Breastfeeding: Part Two
Continued from Part One - breastfeeding hurts, and maybe I have Reynaud’s.
I didn’t have maternity leave - I only had about two weeks fully off from work, at which point I returned part time, and ramped up to full time by five weeks (mid november). So Eliza and I only got to try nursing in the evenings, between 5:00pm and 9:00pm - which was also the time of day when she was crankiest. At the time, I thought it was possible she had some nipple confusion, but in retrospect, I think it was more the time of day and her mood. We were both pretty clumsy with the positioning - I had a boppy pillow but didn’t find it very helpful. I’d usually get Kevin’s help getting her into position, stuffing pillows and blankets everywhere, holding her arms down. She would inevitably get angry and start to holler, and then I’d get upset and have to hand her off to Kevin. Milk would get everywhere. This would all take at least half an hour, longer if we were remotely successful, and by the end, I’d need a shower and a change of clothes (and a hard drink). And then I’d need to pump.
I went back to the LC several times to work on positioning and latching, the latter of which is still impeded by Eliza’s tiny tiny mouth. The pain is very intense still, radiating back from the nipple, and it didn’t go away completely when I wasn’t nursing or pumping. It didn’t get better over time, despite the medicine (nifedipine for Reynaud’s, and an anti-fungal for thrush). The LC is more and more convinced the problem is Reynaud’s, because my nipples never stop being purple even when I don’t nurse for days. She was totally geeking out over my boobs - calling in her LC friends to look at them, and even taking a picture to show some folks in Seattle (with my consent, of course).
After a few weeks with no improvement, when Eliza was about six weeks old, my doctor upped my dosage of nifedipine, the vasodilator. The pharmacy screwed up the prescription, so that instead of doubling the dose, I was suddenly taking SIX TIMES the dose. For two days until I figured that out, I could barely stand up without passing out, and had a raging headache, but I could nurse 90% pain free. So I was finally convinced the main problem is Reynaud’s.
I was relieved to know what is wrong, but still not sure what to do - I couldn’t keep taking that dosage of medicine, and even when I did, I had to nurse Eliza literally every hour because she couldn’t get enough milk to stay full longer than that. Also, to even try nursing exclusively while I was at home, I had to break my regular pumping schedule. This was a huge mental leap, as I was so terrified of what would happen to my already inadequate supply. So basically, I was ready to throw in the towel, and that was what made me able to nurse her even somewhat effectively - so that she was hungry at the same time my breasts were full. In order to let myself try, I did a lot of data analysis… we have this phone app, baby connect, where we had been keeping track of everything - diaper changes, bottles and amounts, and I had been using it to time my pumping sessions (and record the volumes). So I analyzed my pumping. The effects of duration of and interval between sessions on the volume. And I found that they had little effect - I basically always produced half a mL per minute of breastmilk, about 700 mL per day, whether I pumped ten times or six, it was about the same.
Once I cut back to the correct dose of medicine, the pain came back - varying between a 2 and a 6 on the pain scale during nursing or pumping, which was a huge improvement …. but still pretty bad, considering what percentage of my day I spent feeling like that (two to three hours a day actually pumping, and another hour or so washing pump parts, getting set up, etc.). I’d also get clogged ducts every few days, which would ramp the pain back up. I spent every day vacillating wildly between wanting to stop, hating it, and thinking I could manage to keep doing it for a long time, another week, another month, maybe this is going to work out just fine.
Around this time, when Eliza was six to seven weeks old, a number of things happened. First, Eliza starting sleeping in longer chunks - first four hours, then five, then one night - nine. I still woke up every three hours, whether by an alarm or from engorgement. Resentment was building towards my husband, who was getting to sleep as long as the baby, and towards the baby, for… sleeping? for having a tiny mouth? I don’t know. But it reached some boiling point and I decided I didn’t care - I wasn’t setting an alarm any more, and I would cut back to pumping less. So I started getting more sleep, and was pumping four to six times a day, with only maybe a 10% decrease in my supply. Also in this time period, I realized the baby was far better at unclogging my ducts than the pump was, even though the pump was better at fully draining my breasts. Then, the headaches I’d had as a side effect of the nifedipine started getting less severe. Finally, I had been downloading books to read on my kindle app on my iPhone, and found that I could ignore the pain much better, and actually almost looked forward to pumping, if I were in the middle of a good book. So that’s: sleeping baby, sleeping Susie, hoover baby, improved headaches, and good books.
