Tag Archives: Breastfeeding

A Cry For Help.

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Ok, internets.  I’m coming to you for help.

I know I said I was through, that I had given up.  But I truly haven’t.  I don’t know if I will ever allow myself to REALLY give up.

So I’m asking you… I’m begging you to help me.  All moms who have breastfed, all mommies who have tried to breastfeed, all lactation consultants and la leche league leaders, all women who have helped a friend, sister, daughter; anyone who knows anyone who knows something about breastfeeding – please help me.  Please pass this on, pass it forward, spread it around.  There has to be someone out there who went through exactly what I am going through, who has any idea, who can help.  I believe there has to be.

I have been blogging about all of our problems breastfeeding since the very beginning, but I’m going to chronicle them all out here, so it’s all in one place.  This is a little long, but I think knowing the whole history is important.

Ruby was born full term in a natural water-birth.  She was skin to skin immediately on my chest and not taken away for the first several hours.  She latched on within the first 30 minutes and began sucking.  She was evaluated for tongue tie and proclaimed “fine”.

Early on, I had glimmerings of an idea that something was wrong.  Ruby would break suction on nearly every suck.  She had huge (I mean MASSIVE) suck blisters all over her lips – but she was growing well and no one else was concerned.  I eventually took her to a lactation consultant to find out if there was something wrong with her latch.  I had a small amount of nipple pain, but it was tolerable.

The first lactation appointment revealed that I had massive over-supply, that was thought to be the culprit of all of our problems.  The LC said that she had never seen anything like it before, because Ruby didn’t even have to suck, she basically just had to open her mouth and let the milk pour in.  After checking for and again ruling out tongue-tie, she recommended that we get my over supply under control, and the rest would fall in to place.  This was also around the time we began our first bout with yeast.

In order to correct my over-supply, I began block feeding. We started with 3 hour blocks and got all the way up to 8 hour blocks before I felt like my supply was under control.  There was no more heavy letdown, no engorged feelings between feedings, and Ruby was actually able to “comfort” suck at the end of a feeding.  But this “normal” amount of milk in my breasts brought on a whole new set of problems.  Over a month old now, Ruby had never had to find herself a good, deep latch; it became very apparent that she had no idea how to do it.

I went back to an LC and had her watch, offer suggestions, try to help.  She said that it was her opinion that Ruby looked fine and that the clicking and suction breaking was just her compensating for my oversupply.  (Oversupply?!  I didn’t HAVE oversupply, I finally had just the right supply!)  So I walked away feeling totally lost.  Nursing had suddenly started to hurt – badly.  Ruby was unhappy, fussy, angry; she would pull away and pinch and yell.

I began reading and trying everything I could think of.  Laid-back breastfeeding.  Only nursing lying down.  Nursing sitting up.  Anything and everything I could think of to get her to nurse comfortably and happy at the breast.  Her incredibly unhappy nursing behavior started right around the time that I returned to work and Ruby was introduced to the bottle.  It became immediately clear that she had severe nipple preference, and wasn’t interested in nursing.  I started pumping to protect my supply and offered her the breast before every single feeding.  It was a battle just to return her to NURSING position – she would scream as soon as I laid her back.  Through a lot of patience, determination and hard work, I got Ruby back to the breast, only not well.  Nursing had really, really taken a turn for the worse.

The pain from nursing had gotten so bad that I made another LC appointment.  I had purchased a nipple shield on the recommendation of many other mommas, and wanted to get some help.  During the appointment it was found that Ruby had zero milk transfer (with AND without the shield) and was happy as a clam as I pumped out 5 ounces of milk and it was offered in a bottle.  No real help or advice to offer me, the LC suggested she may have a weak suck.

Near the 2 month old mark, I read an article online about “maxillary labial frenum.”  I pulled back Ruby’s lip, and sure enough she appeared to have the most severe level of lip tie.  I knew immediately that I wanted to get something done about it, but didn’t really have the chance.  My husband and I began experimenting with bottle feeding; different bottles, different nipples, different flows.  We have tried every single bottle on the market that touts the ability to be used in conjunction with breastfeeding – to no avail.  Ruby would nurse if she were REALLY hungry, but not well, not happily, and JUST enough to tide her over until the next time she could get a bottle.

We continued like this for nearly a month when I finally decided it was time to have her lip tie divided.  I called Dr. Kotlow‘s office in Albany, NY because I knew if I was getting it done, I was going to have it done by the leading expert in the field.  We flew to Albany the next day and Dr. Kotlow pointed out to me without a doubt that not only was Ruby lip tied, she also had a very significant tongue tie.  I started crying on the spot, not because she was tongue tied, but really because it felt incredibly good to know that I wasn’t making things up – there really WAS something wrong with her mouth.

Dr. Kotlow clipped Ruby’s lip and tongue ties, and I saw an IMMEDIATE difference.  Her latch was better instantly – minutes after the procedure.  She seemed calmer, happier, more willing to nurse.  The pain I was feeling during all nursing sessions was gone.  She wasn’t clicking or losing suction.  She didn’t seem to be struggling to keep herself on the breast.  I thought we were cured.

And then a new behavior developed.  To my best ability to describe this, it appeared as though Ruby didn’t LIKE the feeling of her new, deep latch.  EVERY time she was offered the breast, she would latch on immediately (she seemed willing and excited to nurse, at least!) but she would bring both of her hands up, place them on either side of the breast, and pull back as far as she possibly could.  She would happily suck with just the tip of the nipple in her mouth, fists clenched deeply in to flesh, and remain that way as long as I could let her.  As you can probably imagine, this was excruciatingly painful and I couldn’t tolerate it for more than a few seconds.  But, if I pulled her hands away, held her closer to me, or did anything to change the position that she was attempting to nurse in, she would immediately begin crying, moaning, fussing, pinching and finally just refuse to nurse.

