This post has been a long (long long long long) time in the works. Now that we've progressed through most of the frustrations, I find that I am more inclined to actually document the experience even though the lapsed time has allowed the passions and frustrations to fade. As with many of the pregnancy/post partum posts, this will be very open and frank about my experience. In other words, it may be a little too much information for some of the readers :)
To start with, I am a huge advocate of breastfeeding. I think the benefits to mother and child are great and the breastfeeding relationship should be continued as long as is possible and appropriate. That said, breastfeeding can be hard! I knew that before having Anderson, but the intricacies of the challenges were surprising to me. Additionally, many of our challenges are a little more unusual (serious oversupply and let down, food protein sensitivities) so it was harder to find information and support. I did find KellyMom, an online nursing support platform, to be the most helpful resource.
Anderson latched on without a problem less than 30 minutes after delivery. And then he slept for hours and hours and hours, not even wanting to wake to feed. The nursing staff (at the hospital of course) was a little anxious about this, but I wish I hadn't worried so much. He was a very healthy weight and had no complications. When we got home he wanted to feed and feed and feed. He still had a great latch, but he was sucking so hard he gave me blisters. I honestly have no idea if this caused my oversupply. He was born on Thursday and my milk came in with a vengeance on Saturday. Milk typically comes in 3-5 days post-partum. I prepared lactation cookies to snack on during feedings which may have also contributed to oversupply. Any way, I had SO MUCH MILK. MILK EVERYWHERE. And apparently a little curse called a forceful letdown. In short, I had a ton of milk that came out really hard and fast. Which is hard for little Anderson to handle.
I was worried about plugged ducts and mastitis, and felt all the advice I was getting wasn't very helpful. I understand now that advice just never seems helpful when you have unique problems. It seemed that if I manually massaged the plugged ducts to break them up, it increased my supply. Taking warm shower increased my supply. Eating oatmeal and flax increased my supply. etc etc etc.
My breasts were so swollen and painful that I ended up pumping a little off the top each day. Yes, pumping can increase supply, but I started with a massive supply and figured I'd rather deal with continued oversupply than mastitis.
After a couple of weeks I was pumping around 30 ounces a day in addition to feeding Anderson. This wasn't too bad for awhile; it allowed us to build up a freezer supply of milk and I was still recovering from delivery. However, around a month and a half it started to get old. I'd get so swollen in between pumping and feedings! I gradually dropped two pumpings and then quit cold turkey. At that point Anderson was 15 lbs and was having some crazy diapers (another post on food sensitivities is coming eventually). One of the lactation consultants/nurses at the pediatrician's office thought his diapers were caused by oversupply/feeding. Basically, he was eating a Thanksgiving meal every feed. Quitting pumping cold turkey was a little uncomfortable for a few days, but not anywhere as painful as the engorgement during the first few weeks of nursing.
Up until this point Anderson had continued to latch on beautifully (with the exception of when milk was spraying everywhere. Think lactating fountains of Italy, I kid you not. Milk spraying feet in all directions. Out of control). However, as my supply began to regulate, Anderson had more and more difficulty latching and feeding. I did tons of research and decided tongue and lip tie were likely the culprits. The pediatrician's office ascribed his issues (pulling off, diapers, arching back, discomfort, etc to reflux). So, I took Anderson in to a pediatric dentist who had a lot of experience and has performed many frenectomies. I explained what I suspected and asked her to take a look. I had previously spent HOURS researching the different methods of frenectomies and how to properly diagnose them, and had a long list of questions for the pediatrician to "test" her knowledge and experience. I was quite pleased when she answered all of the questions I had without my even asking them. When she examined Anderson, she did so properly (unlike the pediatrician!), with Anderson on my knees, feet pointed toward my stomach, and dentist at his head, looking into his mouth. She said he had a thick tongue tie as well as lip tie, and that it could definitely be affecting his nursing. *sidenote: my pediatrician said he only had a small lip tie and she can usually "snip them quickly" in the office. GAAAHHHH!!!!!
