Tyler never latched, apart from a first latch a nurse helped achieve immediately after his birth. The first night nurse brought him to the breast twice, waking him up from the initial newborn slumber, and insisting I try the lie-down position (the most difficult at first) and shoving him at the breast, where he just screamed. I don’t know if that’s where it started, but the next day he just slept the hours away and screamed at the breast. West Sub had just the day before fired their in-house lactation consultant and new-mom breastfeeding classes were canceled. Every nurse had a different position and advice. Tyler quickly became lethargic, jaundiced, and dehydrated, and landed in the ER with a high fever not 12 hours after we were released from the hospital.
A lactation consultant was brought in (he was admitted) and taught us how to revive him from lethargy and get him to eat. She ordered a hospital pump and supplies, and came up with a feeding schedule and a plan for how much formula and how much pumped colostrum he should take. I’m cutting out a great deal of detail and other difficulties brought on by the hospital (West Sub), and some high drama involving firing our first pediatrician, for brevity’s sake. This is Megan’s story, after all. Suffice it to say that we nursed Tyler back to health in a very expensive, uncomfortable, and unhelpful hospital room. Once back home, he drank lustily from a bottle and screamed at the breast, and it was possibly the most painful time of my life. Determined to give him the benefits of breastmilk, I pumped for seven and a half months. So, yeah, I was a little paranoid heading into this second birth!
Under our doula, Tanya’s, care, Megan’s first latch was a good one, right after birth. I had called ahead and spoken to a lactation consultant at Prentice and requested, per her advice, to see an LC on the first day in the hospital. We asked and we asked, but an LC did not come on that first day. Megan’s latch was poor, and painful, and when she cried I could see her tongue tie was tight. Taking matters into my own hands, I pumped colostrum and tried the breast-shaped bottle and a bottle with a nuk nipple, neither of which did she like much, tho she did take some. One of the nurses gave us some syringes for mouth feeding, and that was our best bet. We began to track her intake in a chart, much as we had learned to do for Tyler before. Trying to avoid the confusion of each nurse giving different advice and positions that had happened before, I insisted on trying to master just one position, the basic cradle hold, which was most comfortable. Our doula came back the next day and assisted, and supported me in this decision, which I really appreciated.
Right away that day, I could tell that Megan was sticking to the effort. I was impressed by how she kept trying and trying to latch, no matter how many times I asked her to try again, and tho she might cry she did not scream. When the LC thought she wasn’t getting enough, we supplemented with the formula I’d brought, and she took it without complaint. I figured Megan’s cooperativeness was a good sign that we could work this out.
The LC came on our last day, and she was like a friendly, if hurried, drill sargeant. She came in with a trolly of supplies and slapped on latex gloves and got to work, her pager going off constantly and barking commands and questions in rapid fire. Cradle and reverse cradle no longer worked, she said. I was already getting big with transitional milk, and I had trouble with the positioning of my hands, so she ordered the football hold. (Yes, ma’am!) She examined Megan’s tongue tie and tried her latch and sucking strength with a finger, and declared that she was capable. After many tries, I got the football hold down. She felt Megan wasn’t getting enough and that she’d have to make up for not getting enough the days before. How frustrating for us, when we’d prepared way ahead of time and I’d pumped and made sure to supplement the latches! Not to mention our repeated requests for LC help! In any case, she got us started on the SNS (supplemental nursing system), which is a bottle attached to your shoulder with a tube coming down that you tape to your breast or finger, along with a nipple shield, which is like a fake one you put over your own when yours are too flat, to help the baby draw it out and teach her the proper shape to draw it out to.
Let me tell you, this combination is a mess. The first week at home, I was red from hospital tape holding on the SNS tube, and the formula/breastmilk (after one initial bottle, it was all pumped milk) dripping out of the tube filling up the shield and causing it to lose suction and slip off to the side and the tube coming out from under it spilling all over, all the while I’m trying to position baby and my hands in the football hold with a pillow for support, and then trying to get her to open up enough and latch on to all this mess, which took repeated tries. I mean, this is chaos!!!
Our doula Tanya came when Megan would be hungry, at a moment’s notice phone call, and helped me with the mess. After dealing with the whole big mess and tiring Megan out, I’d feed Megan with the SNS on the finger to make sure she’d had enough, which was relaxing for her. After a while Tanya and I figured out that if she has a little bit by finger first, she would be calm and not panic-starving when trying the latch. Tanya taught me how to recognize what they call a “nutritive sucking pattern,” which is what you look/listen/watch for to know your baby is getting what she needs. We would have a great feeding session, then the next one would take a step back and not work again. One day I’d decide Meg and I needed a break, and we’d do all finger-feeding, and start again the next day afresh. I don’t have proof but I feel that really helped us. (Only did it twice.) Nighttimes, when she and I and Ben were half-asleep, were just finger feeding. (For finger feeding Ben was glad to participate, too.)
