Pump, Pump, Pump it up!

Great news this morning - Nicolette gained another 4.25 oz last week so I think we're on the right track with breastfeeding!  HOORAY!

Caught mid-stretch...When I see her in her sweet little leg warmers I can't help but sing "She's a Maniac, Maniac on the floor" - you know from "Flashdance"?  :) )

I'm still pumping 8-10 times a day (for 15-20 minutes per session) which is exhausting but totally worth it.  I was continuing to supplement our nursing sessions with an ounce of expressed breast milk via the SNS however as of last Tuesday (or Wednesday I can't seem to keep my days straight anymore) Nicolette voluntarily weaned herself off of the SNS feeder.  She just suddenly absolutely refused to have anything to do with it (despite how much her mommy tried to force feed her that way out of fear that the little one wouldn't be getting enough to eat otherwise...there are women who have to use the SNS feeder for 4-6 months before their supply is built up enough to exclusively nurse their babies).  It scared the dickens out of me and I was so worried that we were going to have a bad weight check this week because of it but that couldn't have been further from the truth.  We had appropriate weight gain (appx. 2/3 oz per day) withOUT the supplement...all of that crazy pumping must have REALLY worked! 

After 2 weeks of pumping I now have at least a gallon of expressed milk safely tucked away in our freezer.  I don't know how that's going to do us any good though since Miss Priss refuses to take a bottle...oh well, time will tell.  I would really hate to have to throw any of this out!    

The stash - this stuff is liquid gold...hours and hours of hard work to build this up!

We have a follow up with the Lactation Consultant this week to make sure that we're staying on track but other than that I hope and pray that we are pretty much set with this breastfeeding stuff.

Breastfeeding is definitely the hardest thing I've ever done.  Harder than my 3 failed IUIs, harder than IVF even with the daily shots and medications...even harder than natural childbirth.  For someone who is a control freak like me it's really hard not to know if she's actually getting milk and if she is how much is she getting.  I'm one who likes to track things down to the tiniest detail (and import it neatly into a spreadsheet) so all of this "unknown" information was pretty scary to me (still is).  I spent several nights in tears terrified that she wasn't getting enough to eat and trying to force feed her either breast milk or formula from a bottle or the SNS without any luck.  Spent night after night desperately trying to wake her up enough to even latch on much less nurse.  Now she's still a sleepy little nurser and I have to perk her up quite a bit but it is a MILLION times better than where we were 3 weeks ago..what should probably only take 20-30 minutes takes us 45 minutes to sometimes over an hour and then I have to pump for 15-20 minutes after that...and then factor in time to rock her before I pump so that she falls asleep, then washing bottles and transferring milk afterwards so I don't have much (if any free time).  On days where she eats every 3 hours I have an hour or so in between to shower, get dressed, do a load of laundry, catch a quick nap, etc.  But on days when she wants to nurse every 2 hours I literally have no time, just barely enough for me to eat (toast or something super easy to grab) and use the restroom.  

Today was a great 3 hour day.  I even managed to fanagle (is that how you spell that word???) a trip to Trader Joe's!  I loved this - I'm a weirdo who actually loves grocery shopping so to be able to go and take a little time and pick out things that I wanted was a welcome excursion for me.  

Next week I have even MORE field trips planned with little miss in tow...a couple of baby showers, a La Leche League Meeting and a jewelry party.  I'm excited to see how it goes being "out and about" a bit more...hoping that the LC gives me the go ahead to cut out a couple of pumping sessions so that I'm not always so confined to the house!

Since I felt so incredibly caught off guard with our breastfeeding troubles I thought I'd put together a little list of...  

Things I Wish I Would Have Known BEFORE Breastfeeding: 

1. It is HARD work!
2. Although it is a natural, biological function it does not come easily to all mommies (or babies for that matter...babies need practice too).
3. That it can take two months or more for mommy and baby to form a comfortable nursing relationship.  (we didn't start clicking until nearly 6 weeks).
4. LOTS of mommies have LOTS of problems with breastfeeding.  From all of the mothers I've spoken with MORE of them had issues than not.  It's not this seamless experience where your baby is placed on your chest and instinctively starts nursing (at least not for most of the mommies I've spoken to).  I wish I had known this earlier on and perhaps I wouldn't have been so hard on myself.  
5. How LONG nursing sessions can take - I've had nursing sessions as short as 20 minutes (maybe 2 or 3 times) but more often than not we're nursing for 40+ minutes (with the longest on record being 1 hour and 20 minutes). 
6. That you have to man-handle your baby...I always had these images of this sweet gentle baby nicely "latching on"...well that isn't the case.  In the hospital my 3am nurse took my precious baby's head and literally jammed it right on there.  
7. New mommies should ask for help even if they think that things are going fine - better to get help as EARLY in the process as possible.
8. There is an organization called the La Leche League which meets monthly.  Their whole purpose is to educate women about breastfeeding and provide mother-to-mother support and encouragement.  It would have been so helpful to attend at least one of these meetings BEFORE having Nicolette.  I just assumed that since breastfeeding is natural that it would just happen for us...especially since I had a non-medicated birth and wouldn't be dealing with a drowsy baby or mommy due to drugs administered during labor.
9. That it can HURT when things aren't going right...cracks, blisters, etc are all battle scars that may be earned along the way and although it isn't correct it is normal to have some of these things...they're all signs that the baby's latch is not correct.  FYI - Virgin Coconut Oil works WONDERS on blisters and cracks!  Better than any other topical ointment I tried.  And it's all natural!  

