Breast Feeding my Prem... the hardest but most rewarding thing I have ever done
I apologise for the length of this story and if you have reads parts of it before, but I feel for closure on our Journey reflecting on our whole story would leave me at peace with our journey, the end is coming due to Nakita self weaning, which I am now content with as it is her choice :)
I had always wanted to breast feed exclusively, but things just didn't pan out how I had expected. With Nakita born 7 weeks early our battle started from the word go. Due to extremely low blood sugars (0.9) and the inability to suck feed we started expresssing. At first it was hand expressing only getting 0.5-2ml at a time, and N was on 15ml every 3 hours, and I couldn't even do this so which was upsetting. Some feeds we would give her a taste of the Colustrum via a syringe, so she got a taste of "the good stuff", but we only did this occassionally as she needed to work for it some day. The rest of her feed was through a NGT (Nasal Gastric Tube). On day 3 my milk came in, I looked like Pamela Anderson, as painful as it was (I went from a 12E to a 12F in 24 hours), I though oh finally I am going to have some milk, this was a very exciting moment for me, I thought I could finally get some milk to feed her. It was tough as everytime I went to the fridge to store my mik I saw sample bottles full of expressed milk and I thought woo hoo this will be me soon!!!
But it wasn't to be, I organised a pump and was shown how to put it together and use it, okay here I go - OUCH!!! OMG that did not feel good at all, I began to tense up, how can I do this, I had it on a low setting and OUCH!!! But the milk started to drip. I got about 25ml, woo hoo, I had enough to cover a feed, so it wasn't the bountiful supplies I was seeing in the fridge but it was a start. I believe that I was unable to produce a let down, as it was a few weeks later that I began to notice the tingle of a letdown, but after pumping for over 12 months I am pretty sure I know what I need to do next time. It was a pain, we were only provided with a single kit, on a double electric pump, so it would take me an hour for each express, in between returning the pump to the room at the end for others to use. The next feed I would take it down, wow a fully EBM feed, I was sooo proud. Her Paed came in and saw how she was going and decided to up her feed to 25ml/3 hourly, I was okay I can do this!!
The next time I expressed I only got 20ml, what, how come I am getting less, why is this hard, my bbs are so huge and full and hurting yet I can get no milk, what is wrong with me, I just don't understand?
So she was topped up the 5ml with F. I was pumping for up to an hour at a time, I was trying so hard to get milk - I think that was part of my problem, I was trying too hard.
Over the days in hospital I struggled to keep up, or I would just be getting to enough to cover a feed and her feeds would be upped. I was so disheartening. At her lowest in hospital N was 2170grams, thoughout her her time in SCBU she had little gains and more loses, up and down. We tried little BF's, I was allowed one try a day, if she demanded we could try another. At first it was more of a play, she was so tiny and I was so large :redface: she couldn't really latch on but she tried and so did I, I really enjoyed this I felt like we were connecting.
But our BF attempts always depended on the nurse looking after her. One was like no don't do it she needs the energy to put on weight rather than feeding, where as another would always give me a gentle smile and lets give her a go, even allowing 2 a day
Expressing was always a struggle, I wanted so badly to have, milk, but where was it!?!One nurse fed Nakita half an hour early so she could finish her feed on her shift, I was shattered as I had just expressed enough milk for a feed How dare she take that away from me, I didnt get to be there for her OB's, change her nappy or discuss how she was going, whether she had been desatting or not, she walked off and I was left looking at N.
After 5 days her Paed (the head of NICU at WCH) organised a mate who was a Paed at the Private Hospital she was booked into to take on her case, the hospital said no, they don't take them until they reach 36 weeks, Nakita was 34 weeks at this time, but the Paed accepted her case, so the hospital had to take her. I won't go into the dramas of the on again off again transfer, too much bad communicaiton and no understanding from the nurses! If we didn't get this transfer her hospital journey woud have been a further 4-5 weeks, the WCH would not let her out until she was closer to term.
By the time we transferred she was on 35ml every three hours, I was getting close to this for each feed, so once again I was happy that I was catching up, still feeling jealous of the bountiful bottles from other mums in the fridge!
