Monday, November 09, 2009
Breastfeeding: If At First You Don't Succeed
Sherwin's story (below) of her early struggle with her first born son's latch and her determination that he would ONLY receive breastmilk is one I really relate to. Our first born son also had trouble latching at birth. And I was as adamant as Sherwin that he receive nothing other than that which was optimal for him - human milk. So I immediately began pumping the day after his birth (first colostrum, and then milk) and fighting off people who wanted to "just give him a little formula."
We used a finger-technique and syringe to work on his sucking skills and to feed him for the first 4 1/2 days of his life. I pumped with the Ameda Elite (a wonderful hospital grade pump designed to get milk supply in and up and keep it high even when a baby is not able to nurse). And, like Sherwin, I had a 'melt-down' experience as Day 5 approached and our son had not yet mastered his latch.
It was my first birth, my first mothering experience. I had looked forward to nursing my little one with such blissful ideas of how it would go -- how could it be this difficult!? My grandmother nursed 8 babies. My mother nursed 4. I was told that I latched and nursed like a champ from the get-go.
But I was extremely saddened and haunted by the way our planned, gentle, home waterbirth had ended in hospital transfer and the exact birth experience that I had done everything in my power to avoid. And on top of all my other emotions surrounding our issues in birth and breastfeeding, was my professional embarrassment. I had just completed an additional graduate degree with a focus on (of all things!) birth and breastfeeding! I was teaching courses on the subject to college students and workshops of parents. It was more than humbling and slightly mortifying to experience 'difficulty' myself in both areas. And I knew that when birth is 'messed with' -- i.e. not completely physiological and mother/baby-friendly in nature -- it often leads to breastfeeding complications. So feelings of guilt were thrown into my mix as well.
My husband was set to leave for 4 months overseas on Day 5 and I could not fathom him taking off when we were not yet able to naturally feed our newborn baby. We had no family nearby and had recently moved to VA so I knew very few people in the area. Unfortunately, the military does not care much about nursing babies or new recovering mothers.
And so, with all this *stuff* piled on my heart, I sat on our couch with my hungry baby boy at 3:15 am (exactly 5 days to the minute after my water broke) and once again encouraged and cheered for him as he made feeble bird-like attempts to latch and nurse. As Sherwin's lactation consultant advised her to do, we also spent 5 minutes on 'breastfeeding' (or lack thereof) and then used the pumped milk to syringe feed him while we practiced his latch/sucking. On this night, after 5 minutes, he was still desperately trying to latch and nurse on his own. It was heartbreaking. "Please, God!" I begged. If ever I wanted anything, THIS was it. I felt so helpless. So broken. I just wanted to normally feed my little one and not deprive him of everything he was meant to have.
So I prayed and prayed and prayed and tried again.
And this time, he got it! He latched and nursed - all night long - and every day and night since. We exclusively breastfed until 10-months of age and he grew healthy and hearty all the while. Today, 15-months-old, he still nurses whenever he feels like, day or night.
I am so thankful that I had previously been introduced to the Ameda Elite pump and that a lactation consultant helped us master the finger/syringe technique (instead of using bottles). I do believe that this is one reason that our son finally got his latch down that night after 4 days of determined 'practice' with the finger/syringe, rather than at 4 weeks old as Sherwin's son experienced. Either way, her story and our experience are examples of how breastfeeding DOES work and CAN work - even when there is difficulty and nay-sayers and necessary problem solving in the beginning.
Every human baby - even those who come into the world needing a little extra practice and a bit of additional help - deserve the human milk that is designed perfectly for them.
Determination and creative problem solving pave the way to a mother and son's exclusive breastfeeding relationship.
by Katherine Towne Sherwin
(photos below by Cari Ellen Hermann)
I am the daughter of a woman much like many of those featured in the pages of Mothering. My mom wanted to mother her children a certain way, and did so despite resistance from those who should have most supported her: her family members and doctor. She knew, for example, that she wanted to breastfeed her children, an idea that her own mother - a strong, educated, independent, loving, and wonderful woman - found unpleasant, even objectionable.
