Monthly Archives: January 2015

On Feeding the Baby


A quick preface: Finavaire Andrea Smith was born on November 26, at 4:11am. She was a petite six pounds, fifteen ounces and measured 19.5 inches. Because, you know, people dig that stuff.

Aside from the very twilight zone-esque hospital stay that followed, life since then is divided up into tiny little blocks of time in which I actually have two free hands and a mind that is semi-present. As I type this, I am staring down the barrel of the next feeding time. My baby is swaddled and drowsy, propped up next to me in the Boppy pillow. She makes these awesome faces when she’s half-asleep; all puckered lips and gassy smiles.

I can smell her diaper. I’ll have to take care of that, too.

What I should be writing is an edited version of my novel. And if I wasn’t writing that, I should be writing a birth story because, whoa, I rocked a totally natural birth despite a full 24 hours of labor and four hours of exhausting pushing due to the fact that my daughter thought it would be funny to have her hand sticking up next to her head when she came out. Hello everyone. Here I am! Thanks kid.

Instead, I’m going to talk about my boobs. Specifically, my nipples.

There was a time when I was squeamish about my body. Having a baby sort of works that out of you. It probably has something to do with that moment where you realize you’re sitting on the toilet with your husband, your doula, her assistant, the nurse, and your midwife in the room with you and you just don’t care. So, if the topic of breasts as in breastfeeding makes you blush, you might want to skip the rest of this post.

It’s always awkward when people ask me if she’s feeding well. Especially if it’s a guy. The simple truth is that she is. The last time she was weighed, she was almost nine pounds. Her getting the nutrients that she needs and the ensuing weight gain have never been an issue. And I mean, I’m thankful for that. It’s one less potential source of anxiety that I have to deal with. So, if you’re a guy, and you’re wondering if she’s feeding well, she is. That’s the short answer.

The long answer is that while she is doing just fine, I’ve been wading through the proverbial soup of postpartum hormones, sleep deprivation, piles of laundry that I only sometimes can set my mind to, and painful nipples.

It started in the hospital. Remember that kick-ass natural labor? It left me so, so exhausted that despite my adamant wishes that Finn be placed on my chest right away so that she could latch on right away, she was only able to stay there for about fifteen minutes, only one or two of which she actually suckled. It was literally all I could do to hold my eyes open, much less help her get the hang of things. Plus, I was covered in sweat and it was affecting her body temperature. When they took her off of my chest and put her under the warmer, I simply didn’t have it in me to object. I was actually pretty grateful because I thought I was going to drop her.

The next day, the hospital’s head lactation consultant stopped by the room to give me a crash course. She was a very no-nonsense woman who knew her stuff. Hold her like this. Left hand here. Right arm here. The problem was that my newborn baby really cared more about sleeping than the finer concepts of a deep latch and so I was left with instructions to hand express colustum and spoon feed it to Finn in hopes that it would wet her appetite for the real thing, fresh from the source.

“Babies sleep quite a bit the first few days.” She explained. “Just do what you can.”

So I did. I did not, however, see the lactation consultant again. And I get it – this was a huge birthing center and there happened to be tons of births that week in addition to mine. When one of the midwives came to visit me and offered two tubes of lanolin, I was baffled as to why I would need it. Would nursing really be that painful? It wasn’t until the nurse on duty the day that we were released watched me feed her that it was pointed out to me how shallow Finn’s latch was. Basically, she was just gnawing on the end of my nipple.

“You’re going to get really sore if she keeps that up!” The nurse cautioned.

It didn’t hurt at the time, so I kind of shrugged it off. I mean, babies are born to breastfeed. It would come naturally.

I’m going to stop right here and recite my new “one piece of advice” that I will forever after be offering to first-time moms interested in breastfeeding: get that lactation consultant in your room and DO NOT LET HER LEAVE until she’s shown you how to really latch your baby. I don’t care if your baby is sleepy – have her give you some pointers for waking her up. In fact, if you can, have her check your baby’s tongue and mouth shape and observe how she sucks and for goodness sake, make sure they teach you the football hold because forever after, whenever you mention that you’re having problems with your latch, someone is going to ask you “have you tried the football hold?” as though tucking your infant under your armpit will solve all of your breastfeeding woes. If said lactation consultant has to stay for an hour before you’re comfortable or has to come back several times, don’t worry about it. Don’t feel stupid. Don’t feel like you don’t know what you’re doing. Because the truth is you probably don’t and that’s totally acceptable. Get help and expertise right away. You don’t want to mess this up if you can avoid it early on.

