Boulder CO USA
From NEW BEGINNINGS, Vol. 25 No. 4, 2008, pp. 22-25
Kayla was born at home. Her birth was an empowering and positive experience for my husband and me. The midwives placed Kayla on my chest immediately after she was born and, when her newborn exam was complete, they helped me get her started at the breast. She sucked vigorously and I remember one of the midwives telling me that we wouldn't have any difficulty at all with breastfeeding. It took me only a few days to realize, however, that Kayla and I were in trouble. I was so anxious for her to get colostrum that I didn't pay attention to how she was latching on. My friends had all told me that breastfeeding was painful at first, so I assumed that the pain was normal. Kayla was nursing all the time yet never seemed satisfied. A few days after birth, when my midwife saw how damaged my nipples were, she brought me gel pads, ultra purified lanolin, and a nipple shield. Our main problem, however, was that even after my milk came in Kayla wasn't gaining back her birth weight. We made appointments to see the pediatrician and a lactation consultant when Kayla was eight days old. Her pediatrician, our midwife, and the lactation consultant agreed that we had to start supplementing her with expressed milk or formula.
I had already been pumping several times a day in an attempt to relieve the pain from the hard, red lumps in my breasts that were left even after Kayla had breastfed. Unfortunately, I was getting so little milk at each pumping that I didn't have enough to satisfy her demand. On the first day we gave her formula, Kayla drank 16 ounces. I cried the entire time. I didn't want to give her a bottle or a pacifier because I was afraid it would make breastfeeding even more difficult. I tried a supplemental nurser to feed Kayla, but breastfeeding was already so painful and it was difficult to get the tube in her mouth along with my breast. After 24 hours of trying to breastfeed with the supplemental nurser, I gave up and my husband fed her the supplement she needed in a bottle. I felt desperate and sad. I was determined to increase my milk supply so I could at least supplement with my own milk. I took fenugreek and brewer's yeast, ate bowls of oatmeal and calorie-dense foods, drank several quarts of lactation tea every day, and pumped whenever I could.
When my family arrived to meet Kayla, all we did was argue about breastfeeding. They said there was no shame in giving up and feeding her formula; but I disagreed wholeheartedly. I went to see another lactation consultant and she helped me refocus and stay optimistic. We worked on positioning and latch-on to make sure that wasn't the cause of our problems. She said it might take a long time, but that she felt confident that Kayla and I would be able to establish a healthy breastfeeding relationship. I tried to stop thinking that everything would be fine once we made it past a month because that hadn't been the case after two or three weeks (which was the amount of time all the books I had read said it should take). She recommended attending local La Leche League meetings and a weekly breastfeeding club at the hospital. Attending every La Leche League meeting offered in town and reading the mothers' stories in New Beginnings gave me hope that we could make breastfeeding work.
When Kayla was about a month old, I decided that I should try to nurse her without the nipple shield. I thought that the nipple shield was reducing my supply -- a problem I was trying to counter with all the extra pumping -- and I also hated the nuisance of having to clean it and apply it when Kayla was hungry. It was a mistake to remove it, though, because Kayla clamped down on both of my nipples leaving large fissures of open skin on each one. I started to feel a radiating pain in my breast, almost like a contraction, every time she latched on. I thought it was the let-down, but now I know that the let-down does not cause shooting pains that keep you awake at night.
After much cajoling from my husband, I made an appointment to see my doctor. She suggested I take a break from breastfeeding and let my nipples heal; otherwise I was likely to make the situation worse. I was nervous about not putting her to the breast because I was afraid she would lose interest or forget how to breastfeed. My husband reminded me that she wasn't breastfeeding correctly anyway and that if I didn't take care of myself, I wouldn't be able to take care of Kayla. Feeling that I was out of options, I agreed to stop putting Kayla to the breast until at least one nipple was healed. The doctor gave me a prescription-strength nipple cream and instructed me to pump every two hours around the clock to keep up my milk supply. Even with the constant pumping, I still couldn't produce enough milk to feed Kayla. I rented a hospital-grade pump and began taking an herbal supplement, which did seem to increase my supply. Very gradually we were able to reduce the amount of formula we fed her and increase the expressed milk. I never had a stockpile of milk in my freezer, and I was jealous of women who could pump several ounces at each sitting.
I brought Kayla to a La Leche League meeting during the week when I was pumping exclusively, despite my fear that I wouldn't be welcome because Kayla wasn't actually feeding from the breast. The group was so supportive, and the mothers said they were there to help me whether I breastfed for a day or for five years. One of the moms held Kayla while I went to a private room to pump during the meeting. It was such a relief to have that support and to know that I wasn't being judged for what I felt I had to do.
After about a week of only pumping, one of my nipples looked healed and we put Kayla back to the breast with a nipple shield. She was still clamping down, chewing, twisting and fussing, but at least she hadn't forgotten about the breast. We took her back to her pediatrician and it was then that Kayla was diagnosed with a "dysfunctional suck," "tongue thrust," and "high palate." Her pediatrician gave us a referral to see a pediatric occupational therapist. The specialist we wanted to see usually had a long waiting list but when she found out we needed help with breastfeeding, she called us to fill a cancellation in her schedule. My husband was concerned about the cost of all this therapy and wasn't convinced we could "fix" the problem. However, he supported me as best he could -- attending our sessions with the occupational therapist, taking care of Kayla while I was pumping, waking up to feed her at night so I could pump, and making meals for me. I wouldn't have been able to persevere without his help.
When Kayla turned three months old we still had a pretty intense routine. I would breastfeed her with the nipple shield, give her a supplement of my expressed milk in a therapeutic bottle (usually by the end of the day she needed some formula, but only a few ounces by then), pump every three hours, and practice her exercises from therapy. Our entire day was focused on feeding. If I went out anywhere, I always brought my pump and had a bag filled with accessories and formula, just in case. The lactation consultant I had seen was calling me every other week to check on our progress. When I told her that Kayla could suck down the contents of a bottle in no time but was still having difficulty nursing, she said it sounded like Kayla was just being stubborn. Her idea was for us to try a "nursing holiday." She suggested that we relax at home and that I just breastfeed Kayla without giving her a supplement for a day or so. I decided to try it that weekend and to my amazement, by the end of the weekend, Kayla was breastfeeding without needing to take a bottle, and I only had to pump once the entire time! My husband and I were overjoyed. It seems that it was just easier for Kayla to get her milk from the bottle, so she wasn't trying too hard to suck at the breast. Once I put her in a situation where only the breast was available, she quickly picked up the routine.
After three months, breastfeeding sessions suddenly became my favorite times of the day. We took a road trip across the country when she was seven months old and breastfeeding made traveling simple. Every time we sit down to breastfeed, I feel thankful for being able to create this special bond with my daughter. I know she is happy, healthy, and comforted. Kayla is now 16 months old and breastfeeds on demand.
I hope other mothers who are having difficulty with breastfeeding will be inspired by our success and will continue to put forth the effort to work through their problems. We are so glad that we did!