[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!
