Clinical Day.

Last Thursday, I had my first clinical day on my path to becoming an IBCLC.

For those of you not acquainted with the breastfeeding world, that stands for International Board Certified Lactation Consultant.  I spent from 7:30 am until 5 pm helping new mommas learn how to breastfeed their babies.  It was incredible.

There were so many things I took away from my first day.  I wish I had written this the same day, but I didn’t get home until after 11:30pm, and I crashed into bed.

First, it surprised me how ambivalent some mothers were about breastfeeding.  They are ONLY on the lactation schedule if they have specified that they are choosing to breastfeed.  However, several of the mothers we went in to see first thing in the morning were happily feeding their new infants formula.  One mother in particular, when asked why she wanted to breastfeed, remarked “Because it’s better for my baby than formula.”  Meanwhile her little one was sucking away at a bottle.   A few moments later, the baby began coughing, choking on the formula, and spit out the nipple.  The LC I was shadowing took that as an opportunity to offer to help the woman latch the baby on to breast.  With very little effort, they achieved a perfect latch and the woman stated she had no pain.  She was being discharged that day.  Who knows if she will continue nursing when she leaves.

Second, it surprised me how much more there is to lactation services in the hospital than simply helping mothers breastfeed.  So many of the patients we saw required something more than just help latching – supplementation of their babies who had lost too much weight, help learning to pump, help using a nipple shield, discussions about what to do when their hospital stay was over.  It struck me how such a huge percentage of women had to have more than just latch support.

We saw the mother of a baby that was about 30 hours old.  She had lots of trouble keeping the baby awake enough to actually nurse.  She would achieve a good latch and her infant would promptly fall asleep.  We spent nearly an hour with her showing her techniques to wake the baby, and still felt like the baby needed constant or near constant stimulation to stay awake enough to nurse.  We offered to go back for her next feeding to assist again so she would have two good feedings before discharge.  At the next feeding, her baby remained sleepy and difficult to rouse.  She was offered a nipple shield as a tool to help the baby feel the nipple in her mouth… and it was suddenly a different baby!  In a matter of seconds, the sweet newborn sucked with vigor and energy, and appeared to be transferring milk as there was colostrum left behind in the shield when latch was broken.  It was incredible to see this mother’s confidence suddenly soar; previously she had been unsure and already contemplating formula, where now she was again excited about her ability to feed her baby.

There were so many more.  I wish I could write about them all, but this post would span pages.  At the end of the day, I felt so consumed by my emotions.  Humbled by these mothers that open themselves up to our help, and trust us with their breastfeeding relationships.  Unsure of my ability to rise to the needs of these mother-baby dyads.  Overwhelmed by the struggles that women face despite the urgent, desperate desire to nurse their children.  And so, so excited for what the future holds for me.  I’m so terribly thrilled about the passion I feel to do this job, to make this work.  I can’t wait.

The Cold, Hard Truth.

I’m a liar.

I didn’t mean to be.  I thought I was telling the truth.  But I wasn’t – I lied.

And I’m not sorry.

They say a picture is worth a thousand words… these are worth millions.

Ruby and I have been breastfeeding.  Exclusively.  For nearly two weeks.

I don’t know what changed.  I don’t know why it happened.  I said I was done, and I meant it… until I tried again.  And something was different.  Perhaps I had given up the fear of failure.  Perhaps I was no longer hurting in my heart.  Perhaps Ruby just knew.  I don’t know why and it just started working.

Ruby and I took a 2 day nursing vacation.  We started giving her my milk in sippy-cups whenever I’m not here.  I pull her hands down gently when I need to.  I make every effort to nurse every single time that I can.  And it just keeps getting better.  Her latch keeps getting better.  Her patience keeps getting better.  She doesn’t pinch, she doesn’t pull back.  It. Doesn’t. Hurt.

I have been SO EXCITED to write this blog post.  I have been LOVING taking pictures to share.  I have been terrified that if I breathed a word, if I mentioned it, it would all fall to bits.  I wanted to wait until I’d worked enough shifts, until I’d successfully come home and nursed again enough times that I felt like I no longer needed to hold my breath.  I don’t know that we’re entirely past that point… but we’re getting there.  Every day we nurse, we’re getting there.