On arrival at the Private Hospital I had my own fridge, so no more comparing with the other mums milk, I was give my own - yes my very own double pump, with a double kit - woo hoo!! This was fabulous!! My expressing was sporadic, 30ml and on one occassion 70ml!!! OMG heaven!!! We were doing more BF's with the assistance of a Nipple Shield, N could actually hook on to it, we would try and I would have to time her feed, then we would give her a top up through the NGT. We would still only do a couple of BF's a day, with the rest through the NGT, on day 9 the NGT was removed, her Paed said I think she will be fine, to be on all suck feeds a mixture of BBS and Bottle. but her feeds at this stage were up to 65ml every 4 hours - OMG heaven four hourly feeds, this was amazing!!! I thought I can romp this in now, but no, I started getting less and less, so my OB organised Motilium, she had offered it earlier, but it was right after an express of 70ml (the only one I got in hospital) I thought I was fine, I wish I had started it earlier, in hindsight and future issues I know that if my milk doesn't kickstart well, then I will go straight for the Motilium.
On day 11 we went home, that morning she lost 40grams, so I took her home weighing 2190grams, 20 grams heavier then her lowest weight.
I had organised a double electric pump and it sat next to me for more that 12 months...
That night we went into the city I bought a sterliser and some bottles, and I stared at the formula, I couldn't see the one we had used to top up, so I didn't buy any and I hoped for the best and hoped that what ever I could express would be enough on top of the BF's.
After the first 5 days we went in for a weigh in, I was hopeful, but bitterly dissappointed to find that we had a 10gram loss. I felt like I was failing her. she was nearly 3 weeks old and she was only 10grams heavier than her lowest. The nurse was supportive and said it was okay and to come back next week for another weighin.
So I went home and continued to express, and feed, we were still using the nipple shields, any attempt to take them off resulted in refusal and tears.
I would BF then offer a top up. for each feed, offering what ever I was able to express. I wa worried but just went with it and hoped for the best. After another week went by I though hmm she feels heavier, maybe she has put something on, I was terrified, but I didn't want to believe that she had put on weight as I knew that I would be shattered if she hadn't. Once she was on the scale - WOOO HOOO!! 170grams!! OMG what an awesome gain, I was thrilled!!!
We then returned to seeing my OB's private Midwaife who is also a LC. We would go in and see her weekly for checkups, weighin's etc and Nakita was still quite jaundiced and was until 3 months old. Over her first 10 weeks her gains ranged from 60grams to 290grams, sporadic but normal, her average over this period was 80-90grams a week, not quite the 150-170grms her Paed had wanted. But all in all we were happy.
Then at 10 weeks I managed to wean her off the nipple shields, but at the same time, came down with Mastitis and had just reduced my Motiium from 1 every day to 1 every 2 days. I had booked into to see my LC to address her attachment as I didn't think she was attaching properly and she wasn't. She was concerned and weighed her in and we had a 20gram loss. which isn't much, but we couldn't afford a loss, she was already almost 1kg below the 3rd% charts and the words Failure to Thrive were being bounced around, they echoed in my head, three words you don't want to hear.
It was at this point we really had to start forumla top ups. I was in tears, shattered beyond belief, I thought I had failed. But it was on BB that I got a wealth of support, in hindsight, I should have waited another week, we could have waited another week to get her attachment better or return to using the shields. But I caved, I felt guilty as if I was starving her. So she was offered 60ml after each feed, which she took most times. Her feeds since coming off the shields were also back to taking about 1 hour, so it was exhausting, I would also try expressing so it was feeding, top up and expressing, 7 feeds at least a day, I was exhausted but persevered.
She started gaining weight again so I continued, she was hungry and I had to feed her, I was still BF'ing, she was still getting all the good stuff I had. I organised an appointment with a GP/LC who was beautiful and wonderful and told me that I shouldn't have been told to FF. She said she was small but looked perfectly fine. She upped my dose of motilium to 6 day and said to try weaning but if it didn't work just go back to 6 a day.
