Breathe Gently - by Mamajags: Boobs

Showing posts with label Boobs. Show all posts

Turns out, I was right. In short: Claire had a pretty obvious tongue tie, which was 70% restricted & affecting her feeding.

Her checkup with the paediatrician was fairly boring - which was a good thing! Even after telling him about my breastfeeding concerns, he brushed off the idea of a tongue/lip tie, and barely even looked inside her mouth. I thought he might take me seriously when he weighed her & she was showing fairly slow growth on the charts.

She was 4.1kg at birth, 3.8kg on hospital discharge, and at 7-weeks old, she weighed in at 4.8kg. That means, she's gained an average of 100g a week (a 700g difference) which is under what they'd like her to be at. She's gone from being on the 97th percentile at birth, to under the 50th percentile now. It's not that average is bad; it's just that the drop has been consistent every week.

Despite this, and despite me sharing that the pain from post-breastfeeding was bad enough to consider giving up, the paediatrician told me to 'just persevere until she hits six months, as that's a good age to aim for while feeding.'

Are you kidding me? I left that appointment fuming. To disregard our breastfeeding troubles like that, to a Mum who has done this before and KNOWS something isn't right... well, it wasn't a great feeling.

That same afternoon, I rang a qualified Lactation Consultant who specialised in feeding issues and ties, and got an appointment for the following week. That was on Monday.

We had a lengthy consultation, and she spent a lot of time watching Claire feed, and performing an oral examination to see what was going on inside of her mouth. She commended us on feeding and gaining as she had been, and declared that Claire was working the hardest she could to feed well - but despite all of our efforts getting her latch as deep as possible, it was still too shallow to be fully effective.

Claire had a tongue tie that was fairly restricted. She could poke her tongue down, but couldn't reach it up or sideways. She wasn't forming an adequate seal at the base of the breast while feeding, and she was constantly running out of energy because of all the reattaching she had to do to keep up with the feed. She's also got an extremely high palate - likely not helped by the tongue tie - meaning she was never able to draw my nipple as far back as it needed to be.

The LC showed me a few tips to help us continue as we were, with Claire opening her mouth as far as she could to feed; but she also gave me the option to get information about the frenectomy procedure too, so that I could make a decision as to what to do next. I decided to go ahead with that option, and we had it done that same day.

The procedure itself was over with quickly, but not particularly pleasant. We opted to go the scissor route, and so it was fast - but bloody. Claire was a real champion; I was a mess! She fed straight after it was done, and fell asleep not long after that - leaving me covered in breastmilk mixed with blood. (I forgot how much mouth wounds bleed!)

It's been four full days since her tongue tie was revised, and she's definitely feeding better. Her mouth is open, her latch is wider, and she's coming on/off the breast a lot less. It's too early to say whether it's been a lifesaver for myself, but it'll take time to perfect everything - the trick will be whether we can encourage her to change her habits and become more efficient, which should in turn help with the overuse of my nipples that has been leading to vasospasms. We will see!

All in all, it's been a good learning experience - and it's shown that I need to trust my mama-bear instincts more. :)

Update: I forgot to mention- they observed her upper lip too, and while she has quite a thick frenulum, it is not impacting her feeding and is very flexible, so that was declared completely normal & did not require revising.

Boob Talk

I'm going to talk about boobs for a bit, so if that's not your thing, feel free to skedaddle for a bit. :)

So - breastfeeding.

A bit of backstory: When Georgia was born, she ended up in special care from that first day. We never had skin to skin time at the beginning, and when we were finally allowed to attempt breastfeeding, she never mastered how to latch on to the nipple. It took her a long time to develop her suck reflex, and we were never able to feed without a nipple shield. Due to this combination, our journey was always going to be a rocky one. We battled on though; expressing for top ups after each feed, 3-hourly feeds for what felt like months, using messy shields - and we happily made it to that magical 12 month mark.

Needless to say, I was wary of how feeding would go with Claire. It was different this time; we had a good hour of cuddles post-birth, she latched straight on to my boob immediately, and even though there were a few days in special care with formula bottles, she still managed to breastfeed too - and my milk came in just before we were both discharged from hospital.

