Breastmilk, Boobs, Nipples, Pumping, Breast Pads.... OH MY!! (for anyone who is squeamish about those, or any related words, I suggest you just stop reading now.)
I've mentioned before, breastfeeding has NOT been an easy thing for me in the past. I've had different situations and issues with each of my girls, and have learned that, like deliveries and pregnancies, no two are exactly alike!
If you'll give me the time, I'll explain my two previous situations, and how this time, with my third daughter, is different.
G1: She was born at 41 weeks. She was really struggling with her breathing when she was born. I held her for 10 seconds before she was taken to the NICU (this all matters, I promise). She had high acid levels in her blood, a high infection, blood and fluid filled lungs, and an open sore on the back of her head from the vacuum (she was 9lb 9oz and couldn't make it out without help). 5 hours later, at 11pm, I got to really see her in her little incubator.
My nurses told me that they were going to have me start pumping that night to get things going and stimulate milk production. The hospital did not have a 24 hour IBCLC (internationally board certified lactation consultant), so I wouldn't see one of these LCs until morning. I asked my nurses about the pump, but they were very busy and kept forgetting to bring one. Our second time visiting our baby, 1am, I asked the NICU nurse. She brought one to my room a little while later.
This is where things started to go wrong. This NICU nurse was very new, I think it was her 1st or 2nd shift ever. She brought me the hospital grade pump, set it up, helped me get everything on, and turned it on... to the highest suction on the fastest speed. I had never pumped, so knew no better. I was told to pump every 3 hours. So, I did, at 2am, 5am and 8am. The LC came in around 9:30 the next morning, and noticed that my nipples had most of the skin rubbed off. She measured me, and realized I'd been given flanges two sizes too small.
That was the first problem. The LC then gave me soothies:
They felt great, really they did. However, as my skin was already broken, when I took the soothies off, they pulled off more skin and any scabs that had started to form.
The LC and Neonatologist decided that we would try actual nursing at 24 hours old. When we did it that afternoon, G1 had a feeding tube in the center of her mouth. But, we still worked at it. G1 had to learn to nurse around a feeding tube. She did it though. Then (24 hours later) they moved it to the corner of her mouth, she retrained herself, and again, we made it through. 24 hours later, they moved it to her nose instead of her mouth. Finally we were without limitations, but she was so confused by that point, she had all but given up. But we still plowed through. She was in the NICU for 8 days, the 8th day was because she was losing weight and they wouldn't let her leave till she could sustain her weight without a feeding tube.
We made it home, but over that weekend, I dreaded feeding her. My nipples were so scabbed over, and the tissue was so damaged that it was flapping... yeah, flapping. I thought they looked infected, so I went to my OB. They gave me creams to help, but told me that the damage was so extreme that the only way for them to heal, would be for me to quit nursing and pumping for 2 whole weeks. By that time, my milk was gone. I pumped for 2 months to try to regenerate my supply, took fenugreek, mothers milk tea and lots of oatmeal. G1 would not latch at all. Eventually, I had to throw in the towel.
Oops... that story got much longer than I intended, but G2's is much shorter, I promise!
G2: Born at 38 weeks, 7lb 4oz. She lost quite a bit of weight and got some pretty severe jaundice by 2 weeks old, and was admitted to the hospital. It was a different hospital than the one where she and G1 were born. We worked with a new LC, and she was great. I was having pretty bad pain whether nursing or not, but was told that the latch was great and that it would get better after the initial few weeks. It didn't. I saw her again, and again, was told that the latch was great, just strong. I researched on my own, and thought I had thrush based on the pain symptoms. However, a nurse at my OB's office told me that if there were no visible signs, they couldn't treat it. I was in toe-curling, make me gag, pain the entire 6 months I nursed her. On top of that, at around 3 months, my supply started to drop drastically. I nursed till she refused to keep going, then I'd pump, but formula was still needed. I ate and drank all the 'right' things. No matter what I did, I'd waited too long and couldn't get it to go back up. At 6 months, we completely switched to formula.
Now, onto my (so far) success story!
G3: I was so determined to make nursing work this time... and at 6 months, my first goal has been met! I got much better prepared this time.
I ordered 2 forms of Fenugreek before she was even born:
I also ordered Mother's Milk Tea:
It still wasn't an easy start (I'm convinced it never is). Even in the hospital, she went over 12 hours and refused to nurse. Even if she would try, she refused to nurse on the left side. I was finally able to get her to latch on the left with a nipple shield. To avoid confusion, I used the shield on both sides... and guess what? She got it! She still got high jaundice, and we gave 2oz of formula once a day for 3 days, but she gained steadily. I always had The Hubs give her the bottle, so she never associated ME with anything more than 'food from the boob'.