From then on I tried to wean off the Motilium and slowly drop the top ups etc.
We got the top ups to just two feeds a day, the evening and roll over feed. We were making progress. But everytime I tried to drop the Motilium my milk faded away.
Finally at 5 months of age, BF'ing stopped hurting, I couldn't believe it, it was an early morning feed and when it was over I realised that it hadn't hurt. Finally my girl had learnt to attach properly and suck without causing me pain!! OMG Miracles do happen!!! This is what BF'ing was supposed to be like, it was wonderful, I really begun to enjoy it more, was thinking I couldn't believe the pain I had put up with thinking that it was normal, even though people said it was supposed to be pain free and thought I was just being soft!!!
It was also soon after that Nakita's weight gains just flew up! She hit the charts before her 6 months Paed appointment and hasn't looked back since.
We started solids at 6 months and she is taking them like a champion, she was ready, but we always gave her boob before food.
Her top ups dropped, we were on the two, one at her 6.30pm-ish feed and the other at her roll-over feed, they were at 6-120ml, but over the at about 6 1/2 months she had cut them right back, down to 30ml before she had, drank enough, so I stopped them, and that was it, we were fully BF'ing with her solids :)
Things continued on smoothly and we hit the magical 12 months, that was my ultimate goal, I was thrilled, it was the most exhilarating feeling, it was at this point I decided to start weaning off the Motilium, it was a slow process but we managed to maintain feeding morning and night. From there the aim was reaching Nakita's Corrected First Birthday, in the middle of August, which we did, continuing to maintain those two feeds.
Last Sunday Nakita was very ill and required hospitalisation for 4 days and was on oxygen and ventolin, I stayed with her the whole time, we tried to BF'd morning and night and I offered at other times but she refused those. The last night when she was feeling significantly better she wouldn't have a bar of it, so I offered her some milk in a bottle which she drank happily (I didn't have the spare sippy cup with us). Then the last two nights we have been home complete refusal, she would just take 50ml of so from a bottle or sippy cup.
Although our journey isn't quite over, albeit very close, I felt the need to share our journey, as the title says it was the hardest yet most rewarding thing I have ever done, to be a lifesource for another human being can be exhausting but it was worth every second. Like many other BF'ing mothers we experienced nasty bleeding cracked nipples, countless blockages, which after time we grew better at clearing them, a nasty bout (not that there is a good bout of) Mastitis, weight loss and borderline FTT, I had people who lost faith in me and expected that the next time they would see me I would be FF'ing. I had placed a huge amount of pressure on myself especially at the start, and I went through times when I was made to feel guilty for having to use F. But you know what, this was my journey, my challenge and my daughter.
Next time and there will be a next time one day, I am confident that I can trust in my ability to BF, I may need a bit of Motilium, and I won't be afraid to take it from the start if need be. If I have to start out expressing again, I will be much more confident in remembering how to let down, and to relax.
There are so many other BF'ers that have provided support and advice and reading their experiences, triumphs and tribulations has made me understand that I am not alone in this battle. I don't believe that some people really understand the effort than so many mums have to put in to BF, my respect and understanding has grown dramatically over the past 14 months, I had no idea that it could be so difficult.
I am inspired by mothers who express full time, who feed through numerous bouts of mastitis, attachment issues, cracked nipples, biting and so on, everyday there is someone who is fighting to keep BF'ing, and from my experience KEEP FIGHTING it is worth every second.
We made it to 6 months!!!!!
DS and I have now been bfing exclusively for 6 months so I thought I?d post in this thread as a celebration! There were days when it was all I could do to just get through one feed at a time. (It's a bit long, sorry!).