My loves :) - this little one loves her daddy!

Crying over spilled milk now has new meaning...

We had Nicolette's 3 week check up on Friday (July 27) and I was disappointed that her weight was only 7lbs, 6.75 oz...still below her birth weight of 7lbs, 8oz...barely below but still below is below.  You want your baby to be back at his/her original birth weight within two weeks of birth so to still be slightly below was a little concerning.  Dr. Chris didn't seem too worried but did recommend that we meet with a Lactation Consultant soon to see if there are any issues that we need to work on so that we could speed this process up. ( I HIGHLY recommend Jennifer Corbin - she was a million times more helpful than the lactation consultants at the hospital.  When I mentioned that Nicolette wasn't actively nursing much to the LC at the hospital the response I got was "Well breast-feeding is a battle and you just have to win."  Geez thanks lady, that really helps me out a lot considering I've never breastfed before and I literally have NO CLUE what I'm doing!...I'm still irritated at the lack of assistance that the LCs at the hospital provided to me and feel Nicolette and I could have been off to a much better start if we had been working with someone like Jennifer right away instead of being left to "battle" on our own for 3 weeks.

I had a meeting with the consultant Saturday and she was awesome - she came to our house and stayed for 3 hours watching us feed weighing her before and after each feeding and by the end of our session she was up to 7lbs, 7.4oz.  She did notice that I have Low Milk Supply so we rented a hospital grade pump and she recommended that I feed Nicolette for 20-25 minutes on each side every 2 hours, and then pump for 15-20 minutes and then supplement feed her with 1 oz of pumped breast milk (either with a Supplemental Nutrition System* or a Bottle  every 2 hours.  This regimen was designed to help increase my supply.  Its funny how the female body works - the signal for your body to produce more milk is triggered when the milk is being drained.  Since Nicolette was a sleepy nurser and had latch issues that meant that the milk wasn't being drained regularly which further reduced my supply.  It makes me wonder again how people out there can doubt that there is a divine and incredible God out there who designed this whole process!

Now this schedule might not sound TOO bad.  When you do the math that's probably 45 minutes of feeding every two hours but that is SOOO not true.  As I mentioned, Nicolette has a shallow latch so it takes quite a while to get her "on" and ready to go and then since my supply is low she falls asleep so those minutes where she isn't actively nursing don't count towards the 25 minutes.  I found myself literally struggling to get it all done and barely had time to use the restroom & change her diaper before it was time to start all over again!  I had to supplement with a bottle with 1oz of formula at one point on Sunday bc I didn't have enough pumped and I was in tears.  I really didn't want to feed formula to my girl and it was disappointing not to be able to meet her needs but ultimately getting the girl chubby is the most important thing.  She HATED the formula by the way.  We tried it in a bottle and she kept kicking the bottle out of her mouth and when she would take it she would get her mouth full of formula and then spit it all out.  Fun - keep in mind that this still has to fit into my 2 hour repeat feeding schedule. (sigh)

At one point late Sunday afternoon I sat pumping trying to relax (because relaxing while pumping and feeding is apparently so important - the milk literally may not release if you're too stressed out...uh oh that could explain a lot).  I was actually feeling like things were going well.  The LC had said to put a blanket over the pumps so that I don't obsess about how much or how little is being produced (who? me? obsess about something related to performance or production?  she must know me pretty well already).  So I had my blankie covering everything up.  My timer went off after 15 minutes and I looked down and on the right side my shirt had barely gotten tucked up under the flange of the pump which means that all of that precious milk leaked out of the bottle and all over my shirt...are you kidding me...that bottle was totally empty and my shirt was soaking wet????  Cue hysterical tears.

