Several hours after I delivered Jack, I was moved from labor and delivery to my hospital room. My night nurse was terrible. She asked me if I was planning on breastfeeding and when I told her yes she said a lactation consultant would be with me in the morning to teach me how to use the breast pump. She made it sound like I needed to wait for an LC to teach me how to use the pump. Because I didn’t do any research about the ins and outs of breastfeeding I didn’t know I needed to start pumping right away in order to have my milk come in. I was too overwhelmed and exhausted to think clearly, but I remember thinking it was odd that I wasn’t pumping. I figured the nurse would know best and tried to get a little rest. The next morning, at shift change, my day nurse came in to check on me and asked where my pumped colostrum was. When I told her I was waiting for the LC to teach me how to use the pump, she got me set up immediately and told me I didn’t have to wait for an LC to get started. Apparently, the nurses are supposed to teach pumping, but the night nurse was too lazy to be bothered with it. I knew enough to know I was treading on shaky ground to establish a milk supply this long after delivery. I pumped for half an hour and got three drops of colostrum. I was devastated. The nurse came back in and said that was a good start and cheered me on. She told me to go see my baby and to come back and pump again in 2-3 hours. So I went down to the NICU and finally met my son.
Jack was in the NICU for 17 days. He started out on a CPAP machine as a precaution and was getting all his feedings through the feeding tube. I was pumping like crazy, every 90 minutes around the clock, and he was being fed every 3 hours. I was so panicked about my milk supply. I knew how much milk the nurses were giving him and I just wasn’t keeping up. I would pump 15 mL and they would give him 25 mL; I would pump 20 mL and they would give him 30 mL. My nipples were being rubbed raw by the pump and I was in extreme pain every time I pumped. My back hurt from trying to hold the flanges to my breasts to maintain suction. It took me 30 minutes or more to pump. I felt like I was constantly hooked up to that machine. The hospital had WiFi and I spent hours online looking up anything and everything about establishing a milk supply, pumping, and breastfeeding. Jack had a private room and I was able to stay with him 24/7. If I wasn’t pumping or researching, I was doing skin to skin and taking power naps in between everything. I have never been so exhausted in my life. I have never been so stressed out in my life. I have never been more determined to be successful at something in my life.
A week went by and I still hadn’t seen a lactation consultant. My supply still wasn’t catching up to what Jack was being given and I was incredibly frustrated with the lack of support I was getting from the hospital staff. The doctors wouldn’t even let me try to breastfeed despite Jack’s ability to suck on my finger. They claimed he didn’t have a suck/swallow/breathe reflex yet. I don’t know why I listened to them and didn’t just try to breastfeed on my own. Jack had a different nurse every day and every night and no one was giving me consistent advice or information about what was going on. One nurse would tell me to pump more, one nurse would tell me to pump less, one nurse didn’t understand why we weren’t at least trying to latch on, one nurse assured me bottle feeding would be fine. Finally, Jack got a nurse that actually talked to me and asked me what I wanted. She supported my drive to breastfeed and immediately got an LC to see me.
The LC immediately got down to business. She showed me how to hold Jack and to let him open his mouth wide and then try to latch him on. Even after a week I was hoping it would come to us naturally and be an easy thing to do. But it was terribly awkward and difficult. I had never handled a newborn before Jack and no one told me just how floppy their heads can be; I kept thinking I was going to break him. There were tubes and wires in the way and I didn’t seem to have enough hands to hold him, hold my breast, keep the wires at bay, and actually manage to get my nipple in his mouth. The LC was incredibly patient with us and finally gave us a nipple shield to try. The shield helped, but she didn’t really give me any instructions on how to adequately use it. She left and we awkwardly continued to try to latch on. She told me practice makes perfect, so practice we did. And we were awful at it.
The next day a different LC came to see us and taught us some different holds (yay for the football hold!), and we practiced latching even more. And we were slightly less awful at it. The doctors were only letting me try to latch him twice a day and only after pumping first. This was called non-nutritive nursing, and seemed so counter-intuitive. But that’s what we did. The next day yet another LC came and showed me some better pumping techniques and how to hand express. That day was a game changer. It was the first time I didn’t feel completely engorged after pumping and within 12 hours, my milk supply finally caught up to and surpassed what Jack was being fed. He was now 100% on my milk and I was starting to gain my confidence.