It's been anything but easy, though. So far, we've gone through extended engorgement, crappy latching (adjusted thanks to lots of help), on/off feeds, forceful letdowns, oral thrush, and breast pain in the form of nipple vasospasms - agony!

It's been a bit of a vicious cycle:

Wear breast pads all the time, so you don't leak all over the place with every letdown.
Don't wear breast pads, or change them frequently, because they can hold in moisture & exacerbate thrush.
Let your nipples dry naturally after breastfeeding to help the thrush disappear.
But then don't do that, because dry cool air will cause you to have painful vasospasms.
Use lanolin cream as soon as you're done feeding, to keep nipples from drying out.
But then we're back to wearing breast pads, in fear of ruining all of your clothing.

Good lord, this is ridiculous! Boobs, man. What's a girl to do?

Anyway - we've done our thrush treatment and both of us seem fine now. We're back into the 'keep boosies warm at all times' stage, meaning as soon as I'm done with a feed, I whack on the lanolin ointment, and make sure I have breast warming pads in my bra to keep things at a warm temperature. I've also been prescribed nifedipine to see if that helps combat the circulation issues that are causing the vasospasms

Her feeding has definitely improved since those early weeks. When Claire was two weeks old, it was bad - really bad. There were multiple nights where I was up in the wee hours, sitting in the rocking chair and sobbing my heart out, because she was hurting me, my breasts were throbbing, and couldn't we just do formula? My poor husband felt so helpless. Lack of sleep makes everything seem so, so hard. I got a lot of help after that point, and we kept moving forward - making sure she is only feeding with a deeper latch, taking her off if it's even slightly uncomfortable, and feeding off the least sensitive breast first.

It's a lot better now.

The only lingering issue I have is the vasospasms - but I'm trying to combat that with everything I've got. It is uncomfortable, but it's manageable.

I'm meeting with Claire's pediatrician next week & we're going to re-examine her for tongue tie, to see if that's been the cause of some of the issues - but we got the all clear at birth and at our 2-week check, so I don't expect much to come of it. The research seems to be varied; some practitioners don't believe it to be an issue, others don't bother with them unless they're very severe. We'll see what he says.

Whatever happens, I'm grateful to so far have a decent supply that is feeding Claire nicely, and I'm happy she's not stuck using a shield constantly. I've also been expressing (just once a day, after her morning feed) so I have a little bit frozen in case I need a break. We're six weeks in & still going, and that's something. Now to see how the journey goes from here on in!

Did you struggle with breastfeeding? Any hints, or tips, or suggestions for this mama? :)

Where to Next?

If I had a dollar for every time I've heard someone say that their friend/sister/cousin/next-door-neighbour fell pregnant naturally after they went through IVF, I'd be a millionaire. Seriously people, IT DOESN'T HELP. And it's certainly not going to happen for us. Thanks, though. ;)

Enough of that though; let me give you a brief update of where we are.

I breastfed Georgia for 12 months. Can you believe it? After all the struggles we had at the beginning, the feeding issues in the special care nursery, the 3-hourly pumping and then subsequent feed/pump/sleep cycles we had for months afterwards - we made it to the one year mark. I'm really proud of how far we made it. We had a pretty good routine of four feeds a day/night {morning, mid-morning, afternoon, bedtime} for several months, so I gradually started dropping her feeds, one at a time, over the weeks. By her first birthday party, we had weaned completely.

I'm so pleased with how it went. We have gone directly from breast milk + solids, to solids + whole cows milk. No bottles, no formula - just cows milk in straw cups. She's done so very well. My boobs had a few odd days of soreness/fullness, but thankfully no mastitis or blocked ducts. Man, have they disappeared now though. Flat boozies.

That said, there was another reason why I wanted to wean. I've had no cycle at all since Georgia was born, apart from the normal post-birth bleeding. No ovulation, no AF - nada. Nothing. Which makes TTC for a future sibling just a little bit hopeless, though not for lack of trying. I've been using OPK strips to see if anything has been happening, and it's not been good. My body, whether it's still suppressed from the nursing, is NOT playing ball. Let's face it; we all know it isn't the breastfeeding that's stalled it; it's my dodgy PCOS ovaries once again.

