My adventures in pregnancy, motherhood and beyond

Please enjoy the musings and updates and leave me a comment if you'd like!

Tuesday, January 22, 2013


[Disclaimer: Nipples and boobs are discussed. Kinda par for the course with breastfeeding]

There's been a huge push toward breastfeeding lately. It's with good reason--the health benefits of breast milk are innumerable and far-reaching and it's definitely the best thing for your baby. However, the pressure exerted on a woman to breastfeed is, in my opinion, completely unfair. Even though I had always planned to breastfeed, I still felt pressured about it and with the problems I've encountered, this pressure has made me feel that I must justify and explain myself to other mothers, health care professionals, etc why I am not nursing. Anyways, here is my breastfeeding story. I hope it might help other women who may have gone through the same thing.

They put Grayson to the breast about 20 minutes after he was born. I continued to nurse him while we were in the hospital, but it wasn't easy and G would often get very frustrated. I felt like he wasn't getting anything. The lactation consultant came in and taught me how to use a nipple shield and recommended I pump after nursing him since I apparently had flat nipples. We would use a syringe to suck up what I pumped and give it to him after he nursed the next time. The day we went home, my insurance and the company they contracted out with finally came through and my very own pump was delivered.

We returned to the Mother Baby Assessment Unit four days after G was born, and he had lost nearly a pound. While it's common for newborns to lose some weight in the first few days, they were concerned and sent us to the pediatrician for the next available appointment (Monday). They also watched me nurse him and it was determined that he wasn't getting much of anything when he was nursing. He had a weak suck, a high palette, lazy suck, all sorts of theories were thrown out. It did however explain his frustration when we nursed. I went to the breastfeeding workshop the next day, and they gave me a  syringe with a tube attached that I could put in his mouth or inside the nipple shield. I got him to eat a bit, but again, he wasn't too happy, and I was still having to do breast compressions to get him to keep sucking.  The lactation consultant was very nice and said that if we got too frustrated, we could always feed him the pumped milk in a bottle in a pinch.

We tried everything. We used the syringe, the nipple shield, the curved syringe. We put a bit of expressed milk into the shield, I did breast compressions, I stroked his cheeks to initiate the rooting reflex (I don't think he actually had that), we even stuck the tube straight into his mouth. Nothing seemed to work and he just ended up completely red in the face from screaming, and I usually ended up in tears, feeling like I was failing. We finally broke down that weekend and started feeding him expressed milk from a bottle. It was like we had a completely different baby! He ate gladly, with a bit of dribbling, and by the time we saw the pediatrician he was only a few ounces under his birthweight! By his two week appointment he had surpassed it!

We still made an appointment for a private lactation consult, but that resulted in the consultant saying that we were doing so well with pumping that if she were us, she'd stick with that. We also made an appointment with a speech pathologist (pediatrician recommended) to make sure that there would be no other problems from his having a weak suck or high palette. According to her, he had neither. And apparently, there is no such thing as nipple confusion--it's actually a preference; some babies just prefer a synthetic nipple to a real one. Apparently, G prefers the synthetic. And thus began my embarkation into the world of exclusive pumping or EPing.

There's not much out there on EPing. Even at the doctor's office, the question "Are you breastfeeding?" is a verbal and emotional minefield. Technically, he is breastfed, just from a bottle. But if you say you're bottle feeding, they assume it's with formula. And then there's the feelings of inadequacy because as a "good" mother, you're supposed to be nursing. You feel the need to explain that you've tried, very hard, but it just didn't work, and that he's still getting breastmilk. I would honestly love to nurse Grayson. It was something I was really looking forward to, actually. Unfortunately, that's not the way it's worked out for us. I tell myself that he's healthy and happy and that should be enough, but I still worry about that bond sometimes.