I want and need to thank every single person that has helped us on this journey.  Every cheerleader.  Every encourager.  Every supporter.  Each one of you helped me take it one day at a time, push for one more try, not give up in my saddest, darkest moments.  I couldn’t and wouldn’t have done it without you.

Thank you.  Thank you so, so very much.  Thank you for this.

 

Nursing Video

Ok.  I’ve been filming Ruby nursing for a long time.  I don’t think I’ve ever, before now, had a video that adequately demonstrates what a session is like for us – a typical, frustrating session.

I hesitated to post it, because there is a ton of boob.  Really, a ton.  And Ruby was bottomless, but I covered that up.  (It took FOREVER.)  But I want everyone, all of you who have tried to help and offered suggestions, to see what it’s like to attempt to nurse her.  She desperately wants to – she cries when I unlatch her, when I take it away.  This nursing session was just over an hour from her previous feeding, so she’s not overly hungry or ravenous.  She’s not distracted.  This is completely typical.

I’m trusting my community and my lovely followers to know themselves, and also those of you whom I work with that troll my blog: if you don’t want to see my breast, don’t push play on the video.  That means you, Dad.

Breastfeeding Ruby – Update

It’s been almost two weeks since I talked about breastfeeding!

Heck, it’s been almost a week since I’ve posted at all.  Whoops.

Since I last posted, I had a heartbreak.  I stopped nursing all together.  I started focusing on my pumping output, and making sure Ruby was getting enough from a bottle.  We stopped practicing all of our bottle habits – paced, upright and delayed feeding – and had just started to try to let feeding be stress free.  I haven’t been upset or frustrated, and neither has Ruby.

My pumping volumes have increased and decreased, but I’m now getting to where I have 6-7 extra ounces a day to start putting in the freezer.  I’m starting to get a freezer stash again!  I’m nearly up to 50 ounces already, and that’s more than I’ve had since early in Ruby’s life where I ended up tossing 70 ounces of ‘yeast’ milk. 

All of this being said, I nursed Ruby today.  All day today.  (Well, okay… not all day.  But every feeding.)  She would try to grab at my chest, and I softly grabbed her hands and told her sweetly, “No pinching.  Nice touches.  No pinching, Ruby.”  I pulled her hand gently away every time she pinched, and told her again, “No pinching.  Touch nice, baby.”  She would look me in the eyes, little brows furrowed, and I could tell she was frustrated… but she would stop.  She began grabbing on to my shirt, or played with my lips and teeth.  She pulled at my hair… she stopped pinching.

I did this for every feeding.  Every time, I had to talk to her, I had to tell her no pinching.  Every time, it frustrated her.  Sometimes she got so upset we ended the session early.  Sometimes she relaxed and nursed.  Either way, it made me feel like we’ve maybe made some progress. 

Dang, it felt good to nurse all day.  It really felt good.

I think I’m gonna nurse all day tomorrow too.  Then, a week or so from now, I’ll take stock and see how we’re doing.

Fingers crossed we’ll be doing even better than now.

 

Wah Wah Wah.

Wow, I bet ya’ll are all tired of hearing about Ruby and breastfeeding!  I’m tired of thinking about it, and talking about it, and worrying about it.  Seriously.

So, I wanted to clarify some things.  First, and I heard this one a lot – Ruby doesn’t hate breastfeeding.  She’s not miserable.  She loves it.  She adores clawing at my chest, and pulling back on the nipple, and biting down with her gums.  She pulls at my shirt to get to my boobs.  She dives towards them like she’s starving.  She plays with them, and smiles at them, and cuddles them in her sleep.  She doesn’t hate nursing, and I’m not forcing her to nurse.  She just has NO IDEA how to nurse without hurting me.  Her behavior changes when I don’t allow her to nurse for an extended period of time, and I feel like she misses it.  It breaks my heart a little bit.  I’m not making her miserable when we keep trying… only me.

Second – I don’t feel guilty.  How could I possibly feel guilty?  I have fought and fought for this little girl.  I have questioned everything, everyone.  I have TRIED everything.  I have done everything possible to make this work; when it doesn’t, it wont be for lack of trying.  When I give up nursing and start pumping for good, it will be because I have exhausted every option, tried every trick, called on every resource possible to me and NOT because I backed out and didn’t try hard enough.  I have no reason to feel guilt, so I don’t.

