Sunday, September 30, 2012

2 Month Update - Breastfeeding Woes

These last few weeks have been quite the circus around our home.  Adjusting to life with a toddler and a newborn along with my husband's hectic work schedule has been quite the challenge.  As the baby is getting bigger and my toddler is getting adjusted to life as a big brother, we are hoping to finally turn a corner and have more time to indulge in the little things like write a new blog entry.  Up until this point, my husband and I have had to juggle constantly holding the newborn.  Being able to type with two hands on a computer and not on my phone has been a luxury.

I would have to say that this baby has been an interesting experience when compared to my older child.  They say every baby is different and this is certainly the case for us.  With my older child, I had difficulty breastfeeding in the beginning due to a bad latch.  As a result, my milk took a while to "come in."  Since he was losing too much weight, we had to supplement him with some formula for a few days.  This baby, however, has been completely different.  Since I only stopped nursing my older child back in March (he was 22 months old and I was 20 weeks pregnant), I don't think I ever stopped producing milk.  As a result, my milk was pretty much ready for this baby from the very beginning.  At first it seemed great since I didn't suffer from the issues that typically surround the early days of nursing like sore nipples, engorgement, etc.  I had a brand new tube of Lansinoh and gel cooling pads ready to go and I didn't have to use any of it.  Since I already breastfed my older child, I didn't have any of the latch issues either.  I thought everything was going great until...

Reflux reared its ugly head.  My poor baby seemed to be getting too much milk!  After each nursing session, he would choke and appear to be drowning from my milk!  It was awful!  We couldn't lay him flat on his back as recommended because as soon as we did that, he would start to get horrible reflux.  It didn't matter if we kept him upright for an hour after nursing, he still would begin to spit up and appear to choke on his spit up.  The only way any one in our house was to get any sleep was to literally hold him upright for what appeared to be 24 hours a day.  To say that we are tired is a gross understatement.

Part of my problem after researching some of my favorite websites for information about breastfeeding was that I had a fast letdown (my milk would come out too fast) and I was over producing creating a foremilk/hindmilk imbalance.  With the fast let down, the milk literally came out of my body like a geyser.  Its the craziest thing which never happened with my older child.  I was so impressed by it, I actually took a video of it!  Since it came out so fast and hard, my baby would have to release his latch or risk choking on the milk!  I tried nursing at an incline so gravity would try to slow the flow and the baby would have to "work" at getting the milk out.  That, unfortunately, didn't work since even being flat on my back would cause the milk to shoot straight up.  Also, since I had too much milk, the baby would get full before emptying the breast.  As a result, he would get too much of the watery foremilk and not enough of the fatty hindmilk.  The poor guy had to deal with green, runny poop as a result of not getting enough of the fatty milk.  I had read that pumping before nursing would help but that left me with a catch-22 since pumping stimulates milk production which is what I didn't want to do.

I thought the best solution for everyone was to pump and then feed the baby a bottle at least once a day before bedtime so he could at least rest at night without having reflux issues.  It was a great idea until we realized the baby would not take a bottle!  It seems like if it wasn't one thing it was another.  On top of all of that, if he was going through a growth spurt, he would start cluster feeding which further stimulated my production.

Now that the baby is nine weeks old, it appears that things are beginning to get a whole lot better.  We can now put him flat on his back for at least a few hours at a time (we don't have to constantly hold him) and he is taking a bottle again at least once a night before bed.  I think the bedtime bottle has been key to helping him sleep for at least four hours at a time.   I also think that his reflux is getting better simply because he's a little older and his gastrointestinal tract is more mature and able to better handle eating.

Things are better for the most part but we are, unfortunately, still experiencing little "hiccups" along the way.  Tonight was a little strange since the baby refused the bottle from my husband.  Instead, I gave him the bottle which seemed to break the "mold" when it comes to bottle feeding a breastfed baby.  I have to admit that it was weird feeding him a bottle.  I think with my oldest, I only did that a handful of times like when we were in a car so feeding my babies from a bottle is in general a weird thing for me.

I am hoping this continues so everyone gets more sleep and I may even consider donating my breastmilk.  I had always wanted to do that but never seemed to produce enough.  Now that I seem to be producing too much, it is something that I'd like to explore.  Do you know of any good organizations that I could donate milk to?