A few days after that, daylight savings time ended. When the clocks were switched, all the babies in the NICU had to wait 4 hours between their midnight feeding and 3 am feeding instead of just 3 hours. This is when I decided to take matters into my own hands. Jack was expecting food in his tummy after 3 hours and I wasn’t about to sit by his side and listen to him cry for an hour just so the hospital staff could stay on their schedule. As soon as he started to cry from hunger, I got him, latched him on, and for the first time, actually fed him directly from the tap. We still weren’t very good at latching, and I think he slept just as much, if not more than he nursed, but we were finally doing it! I wasn’t terribly worried about how much he was actually getting from me because I knew the nurse would be in soon to feed him through his tube.
It still took us a couple of days to eliminate his tube feedings. We still weren’t very good at nursing; it took forever to get him latched, it took forever for him to eat, and the doctors were concerned about his lack of adequate weight gain, but he seemed happy and was having plenty of wet diapers, so we were finally released from the hospital.
The next three months were the hardest three months of my life. Our pediatrician was also worried about Jack’s slow weight gain (he wasn’t even back up to his birth weight when we were released from the hospital), but knew how determined I was to not supplement so let us keep trying. By this time, I had become fairly well versed on the ins and outs of breastfeeding and understood supply and demand and how supplementing can negatively affect supply. After working so hard to have my milk come in and to actually breastfeed, I wasn’t willing to let anything negatively affect that. The pediatrician had us come in every two weeks for weigh-ins, and finally, at his 6 week check-up, Jack weighed more than his birth weight and our doctor felt like we didn’t even need to consider supplementing.
I was so worried that we would have to supplement that I nursed Jack pretty much around the clock. He was a slow eater, sometimes taking 45-60+ minutes on each breast. He would sleep for 60-90 minutes and we would be back to nursing. I slept on the couch with him because it was easier to put on the nipple shield and latch him on before he got into full blown hunger melt down that way. It was so exhausting, but I was so happy that we were actually breastfeeding. I hated the nipple shield; it was a pain in the butt to use, but every time I tried to latch Jack without it, it didn’t work. No one ever told me that a nipple shield can negatively affect milk supply, so we probably used it much longer than we should have.
I went back to work one day a week when Jack was 6 weeks old, so I continued to pump and freeze my milk. I noticed at about 3 months that I wasn’t able to pump as much milk and immediately got worried and started researching nipple shields and latching techniques. My suspicions were confirmed, so I decided to stop using the shield pretty much cold turkey. And it was awful. Jack had never learned how to properly latch; the shield allowed for a lazy, shallow latch, so when I threw out the shield, he wasn’t latching correctly and nursing hurt. A lot. Way more than I knew it should. Again, I consulted the internet, and we figured out how to properly latch. At long last, we were breastfeeding without any assistance of any kind.
Our story continues, but that pretty much tells how we began our journey. Jack is now 10 months old and thriving! He’s a great nurser and it only takes him 3-5 minutes on each side to get a full belly. I know that we were extremely lucky to get to this point. Although our hospital was supposedly breast friendly, we had to overcome so many obstacles to get to where we are today. There were many times I thought about giving up and just bottle feeding, but breastfeeding was too important to me (I can be crazy stubborn). I wish I had done more research from the beginning; my over-sure attitude hurt my chances of successfully breastfeeding, but I quickly caught up with all the information that was out there.
My advice to other mothers is to do your research. Learn everything you can about breastfeeding while you are pregnant. Take a class, read a book, look up things on the internet. Don’t hesitate to reach out for support. Call a lactation consultant or Le Leche League if you need help. Breastfeeding is tough work. It can be surprisingly awkward at first, and you may feel like you’re in over your head. Not every baby latches right away or is in a position to get to try to latch immediately. Breastfeeding is a skill both mother and baby have to learn and practice. Find other breastfeeding mothers online or in your community for support. If breastfeeding is important to you, don’t give up. Be stubborn and stick up for yourself and your baby. Don’t let anyone tell you you can’t (other than for medical reasons). You can do it!!! And if for some reason you can’t, you’re not a failure!!! If you bottle feed or formula feed or breastfeed, you are a wonderful mom doing the best for your baby, yourself, and your family. I think we all need to support each other, no matter what position we end up in.
What a story! Jessica, I was so emotional as I read, I can't imagine how difficult and frustrating it must have been in the beginning. You are so strong and determined, your son is so lucky to have you as his mother!
It is amazing what a determined mother can do! It is so sad that you did not consistently get the support you needed from the hospital staff but fortunately you sought information and support from other sources. Congratulations.