Saturday, April 24, 2010

Lactation Goodness...Part 2

(Lactation Goodness...Part 1 can be found here.)

Let me begin by saying that this week was bad.  It was so bad that rehashing it through this post will probably bring tears to my eyes.  So please, bear with me as I explain to you my journey to breastfeeding hell and (thankfully) back again...yes I said back again! 

Where to start? Where to start? I guess let me start with my mom's group that was before my appointment with the postpartum clinic.  Everything was going great. I was chatting with friends, S was cooing cutely at the women on either side of us,  we were getting ready for a presentation on Baby Boot Camp, and life...was...good.  But then, things changed.  It was time to feed S.  I took a deep breath and started to nurse.  Two sucks and he pulled off.  Try again.  A few more sucks and he pulls off again.  Try again.  Now he won't even try to suck because he is pissed.  So I switch sides and my eyes fill up with tears (must...fight...the...tears).  At first he seems happy, but then...oh crap...he pulls off again.  You have to understand that while I am going through all of this, everyone is listening intently to a presentation all about Baby Boot Camp and so I am trying so, so hard not to draw any attention to myself and S.  So, I look to the mom to my right and say, "I am so tired of this, he...just...won't...latch".  She gives me a "I am so sorry, I wish I could help you" half smile and I feel slightly less alone in this struggle with S. I try again...and again...and again...and by now I am so close to sobbing that trying again seems stupid and so I get up and start to walk out of the room, but then the doula that runs my group sees me and I can't help but start to sob.  She immediately gets up (despite her current issue with vertigo) and walks out with me to the hallway.  God bless her because she lets me tell her everything, she gets me more tissues, and then she validates everyone of my fears regarding this whole dang thing.  I know that she said other stuff...probably even gave me some reasons for why S was pulling off, but I was out of it that I didn't hear much of it.  All I knew was that I felt heard, validated, and positive that I could survive the few short hours till I met with Nancy.

So fast forward a few hours to my appointment.  As I predicted, I started telling Nancy all about the latch issues, the fussiness, S's screaming, my tears and she just listened.  I told her that the last consultant thought it was because I wasn't using the nipple shield, but that it didn't matter if I used it or not...S still fought me.  She listened as I broke down, telling her that I felt like I was failing as a mom because I couldn't provide for my son.  She wanted me to try feeding S in front of her and as soon as we started S pulled off (as if on cue) and she proclaimed...IT IS A SUPPLY ISSUE, as if she had seen this a million times (which she probably has given her expertise).  She tells me that he doesn't like that the flow is slow and so he is fighting me.  To take it one step further, she proved that it was a supply issue by having me continue to feed him the best I could and then weighing him again....he had only taken in 2 ounces...2 ounces is not enough! I can't feed my son on just 2 ounces!  WTF??? I have a freezer full of milk to suggest that I do not have a supply issue at all.  She says supply levels can change for a variety of reasons.  At this point my anxiety goes into full swing because I just want to be the best mom I can be and my poor son is starving because I am not producing enough milk.  I never, in a million years thought that I was not actually producing enough milk.  The guilt that I had been feeling quadrupled at that point...and I think I just went blank for a few minutes while I digested the information.  I was not providing for my son.  I was the reason he was not gaining enough weight.  To put the nail in the guilt coffin she tells me that infants will happily starve to death so we don't know they are hungry till it is too late sometimes.  Ugh!!! Starve??? I don't want to think about my son starving for the last few weeks, much to bear.

So what do you do when you don't have enough milk?  Well Nancy tells me that it is time to go back to the basics.  I am to nurse and let S do "his personal best" for about 30 minutes and then supplement if needed.  Then I am to pump after each time (except in the middle of the night) to make sure that my breasts are empty and signaling that more milk should be made.  She says I need to do this for 72 hours and come back and see her on Friday.  72 hours...I can do this, right?

The rest of Monday is okay.  I am no longer surprised that S is frustrated with me, but I am able to get him to latch for 15-20 minutes or so each time.  I supplement with one of my bazillion bags of milk, I pump, and I am okay.

Tuesday starts off okay.  S seems to get enough to eat from the first feeding, but the second feeding goes horribly.  He barely latches and I know he didn't get much milk from me.  I give him a bottle, put him down for a nap and then pump.  Only nothing really comes out...maybe a tablespoon? Can you believe this crap?  Ms. Ihaveafreezerfullofmilk barely pumps a tablespoon when S barely fed.  I think it is this point that I start to loose it.  I know that anxiety will kill anyone's supply so I try some deep breathing, but nothing is working.  I am in full anxiety attack mode.  It is at this point that I decide to call my psychiatrist.  Yes, I have a psychiatrist.  I suffer from ADD and depression, as well as periodic issues with generalized anxiety.  So no, anxiety attacks are not new to me and I knew that the only way for me to get rid of them at this point is with professional help.  Fortunately, my psychiatrist is available on Wednesday...THANK GOD.  At some point during the day I headed to the local nature foods store to pick up some Fenugreek.  I decide I am going to throw everything I've got at this issue so I am upping my water intake, calorie intake, taking Fenugreek, and eating more oats. 

