Saturday, December 11, 2010

To Gem, on this day, you have been with us 153 days...

Dear Gem,

     I'm going to have a lot to explain to you about your birth when you're older because I don't know much about my pregnancy.

:insert episode of I Didn't Know I Was Pregnant here:

I do not feel I need to explain why I did not know. I just did not know. I can make connections now to all the warning signs, but at the time I was oblivious. In any case, Gem, I'm writing to you now about our breastfeeding journey so far.

I only mentioned that I was unaware I was having you because I had no birth plan at all. I started your birth at one hospital and ended at another. I was pumped with drugs, I was overwhelmed, and I was just plain scared. Scared I had hurt you, scared things would go horribly wrong, and scared that I wouldn't know what to do when I met you.

Then I met you, and everything seemed perfect. Except that you were whisked away because the nurses said it looked like I needed to rest. Nanni was with us, but she did not want to force any of her opinions on me. I do not think she realized that I needed guidance. My brain was not functioning at higher levels, and I almost did not remember how to take a drink of water let alone how to nurse you.

I was told you would be brought to me in a few hours. Six hours later Daddy had been snoring so loud I think our friends almost two hours away could hear us. A doctor came in to ask me a few questions. First, he asked if I had any rest. I told him, "No, I'm waiting for the nurse to bring Gem to me. Everything is okay right? They told me she would be here!" I spent the night on the verge of tears and broke down in front of this doctor who I think was just there to make sure I was not bleeding too much. He sent the nurse to get you, and I eventually calmed down.

At this point I had damaged our breastfeeding relationship in so many ways.

1) I should have brought you to the breast as soon as you were born.
2) I should have made sure you were able to room in with me and Daddy.
3) I should not have counted on the nurse to bring you to me.
4) I should not have let the nurse give you a pacifier.
5) I should have not let you have formula from a bottle.

As you can see, I made a lot of mistakes. Gem, I love you so very much, and believe me when I say I have been trying my hardest to make everything right again. I wish there had never been a drop of formula in your delicate belly. I'm sorry I was not prepared to be a mom. You brought a whole new life to me. I am learning everyday about what is best for you, and I am trying to make all the best choices for you.

With that being said, Nanni helped me understand breastfeeding in a way I had not before. I thought babies were born, and milk would just come out if you would suck. I did not know my nipples would be sensitive to your strong suck. I did not know how milk was made, and I did not understand supply and demand. As soon as we came home Nanni set us up with our Boppy pillow and told us to call the Le Leche League. I was nervous and embarrassed that I did not know how to feed you. It seemed like something I should just know. I did not understand at the time that we were learning together.

We started breastfeeding before we left the hospital because you tried to latch on through my gown. The lactation consultant came in and helped me latch you in a very forceful way, which I soon realized was unnecessary. She outfitted us with an SNS, a backpack full of formula samples, and an annoyed look at Nanni for asking her questions.

The next two weeks were not perfect. I was unable to sit comfortably because of tears that were still healing on my bottom. I was up all night every night crying to Daddy because I was afraid you were not getting enough milk, and because I was in so much pain. I started watching videos and reading personal blogs for advice.

Our latch was perfect, but it was going to hurt just a little bit because your mouth was so small. I made a "boobwich" and this helped. As you got a little heavier, I was not supporting you properly so you were sliding off my nipple. I had cracks and even bled a little. I was at fault, and was only suffering because of my own mistakes. Our pediatrician was not breastfeeding friendly. She did not understand why we did not want to continue with formula when I wanted to stop using the SNS and exclusively breastfeed. She could not answer my questions, and sent me home with a headache.

I did not use the SNS properly. The lactation consultant at the hospital had us supplementing with almost an extra ounce of formula at every feeding, when you would really only need my colostrum while we were still at the hospital. I became severely engorged. When I started to leak milk, we decided we did not need the SNS. I know now that I had been supplementing too much, and trying to wean cold turkey made it more difficult. I was engorged, so you had trouble latching. The bad latch led to soreness, and you were not emptying my breast completely because I would stop nursing you when it hurt too much. You were not receiving enough hind milk. You were gassy, always hungry, and I was getting more and more engorged because you were not "emptying" my breasts at each feeding. I developed plugged ducts.

I still had not called the La Leche League. I was embarrassed that we were having so much trouble. I did not know what to do, but between each feeding being cut short, all of the stress, and the plugged ducts my supply dropped dangerously low. Plugged ducts led to mastitis on the right side. Lack of fatty hind milk led to you not gaining enough weight between your first well-baby visit and your one month well-baby visit.

I still did not understand how my body worked. I was given antibiotics to clear the infection. I did more research and was using a hand pump to relieve the fullness on my right side. I was still so sore, you hardly fed from that side at all. What I should have done was taken you to bed with me and not left until you were so full you couldn't drink another drop, and my plugged ducts were opened up again. Instead I listened to the pediatrician.

She sent us to a lactation consultant who gave me a hospital grade pump, formula samples, and ANOTHER SNS. I had a rigid pumping schedule, herbs to increase my supply, and a schedule when to feed you.