Ruby and I continued with this nursing battle for nearly 3 weeks before I couldn’t take it any more.  Every single nursing session reduced me to tears.  I would get so hot, and hurt and angry that I couldn’t even look at her.  One day, I finally decided that she NEEDED to eat, so I went and got some frozen pumped milk, put it in a bottle, and I fed her.  I cried, and I cried but I decided we were done.  Nursing her wasn’t working for either of us and it was just causing more heartache than good.  From that day forward, I have exclusively pumped, and Ruby has been bottle fed.

About two weeks ago, I took Ruby to see a speech therapist.  She did a suck evaluation, and tried Ruby on about 5 different types of nipples, with different types of flows.  She determined that Ruby has an uncoordinated suck, in that she doesn’t take any breaks.  She just sucks and sucks and sucks and sucks, with little time to swallow or breathe.  This causes her to have a very urgent, demanding feeling to her feeding.  We began paced bottle feeding and have seen an improvement in her demeanor while she is bottle fed, but there has been very little change in her nursing behavior.  She doesn’t nurse like a normal baby, who will suck, suck, suck, suck, swallow, breathe, rest.  She doesn’t rest.

And this is sort of where I stand.  Ruby wants to nurse, and I will attempt to allow her to occasionally.  She hurts me terribly the entire time.  I have cuts and claw marks on my chest and nipples.  She squirms and kicks and rears her head back.  She PINCHES.  There is nothing I can do to ease her discomfort or get her to relax.  I say I have given up, but I really haven’t; I want her to nurse.  I so desperately, deeply, fully want her to enjoy nursing, for it to become a nursing relationship that makes us both happy.  I want to nurse Ruby until she doesn’t need the milk any more.

I want to nurse.

Please help.  Please send this to anyone who might be able to help.  Please give me all of your ideas and suggestions and advice.  Please tell me even if you think I’ve already tried it.

Ruby is 5 months old.  I’m not finished.  It’s not over yet.  Please.  I need help.

 

 

 

Maxillary Labial Frenum and Tongue Tie

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When I think of a ‘whirlwind vacation’, I imagine jetting off to Paris for a romantic weekend.

Jetting off ANYWHERE is not relaxing or romantic at all.

I flew with Ruby to Albany, New York yesterday… and here’s why:

Ruby and I have had nursing troubles for ages, and there didn’t seem to be any real solution beyond just muscling through. She had been ‘checked’ for tongue tie at birth and I was told she was fine. She was ‘checked’ again by a lactation consultant and again by my pediatrician who all pronounced her ‘normal’. Several weeks ago, I read an article on “maxillary labial frenum” tie on Facebook, and it got my wheels turning. I checked Ruby’s upper lip. It looked like this:

Ruby's Maxillary Labial Frenum

I was sure the moment I saw it that it was tied. My little wheels kept right on squeaking. I tweeted about it. I had a bunch of responses, but one person in particular (and I can’t remember who) sent me to www.kiddsteeth.com, where I started reading article after article. I knew it, this was our problem, and Ruby need to be ‘fixed’.

I began talking with Brock about getting Ruby’s lip tie separated, and brought it up with our pediatrician. I knew many people flew to Albany, NY to see Dr. Kotlow because of his experience and his methods of laser separation WITHOUT the use of anesthesia, and we were prepared to do so as well. My pediatrician talked me into getting a consult with a plastic surgeon before I considered flying. When they called to schedule my appointment, the earliest they could get us in for a consult was June 22nd. I called Dr. Kotlow’s office and asked how soon they could get us in – to see if it would be worth our time going that route. I was asked, “Would you like to come in tomorrow?”

That sort of cemented it for me. I looked into flights to Albany, and there was a non-stop option. Brock’s dad, Ted, help me plan out the flights, the tickets were bought… and it all happened to work out. We were going. The very next day.

That night, I slept well but woke at 6am and couldn’t go back to sleep. I got up and showered, got dressed and myself all ready. I re-packed the diaper bag and picked out an outfit for Ruby. I cleaned. I ate. I changed the car seats so Brock would have a seat for Ronan while I was gone. I sat. I tweeted. I got really, really bored. It was 9am and NO ONE else was awake. I finally woke Brock up so I would have some company.

Ruby eventually woke a little after 9:30, and I bathed her and dressed her. She was in a great mood and I was excited for our day. We loaded into the car – me, Ruby, and my trusty Ergo – and it was off to the airport. After parking and checking in, we were really on our way.

Mommy and Ruby - Ready to GO!

Security took us mere seconds to get through. In the Charlotte airport, I wasn’t asked to take Ruby out of the Ergo, but instead was given a quick pat-down. We arrived at our gate and patiently waited. Ruby was handing out smiles left and right! I stood near the counter so I could be sure to hear if they called my name, and I could see on the monitor how many passengers had checked in, how many seats were left. We were flying stand-by, and all we needed was ONE seat to get on the plane! I watched as person after person walked down the jet-way, and I felt myself getting more and more nervous. My hands started shaking, and I was a little sweaty. There were at least 4 other people still ‘sitting’, so I assumed they were also stand-by. By my counting, there was only going to be one extra seat. After the last person boarded, I nervously walked up to the counter and said who I was, and that we were waiting for a seat on the plane. I had mentally prepared my sob story, and how I was taking my poor, sweet baby for surgery… but the gate agent picked up a boarding pass that was sitting next to him, scanned it, smiled at me and said, “Enjoy your flight!”