Wednesday---my supply seems to be dwindling with each feeding.  I thought the pumping was supposed to make things better, but it seems to be getting worse.  I can't believe it is getting worse!  So, I go to my psychiatrists appointment and after much discussion we settle on a medication to use as a short-term solution since we are both pretty sure that this is a short term problem.  If I can kill the anxiety, my milk supply should get better.  If my milk supply gets better, my anxiety should go away.

The rest of Wednesday shows no change.  In fact, I began to think that I was seeing the last of my supply and that my days of breastfeeding were numbered. But Thursday I wake up and have a successful feeding and then another successful feeding, and then S goes down for a nap.  I am feeling great at this point...things are really starting to improve.  I even tweeted that I had milk.  :) Then S woke up and I tried to feed him.  He reverted back to the pulling off and refusing to latch.  I begged with him, I pleaded with him, I knew I had milk...why wouldn't he just latch a little bit to get the flow going???? I eventually gave up, gave him a bottle, and pumped.  I learned that I can also take Blessed Thistle to help with supply so we after that feeding we head to Whole Foods to pick some up.  Unfortunately, my next feeding at 2 went no better and then just when I thought things couldn't get worse...yup, they got worse.  At 4ish he didn't want to even come near my breast. Every time I laid him down to nurse he started to scream.  Again, I pleaded with him, I begged him, I even try to bargain with him...nothing seemed to work.  So I gave him a bottle and then after he drank an ounce or two, I tried again.  Eventually he latched, but he didn't seem happy about it.  Fortunately that was the last feeding I was doing with him for the night since hubby and I were going out and S was staying with friends.

So we brought S over to our friends, headed to the Blazer game, and I began to relax a little.  We got a beer, some food, and things were great.  (This may seem like TMI, but bear with me...) I decided to go to the restroom before we headed to our seats and while I was there, I was greeted by an old friend...yup I got my first period since getting pregnant.  Fun times!  I am not just telling you this because I was unprepared for this event and was thanking my lucky stars that I had quarters in my purse.  I am telling you this because as soon as I finished being flustered about being unprepared for this moment, my wheels start spinning.  Didn't I hear somewhere that your milk supply can diminish a little before you get your first period? Could this be what has happening all week?

That night I did some googling and sure enough, says that many women notice a TEMPORARY decrease in supply the week leading up to your period.  The site even references an article about Menstruation and Breastfeeding that says your milk supply may not be the only thing that changes.  The taste of your milk can change too...could this be why S wouldn't even try to nurse earlier that day?  At that point I couldn't wait till my appointment with Nancy the next day to see if my new theory was correct.

As if on cue, things immediately began to improve.  S successfully fed, with minimal pulling off, for all the feedings leading up to my appointment with Nancy.  When we got to the appointment I shared with Nancy my new theory.  She immediately confirmed what I had read.  Hallelujah!  She said it is one of those things that she doesn't think about right away because it isn't a typical scenario (and you don't really know that is what is going on until after), but that this was a good reminder for her.  In fact, she was going to bring it up to the other lactation consultants at their next meeting. 

So everything is perfect again, right?  Well not exactly.  I still need to stay on top of my anxiety, although things have been a lot better.  I am still working to get my supply back up to what it was before all of this.  She said that my late afternoon/evening supply may never fully return and I may have to supplement with milk I pump in the morning.  She also told me that I will probably need to work to keep my supply each time I am about to get my period, but that it may not be as bad next time.  She recommended that I visit a naturopath because they have a lot more options for alternative treatments (like acupuncture) and herbal supplements (beyond the fenugreek and blessed thistle).  She mentioned that there is a website that helps people with breastfeeding issues and I thought she was going to mention, but instead she introduced me to MOBI Motherhood International.  The site is a resource for women with chronic low milk supply. 

So there you have it.  This was probably the most emotionally exhausting and physically draining weeks I have had in a long time.  I can't imagine what I would be saying about this week if I hadn't had the support from Nancy and the Postpartum Care Clinic at St. Vincent's Hospital in Portland.  I thank them from the bottom of my heart.

If you are reading this and are having issues with your breastfeeding, please, please, please go get help from a lactation consultant.  They may not be able to fix every breastfeeding issue, but they can help you fix most of them.  If your insurance doesn't cover it, it is worth the cost to pay out of pocket.  If they can help you solve your issue now, they will save you hundreds of dollars that you would have had to spend on formula. 

Resources: Breastfeeding and Parenting

MOBI Motherhood International

La Leche League

Breastfeeding Essentials


Kimberly Bepler said...

Did you see on Kellymom how to use magnesium for overcoming the dip in milk supply during mestruation? I have a few mamas that say this works well for them (and it doesn't require a trip to the doctor!).
So glad you found your cause and cure...

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