That winning combination, along with Eliza’s increasingly large mouth, has seen me through a slow decrease in pain over the last two months. At some point I stopped taking the nifedipine - I kept forgetting doses, and then didn’t take it on a trip. That basically brings us to now, which I’ll write about in a final installment.
Breastfeeding: the first two weeks
I’ve decided to write up my thoughts on breastfeeding, so that I might be able to remember what happened and know what to expect if I end up trying it again with future babies. So here we go, in several installments.
My daughter, Eliza, was born in October. Prior to her birth, I was much, MUCH more worried about breastfeeding than I was about labor, or really anything birth/child related - I have had non-cyclic breast pain as far back as I can remember, not bad, but bad enough: my boobs have always been off limits in intimate situations, I never ever stand facing a shower. Exercising has always been a tricky business - how many sports bras can I wear at once without making it impossible to breathe? (Answer: two, sometimes three.). I own probably 20 sports bras in a variety of colors because I wear them almost exclusively, to minimize movement and friction. So, going in, I am terrified, and have been voraciously consuming breastfeeding information on the web. And frankly I thought the majority of it was crap guess work (relevant: I’m a research scientist, and very little of the breastfeeding info out there is remotely evidence based).
In the hospital shortly after she was born, I latch Eliza on and commence squirming in pain, but I expected it to hurt, so I just deal with it. There is blood, there is crying (me and Eliza), I can’t really hear the baby swallow, but I know she does because later she pukes up blood. BLOOD from my BOOBS. I keep trying for the first 24 hours. The lactation consultant is called in on her day off, takes one look at my nipples, and tells me to not even try for four days because they are so purple and unhappy. We start giving Eliza formula when she is hungry, and I commence worrying about nipple confusion and the fact that if we were nursing, she’d only be getting a few milliliters at a time, versus the two ounce portions she is now wolfing down. The LC helps me get started with my pump, which hurts just as badly as the baby - I remember yelping in pain when I turned it on the first time, at the lowest setting. I pump every three hours, getting only a single milliliter or two of colostrum. I remember feeling proud and excited when I realized I could use a 1cc syringe to feed it to the baby - antibodies! My milk finally came in on day 5 - I figured that out after my mom accidentally elbowed me in the breast and my my milk let down hard and painfully.
Five days later at my post-partum check up, I meet with the LC again. She said the baby’s mouth is too small, and informed me that I have enormous nipples (who knew?). She said it could be six weeks before the baby will be able to latch well. She said I should try to nurse the baby once a day if I can stand it, and pump 8 - 10 times per day to keep my supply up. She was surprised that the bruising hadn’t abated more - my nipples are still aggressively purple. I wonder if they weren’t always that color, as I hadn’t paid a lot of attention to them before. My breasts hurt all the time - though much worse when I was pumping or trying to nurse. I’d say it was about a 1 - 3 on the pain scale most of the time, 3 - 5 during let downs (which happen every hour and half or so), and 6 - 8 when pumping or nursing.
At the beginning of week two, I went back to the LC. She remained surprised about the bruising and the pain that wasn’t getting better. It’s a deep, radiating pain. She mentioned thrush, and I mentioned Reynaud’s disease, which is a vasospastic disorder that has previously affected my fingers. Basically, when I am cold, the circulation to my fingers occaisionally shuts off. My fingers blanch white and go numb - like a limb that falls asleep - and when they warm up, I get some pins and needles, but it doesn’t hurt. I had read that this can happen to nipples and breast tissue, and though I have trouble associating the painless phenomenon I have observed in my fingers with the incredibly painful issues I was having with my breasts, I felt it worth mentioning. As soon as I said it, the LC’s eyes lit up. She was convinced that is the problem, and sent me immediately to my doctor for a prescription for a vasodilator, nifedipine. He also put me on an aggressive two week course of anti-fungals for possible thrush, as the two issues have overlapping symptoms (deep, radiating, intense pain). I also started taking fenugreek and blessed thistle to attempt to increase my supply, as well as doing power pumping sessions in the evenings - 10 minutes on and 10 minutes off for an hour, instead of the normal 15 minute sessions I did the rest of the day.