We were on the plane!

Nursing... on a plane!

While on the plane, I began chatting with the lady sitting beside me. I told her I was planning on nursing Ruby while on the flight, and she was very pleased! She told me that she had breastfed all three of her children, the youngest of which is now 47. We had a lovely conversation about breastfeeding and how it would be wonderful to see more women doing so, more normality and less derision. Ruby smiled and smiled at her. I think it made her day. She became Ruby’s honorary airplane grandma, and held her so I could have a bathroom break.

Ruby and her new friend.

After landing in Albany, I hopped in a cab that was waiting curb-side at the terminal. I told the driver the address, and we were on our way. Nerves had really started to to kick in, and I was starting to feel scared about putting my tiny, sweet baby through surgery. We arrived at the dentist’s office, and it looked like a repurposed house. I wish I had taken a picture of it. But as soon as we walked in, it became apparent that this place was in the business of kids. There were sweet, lovely, colorful signs every where… there was even a carousel in the waiting room! Dr. Kotlow has been a pediatric dentist for so many years, his patients are referred to as “Kotlow’s Kids.”

Kotlow's Kids - 20 minutes early!

I filled out mountains of paperwork, and Dr. Kotlow came in and introduced himself. He asked to examine Ruby, and laid her down between us with her bottom in my lap, and her head on his knees. The man is incredibly professional, and incredibly proficient. He pulled Ruby’s lip up harder than I ever have, and it immediately became apparent how tied her lip really was. He then forced his fingers and thumbs in her mouth and pulled her tongue up as far as he could, and showed me how tight her lingual frenulum was. I had no idea how significantly tongue tied she was, but he described it as a “very severe tie”. Ruby wasn’t bothered in the least by all of this, and he handed her back to me so I could watch a video about the procedure. While the video was very informative, and showed exactly how the procedure is done (using clips of actual procedures) my heart was racing. I wasn’t sure I wanted to go through with it.

Dr. Kotlow came back, asked me if I had any questions, and said, “Ok! Let’s get this done!”

He held his hands out to Ruby, and I hesitantly placed her in his arms. With very confident, assured hands, he carried her away.

I was suddenly very alone with her paci and my tears.

Seeing this picture still makes me cry.

I strained and strained my ears to hear her screams of torture. I convinced myself that it was awful, and my poor baby was going to be scarred for life. I prepared myself to sit in suspense for the duration of this exhaustive procedure. Moments later, and I am not exaggerating, but mere MINUTES later, I heard her whimpers coming back down the hall. My shock was washed away with relief at seeing my baby with tears down both cheeks, but quite obviously fine. He said the procedure went smoothly, and commented that she was a VERY good yeller. He showed me her incisions, and it didn’t seem to bother Ruby at all. I suspected that she was crying simply because she had been restrained and not at all because she was in pain. He said he would leave the room and allow me to nurse to see if I noticed a difference.

Boy, did I notice a difference.

It was as though I was nursing a different baby. It was as though our problems had melted away. It was as though she was nursing the way she was meant to all along. I cried, and I cried – happy tears. I felt justified, vindicated… but most of all, just thankful. My fears of picking up and flying across several states for a problem that may have been all in my head just melted away.

Dr. Kotlow returned and could tell from my face that things had improved. I thanked him profusely and we went over our “discharge” instructions. He showed me how to stretch her incisions so that they wouldn’t heal back together. We discussed what normal healing would look like. He pointed out potential problems to look for and gave me his cell phone number. He told me I could call or email him any time with any questions or concerns. He then apologized that we came such a very long way for such a very short visit, and I assured him that it was incredibly, unbelievably worth it.

Happy it's all over.

We cabbed our way back to the airport and over-exhausted Ruby fell asleep as I was waiting in line to check-in. I walked to security, and put my things on the conveyor belt, assuming that I would be allowed through with Ruby in the Ergo as I was in Charlotte.

Wrong.

They insisted I take her out of the Ergo and put in on the conveyor to go through the x-ray. I questioned it, told them I hadn’t been required to take her out at our previous airport, and was informed that it was “regulations” and that the rules were the same everywhere. Let me just say this – airport security, and all your pompous crap is just power tripping. Anyways.

I had lunch at a cute little salad bar, and watched as leagues and leagues of people went to McDonalds next door instead of opting for soup, salad or sandwhich. I laughed and moved on to our gate. We waited almost two hours for our flight home, and I was given a seat before we even started boarding. The flight wasn’t even close to full, and my last anxiety faded away. We had survived the trip, we simply had to survive the flight and we’d be home free.

Ruby was fussy on the flight, and unable to fall asleep. She comfort nursed more on that single airplane ride than she ever had before, and I think both of us found it relaxing. I can already tell that she finds nursing to be less frustrating than ever before. Near Charlotte, when we started making our descent for landing, I strapped Ruby in the Ergo and she became very upset. She was screaming and didn’t want to be strapped in, but I felt that it was necessary to have some extra security when taking off and landing. I whipped out mah boobage and nursed her in the Ergo and it calmed her instantly. BECAUSE she was in the Ergo, it was nearly impossible to tell that I was breastfeeding her. However, when the flight attendant walked by, she stared intently at what we were doing, and when she figured it out, she gave me the most heinous stink-eye I’ve ever seen. I laughed it off, and said to my seat-mate, “Did you see that look? I’m entirely impressed,” to which she responded, “You’d think she’d just be glad the baby isn’t crying.”

