A new mommy's mishaps, mayhem, and majesty

Wednesday, January 19, 2011

anxiety and breastfeeding

I have a lot of pent up thoughts and emotions about this.

I can't remember how I wanted to start this. I feel I've been burying some important thoughts and emotions about this, and writing has always been the best way for me to get my thoughts and feelings in order. so here goes:
In my pregnant and pre-motherhood days, I had always thought I would breastfeed my babies. A secret part of me was a little weirded out by the idea, but then the thought of going through labor terrified me as well (or maybe it was thinking about that epidural needle that terrified me. Consequently, when the anesthesiologist came in to place the epidural catheter, I did not turn around to look because I knew the size of the needle that awaited me. Strange, that I have a hard time with needles passing through my skin but I can't wait to learn to stick other people with them. sadistic? I digress...). Though I have both watched and bottle fed babies in the past, I just figured breastfeeding would come so naturally. It never occured to me that it would be common to have problems with breastfeeding...
It all started from day 1...0?
After a challenging but healthy pregnancy, the labor and delivery went smoothly for both me and Lily. I never had a formal birth plan, but all the major things that I had hoped (and prayed a little) for came true: water broke, Matt was not at work, did the hour + 15 min drive to the hospital in 45 mins (who knew our crappy van could do 90 on the freeway?), did not get sent home the first time I went to the hospital, arrived on time, got an epidural, delivered vaginally after 30 min of pushing and 10.5 hours of active labor (I couldve gone a few hours earlier, but Lily had never dropped, so we had a long "rest and descend" period when I was fully dilated) , baby was healthy and most definitely the same sex as seen on the ultrasound. the only hitch I felt was that my parents arrived at the hospital 20 minutes too late (they are both RN's who work with babies and this is their first grandchild) after driving straight from California as soon as my water broke. Anyway, I should've known things were going too much like I wanted.
I was informed during our first attempt at breastfeeding that my nipples are flat. That may be a little too much info, but apparently it can be a major problem. After some rocky tries, Lily finally latched on. It was difficult for the first couple of days, but she seemed to be eating ok. She was sure sucking a lot. So much, in fact, that I ended up asking the nursery staff to give the girl a binky so I could have a break. I was aware that pacifiers can cause nipple confusion in young babies, but I figured she was doing ok- besides, I think binky babies are cute.
In addition to being a L/D RN, my mom is also a certified lactationist. while she was here the day that Lily was born, she went back to CA for the weekend because my sis was in a dance show fundraiser and it was kinda a big deal (all the time she kept sayong, "you're not allowed to go into labor until AFTER [the following monday]". it's karma, mom. what you don't want to happen will happen.). she and my dad drove up and then turned around and went back that night. Mom had been planning on coming up on monday for a few weeks to help us out with the new baby. But since she wasn't there for much of my hospital visit, I had to deal with the Lactitioner at the hospital. Though I tried explaining that my mom does lactation, she didn't seem to be satisfied with that. Mom had helped me the first day, and at this point (the 3 day, when we were supposed to leave), she wanted to try and change the way Lily and I did things. I felt we'd been starting to get the hang of it. At least, she could've been nicer. This lady seemed kinda high maintenance. And acted like her opinion was the only one that matters. She kept telling me that I was doing it wrong, and insisted I do it a different way. And then she got worked into a huff about whether or not my mom was board certified, and kept trying to talk me into renting a breast pump from the hospital when I informed her that I already HAVE a pump (a good one, too), but I needed the attachments for it and just needed to purchase those. In addition, she thought I needed to come to the lactation clinic for $30/hr. Why not: 1. I live in Ephraim, over an hour away; 2. Like I just told you, my mother is coming for a couple of weeks and she IS a lactitioner. So why am I gonna drive all the way up here and pay money I don't have for the same advice that I can get FOR FREE at home? and why rent a pump when I already have one??
She got a rather sour look on her face when during the time she was with me, my mother called and said she was at the breastfeeding store at her hospital (she gets a good discount) picking up supplies before she got on the road and wondered if the lactitioner thought I needed anything in particular. This lady was just trying to make money off of me, I think. And she didn't make a dime.
I think the worst part was when she told me that not only are my nipples flat, but that I have "mini-marshmallow nipples." I felt rather humiliated. If she had been nicer I might've paid more attention. I was already a little self-conscious about losing my privacy. Comparing me to other women was not a good way to get on my good side. I had no idea that there was anything about my breasts physically that could cause a roadblock. My experience with this lady destroyed a lot of confidence that I had about breastfeeding.
Apparently I wasn't the only person she rubbed the wrong way. The door hadn't even closed all the way before Matt said, rather audibly, "WHAT a piece of work!" I don't know if she heard him or not, but I could see those stiletto boots of hers under the curtain as she clacked out of the room. The nurse manager came in a few minutes later and asked about our experience with the hospital and staff. Matt made a few comments, and she AGREED with us! Wonder what this lady is like to work with... glad she isn't at my hospital.
