Thursday, December 19, 2013

Breastfeeding: Making it Work

Breastfeeding. This will (hopefully) be the last post I spend on this subject. But I decided, before I move on, that I would like to write more about my experiences with breastfeeding, in the hopes that maybe it will help someone else who reads this.

First of all, as I said before, I never anticipated that I would have a hard time with breastfeeding. Even though I read many accounts about how difficult breastfeeding can be...I never took it to heart. I took a breastfeeding class and was so excited to do it myself. In the hospital, breastfeeding started out just as I imagined. When my baby first latched on, I was amazed and shocked and so proud of my little baby. For those first few days I remember my nipples feeling kind of tender while he nursed, but that tenderness was overshadowed by the uterine cramping and blood pouring out of me every time I nursed.

When I got home, I had a lactation consultant from the birthing center come over to help out, but just because I thought it would be "nice." Not because it would be necessary. She showed us different positions to use in different places around my house and when she left I felt happy and confident.

I'm not sure what went wrong from there. I think that slowly the initial tenderness just became more and more painful until each feeding felt like shards of glass were ripping my breasts apart from the inside. Seriously. Especially the first minute of feeding. I would bite my tongue, curl my toes, and count down inside my head to get through the pain. I know this sounds dramatic, but this is how it was. It got so bad that I would dread having to feed my baby. I'm not going to go into details, because I explained it in another post, but basically the pain of feeding led me to question whether I could continue each time I fed. The first few weeks were interspersed with periods of me sobbing to my mother or husband about how I felt like such a failure. It was only sheer determination that kept me going. Pure and utter stubbornness because I didn't want to give up.

So. The purpose of this post is to talk about what worked and didn't work for me. It is not by any means a prescription for what will work for other women. It's just what worked for me. And if there is a take home message here, I think it should be that breastfeeding can be extremely hard work and you need to find what works for you.

Latching. This really is as important as they say. At first, I was convinced that my latch was okay. Why did I think this? Well, every time someone checked me (nurses, lactation consultants, La Leche League leaders, etc), they told me I had a great latch. So I would read materials that stressed the importance of a latch and I would roll my eyes in frustration. But, looking back, I believe this really was the key to my problems. I knew how to latch and was capable of helping Owen latch, but I wasn't consistently getting it right. The more painful the feedings, the more avoidant I was, which created a worse latch, which made me more fearful...enter vicious cycle. This was only worsened by nighttime feedings when I was extra-tired or cluster feedings on the hour. Finally, after another consultation with the LC, I remembered her saying "Just get him on there." From then on, that became my mantra. Stop playing around and just get him on the nipple. I also made sure to focus on scooping him up from below the nipple and really aiming below the nipple, instead of above. I think that this was the primary change that helped me.

Nipple Creams. I tried all of them. Medela Lanolin. Lanisoh Lanolin. Hydrogel Pads. Breast milk baths. Boob-Ease Cream. APNO Prescription Ointment. It started to drive me crazy when people would say, "Have you tried...." The answer was always yes. In the end, I think it was a combination of the APNO (1-2x/day) and the BoobEase (similar to MotherLove, natural with olive oil, calendula, etc). However, I can't really say if either cream made a difference because those also happened to be the last ones I used. Everyone swears by some type of cream. I guess my advice here is TRY THEM ALL and find out what works for you. Even now, I still put the BoobEase (seriously, what a name) on my nipples after a particularly voracious feeding session.

Latch Assist - I wish I had found this earlier. I have flat nipples. That is not something I was ever aware of before. I though all nipples looked like mine? Now 7 weeks in, they aren't as flat as they used to be. But, initially, I think part of the pain during initial latch was him literally sucking my nipples out. POP. The latch assist does this painfully in two seconds. I highly recommend.

Milk Saver This didn't necessarily help me with the pain of breast feeding, but again, I highly recommend this. The point here is to put the Milk Saver on whatever breast you are not feeding on, and it will catch the extra milk. In the beginning, before I regulated, this was a huge deal. It made the difference between being drenched in milk by the end of a 15 minute feeding session. By putting the Milk Saver on, not only did it prep my nipple a little, but I was able to get 3-4 oz per feeding out of just one breast. Amazing! Now that I'm more regulated, I don't need to use it any more. I checked today just to see, and I was only getting about half an oz.