I am raising a beautiful, happy, healthy, smart, funny, wiggly little girl.  She makes me smile every single day.  She loves her brother and adores her daddy.  She is growing like a weed, meeting and exceeding all of her milestones… she just wont nurse.  That doesn’t make me a failure, or make her a bad baby.  It doesn’t mean we wont survive this.

But it also doesn’t mean I wont be sad about the loss of the sweet nursing relationship I had dreamed of as I grew her inside of me.  And it doesn’t mean I wont try again with my next child.  I have learned.  A lot.   I wont make the same mistakes again.  Maybe someone out there will learn from my mistakes, and be more successful than we have been.  Maybe good will come of this.

I haven’t given up yet.  Not quite yet.  I have a plan, I have a few more cards up my sleeve… and if they don’t work, it’s okay.  We will be okay.  I keep trying because when this ends, which it will, I will be able to look back knowing fully and completely that there was nothing else I could do – and be proud of all that I did.

I AM proud.  No matter what, I am proud of Ruby Kate, and I am proud of myself.  We are doing pretty good.

And we will be okay.

Defeated Today.

I want to write blogs that make people happy.  I want people to cheer for us, and be proud of us, and be so thankful they stopped by to read.  I want to inspire moms, and empower women, make dads laugh.  I want to make people smile.

So when something doesn’t go the way I want it to, or when I’m down and frustrated and upset, I don’t want to write.  Instead, I just do nothing.  I don’t blog, and I don’t tweet and I turn my back on my friends.  I don’t want people to feel sorry for me, or to feel pity for me.  I don’t want it, so I do nothing.

Right now, I’m writing instead of doing nothing.

I worked all weekend.  This means that I pumped and Ruby was bottle-fed.  Since Saturday morning, I haven’t had the chance to nurse her, and she drank more milk than I was able to pump.  When I left Saturday evening, there were 25 ounces of milk in the fridge.  When I got home, I brought 13 ounces with me.  I didn’t even come close to replacing what she had drank, and it scares the shit out of me.  I hate myself for ever taking the steps to decrease my oversupply, because I had never, ever dealt with this problem beforehand.  It’s stressful.  And it sucks.

When I woke today, Ruby was acting hungry.  I offered her the breast, and she wouldn’t even put it in her mouth.  She played like it was a neat toy.  LIke she had forgotten the purpose of a nipple.  Like she was willing to sit quietly and patiently until I got her a bottle, and then she would eat.  I didn’t force her.  I put her in the bumbo and gave her a hunk of banana. (BLW!) I put her down for a nap.  And when she woke, I offered again.

No thanks, mama.

I prepared a bottle, and I fed it to her.  And I cried.

I cried because I want it to work so badly, and it’s not working.  I cried because I somehow failed her, at some stage of this, and allowed it to get to the point that I can’t recover.  I cried because I want to seek help so badly, and the funds aren’t there.  I cried because it shouldn’t cost us our grocery money and our car payment to seek help, to teach my daughter to eat properly.  I cried because I felt defeated today.

I don’t want to feel heartbroken every time things don’t go right.  I don’t want to be done, but my heart hurts.  I’m tired of crying.

From now on, I’m taking it one day at a time.  We will do what we can, when we can.

Because no matter what happens, she will always be my baby girl.

One Step Forward.

I had a skype consult with an amazing IBCLC.  (Look ma, I gave her a chance!)  She has worked with Dr. Jack Newman, and has been a supporter of nursing women – and women in general – for years.  I didn’t ask for her permission to use her name on my blog… but suffice to say, she is wonderful.

We had a great conversation about nipple pain, and behavior, and positioning.  One of the questions she’d asked me is if Ruby has her chin to her chest while nursing; does her nose touch my breast?

Not nursing at the moment, I wasn’t entirely sure, but I’d guessed that she was correct.  She asked me to imagine going out for a run, and getting home to have a big drink of water.  She said to try to imagine trying to drink a huge glass of water as quickly as I could… with my chin tucked into my chest.  Go ahead and try it!  Try swallowing quickly a few times.  It’s uncomfortable, and awkward and difficult.  She then pointed out to me that during a nursing session with Ruby, that is probably exactly how she feels.

