Duo Ventures

Monday, August 8, 2016

The Nursing Chronicles Part 1: The First 2 Weeks

For over a year now, I've had some miscellaneous thoughts regarding my breastfeeding experience scattered in a single blog post that has sat as an unfinished draft.  However, with it being National Breastfeeding Awareness Month & World Breastfeeding Week, I felt like it was the perfect time to share my story & all the challenges we went through to get to where we are today.

Currently, Sami is almost 16 months old & we are still nursing about 3-4 times a day.  I always said I wanted to make it to a year, but somehow that year came & went and here we are still going strong.  I'm so thankful that it's like second nature for us now, but it was not an easy road in the beginning.

Being a new mom can be extremely lonely & isolating, and it's nice to know that you're not the only one going through those tough times.  I hope that by sharing my story I can give encouragement to other mamas out there who may be going through a rough patch.  It will get better!  I'm also hopeful that my story might inform & educate new moms on topics they should be aware of for their own sake - there were SO many things I didn't even know to look out for until it was too late.

So where to begin?  As I sat down & tried to recall all the different topics & stories I wanted to touch on, it became clear that I actually had a lot to say about the ups & downs of breastfeeding.  I decided to break up my post into a mini blog series instead.  Part 1 of this series will cover the first couple of weeks after Sami was born.  Who knew so much could happen in just 2 short weeks?  Here we go....

Shortly after Sami was born, I was wheeled out of the L&D room and into my own room.  Once we were settled in, I made my first attempt at getting Sami to latch...EPIC FAIL.  I was immediately dissapointed.  How could I have just endured hours of labor, yet not even be able to breastfeed my baby?  Part of the reason I opted for an unmediated birth was because many studies have shown that an epidural-free birth can help facilitate latching & breastfeeding.  So when it didn't come naturally & happen right away for us, I was confused to say the least.
I can't even tell you how awkward & uncomfortable it was.  There wasn't one singular reason it wasn't working out, but rather a combination of several factors.  Between my massive engorged boobs, mildy "flat" nipples (more on that later), Sami's tiny mouth, mountains of pillows, pregnancy induced carpal tunnel, & an un-diagnosed tongue & lip tie - we struggled BIG time.

After 45 minutes of excruciating nursing attempts, I finally relented and the nurse advised that I express the colostrum with my hand & feed it to Sami using my finger instead.  I couldn't believe that a few drops of this liquid gold would really be enough for him....but it was.  This is how I fed Sami for the first 6 hours of his life.  He was born around three in the morning, but I wasn't able to get him "latched" until about 9:30 AM.  Wouldn't you know it, by the time I finally did get him latched he fell asleep almost instantly.  We tried everything to keep him awake, but nothing seemed to work...so back to expressing & feeding with my finger.

Over the next day, I would try to get him latched & nurse him every couple of hours.  Some attempts would work, but he would inevitably fall asleep & stop sucking.  The other half of the time I could just not get him on & so we would have to revert back to hand expressing drops of colostrum.

The day after Sami was born I asked to meet with the hospital lactation consultant.  I explained to her that we were having a really difficult time latching.  After taking a quick look at my boobs, she started nodding her head & proceeded to inform me that I had mildly flat nipples.  Say what?!  What the hell are flat nipples?  They looked pretty normal to me.

That's when I learned about all the different types of nipple shapes & how they can impact breastfeeding.  With a "normal" nipple, the infant's sucking reflex is initiated as it touches the roof of their mouth.  However, there are many women who have short, flat, or even inverted nipples that may not be long or erect enough to help initiate that reflex which can ultimately contribute to latch issues.  Apparently mine weren't completely flat, but they where on the shorter side which explained part of the reason why we were having so much trouble.  Her only suggestion was that I could try pumping which may help to elongate them more.

She also gave me some advice on different nursing positions.  We tried the football hold, cross cradle, & the regular cradle hold - but nothing felt natural or comfortable.  We tried manipulating my boobs into every awkward position you could think of.  The problem was that they were so full and firm - not pliable at all...and trying to fit them in a miniature mouth was almost impossible.  My pregnancy induced carpal tunnel also made it very difficult to breastfeed because I had little to no strength in my wrists to support Sami's head & neck.  As a result, my wrists constantly felt fatigued & sore.  It was not a good combination.

