Tuesday, December 13, 2011

Boob Juice: the situation so far

One of the reasons I haven't finished the birth story is that my hands have been full, in a very real sense, with feeding this baby. With the exception of three days, my 8-week-old son has been fed only breast milk, and he's thriving: he's over 12 pounds now, and is big and strong (95th percentile for length! And he can already roll over! And... I'll stop. But I'm very proud of him). After the first five days of his life, my milk supply has kept up with his demand pretty well; the "girls" are producing plenty to keep him fed.

Easy peasy, then, right?

Not exactly.

About two weeks ago, as I was struggling through yet another excruciatingly painful nursing session, I was composing a blog post in my head entitled, "Breastfeeding is An Enormous Pain in the Ass". I felt duped, and I felt like there was no getting out of the hell I'd gotten myself in to: my child was thriving on my plentiful milk, but I was crying at the end of (and sometimes the start of) each nursing session. This was clearly great for him and awful for me. Everyone had told me that the first two to three weeks would be difficult, but things shifted from challenging (i.e., figuring out the mechanics of nursing a new baby) to painful after those three weeks. I kept thinking I needed to tough it out, or maybe I was just more tender because I had a big, strong baby who liked to eat in gulps, or maybe I was doing something wrong... it all boiled down to something being flawed with me, or with my approach. I just had to figure out what it was.

Thanksgiving week was when it finally hit the fan; when I was sobbing in bed while my son was contentedly nursing. I was sobbing for two reasons:

A) The unending, burning, stabbing pain while my son nursed, and

B) The need to stock up on milk so I could go shopping with my mother that Saturday.

Item B is probably the topic for a separate post about difficulties with my family and their growing tendency to ignore my needs, but it did mean that I was pumping milk after each nursing session, trying to glean enough extra so I could spend precious hours away from my month-old son, shlepping around in a crowded shopping mall during Black Friday weekend. This was creating additional stress for me, which wasn't helped by item A: pain.

DH made the suggestion, while I was weeping, that I just start pumping until I could figure out what was going on. We had both given up on what we thought were La Leche League lies ("breastfeeding should never hurt!"), but he offered that perhaps it shouldn't actually hurt this much. And pumping was less painful.

The Sunday after Turkey Day I began exclusively pumping, and our baby started getting all his milk from bottles. (Side note: He is so easygoing. As long as there's milk, he doesn't care where it's coming from. I love this kid.) While I pumped, I Googled things like "agonizing pain while breastfeeding". And I learned a few things:

First, I learned that, while "breastfeeding should never hurt", it often does, especially in the early weeks. I found a message board of women describing the pain when their babies initially latch on as being equal to or worse than labor pains - and I nodded in agreement. And while I was told to expect "discomfort" for 2-3 weeks, several of these women said it took two to three MONTHS before that latch-on pain dissipated.

And by "latch-on pain", I mean take-your-breath-away, toe-curling, 9 on a scale of 1 to 10 pain.

Second, I learned that, though it can (and often does) hurt to start with, what should never happen while breastfeeding is a burning feeling, like the intense burn I would have for about 30 minutes after each feeding. That's a sign of a problem. Other chest-area problem signs I had: urgent itching during a nursing session, occasional shooting pains at any time, and, yes, pain intense enough that I cried while feeding my son.

Dr. Google told me I might have thrush, which hadn't occurred to me. OK, it had, but I kept checking my baby's mouth and he had none of the fuzzy white spots I knew to look for, and he never acted irritated when he nursed. If he didn't have thrush, how could I have it?

That Monday, I relayed my concerns to our pediatrician at the kiddo's one-month appointment. The doctor checked him carefully and told me she saw no signs of thrush in him, but it was possible - especially if I'd been given antibiotics and he hadn't - that I had thrush but hadn't transmitted it to the baby. She suggested I use Lotrimin (yes, the athlete's foot medicine) 3 or 4 times a day and see if that helped.

She also did what all the health professionals do, and complimented me on my milk supply. Thanks, but I would enjoy being able to give the milk to my child without the delivery of said liquid being such an issue.

After a couple of days of only pumping and using Lotrimin, I didn't feel like things had improved markedly - I was crying less, but only because I wasn't nursing. And I was sad about not nursing.

Also, all the dealing with bottles and the pump actually created a lot of friction between me and DH: when I exclusively nursed, I just took charge of the kid for an hour at a time, no fuss, no muss. I was forced to put my feet up and DH had some time to do what he wanted. With the exclusive bottle feeding, DH would feed him while I pumped, or else I would feed and burp the baby and then hand him over to DH so I could then pump... and then one of us would have to wash all the pump parts and bottle apparatus every day or so. It was a huge hassle, and felt like way more work for both of us.

So on that Wednesday I did what I should have done probably two weeks earlier: I called the midwife's office. The triage nurse who talked with me was awesome - she immediately made it clear that I shouldn't be in this kind of pain, and she made me feel, for the first time in a long time, that I wasn't inherently flawed or doing anything wrong. After a couple of conversations with her, I had a prescription waiting for me at a local pharmacy: two doses of Diflucan and a tub of All-Purpose Nipple Ointment. I'd heard of APNO several times, and it kind of sounded like a wonder treatment. Diflucan was referred to in a lot of the search results I found when I Googled around about thrush.

The nurse also told me that as soon as things stopped hurting terribly, I should get back to nursing the kiddo - there wasn't a big concern about giving him the thrush.

So a third thing I learned is something plenty of people have told me: ASK FOR HELP. If something hurts? Ask for help. If you feel like something's just not right? Ask for help! If you're crying while you're feeding your kid? Ask. For. Help. Or clarification, at least. I got really invested in toughing it out when what I needed was a prescription.

And a fourth thing: if you're sore (and if you're nursing, you will be, especially if you give birth to a mini-Hoover like my son), use these Soft Shells. They were recommended to me by a new-mom friend of mine and they work beautifully. Between these and my prescription ointment I started healing noticeably in a couple of days.

We're up to the point now that I'm nursing the kiddo about half-time, and the other half of his feedings he's getting bottles of pumped milk. In the last couple of days, I've had several nursing sessions when latch-on pain was minimal, and the rest of the feeding was essentially pain-free. It's amazing, and I think I can see where this is going: I'm back to hoping I'll be able to breastfeed this kid for a solid year, whereas a few weeks ago 12 months sounded like a lifetime of pain and suffering.

When it doesn't hurt, I have to say that nursing a baby is pretty awesome, in the true sense of the word. I gestated this baby, and now I'm still sustaining him with my body. I love the snuggle time that is guaranteed during a nursing session, and generally extends for a while afterward when I'm burping him and he dozes off on my chest, content with a full tummy. Nursing can certainly feel like the best kind of tender loving care a mother can give to her child.

But while I already stated for the record that I would be completely fine with some formula supplementation - which is exactly what we ended up doing in the first few days of his life, when he had jaundice, my milk hadn't yet come in, and he needed to poop out that bilirubin - I will now say, after two months, that I certainly don't blame women who don't stick with breastfeeding. If I hadn't had two solid months off work and a spouse who was home with me full-time and a health care professional who was extremely supportive, I don't think I could have weathered the learning curve. Of course now I know I had some issues that were unaddressed for too long (ASK! FOR! HELP!), so my case was probably not typical.

So, yes, so far we're exclusively breastfeeding, and as we come to the 2-month point I anticipate that will continue to be the case. But just because it's "natural" does NOT mean it's easy, not in the first two months, at least. I'm becoming convinced that anyone who says it is must be trying to sell you something.

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