Thursday, November 13, 2014

A year of Breastfeeding

Cora's first birthday marked a whole year of firsts. Our first child, a year of parenting, of being a mom and putting someone ahead of me 100% of the time. It was also a whole year of breastfeeding. 

When Cora was born, I knew that we were going to make breastfeeding work for us! I was not naive of potential problems and challenges with breastfeeding, but I choose to not focus on that. I was going to power through and if I was going to stop breastfeeding, it would not be for a lack of trying every other option to make breastfeeding work first.
nursing at 8 months old

I was initially so determined for breastfeeding to work that I wouldn't allow formula in the house before Cora was born. I told everyone that if I was going to give a bottle of formula, I didn't want it to be easy or a rash decision. I wanted the whole drive to the store to get formula to think about whether or not I was going to quit.

Originally we planned to breast feed until 6 months. When we were first starting out that seemed like such a daunting goal! I would give myself pep talks late at night when I was so weary with it all that we could quit at 3 months if I wanted to. 3 months became 4, 4 became 5 and before I knew it we made it to the 6 month mark and introduced solids (making my job a lot easier)! The second half of the year has been much easier than the first. 

Our breastfeeding journey has been a huge blessing. We have been fortunate that many problems that so many breastfeeding mothers face we have managed to avoid (so far). 

Although by many standards our breastfeeding experience has been without complication, there have been ups and downs. Even without extra difficulties, breastfeeding has been one of the very hardest things I've ever done emotionally. When we started out my concerns were clogged ducts, mastitis, cracked & bleeding nipples. I had no idea that the ideal situation would still be hard...
...For 365 days, one day did not pass that I was not solely responsible for providing my child with nutrition.
... breastfeeding meant that I did every. single. bed time. 
(except the two times my Dad kept her overnight and once that we had a babysitter = 362 bedtimes) 
... there were so many times where Dad wouldn't do the trick, Grandpa wouldn't do the trick, the only person who could soothe or calm the crying baby is Momma. Meaning Momma has to drop everything to sit down and nurse (at least 30 minutes when she was younger).

We got off to a rocky start. When Cora was born there were some issues. For the first day of her life, I only got to hold my child for less than one minute (heartbreaking). We weren't able to try breastfeeding until after she was 24 hours old and even then I was only allowed to hold her for a few minutes at a time, a few times a day. Even with a Lactation Consultant and great, helpful nurses standing right there to help, getting her to latch and suck was hard and time consuming.They only allowed 30 minutes of contact & stimulation for her so in that small amount of time we had to try nursing on both sides then do a syringe feeding with whatever colostrum/milk I was able to pump and then formula as a doctor-ordered supplemental feeding.

When we were in the hospital I wanted to quit so badly. I was exhausted. Each feeding we'd walk down to NICU (which took about all the energy I had), use the 30 minutes we had allotted to us to handle our daughter to get in a diaper change, attempt nursing, do a syringe feeding and get her back in her isolation bassinet. Walk back to the room (moaning, nearly in tears from pain/exhaustion) and then spend at least another 30 minutes of a pump session, then clean the pump parts, send John down to NICU with the milk I was able to pump for the refrigerator. I might get a 30 minute nap or entertain guests that stopped by the hospital or scarf down a quick meal and then it was time to start the cycle all over again. 

Nursing was finally clicking for us until the first night we got to have Cora room-in with us out of NICU. I couldn't get her to latch at all. She was screaming, I was an emotional wreck. There wasn't an LC at the hospital at night to help. It was a long night until we were the first stop on the LC's rounds the next morning. Turns out she'd been getting too much passifier time in NICU (never mind my no-artificial nipple request). The LC taught us how to do some suck training and got her latched for the first time in hours. Now suddenly the latching hurt, it hurt toe-curling bad! Poor Cora had lost that instinctual suck she was born with and we were working so hard to reteach it to her.

Poor Cora was also crying constantly. I'd nurse her and then do a syringe feeding of whatever I'd pumped and then do the required formula syringe supplemental feeding and it just didn't ever seem to be enough. So I'd do it all again just to have her cry some more. Finally at my whits end I called the nursery nurse that I had clicked with in NICU. I explained what was happening, that she just couldn't seem to get full so she pulled Cora's feeding log from the night before (when the passi had been administered and all these problems started). The feeding that I had been encouraged to skip trying to nurse (because I was "over stimulating" my daughter with failed attempts at nursing/latching) she had been syringe fed 4 ounces of formula. 4 ounces! Her stomach should only have a capacity of about 1 ounce at her age!! Her poor tummy was stretched and she just couldn't feel full with breast milk that digested so much quicker than that formula.