I did not get any immediate relief from the nifedipine, but I did get a wicked headache as a side effect. I continued to pump every three hours, and attempted to nurse the baby once a day for fear of her developing nipple confusion. She seemed thankfully content to suck on anything near her mouth hole. I reeked of maple syrup from the supplements. I randomly burst into tears at least once every day.
I was determined not to let breastfeeding make me crazy - early on I read the whole “step one, feed the baby. step two, enjoy feeding the baby.” credo and at least the first step stuck with me. Eliza got about 25% formula and 75% expressed breast milk from the day my milk came in. I remember wanting to delete all the photos where you could see her drinking formula, or out of a bottle, in the first few days because I felt judged (by WHOM??). I was very glad that my husband could (and would) help feed the baby - I would pump every three hours, and he would feed the baby on approximately the same schedule (determined by her). I was so glad that he could do it, enjoyed it, but I was also PISSED because he got to hang out and bond with the cute little baby, and I got to hook my tits up to a machine that HURT. Even after the initial trauma to my nipples healed, it hurt. It hurt so much that I would cry the entire time I pumped, and eventually I would start crying before I pumped because I knew how much it was going to hurt, every three hours, every day. I thought about stopping constantly, how much longer could I handle this, but I wanted very much to make it work. If it had been a matter of flipping a switch, if there were an off button instead of the necessity of ramping down the milk production, I would have stopped. But I really wanted the bonding experience I’d heard so much about, I wanted the immune system boost for my daughter. I was worried about the impact on her future - obesity risks, intelligence, things I knew were absurd except at the population level.
More than any of that, though, I wanted simply not to fail.
Eliza at Three Months
Oh y’all, she is just the best. This month has been filled with more smiles by the day. Eliza gets so busy smiling and sticking her tongue out that she forgets to sleep. She is looking around at everything, no longer content to stare back at us when we hold her on our laps. She is so strong - she will stand up on your lap if you hold her hands, do squats, up and down and wiggle. We busted out the bouncy swing this month, and now sometimes when she is fussy, it’s because she wants to be upright, bouncing, standing. She also sits in her knock off bumbo chair while we eat dinner, just watching us and looking around. She’s babbling up a storm, coos and goos and sometimes multi-syllabic nonsense. She is still sleeping great, occasionally waking at night but usually sleeping from 9 pm to 7 am or later. She wakes up just like Kevin - slowly, lots of stretching, resisting the day, making adorable squished up faces against the light. But as soon as her eyes open and she sees us, it’s all smiles. And she smiles with her whole body - it starts on her face, big round cheeks and lit up eyes, and then wiggles all the way down to her kicky feet. Kills me, every time.
She is reaching for toys, holding on to things - when we put Sophie the Giraffe (favored toy of babies everywhere), you can see her concentrating intensely on grabbing her, and the surprise when she gets Sophie and elicits a squeak is pretty awesome. She loves other people and especially other babies - she grins ear to ear when we are with Lucy (8 months) or Paige (~2 yrs), but didn’t know what to make of Vaughn (1 week). She is also just starting to blow raspberries, and it is CUTE.
Eliza slept through Christmas, but has been enjoying her gifts - Sophie, books, toys, and some adorable clothes. Other exciting highlights were the trip to L.A. for a frisbee tournament last weekend. Eliza did great on the trip - barely any fussing on the plane, she mostly slept and smiled through the flight. Once we arrived at our friends’ house, she was so excited she wouldn’t sleep at all. No naps during the afternoon, and she was up every hour the first night we were there, either grinning or fussing from being over tired, or both. The next day at the beach, she conked out a good bit and was much more laid back (and sleepy!) for the rest of the trip. We were able to spend all day Saturday and Sunday at the beach playing frisbee, taking turns holding her, and go out to dinner both nights. We didn’t end the weekend very well rested, but we had a blast and were really impressed with how flexible E was about the weekend. Hopefully she stays flexible, because we have lots of fun and traveling coming up this year!