Whether or not it is the "right" way according to her, Lily and I have made it work. She is thriving. Although, I have had to supplement her with a bottle....
THAT started the day after we came home from the hospital. Lily's bilirubin levels were getting high upon our discharge, so we were instructed to take her in to have her bili levels drawn the next day. We went to Sanpete Valley- I wasn't going to drive to Orem just for labs. She was looking a little orange that morning, but she had been before we left the hospital. I was a little concerned that she hadn't pooped in 24 hours, and her pee was looking a tad orange. The lab results came back as I was showing off my little baby to my coworkers. Her bili levels were at 18.7- almost at a dangerous level. In conjunction with that, the poor girl was apparently dehydrated. She would have to be admitted.
I was rather hard for me to see my poor little newborn back in the hospital so soon after coming home. I hadn't had a good night's sleep in weeks prior, and certainly not since giving birth. It's a good thing I knew everyone at the hospital- it gave me some support and encouragement I desperately needed. Especially watching my sweet Lily get her first IV- on the scalp, because her dehydrated little veins were hiding everywhere else. She was placed in a bili light bed, and since my milk was still coming in, I had to pump every two hours, feed her what I got, and then finish her off with formula until she was full. I really hadn't been planning on bottle feeding her at all. Grandma had bought her this set of bottles which are supposed to mimick the breast, requiring both suction and compression instead of a traditional nipple, which only requires suction. Those bottles were at home, so she got the cheap 'n easy nipples at first. But the damage had been done. She found it much easier to suck on the bottle nipples than mommy's. And when her bili started going up instead of down, the doc told me not to give her breastmilk, just formula, and see if she improved. Breastmilk can contribute to jaundice. So for now I was pumping and storing my milk. That was another big blow for me. Not only was my baby not getting enough fluids from me, but my fluids were probably making it worse. Mom stayed with her the secind night so I could get some rest. I went home and bawled. I felt like a horrible mom because my baby was dehydrated and her jaundice was related to breastfeeding. I felt like an idiot for not realizing earlier that something was not right. And now it was going to be even harder to get back to breastfeeding- the little stinker had made up her mind that she liked the easy bottle better (I was a little offended). She had formula for several days before I was given the green light to nurse her again.
I was still dealing with the typical nipple pain most new moms experience, not to mention the engorgement as my milk slowly came in. Now I had to deal with nipple confusion. Trying to breastfeed her after coming home again was pretty much a nightmare. She wanted nothing to do with it. Even with all the tricks my mom knew, Lily was a difficult case. It took a different trick each time to get her to nurse- sugar water, nipple shield, inserting expressed milk/ formula under the shield, removing shield when she kept pulling it off with her gums, changing positions, using a syringe, squirting in her mouth, putting the bottle next to the boob, skin-to-skin, using a latch assist, pumping to bring my nipples out more, getting her to latch while asleep- we even tried the "rebirthing" method; putting her on my chest in a warm bath and encouraging her to instinctively find the breast. That worked for about a day. She's as stubborn as her mommy, I guess. In addition to her temperament, breastfeeding was still very painful for me. As soon as she would latch, my body would tense up as I tried not to holler. That wasn't helping the milk flow any. Nor was she all that patient about waiting for let-down.
I got to be such a struggle that I began to dread her hunger cry. Because it was likely to result in more screaming, frustration on both our parts, and end with me giving her a bottle of breastmilk and going to pump my boobs afterward. I started going straight for the bottle, especially at night. I do have to admit, it was nice to have a break when my mother or husband fed her instead. I was just about ready to give up. And why not? Plenty of moms have had trouble breastfeeding. I wanted her to have breastmilk because it is infinitely cheaper than formula, and better for her, too. I could just pump a few times a day before meals and feed her that way.
We don't have a dishwasher so I wash everything by hand. Bottles, pump attachments, nipple shield, milk storage bottles, not to mention the rest of our dishes. I was starting to feel like a cow. And boy, was I tired of washing so many dishes several times a day!
Finally, I grew tired of milk spilling everywhere each time Lily would start eating with the nipple shield and the rip it off in frustration. Not to mention dripping all over myself when I would shift the pump attachments wrong and break the suction.
I'd hung on to the shield because it was less painful wearing it. Then a girl in my nutrition class told me that after nursing with a shield for 6 months, her milk had dried up. I decided I'd better get rid of it.So she was just going to have to get used to doing it the old-fashioned way. She was a bit older now, and despite her fussing, she eventually caught on. And now the big problem was still the pain, which supposedly goes away after the first few weeks. Maybe my nipples just needed a bit of toughening up.