I had an "unplanned" (emergency) c/section. DS stayed with me in recovery and we were able to have our first feed within about an hour or so of his birth. The feed lasted about an hour. The nurse in recovery was awesome! She helped me to attach him and swap sides. DS had good attachment and a good strong suck (well he was 11 days overdue!!). I was told my milk might not come in on time due to a heavy PPH immediately after his birth. I accepted a blood transfusion on about day three and my milk came in soon afterwards. I was told his attachment was 'textbook' and I felt really pleased and relieved that he seemed to know what he was doing. Bfing had been very important to me during my pregnancy but now that I?d had the exact birth outcome I had most dreaded/feared/wished to avoid, bfing took on a whole new level of importance. I didn't get anywhere close to the birth I had hoped for so I wasn't going to be giving up on bfing him! I had read a little bit about bfing and knew it would be 'hard' but I had no idea how difficult it was to turn out to be. Bfing my son is probably the hardest thing I have ever done in my whole life. We had one issue after another, often overlapping for probably 10-12 weeks before things settled down.
Things seemed great for about a week or so, then at the first home visit, DS had not quite gained his birth weight after just over 2 weeks. He was only 20g off but that's when the pressure started for him to gain more. So began a period of weekly weighing and ever increasing stress about his feeding and weight gains. His gains were implied to be small and decreasing, 150g, 120g, then 60g. I was told they wanted him putting on 200-250 and feeding at least 8 times a day. He was feeding 7 times a day and it was difficult to fit any more feeds in. 7 was his magic number. Each week they said, "hopefully next week we'll see a bigger number". When he only gained 60g they started talking Motilium and said my supply had dropped. I'd had no idea. My breasts never really got that engorged and I didn't leak much. Mum said she didn't either so I hadn't been that concerned about it. He'd always had plenty of very wet nappies and nearly every one was dirty as well. I started expressing after every daytime feed (so 5 times a day) and topping him up the previously expressed milk afterwards. I did that for a week and only left the house briefly twice in that time. I nearly went mad but I was determined to avoid Motilium if I could and I wanted to keep it as a back up plan just in case expressing didn't work. DS was taking up to an hour to feed, plus extra time topping him up, then I would put him down and settle to sleep (he NEVER stayed asleep after a feed!), then I would express with a hand pump for 15 mins a side, then wash everything up and sterilise for the next feed. Often I only had 15 mins before he woke for the next feed. I could eat or I could shower but I couldn't do both in the time I had between feeding. (Showering took me a while after the c/s). That week he put on 280g. The attitude and gushing congratulations of the MCHNs was so different to the previous week's concern when the only positive thing they could think to say was that I was "trying really hard".
After that week I stopped topping him up as much and I also eased up on the expressing. Possibly a little too early because he only put on 120g that next week so the stress and worry returned. Again I was encouraged to 'try for a bigger number'. I was so concerned about his feeding, unsettled behaviour during feeds and weight gain that I started keeping notes of every feed, including whether his nappies were wet/dirty and how much I was topping him up. I was paranoid they were going to start saying that I wasn't feeding him enough or properly or something and make me put him on formula! Sleep deprivation has a lot to answer for!! It was suggested that I try to keep him on each side for 20mins and there was lots of talk of foremilk and hindmilk. This turned out to be bad advice for DS, he wanted to be a quick feeder right from the beginning. Trying to keep him on for specific time periods just led to lots of 'battles' after a while and lots of tears from both of us. I continued to stress about how much he was getting and what his weight was doing. Because I'd had no idea my supply had dropped before I lost confidence in both of us. I still feel terrible admitting that now. I was listening to other people who barely knew us, rather than watching and trusting my son to take what he needed.
