to try and boost my supply.  

Regrettably, the details get pretty hazy at this point because I’ve waited too long to write all of this down.  I know that we settled into a routine of nursing Eden for 30-45 minutes, supplementing with the makeshift SNS mentioned above with breastmilk when available and formula when it wasn’t, and pumping 8-9 times a day (at the least).  I was still setting an alarm at night and feeding Eden at least every 3 hours.  She was SUCH a good sleeper at this age.  But, I couldn’t allow her to sleep for fear of my milk supply dipping even further and fear of her losing weight.  I was MISERABLE.  I was coming to my wit’s end.  Something had to give.  I can’t remember how I heard about her but someone recommended that I see a local IBCLC (International Board Certified Lactation Consultant) named Jane Bradshaw (she doesn’t need to remain anonymous because I have absolutely nothing negative to say about her).  After almost two weeks, minimal weight gain, and no apparent increase in my milk supply, I was willing to try ANYTHING to see some improvement.  I’m not a quitter and I wasn’t ready to give up on my baby girl just yet.

The first time we met with Jane, she sat and listened to me tell her everything that we had been through.  She didn’t interject and try to fix our problem until she had heard everything.  She prompted me with questions at times but overall, she was just an excellent active listener.  She weighed Eden and watched her nurse.  She said that Eden was a “lazy nurser.”  Although I didn’t want to blame my baby, it was such a relief to hear that this wasn’t all my fault.  She explained to me the importance of the baby’s role in establishing your milk supply and we discussed the nipple shield, skin-to-skin…the whole nine yards.  We came up with an action plan.  She wanted me to continue what I was doing if it was working for us (which it was) but to tweak it a little so that I could get some rest and not feel like I was feeding Eden all day, every day.  She gave me permission to sleep for four hours at night.  This was music to my ears.  If you think getting up to nurse your healthy eater in the middle of the night is difficult, try setting an alarm, getting up, going downstairs, mixing formula, heating it, gathering all of your supplies to supplement, waking your baby, sitting in the nursery all alone, breastfeeding your baby for 30 minutes, trying to get all the extra supplementation (up to 2 ½ ounces at first) in those 30 minutes, trying to wake a sleepy baby up to nurse when she wasn’t hungry (often), burping her, lying her down in her Rock N Play hoping she would stay asleep so that you can pump for 10-15 minutes, washing everything, and going back to bed, only to get up 3 hours later and repeat the whole process!!!!  This was my life for the next several weeks.  Jane continued to give good advice, helping me with supplements I could try taking to boost my supply, weighing Eden at least once weekly to ensure good weight gain (she was gaining well with the supplementation), and encouraging me to keep going even though things were improving at a snail’s pace.  I think her cheerleading was the most important thing and what got me through.  But after weeks of the above regimen, I was exhausted and frustrated that even though we had seen some improvement in that Eden was getting more at the breast and supplementing less, we were still having to supplement.  