Pumping hasn't been easy either. First, my nipples cracked and bled. They were so sore that the nursing pads, my bra, my shirt, everything that touched them or put any pressure on them hurt. They would bleed. A few times, it actually tinged the milk red. I threw out that milk the first time before the pediatrician told me that if he were nursing, he'd be getting it anyways. Still creeps me out, but it hasn't happened that much. Then I got costalchondritis, which is an inflammation of the cartilage that attached your ribs to your sternum, but presents as breast pain. I felt like a knife was being dragged along inside my breast with each breath, but holding my breath didn't relieve the pain. James came home to find me in bed, trying to stifle sobs to keep Grayson from waking up. Tylenol only blunted the pain, but it finally went away after a few weeks. My OB put me on a low dose estrogen pill. None of his other patients had problems with it, but it cut my supply in half within 5 days, and I switched to the mini-pill which has totally messed with my body. I ate fenugreek like candy until I reeked of maple syrup (it really works!) and drank Mother's Milk tea religiously. I pumped every three hours, I did powerpumping (ten minutes on, ten minutes off for an hour or once an hour all day). I woke up in the wee hours of the morning to pump. In the first ten weeks, I had 5 bouts of clogged ducts. Looking back on this, I'm pretty sure at least 3 of them were full blown mastitis since they hurt so badly I could barely move my arm. I pumped through the pain, even massaging the clogged ducts (sometimes through tears and curses) and haven't had a bout since a very minor (6th one) over Christmas. I even had to pop a clogged duct on my nipple (milk blister) to unclog one bout with a sterilized pin. I got blisters on my nipples that the pump would pop, and they would bleed. I even got to the point where James would have to wake me up to pump what Grayson was going to eat, which meant he screamed for 15 minutes while I pumped. I've agonized (and cried) over how much (or how little) milk I was producing and panicked over the possibility of supplementing with formula (and bitched at James for suggesting it. We've never had to, thank God). I've pumped in public bathroom stalls, cold showrooms, at the front desk at work, in the car in broad daylight, in the car at night, on the floor in an empty room, and twice in airplane seats (by far the worst).

After all of this, I've finally seem to have settled into a routine. I pump 5 times a day, every four hours, starting at 6 am and have been able to drop the middle of the night session. I can even put off a session for a while if I really need to, though my breasts will get engorged, leak and be sore depending on how long it's been. My breasts are still tender sometimes and my nipples are still sore and get a blister or two, but after the initial twenty seconds of cursing under my breath, I'm fine. I also still have to do breast compressions, but I get anywhere from 10-14 oz in the morning, then usually 6 oz every session after that, though sometimes my last session of the day is a little less. I've learned how to use the pump to my best advantage--turn it up about 90% power during the let down phase, then when it's done with that, turn it down to about 75%. That plus the occasional fenugreek has helped increase my supply by about three fold. I can usually put 2 bags in the freezer every day, and have a stash of 30-40 bags in there (I'm running out of room!) along with at least 6 bags in the fridge at any given time. After some research, I discovered I have what is considered an over-abundant milk supply. It's probably why I've had problems with clogged ducts and mastitis, but I couldn't be happier--it means I have enough to feed my baby and I can probably even donate some milk when he's done drinking breastmilk. And there are great benefits: when he goes to the Infant Care Center the afternoons I work, he's still getting breastmilk. James can feed him, even in the wee hours of the morning. The same goes for grandparents, friends and sitters, even Great-Grandma Van fed him. I still wish I didn't feel as judged and feel the need to explain and justify when asked if he's being exclusively breastfed and I wish I could convince myself that pumping in public should be no different than nursing (for some reason, it is), but maybe our society will get there eventually. For now, you can find me pumping at 6, 10, 2, 6 and 10 every day.