At 3 days post delivery, my milk came in full force. No matter how much she nursed (which I pushed a LOT to help kick the jaundice), I couldn't get comfortable. I was started to get clogged ducts. I stood in a hot shower and massaged, and it didn't work. After 24 hours of pain, I caved and pumped, and pumped and pumped. I just needed to be empty.
After 2 weeks, my milk supply started to suffer on the left side. I have no idea why, but she was refusing to latch. So I pulled the shield off, and she nursed without it. She was stimulating it better and getting more without the shield. After a few days, she dropped the shield on the right side as well.
Now, I'm not going to let you think that it was just that easy. There were a few days of starting with the shield, then taking it off, or vice versa. I decided to just let her do what she was going to do and go with it instead of trying to 'train' her into doing it one way or another.
I was still having quite a bit of pain in the entire breast on both sides at 7 weeks. I went back to the LC, and discussed that it was the same horrible pain I'd had with G2. She suspected non-visible thrush, and told me to put monistat on my nipples. G3 wouldn't nurse, I guess it tasted funny. So, I turned to Dr. Google, and found many women who'd had success with Gentian Violet.
I ordered some from Walgreens and tried it immediately. I won't lie, the first (and only) day I put it on was horrible. The pain was at least double what it normally was. I vowed I wouldn't use it again. Yes, my nipples were dark purple, and yes, it turned G3's mouth purple, but that didn't bother me... the pain did.
However, the next day, the pain was back to normal, the next day, it was cut in half again. After 2-3 days, the pain was gone. I was amazed at how much more I enjoyed not only nursing my baby, but my baby! I enjoyed holding her, because it didn't hurt! That was a first for me out of 3 babies!
Once I got past the pain, I settled in determined to maintain a high supply. I think that I've always had a great supply in the beginning. I just didn't work hard enough to maintain it.
Here are my tips to maintaining a good milk supply:
1. Fluids... like, crazy fluids. This is my 52oz gas station mug. I drink a minimum of two of these a day. Water, flavored water, tea, lemonade, juice etc. Powerade is great for boosting supply.
2. Food. You have to eat! The amount of food I currently eat in a day is probably double what I'd normally eat, but if I don't, if I let myself get just the slightest big hungry, my supply dips. Eating warm, soft foods in beneficial, because your body doesn't need to put as much effort into digesting it. Your body can put all it's efforts into making milk!
3. Rest. And I know it can be hard... trust me. I have 3 kids, the oldest is 4. I have a part time job. I want to be good at both. I also want to breastfeed. I have to sit when I can. I have to sit when I really shouldn't! I have to go to bed with dishes in the sink, because I need to sleep! Making milk is an activity that your body has to do. It has to have the energy to do it. *I personally can't do much in the line of exercising if I want to maintain a supply. A 30 minute casual walk tanked my milk supply for 2 days with G2. This time, I'm just not doing anything to get into shape. I will, when I'm done nursing. I just have to be ok with that.
4. Fenugreek. I put a dropper or two in my coffee every morning (and it's true, caffeine in any form, including coffee, isn't great for milk production). I think of it as my 'instant boost'. I take 2 fenugreek pills 3 times a day, it's my 'continued support'. If I'm noticing a growth spurt in G3 and/or a dip in supply, I take 3 pills 3 times a day. If I have an oversupply one day, I don't take the pills that day.
5. Lactation Bars I really believe that these were my saving grace when I was really starting to feel like things might fail. We'd gone 2 weeks needing to give 2oz of formula every night when I finally made these. I ate quite a few that first day, but that night, no formula was needed.
6. Just Nurse. Now, I know that this doesn't always work. I was so frustrated when a friend of mine told me this with G1, when I couldn't even get G1 to attempt to latch. However, If your baby will nurse, then take time to just let them. Grab a few movies or a new series on Netflix, a huge supply of snacks and drinks, and spend hours, even a whole day, or days, curled up with baby. Couch, bed, recliner, wherever, just stay there. Get up to go to the bathroom and go right back to cuddling... and nursing, and cuddling... and nursing, and then do it some more.
Those are my tips. I've had some interesting experiences with nursing, but I can't be the only one. I KNOW I'm not actually, because no matter how 'natural' people will tell you it is, it's still something that you and your baby need to learn to do, like walking, and you need to learn to do it together, like running a 3-legged race!
*I'm not a Lactivist by any stretch. G1 only got breastmilk for 8 days and she is insanely smart and super healthy. Seriously, she's been sick about 3 times in her entire life. Loving and Feeding your baby are all that really count. Breastfeeding is something that I wanted to do, and for it to not work, well,... Challenge Accepted!!!