I'd also like to share links to my favorite breastfeeding websites that provided me with invaluable information these last few weeks.  I hope that you may find these websites useful if you are experiencing difficulty with breastfeeding.  I would also like any feedback of other websites that are useful to the breastfeeding mother.

http://kellymom.com/
My favorite website.  I always look things up here first before exploring other websites.

http://www.workandpump.com/
Great resource for pumping questions.

http://www.breastfeedingonline.com/newman.shtml
A Canadian doctor's website.  He's very pro-breastfeeding and I appreciate his insight.

https://www.breastfeeding.asn.au/
An Australian website with great information.



Saturday, September 8, 2012

Bottle & Pacifier "Strike?"

These last few weeks have been challenging with a newborn and toddler.  As a result, this blog and many other things in my life has been neglected.  My day to day life now consists of nursing every 2-3 hours, changing diapers, cleaning spit up (and occasional pooplosions) cooking, grocery shopping and entertaining a very active toddler.  My time spent on the Internet has been limited to whatever I can do on my cellphone while I nurse.  Typing one handed is frustrating and time consuming.  Despite all of this, I am finding a way to peck this post out of desperation.  I am presently functioning on no more than 3 consecutive hours of sleep since the baby was born 42 days ago.  To say that I am delirious is a gross understatement.  Please excuse any typos or grammatical errors since many things do not presently make sense.

My lovely baby has decided to go on a pacifier and bottle "strike."  He had taken a pacifier and bottle before.  Unfortunately, over the last week, he is refusing to take either one and only wants me to nurse him.  He is absolutely refusing to even latch onto a pacifier or bottle.  We have been trying nightly without any success.  A lot of milk has been wasted in our futile attempts.  To make matters worse, my husband has been working two weeks straight without a day off so I have been his primary caregiver.  I have turned to my favorite breastfeeding website, kellymom.com, for answers and despite trying many of their suggestions, the baby is still refusing to take a bottle.  We have a wedding to attend on Sunday but I am finding it less likely that I'd be able to go if this baby will not take a bottle.  I would also like to start getting more than 3 hours of sleep.  I can't do this if my husband cannot do a feeding with a bottle.  My supply is well established (which brought its own set of problems that I can write another post about) so supply being compromised is not a concern. I have plenty of expressed breastmilk ready to give to him and we do not have to use formula.  We have tried the following thus far:
  1. Feeding the baby when their cues indicate hunger, rather than on a schedule.
  2. Held in an upright position; it is especially important to avoid letting the baby drink from a bottle when lying down. Such a position is associated with bottle caries and an increased frequency of ear infections. Note also that babies should be held often at times when they are not being fed, to avoid the baby being trained to eat in order to be held.
  3. Gently, allowing the infant to draw nipple into mouth rather than pushing the nipple into the infant’s mouth, so that baby controls when the feed begins. Stroke baby’s lips from top to bottom with the nipple to illicit a rooting response of a wide open mouth, and then allow the baby to “accept” the nipple rather than poking it in
  4. Use a silicone rather than a rubber nipple to avoid an unpleasant odor or taste.
  5. Warm the nipple under running water before offering the bottle to the baby.
  6. Make sure the milk is not too warm and not too cold. If when holding the bottle in your palm, it feels warm to the touch, it is most likely too warm. If it feels cool to the touch, it is most likely not warm enough. If you can feel no difference in the temperature of the bottle and your palm, the milk is probably at the right temperature.
  7. Most babies will accept expressed breastmilk more readily than formula.
  8. Offer the bottle while holding the baby with his back to your chest so that he is facing outward, rather than trying to cradle him.
  9. Move with the baby - rock, sway, bounce, walk, walk in circles, etc. as you offer the bottle.
  10. Place the baby in a swing, bouncy seat, infant/car seat, etc. and offer the bottle. Try to distract the baby with something else as you offer the bottle.
  11. Place an article of mother's clothing up near the baby while offering the bottle, or wrap the bottle with an article of mother's clothing.
  12. Lightly tickle the baby's lower lip with the nipple and allow him to pull it in his mouth rather than trying to force the nipple in.
  13. Offer the bottle when the baby is already sleepy or just waking up (but not fully awake) or once the baby is already asleep. Many babies will instinctively suckle at these times.
  14. Try to use a bottle with a newborn or slow flow nipple no matter how old your baby is so that he always has to work hard with the bottle just as he does with the breast.
  15. Having my husband feed the baby without me in the vicinity of the bottle.
We have tried Tommee Tippee bottles and Medela bottles.  Our older baby used the Tommee Tippee, Medela and Dr. Brown's bottles without any problems.  He also used a pacifier until he was four months old and we discontinued using the pacifier.  This baby is six weeks old and I do not know if the six week "growth spurt" is the cause of our troubles.  Does anyone else have any suggestions or ideas??  I love my baby but mommy needs to get some sleep!