Needless to say with all of this pump, feed, pump, feed, pump, I was a wreck.  Keep in mind that since I was planning to exclusively breast feed I hadn't sterilized any bottles, nor read anything about how to prepare formula how to store breast milk, nothing.  I felt totally unprepared to be thrown into this situation and literally had NO free time to read the instructions with anything.  By Sunday night for her 1am feeding she wouldn't eat anything - she wouldn't take the breast, wouldn't feed with the SNS, wouldn't take breast milk out of a bottle and wouldn't take formula out of the bottle.  I was in tears and so was she and the poor hubby didn't know what to do to console either of us!  I tried to feed again every 2 hours and she wouldn't eat at all throughout the night.  My nerves were shot and I was convinced that my child was starving so I called the doctor first thing in the morning to see if we could get in for a weight check.  At 10am nervous, neurotic first time mommy and baby Nicolette were at the Doctor's office waiting for our weight check.  Now during my time as a cheerleader for the Panthers I had countless weigh ins but I have to say that this was the first time that I was ever hoping to see the numbers on a scale go UP!  They put her on the scale and I said a silent prayer and HALLELUJAH we see 7lbs, 11.5oz!!!!!  That little stinker had somehow packed on nearly 5 ounces since her Friday appointment.  The last time I felt this much relief was when I got the call from REACH letting me know that we were pregnant!

Dr. Chris reassured me that Nicolette is just fine he said that even though her weight was low last Friday that she was still gaining so we didn't need to worry about "Failure to Thrive" (which is associated with babies who continue to lose weight or stall and don't gain ANY weight).  Failure to Thrive babies often face brain developmental issues, may grow to be short in stature and are prone towards mental retardation so you can understand why a new mommy would want to avoid having those terms ever associated with her little one!  Dr. Chris also prescribed a medication for me to help increase milk supply - it is called Domperidone or Motillium.  I started that today and we'll watch over the next 4-6 weeks to see if that helps.

I've spoken with the Lactation Consultant several times over the past 3 days and she recommended that we go to a 3 hour feeding schedule instead since Nicolette was obviously starting to put on some weight.  We've also made additional tweaks based on what I'm finding from my sessions with Nicolette.  I'll include our current protocol below in case anyone is struggling with the same issues and might want some ideas of how we're making it work...

Kelly & Nicolette's Current Protocol

• Wake Sleeping Beauty - change diaper (praying for poops as that means that she's getting plenty to eat and gaining weight).  This takes 15-20 minutes to get her awake enough to nurse.
• Feed 1-2 oz expressed breast milk via SNS* (this takes anywhere from 15-20 minutes depending upon how hungry the princess is).  We know it's time to stop when the princess is "milk drunk" - arms limp, eyes closed and totally zonked out!  If she's not then she gets switched to the other side to try to nurse for 15-20 minutes.  Keeping in mind that it can take 5-10 minutes to get her "on" and ready to go
• Put the princess down to nap and get ready to pump.
• Double Pump with hospital grade Medlea Symphony Pump 15-20 minutes...at this point since my supply is low I usually get about 30ml (1oz) but it varies...had one disappointing session with only 5ml and then an awesome one with 65ml.  The LC said it's not about quantity at this point.  The goal with pumping is merely to stimulate the milk production..."if you build it they will come" you might say.  
• Find some time to snuggle with Sleeping Beauty - skin to skin contact between mother and baby is vital to breastfeeding success.  
• I also take supplements
• Fenugreek = 3 610mg supplements 3 times per day
• Blessed Thistle = 3 390mg supplements 3 times per day
• And the aforementioned prescription
• Domperidone/Motillium = 1 20mg capsule 3 times per day
• Weekly weight checks with the doctor until 6 or 8 weeks to make sure that we're making progress.

We repeat every 3 hours.  In between I have to wash all of the bottles, pump parts, etc as well as try to take care of myself so it's still a challenge but this 3 hour schedule is much easier than the 2 hour schedule we were on this weekend.  Poor Nicolette was miserable and so was I!

*I prefer to try to feed with the SNS as that consists of a tube hooked to a bottle of either expressed breast milk or formula with the other end of the tube running down the breast so that the baby actually nurses AND gets the supplement at the same time so you don't have to worry so much about nipple confusion that may come with giving a newborn a bottle.  

OK - so there is more than you probably ever wanted to know about breastfeeding.  Sorry for the lengthy post.  Hopefully there might be someone out there reading this who may find it helpful.  I know that during my few minutes here and there of free time I was struggling to find information and people's real life experiences to try to gain insight into my own issues.  As far as this goes I'd like to say where there is a will there is a way but the truth is that some women are not able to breastfeed as their supply simply will not increase...hopefully I'm not in that small minority but if so, we'll cross that bridge when we get to it and make decisions at that point.

As I finish this lengthy post I hear my precious little one tooting away...here's to praying that we have a nice full diaper.  It's the little things...I literally celebrate every poop...means mommy is doing her job and helping her baby grow!  Send prayers our way for lots of poop!  (never thought I'd ask for prayers for poo).  :)