Landed, traversed the airport, and a short car ride later we were HOME. Brock immediately noticed how mobile her tongue was – it’s incredible to watch her experiment with her new-found mobility. I nursed her again and put her to sleep around 9:30pm, and she slept until 7 this morning. She’s my hero.

Here is a before and after comparison of Ruby’s lip.

Maxillary Labial Frenum - Before and After

Since photo-blogging our journey yesterday, I have had several people ask me questions about the lip-tie, the procedure, and what to do. Here’s how I feel about it – it was so easy, so fast, and quite obviously doesn’t bother Ruby a bit. (I have done the stretching exercises several times since we’ve been home, and she smiles immediately afterwards.) My only question is – Why not? If there is a chance it could improve your nursing relationship, or improve your child’s chance of not having speaking/eating/etc problems in the future… what really is there to lose? I read an entire thread of people on Facebook yesterday who opted not to have tongue or lip tie clipped as an infant and ALL of them had it done at a much later time, suggesting it be done earlier because it’s easier and heals faster.

Check out the link (again, it’s www.kiddsteeth.com) and see what Dr. Kotlow has to say about it. I am SO thankful I decided to go through with this, and could not be happier with the result. If you have a question or a concern, consult a pediatric dentist or ENT – and find someone that can do it without general anesthesia, because it isn’t necessary. And good luck. :D

Breastfeeding Frustration.

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I keep messaging, texting, tweeting and talking on the phone about this with people. I can never remember whom I’ve told what, and how much they know, so I really want to get it all in one place.

From the start, Ruby has been unusual. At birth, she latched right away, and nursed like a pro. But it became evident after a few days that she had digestive issues. Her lack of consitant pooping has been frustration and worry since day one.

After many calls to the pediatrician and frequent visits, I was told that it is possibly just “normal” for her to go 4 and 5 days without pooping, and to give her prune juice to help soften her stools. I did not accept this advice.

Approximately 3 weeks ago, I sought the help of a Lactation Consultant. She informed me that I had massive oversupply, that was frustrating my baby at the breast, causing her to pull back and choke, which was damaging my nipples and leaving us prone to becoming infected with yeast over and over. She encouraged me to begin “block feeding” to reduce my supply, and then address my other issues when that was under control.

I began block feeding, and Ruby’s poops returned to what could be considered “normal” immediately after.

The following weekend, I started back at work, and Ruby started at the bottle.

After block feeding for about a week, I noticed that Ruby was becoming more and more frustrated at the breast. Her agitation became anger, and she would yell at the nipple. She began pulling back, arching her whole body, turning her head with the nipple in her mouth, biting down as well as other indescribably painful behaviors that made me want to scream. I made another Lactation Consultant appointment to address what I believed was new “latch” issues. I felt as though my supply had dropped enough that she was no longer comfortable with the flow of milk, and we were struggling to get a proper latch. Because of the heavy flow of milk before, we’d always been lazy, but it worked – it wasn’t working any more.

My appointment was a waste of time. I was told that her behaviors were “compensation” issues for my heavy, fast flow of milk, and that it was “normal” for her. My supply was less than HALF it was from my first appointment, and these new behaviors were supposed to be compensating for heavy flow? Why didn’t she have them before?

I continued to struggle with nursing, and hoping things would improve… and they seemed to. Until I went back to work for another weekend.

Another two days on the bottle, and when I returned home to nurse Ruby, she wanted nothing to do with it. Her protests at the breast became impossible to ignore, and she was hurting me so badly, I had no choice but to stop trying to nurse her. The only time I could get her to settle in and really eat was laying in bed when she was about to fall asleep. We started barely nursing at all during the day and spending more and more time nursing in bed overnight.

Then, one night I went out to Target and didn’t get home before it was time for Ruby to eat. Brock made her a bottle, and I walked in as he was feeding it to her. I watched as she laid quietly in his arms, passively eating and looking incredibly content. It struck me like a palm to the cheek – she preferred the bottle. This was nipple confusion. She didn’t WANT to breastfeed, it wasn’t that she couldn’t or had a bad latch.

After much research and frustration, we planned to use the “breastflow” bottle while I was at work. I had been told by many people that it so closely duplicates the breastfeeding method of eating that she would be glad to go back to the beast when I returned home Monday morning.

This wasn’t the case. Now, not only was Ruby uninterested in nursing, but my supply took a nose-dive. She hadn’t been eating much during the day, so my body wasn’t making much. This became exceedingly obvious to me on Wednesday of this week when I went to the Lactation Consultant to seek help with Nipple Preference.

At my appointment, Ruby was weighed before I nursed. She hadn’t eaten in almost 3 hours and was good and hungry. I got her latched perfectly, and she started sucking away. She drank happily through my let down, and as soon as it was over, she started fussing. The LC pointed out everything that she was doing that was frustrating and painful… as though my nipple couldn’t feel the actions she was taking. I let her ‘nurse’ like this for about 10 minutes, and when I couldn’t take it any more, I broke her latch and burped her. I told the LC, “This is when I would typically assume she is full, or done, or whatever, because she doesn’t want to nurse any more.”

The LC took her to the scale to weigh and see how much milk she had transferred.

Half an ounce.

I was incredibly shocked. I had no idea there was so little actual eating going on. I had no idea how long it had been going on for. It was another punch in the gut. She asked if I wanted to try with the nipple shield, and see how that went. We re-latched with the nipple shield, and Ruby was incredibly content. She nursed happily for another 10 minutes but I didn’t really ever see or hear her swallow. It was as though she was using the shield as a pacifier. She fell asleep several times, and we finally broke latch, weighed her and found she had transferred exactly zero milk.

