Breastfeeding-It Doesn't Always Look the Same for Everyone...

October 17, 2017

 

Hello everyone! I am so lucky that I get to work with so many different mamas in my work. I have been at Sunshine Pediatrics for almost a year now (where has the time gone?!?!) and one of the things that I have learned is that breastfeeding is not a one size fits all. One of the things that I strive to do in my practice is to be supportive of ALL mamas no matter what their breastfeeding journey looks like. I have been on both sides of the feeding fence having my first kiddo that was formula fed after the age of 3 months and then my second kiddo was my exclusively breastfed kiddo. There are some lactation consultants out there that are so gung ho about breastfeeding that they fail to stop and look at the whole picture....the well being of the baby and the mother. At the end of the day, the baby has to be fed. 

 

I had the amazing opportunity to work with an amazing family. Deena and her darling baby boy "S" have so graciously allowed me to share their breastfeeding journey with you all. I am so proud of Deena. Thank you Deena and Trishna for allowing me to be a part of such a special time in your lives. You are both such amazing women and I am thankful to know you both and call you my friends!! Here is Deens'a journey written in her own words: 

 

I started my breastfeeding journey with my first son a little over three and a half years ago. Or maybe I should back up even further. Perhaps it started when I got a breast reduction in college. There were many factors that led to my decision. I can say for certain that as a child, I always wanted to be a mommy. And I always wanted to be a mommy that breastfed. But as I got older and my body started changing, my breasts became wildly uncomfortable. My mother had breast cancer when I was five, so my decision also factored in the fact that my breasts were so large, it would be hard to find lumps (or so I was told). I remember the consult with the plastic surgeon vividly. 

The doctor sat me down and went over the procedure. He said there were two ways he could do the surgery. One way he described as a button hole, where the nipple would remain attached with all the tissue underneath and just be brought up higher. The other way would remove the nipple altogether and then place it back on the breast. I asked about breastfeeding. The doctor basically said that the button hole procedure would give me a slim chance "but if I got any milk at all, it would be a very difficult process and both mom and baby were likely to just get frustrated." As a college student I thought long and hard. I didn't want my future babies to be frustrated at the breast and he said the other procedure produced better visual results. 

That decision still haunts me to this day. With my first son I thought I'd just try. I’d try to see if perhaps I could produce ANY milk. I gave birth in a hospital in Brooklyn. And I'd had a lactation consultant lined up and had even met with her prior to the birth. She was busy, and old school, and couldn't say one way or the other whether I'd be successful or not until we tried. I didn't see any colostrum early. But I most certainly tried in the hospital after giving birth. My son latched beautifully. But I honestly had no clue what I was doing. My support was minimal - even from my LC. I was told in the hospital that my son looked slightly jaundice. I barely had put him to the breast at all because he slept so much. They insisted on formula in the hospital. So that's what we did. When I arrived home I did research on an SNS. I bought the Medela and it was shipped to me about 4/5 days post birth. My son was fully on bottles at this point (minus a latch here and there). My breasts became fully engorged and yet nothing was coming out. My emotions were still crazy from all the hormones in the early days. I was so mad at my 24 year old self. Why did I choose to get that reduction? How could I have done that? I was mad at that doctor. How could he have told me such horrible information? Why wouldn’t he encourage a woman to at least TRY to produce breast milk?

I was emailing and calling my LC constantly. And getting minimal responses. I took my son to her office finally and had a before feeding and after feeding weight. I was told he got about 5 ml from one breast. I was heartbroken. My LC told me to focus on pumping rather than putting my son to the breast. My wife didn't know what to tell me. She was formula fed and didn't see the harm in bottle feeding. But my emotions didn't understand that logic at the time. The Medela supplemental system was impossible for me to figure out, my son was used to stage 1 bottle nipples, and now there was no going back for me. I felt like a failure. Tears came many nights as I tried desperately to pump and got nothing. But I held my chin high and hid my disappointment and eventually moved on. To make up for my failure, I made his formula from scratch every morning. I wanted to feel some control over what went into my baby's precious growing body. I still felt horrible whipping out a bottle in public. The "breast is best" campaign made me feel even worse. 

So three and a half years later I vowed I'd try again. And this time I would do things differently. Around 7 months I started getting colostrum when I squeezed my nipples. I decided to research Supplemental nursing systems in depth BEFORE my son was born. I had my Lact-aid trainers ready. I had formula on hand (I am lucky to be able to afford the formula I decided on). I met with an LC beforehand and went over my first experience. I opted for a homebirth. It was beautiful and perfect. And everything was ready. 

