It Ain't Easy

Breastfeeding. Yep, this is an epic post that is all about boobs. You've been warned, folks.

Much like my birth plan {which, if you'll remember, was 'not to have a plan'} - I didn't really have a plan when it came to feeding my baby. I had high hopes that we'd be able to breastfeed, but I've also heard so many guilt-ridden stories about things not going right, that I was determined not to get too focussed on it as the be all and end all. If it worked, it worked. If it didn't, it didn't. Either way, I'd have my child at the end of it all.
When Georgia was born, she had some respiratory distress and required oxygen for several hours after birth. While these problems cleared up really quickly and she was off all monitors and support by the following day, it affected her feeding. We were never able to have our first attempt breastfeeding skin-to-skin after birth, and because she was in the Special Care Nursery, they made the decisions on her feeding without consulting me. 
Georgia was not able to take formula from a bottle, so she was given formula via a feeding tube down her nose. Walking in and visiting her in the wee hours after the birth, and seeing her with a tube stuck to her face, well, that just broke my heart. This was not what I'd hoped for my daughter's first hours of life.
Less than twelve hours old in the Special Care Nursery. Broke my little post-partum heart.
I expressed colostrum manually for the first 24 hours, which was inserted directly into her belly via the tube. After 24 hours, they introduced me to the hospital breast pump & had me expressing {or attempting to express} every 3 hours. I didn't get a chance to breastfeed Georgia until day 2/3, and only for very short attempts. She had no real idea what to do on the breast; wasn't able to latch and hadn't mastered the sucking reflex. The same went for bottles; she couldn't figure out how to do it. It was heartbreaking for me, and frustrating for her. She would sit on my lap and cry, or simply fall asleep, because it was just too hard for her. And so, the tube feeding continued, and I kept on pumping, desperate to give her something other than formula.
Here's where things went a little pear shaped.
Firstly: the hospital pump. Other than showing me how it worked, and how to sterilise the parts and store the expressed colostrum, I was pretty much left to my own devices with it. I was pumping every 3 hours as instructed, but getting pretty much nothing from it. I got frustrated, I got emotional, and I got stressed. Second, it didn't help that another woman in the nursery, who had given birth the same night as me, was also pumping on the 3-hourly intervals, and she was getting breast milk - bottles of breast milk, while I was managing to express 2ml of colostrum, if I was lucky. Comparing my efforts expressing to hers... it sucked.
By day 4, my milk still hadn't come in. Georgia was on tube feeds regularly, and I fought to try and get her trying the bottles a little more - anything to help her practice her sucking. They let her attempt breastfeeding/bottle feeding on every third feed rotation: the idea was that she would rest and get her strength up through tube feeds for two rotations, before attempting the suck feed. All I wanted was to have my baby on my breast. In my heart, I knew tube feeding was helping her build her strength, but it didn't make it any easier. When things hadn't happened by the afternoon, the midwives called in a lactation consultant to meet with me. She explained that while most women had their supply in by day 4, it varied from person to person. She also suggested that there may be a link between milk supply & PCOS - and suggested oatmeal & fenugreek, which I was already taking daily. We agreed that if I hadn't had any milk come in by day 6, we could look at prescribed drugs to boost milk production.
Thankfully, milk arrived on day 6 - after an agonising day of engorgement and nipple blisters {oh lordy, the nipple blisters} that appeared on day 5. I've never been happier to have Dolly Parton boobs, but they do NOT prepare you for the pain of your milk coming in. That was almost as agonising as post-childbirth, for me anyway. That being said, I was so excited to see if Georgia would take to breastfeeding a little better, now that there was something worth waking up for! And if she still wasn't able to feed from me directly, I'd at least have expressed breast milk to feed her via the tube.
My milk increased gradually, which made me stress less. While I still wasn't producing enough to feed her for every 3-hourly rotation, more and more of her feeds became breast milk over formula. My goal was to completely wean out the formula altogether, and I managed this eventually. Since my boobs were playing ball, the paediatrician finally decided to try out alternate feeds for Georgia - one tube feed to one suck feed. Her latching troubles continued, even with midwife help, so I trialled a shield, and BOOM. It suddenly clicked. We had our first real feed on day 6 - it was short and sweet, but it was glorious. I cried; this was breastfeeding.
Once she figured out what she had to do on the breast, we were thrilled. She was making progress! We had a few more hurdles to get through; predominantly exhaustion. Sure, Georgia was a good size at birth - but she was still premature and tired very easily. With the shield {I used the Medela ones} she was able to last a good few minutes before falling asleep; then we'd have to employ every technique in the book to wake her up - stripping off, tickles, head stroking, squeezing hands, nappy changes, baths, cold face washers. When she was asleep, she was really asleep. I was assured that she would outgrow this stage at her own pace. 
We were due to be continuing alternate feeds, but one morning, Georgia yanked out her feeding tube {again} when she was due for a tube feed. The midwife on duty laughed, and suggested we try another suck feed instead.. worst case scenario, if she couldn't finish her boob/bottle combination, we could put another tube in. Georgia showed her - we had a great feed AND she got through her bottle. Champion! And so began our next challenge: getting through on all suck feeds. Thankfully, she did well, and we were eventually discharged from Special Care & put into the regular ward instead. We went home as a family the following day.
Our routine at home goes something like this: a breastfeed focussing on one side at a time, offer other breast & top-up with expressed milk. This is up to our discretion now: if she's had a long feed and puts herself to sleep, we don't top-up - if she's had a lazy feed or continues fussing after a short period of time, we top-up. The amounts are fairly small, usually around 25-30mls of expressed milk. Then we rinse and repeat every 3-4 hours. Georgia is finally able to wake herself up and fuss when she's hungry: this is huge progress, as prior to this, I'd need to set my alarm and wake her up for her 3-4 hourly feeds. If she sleeps a little longer at nights, I let her go - happy baby AND happy mama! ;)
I'm still pumping, though not after every feed like I was in the hospital. We invested in a Medela Swing Maxi, a double electric pump - saves time and is way more comfortable than the hospital pump. I express after our first feed of a morning {usually when I get the 'most' milk - though it's still not a lot}, once after an afternoon feed, and once after our last feed before bedtime, mainly for comfort overnight. Three times a day seems to be working for me at the moment. I don't have a huge supply, but I seem to have enough to cope with her needs for now. I'm starting to develop a little freezer stash too, so that gives me some relief on the off days where I don't express very much milk. I've continued with the fenugreek and oatmeal, but my supply is still fairly average.
Feeding my daughter has been my sole focus and biggest challenge since becoming a new mother. I don't know how long we'll last for, but I'd really like to hit the six-month mark, all going well. But, like I said way back at the beginning, if it doesn't work out, it doesn't work out. If we swap to formula at some point, I'll be okay with that; I know I've done everything in my power to help give Georgia a good start in life.
Is it dinner time yet?