Emmi's Tips for Better Pumping:
-Use heat, especially if you have a clogged duct. Heat encourages the milk to flow, and with a clog, it seems to loosen it. It usually took me 3 sessions with heat to unclog a clogged duct (with massage)
-Breast compressions help empty your breasts completely each time you pump. This is very important to help prevent clogged ducts
-Have a set length of time that you pump for (17 minutes for me), but if you're still expressing milk, keep going until your breasts empty
-Have a schedule, whether it's every three, four or five hours. Your body will get used to it and expect it
-If you need to bump up supply, increase how often you pump. When my supply dropped I went back to every three hours for a day, and it was back to normal again
-Drink lots of water!! When I don't keep hydrated enough, my supply drops
-Supplement with fenugreek. I was taking 2-3 tablets 4-5 times a day. (You're taking enough when you start to smell like maple syrup). Mother's Milk tea also helps, but the fenugreek is by far the most useful
-Turn the suction power up during the letdown cycle, then down after. That better mimics how an infant feeds
-Make sure you're using the right size flanges. I went from the M the pump came with to a L, and now use an XL
-Use lanolin on your nipples prior to pumping to help lubricate. It's safe for breastfeeding. I use the Medela brand since the Lansinoh brand is too thick for me
-Remember to eat. It's estimated that breastfeeding burns 20 calories per ounce, and it's got to be at least as must for pumping, so keeping up your energy is important
-Remember why you're doing it when it hurts, but if it gets to be too much don't feel bad if you have to stop! You have to take care of yourself first, or else there won't be anyone to take care of baby!

Thursday, January 17, 2013

Grayson's Birth Story

Whoo! Finally getting around to writing Grayson's birth story. And it only took 3 months.

We went to bed Saturday night around 11pm after running errands all day. We were pretty beat since we'd been up late Friday night for our friends' wedding and then didn't even sleep in Saturday, opting to get stuff done instead. And good we did. James got into bed, and I laid down, but just couldn't get comfortable. I had been sick Thursday and still felt icky, plus I was really nauseous and I was having (what I thought were) Braxton-Hicks contractions. I knew there was no way I was going to be able to sleep yet, so I decided to get up and walk, get some water, then surf the web a bit.

I ended up on the bump, and they had a contraction timer. Since they had been getting a bit stronger, and seemed more frequent, I decided to time them for fun. After a few, I realized they were nowhere near regular, though they were getting stronger, and were only 3 minutes apart at most. I figured I was probably in labour, but didn't think much about it since our class had said we would probably labour at home 8-9 hours before heading to the hospital. HAH. As soon as I realized I was in labour (and had decided I wouldn't wake up James til I needed to), I all of a sudden felt like I had peed myself a little. It was surprising and disconcerting, and I hadn't had any incontinence the entire pregnancy. It was my water breaking! Like everyone says, it's nothing like the movies at all. This was around 12:45 am, and I went and woke up James, saying "I think my water broke...what should I do?" Since we'd had the false alarm before, I didn't want to end up in the hospital again if it wasn't the real thing. James did a very comical jump out of bed, wide awake immediately. He told me to call the doctor...we waited for about 45 minutes for a return call, with my contractions getting stronger and stronger. It was at the point where James was going to take me in with or without the doctor's recommendation when the doctor called back and told me I needed to go in to the hospital.

We headed to the ER, since the main hospital entrance was closed (this was around 1:20 am), and by this time my contractions were intense, though no more regular than before. I was in qite a bit of pain, but still able to walk. However, when James turned into the wrong entrance and we had to turn around and drive further, I was not a very happy camper. I got wheeled up to labour and delivery and they checked me in which seemed to taken an eternity. By the time they put us in a room, I was screaming myself hoarse with each contraction. They checked me and said I was only 2 cm dilated and that if the amniotic fluid test came back negative or I hadn't dilated to 3 cm within an hour, they'd have to send me home. I guess I gave the nurse a death stare because she hurriedly added that they'd give me painkillers. I'm sure everyone else on the floor was thrilled I was there because I was making no effort to be quiet. My nurse went to lunch right after that, and aonther came in to readjust the fetal heartrate monitor. By this point my legs were quaking (not just shaking, but quaking) between contractions. She said that was caused by the hormone that causes you to dilate. She stared at me for a few seconds and said, "I'm going to check you again because you look like you're in a lot of pain, and if you're progressing we can go ahead and get the epidural blood and paperwork started." It had only been about half an hour, but I had already reached 3.5 cm and was given the official you're in labour paperwork. We called my parents and I can just remember looking at James saying "We're not ready! We haven't vacuumed or organized the bookshelves yet! We aren't ready yet!" His response? "Well, I don't think this is going to stop at this point."