We left the hospital on a Friday. Due to a stint with jaundice, Finn remained a fairly lethargic baby for the first few days at home. This meant that we had to wake her up every two hours around the clock to make sure she was getting what she needed. So we did.

It’s one thing to read that a newborn feeds 8-12 times a day. Doesn’t sound too bad, does it? That’s reasonable. They have small tummies after all. However, it’s impossible to truly understand how grueling that is, especially when your alarm goes off at two in the morning, the house is cold, your husband is confused, you’re confused, your baby has no interest in waking up and even if she did, she sometimes plays clueless when it comes to feeding and lays there with big, innocent eyes while you try to make yourself as uncomfortable as possible so that you stay awake long enough to feed her. Nevertheless, I persevered. It wasn’t until the couple of days leading up to her three-week pediatric appointment that I relaxed a little and allowed her to go for more than 2.5 hours without feeding, day and night.

By Saturday afternoon, I was starting to feel uncomfortable. By Sunday evening, I was dizzy with pain every time she latched on.

“It gets better.” Everyone told me. “It always hurts at first. Your body will adjust. You’ll toughen up. Give it a few days. Use lanolin. Rub extra breastmilk in. Try the football hold. It gets better.”

One week after my daughter was born, I was revisiting my deep-breathing techniques that I had learned for use in labor. Jason was also using his supportive partner techniques for almost every single feeding. I vividly remember him rubbing my back and telling me, “It’s alright, it’s alright” at three in the morning while I fed our tiny baby by the light of a thrift store lamp.

Friends were bringing us meals during this time. While discussing my woes with one of the ladies as she dropped off the food, she mentioned that a friend of hers had visited a lactation consultant and that it had helped tremendously. This roused some curiosity in my pain-riddled brain. A lactation consultant. Who would have thought.

The next day, I texted a fellow mother who, with three kids under her roof, has been the wise old sage that I’ve needed to get through this insanity. She and I had already had numerous conversations about the irony of breastfeeding. How unfair it is. How you work your ass off to bring this baby into the world without drugs and just when you think you deserve a break and some nice, cuddly baby time, you get the fiery inferno every time you feed. Which is all the time. Thanks.

“Did you ever get bloody cracks in your nipples?” I asked.

She hadn’t.

I called the lactation consultant. It was the same lady I had seen during our postpartum stay. Thankfully, she could get me in that afternoon. Within five minutes of being in her office she saw that Finn had a minor tongue tie. I won’t go into the specifics of it, but the gist of it was that Finn’s mouth was physically unable to latch and suck properly. The nice lady sent me on my way with a prescription for an anti-everything cream (the knockoff version of this) and a referral to an ENT to get Finn’s tongue tie corrected.

We couldn’t get in before the weekend. In fact, it was almost a full week before we could get in and even then, the ENT said that he wanted to evaluate the severity of her tongue tie before agreeing to clip it. Aside from going out of my mind from the pain, I came down with a high fever due to what I think was mastitis. Because when you have open wounds on your body, they can get infected. Yeah. I kept telling myself that I just had to make it until Wednesday. Finn’s two week birthday. The day of the sacred ENT appointment. It would all get better then. She would latch on like a pro and I would heal up and we would have that blissful breastfeeding experience that everyone talks about.

The tongue tie was snipped with little fuss. The ENT doctor was a kindly, gangly man who gave me a private room to nurse her in after the procedure. My sister came along because I was worried it would be traumatic and Jason had to work that day. After I nursed her, the doctor asked if I noticed a difference in the latch.

“It’s alright if you don’t.” He reassured me. “You might need to heal before you do.”

I didn’t notice a difference.

I gave it time. Some of the cracks grew until they were more like chunks. The ointment didn’t help. Lanolin didn’t help. Saltwater soaks didn’t help. The football hold didn’t help. Nothing helped. Well, I suppose the maximum doses of ibuprofen that I was taking around the clock helped. Until they wore off, that is.

On Sunday, I called the hospital’s lactation office again. The weekend nurse told me to pump for a few days and give Finn the expressed milk in a bottle so that I could heal. Friends, this is where the craziness of motherhood comes in. I sobbed the first time I skipped a “real” feeding and gave my baby a bottle. It didn’t matter how much pain I was in. It didn’t matter that she was still getting all of the nutrients of breastmilk. It didn’t matter that now Jason could actually help with feedings or that I could feed her in public easily or that my milk supply was so crazy that I only had to pump three or four times a day instead of the recommended eight. It wasn’t the real thing. It wasn’t the close, quiet cocoon of warm skin and the soft swallows and her big eyes sliding up to look at me. I had failed.