Position This is also highly important. Have you noticed how obsessed the lactation consultants are with positioning? Every time I would have the LC come over, she would show me ways to put arms, footstools to use, and origami designs of pillows. Eventually I learned that not only was it important to be ergonomically correct, but it was much more important to just be comfortable and relaxed. My favorite position started to be Laid Back Breast Feeding. Google it. It's awesome. But basically, I would lie back with the baby on my stomach and let him latch on from below the breast. This seemed to be a good position for latching, but also just emotionally because I felt relaxed. So, what am I saying here? I guess just find a position that you would like to be relaxing in if you didn't happen to be breastfeeding. Get comfy and cozy. Make the best of it!

Getting Comfy. Related to getting comfy in positioning, you also need to have all of your "extras" with you. For me, that was a soft pillow, a bottle of water (it makes me SO thirsty!), the Milk Saver, my cell phone, and TV. Yes, TV. TV was pretty much the most important thing for me because it distracted me and allowed me to enjoy the breastfeeding when it wasn't initially so enjoyable. I know it sounds silly, but I'm pretty sure when I started inviting Netflix to the breastfeeding relationship, it all got way better.

Taking a Break This was the hardest thing I did. When my left nipple got so bad (literally - NO skin) that I couldn't handle it anymore. I ended up giving my left side a break. This was really, really hard to do because it meant that every time I fed the baby I also had to pump. So picture this - middle of the night feeding on the right side, then rock the baby to sleep, then I'd still have to pump. The other really hard thing about this is I never knew if he was getting enough milk from just one side and so we also were supplementing with bottles of breast milk (thank you Milk Saver!). So, then there was the added stress of bottle feeding and guilt of giving my little baby bottles at 2-3 weeks of age. But, in the long run, this was SO worth it. Watching the skin grow back on my nipple was amazing.

Mindset. This is important too. I got stuck in a mindset that it would always be this way. Then, I read something on Esperanza's blog about approaching each session as it's own session. Even if the last session was terrible, that doesn't mean the current one will be bad. And vice versa. It also doesn't mean the pain will go on forever. As a therapist, I had to remind myself to stay away from words like forever, always, worst, unbearable... You get the idea.

Time. Everyone says, It gets better with time. The problem with this is, every one has an answer to a question of how much time. At first, everything I read said two weeks. After two weeks it will be better. I remember in the beginning the pain was so bad that I couldn't imagine it going on for two whole weeks. HA. In the end, it took me five weeks. The thing is, the amount of time is different for everyone. But it won't go on forever. The question just is, can you outlast the pain?

I'm sure there is more I could say about this, but I started writing this post almost two weeks ago and I just want to get it published. I will do my best to respond to comments on this post though, so maybe we can get a conversation going. So feel free to ask questions about anything I didn't mention. For example, nipple shields? Yep, tried them. Didn't work. Ouch. Or to leave suggestions on what worked for you.

Before I post this, let me leave you with a Where I Am Now Picture. At 7 weeks, I am in SUCH a different place that even finishing this post - something that seemed so important to me two weeks ago - was hard work for me. Breastfeeding is so easy for me now. I love that I have exactly what my baby needs and it will always calm him when all else fails. I love that I can seduce him into a breastmilk coma in a way that a bottle never can. I love stroking his hair and watching his eyes slowly close as he swallows. It has become so connected, so intimate easy. Thank god. It is also convenient. No more cleaning bottles, pumps, etc. Nothing to bring with us when we go out. I just have everything he needs. And feeding him in the middle of the night? So easy. I just pull him into bed, feed him, and put him back in his bassinet. This is how I hoped it would be.

In sum, I hope that people reading this can see two things. One, if you are having a hard time, you are NOT alone. And two, there is hope at the end of the tunnel. If I can go from crying, sobbing, and feeling like a failure, to feeling like a pro, then there is hope. If you want to make breastfeeding work, the best thing you can do is keep trying to find the unique combination of things that work best for you and your baby and then just give it time. But, if you feel that isn't bearable and you cannot wait it out. Then I totally understand. Every single day I walked the line between quitting and continuing. Whatever each woman decides should be her own choice and she should be respected for that choice.