By the end of our little consult, I still didn't feel very confident or comfortable about going home to nurse on my own, but I wanted out of that hospital so badly.  In the back of my mind, I knew Sami's first doctor visit/lactation consultation was only a day away, so I figured we could survive the next 24 hours on our own.

My milk started coming in about 36 hours after Sami was born.  Luckily, I didn't have too much pain, just a lot of pressure.  My main concern when we got home was if Sami was getting enough milk.  As a first time mom, you just have absolutely no idea what you are doing.  At least I didn't.  I had no "mother's intuition" or special gut feelings that told me we were doing alright.  I just worried the whole time.

We did the best we could, nursing every couple of hours through excruciating pain.  Everyone kept telling me that it was going to hurt for the next few weeks.  Before I knew it, I had cracked nipples & even started to bleed on one side.  I freaked out & called our pediatrician's office to make sure it was still safe for Sami to nurse.  They assured my that he would be fine & a little blood wouldn't hurt him.

At first, our nursing sessions would last anywhere from 10-20 minutes and gradually grew to last about 30-40 minutes.  We nursed about 10-12 times in a 24 hour period.  I chose to only nurse on one side per feeding & would pump the other side to build my freezer stockpile.  The other reason I chose to only nurse on one side per session was so Sami would be able to get a good balance of both foremilk & hindmilk (more on foremilk & hindmilk here).

Sami was born on a Sunday, and on that Wednesday we had our first checkup with Sami's pediatrician.  We also met with a lactation consultant the same day.  I explained to the LC that I was still having a very difficult time getting a latch, and when I did - the pain was severe.  She replied by saying that breastfeeding can hurt or be very uncomfortable for the first several weeks, but that I should never feel any "sharp" pain after 10 seconds into nursing.  Many people had told me something similar, but it hurt the entire time for me.

Before our appointment, I had been reading some online forums pertaining to breastfeeding pain & I had come across the topic of tongue ties.  When I brought this up to Nader, he told me that he actually had the same condition when he was a baby.  After he told me that, I definitely thought it was worth mentioning to the LC.  After peaking in Sami's mouth, she concluded that his frenulum was definitely tight, but that it might loosen up over time.

She also wanted to take a look at my nipple shape, as this can sometimes be a contributor to latch issues.  Just like the nurse from the hospital, the LC reaffirmed that I did have fairly flat nipples.  That's when she suggested that I might benefit from a nipple shield (you can read more info about nipple shields here).  Of course, I had never heard of such a thing, but she assured me that they can be very helpful for persistent latch problems.  The shield seemed humongous & almost comical at first.  Nader & I both laughed when we saw it (you know, because we are mature like that).

She showed me how to put the shield on & then decided to do a test weigh to ensure he was eating enough with the shield.  To do this, we simply got his pre-nursing & post-nursing weight to determine how much actual milk he was getting.  After about 25 minutes of nursing, Sami had transferred about 3 ounces, which she said was a good feeding for a 3 day old.

It still hurt to nurse with the shield on, but I would say it felt a little bit better than it normally did.  I felt a huge surge of relief knowing that he was getting enough milk & that I had a solution that could help us with our latch problem....that is until she started talking about how crucial it was that we NOT become dependent upon it.  She suggested using the shield for the first 2 minutes of nursing, but advised that I should try to remove it & get him to latch naturally for the rest of the feeding.

The LC also gave me some other suggestions that might help heal the cracks in my nipples.  First, she said to always let them dry out after nursing.  She recommended applying my own breast milk, ointments such as lanolin or Honest Co Balm, & even olive or coconut oil.  She also suggested hydrogel pads or regular breast pads (as long as I changed them frequently).

Once I got home, I still felt relief knowing we could utilize the nipple shield, but I also felt this enormous pressure not to use it too much.  While I did try to remove the shield mid feed, more often than not I just left it on for fear of trying to remove it & having to re-latch Sami.  I dreaded that process SO much.

It was honestly like a major production just to feed this little creature.  I had mountains of pillows & nursing pillows surrounding me, always trying to find the perfect comfortable set-up.  Let's face it, if I was going to sit in the same position, unable to move for 30+ minutes - I wanted to be comfortable.  Once I was finally in a semi-cozy position, I had to get the nipple shield on (which was a hassle in and of itself most of the time).  Then I had to have someone hand Sami to me & try to get him latched without knocking off the nipple shield.  It. Was. A. Process.