We scheduled the frenectomy for a few weeks later so the dentist could use the newer laser she was waiting on. It was a fairly quick procedure and took about a week to heal. Anderson can now keep a pacifier in, though he doesn't love them. One downside of the frenectomy is I think he developed an oral aversion at first. He didn't want anything going in his mouth. We've worked on making "mouth time" a pleasant experience for him since then, and now he loves putting everything in his mouth. Except he doesn't like sucking on pacifiers.
He is now 4.5 months old and I finally feel like nursing is the peaceful bonding time it has the potential to be. I am no longer engorged beyond belief (I'm now down to a 28J size, instead of a 32H/I and it is SO HARD to find a store that sells that size!!!! Fail Motherhood Maternity, Fail.), and while I still have a forceful letdown, it doesn't last for several minutes. Anderson is still easily distracted during feedings, but we've managed to find ways to alleviate this problem (nursing in darker rooms, waiting until he's really hungry, using a nursing cover, having a noise machine going).
AND, now that we've addressed most of his food sensitivities, things are a lot better with his diapers. For awhile it seemed like he was feeding just so he could fill a diaper. He would feed then bite down (even baby gums still hurt!) and pull as he strained his body. It was not a fun experience for anyone involved, and I remember many nursing sessions where he was hungry and crying and straining to have a bowel movement, and I was spraying milk everywhere and crying and feeling inadequate.
*sigh.
I think ultimately there were several factors that played into our struggles: oversupply and forceful letdown, food allergies and crazy bowel movements, frenectomy and latching, and time and Anderson's physiological capacity to take in larger quantities of milk.
One of the most frustrating aspects was the lack of concern from my pediatrician's office. Anderson was having 8 blowouts of mucousy green grossness a day, nursing was a struggle, and he was clearly uncomfortable. BUT he was in the 95th percentile for weight and height, so he clearly wasn't failing to thrive. His doctor seemed to assume that since he was a healthy weight, things were just fine. The thing is, I have a really high fat content in my milk, and even though he only nurses 10 minutes (max!), the forceful let down increases his intake in a short amount of time. Again, I'll write a post about his food allergies later.
BUT. We've fired the pediatrian, found a new one, addressed the bulk of his sensitivities, and given everything time. Additionally, we are not giving Anderson any reflux meds. WIN! And nursing is a bonding experience, WIN! Anderson now takes time to occasionally unlatch and just sit and smile or chatter at me before resuming feeding. And he is happy and healthy, WIN WIN WIN.
As far as supply challenges, every mother has such an individual experience. I can't imagine being in the place of a mother who struggles with undersupply and the anxiety of not being able to provide enough milk for her baby. Or struggling with inverted nipples and latch and having to use a nipple shield. But I can totally commiserate with mothers who choke their babies with too much milk, flooding their little mouths with greater quantities of food than they can handle. I understand the pain associated with plugged ducts and the worry of mastitis (though I managed to avoid that malady!). I will say, oversupply is a fairly uncommon condition and it's really hard to find helpful information. I finally did something called "block feeding", where I'd feed only from one side for a few hours, then switch to the other side. I can't pump or else my glands will kick into high gear again. And going out takes some planning. Even though we still have a massive freezer supply of milk, I have to nurse Anderson or else I'll become engorged again. I also have to be careful of what I eat- high carb foods seem to increase my supply to uncomfortable levels. I've had a cold the past week and have taken pseudoephedrine and phenylephrine without a dip in supply. I shower with a peppermint shower gel without a dip in supply. Three hundred years ago I would have been the wetnurse and fed village after village!!!
And lastly, Garrett has been amazing and supportive and wonderful through all of the nursing adventures. It's been a little hard for both of us since he can't feed Anderson the way I need too, but he's been with us every step of the way, and has done so much research to understand and get ideas to troubleshoot. Garrett also took middle of the night diaper duty after we weaned Anderson from middle of the night feedings. And to clarify, Garrett took diaper duty after I would feed Anderson each time, but also continued diaper duty after weaning. Fortunately we've gotten into a feeding routine that has mostly weaned Anderson from middle of the night soiled diapers. Garrett is a companion and parent, not just a helper and supporter. And I love him so much!
Welp. This turned into a novel. All this said, I'm going to go smooch Garrett and check Anderson's diaper :)
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