Breastfeeding - Battles or Bliss?
My personal worst and best stories.
So many new subscribers have come to MomsMatter from The Lactation College. I am so glad you are all here! Your interest stimulates me to share my worst and best personal breastfeeding stories. Whenever I share these stories with mothers, they act so amazed, that a neonatologist, well-trained in the complete care and support of newborn infants, could have had such struggles with breastfeeding.
Here goes: Breastfeeding began as something healthy mothers could do for their babies. The medical benefits were substantial, so I naturally wanted to breastfeed my own children. (Plus, I didn’t like those formula rep’s hanging around the hospital, giving out samples and free food for residents.)
Maintaining my milk supply while back at work was difficult.
o Maternity leave too short
o Inadequate breast pump
o Lack of proper advice and support
You are all aware that working full-time and breastfeeding is problematic, to say the least, and there are many barriers to overcome along the way. Returning to work just eight weeks after the birth of my first child, David, and using a hand-held, battery-operated breast pump (insufficient) was a recipe for failure. At the time, I didn’t understand the feedback cycle of demand and supply. I got busy in the NICU and didn’t sit down often enough to pump. In addition, I often waited until my breasts felt full to stop and go pump. Of course, we now know that breast fullness signals a decrease in milk production. My milk supply dwindled and then plummeted. I felt like a failure just like so many new mothers do when they struggle without proper support, an effective breast pump, and a good understanding of how to maintain a milk supply.
Engorgement and sore, bleeding nipples plagued me.
o Painful latch of unknown cause
o Engorgement and plugged ducts
o Mastitis
From the beginning of nursing my second baby, Anne, I had tremendous trouble with engorgement and sore nipples. In the hospital on day two she hurt me. It felt like she was biting me. The LC who briefly visited me and “observed” her latch thought it “looked alright.” Neither she nor I assessed her suck! They kept her in the nursery one evening and fed her some formula, so she was asleep when my milk came in on day three. Misery! Then the pediatrician, an old friend, visited me, and he asked ME if I had any idea why my daughter had not stooled since birth. He obviously knew nothing about breastfeeding and the gastrocolic reflex, much less that adequate stooling is THE hallmark of adequate breastmilk intake!
Once at home, my daughter continued to nurse like a shark, and my nipples were raw, cracked, and often bleeding. They were painful for five weeks. My husband would sit by the recliner while I nursed her so that he could massage the engorged sections of my breasts. Aiming her nose towards the plugged ducts helped only temporarily. I could not understand why I kept getting so engorged. I nursed her often and he helped me greatly with massage. Cabbage leaves felt good on my sore breasts but were no solution.
Painful nipples, swallowed blood, and mastitis signaled failure.
o Bloody, traumatized nipples
o Swallowed maternal blood
o Mastitis
Once Anne vomited up some blood and I freaked out! I called my husband to come home and check on her. By the time he arrived she was fine, fully recovered from vomiting up swallowed maternal blood. I struggled through a horrible bout of mastitis when she was six weeks old. I used Telfa patches on my nipples, air dried them after rubbing in breastmilk, and walked around topless. I was pitiful.
Somehow, we made it over that high hurdle of sore nipples, and my nipples healed. My pediatrician brain didn’t remember to put my finger into her mouth and assess her suck, and my mother brain never considered it. Much later, I figured out that she probably had ankyloglossia, or tongue-tie. (For non-medical folks this is a congenital short or tight lingual frenulum that limits tongue movement and makes nursing nearly impossible.) How could I have missed that? Would a frenotomy have cured our problems? Looking back on that period I must have gotten through on sheer willpower. I was determined to breastfeed my second baby longer than my first.
Returning to work was easier with access to an electric breast pump.
o Adequate breast pump
o Strong let-down reflex
o Stress in the NICU
After my second child’s birth, I returned to work again at eight weeks (too soon) but used an electric, hospital-grade breast pump with a kit for double pumping. Heaven! I continued to have trouble with engorgement off and on, which was manageable. But whenever I heard an infant cry in the NICU I had a brisk letdown. Despite using thick breast pads, I was a wet, sloppy, milky mess all the time and often had to change scrubs. This time, however, I maintained an adequate milk supply for four more months until the stresses of busy NICU workdays took a toll and I carved out insufficient time for pumping.
Camaraderie during pumping was so reassuring.
o Support and reassurance went both ways
o Bonded with preemie moms
Visiting with the preemie moms while pumping in the quiet, comfortable pumping room adjacent to the NICU was the most pleasant part of my day. The walls were adorned with posters of angelic young moms, snuggled comfortably in rocking chairs, gazing lovingly at their nursing preemies. The atmosphere was serene and soothing as we sat in soft recliners listening to our pumps whirring and pulsating. It was fun to hear their stories, and I - the knowing doctor - interjected encouragements for them along the way. The preemie moms had great incentives to express their milk because of all the medical benefits of breastmilk feedings for premature infants that had been recently identified. (This was the late 1980s.) They never realized how much their presence and loving persistence helped me as much as my presence as the breastfeeding-pumping-friendly-neonatologist helped them.
The third time was the charm.
o No problems
o Longer maternity leave
o Easy, big baby
Once you have made every possible mistake with breastfeeding, pumping, returning to work, engorgement, and mastitis you deserve a good experience, right? I finally got one. My ten-pound two-ounce baby girl, Laura (who was not an infant-of-a-diabetic-mother) was the most perfect nursing baby. For her, breastfeeding was like rolling off a log. She slept through the night at two weeks of age! I did have some early trouble with engorgement since she nursed at four-to-six-hour intervals, but my milk supply acclimated quickly. I stayed out of work for four glorious months, while we moved to a new city for new jobs. Once back at work I had access to a good electric pump; however, I was confined to pumping in a NICU storage closet. That experience stimulated me to set up a NICU mothers’ pumping room, create regular lactation rounds in this new NICU, and hire an LC just for the NICU. Success! I nursed my third child for a year; however, I remember feeling disappointed that I never got to nurse a toddler.