Wednesday, October 10, 2007

Losing the war, but winning the battles - Breast Fest 2007

Today was the fabulous Breast Fest. There have been posts, there have been videos, there have been beautiful photos.

I have no photos.
I have no video.
I do, though, have our story.

When your baby is born early, you will realize, very rapidly, that your entire birth experience will slip through your fingers, handed over to the specialists who will be tasked with stabilizing your baby. Many hands (not yours) will touch your baby. You may get a glimpse, perhaps a brief moment to cuddle, but then the baby will quickly be whisked away out of sight, for the tests, the tubes, the plastic box that will be their home for the next weeks. You will not get an opportunity to breast feed shortly after the birth, not after their first bath, possibly not for days or weeks.

This was our experience. When the Peanut was born, we were lucky enough to have a few brief moments to cuddle before she was moved to the NICU. But feeding her, nourishing her? That came much later.

When a baby is born as early as the Peanut, they haven't perfected the suck-swallow-breathe reflex. Because of this, they are fed by a tube leading down to their stomach. Later, they are often started on a bottle, as breastfeeding takes much more energy and is quite tiring for the baby and can lead to weight loss that the baby can not afford.

Five ccs of formula. A humble beginning.

Oh, how I wanted to breastfeed my baby. Instead, she was fed by a test tube, scotch taped to the inside of her incubator while I watched.

As a mom of a preemie, the pump was promptly wheeled in to my room by the end of the first day. And I pumped.

And pumped.

And pumped.

Nothing happened. I was told to go and look at my daughter, gaze on her, keep a picture of her with me when I pumped.

Still nothing happened.

Finally, after three days, I pumped a stunning 12 ccs of milk. A small victory. And after approximately ten days I was allowed to try breastfeeding my little Peanut.

There are mechanics to breastfeeding a preemie, so much to learn.

Regardless, we got settled into a chair, two nurses and a lactation consultant assisted. One nurse held the Peanut, the other attempted to jam her tiny, tiny little mouth onto my nipple. My hands flopped around helplessly, aimlessly. The nurse and the lactation consultant started bickering about method, technique, the baby herself. I was lost. Finally after a few more attempts (no more than one per day), the nurse finally came and told me to go and buy myself a nipple shield. The baby's mouth, she said, is too small. The nipple shield will help.

So I did as I was told. And the nurse was right, the Peanut was able to latch on to the nipple shield where she had failed with my nipple, and slowly, we were off. At one point the lactation consultant came in and saw me using the shield, and clucked and scolded and chastised. Lacatation consultants, as I found out the hard way, don't like the nipple shield. But damn it, the Peanut was learning to breastfeed, and I would use that shield for the next year if I had to.

During this, I continued to pump. I had a hard time with it, driving back and forth across the city from my home to the hospital on the other side of the city where the Peanut was, trying to find a bit of privacy in the hospital to pump. My milk supply wasn't great and often I couldn't pump enough to meet her needs for the day. But oh, how I tried.

Eventually we reached a point where I was allowed to try to breastfeed her for every meal that I was at the hospital. Even then, there were more mechanics. You strip the baby to her diaper. Weigh her. Feed her. Then weigh her again, to ensure that her weight is now 40g more than the initial weigh in, the 40g being what constitues a full feed. If she had stopped eating or fallen asleep and was not 40g heavier, and was too tired for the bottle then the difference between what was ingested and her prescribed feed amounts was tube fed. So many mechanics. Such an unnatural environment.

A lot of preemie moms give up. For your child to leave the NICU, amongst other milestones, they must be off tube feeding completely for at least three days. If you are breastfeeding, it is more likely that you will need to tube feed occasionally. The nurses, overworked, stressed and desperate to get the babies home with their parents, can sometimes be discouraging towards the breastfeeding process. In the NICU, with everything else going on, they just don't have the time to supervise it in the manner they feel they need to (although they push hard for you to pump. Pump Pump Pump!). Oh, they say, you can focus on breastfeeding when you get home (weeks or even months after your baby has been born. Weeks and months of tube feeding and bottle feeding, and a milk supply compromised by stress and exclusive pumping.)

But the Peanut and I? We battled on, eventually breastfeeding every meal. The nurses were surprised and pointed to me as an example of what it was possible to accomplish - a small NICU victory. But I was nervous. I knew my milk supply was not keeping up. I took Domperidone, I took fenugreek, and I worried and I hoped.

When the Peanut came home I breastfed as much as possible, but my low milk supply combined with the Peanut's propensity for falling asleep at the breast, meant that we were dependent on formula for parts, or whole, meals. At 4 lb, we couldn't afford for her to lose weight. Then, nearly three months after she was born, the Peanut finally learned how to latch without the shield. What a great day!

