Tuesday, December 24, 2013

Birth/Breastfeeding Connection? (2 of 2)

As it would turn out, while my little girl’s being small (5 pounds, 10 ounces) may have been beneficially for me during birth, it would prove a stumbling block to establishing a good latch.  Her mouth just seemed to be too small to take in the appropriate amount of the areola, nibbling instead on the nipple itself.  Furthermore, having come a couple of weeks earlier than expected, she fell into a category no one mentioned before – near-term baby.  As such, her rooting motions were quite jerky, and her sucking not very well coordinated.  Add to that a mom traumatized by early nipple damage, resulting in an inability to boldly and quickly maximize the few nanoseconds baby’s mouth stays open before attempting to suckle, and painfully sore nipples are bound to happen. 

Although everyone not directly involved with La Leche League claimed that a painful beginning (days? weeks? months?) was part of the deal, I had a hard time believing that my threshold for pain was that much lower than all of these other moms’. The aforementioned nipple damage traumatized me quite a bit. It was the last straw on a heap of a week’s worth of painful nursing sessions.  Contrary to what I knew had to happen once I began lactating, I was so afraid of anything coming anywhere near my damaged breast that I neither nursed nor expressed any milk from it for 12 hours.  When the scab came off in the bath, I was able to attempt to express milk using the manual pump I had “just in case”. But because my milk had just started coming in the day before, I spent two hours in all sorts of crazy positions, trying to maximize the amount I got with the help of gravity, yielding just enough for one feeding – by miniature bulb syringe – before realizing that I simply could not keep up with my little one’s needs.

First bottle feeding, day of trauma and drama :(
Utterly disappointed in myself for my inability to nourish my child the way nature intended, I had to succumb to allowing formula into the picture.  We had received some formula samples in the mail which I had gathered to donate, since formula did not fit into the ideal I was trying to establish in my early days of parenting.  But now I was so thankful that there was a way I could feed my baby, even if it was no thanks to me.  Alex, bless his heart, offered to take the entire night shift (since this became a possibility with the introduction of formula into the picture) so that I could sleep and thereby try to recuperate a bit from the day’s drama.

The next day, I found my damaged breast to be severely engorged, leaving me with a fever, chills, and later night sweats.  I proceeded to nurse my baby on the one good breast during the day, leaving the night feedings to my husband.  The following day, I began to wear cabbage leaves in my bra to soothe the heat and pain that I felt in my damaged breast, and tried to express milk with my manual pump.  I was convinced that between that and the rest I was getting, everything would just fix itself.  It wasn’t until four days after the damage first occurred that I finally called my midwives.  I was no longer just dealing with painful engorgement; I had a breast infection.

That whole day was spent trying to follow the midwife’s instructions for how to best begin the healing process.  After trying to no avail to find a medical supply store in our area that (a) sold electric breast pumps and (b) would bill our insurance, Alex drove around town picking up my antibiotics and nipple ointment.  As it finally turned out (thanks to the insight offered by whoever answered the phone at the lactation office I called), the idea that we could purchase a breast pump and have it go through our insurance was a rouse.  In fact, we had to order through our insurance and wait for it to ship in 4 – 6 weeks.  Well, I needed the pump that same day.  And so we paid for an electric pump out of pocket and I began pumping more efficiently.

However, over the weekend, I noticed one stubborn area of my breast where the redness and bumpiness was not going away.  Convinced that it was a blocked duct that wouldn’t go away (I tried warm compresses, massage, even putting an electric toothbrush to the area), I called my midwife back and asked about a solution I had read in The Womanly Art of Breastfeeding – an ultrasound that could break down the old milk proteins in the ducts and get the milk flowing again.  Since my two week postpartum visit was a few days away, the midwife preferred to wait until then before sending me in for an ultrasound which she wasn’t convinced would work. 

The night before my appointment, as I was flipping through The Womanly Art for the umpteenth time, I came across a small section about an “uncommon” problem called a breast abscess.  I had Alex read it to see if he thought – as I did – that perhaps I didn’t have a stubborn blocked duct; perhaps I had a breast abscess.  We both agreed that it was a possibility, and it was confirmed the next day.  My midwife scheduled an ultrasound to confirm her diagnosis for the following day.  From the ultrasound, I was sent directly to a breast surgeon who could drain the abscesses (turns out there were three!) that same day.

Over the weekend, there was noted improvement, though a lump remained, albeit somewhat smaller and less discolored.  At my follow up visit, I had the remaining abscess drained again, this time via an incision that would be left open to allow for ongoing drainage.  (It’s as creepy as it sounds.)  I also found out that the abscesses were resistant to the antibiotic I was on was.  However, my options of an alternative were a bit limited.  I’m allergic to penicillin, and I needed something that was safe for continuing to breastfeed. This left three options, all IV-based.  And so I ended up with an antibiotic that wasn’t quite as effective but still better than what I had been on up until that point, with the instructions to pump and dump my milk for the first few hours after taking each daily dose.

However, since the week I had already been on a supposedly breastfeeding-safe antibiotic caused Maya to have pure liquid poop (I’m not talking runny the way you’d expect on breastmilk, but basically what looked like brown pee), Alex and I agreed that it was best to eliminate it from her diet until I was no longer on an antibiotic.

It has been a week since I breastfed my daughter.  This brings tears to my eyes, in spite of the fact that often times, nursing her literally brings tears to my eyes as well.  But I’ve found the silver lining in this challenge.  While the pro-exclusive breastfeeding folks would have me believe that I am – and ought to be – the center of my baby’s universe if I know what’s good for her, I in fact believe that God has used this time to humble me instead.  I have to share my daughter with formula, bottles, and pacifiers, because pain prevents me from being able to fulfill all of her suckling needs on my own.  And this helps me to remember that Maya is a child of God first and foremost, and I have merely been tasked with the responsibility and privilege of raising her.

Here I am experimenting with a couple of holds to try to keep breastfeeding.

Football/clutch hold. For some reason it helped to stand up.

The whole first week we nursed in the clutch/football hold, as it is supposed to work better for tiny babies.

The cross cradle hold on the Brest Friend pillow.  Supposed to help by freeing my outside hand to hold breast in a "C" and observe her latch.
Yesterday I took my last dose of antibiotic.  Today, we began nursing at the breast again.  So far, it would seem that allowing my nipples to rest and giving Maya practice on the bottle and pacifier seems to have helped!  (We use paced bottle feeding to keep the flow similar to breastfeeding, ie. slow.)  She wasn’t too keen on Leftie (the traumatized breast), but she latched onto Rightie (you guessed it - the breast that had been holding down the fort on its own) no problem.  I kept trying to check her latch because it didn’t hurt going on, but it seemed fine, and she nursed for a half hour before falling asleep and letting go.  My nipple came out not looking like lipstick for the first time!  I immediately put on the nipple ointment, and it is sore right now.  But what I learned over these last couple of weeks is not to try to be a hero and to find that happy balance where I’m giving my daughter my best while still enjoying the miracle and blessing that she is.


  1. I'm so sorry you had such a rough time. Your last sentence is absolutely beautiful. I think you should write those words all over your house and revisit them many times over the next 18 years :).

    Prayers for you all! Much love and congratulations :).