The next day the LC stopped by to check on us again. We had gotten the all clear to go home from everyone else, we were just hanging out waiting to see our amazing Lactation Consultant. She watched Cora nurse, we were still struggling pretty badly. She recommended a nipple guard to help with the latch pain & to help Cora to latch properly. She warned not to use it for long and to always try to latch without it first. She also worked out an increased formula supplement schedule to wean her back down to the prescribed amount of formula. She explained that in a day or so Cora would have forgotten the "full" feeling that formula provided with it's slow digestion and that she would go back to being satisfied with breast milk. She encouraged on demand feeding until a schedule naturally emerged and dismissed the silly idea of only 30 minutes of "stimulation" at a time that I was being pushed into. The reassurance and nipple guard helped enough for us to feel confident to pack up and go ahead and head home.

We planned to only use the guard for a week or so, then wean off of it but that was a failed idea. We used the nipple guard for the better part of six months! In fact, Cora basically weaned herself from it because she didn't like how it affected the flow of my milk. It was cumbersome and a pain to always know where a guard was, but I'm so thankful for them. I have little doubt that without a nipple guard we would have not been successful at nursing outside the hospital.

We ended up having formula around the house after her NICU stay while we were still under doctors orders to supplement her feedings. At a 1 week we were given the okay by her pediatrician to suspend the supplemental formula syringe feedings. The formula sat in my pantry for months without being used. Finally we broke down and had to use some to mix with breast milk after a quick growth spurt that depleted my milk store in the freezer and I just wasn't able to pump enough to keep up with her demands. All-in-all I believe she had five or less bottles of half milk/half formula before I discovered the wonder that is Fenrugreek! I can't believe we waited until she was seven months old to try it!

I stopped pumping at the end of July (9 months old) when I started staying home with Cora. I can't tell you how much I do not miss pumping. I am so thankful and love being home with Cora if for no other reason, certainly because I don't have to pump anymore! Pumping at work from March through mid-July wasn't awful because her demand had dropped. I could go seven hours between pump sessions (my employer during this time didn't have a place or allow time for me to pump). At the job I left a few weeks after coming back from Maternity Leave pumping was a full time job in and of itself. I had to pump every three hours for at least 30 minutes and I still wasn't keeping up with what she was consuming while I was away. I pretty much kept my office door shut all day and worked away with the pump whurring in the background (and in a month and a half of doing this my boss only walked in on me once!)

With this year behind us we've started looking to the future and the natural question of how long do we want to continue breast feeding. It seems like that's what everyone is asking me "how long do you plan to do this?". Well the truth is I don't know. It doesn't seem fair to Cora to stop just because we passed some arbitrary time marker. 365 days doesn't mean boo to my baby girl. She knows she wants to nurse and doesn't care that she is a year old. For now, just to make my life easier I primarily feed her first thing in the morning and last thing at night. During the middle of the day I offer her other beverages and will only nurse when she "asks" to by patting my chest or pulling on my shirt. Middle of the day feedings get more frequent when she's not feeling well be it an illness, allergies or teething; some days we may nurse up to three additional times during the day. For now, my plan is to just see how it goes and play it by ear!

This year I learned that breastfeeding, even the most idea situation still isn't easy, but I would do it again without giving it a second thought. Some tips I picked up this year -
  • Babywearing = WIN! You can nurse while wearing your baby, you can get things done & you aren't stuck sitting in a corner trapped there for half an hour or more. 
  • When you're first starting out and you feel like you're juggling 6 balls just trying to master the basics of nursing, it's okay to sit around topless! Trust me, it's just easier to ditch the shirt. Plus this gives you and baby that oh-so-important skin-to-skin contact!
  • Nipple Guards are not of the devil. I know that they don't work for everyone and can cause new problems but if you need them, use them!
  • When you're first starting out, when the baby latches on giving you that toe-curling pain. Count slowly to five before you take the baby off. Usually by the time I got to five the pain had subsided. If the pain was still bad chances were she wasn't latched correctly & I should re-latch her anyway.
  • If you even think you might be getting a clogged duct, pump, pump, pump! Get all that milk out of there! Also, when pumping, let the pump run as close as you can stand to 5 minutes past the end of your milk production to ensure empty ducts (this will also stimulate production)!
  • In the hospital, regardless of if your child is in the NICU or not, be your baby's advocate! Check those feeding logs! Push for breast milk supplementation rather than formula if necessary! You're the parent, don't second guess yourself!!

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