It Ain't Easy

Breastfeeding. Yep, this is an epic post that is all about boobs. You've been warned, folks.

Much like my birth plan {which, if you'll remember, was 'not to have a plan'} - I didn't really have a plan when it came to feeding my baby. I had high hopes that we'd be able to breastfeed, but I've also heard so many guilt-ridden stories about things not going right, that I was determined not to get too focussed on it as the be all and end all. If it worked, it worked. If it didn't, it didn't. Either way, I'd have my child at the end of it all.

When Georgia was born, she had some respiratory distress and required oxygen for several hours after birth. While these problems cleared up really quickly and she was off all monitors and support by the following day, it affected her feeding. We were never able to have our first attempt breastfeeding skin-to-skin after birth, and because she was in the Special Care Nursery, they made the decisions on her feeding without consulting me. 

Georgia was not able to take formula from a bottle, so she was given formula via a feeding tube down her nose. Walking in and visiting her in the wee hours after the birth, and seeing her with a tube stuck to her face, well, that just broke my heart. This was not what I'd hoped for my daughter's first hours of life.

Less than twelve hours old in the Special Care Nursery. Broke my little post-partum heart.

I expressed colostrum manually for the first 24 hours, which was inserted directly into her belly via the tube. After 24 hours, they introduced me to the hospital breast pump & had me expressing {or attempting to express} every 3 hours. I didn't get a chance to breastfeed Georgia until day 2/3, and only for very short attempts. She had no real idea what to do on the breast; wasn't able to latch and hadn't mastered the sucking reflex. The same went for bottles; she couldn't figure out how to do it. It was heartbreaking for me, and frustrating for her. She would sit on my lap and cry, or simply fall asleep, because it was just too hard for her. And so, the tube feeding continued, and I kept on pumping, desperate to give her something other than formula.

Here's where things went a little pear shaped.

Firstly: the hospital pump. Other than showing me how it worked, and how to sterilise the parts and store the expressed colostrum, I was pretty much left to my own devices with it. I was pumping every 3 hours as instructed, but getting pretty much nothing from it. I got frustrated, I got emotional, and I got stressed. Second, it didn't help that another woman in the nursery, who had given birth the same night as me, was also pumping on the 3-hourly intervals, and she was getting breast milk - bottles of breast milk, while I was managing to express 2ml of colostrum, if I was lucky. Comparing my efforts expressing to hers... it sucked.

By day 4, my milk still hadn't come in. Georgia was on tube feeds regularly, and I fought to try and get her trying the bottles a little more - anything to help her practice her sucking. They let her attempt breastfeeding/bottle feeding on every third feed rotation: the idea was that she would rest and get her strength up through tube feeds for two rotations, before attempting the suck feed. All I wanted was to have my baby on my breast. In my heart, I knew tube feeding was helping her build her strength, but it didn't make it any easier. When things hadn't happened by the afternoon, the midwives called in a lactation consultant to meet with me. She explained that while most women had their supply in by day 4, it varied from person to person. She also suggested that there may be a link between milk supply & PCOS - and suggested oatmeal & fenugreek, which I was already taking daily. We agreed that if I hadn't had any milk come in by day 6, we could look at prescribed drugs to boost milk production.

Thankfully, milk arrived on day 6 - after an agonising day of engorgement and nipple blisters {oh lordy, the nipple blisters} that appeared on day 5. I've never been happier to have Dolly Parton boobs, but they do NOT prepare you for the pain of your milk coming in. That was almost as agonising as post-childbirth, for me anyway. That being said, I was so excited to see if Georgia would take to breastfeeding a little better, now that there was something worth waking up for! And if she still wasn't able to feed from me directly, I'd at least have expressed breast milk to feed her via the tube.

My milk increased gradually, which made me stress less. While I still wasn't producing enough to feed her for every 3-hourly rotation, more and more of her feeds became breast milk over formula. My goal was to completely wean out the formula altogether, and I managed this eventually. Since my boobs were playing ball, the paediatrician finally decided to try out alternate feeds for Georgia - one tube feed to one suck feed. Her latching troubles continued, even with midwife help, so I trialled a shield, and BOOM. It suddenly clicked. We had our first real feed on day 6 - it was short and sweet, but it was glorious. I cried; this was breastfeeding.

Once she figured out what she had to do on the breast, we were thrilled. She was making progress! We had a few more hurdles to get through; predominantly exhaustion. Sure, Georgia was a good size at birth - but she was still premature and tired very easily. With the shield {I used the Medela ones} she was able to last a good few minutes before falling asleep; then we'd have to employ every technique in the book to wake her up - stripping off, tickles, head stroking, squeezing hands, nappy changes, baths, cold face washers. When she was asleep, she was really asleep. I was assured that she would outgrow this stage at her own pace. 

We were due to be continuing alternate feeds, but one morning, Georgia yanked out her feeding tube {again} when she was due for a tube feed. The midwife on duty laughed, and suggested we try another suck feed instead.. worst case scenario, if she couldn't finish her boob/bottle combination, we could put another tube in. Georgia showed her - we had a great feed AND she got through her bottle. Champion! And so began our next challenge: getting through on all suck feeds. Thankfully, she did well, and we were eventually discharged from Special Care & put into the regular ward instead. We went home as a family the following day.

Our routine at home goes something like this: a breastfeed focussing on one side at a time, offer other breast & top-up with expressed milk. This is up to our discretion now: if she's had a long feed and puts herself to sleep, we don't top-up - if she's had a lazy feed or continues fussing after a short period of time, we top-up. The amounts are fairly small, usually around 25-30mls of expressed milk. Then we rinse and repeat every 3-4 hours. Georgia is finally able to wake herself up and fuss when she's hungry: this is huge progress, as prior to this, I'd need to set my alarm and wake her up for her 3-4 hourly feeds. If she sleeps a little longer at nights, I let her go - happy baby AND happy mama! ;)

I'm still pumping, though not after every feed like I was in the hospital. We invested in a Medela Swing Maxi, a double electric pump - saves time and is way more comfortable than the hospital pump. I express after our first feed of a morning {usually when I get the 'most' milk - though it's still not a lot}, once after an afternoon feed, and once after our last feed before bedtime, mainly for comfort overnight. Three times a day seems to be working for me at the moment. I don't have a huge supply, but I seem to have enough to cope with her needs for now. I'm starting to develop a little freezer stash too, so that gives me some relief on the off days where I don't express very much milk. I've continued with the fenugreek and oatmeal, but my supply is still fairly average.

Feeding my daughter has been my sole focus and biggest challenge since becoming a new mother. I don't know how long we'll last for, but I'd really like to hit the six-month mark, all going well. But, like I said way back at the beginning, if it doesn't work out, it doesn't work out. If we swap to formula at some point, I'll be okay with that; I know I've done everything in my power to help give Georgia a good start in life.

Is it dinner time yet?