Stats at 3 months (on our home scale, with our own measuring tape):
Weight: 12.6 lbs (57%)
Length: yeah nevermind.
Head Circumference: wait for the doc next month, y’all.
Yearly wrap up, 2011
1. What did you do in 2011 that you’d never done before?
Pregnancy, baby, parenthood. Went to an all-inclusive resort (Mexico, January 2011). Planned and hosted a baby shower. Had kidney stones (ouchie!). Used real power tools to build out a closet. Went on an overnight rafting/camping trip. Ran my first 5k since high school.
2. Did you keep your new year’s resolutions, and will you make more for next year?
Last year’s: some yes, some no. The monthly food resolutions went off the rails almost immediately when I got pregnant, as I had to eat whatever sounded good at that precise moment, or risk irritating and long-lived bouts of unproductive nausea. The “self-improvement” resolutions went ok for about half the year - particularly fun were no-iphone-in-social-situations month and recycled bag month. I also read a fair number of the books I set out to, and cooked many new recipes, and went on many adventures, although I’d guess that none of these were as evenly spaced as intended (nor as well documented). Thus, since the point, generally, was about intention and attention, I would give myself a C overall (with recognition of a solid excuse).
This year: yep! I love resolutions. I am not sure what all I’m going to do, yet, but I’m sticking with the monthly themes as I think they are much more approachable and attainable. For January, I’m doing no candy for my food resolution, and 2+ chores per day for self-improvement. I’ll also be doing a monthly book, recipe, and adventure. Kevin is going to play along a bit, I think - he’s doing meal planning and exercise this month.
3. Did anyone close to you give birth?
Me! And the Cramers! It was a big baby year over here in WA, and that will continue in 2012 with at least three more babies in the first three months.
4. Did anyone close to you die?
No, thank goodness, again.
5. What countries did you visit?
Mexico in January, and now my passport is expired, so I can only go to Canada unless I deal with it. And considering how terrible I am about such things, I’m betting 2012 will be slow, travel wise.
U.S. places I visited were: Baltimore and D.C (March, SOT and friend-visiting), Versailles OH (June, Pdays!), Atlanta/Savannah/Amicalola (August, family visits and a wedding!). I feel as though I might be forgetting some others…
6. What would you like to have in 2012 that you lacked in 2011?
Job security, again, though that likely won’t be confirmed until 2013 at least.
7. What dates from 2011 will remain etched upon your memory, and why?
October 14th, Eliza’s birthday, because a human came out of my brewster.
8. What was your biggest achievement of the year?
Utterly cliched, but delivery of the baby. That was hard, and one of the coolest things I’ve ever done for sure.
9. What was your biggest failure?
Getting an epidural! Just kidding, that was a good decision. Hmm… giving in to my irrational brain on subjects relating to pregnancy. Such as being too scared to play frisbee while I still could. That’s not much of a failure though, so instead let’s say: not exercising adequately while pregnant (or since…).
10. Did you suffer illness or injury?
I haven’t had any significant communicable illness since fall of 2010, which is AWESOME and also a bit like waiting for the other shoe to drop. I did have some exciting medical adventures, such as kidney stones! And a baby! And that whole Raynaud’s thing I got diagnosed with in 2010 came back to bite me in the
ass boobs as it has made breastfeeding excruciatingly painful. Hooray!
11. What was the best thing you bought?
12. Where did most of your money go?
Mortgage/car, food, AMAZON. Amazon Mom is evil and wonderful (free Prime). Childcare in the last two months has also been a new money drain, hoo boy.
13. What did you get really excited about?
Eliza. Watching Keivn play with Eliza. My parents coming to visit when Eliza was born. Seeing all my buddies in June for Pdays.
14. What song will always remind you of 2011?
This is terrible, but You’s a Ho (Ludacris), because we replace all the Hos with Bear. There are a lot of songs we do this to, but this is my favorite.
15. Compared to this time last year, are you:
– happier or sadder? Happier, though a year ago was pretty solid as well.
– thinner or fatter? Interestingly, I am thinner. Well, I weigh less. My hips are still a fair amount wider than before.