14 Comments • Labels: ,  

14 comments:

JB said...

I empathize with your breastfeeding woes! I posted about this too...definitely harder than I thought! I also added blessed thistle supplment to my fenugreek and oatmeal and now I'm pumping 8oz during the feed where Daniel's at the sitter. It's still up and down of course but my production seems to be good now. Not crazy milk-cow good, but good :)

Good luck momma. She's gorgeous.

Sarah at Midwest Pillowtalk said...

i am most intimidated about breast feeding but want to accomplish it so badly. im so glad you shared this and that georgia is progressing with it so well!

Keep Calm and Carrie On said...

My little Jack had an unexpected NICU stay a few days after birth thanks to -- get this -- "breastfeeding jaundice." He wasn't getting nearly enough to eat since my milk didn't come in until day 4... he was so dehydrated and sick! It was terrible and I almost gave up on breastfeeding then and there (like you, I wanted to do it but if it didn't work out, oh well). We stuck with it, though, and it's easy peasy now. Keeping my fingers crossed that it gets really easy for you soon! Georgia is adorable :)

Tia said...

Good job sticking with it! I highly recommend you pump more now. Now is the time to get your supply increased. I think I pumped 6-8 times per day the first month or two, along with breastfeeding. You'll thank yourself for working hard at it now, because it gets harder and harder to keep up as the volume she eats increases. She is so cute, and it's really interesting to see the differences between the hospital processes in AUS and the US.

Egg Timer said...

I too have heard so many of those guilty moments from my friends who couldn't breast feed. I am glad you were finally able to meet your beautiful daughters needs.

Kristina said...

Stick with it! My twins were born at 33w5d and were in the NICU for 12 days and barely BF because I just wanted them out of there. It took 2 months but they were exclusively bfeeding every feed. They will be 9 months next week. You can do it.

Jen said...

I keep meaning to send you a message, but I'll just comment here for now- you're doing so well, I admire your determination to keep trying when you had several factors working against you. Hopefully it's onwards and upwards from here as Georgia gets stronger and stays awake more, she'll be so much more efficient at getting milk from you than pumping.

Ashley said...

Garrett and I had a lot of the same problems at the beginning (minus the tube) as he was a preemie too. My goal was 6 months as well, but it turned out that after awhile, as things got easier, I DID care more about whether he got breastmilk or formula, and now we're going for the gold and nursing to a year!

Kemma said...

Is it weird that I'm so ridiculously happy for you that you're successfully breastfeeding??

Keep up the wonderful work Mama, you're doing an awesome job!

Oh, and just a heads up but you could be about to hit the six week growth spurt, just nurse, nurse and nurse some more and you'll get through it!

Audrey said...

Aly, you're doing SUCH a great job with little Georgia! I'm so glad things are improving for you guys after those less-than-idea first days.

I also know ALL about the self-imposed guilt that comes with the many trials of breastfeeding. Just try to remember that she'll be happy and healthy no matter what, and your happiness is also incredibly important. If pumping your current routine is working for you now, then it's exactly what you should be doing. Try not to pressure yourself into thinking you should be doing more or less or different. Just do what works and enjoy your darling little girl.

She's amazing, and she's got a GREAT mama.

Emma R said...

I don't know if my last comment came through or not...

I just wanted to let you know that my son spent some time in NICU when he was born. I pumped and gave the NICU nurses what I pumped (really, not much). They were supposed to mix what I had pumped with his formula, but never did. In fact, some of the nurses looked like they wanted to laugh at what I handed to them. It made me feel like crap, I won't lie.

It was hard at first, I think it took us 3/4 months to finally get the hang of nursing. Then he prefered the boob to bottles!!

And Georgia is simply adorable!!

ICLW #61

Hilary said...

I haven't visited is so long... I am so happy for you.. your daughter is beyond beautiful!

Sarah McK said...

Ahoy!

I nominated you for a Liebster award. Get your ?'s and details on my blog.

http://themchive.blogspot.com/2013/04/liebster-award-aka-things-you-never.html

acoursetothefinishline said...

Hi from ICLW

With our twins due soon my biggest stressor right now is feeding - mainly how am I going to manage with two? The problem is its impossible to plan bc I don't know if they will have difficulty sucking or need time in the Special Care Nursery themselves, so I'm trying to take a similar attitude - the goal is to breast feed or at least pump and bottle feed, but if we have ot use formula I'm not going to beat myself up about it.
You're doing a great job, mom :)





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