Mom believes that if more support had been available to her, she might have done much better in her attempts to breastfeed me, her first child. But although she tried, weeks after birth I was still losing weight, and cried hungrily all the time. First, to relax her, the doctor suggested wine or beer, which my normally temperate mother dutifully tried. When that didn't work and the doctor suggested formula, Mom chose what she understood to be my survival over her own idealism, and was so grateful when I then eagerly took the bottle. Later, she went on to successfully breastfeed my two brothers and three sisters, and I grew up "nursing" my dolls, never questioning my own assumption that my children, too, would be breastfed.
When I was pregnant with my first child, it never occurred to me that breastfeeding might not be a fairly easy thing to do. After all, if any new mother was blessed with support and experienced
help, I was: My husband and midwife both supported my decision to breastfeed, and Mom had breastfed five of her six children. While in the hospital for the birth of our baby, I confidently told the nurses that, no, the baby was not to be given a pacifier, and no, he was not to be given a bottle of formula. I was going to breastfeed! And for the few days we were in the hospital, we valiantly tried to do so.
But my beautiful son, Thomas, had other ideas. It was only after having such difficulty breastfeeding him that I could picture my own mother at 27 - just my age - struggling to feed a hungry bird of a baby, and finally being so grateful for the nourishment provided by a bottle of formula.
It was the baby-bird thing that made me so desperate for help. Thomas would bob his head around my breast, mouth open, wrinkled neck long and scrawny, whimpering pitifully. I've always been personally modest, and was embarrassed when every nurse on every shift tried to help Thomas latch on correctly. They encouraged me to try different techniques - some preferred the "football hold," others the "cradle hold" - and everyone of them grabbed one or the other of my breasts, and pulled and squeezed and shoved it into the waiting open mouth of my tiny, hungry new baby. But no matter which hold I used (I quickly found that I preferred the cradle hold, just as Mom had), or which nurse was helping, my little one just couldn't latch on. His tongue kept getting in the way - he'd keep the tip of it touching the roof of his mouth, so even when nipple and areola were properly placed in his mouth, he wasn't able to suck. No matter how many times I'd maneuver my nipple into his mouth, he couldn't seem to find it.
The day after Thomas was born, the nurses let me know that they were worried that he hadn't yet gotten any nourishment. They told me his fussiness meant he was hungry, and asked if I was still sure I didn't want him to have a bottle of formula. Yes, I told them, I was sure. But my confidence was waning. I knew it was common for babies to lose weight between birth and being discharged from the hospital, but Thomas did seem hungry and thirsty; his dry, throaty little cry would quickly wear him out, and he'd fall asleep as much from exhaustion as from what seemed an attempt to escape this cruel world he'd been born into, where he was always hungry.
That night, the nurses suggested I pump a bottle full of breast milk for him. So at 2 a.m. I tried, while Thomas was crying, but all I could extract was the tiniest bit of colostrum. He was able to drink it from the bottle, and I knew it was the same as what he'd be getting directly from the breast had he been nursing. It would be enough - it had to be enough - even though it was hard to imagine it would be.
I was eager to get home. I felt sure that, once home, and away from the nurses trying to maneuver my nipple into Thomas's mouth, we'd figure things out. I'd be more relaxed, Mom would be there to help, and everything would work out.
On my second day home from the hospital - the fifth day of Thomas's life - I had a total collapse. I'd been repeatedly struggling to get Thomas to latch on, but my hope that everything would be fine once I was home had not been fulfilled. He continued to sniffle and snuffle around for the nipple, whimpering and panting, then going into full cry before falling fitfully asleep again. lt was heartbreaking. "Isn't this supposed to be a natural process?" I wondered. I was already sick of the phrase "having trouble getting Thomas to latch on," which I repeated to everyone who asked how he was nursing. I sat on the couch with Thomas that fifth morning, the two of us crying our eyes out - which is how Mom found us when she stopped by. She took Thomas in one arm and me in the other, and we talked and prayed about what to do.
It was important to me that Thomas be fed breastmilk exclusively, but it was even more important to me that he thrive. And then it occurred to Mom: Why not pump? She'd done so for my sister, who, after birth, had spent months in a coma because of brain damage caused by her traumatic birth, and couldn't latch on. It seemed the perfect and most logical answer, and yet, until that moment, neither of us had thought of it. Indeed, my mom remembered that when she, a new, first-time mom, was having so much trouble trying to breastfeed me, no one had ever advised her to pump.