An appointment was made, a fertility specialist visit was conducted - and we're starting to get things moving again for the coming months. First things first, induce a period. Ah progesterone, I've missed you. {NOT.} Hopefully in the next few weeks, I'll get that sorted. Then it's bloods, scans, monitoring, another induced AF. Sometime, maybe June or July? We'll have more actual plans in place.

Until then, it's all about Georgia. My sweet, adorable Georgia. She's all sorts of incredible! More updates soon. :)

Retiring the Breast Pump

As of tonight, I am officially done with expressing. The pump has been put away, the bottles are currently drying after their last official sterilising - and I have at least a free half hour this evening all to myself.

It's a funny feeling. On one hand, I'm thrilled to be done - no more feeling like a dairy cow, no more sitting around with my boobs out {except for nursing}, no more being disappointed with spending lal that time and energy only to get a measly 20, 30, 40ml of milk. But at the same time, it feels really strange.

While I've worked my arse off to be able to breastfeed Georgia, and I'm happy about that, I have the pump to thank for that. For the first few months of her life, I pumped after every feed - to boost supply, but also to give to her in the form of top up bottles. I gradually scaled it back to two a day; once in the morning, once at night. As she got stronger and more efficient at the breast, I dropped the morning pump, but continued to express at nights - at first to store in the freezer for emergencies, and afterwards to use for her solid food breakfasts. It's become such a habit, and without the pump, my breastfeeding experience would have ended a long time ago.

But for now, we're done. I still have some frozen expressed milk in the freezer that I'll gradually use over the coming weeks - mainly for cereals in the morning, and the odd bottle if we're out. I suppose I'd better get used to all the emotions that come with moving on from things; she's moving further away from the baby stage & dipping her toes into the little person category. I wish time would slow down just a little bit.

A Feeding Update

It's been a while since I talked about how things are going on the feeding front. In fact, the last update was when Georgia was three weeks old! Before you start reading this post, yes, this will talk about boobs. Here's a random baby picture to make it worth your while, if you choose to stop reading here. :)

Georgia is 16 weeks old now. She'll be 4 months old next week. And, I'm happy to say, we are still exclusively breastfeeding! It's been a long, hard stretch, but I am so pleased that we managed to get this far.

I still enjoy feeding her this way. It's convenient, and it's comforting. She's starting to become more efficient too, which makes for a much quicker feeding session. I must say, I like this a LOT. In the early days we went from falling asleep at the boob, then switched to marathon 30-40 minute sessions. We're currently at 10 minutes a side, sometimes less, and feeds are around every 3.5 hours. {As a side note, she's also becoming more curious and cheeky while she feeds. I can't count the amount of times that she pulls away and just gives me the biggest grin. Love this child so much!}

My supply is holding up, for now. I don't have a lot leftover at the end of the day, and I'm down to one pumping session just before bed. I usually only get around 40-60ml. Certainly not a power pumper! But the good news is, I have a nice little freezer stash - and I'm only topping up with expressed milk ONCE a day. That 40-60ml I get from the previous night, is what I feed Georgia before bed the following night. It's probably not a necessary top up, but it makes me feel better. Our bedtime routine is usually bath, bottle of expressed milk, boob {mostly for comfort} & bed. We'll be introducing a bedtime book to our routine soon.

The next few months are going to be interesting. The solid food guidelines have gone from 6 months to 4 months to 6 months again, and we're aiming to start her closer to 6 months. She's not showing any interest in food yet, though is watching us more closely at dinner time now. And since she did come that little bit early, feeding her solid foods later rather than sooner seems to make more sense to us.

As for breastfeeding, it would be pretty bloody awesome to keep it up until she's done needing it/me - but I'm not getting too far ahead of myself. If I can continue solely breastfeeding until we start solids, that would be the dream. And if I can keep it up while we're mix feeding solids, I'll be thrilled. One week at a time, though. :)

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?

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