It helped having Tanya come over for feedings. It was just a support, as well as good instruction. I wish all new moms could have a doula or full LC for the first few weeks of their baby’s life. Otherwise I have been very internal with this process, unwilling to share much with others or have friends and family come over to watch me try. It was so painful last time, I wanted to be very private this time. One new friend, tho, asked me about it. Kristin, the mom of Tyler’s day-care best friend Luka, asked me how it was going. I gave her a headline, and it turns out she had the exact same problem! Her firstborn never latched, her second (he’s just 6 months older than Tyle) had the same problems as Megan and I! She also did the SNS and shield combo and the nighttime finger feeding. She said it took a month to work it out. I thought, wow, that’s a long time. I excitedly told Tanya about this, and she said to be prepared for it to take two months! Anyway, Kristin said, after the initial difficult period, she had a great nursing experience. I really took heart at that.
I don’t know what kept me going, but sheer determination. Kristin’s story gave me hope. Breastfeeding isn’t easy, and most everyone I know has had trouble, except my mom who was a natural. Cousins and friends all had difficulties with various outcomes, and one friend ended up pumping for all three of her kids! It’s not just enough to know that “breast is best”—it’s the doing that’s sometimes impossible. I used to get looks for giving Tyler a bottle in public, and I’d want to say “Hey! It’s breastmilk! Give me a break!” Now I’m worried about looks for nursing in public! Anyway, I wanted to get that end result that Kristin got, and a good year of happy nursing.
What really kept me going was Megan. Every time I asked her to try a new latch or a relatch, she would do it. She was a real trooper. I would feel really down, and I would announce to Ben that I was quitting. And he was a great support, even tho he was as anxious as I was to keep her healthy and hydrated. He would say he’d back me on any decision I might make, it was okay if I quit, he’d support me. But then when Megan was hungry again, I would just wordlessly put her to the breast again. And we kept on that way for a while.
Once my milk came in fully I did not need to tape the SNS to “the girls” and they were grateful, ha ha. Then the SNS was finger-feeding only. After awhile I got good at working with the shield, and carried it in my bra where my cleavage would keep it warm and it would be ready at a moment’s notice. Soon she was big enough to go back to the cradle hold, and I found it worked! I even nursed her, w/ the shield, for the first time in public, in the pediatrician’s office, I was so proud. I began to wonder if I’d have to use the shield all the time.
Then the law of diminishing returns set in. First, the SNS finger feeding wasn’t 1) big enough to deliver enough, or 2) fast enough to satisfy her. The pediatrician, Dr. Mercola, said she had outgrown it. Away it went. Next, the nipple shield. My first clue was that Megan began to get fussy during feedings. My next clue was that I was getting sore and red from its use. I opened my many trusty breastfeeding books and they all warned against long-term use of the shield. It restricts the nipple ultimately, and slows down the milk delivery making it inefficient. Whoops! So one day I tried without it, and while the latch hurt, Megan seemed much happier, and continued to thrive. So, away it went. We were officially back to basics. Megan was six weeks old. Six weeks, a month and a half, to do away with the accoutrements. Not bad!
After a week of latching and relatching, Megan stopped slipping off down to the tip, which really hurts, and seemed to have the hang of it. My greatest concern at that point was that more often than not she didn’t open her mouth wide enough to get more in and it would hurt. I kept on asking her to relatch, hoping that she would eventually grow big enough to fit better. I think now that she has. I began to practice other positions, mainly side-lying position, which is excellent for nighttime because you can doze while she eats at leisure and as sleepily as she likes. It’s lovely, and has saved my sleep-deprived sanity.
It was hard for awhile to tell whether I had pain because of her latch or whether we had a low grade yeast infection/thrush or even a type of mastitis. I perused my trusty books and found the symptoms overlap they are so similar. Eventually it cleared up, and they can clear up on their own if they are not serious. One weekend I spent helping a friend move and did not pump often enough, and I developed a low grade mastitis that spread from one side to the other. Again, back to the books for home treatment options. Luckily it cleared up on it’s own again with home treatments. They say if it doesn’t clear up w/in 24 hours you need antibiotics. Whatever the case, I was okay.
Recently, at about three months old, I was nursing her when I suddenly realized that it didn’t hurt! That mostly it doesn’t hurt usually. I sat there trying to remember when it last hurt. You see, it would hurt initially and then fade away and I’d be fine for the rest of a feeding. I’m sure it was latch related, that she was taking in more of the areola gradually. And let me tell you that idea of “toughening them up” is a myth. I began to think that I was one of the lucky ones who is naturally sensitive and no way around it. But at three months, I think we’re finally nursing happily. Yay!
Now if we could get her to take the bottle a little more readily while I’m at work, that would be a good thing. We had a great rhythm by the end of my leave, she and I, and our supply and demand was perfectly set up. Now I have a private room at work for pumping and I try to approximate the timing of her feedings while I’m away. It’s working out pretty well. Except that sometimes she just doesn’t want the bottle. So I worry about her. But she continues to grow fat and tall and to laugh and coo, roll around and grab her feet, and do what babies do. And you can’t ask for better than that.
caption: This photo, added to this entry months later, shows a thriving and healthy Megan enjoying a "meal." She's become an old hand at it! I feel so lucky, it's like a gift. Isn't she, and nursing too, just so beautiful?
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