Plus, bottle feeding is super messy and tedious.

I gave myself two full days. On the third day, I tried latching her back on just before heading out the door to meet someone. She clamped right back on the end of my sort-of-healed nipple, popped off, clamped on, popped off, cried in between…

I set her in the car seat, sobbed, and threw the Boppy pillow across the room.

That particular attempt at feeding stands out as a very low point for me. Nothing could be worse than that.We tried later and it was alright. It wasn’t great. But it was better than before. Slowly, I went back to straight breastfeeding. I kept in contact with the lactation consultants. Someone from the midwife clinic I birthed with called me and said that she had heard I was having some problems and she wanted to see me. Hope sprang anew. She would help. She would guide me. She would make the ridiculous agony stop.

“It gets better.” Everyone kept saying. What I didn’t feel like explaining was that I wasn’t just sore. I was cratered. It was to the point that the midwife was a little taken aback when I showed her the damage. She gave me a prescription for antibiotics and said that I could probably try a nipple shield.

“So, I just go to Target and get one?” I asked.

“Yeah, that’s fine.” She said.

I was so exhausted and depressed that I walked out of the appointment without realizing that she hadn’t even asked to observe me feed Finn. Which, I mean, being that her latch was the likely culprit, wouldn’t that have made sense? She even told me to bring her hungry and then I didn’t end up feeding her so that when I went to Target, she was hungry and upset while I stood in the breast pump section wondering what size I was supposed to get in nipple shields. I guessed and thankfully I think I got it right.

Finally, it didn’t hurt. There was a definite “gadgety” feel to the whole thing, but it wasn’t a bottle and I was able to feed my baby from my breast again without the stabbing sensation. I even got bold at times and took the shield off after a few minutes so that Finn wouldn’t forget how to “really” suck. It was messy and I had to wash the damn thing off all the time but it helped us limp along for another few days until I noticed that something was different. Finn didn’t seem to be getting enough. She would feed for a long time but was extremely gassy and fussy and appeared to be constantly hungry. Her poop (I mean, hey we’re talking about boobs already. What’s a little poopy talk at this point?) changed from the healthy, hearty mustard custard to runny green.

I should mention that all during this time I was stuck in this vicious cycle of feeding, burping, and googling. Feed the baby. Burp her. And then Google. It was always the same problem but with a whole variety of search terms. Nipple pain. Painful latch. Tongue Tie. How to heal giant wounds on nipples. Why does it still hurt to feed my baby. You know, all that. Aside from driving myself crazy, I did discover that part of my problem was that I was actually producing too much milk. Who knew that could be a problem? Well, it is. It makes babies clamp down when they feed because they’re gagging. It makes your already sore chest unbearable overnight when your body produces most of your milk. It means messes everywhere and the stink of old breastmilk and lots of laundry. It also means that your baby is likely not getting enough hindmilk and so they end up with radioactive green poops and horrible gas. Fortunately, it can be easily solved by feeding on one side only until things even out.

I still feel a profound sense of accomplishment for having solved that one myself. And yes, it did even out and some of the problems I was having are now non-issues.

The pain marched on. I fed without the shield until I couldn’t stand it and then I fed with the shield until my gassy, hungry baby couldn’t stand it.

“I want to quit.” I moaned to Jason one night. I had gone into the other room to feed Finn and between being hungry and me being in pain we were both crying. He woke up and came into see what was going on. “Why is this so hard?”

I placed another call to the lactation office I had been working with on December 23, almost four weeks after Finn’s birth. I also reached out to Finn’s pediatrician and asked if they had a lactation specialist that they recommended. They did. If I could have found a third route, I would have tried that, too. I was desperate and willing to head straight to whichever office could get me in first. It happened to be the ped’s recommendation and so I loaded my hungry baby into the car again and sped off to another medical facility.

This lady was actually the best I’ve seen so far. She was empathetic, she was knowledgeable, she was incredibly kind, and best of all, she actually helped me work on the latch. Which I kept mentioning all along was the problem. Duh.

That was a week and a half ago. Since then, I’ve had some good feedings and I’ve had some terrible feedings. I’ve had days where I feel like I’m getting this and it’s truly getting better and then I’ve had days where I feel like I’m the one useless mom who can’t figure out how to feed her baby properly.