Twenty minutes of nursing has yielded 1/2 an ounce of milk ingested.

So I flipped her around, latched her to the other side, and let her nurse gnaw on my boob for another 10 minutes. We weigh again. This time she has eaten less than half an ounce.

At this point, I’m frustrated to tears. 30 minutes later and my child has eaten a single ounce of (probably entirely) foremilk, hurt me for 20 of those minutes, and we’re nowhere closer to an answer. The LC asks me to pump to see if I have any milk remaining in order to determine if I’ve reduced my supply TOO much. So I pump.

5 ounces of milk.

It is IN THERE. There is MILK in my breasts. She is just not willing to do the work to get it out. I start asking questions – how can I get her to want to take the breast? What should I do so that she stops pulling off? What should the plan be from here forward?

I get NO information to help with the problem. The LC tells me that I should focus on making sure I don’t lose any more supply and to get our yeast problem under control. That is it.

So now I’m stuck. I have a baby that doesn’t want to nurse, and it breaks my heart. I’m not ready to stop, I don’t want to be an “exclusive pumper” and I can’t believe that it’s gone. I have cried and cried over this. I have spent hours wishing that it wasn’t the case, and being angry for having to go back to work, and raging that people try to say that there’s no such thing as Nipple confusion or preference. I have wished and wished that she would just suddenly remember how lovely it is to breastfeed, and magically start to refuse the bottle.

Instead, I have started pumping to make sure she’s eating something, and constantly worrying she’s not getting enough. I have felt like my breasts are always empty when I have never before had to worry about low supply. I have been bottle feeding my little girl, and it is killing me.

I have not given up. I nurse her at night, when she’s sleeping. Then, she seems to forget that she doesn’t want the breast. And I plan on taking a “Nursing Vacation”… just me and Ruby in bed for a day or two, doing nothing but nursing and spending time together. I have faith that something will work.

And that is where we stand.

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Nipple. Confused.

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I hate that term.

Nipple confusion.

Ruby is not confused.  She knows exactly what she wants.  She wants the nipple from a bottle, and putting the breast in her mouth makes her ANGRY.

I have asked and asked for advice and help.  I have spoken to numerous lactation consultants.  Other breastfeeding moms.  Internet websites. Anything I can find.

There are two schools of thought on nipple confusion.

1.  We need to stop bottle feeding altogether, and move to cup feeding or some other alternative feeding method.

Or

2.  We can quit breastfeeding altogether and move entirely to pumping/bottle feeding.

Honestly, both of those options make me want to cry.

Cup feeding means that Brock will have to get up in the middle of the night and feed Ruby out of a cup.  I can only imagine one or both of them getting incredibly frustrated, and giving up.  I feel like it is a lot to ask of them.  In the middle of the night when they are already tired, frustrated and struggling together.

Exclusive pumping means I give up breastfeeding.  That I love.  That I have waited so impatiently for.  That I was so excited to get to do again.  Something that I will only get to do a very limited number of times in my life.  Something that is gone all too quickly already.

I keep sitting back and hoping this will magically fix itself.  That she will suddenly stop pulling off at the breast, biting down on the nipple and getting angry.  I keep hoping that she will remember how wonderful everything was before I went back to work, and our nursing relationship will return to what it was.

I keep wanting to cry.