Wow. This post is disjointed. I wrote it over three periods of time in between baby naps. But you know what? I'm going to post it anyhow. Maybe it will help someone. And I hope it starts a conversation. Please leave comments with what worked for you or what didn't work for you. OR why you decided to keep going or decided to switch to a different method of feeding. And if you have any questions, I will do my best to answer.


  1. I'm so glad that breastfeeding ended up working for you. You really did stick it out through some intense stuff and I'm so glad that you're happy with your decision now that you've finally arrived at the other side.

    I wish I would say that my breastfeeding experience finally ended up where I wanted it to be, but it wasn't meant to be for me. I guess we just had too many things working against us and there were no guarantees that any of it was going to get better. Between our oversupply/over active let down issues, a baby who couldn't latch/suck, diflucan-resistant thrush and then mastitis that turned into sepsis and required hospitalization... it just wasn't in the cards for us. I tried everything at my disposal and it just kept getting worse.

    The good news is I am happy with where we are now, at least for the most part. It's not the ideal situation but it's the ideal solution for our specific set of circumstances. Right now I'm exclusively pumping. I finally finished my two weeks intensive course of antibiotics and the mastitis has cleared up. Unfortunately we both still have thrush but it's not as bad as it was and knowing that I can't get it back from him makes me way less stressed out about it. I'm hoping that eventually it will go away altogether. At that point, if my son seems to be getting better with his suck (we still have good days and bad days with this, sometimes he can latch onto a bottle no problem and other times it takes five minutes for him to get his own tongue out of his way) I may try to put him back on the breast... but I have to admit, the though of getting thrush again terrifies me. I just don't think I can handle that again: dealing with it takes SO MUCH ENERGY. You have to sterilize EVERYTHING that comes in contact with your milk, even your clothes, after just one use. The amount of laundry and dishes is just insane. So yeah, the fear of thrush may keep me exclusively pumping for the remainder of my maternity and maybe even beyond. The good news is that my oversupply works FOR (instead of against) me when I'm pumping and I currently make about 5-10 ounces more a day than my son needs. Unfortunately I can't freeze any of it because of thrush so I end up dumping a lot of it. It sucks but again, sometimes you just don't have control over the negatives aspects of breast feeding.

    So that is where I am. I tried, really really hard, to keep up our breastfeeding relationship but I knew from prior experience that thrush was likely something I would never get rid of as long as we were breastfeeding. The pain of it, and the time and energy it took to try to get rid of it was just too much, especially with a 3.5 year old demanding my attention. Sometimes breastfeeding is just not the right answer and it took me a while to see that.

    And there are some significant pros to bottle feeding: I am no longer the sole person that can give my baby nourishment. It is REALLY nice to be able to hand him off to someone else when I'm tired or I want to get away. It's also nice when I'm with my daughter and I know I don't have to push her aside to feed the baby; I can tell it has eased her stress to know that the baby crying does not equal mommy having to leave. I also have a better relationship with my son now, and I would argue that yes, you can get your baby milk drunk off a bottle, and the snuggling that happens while bottle feeding is still very special. In fact, it's a much more positive experience than breastfeeding ever was for us, we just never got to a place where the pleasure outweighed the pain.

    I'm glad it has become a really positive experience for you, and that your efforts resulted in the breastfeeding relationship you always wanted. That is so very, very awesome.

    1. Oh I am so glad you commented because I was thinking of you while I was writing the post. I wanted to address in a more meaningful way how I feel about the choice to not feed anymore, but my brain is pure mush lately. But truly, I know for sure I wouldn't still be feeding if I had to deal with everything you dealt with. The thrush especially just seems so overwhelming and terrible and then the mastitis on top of it? My god woman I am amazed you made it as far as you did.

      I am so glad things are working out for you. Especially because I know that is a good solution. Exclusively pumping allows him to get what he needs, but saves your sanity (and pain experience!). And as far as my comment about Owen being calmer after nursing versus the bottle, that could be purely in my own head out of guilt. I think if the bfing had continued to be so painful and awful there is no question that bottle feeding would have been a more bonding experience. The first few painful weeks were definitely not good for bonding :(

      I wish we could have both made it work, but I'm glad that we've both found good solutions. The end-all message here is that woman should be able to communicate openly about this and should feel supported through out the whole process and in their ultimate decision.