In the middle of all of this we got thrush twice. I'd never had it before and didn?t realise what was going on. Because I hadn't been able to feel my let downs, initially this is what I thought it was LOL! I also had damaged nipples that started in hospital despite his good attachment. Right before I started expressing to help him gain weight and increase my supply, I had ended up resting my left side for 36 hours due to ongoing pain. I was breathing through it at every feed. The nipple wasn't cracked but ringbarked at the base. Although his attachment was 'textbook' DS had been pulling back on my nipples. Nobody told me to stop him doing that. Everything I read focused on attachment and his was good so I stopped paying attention, even though it hurt when he pulled, his actual feeding didn't hurt. He damaged the right side too but not as badly as the left and it healed faster. I finally worked out that he was pulling in frustration at the slower let down on the left and possibly a slower flow as well. DS liked his milk fast and immediate. Occasionally he would bite me, especially on the left side. Ouch!! Of course, topping him up with a bottle wasn't helping because it was fast and immediate and he didn't have to work for it as hard. I suspect this is why my supply dropped in the early days. He was giving up too early. I couldn't feel my let down so I didn't know what was going on. It wasn't until he was about 10 weeks old that I started to feel my let downs and that's when his behaviour started to make some sort of sense. He also seemed to 'train' the left side because it started letting down faster and by about 12 weeks, he was feeding the same off both sides and not pulling back as much. To say that he was an unsettled feeder would be an understatement. He still fusses and carries on with crying even now at 6 months old, especially when he's tired but I know what's going on now so I am able to stay calm, try to relax myself more and keep encouraging him back on until the let down occurs. Sometimes he gets so worked up I have to give him the dummy to regulate his sucking and breathing before he can attach properly. He wants to feed but just gets beyond it. Strangely, he is easiest to feed when we're out and about. There's too much to look at, he's super fast and never cries :clap:
We've also had the typical issues more recently with him being distracted (even at home). He often turns to see what's going on but tries to keep my nipple in his mouth. The left side has started hurting again recently, although there isn't any damage that I can see and it seems to be improving again. Also a few weeks back I had a close brush with mastitis. Luckily I caught it early, knew to keep him feeding off that side and I also expressed a few times as well, even overnight for the first 12 hours. So I guess I know there still could be ongoing issues because of the way he feeds but I now have the confidence to work out what's going on and what I can do about it. DSs weight is still on the low side but I have finally accepted that he knows what he's doing (and so do I!!). Funnily enough, he's now feeding 8-9 times a day but only taking about 10 mins all up at each feed. Even though I am more relaxed about feeding him, the habit of counting his feeds and watching the clock is hard to break. :rolleyes: Now when he pulls off and looks around or fusses I know that he's finished that side and there's no point trying to get him to take any more. He still cries at times during the switch from one side to the next like he thinks he's not going to get the second side even though he's always had it at every feed!! He's a pretty happy, easy going kid most of the time, even when he's so tired his eyes are out on stalks we can still get a laugh out of him. I'd estimate that 80-90% of his crying has occurred around and during feeds.
I have to give a huge amount of credit to my DP and my mum who, IRL, provided me with endless support to keep going during the tough times. DP spent some of K Rudds money at Easter to buy me a double electric pump and it changed my life!! :) If it weren't for their practical and emotional support and encouragement I might have caved in and given him formula. And although that normally wouldn't have been the end of the world for most people, it would have been to me, partly because I would have seen it as another failure after his birth. I'm so proud that he's only ever had BM and I credit my ability to successfully bf DS with keeping PND at bay.
I also have to give the bfing problems and support forum and the regular girls who post in there lots of credit too. I didn't always post very much but reading what others were going through and the advice they were given was invaluable. To the regular posters who always reply and share their wisdom, I owe you a lot. :hug:
The main things I have learnt are:
*there is more to bfing than simply attachment*,
*no matter how much you want to bf a baby, only he is in charge of how much he drinks*,
*I need to trust my baby, ignore the charts, and put the numbers in perspective*.
And due to my experience of bfing DS, we have decided to do BLS. After trying to 'force feed' him for set periods of time at each feed etc which only led to stress for both of us, I never want to go down that road again. Although I feel guilty for not realising sooner how he was feeding and that it was ok, I am using that lesson to inform the rest of our feeding journey. He is not very good at increasing my supply on his own when he needs to so I need to leave him in charge of dropping feeds and not fill him up on solids too early. So far (5 days in) he's loving his finger food and actually eating some of it too! Although it is sometimes frustrating to still be feeding him 8-9 times a day, I know I will be sad when he starts to cut back on the number of feeds. I can't actually imagine him ever weaning, although logically I know he will eventually. When he's feeding calmly, it's some of the happiest moments in my day and I'm forever grateful that I persevered through the difficult early months. It has been so worth it.