Easter weekend, we went to my Parents’ house to visit.  When I woke up in the early morning hours on Easter Sunday to nurse Eden, I noticed that I had a painful lump in my right breast indicating a clogged duct (I was no stranger to the clogged duct).  What a nice gift from the Easter Bunny, huh?  Since I had dealt with this same scenario multiple times before, I knew exactly what to do and the pain actually subsided fairly quickly.  The next day, I noticed four little dots on my right nipple (remember, I was still using a nipple shield and by this time, Eden had successfully pulled my nipples out, more on the right than the left).  I had just recently read an article about nipple shields and it mentioned that one adverse side effect can be having your nipple pulled so far out that it is literally sucked through the holes on the shield.  When I saw those four little red dots, I knew right away that’s what was happening.  It wasn’t painful…yet.  I knew immediately that I could no longer use the nipple shield on that side.  Thank God, Eden latched well without it and stayed latched on for 14 minutes.  I was relieved.  I kept using the shield on the left breast because it was much easier for me to use the SNS with a nipple shield since I simply slipped the tube into the corner of Eden’s mouth (it’s much easier to slide a silicone tube past a silicone nipple shield than skin).  Anytime I was not using supplementation, as in when I would just nurse Eden for comfort, I wouldn’t use the shield and Eden was able to latch on.  I soon noticed, though, that I had to hold my breast in her mouth for her to stay latched on.  I didn’t think it was normal to still have to do this for a 2 month old baby but I wasn’t sure.  I also noticed that she was making a clicking noise while nursing.  I’m not sure if she didn’t do it before because of the nipple shield or if I simply had not noticed up until this point.  My main concern was the pain I was experiencing in my right nipple.  It was unbearable at times, even to pump.  So, I went and saw Jane that week so we could troubleshoot.  I also used a lot of lanolin and it worked fairly quickly to heal the nipple right up.  Jane was concerned about the difficulty staying latched and the clicking noises.  She was worried that Eden had a tongue tie (TT).  I did not see how this could be the case since Jane had checked Eden for a tongue tie (TT) the first time we met and Eden could stick her tongue out just fine.  In fact, she had been doing so since the evening she was born!  Jane checked Eden again and still could not appreciate one but Eden was also not very cooperative.  Jane showed me lots of pictures and we talked about some ways to tell if she had a TT.  I was still in denial.  The next week, I went back to get Eden weighed and Jane was now convinced that Eden had to have a TT.  We discussed how it explained a lot of our problems and then, I was convinced, too!  Jane gave me a referral to a local ENT doctor to get a consultation.  Unfortunately, this was on a Friday and they were already closed.  I waited all weekend and called first thing Monday morning.  They weren’t able to get her an appointment until the next day.  I realize this is super fast but at the time, I was really hoping they might have an appointment that same day.  Anyhow, we made it until the following day when we went to see Dr. Kittrell and got Eden evaluated for a tongue tie.  She agreed that Eden did in fact have a very tight posterior tongue tie and she agreed to clip it right then and there.  I signed the consent without hesitation.  I had asked for some advice and encouragement from Moms who had been through this on a Facebook group I am a member of called Lynchburg Moms Supporting Moms.  I got a lot of positive feedback and encouragement to go through with the procedure.  I was very optimistic that we would see results very soon after the procedure.  I allowed them to take Eden to do the procedure without me.  I couldn’t bear to watch them hold her down and inflict pain.  It was very quick but Eden was beside herself, sweaty from being held down, and crying inconsolably when they brought her back to me.  I tried to nurse her but she wouldn’t latch on.  I was beside myself being unable to console her because of something I chose to have done to her.  Things got much worse before they got better, too.  When we got home, Eden still wouldn’t nurse.  I decided to give her some Tylenol and we took a nap together.  Thankfully, when we woke up from our nap, she did nurse a little bit.  The next few days were rough but with some Tylenol around the clock, she did nurse.  At Jane’s advice, we supplemented even more than we had been before because she expected Eden’s tongue to be sore for a few days.  She also instructed us in how to do some tongue exercises that would help Eden be able to better use her more mobile tongue to nurse effectively.  It took about ten days but we were able to get off the supplementation and Eden steadily gained weight.   

As of May 17, when Eden was 12 weeks old, we threw away the SNS and never looked back.  [I forgot to mention that somewhere along the way, I was able to produce enough milk to supplement with only pumped breastmilk and Eden had not had any formula since April 15, the Tuesday before Easter.] I had to continue pumping after many feeds to ensure that my milk supply stayed up but that only lasted about two weeks.  Thankfully, this coincided with my return to working part-time as a nurse.  Very soon, I was only pumping when I was at work or away from Eden for some other reason.  Eden is now six months old and a chunk!  I am so incredibly proud of myself (and her) for overcoming all of those obstacles.  I know that, among many other things, this experience has made me a huge advocate for breastfeeding.  I also want to make sure people are aware of the possibility of tongue and lip ties and how they can affect the breastfeeding relationship.  Last, I am so very thankful that I am able to exclusively breastfeed my child and I don’t plan on stopping until she and I are both ready.  I know there still may be bumps in the road, but I am determined to overcome every one.