Baby Gem, you are stubborn. You enjoyed the fast flow of the bottle compared to the breast, but did not like other people to feed you. The only way I could realistically have time to pump enough milk to supplement an extra 1.5 ounces EVERY feeding was if you let other people give you a bottle while I pumped. When I left the lactation consultant's office, the plan was to nurse you, nurse you with the supplement milk in the SNS, and then let you sleep or play while I pumped for 15 minutes after every feeding.

However, I did not always get the same amount. Some pumping sessions I would only pump half an ounce. Sometimes I could pump 2 ounces. Sometimes I would only need 10 minutes and I would have 2 letdowns. Sometimes I would pump for 15 minutes and not have one at all.

During all of this, you decided you did not want to sleep anywhere but in my arms. You did not want Daddy to walk you around while I pumped. You did not want to nurse with the SNS tube in your mouth.

I broke down and let Daddy supplement you with the bottle while I pumped. I almost ruined our nursing relationship by doing so. You guzzled the pumped milk so quickly, then screamed and screamed until we gave you more. I was so worried that I had not been giving you enough, that I let Daddy put formula in with the breastmilk to make sure you had enough. I spent more time pumping than we spent nursing.

Seven days later you had a weight check, and the doctor still did not think you were gaining enough. I followed all of the advice from the lactation consultant. I made sure you were getting more supplements. I took the herbs to increase my supply.

The pediatrician told us to take you for blood work and a urine analysis. Then we would know that if there were no metabolic problems, then my milk must not be good enough. That we should switch to formula, and that if you did not gain she wanted to admit her to the hospital where they would make us switch to formula while they performed horrible and painful tests on you, and kept you away from us. In mind I knew my milk was exactly what you needed. Bullying by the doctor made me ignore my instincts.

I cried and cried until I had no tears left. Daddy almost punched the nurses who were trying to take your blood. They poked you six times, and still did not get enough to do all of  the screenings ordered. They watched you pee all over the bed, then asked me to give you a bottle because they needed to give you a catheter.

I was almost numb at this point. All I wanted to do was hold you in my arms and let you drink until you were smiling in your sleep. Daddy liked to call that look "milk drunk." I always thought you were dreaming about angels. You were screaming from the needle pricks and strangers touching you. Because the bed was covered in crunchy paper, because I was not holding you and keeping you safe from these people. You were constipated from the formula confusing your still developing digestive system. I did not know what to do to stop all of this. I was in a nightmare. We were supposed to take you back to the pediatrician after all of the tests. Instead we took you home. I put you in bed with me, grabbed some movies and some water, and we did not leave.

The doctor called us three days later to tell us you had no metabolic problems, and for you to come in for a weight check. I did not mention to the nurse that I had not pumped or supplemented in three days. All we did was nurse in bed. On demand. I continued to take the herbs. I made sure to drink lots of water. We did not go visiting anyone. I did not try to let other people hold you so you could "get used to it". My family told me I was spoiling you. I stopped taking calls. I told Daddy to tell everyone you gained just fine so they would leave us alone. The doctor said when we went to the office that if you hadn't gained in the last three days at least a half an ounce each day that you would need to be hospitalized. You gained more than that. I did not tell her anything about what we were doing, she just assumed I was still pumping and supplementing.

Looking back, I think we had a rough start. I did not know enough about breastfeeding. I did not know about supply and demand. I did not know about fore milk and hind milk. I did not know I was negating all of the pumping I was doing if I continued to give you equal amounts of formula as breastmilk.

I do know now that my infection led to a low supply. It did not mean that you weren't getting enough, it just meant that we needed to slow down. So many people wanted to meet you, but we needed to stay home and rest. We just needed each other. You would drink more milk so I could make more milk. I did not really need the hospital grade pump. It was interfering with our nursing relationship. It was making me time your feedings, but you fed quickly sometimes and sometimes you liked to linger. I was trying to fit you in schedule, but you wanted to be the boss. I could have just hand expressed some milk when I was engorged so you could latch on better. I apologize for not trusting my instincts. For buying into all of the propaganda we were being served by the medical professionals we went to see. We took you for a weight check five weeks later, you surpassed all of the expectations. We had kept the hospital grade pump just in case, but returned it on that day as soon as the lactation consultant told us you had gained.

Four weeks after that you gained even more weight. You have become much more efficient and do not feed for as long. However, you still like to sleep in my arms, and you still get gassy when you stop drinking too soon because something distracts you.

Gem, you are five months old today, and you are reaching all of your milestones. You are "on the charts" like the pediatrician wants. You have a belly exclusively full of my milk, and the best baby smiles in the world like I want. I love nursing you. I love you. You are my everything.

Despite how hard this journey has been so far, the means have been well worth what we have now. I hope if you ever have babies I can help you nurse them so you can experience the encompassing warmth I feel every time you nurse.

Gem, now we just have to survive teething and starting solids. Here's to the last five months, and as many more as you want!

Love always and forever,


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