My son had a wonderful latch and suck. I called my LC the day after he was born. I had been putting him to the breast pretty consistently. She did a weighed feed. She told me he got 10 ml of colostrum. Which made my heart soar. I felt like it's a miracle he's getting anything at all because of my reduction and the procedure I chose. It had been so long that my body actually reconnected some of the milk ducts! On the second night he seemed really fussy. It felt like he lived on my breasts. I was exhausted. And I felt something wasn't right. My LC told me the second night is always the worst. So I kept on. When day three came, we headed to the pediatrician's office for his first well visit. He had lost a pound since his birth. He weighed 9lbs 8oz at birth. He was a big boy and required more milk. The pediatrician wanted us to get his bilirubin levels counted. He seemed slightly yellow, but so was my first son so I wasn't particularly concerned about the jaundice. I was more concerned with the weight loss. I tried the lab first, but they wanted to take three vials of blood from my newborn’s vein. I told them they were insane and had to call the doctor to check. The doctor told me that wasn't right and that I needed to take him to the lab at the hospital. When we got the levels back he was one point away from needing the light therapy. I knew I had to start supplementing. That day was spent running around and not feeding much and I felt terrible and so stressed. I also knew I wanted to change pediatricians due to some other stuff that happened, so I think that was the blessing in disguise because it led me to Brooke.

The moment I got home I told my wife I needed to start using the supplemental nursing system. I had to make formula and pour it into a bag. Then insert the tube/trainer system. After that, I'd wear the bag in a little pouch around my neck. I'd need to simultaneously latch my newborn infant and insert the tiniest, noodle-like tube into the proper spot in his mouth. Some feedings it would take me 20 min to get the tube properly inserted. I was in tears nearly every feeding. And feeding was around the clock. After each feeding, I’d sterilize the tubes. But I was determined. At my new pediatrician's appointment, I recounted my experience with tears streaming down my face. My doctor said, “Call Brooke. She's the best around."

And on my way home I did just that. With a lump in my throat I choked through my story once again. She came that afternoon. I was a mess. She held me in her arms and she told me it was ok. She said to relax. She said a bottle wouldn't ruin all the work I'd done. And that I need to turn over some of the feedings for my own sanity. She showed me a different supplemental system with a bottle and a feeding tube they use in the NICU. The tube was harder at the end which allowed for a latch followed by inserting the tube. I had the biggest sigh of relief. But I also had heartbreak as she weighed my baby and said that he didn't seem to get any breastmilk. I cried. I tried to hold it together, but I couldn't. The waves of emotion overtook me. Knowing that I had been trying so hard all this time. That I never missed a feeding. That I had spent literally hours trying to get it right. I questioned everything. Where did I go wrong? And why did I have that breast reduction? I felt like I was robbing my sons of the best immune systems they could have. I felt so angry with myself. I felt selfish for choosing looks over feeding my children. I was mad at the plastic surgeon for his advice- so mad at him. Brooke told me all was not lost. She let me know that it was the end of the day and supply sometimes goes down. I asked her if it was worth it? Was I being ridiculous for wanting this so badly? She said no. That I was doing a good job. Sometimes that’s all a person needs to hear.

I kept it up. The new system was so much easier to use. I had to talk myself into a few things in the early days. One was allowing the bottle. The second was continuing to try to breastfeed, and the third was trying to push out other people's opinions. I persevered. And it hasn’t always been easy. My son is now 5 months old. I'm still using the SNS. Though now we've moved into the Lact-aid because we are both pros. He gets maybe two bottle feeds a day when I'm unable to feed him or simply not in the mood. I no longer pump. I wasn't producing anything aside from some drops of milk on my nipples from pumping. It was stress inducing and didn't seem to work for me. But I know in my heart he's getting milk. I do get sprays of milk if I squeeze my nipples. It may be only a tablespoon at each feed. Who knows? But I'm convinced that I'm doing what works best for me and my son. 

There are so many tender moments that will forever be etched into my mind of my son nursing. To look down and see him sleeping peacefully, or looking at me as he nurses is something I thought I had lost. Sometimes when I think about it, there's still a twinge of jealousy that some moms can feed their baby on demand without having to prepare a baggie full of formula. And then I feel inadequate. But I know some moms can't do that at all. Some moms don't have the birth experience they wanted, some can’t to get their baby to latch, some have children born in their hearts from the womb of another woman. There are all different kinds of moms out there and likewise, all different breastfeeding and formula feeding journeys. Mine happens to contain a little (now a somewhat not-so-little) baggie around my neck with a tube. 

I’m still on the fence about wanting a weighed feed or not. I wonder if it will break my heart again to hear the results. Or maybe it won't. But I'm learning that it might be best to trust my path and give in to my journey knowing that it doesn't matter to me because in the end, fed and loved is best. And I cannot measure in ounces what this means to me.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Brooke Simmons, IBCLC

Sunshine Pediatrics of Central Florida

210 Lookout Place

Maitland, FL 32751

(407) 221-4475

(407)429-3975 Fax 

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