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Monday, March 12, 2012

Booooooobs.

I've been thinking about writing about my breastfeeding journey for awhile now.  I've become quite the pro at troubleshooting issues, have lamented to many of my girlfriends along the way, and have been a sounding board for many others.  When my friend Lorryn wrote about her experiences making "skim milk", I decided that it was time to get it down in writing.  It's a long post kids, so hang in there.  And if talking about boobs and nipples makes you squeamish, this is totally not your post.  Go back and read the one about how daylight savings time sucks or something.


I am more familiar with my boobs now than I have ever been in my entire life.  We've been part-time breastfeeding for 6 months now.  It's been a loooong journey that isn't even close to being finished.  But I'm finally at a point where I want to share my struggles.

I always knew that I wanted to nurse my babies.  And there was never a moment that I doubted I'd be able to do so.  I was well acquainted with formula and the breast pump (from nursing issues with Brennan) and had no problem bottle feeding when needed.  But I wanted to nurse.  So.insanely.bad.

After the boys were born, I brought them to breast as quickly as possible.  Unfortunately, due to reasons you can read about in the birth story (here), it wasn't as quickly as I had planned.  Nonetheless, as soon as we got back to the room, I nursed Kiernan.  He seemed pretty good at it, but he was tiny and I needed reassurance, so I asked that a lactation consultant come to our room.  While waiting for her, the nursery nurse brought Beckett to the room and told us that his blood sugar was "borderline low" (it was 46; newborns should be about 45) and that he needed to be fed.  I tried and tried and tried.  But that boy wouldn't latch and wouldn't suck.  He was insanely sleepy.  Kiernan went to the nursery for his assessment while I settled in for some skin-to-skin time with Beckett in an effort to get him to nurse.


Finally, the lactation consultant arrived.  She worked with Beckett and I for a few minutes until the nursery called to ask if Beckett had eaten.  I told them I wasn't willing to give him a bottle, but would be more than happy to do a syringe or finger feeding.  I didn't want his blood sugar to drop.  I knew he needed to eat.  I wasn't opposed to formula.  But I also knew that there were avenues to explore other than sticking a bottle in his mouth.  I looked to the LC for help and advocacy.  Instead, she informed me that they didn't have the proper equipment for either one and that she would instead show me a technique with the bottle to get food into his belly, but not cause him nipple confusion.

And then she informed me that the nursery nurses had used the same technique with Kiernan in the nursery because his blood sugar had been low.  I went BALLISTIC.  No one had informed me that my child's blood sugar had been low.  No one offered me the opportunity to nurse him.  No one asked me if it was alright to bottle feed him.

As an L&D nurse, I am fully aware of the need to keep their blood sugars normal.  I've lamented about moms who fought tooth and nail not to have formula enter their kiddo's body in fear of not being able to nurse, even after I suggested options like syringes and finger feeds.  But I wasn't being "that mom".  I wanted formula in my kids' bellies.  I just didn't want bottles in their mouths until we had this breastfeeding thing down.  I knew other methods of feeding them and just needed the tools and support to do so.  I requested the person who was supposed to provide me with both of those things ... and couldn't get either.

Over the next few days things got a bit better.  The nurses and other LCs who rounded were very supportive.  They stressed pumping to increase my supply and suggested one bottle feed during the night so that I could get a solid 3 hour chunk of sleep.  They encouraged and helped me tandem feed, but it was awkward and uncomfortable and I still felt like nursing was not going well.

The days after we came home were hectic.  I was diagnosed with a DVT in my leg which made moving around difficult.  Luckily my mom was in town to help us manage.  The boys first pediatrician visit was stressful.  Beckett was a bit jaundiced and both boys weren't gaining weight quickly enough.  The pediatrician mandated that we supplement with the bottle after every nursing session.  I wish I would've found another LC at this point to help me with alternative ways to supplement.  But instead I used the bottle.  After all, what was most important to me was to feed my babies.  So we tandem nursed, then supplemented with the bottle, then I pumped to increase my supply.

Tandem nursing and snuggling with a toddler.  Multi-tasking at it's finest.

After 3 weeks, breastfeeding wasn't getting any easier.  I called to make an appointment with the LCs at the hospital where I delivered the boys.  Unfortunately, the only one who sees patients in the clinic is the one who came to "help" after I delivered.  Desperate for advice, I went to see her anyways.  She was very sweet and very encouraging, but simply reinforced what I already knew to be true: they both could latch, but had difficulty staying latched.  Her solution was simply to supplement more with the bottle and to keep trying.  She also blamed the fact that they couldn't stay latched on a low milk supply.  She recommended 10-12 pumping sessions per day and sold me some fenugreek. I went home feeling defeated and started resigning myself to the fact that I'd be destined to continuing the breast-bottle-pump routine.

And so it continued for another month.  The boys were gaining weight just fine - in fact, very quickly.  Those bottle supplements were doing their job.  But no matter how much I worked with them, they couldn't stay latched to my breast.  And I was simply maintaining a less-than-average milk supply.  But I was determined to keep going.

Along the way, I met a girl who also had twin boys who are just a few months older than my boys. She suggested I see an LC that helped her with nursing her twins.  I made an appointment for later that week and eagerly anticipated meeting this miracle worker.

