Boob

This is a post about breastfeeding, so guys, fair warning given.

I have had very different breastfeeding experiences for each child, both were a struggle at first, but then we 'got it' and amazingness followed and it was all worth it.

*Please note that this post is not medical advice, I am simply sharing my experience. Should you have any issues with breastfeeding please speak with a lactation consultant or contact your local La Leche League.*

I'm not going to lie. Breastfeeding is hard. It is this thing that is supposed to be all 'natural' and 'easy', but it is not (at least not for me and every other mom I've spoken to). But that doesn't mean it isn't the most wonderful thing in the world, it is. It is just something that, quite unexpectedly for me, you have to really really work on and want to do. And even then, sometimes it just doesn't work out. And that's ok. As moms we try so hard to provide the very very best for our children and sometimes, for a host of different reasons, that means not breastfeeding. We just do our best. Here is our story.

My experience with Liam
Liam was born three weeks early, and while this is still considered term, I never thought it could have factored into the initial difficulty we had with breastfeeding until I had a real preemie! It took Liam and I over 6 weeks to fall into the rhythm of breastfeeding, so when he and I finally 'got it' he was almost a month past his due date. We consulted with lactation experts, who gave us some excellent advice on how to hold him and insist on a good latch. Liam would often not open his mouth wide enough, so we would spend quite a bit of time latching and unlatching and getting it right. Then he would suck properly and promptly fall asleep. It would take 30-40 minutes every 2 hours at the beginning. But we kept at it, and after about 6 weeks he was an expert - on and off in 10 minutes, totally on demand (not scheduled!). But nobody told me we would have to work so hard at it and it could take 6 weeks! That was like an eternity! He then nursed like a champ until we weaned him at 19 months. Yes, 19 months. Liam loved his boob. And I loved nursing him. It was great! No bottles (he had a bit of an oral adversion, he never even let me put a spoon in his mouth) to clean, no milk to warm up, just pop, boob, eat, done. Easiest thing EVER!

But in those 19 months I had many MANY blocked ducts. This is when milk get clogged in one of the ducts and results in a hard lump in your boob. Feels like a big marble is in there. I consulted with a nurse and baby expert who gave me some great advice "Heat, massage and feed on that side every two hours until it is gone". This means, get myself a hot pack, warm up the marble in my boob, massage firmly yet gently towards the nipple using olive oil (it is edible, massage oil is not) and get my kid to feed from that boob every two hours. If he's not hungry or the other boob is full, get out my breast pump. This could sometimes take up my whole day or night. The fastest I ever got rid of a lump was after about 6 hours, but usually it would take at least 12. If I found a marble in there, my day/night was now dedicated to getting rid of it - cancel all plans, I've got a blocked duct! The goal here is to unblock the duct before it gets infected and causes mastitis. I never had one case of mastitis in the 19 months I nursed Liam. But I had lots of blocked ducts. I stopped counting them after I got to 15. They became less and less frequent as time went on for several reasons I think: I got better at making sure he fully drained a breast, I stopped sleeping on my boobs (I'm a stomach sleeper so this was very difficult) and I bought good nursing bras (no wires). So, even with all this pain-in-the-boob business, was breastfeeding worth it? Hell yes! Small, small, small sacrifice for me so that Liam could have the best nourishment in the world. Plus I hated cleaning bottles.

My experience with Adeleine
Breastfeeding a preemie was a whole other adventure. Adeleine was 13 weeks early and at 2lbs, 2oz she could barely breathe on her own, let alone eat. I began pumping about 4 hours after her birth. The nurse woke me up at 5 in the morning with a industrial strength (hospital grade) breast pump and handed me my kit. I was to pump every 2 hours - starting...NOW! Apparently, just because your kid is in the NICU doesn't mean you get to sleep in. So it began. The NICU nurses would ask me if I got anything yet every time I went to see her because they described the first colostrum as 'liquid gold'. I would get just a ml or two in a teeny tiny syringe and bring it to the NICU like it was this big deal and they would get SO excited about it! It made me feel really good. Like even though I couldn't hold her, or comfort her and I was feeling this immense guilt of not keeping her in long enough, I could still do something for her. I could still give her my milk. I could still be her mom and provide the best I possibly could for her. That milk meant a lot. To both of us.

I was very ill after I had Adeleine. I had an infection in the placenta which after the birth resulted in an infection in the lining of the uterus (Endometritis - not to be confused with Endometriosis, which I didn't have thank goodness). Anyhoo, by the time I left the hospital I had been on 3 or 4 different types of antibiotics and another two more were added when I got home. Antibiotics kill all bacteria, even the good, and tend to result in bad bacteria taking over. This combined with the fact that I was sweating so much at night I would change my shirts three times (creating a very damp dark environment, perfect for bacteria), all the stress, getting up in the night to pump, not sleeping anyway because I was so worried, and finally the fact that pumping is just not the most efficient way to drain a breast (babies are), caused me to get mastitis. One Saturday I didn't pump on my regular schedule, I was late for a few pumpings and then I chose to hold Adeleine for a few hours instead. Apparently not sticking to my pumping schedule was a big mistake. I had no lump to warn me, just suddenly a red infected boob and feeling totally like shit. I DO NOT HAVE TIME FOR THIS!!! Back to the clinic for more antibiotics. Wait, didn't they contribute to this mess in the first place? Yes. But that's the treatment. OK then. Moving on.

The lactation consultant was worried that given my previous experience with blocked ducts and the fact that Liam was little, that I would not have enough milk. The goal was to pump 1000ml a day to keep up with Adeleine's demand when she got home. I recorded every drop of milk pumped in a little booklet each day, gauging my 'work day' by how close I got to 1000ml. I was a 750-800ml girl, on a good day I'd occasionally hit 900. I don't think I ever got to a litre. While my volume surprised the lactation consultant, I was constantly disappointed by not getting to that magic number. Let's just add that to the pile of stress ok? Good.