I also tried adjusting her latch so she had more of the areola in her mouth. Her comfort nursing was the most painful, so after she fell asleep I'd sneak the binky in instead of my breast. Funny enough, she now wanted to nurse almost all of the time- even refusing the bottle sometimes. We settled in to some sort of routine. She still never seemed satisfied at the end of a feeding session, even when she chose to end it, so I'd offer her a bottle. The nipple pain was diminishing, and I finally was able to relax more and let nursing do me some good as well. It finally seemed like smooth sailing.
And then I got mastitis.
I followed the doc's instructions to keep nursing and pumping to relieve the hardness and swelling, along with a round of antibiotics. The redness and boob pain went away after a couple of days, but shortly after my nipple pain returned. The anxiety I had experienced every time she was hungry increased. I had become conditioned to slightly panic every time she wanted to eat.
I have a variety of emotions about this. I want to do what's best for her, but I need to take myself into consideration as well. On the one hand, I am grateful that I have enough milk to feed her with. On the other hand, it has been such a hassle and struggle that maybe weaning her now would make it easier for both of us. I've talked to other moms that have had similar problems that nursed for shorter periods of time. I also have a cousin who pumped for 6 months because she could not get her oldest to go back to breastfeeding. But for some reason I've attached some of my self-worth as a mother to my ability to nurse my child. I am envious of other moms I've seen who effortlessly pop their babies on/off their boobs for 15-20 minutes, and the child is happily satisfied for a few hours. When I can get my baby on, she wants to stay there for hours, and never seems satisfied. Nowadays she 's fallen into a bad habit of falling asleep after a few swallows and wants to comfort nurse all of the time, which is the most painful for me. Perhaps I am a rare exception to the pain rule. Positions and latch adjustments do not make a difference.
For some reason, I feel like I would be a bad mother if I chose to wean her at only 2 months and go to full-time bottle feeding. This doesn't seem fair to the moms that have had to resort to other options. Their children seem just as happy and healthy as the rest. But not only does the cost of formula scare me, the horror stories about tainted formula cause me anxiety as well. I really have no idea what is in the formula I feed my child- I have to trust it is what the label claims it to be. And the thought of pumping several times every day, plus feeding, plus washing the bottles is somewhat exhausting. But I feel that we can bond with a bottle just as easily as nursing. It would be less of an emotional stress on me, and less confusing fo her without constantly switching from breast to bottle. The idea calms me, but at the same time I feel guilty. Women in olden times didn't really have that option, did they? I'm sure they found a way to feed their babies, whether by a wet nurse or some sort of bottle and alternative food source. Really, the thought that I should torture myself because ancient women had to is ridiculous, and does not show gratitude for the blessings of our modern-day world. And I shouldn't think that this is my only opportunity to nurse a child. Perhaps my second baby will be easier. Not only that, but trying to force her to breastfeed like that could affect our relationship.
I am also having anxiety over another matter. 3-4 days into my round of antibiotics, I remembered that antibiotics + birth control = no bueno. That was how Lily's second cousin, born 5 days after her, came to be. My boobs were very sore during my first trimester carrying Lily. Not to mention my insatiable hunger and thirst the last couple of days, along with a very slight pressure in my abdomen, I've also read that a second pregnancy can cause feelings of restlessness and soreness while breastfeeding. Certainly it would explain my mood swings.
I don't think that it is likely, but at the same time, I have to wonder- would I be able to handle it? Would it be worth it to me to continue breastfeeding while carrying a second child? That would muchly depend on how long I can stand the pain of being gnawed on during a very sensitive period for my boobs. And I would be concerned for the development of another very tiny person. Most likely if that were to happen I would pump a few times a day and give her formula the rest of the day. I'm not sure I could handle two babies under the age of two. The plan was to wait at least until after Lily's first birthday before trying again. I for some reason had this crazy notion about wanting to be pregnant again- but it was a crazy notion I'd chosen not to act upon. Accidents happen. That sounds horrible. I hadn't planned on having Lily, but I had really wanted her. We were not financially ready for it. It was divine providence that we got to where we did before she came. I would gladly welcome another child whenever they chose to come to our family, but I would like to be actively trying first!
Sheesh, all this steeling myself for the possibility has made me excited. It might be harder to accept that I am not pregnant if I keep thinking about what if I am! I seriously doubt it.
The point I am trying to make to myself is, I have to do what is best for my children and what will bring me peace. If I need to be unconventional, so be it. I cannot make an accurate comparison between what works for me and what worked for someone else. My situation is unique, and so are my needs. As long as my baby(ies) are healthy and happy, and it keeps me mentally sane, that is the important thing. If you've stuck with me throughout this ridiculously long post, I appreciate it, though this therapy is more for me than it is for you. I am my harshest critic. I need to cut me a bit of slack and not worry about my work ethic if I choose to take a few shortcuts along the way.