Thank God for the epidural. By the time they came in half an hour after that, I was at 5 cm and still screaming. The anesthesiologist was great, and I barely even felt the needle. I freaked out for a while after getting the epidural since the contractions still hurt, but after about 30 minutes, I finally had some relief. They tried (three times) to attach an internal fetal heartrate monitor to the baby's head, but after it fell off the third time they gave up. I also had an internal contraction monitor, and we could watch all of it on a screen next to my bed. James was thinking about going to walk the dogs since he figured we'd be there a while, but that idea went out the window when they came in to check me again about an hour and a half later and I was already at 8 cm. The nurse had just walked out of the room, when she came rushing back in with another nurse. There'd been some spike or drop in the fetal heartrate that they wanted to check. The second nurse checked me again, while my nurse said "She was just at 8 cm." The nurse looked over at her and said to me "You're fully dilated [10 cm]. Was this the girl you were going to send home?" All in all, I went from 2 to 10 cm in 5 hours, much to the shock of my nurses, who said that was very rare for a first time mom. At least that explains the intensity of the contractions.

"Wallaby" still hadn't dropped, so I was instructed to sleep and see if he'd drop any more before starting to push. I don't know how long I slept, but even though he hadn't dropped much more they decided to have me push. I pushed for an hour. It was coached pushing since I had an epidural--the nurse would monitor the contractions and tell me when to push. I would push 3 times to a count of ten during each contraction. After an hour I was told to rest/sleep again. I'm guessing I rested for about an hour or more before I pushed again. They had turned down my epidural by half and given me pitocin since my contractions were weakening. They said they wanted me to feel the urge to push (which I never did until he had already crowned, when I wasn't supposed to push). So I spent another hour pushing and was completely exhausted by the end of that hour. They had set up a mirror since they said it helped to focus the pushing, but I wasn't too pleased with that. At this point the nurse thought I might be a candidate for the vacuum extraction. She said she'd go get the doctor, but that when he came in, I had to push as hard as I could. He came in, I pushed and he agreed, though he warned me I only had one contraction (three pushes) to use the vacuum assist since it can't be used indefinitely. I was pretty sure the other option was a c-section and was getting a little scared, but was determined that this would work. And it did! With the doctor using the vacuum assist, I delivered the baby. Little Grayson Henry had arrived at 1:51 pm on Sunday, October 14!

Everything after that is a bit of a blur. I know he was toweled off and placed on m chest very quickly. James cut the cord, they gave him his vitamin K shot and eye drops, weighed and measured him and got him back on my chest for skin to skin time very quickly. While they were measuring the baby, the doctor was taking care of me. If I hadn't been so tired I think I might have punched him when he pushed on my stomach to deliver the placenta. That was probably the most painful part. He kept massaging to help the uterus start to contract back down to size and make sure all the placenta was delivered. I had a second degree tear (not bad) so he stitched me up and I was good to go. By this point, Grayson was back on my chest. He was 7 lb, 12 oz, measuring 20.5". He was an absolutely beautiful baby (though a little squished at first) and so tiny and perfect.

We spent all Sunday and Monday in the hospital before being sent home on Tuesday. My doctor came by on Monday and told me that my bloodwork had indicated that I was moving toward preeclampsia, so they probably would have induced me at my appointment Monday night. But, as he said, "Nature knows best." He had his first bath in the hospital, with James helping and Lynn was an absolute blessing, walking the dogs, bringing James breakfast, bringing us both some lunch and being so helpful. My parents arrived late Monday night and were amazing--they stayed for two weeks and took a lot of the night duty so we could sleep. It turns out Grayson couldn't (still can't) nurse, so I was pumping (pump saga finally worked out WHILE I was in labour thanks to James). But that's another post altogether. Well, it took me over 3 months, but here's his birth story! It's a bit long, but so is labour :)

Birth plan: Epidural-->Sleep-->Push-->Baby

Grayson Henry Lawrence.
Born Sunday, October 14, 2012 at 1:51 pm
7 lbs, 12 oz. 20.5 in long.

With the stuffed animal that was originally his aunt's, then his dad's
We even have a photo of this animal with his dad in his bassinet :)

Proud daddy
Tired, but happy, mommy

Daddy and a finely swaddled Grayson

Skin to skin time, and I can't get over his perfect, tiny fingers

Our go-home checklist