A week later I got a stabby pain in my boob. Like several knives all at once. It hurt to pump, it hurt to move. What the hell is this now? I spoke with the lactation consultant who diagnosed me with 'intraductal yeast'. So the wet nightshirts, heavy doses of antibiotics, stress and no sleep had all resulted in the perfect storm for yeast bacteria to take over my breast ducts. What the hell??? Again I DONT HAVE TIME FOR THIS!!! So, I get on some crazy medication to treat the yeast, which at this point had me suddenly yelping in pain as I walk down the street. People think I'm nuts. I look like shit, I feel like shit, I cry at the drop of the hat, I scream "OW!" for no apparent reason - anyone that didn't know why this was all happening would have had me committed. Oh, and I forgot to mention that the medication turns your nipples purple. PURPLE!!! As if I don't have enough going on now I have to deal with purple nipples that can permanently stain anything they come in contact with, not to mention look ridiculous on someone who already admittedly looks like shit, so self-image at this point was at an all time low. Liam looked at me when I came out of the shower one day and screamed "Mommy! Why are your nipples BLACK????".  Purple Liam.  They are purple.  Ugh.

Ok body, lets just get through this and get better shall we? Moving on? Please? For about two weeks, yes. Then mastitis again. No warning again, just woke up with a rock for a boob, a red streak down the side and could hardly move. Bam! I was down again for another week, back on antibiotics and worst of all, couldn't go see my baby in the NICU. At this point my mother had enough and was pretty frustrated with me and yelled "Well I would have quit a long time ago!" Translation: You are doing this to yourself. Stop pumping. Love, your mother. The lactation consultant waggled her finger at me and said "Tut,tut,tut. One more time and you are done lady". Translation: You have had just about enough and you have my support to stop if you want. This was very freeing for me. To know that it was my choice to quit and that I would be supported and it would be OK. But how could I quit? My milk was providing antibodies to a baby with NO immune system. A baby that should still be inside me, protected. There was no way in hell I was going to be the one to quit. If she could fight through every day in the NICU, I could at least do this. Adeleine was going to be the one to tell me to stop, and so far, she was loving every last drop of my milk and it was keeping her healthy. It was the only thing I could really do for her. So I kept pumping.

Two weeks later I was diagnosed with intraductal yeast again. Apparently the purple stuff had not got it all (Should have had Sunny D! ...sorry, couldn't resist), so I went on the purple stuff again along with some ridiculously strong antifungal medication for two weeks (no fungus will ever live on me for the rest of my life I'm sure). This seemed to do the trick. Wait? Did it? Not really. I got mastitis AGAIN. So why didn't I quit then? Lord knows I had nobody left who still thought it was a good idea (except my wonderfully supportive husband). At this point most people just rolled their eyes at me.  I kept going because we hadn't even given breastfeeding a REAL try. We hadn't even started yet! She was still in the hospital, they would let me try and breastfeed her once a day if I was lucky and she wasn't tired out. I was going to stop when Adeleine told me to stop. In my mind, we hadn't even really TRIED yet.  My job was to give her the opportunity to breastfeed and I couldn't take it away before she was ready to start. So I kept pumping.

If you have lost count I had mastitis three times and was treated for intraductal yeast twice. In 15 weeks. The longest I went without being sick was something like 3 and a half weeks. Was it worth it? Hell yes. Yes, yes, yes, yes, yes. I would do it again for her in a second (not that I'd enjoy it obviously, but I'd do it). Totally worth it. It took a month after her due date (two weeks after she came home), but Adeleine finally had the strength and the coordination to breastfeed exclusively.  And with such enthusiasm! She much preferred breastfeeding over bottles. She loved her boob. She just needed me to wait for her to be ready for it. I already knew with Liam it took several weeks, but if she had been my first child, I probably would have quit, not having the confidence or patience to believe we would ever get there. Breastfeeding a term baby is hard enough, breastfeeding a preemie is super difficult. Early on when we started to try (at 35 weeks gestation) she struggled with having enough energy to eat, reflux, choking, getting the whole 'suck, swallow, breathe' coordination down and taking in enough to keep the dietitians happy. It appeared pretty hopeless for a long time. She was just so little and tired.  So I waited for her to be ready (ng tube out and getting her doctor's ok) and we gave it a good try - no bottles and 'real' on-demand feeding for a full day - and she took off and never looked back. (We tried 'on-demand' feeding once when she was in the NICU and I have to say, that they have a strange definition of on-demand. The NICU's version of on-demand was waiting for the child to cue, but if it was more than three hours in between feeds the nurse would freak out and tube feed them. How is that on-demand? Seems like the regular 'every three hours' schedule to me - but whatever.) Since I stopped pumping and Adeleine started feeding, I have had no breastfeeding issues. Not a blocked duct, not a hint of anything wrong. (Knock on wood!!!!!) Adeleine is about 16 lbs now, a great weight for 5 months (corrected age). I plan on breastfeeding her for as long as possible. As long as SHE wants to. We struggled to get to this point together and we are both enjoying it so much - it does us both a lot of good.

So, breastfeeding was hard at first. With Adeleine the 17 week struggle just to get to breastfeeding was harder. BUT then it is so very easy. And awesome. And you forget about the struggle and just enjoy every moment with your beautiful child. I got through the hard times with the help of lactation consultants, the support of my husband who knows the value of breastmilk to a child, my own pure stubborn-ass-ness and the incredible inspiration of my teeny tiny baby girl.

Resources/Links
Here are a few resources that I used:
Hospital lactation consultants
Community lactation consultants
Other breastfeeding moms
Dr. Newman's Website
La Leche League
KellyMom