So!  So she gave me some pointers on how to get Ruby to extend her neck.  Besides nursing her in bed, today was the first time I had a chance to try it.  Press between her shoulder blades, hold her lower body tightly to me.  I managed a position where she was laying, looking up at me, body extended and and comfortable.  Ruby was so much more relaxed.  She played with my lips and nose.  She smiled at me.  And she stayed in the deepest latch she has in… months.  Yes, months.

I’m not saying we’re fixed, and I’m not saying that everything was perfect.  But hell… it’s a step in the right direction.

(Sorry for the quality of the pictures – they were on Brock’s old phone, and the lens was dirty!)

Notice: No claws!  No pinching!  No HANDS!  (And naked bum baby!)

Nursing Ruby – Update

Wow.

I mean, really.  Wow.

Did I hope that my blog would get out there, and I would find help?  Yeah, you bet I did.

Did I have any idea it would recieve the attention, support, love, caring, kindness, suggestions, advice, and amazing offers for assistance that it did?  I had no clue.

Absolutely no clue at all.

This is the power of social media.  The power of the internet.  The absolute power of mothers who are all about other mothers.

Thank you.  Thank every single one of you.  Thank you to all the people who read our plight and didn’t have any advice to offer, but wished us well anyways.  Thank you to everyone who passed it on, and showed it to friends, and asked for help on our behalf.  I cannot thank you enough.  Thank you to every momma who had been there before, and took the time to tell me about it.  Thank you so, so much.

Since this post was written, I have read, processed and replied to over 300 comments.  There is more information here than one person can hope to absorb.  There is so much help out there.  There are so many things to try.  Since I wrote, Ruby and I have started ‘suck training’, encouraging her to suck on my finger and allow it to reach her soft palate.  She has seen the chiropractor and had her jaw adjusted.  We’ve nursed at night, all night long, and felt calmness.  Today, we had a craniosacral therapy session where I was informed that not only did she have a very high palate (adjusted!) but she also carries tightness and frustration through her whole spine.  The therapist helped her to release the energy (in the form of heat) and by the time she was done, Ruby felt like she had a fever – but she was as happy as can be.  It was incredible to witness.

I have only nursed Ruby twice since we started making changes, and I feel small differences.  No quick fixes, no miracle cures.  But we started on this journey a long time ago, and I don’t expect us to reach the end in one day.  We are learning to do what she needs – together.  I want to thank each and every one of you for taking this journey with us.

A Cry For Help.

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 aboutmaxillary 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.

 

 

 

I Give Up.

This is a really, really hard post for me to write.

Part of me doesn’t want to write it, but instead keep it secret and act like everything is okay.

I can’t keep on like this.

I took Ruby across the country to a specialist, advanced in his field to remedy a problem. He fixed her mouth, but he did not fix our problem.

My heart is broken.

Ruby still doesn’t like to nurse. She still gets angry, upset, frustrated. Only now, it’s because she doesn’t want the deep latch she is capable of. She wants the breast to sit in her mouth like a bottle nipple.

I can’t keep fighting her.

She uses both of her hands and pushes the breast away from her. She arches her back. She pulls as hard as she can until she is just sucking on the tip – then, and only then is she happy.

The pain is unbearable.

When I hold her hands down at her sides so she can’t pull, she screams. When I cuddle her close so she can’t arch back, she jerks her head off of the breast. When I move forward and reduce the space between us, she cries and stops nursing.

She doesn’t want the breast.

It has taken me a long time to come to this point. I have gone through a lot of hard work and heartbreak to get here. But I don’t want either of us to be miserable any longer. I haven’t cried all my tears yet, and each time I give her a bottle instead, more will fall. She is still my sweet baby girl, and I am still her mama. But nursing will simply no longer be a part of our relationship.

It hurts so badly.

I don’t want to give up. I want to believe it will get better, and she will suddenly realize she likes to nurse, and we will both be happy and nothing will hurt. I’ve been trying to believe it for four months. I don’t know how to believe any more. I don’t know what is wrong, and I don’t know how to fix it.

I’m tired.

I’m hurt.

I just want to enjoy my baby.

Starting today, I’m going to pump milk for my daughter. I will continue to pump until there is no milk left. I will pump for as long as she wants milk, and make sure she is always satisfied.

But I give up.

We will no longer nurse.

 

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