She was the sweetest lady I've ever met.  She told me all kinds of success stories and listened to my thoughts and concerns and wishes.  She watched my sweet boys struggle to stay latched and showed me a few techniques to help them.  More than anything, she celebrated with me when they successfully nursed for any amount of time.  I'll never forget tearing up when after 3 minutes of Kiernan successfully staying latched, she said to me, "You just nursed your baby!  What a great mommy you are!"  No one had celebrated small successes with me up to this point.  It was foreign and amazing and wonderful.  Before heading home, we made another appointment to see each other the following week and she gave me some suggestions of things to try at home.

Over that next week, my thoughts changed.  I had a renewed sense of determination to make this a success.  I didn't need to exclusively breastfeed my babies, but I didn't want them to rely on supplements from bottles either.  I wanted to nurse my baby and leave him feeling full and satisfied.  So I continued the herbs and I pumped (and pumped and pumped) and I took warm baths with my babies and I carried them around in my Moby wrap, snuggled up skin-to-skin.

LOTS of babywearing ... inside and outside the house!

When we went back to see the LC, she celebrated my successes with me.  The boys were doing better, but I also expressed to her some difficulty we were having with the boys necks and that I was concerned about torticollis.  She suggested that we see a local speech therapist who is also an LC and runs the weekly Mom's Club along with herself.  I contacted the insurance company, got the necessary referrals, and made the appointment.

This woman is the other sweetest person I've ever met.  She is kind and reassuring and immediately recognized that indeed, my boys had difficulty staying latched.  They both had facial weakness, possibly in relationship to their torticollis, which was causing this difficulty.  She gave us exercises and stretches to try with the boys and recommended strategies to help them strengthen their tongues and faces and enjoy time at the breast.  More importantly she celebrates small accomplishments and is incredibly encouraging.

One thing she suggested and helped me implement was the SNS (supplemental nursing system).  It's basically a tiny tube that you slip into the baby's mouth while latching him onto the breast.  This allows him to get the appropriate amount of supplement and breastmilk at the same time while stimulating the breast to make more milk.  This has significantly helped to increase my supply.

The SNS


Of course, this isn't the only way I've been attempting to increase my supply.  I continue to pump throughout the day, when appropriate for our family.  I've stopped killing myself over pumping.  I don't want to look back on this time and regret missing things because I was hooked up to a breast pump.  So I do it when I can, as much as I'm able.

My pump.  We're BFFs.

Between the SNS, pumping, a medication called Domperidone, eating oatmeal, drink Mother's Milk tea, keeping up on calories and water, I'm doing everything I can to increase my supply.  At this point, the boys are getting about 1/3 of their nutrition from me and the other 2/3 from formula.  It's been higher, but that's with exclusive use of the SNS.  And I'll be honest, as much as I love what it does for my supply, it's definitely more time consuming.  When I have 2 hungry babies and I'm by myself, the SNS just doesn't cut it as they refuse to nurse in the football hold anymore therefore cutting out the option of tandem feeding.

So at this point, I'm continuing on with the nurse/bottle/pump cycle.  Except that because of the boys problems with reflux, we've had to split feedings and feed smaller increments more frequently.  So I usually nurse them when they wake up, then maybe pump, then bottle them before they sleep, then maybe pump again.  I nurse when I can, I pump when I can.  I follow their cues and don't push things on them.  We do what works best for all of us.

I've resigned myself to the fact that they are 6 months old and they are used to bottles.  Bottles soothe them and help them get sleepy.  Nursing is harder work for them.  Sometimes they go on strikes and won't nurse at all.  While it stings me to the core, I try not to take it personally.  It's not ME they are rejecting.  I am their mom and they love me like no one else.  It's just that nursing is hard work compared to the bottle.  And the slower flow from the breast is frustrating to them.

But that doesn't stop me from feeling guilty, inadequate, and like a failure from time to time.

What I'm working on is remembering that moment in the lactation consultant's office when we celebrated that I had nursed my baby.  Sure it was only for 3 minutes, but those 3 minutes were successful.  We have been successful at breastfeeding.  Sure they get formula and breastmilk from a bottle too, but that doesn't mean we aren't breastfeeders.  And who cares if we aren't exclusively breastfeeding?  Exclusive breastfeeding is of course something to be proud of, but so is accepting what nature and life has thrown at you and making the most of it.  As long as my babies are happy, healthy, and have food in their bellies, I have done well.  So while I may dread washing bottles and pump parts at the end of the day and loathe trips to the store for formula and get a little heartbroken when one of the boys won't nurse, I'm still proud of what I have accomplished.  I have breastfed my twins for 6 months.

Our story isn't even near it's completion.  My goal was to nurse my boys for 3 months.  I've doubled that.  And I'll keep going until I feel done.  At times I tire of the routine.  Every once in awhile I take half day breaks from pumping or nursing.  Some days we have great nursing sessions with few supplements needed.  Other days they turn their faces away from me and clamp their mouths closed.  Sometimes I wonder if it's all worth it.  But when one of my boys smiles dreamily up at me while nursing, his eyes bursting with as much love for his mama as I have for him, I know that it is.  Every.Single.Second.







1 comment:

  1. Great post Kel! You began providing for them long before their arrival - keeping them healthy far longer and growing much bigger than most multiples...you should applaud yourself! You are an awesome momma!

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