At this point, there is nothing left to Google. I have every deep latch technique memorized. I know all of the different remedies one might use to heal their sore nipples and I’ve tried about half of them. I’ve dropped a fair amount of money in the bottle/pump aisles of my local Walmart and Target. I’ve jostled poor Finn around from position to position in an attempt to find one that doesn’t hurt.

But, for whatever reason, it still does. Not as bad as it did in the beginning before her tongue tie was corrected. Oh, but it’s still bad. I still sit with silent, gritted teeth for the first minute or so of every feeding. I still have times where I simply can’t stand it and I have to break the latch and start over. I still look at her intently before I attempt to feed her and ask, “Please, Finn? Please help me out this time?”

And I know. I know. Breast is best. Someday it won’t hurt. And then I won’t even remember what all of this felt like. And you’re all probably right. I’m sure lanolin and breastmilk are usually quite effective too. No, really. I mean that. I’m sorry for my sarcasm. It’s just hard. Because I want this relationship. I want to keep entering into the little world that her and I build whenever I feed her. I want to give her the best possible source of nutrition. I want to say that I got through this, just like I got through labor without any drugs or interventions.

I also want to not feel my motivation seep out with every painful feeding. I want to not feel like all I can really do is sit in the rocking chair while she sleeps and try yet another search term in Google. I want to not feel resentful towards her, Jason, God, and all of those mothers out there who sheepishly say, “Well, I loved breastfeeding.” I want showers to be enjoyable again and bath towels to feel like bath towels instead of sandpaper.

I had a follow up appointment at the midwives clinic today. Currently, I’ve been put on an anti-fungal medication on the very possible chance that I contracted thrush from taking those stupid useless antibiotics and having open wounds exposed to moisture all the time. I’m also loading up on probiotics . I even bought some infant ones for Finn that I keep forgetting to give her. Besides, no harm can come from taking probiotics. And I do like kefir.

I’ve concluded that the whole thing might be a combination of Finn’s mouth shape inhibiting her from latching properly and my naiveté inhibiting me from teaching her how to latch properly from the get go. I do notice that she’s started to open her mouth wider here and there. She’s starting to “get it.” She pulls herself off towards the end less often.

To be honest, I don’t know how I’ve made it this long. I can look at my exhausting labor and remember all of the water therapy and counter-pressure and position changes that got me through it but this has started to feel a little insane. It’s not even about it being painful anymore. That I’ve somehow learned to deal with. It’s just that I find myself worrying that I’ve done some sort of permanent damage both physically and emotionally. Like, am I going to have post-trauma issues from breastfeeding? Am I going to get a really terrible infection and have to quit regardless because I need to have a mastectomy? Is my baby going to be plagued by very early memories of mother frantically breaking the suction and starting over again and again, only to end up in tears regardless?

Alright, that was dramatic.

I will leave you with something hopeful. Because despite everything, I do have hope. I may have used up the reserves of my stubbornness to birth my child but now it’s comeback in small rations and I’m determined to stick this out until the bitter end. That may be when I go back to school in three weeks and have to somehow be able to offer her a bottle without panicking that it will mess up her improving latch, and it may be in eight or nine months when we start offering her solids. Or it may be in a year or two when we’ve made to the breastfeeding nirvana that everyone talks about. The shiny prize that made all of the pain totally worth it. I’m skeptical, but who knows.

Jason, who has been nothing but supportive, asked me the other day what my intuition tells me about the situation. He says that he’s come to appreciate the motherly intuition, having seen it in full on action during pregnancy and birth. I told him that, as vague and lame as this sounds, my intuition says that everything will turn out alright regardless. It will be alright if I choose to keep trying for another month or so, and it will be alright if I decide that, for my own sanity, we need to do something different. It will be alright if I am never one of those confident moms who can magically pull her shirt up and get the baby latched in the blink of an eye in a restaurant booth and instead end up swirling formula around in a bottle for my daughter. I can at least say that I tried everything that could be tried. Nipple shields and football holds and APNO. Coconut oil and probiotics and lanolin. Suck training and biological nurturing and plain old grim determination. Antibiotics and anti fungals and jaw massages and finally, time. I can say what worked and what was a waste. I can say that I persevered through some of the hardest weeks of my life, that I survived the holiday family visits and sleep deprivation and still managed to feed my baby throughout all of it. That is something. That gives me the certainty that I need to be able to look back and tell myself that somehow, it does get better.

I’m going to go feed my kid now. Right after I rid her of the curdling soup in her diaper.