That afternoon, sunlight finally burst through the gloom of those first few days as my husband went to the store to buy the Avent Isis pump and bottles, which I'd read were the best for preventing nipple confusion due to their Similarity to a mother's own anatomy. When I was able to force Thomas's tongue out of the way with the bottle's nipple and then watch him devour my bottled breastmilk, I finally - FINALLY - felt like the good mother my beautiful child deserved.
He immediately started sleeping better and putting on weight, and a successful, yet exhausting, routine began to emerge. When Thomas was hungry, I'd give him a bottle of pumped breastmilk, and then I would pump again, to be ready for the next feeding. All day and all night, I fed and pumped, fed and pumped. My back was weak and sore from my nervous, hunched-over pumping posture, and I found that there was little around the house that I could do without my back and shoulders aching. But I am so grateful for two important things that happened during those days: First, even though I was being stimulated only by a pump, and a hand pump at that (I didn't want to invest in an electric one until I was sure that normal breastfeeding was out of the question), my milk supply kept up with Thomas' demand. Second, I had the conviction and stubbornness to continue pursuing my hope that my baby would be entirely and exclusively nourished by my own breastmilk.
When Thomas was a week old, and two days after I'd begun pumping, I went to see the lactation consultant at the hospital where I had given birth. She told me to bring in the baby, still hungry, so that she could see what happened when I tried to nurse him.
That's what I did - and Thomas remained asleep the entire time. After the consultant and I had each tried, unsuccessfully, to wake him, she finally said in exasperation, "I can't do a thing
with him while he's sleeping." She advised that, before each feeding, I spend a few minutes trying to get him to latch on, or just letting him rest on my breast, so that at least he would receive the comfort and closeness that breast feeding provides.
For the next two weeks, before each bottle, I tried to get Thomas to latch on to my breast. At the suggestion of the lactation consultant, I limited these attempts to five minutes, so that neither Thomas nor I would get too frustrated. It wasn't easy - feedings took longer, because I first let him try to breastfeed before giving him the bottle, then pumped for the next one. But Thomas was growing and thriving, so although I was tired - as all mothers are - we were both happy.
SUCCESS AT LAST
Then came a rainy late afternoon in mid-October, when Thomas was nearly a month old. I'd settled on the couch to feed him. He was hungry, the bottle was ready, and as usual I took him to my breast and watched him snuffle around for my nipple - which, also as usual, was already in his mouth. "Come on, Thomas - it's right there!" I chanted my constant mantra of encouragement and frustration as, again as usual, I tickled his lower lip with my nipple, then swooped it up into his mouth. But this time, something different happened. He seemed to latch on correctly.
Had it actually worked? At first I wasn't sure-too many times before, especially when we were still in the hospital, I'd thought he'd latched on when he hadn't. But now I heard him swallowing rhythmically, if a bit frantically. When he burped well and fell right asleep, I knew we'd been successful. For the next few days, just in case, I kept the pump close by, but I never
needed to use it for Thomas again. It felt so wonderful and liberating to finally be a breastfeeding mom!
Two years later I gave birth to our second son, Gabriel, who took to the breast much more easily, though he, too, had problems with latching on. He did well enough in the hospital that the nurses weren't concerned, but when we got home, I did resort to using the pump a couple of times.
At Gabriel's one-week checkup, the pediatrician suggested I try formula, as Gabriel wasn't gaining back the weight he'd lost as quickly as she would have liked. When I told her that I'd been
giving him bottles of pumped breastmilk, she warned me about nipple confusion. But while I appreciated her professional opinion - the best she had to offer - I was confident that Gabriel and I would do just fine. Indeed, just a day or two later, he was exclusively breastfeeding, and
I never again had to use the pump with him, either.
Last summer, just before my third son was born, and after having had so much experience in breastfeeding Thomas and Gabriel, I was once again hopeful that breastfeeding would be the natural, normal experience I've always expected. And it was: From the first moment, John took to the breast like an expert, and since then has consistently been a far more voracious nurser than either of my other two.
I've learned so much about breastfeeding from each of my boys. I take comfort in knowing
that if my husband and I are blessed with another child, and that new baby struggles to latch on, I'm well armed with good strategies: pumping and trying, trying and pumping.
Katherine Towne Sherwin is a woman, wife, mom, and writer, trying as hard as she can to be the best of each. She lives in upstate New York with her husband, Steve, and their three sons.