This is how we rolled for the next week - it did not feel natural or easy, but we made it work.  He always had plenty of wet & poo diapers, which is always a good indicator of milk consumption.  The pain never got better, but I assumed that it would be awhile before it felt "normal".

Some people may wonder why I didn't just pump & feed him bottles.  The truth is that I was scared of "nipple confusion" & was so worried that he wouldn't be able to breastfeed normally after bottle feeding.  I figured that he was already having so many latch problems as it was & I didn't want to confuse him even more.  Had he not been getting enough milk from breastfeeding, then I would have switched over to pumping, but he happened to be getting plenty.

The following week, we went to see the pediatrician for Sami's 2 week checkup.  His doctor asked me how breastfeeding was going & I informed her about our situation.  Although I had already inquired about the tongue tie with the LC, I decided to ask our pediatrician about it too.  After taking a look in Sami's mouth, I remember her saying something about a "frenulectomy", but she never once suggested that this was a procedure that we should consider.  I was told again that nursing will be painful at first, especially since I had deep cracks.

One of the last things she said to me before we left was, "Just be careful that you're nursing or pumping enough throughout the day, you don't want to get a clogged duct...or even worse - mastitis.  Mastitis is just nasty!".  I remember thinking to myself, "Oh ok...I have no idea what that is, but I'm pretty sure I don't need to worry about that."

Oh the irony.  Less than 2 hours later, I started noticing a hard, red, warm, & painful spot on my left breast.  Within an hour, I also started feeling an achy soreness creeping into my lower back.  By that evening, I felt like I was dying.  After a Google search, I realized that I most likely had this horrible condition our pediatrician had mentioned earlier in the day.  Seriously, like what are the chances?!

I've heard other women describe mastitis as a flu on steroids & I would say that's pretty accurate.  For me, EVERY part of my body ached, it hurt to move, and it even hurt to touch my skin.  I was already exhausted from being a new mom, but the mastitis just took me over the edge.  It took everything in my being to get up out of bed to go to the bathroom or nurse Sami.  Unfortunately, I had not managed to successfully nurse while lying down, so that was not an option for me either.  I tried everything to help remedy the clogged duct - hot showers, warm compresses, massaging, nursing/pumping...but nothing seemed to help it at that point.

That evening, I had the worst night ever - fever, chills, & aches like you wouldn't believe.  By the next morning I knew that I had to call my OB & get treated.  The redness on my breast was also starting to spread & streak outward.  I called their office & told the nurse that I was 99.9% sure I had developed mastitis from a clogged duct.  After I described my symptoms, she agreed that it sounded like mastitis, but that they wouldn't be able to prescribe me any antibiotics without seeing my OB first.  I begged her to just call in the Rx at my pharmacy, but she said I had to see the doctor.  At the time, I thought they were so evil for not accommodating my wishes...as the thought of having to physically get myself and Sami ready, get him loaded in the car, & drive to the hospital felt like an enormous task.  Thank god I had my mom there to help me.

Once we were at the doctor's office, my OB took one look at me & confirmed my suspicions that I had mastitis.  She posited that I had either developed an infection from the clogged duct or possibly even contracted an infection as a result of my cracked nipples.  She gave me an Rx for antibiotics and told me to to limit my sugar intake, eat lots of yogurt, & take a probiotic.

You guys probably already know that, while antibiotics kill off any bad bacteria in your body, they also knock out all the good bacteria as well.  Without an abundance of good bacteria, fungus like yeast can start to multiply more rapidly.  Eating yogurt & taking a probiotic can help reduce the risk of a yeast infection.  Unfortunately, I didn't really follow doctors orders in regards to the yogurt or the probiotic.  Even so, I felt MUCH better within a day or so.

A few days later, I started noticing little white spots on the inside of Sami's mouth - mostly on the inside of his cheeks & under his lips.  Back to Google I went, and found that they were either milk stains or yeast overgrowth.  As it turned out, they didn't go away when I tried to rub them off, which meant Sami most likely had oral thrush.  In addition to that awesomeness, I started noticing the tell tale signs of a vaginal yeast infection.  UGH.  We just couldn't catch a break...

I'm going wrap up Part 1 on that note - you're welcome  ;)

I'll be picking up the story at Sami's 1 month check-up & fill you in on what happened with the thrush situation in Part 2...

Thanks for reading & if you have ANY questions, please let me know!


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