    2. I absolutely agree that in the end it needs to come down to women feeling supported. I still want to write a post about how, at times, I almost felt like I wouldn't be supported if I tried to KEEP breast feeding... Things were getting so bad that people felt I HAD to quit. And that was a really hard place to be in. I mean, I really appreciated people trying to help me get past my guilt and other issues with quitting but it was still hard. I wonder though if the issue is just so wrought with emotion that no one can ever truly support us in exactly the way we need, because we aren't even sure WHAT we need.

  2. Funny...I had the same experience of people encouraging me to quit. I think it was hard for them yo watch me suffer so much, it was especially hard for my husband. He kept trying to "Fix it," but it's not something you can fix. You just have to suffer through. In the end, he would internally leave the room when I fed because it was too stressful for him. Just the other day he said he finally can enjoy watching our son eat. So sad. And definitely an argument for bottke feeding.

  3. I think this is a great post. I really appreciate the honesty of both you and Esperanza in her comment. I will check back later to see if more people commented, it would be nice to hear about more women's experiences.

    Also, I'm glad you posted about the latch assist. I've never heard of it before, but I think I also have flat nipples and I might just buy this right away to hopefully avoid some pain. Thank you so much for letting us know about it!

  4. Oh see I feel like such an asshole for having no problems. I was so ready for it to be a disaster as well. I'm completely torn with night feedings though. On the one hand it's so nice to just pull her into bed and stick her on (however she happens to land...) but after a night of hourly cluster feedings then the inevitable gas that gives her, God do I wish husband could do half. Maybe some day soon.

    The hospital lactation consultant told me I had very long nipples (such a weird compliment? Insult?) So I wonder if that is what's helped us? I have no idea. I've decided all parenting is 90% pure dumb luck.

    No suggestions on what works per se, but I loved the Motherlove cream and my pillow with arms, which kept me in a really good position. x

    Finally, I am so excited to drink Christmas gin and tonic with you tonight- milk is pumped and bottle primed so I can have 2!!!

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  6. First of all, it makes me so happy to read that you and baby managed this and that you are doing and feeling well. Thanks so much for your honesty, this really is helpful, and I am sure I will be coming back (or directly emailing you) with questions when the time comes. I have the lanolin 100% cream, and my mom told me to start putting it on my nipples already (starting at month 7) to give them form.

  7. I almost unconsciously made the decision to switch to pumping over breastfeeding. They both had latch problems and one still has a problem of chewing instead of sucking. They also didn't have the energy in the beginning to get enough milk from me. I had 2 LC's weigh them before and after a feeding and they weren't getting nearly enough so I would have to BF, supplement with a bottle and then pump. It was too much on top of all the anxiety and pain at every feeding. So, I took a break to let my nipples heal and get over some thrush and a clogged duct. And I never really went back. I meant to and made a couple of halfhearted attempts, but I think that ship has sailed and I have only very recently admitted that to myself. I had some great moments breastfeeding and even a couple times where I got them both to latch at the same time, but those were far outnumbered by the bad feedings. I think if I had one baby, or only one was having problems I could have stuck with it and made it work. I just couldn't do it with both. Honestly, I don't miss actual breastfeeding at all. I think I am sad about the loss of the idea of it more than the reality of it. I do wish it could have worked out for us, though.
    It does add a lot more work with all the pumping parts and bottles that need to be cleaned everyday. And leaving the house means figuring out how long we will be gone and how many feedings to take and worrying about missing a pumping or finding a place to pump. It isn't perfect, but it's what is working for us. The good part is that someone else can help with feeding them. I feel a little more free and relaxed knowing I am not solely responsible at feeding time. I have to admit, I do like knowing exactly how much they are eating instead of hoping they are getting enough all the time. In the end, they are still getting breastmilk and there are other ways I can bond with them. I wouldn't say I am happy with how this worked out, but I think I am finding peace with it.

  8. I want you to know that I found this incredibly helpful, and I can definitely see myself coming back to reference it in six months. Thanks for posting!

  9. What a great, helpful post on nursing! I am so impressed that you stuck with it. Good for you! Harriet and I struggled at the beginning as well but pushed and pushed and pushed through it until we could nurse without even thinking even it. I am so glad we didn't give up. And I'm glad you didn't either. I hope that what you wrote here will be helpful to lots of new moms.


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