I don’t really know what else to say, other than I had to get some of this out.  Please just keep us in your thoughts.  I don’t know how things will work out, but I hope they do.

~~~~~~~~~~~~~~~~~~~~~~

Ruby is 9 weeks old.

Head Meet Wall.

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Okay, so here’s the deal.

I just spent 2 hours getting Ruby to sleep, so I’m going to sit here and pound out a blog post. If she wakes up, I’m hitting submit, regardless of where the post is standing.

Shit.

Yeah, I’m writing about poop again. The low-down – Ruby doesn’t poop. From day one, she has never pooped normally. She passed her meconium, had a normal poop or two, and then stopped. She started stooling every other day… then every two days, then every three. Her little poops were getting firmer and firmer. When she got to four days without a bowel movement, I ‘helped’. (Yeah, it really sucks.) She went another four days without pooping, and I helped again. This time, her poop was entirely solid, clay-like and painful. She screamed. Her poops were streaked with blood, likely from fissures from being so terribly constipated.

YES, constipated.

YES, I know that breastfed babies can go days without stooling, and that’s normal.

What Ruby is experiencing is NOT normal.

Neither is the damn runaround I keep getting from any help I seek. I called my pediatrician’s nurse line, and was informed that I needed to drink more water, that would probably help.

WTF? I said my baby was constipated, not me.

Two days later, and more than a little irritated, I demanded to be seen by the pediatrician. She took me seriously, checked to make sure Ruby’s little pooper-hole wasn’t too small, addressed dietary issues, and then told me to give her prune juice or Karo syrup.

WTF? She was at that point only 6 weeks old. Sugar?

To take words out of my dear friends mouth, Breastmilk is supposed to be the PERFECT food. It’s not missing karo syrup from its ingredients, so it’s pretty likely that I don’t need to supplement with that. She offered me solutions to symptoms instead of looking for the problem.

My next step was to consult a Lactation Consultant.

I’m glad I did, because she IMMEDIATELY acknowledged that there is a physical problem here – breastfed babies should be having 3-5 poopy diapers a day between birth and 4-6 weeks old. Period. She was livid that I have been brushed off for so long, and swore to get us help.

But she also made me feel like an idiot more than a few times. She watched me nurse Ruby, saw her cough and sputter, pull off of the nipple and struggle. She made comments about my massive oversupply, and wanted to know why I wasn’t doing anything to handle it. She sighed, and “Tsk!”d and shook her head when I described the methods I had been trying in order to control my supply issues, and also to help Ruby any way that I could. She reduced me to tears 3 times in a one hour appointment. Her intent was to help, but her manner left me feeling dejected, like a failure. I appreciate her help, but I wish I had used my guts and stood up to her less-than-caring attitude.

Of COURSE I’m doing things wrong. I don’t know everything there is to know about lactation and breast feeding. Very few people do. And if we all did… she’d be out of a damn job.

But fuck it if I’m not trying my best, doing my best, and just wanting to make things better for my little girl.

Ruby’s up. I’m done. Will post the plan of action later.

Breastfeeding.

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I always knew I would breastfeed my children.  Literally, always.  I remember being very young, around 5 years old, and finding out that my boobies were meant to feed a baby some day.  I was absolutely amazed, couldn’t WAIT for that to happen, and would hold all of my dolls up to my chest to ‘nurse’.  I remember very distinctly going to bed at night and praying that when I woke up in the morning, my dolls would become real babies so I could take care of them.  So I could breastfeed them.

When I became pregnant, I also became determined to succeed.  I talked to friends and co-workers who had breastfed, got advice, tips and tricks.  I read books, websites, watched videos.  I wanted to know SO much about breastfeeding that nothing could stop me, there would be no booby-trap to get in my way.

I was lucky.  I had a very easy breastfeeding journey.  Ronan was born with a great latch and a strong desire to suck.  It took very little work on my part to position him properly, to where it wouldn’t be painful for me.  I also was blessed to have my milk come in less than 12 hours after delivery, which meant very little questioning of whether or not my child was getting enough to eat, whether he was growing, etc.  Born at 7lbs 4oz, we left the hospital at 6lbs 13oz.  2 days later, at his first checkup, he was back to 7lbs 4oz already.  So many people; nurses, lactation consultants and pediatricians alike, told me it was unheard of for milk to come in that fast, but my mom assured me she was the same way.

My path on the road of nursing continued to be wonderful, and enjoyable.  Ronan was a very quick eater, which meant ten minutes or less on the breast.  I had enough supply that he only nursed one side per feeding.  When offered the other side, he would make it known that he was no longer interested in eating, thank-you-very-much.  I absolutely loved every moment of it.  I loved holding him, feeling him near to me.  I loved watching the intensity with which he ate, his little fists pulled furiously up near his face in hunger and then slowly falling down to his sides as he became sated.  I adored his little post-nursing milk coma – he looked like he was enjoying pure bliss.  The way his sweet head smelled, the roundness of his tummy – it’s all so strong in my mind, and yet faded like an old photograph.  I can see it clearly, but the reality of it is drifting away.  I wish I could hold on to it forever.

Side-lying nursing was one of the greatest things I ever figured out how to do, as it meant getting a few extra precious moments of sleep, rather than spending minutes at a time positioning pillows and trying to get comfortable.  I remember the first few nights, trying to sit up in order to nurse, with my head lolling over to the side, or slamming back into the wall.  Side-lying changed the whole situation for the better, and I no longer detested night wakings.

Further along in our journey, things didn’t stay so smooth.  Ronan cut his first tooth at 3 months old, and had all 4 of his fronts within 2 weeks.  Holding my hand up to the sky, I am thankful that he only bit me twice after his teeth came in.  Those two bites were enough for me to know without a doubt, I could not continue if he continued.  He didn’t, and we survived.

I also had less support from family members than I would have liked.  It seems to be the common opinion that children only need breastmilk for the first several weeks, and then do just fine on formula.  Perhaps that’s the case, but honestly?  We enjoyed it, both him and I.  It was easy, and quick, and required no preparation.  I didn’t have to pack or sterilize bottles, measure out formula, wonder where I was going to warm up his drink.  And best of all?  It was FREE.  I don’t know how well you know my husband Brock and I, but the cheaper choice is always the better choice.  And spending 20-60 dollars a week on formula did not strike us as the most logical option, when breastmilk, which is more nutritionally fit for our child, is also less expensive.