4 comments:

  1. Ugh, reading this is bringing back so many memories of trying to get Anya to breastfeed. I kept hearing that many women get stimulated by their baby feeding, and I cringed just thinking of how much it was going to hurt. We've been at it for almost 8 months, and it still hurts. Don't worry if you wean Lily! Formula kids go to college too! And you are right, you don't have to torture yourself just because women throughout history have. It sounds like you guys are doing great, even with all the bumps in the road! You are such a trooper!

    ReplyDelete
  2. Besides, kids fed with formula don't have to take Vitamin D drops or worry as much about trying to get enough stupid iron! Anya would be getting at least some formula if she didn't hate it so much. *grumblegrumble*

    ReplyDelete
  3. Oh wow I feel like you wrote my story minus the hospitalization for jaundice. I was so frustrated with breastfeeding and trying to get Aly to eat. She didn't gain her birth weight back for almost a month. Finally we switched to formula and it's so much more convenient and lots less frustrating!! I seriously think I cried for the first week of her life. Between her refusing to eat and the pain of trying to make her latch...My poor husband had a lot of consoling to do! You're lucky it got better!! Alysha only breastfed for 2 months and I dried up.

    ReplyDelete
  4. Sounds like problems with breast feeding are very common though. In the "old-times" women might not have had other options, but the infant mortality rate was much higher! Even if it doesn't work out for Lily, it doesn't mean it will be the same for future children. My sis in law couldn't breast feed her first but her second has taken to it right away and is doing great. I know you're being the best mommy you can be!!

    ReplyDelete