We hobbled along, her and I, breastfeeding as much as possible, always in the morning and at night, before bed and periodically throughout the day. I tried all the remedies to increase my milks supply - drugs, oatmeal, constant pumping - but nothing worked. After a while, I realized that she really wasn't getting much nourishment from the feedings (as she would cry in hunger even after being at the breast for 20 minutes or more), but in its place breastfeeding had become the Peanut's calming and soothing mechanism. She wouldn't take a soother, (oh no, no soother for her, despite the small fortune I spent on testing each and every damn brand out there) but she would nurse to sleep before every nap, before bedtime. She would nurse in a restaurant to calm herself down. She would nurse on the airplane on our trip to Vancouver. She would nurse while hanging out with friends on a Saturday evening. As tied down as I was by it, I loved it. I felt empowered by my ability to calm the Peanut, to soothe her, to help her fall asleep.

Then on the weekend of her christening, when she was seven months old, the Peanut took a couple of nips at my breast, turned her head, and fell asleep.

She didn't want me anymore. She didn't need my boobies, didn't want my boobies. And she didn't change her mind.

I joked with people about it, laughed it off. I told my husband that he could now do bedtime duty. But inside I was crying, for I wish that I could have breast fed her exclusively. I wish I could have breastfed her longer. I wish I had photos and videos of that special time.

But at th end of it all, I know we did our best, her and I. I
'm so proud that we did our very best. We may not have won the war, but we certainly claimed victory in a few battles.


painted maypole said...

great story. How great that you had breastfeeding advocates in the hospital, even if they bickered right there in front of you! ;)

ewe are here said...

It sounds to me like you did a spectacular job under the circumstances. Truly spectacular.

Sometimes I think lactation consultants/midwives have lost the plot re breastfeeding. Your lactation consultant fretted over a nipple shield? Good grief. 'How' the baby gets breastmilk shouldn't be the issue if a mom is willing to try to give her baby breastmilk; it's the end result that matters, and in your case, it was working.

Mad Hatter said...

What a stunning, lovely and honest post. I had many of the same difficulties although Miss M was not premie: just small from interuterine growth retardation and jaundiced). It is very had to tell the war stories of breastfeeding and manage to convey that sense of frustration and disillusionment and, oddly amidst it all, joy. You have done that beautifully here.

Roz said...

What a lovely story :)

NotSoSage said...

Exactly what Mad said...this was a wonderful thing to read, and a good story to share.

Kellan Rhodes said...

This was a wonderful story. I loved the last lines! I love that you have all these memories and are able to document them for Peanut.

Aliki2006 said...

You should be so very, very proud. I'll never forget how shocked I was to realize, with Liam, that breastfeeding was *not* easy and that the nurses made it seem very, very unnatural, there in the hospital.

How wonderful for you to put this all down in words--it will be so important for the both of you.

kittenpie said...

As another mother who struggled, I tell you, you should be really proud of giving her as much as you could, accomplishing that much. It takes dedication. I know of what I speak, because we never got the latched and I pumped for a year. It was a pain in the ass, but I'd do it again.

Alley Cat said...

I know that if I had been in that position, the pressure from family to give up on breast feeding would have been high. Good for you for sticking with it.

Gabriella said...

Thanks for sharing your story with us. You did an amazing job and persevered through something that many might have given up! Be proud!

Lisa b said...

oh my goodness. I cannot imagine having to go through this with my first child. A small ill baby is stress enough without having to deal with the conflicting assvice of experts.
I was lucky that both the hosptials I was at had pump rooms. I am horrified you had to try to find somewhere to pump.
You did an AMAZING job.

bubandpie said...

The nipple shield-hating lactation consultant is the part of this post that got to me too - how I hate that aspect of infant-parenting - the way so many things are sternly forbidden on the off-chance that they cause a problem, even though soothers, nipple shields, and even tummy sleeping for some babies may make the difference between sanity and insanity.

nomotherearth said...

You did a damn fine job.

Oh, how I remember the trips to the hospital, the stripping, the weighing (the constant weighing). I thought I was alone in these breastfeeding issues, and now I'm wondering if it's easy for anyone..? It sure would have helped me to know there were others out there struggling like me (that sounds bad, but I hope you know what I mean).

Thanks for sharing.

slouching mom said...

What a beautiful story. Poignant, so poignant. And moving.

(I was a preemie -- born at 30 weeks weighing 2 pounds. But at the time nursing wasn't even offered to my mother as the remotest of possibilities.)

Family Adventure said...

Beautiful posting. Very touching. You did well hanging in there! I had a rough time with my first (preemie, but nothing like yours), and eventually gave up. In hindsight, I can see that it was inexperience and feeling of being overwhelmed that made me quit too soon. That and a couple of mad experiences at the hospital. So hats off to you! And thanks for sharing!
- Heidi

cinnamon gurl said...

I meant to comment last week, but blogger was being a beast at work. This is a great post, an important story to tell.

And good for you for sticking with it for so long. I never got the hang of pumping and couldn't imagine doing it full time for any length of time.


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