I continued to brush suggestions and comments like, “How much longer are you going to keep breastfeeding that child?” and “Are you STILL nursing him?” aside, and continued to nurse.  Ronan never became terrible about popping off, or being too distracted to nurse – he was such a quick eater (5 minute nursing sessions were enough by now) that he never got bored.

Our most difficult phase occurred during night time feedings, while side-lying.  Ronan had begun a habit of latching on, and then pulling back as far as he possibly could from me, stretching out boob and nipple very nearly to their breaking point.  As you can probably imagine, it is nearly impossible to have a “correct” latch when pulled so far away, and he would suckle merely on the very tip – it was incredibly painful, and terribly frustrating.  If I pulled him towards me, he would arch his back and pull away with a jerk, causing me tremendous pain.  If I moved closer to him, he would simply inch away.  If I forced him to stay close, he would stop eating and cry.  We were both angry, upset, and unhappy with the situation.  Many times in those few short nights I told him I was “done”, that he was getting a bottle and I couldn’t take it any more.  Many tears were shed.  I suspect that my hot natured boy simply didn’t like the forced proximity, as it caused him to sweat and become uncomfortable.  However, very soon after I figured out that if I prepped him to nurse with his head in the crook of my arm, I could simply keep it bent, and he could not pull his head away.  This allowed him to move his body as far away as he liked, but included no pain or discomfort for me.

We continued nursing like that for weeks, and happiness quickly returned to our partnership.

After many happy months of nursing and pumping at work, I saw my supply decline.  Ronan was only about 10 months old, and I was scared, as I wasn’t ready to quit nursing and didn’t want to start Ronan on formula.  Instead, I took some fairly drastic measures to increase my supply, and was thrilled when they worked.  But the success was short lived…  Ronan wasn’t nursing as often during the day because he was eating more and more solid foods, and I wasn’t able to pump often enough on the weekends because work was so busy.  There were entire shifts, whole 12 hour nights where I didn’t even get to pump ONCE.  My supply took a hit, and so did my confidence.  I had a hard time pumping enough milk while I  was at work to even feed Ronan the next day.  Brock had to start giving Ronan solid meals in place of bottles every now and then just to make up the difference.

As an aside, I would like to point out here that I had no ‘frozen supply’ stored up.  I had something called “Overactive Lipase”, which was finally diagnosed after weeks and weeks of trying to figure out why my milk spoiled so quickly.  We were told, as a general rule, milk could be left out warm for 7 hours, in the fridge for 7 days, and in the freezer for 7 months.  My milk?  Spoiled within an hour.  Went bad in the fridge over night.  Frozen?  We were lucky if it lasted a week.  I tried EVERYTHING to figure out what caused it – stopped working out, cut whole food groups out of my diet, stopped using ANY and EVERY beauty product with a name I couldn’t pronounce in case it was causing a reaction.  In the end, a lactation consultant brought up the lipase issue, which basically means that my body produces too much of the enzyme that digests fat; literally, my milk would digest itself as it sat.  The only ‘cure’ for it is to scald the milk, bringing it to the temperature right before boiling, which deactivates the lipase.  I tried it once, and burnt the milk, wasting the WHOLE batch.  Eventually we decided to use milk management, and not worry about saving up any milk bank.  But it meant that I had no back up option.  If I didn’t pump it, it wasn’t there.

Then, we introduced whole milk.  Just one bottle a day.  One little, simple bottle that gave me so much freedom, such release from stress that I cried with relief.  Just that one bottle of whole milk meant that I didn’t have to sweat not having enough breastmilk, I didn’t have to cry over how much I had pumped.  I didn’t have to worry that he wasn’t getting enough to eat.  And if I made even a little less, it was okay… because we could give him a second bottle of milk.  It very seriously saved my sanity, and my heart.  He was still getting enough breastmilk for it to be worth it for me to continue, but I didn’t have to constantly worry about “not enough.”

As the months crawled on, and Ronan got older, he continued to nurse less and less.  Most of his feedings were during the night, when he was waking 5 and 6 times to eat.  He nearly never nursed during the day any more, and would continue playing despite it being offered.  When 13 months hit, and we walked the path of sleeping through the night, nursing changed forever.  He no longer woke in the night to eat, so he very nearly no longer nursed.  When I would get him up in the morning, he would ask to nurse, and that was it for the day.  No evening nursing, no bed time snack, no nothing.

One morning, I brought a cup of milk with me upstairs and gave it to him instead of the breast.  He didn’t complain, didn’t fuss, and that was the end of it.  We never nursed again after that day.

Ronan was 13 months old, and I admit very strongly that I feel like we stopped too soon.  I miss nursing with all of my heart, and while Ronan doesn’t seem to be any worse off because of it, it hurts to let go of something so easily that you can never get back.

I have a video of Ronan taken just a few short days before he weaned, where I am playing with his toes while he nursed.  When I watch it, it makes me cry.

I’m proud of myself for nursing as long as we did.  I’m excited for the opportunity to raise and nurture another child in the same way.  I love the bond and beauty of breastfeeding so much, I wish I could help others have an experience like mine.  I support moms who breastfeed, moms who nurse in public, and moms who don’t get much support anywhere else.  I never once felt like a cow, or hated having to have Ronan close at hand to feed him.  I wasn’t resentful that no one else could feed him.  I was happy that something I did, some part of my being a mother was done right… that something I did was good enough.

Why Yes, Yes It Does Scare Me.

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We are eight days into January already.  Eight days into the year two-thousand ten.  A little over a month and a half until my son turns one year old.

And it scares the crap out of me.

When does it stop?  Will there ever be a point in my life where I hope he grows up FASTER?  I’m sure it will be somewhere in his teenage years.  But even then, it’s frightening to see how quickly time now passes us by.  In retrospect, my life was a sluggish drawl before now.  I was always waiting for things to happen.  Now I wish they would just ease up a little.