– richer or poorer? Richer, as we both got raises and promotions, but poorer, as we now have an expensive little bear.
16. What do you wish you’d done more of?
Always more adventures. More sleeping, for the last half of the year. More frisbee, for the first half.
17. What do you wish you’d done less of?
TV. Procrastinating. Worrying.
18. How did you spend Christmas?
With my little family! With a hilarious multi-family video chat on Google+, and dinner at the Cramers’ (complete with Carolyn’s extended family). Then, the week after, I worked my butt off, so frankly it wasn’t the most relaxing holiday season. The day itself, though, was fantastic. Best present: dinosaur marionette from the Crowells.
19. What was your favorite TV program?
I think it was Terra Nova, even though it’s really not very good. The New Girl is also a new favorite. I have basically ditched Glee.
20. What were your favorite books of the year?
I read two books by Zadie Smith that were really fantastic and made me think - White Teeth, and On Beauty. Caitlin Moran’s How to be a Woman was hilarious. I can’t remember what all else I read - I’d like to do better at keeping track.
21. What was your favorite music from this year?
Mumford and Sons, Avett Brothers, poppy crap on the radio, my Baroque pandora station.
22. What were your favorite films of the year?
“Films,” hah. Um, Friends with Benefits was hilarious. Blue Valentine was really good but terribly depressing (sidebar: me and Carolyn ditched work to go see it, on the day I found out I was pregnant).
23. What did you do on your birthday, and how old were you?
I turned 27. I remember we were going to go camping on the coast but instead we played in a frisbee tournament in Wenatchee - the last time I got to play before I was deemed too pregnant by my peers. It was great, as I didn’t anticipate getting to play. Also, our old roommate Kelly threw me a low country boil at our house, which was really fun and tasty.
24. What one thing would have made your year immeasurably more satisfying?
Having a magical part time/full pay job. Or at least having had more leave to spend with little bear. Also - breastfeeding not sucking so much.
25. How would you describe your personal fashion concept in 2011?
Jeans and girly shirts. Spandex for most of the year. Since Eliza arrived - jeans, sweater, long underwear (it hurts when I’m cold! And I lost my personal heater!)
26. What kept you sane?
Kevin, Rebecca, Carolyn.
27. Tell us a valuable life lesson you learned in 2011.
One I learned many years ago - it’s gonna be fine, so quit worrying about it.
Eliza at two months
Eliza is such an easy baby. She started sleeping in longer stretches this month, and the last two weeks, she’s barely ever waking to eat at night. She stays up with Kevin until somewhere between 10:00 and 12:00, and then sleeps until sometime between 5:00 and 8:00. Definitely lucky so far, though we hear it could change at any time! She still likes to be carried around a bit in the evenings, but isn’t that fussy. Just this week she has managed to get a hand or whole arm out of her swaddle by the time she awakens in the morning.
Eliza has started smiling, and it’s predictably adorable. Kevin and I spend a lot of time making fools of ourselves trying to elicit a gummy grin. She seems like she will starting giggling pretty soon, too.
I procrastinated about getting the next size of prefolds for her diapers, so she retaliated by peeing on us a couple of times. While that might sound unpleasant enough to drive us away from cloth, using disposables while we waited for the new diapers to arrive reminded us both we like the cloth better. It helps that they are super cute, too. Looks like we are going with prefolds and covers over the pocket diapers, at least for now.
Eliza loves bath time and getting her diaper changed. I hung some kitty cat decorations over the changing table and she stares and smiles at them while we change her. Sometimes if she is cranky I will change her just because I know it will make her happy for a few minutes. She also loves to stare at the picture wall and the bookshelf over the couches in the living room. We say she is looking at the DVDs and the pictures of us.
Eliza rolled over several times one day, but hasn’t done it again since then. She is reaching for toys and cooing up a storm - basically right on target for all her developmental milestones. She’s getting more interactive by the day, and we are having a great time!
Stats from the two month check up on 11/15/11:
Weight: 11 lbs 1 oz (57%)
Length: 23.5” (84%)
Head Circumference: 15.5” (65%)
Appreciation of Needles: Low to Screamy.