Ronan has cut four molars in the last three days.  If that doesn’t cause a cranky, difficult baby – trust me, it does.  I no longer hope everything will magically get easier, I guess I just hope for a good night every now and then.  One where he stays in bed after we put him down, and get some grown-up time.  One where my stress doesn’t start coming out my ears.  But if not, that’s okay too.  I promise, I was kidding when I said I wanted to sell him on eBay.

So, on the breastfeeding front.  My son has always been an efficient, no-nonsense nurser.  He gets in, gets the job done, and gets out.  I’ve never minded.  Now, however, he’s gotten into the habit of latching on, and then pulling his head back as far as he can without letting go of the nipple, and nursing there.  Say it with me now… “Ow.”  Yes, it really, REALLY hurts.  I’ve never had any sort of nipple injury in my nursing career, and now I have a blister that makes me want to cry.  I wanted to nurse until Ronan was one.  Really, it was a goal of mine to get him all the way to his first birthday, but I can’t do this any more.  If I move closer to him, he arches his back and pulls farther away.  If I pull his head closer to me, he screams and fights.  I don’t know why he’s doing it, and I don’t know how to get him to stop… but I can’t continue nursing when it hurts this badly.  It’s supposed to be enjoyable for both parties, and the status quo is that it SUCKS.

NO. PUN. INTENDED.

I don’t really know how to go about weaning.  I was sort of willing to let him take the lead on that one.  But I can’t wait until he’s ready if he’s going to continue mauling my chest like this.  I guess we’ll try pumping and bottle feeding until I can’t take that any more either.  But honestly, the sooner I stop making breastmilk, the better.

It’s no secret that I’ve had trouble maintaining my weight since Ronan was born.  Pre-pregnancy, I was a healthy 118 lbs.  I delivered around 140.  Within six weeks, I was down to 120 again.  Today, I hit 104.  Yes, that’s right, I have reached the lowest weight I’ve been since I was 14 years old.  It’s a little scary, and I don’t seem able to eat the necessary amount to combat it.  I drink “Ensure” shakes during the day to boost my calorie intake, and it still doesn’t seem to be enough.  So once we’re done nursing for good, hopefully my weight will start to improve.  There IS such a thing as ‘Too Thin’.

Don’t Cry Over Spilt Milk.

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11

What about lost milk?

I decided, way back when I decided to breastfeed my children, that I would want to nurse them until they were at least 6 months old.  To me, that seemed like an eternity… I would probably be sick to death of nursing by then.  Gosh, who wouldn’t?  I think I decided this at the tender age of eleven, or maybe twelve.  More recently, I found out that the American Academy of Pediatrics recommends that children be breastfed until they at least 1 year old, and then put on whole milk afterwards.  When I realized this, and consequently easily nursed Ronan to his 6 months, I decided it was entirely possible (and actually quite probable) to continue to breastfeed until his first birthday.

It really has been quite a commitment, since I have to pump at work, and my milk spoils awfully quickly so we can’t take chances with it.  (We don’t have any saved up in the freezer – it goes bad FROZEN in about 2 weeks.)  This means, when I decide that I’m done… we’re done.  No stretching the milk bank out and going a little further than I’m capable of.  Weaning will be a cold turkey event in our household.

Even though that is the case, I have persevered, and Ronan still enjoys his booby juice.  Last week, howeIMG_0395ver, I started to notice that my breasts were never quite as full feeling as they used to be right before a feeding.  I thought it felt strange, and I also hadn’t been noticing whether or not I was having let-downs.  If you have ever experienced a let-down (remembering that some women don’t,) you understand when I say that it is VERY unusual for me to not be aware of one happening.  I realized this, and noticed that my son continued to fuss and complain, even after I has just finished nursing him.  It started gradually, but it really hit home when I came in to work on Saturday, and had to pump for the first time.

For reference, I normally pump twice in a 12 hour shift, and once again as soon as I get home.  I typically get between 8 and 12 ounces per pumping, with a varying amount from each side, but I would say that I average around 10 ounces per pump session.  That means I can usually pump around 30 ounces in a 12 hour shift.

Saturday night, I pumped the same way I always have, and got – are you ready for it? – eight ounces.  Total.  For the whole shift.  The whole night.  8 measly ounces.  HOW AM I SUPPOSED TO FEED MY CHILD WITH EIGHT OUNCES?

Thankfully, for the next night, I had a small surplus of frozen milk in the freezer, and Brock was able to feed Ronan a few meals of solid food to tide him over.  I guess it never really occurred to us that that was part of the problem.

I called a lactation consultant, and explained the problem to her, the symptoms that I was experiencing.  I asked her if it was possible that my son was actually weaning himself, and not interested in milk anymore?  She said that it was very unlikely, and suggested some methods for increasing milk supply.

So, for the next 5 days, I pumped for 10 minutes after EVERY SINGLE nursing session.  That is dedication. I pushed my water intake, and started taking Alfalfa pills.  I ate oatmeal for one meal every day.  We cut Ronan’s solids down to NOTHING.  And I prayed a little.  I have to be honest, I’m not ready to wean yet.  I still enjoy it, and if I can get Ronan to a year old without giving him formula, I would prefer to do so.  Brock feels the same way.

I started to feel, within two days, like Ronan was more satisfied during feedings.  I was feeling heavy let-downs, and hearing him gulp as he was nursing.  But, since I only pump while I’m at work, I had no real, palpable evidence that things were improving.

The following Saturday, a week from discovering that my milk was drying up, I went up to the pumping room with a little trepidation.  I wasn’t ready to find out it had all been in vain, and that my milk wasn’t coming back.  I hooked up the pump, pulled out my phone, and ignored the goings on like I always do – you can’t get milk out if you stress about it.

15 minutes later, I looked down and realized I had pumped a full 12 ounces.  Both bottles were filled above the top marker.  My heart soared, and I felt the vindication of a job well done – believe me, pumping for 10 minutes after every feeding for several days is nearly enough torture to make one throw in the proverbial towel and walk away.

I’m now happy to say that my milk has not only returned, but my supply seems to be better than ever.  My son has started to look chubbier and chubbier in the last couple of days, and it feels really good.  I bite his chunky thighs, and I feel accomplished; job well done, Mandy.  Keep that baby boy bouncing.

Yes, I know I spelled “Spilt” incorrectly.  I like it better that way.