Friday, December 18, 2009

Breastfeeding Diaries: Pre-term babies = an uphill battle

While I was pregnant people would always ask me if I planned to breastfeed my baby. I have friends that were big advocates, and others that formula fed their babies, so I was getting opinions from all sides. I figured I would give it the old college try - I knew it was supposed to be the best thing for both the baby and myself, and heard that it came naturally, so why the hell wouldn't I give it a try! I read as many books as possible about breastfeeding, talked to friends about it, took a class on it, watched videos, researched online - for some reason I was more nervous about breastfeeding than I was about giving birth, so I wanted to be as prepared as possible.

Cut to the hospital after giving birth to my baby 4 weeks and 2 days before her due date. When the nurse asked "do you plan to breast of bottle feed," I of course said "breast." After a quick trip to the NICU, our baby girl was whisked down to our recovery room to being her rooming in, and when she arrived she was a hungry hippo. The new nurse that was tending to us brought her to me and said "here you go, she is ready to feed." And then stage fright set in.

As I held my tiny 5.5 pound baby in my arms I started to freak out...OK, what hold do I do? The football? The cross-cradle? Remember what the photos in the book looked like. Deep breaths...they said to relax...deep breaths. Do I put a pillow behind my back? Right boob or left boob? Shit, how do I get her to open her mouth? Is her body aligned correctly? Oh my god my boobs are huge! And her mouth is so teeny - this will never work! She is starting to cry, crap - I am going to cry...

So I looked up at the nurse and said "I have no idea what I am doing!" To which she responded (now she was not the nicest person, and thank god we only had her for an hour before the shift change) , "You just have to get her to open your mouth and shove your boob in there." THANKS!! I knew that much you dumb bi-atch.

After what seemed like an hour of failed attempts to get my little girl to latch on to my Dolly Parton-esque boobs, the nurse said we needed to feed her right away and was it ok to just give her formula...Shit...Yes? I don't want her to starve?!?

Thus began my uphill battle with breastfeeding my little girl.

The nurses explained to me that with pre-term babies (35-37 weeks) they have yet to develop the correct sucking technique needed to breastfeed, hence the use of the very fast flow nipples on the bottles they were giving her. They also do not have the ability to open their mouths as wide as need be in order to get and maintain the correct latch needed to successfully breastfeed. So basically I was not going to be able to breastfeed as planned for a while...

While at the hospital I met with two lactation consultants who put me on a plan:
- bring the baby to breast every time she is hungry
- attempt to get her to latch on
- if no successful latch after 10 minutes, bottle feed (with formula while I was not yet producing milk)
- then pump for 10-15 minutes

This plan lasted about 10 days - and in those 10 days I developed the most painful red ring around my nipples. I am talking on a scale of 1 to 10, my pain was a 9 every time I pumped, so I had to take 3 advil about 30 minutes before pumping, and still I was in tears and doing my Ugai breathing...I was about to throw in the towel, but my husband kept telling me that we should contact a lactation consultant to get some help. I couldn't handle the pain anymore, so I put a call into a woman that came highly recommended by a friend - Dot Norcross (of Newton, MA).

Now when I think of Lactation Consultants, I tend to picture them like I picture Doulas and Midwives - kind of crunchy hippies, older, gray hair, soft spoken, shop at Chicos and wear patchouli - and they might be practicing witches. Don't ask me why, but this is what I thought (no offense to anyone - totally my own opinion of course!).

Dot runs her small business out of her lovely Newton victorian house, and employs a group of the kindest elderly women on her staff. I felt like I was going to see my beloved grandma and her friends...we were greeted at our car and whisked into the "pink room" where we sat in chairs that were straight out of Grandma's Home & Garden. After a quick discussion about the birth, pregnancy and time at home so far, it was time for the "whip out your boobs" portion of the program.

As I was undressing in "grandma's" living room, I explained to Dot about the severe pain I was feeling around my nipples. As soon as the girls were out for her to see she looked at me and said something of the likes of "wow - you must be in terrible pain!" Turns out that I had a build up of yeast around my nipples that was causing the pain and swelling. It was due to a combination of not having the correct size flange for my pump, and the fact that I was taking medication for the cold I was battling. Who knew that there were different size flanges for breast pumps?? I did not of course! So she fit me for larger parts and called in a prescription for APNO (all purpose nipple ointment) to my OB...already I was feeling a little relived about the whole sitch.

Once we got into the latching and feeding portion of the consultation, Dot told me bluntly "with the size of your nipples, and the tiny mouth on your daughter, you are in for an uphill battle." Not exactly what I wanted to hear, but kind of what I expected to hear. She then introduced me to the trusty nipple shield - a tiny thin piece of silicone that fits over your nipple and resembles a nipple on a bottle. Well with the nipple shield in place, and a wave of her wand, Dot was able to get my little-mouthed girl to latch on and go to town. My eyes immediately welled up because I was so excited that it was actually happening (and I was in the second worst pain of my life - first being giving birth with an epidural that didn't work, of course). There was a light at the end of the tunnel!!

I don't want to give away all of Dot's secrets but we learned so much from her; what type of bottles we should be using, the correct way to hold them, the right way to burp our little baby, etc. All things we were doing wrong! And how were we supposed to know?! We came out of the 2 hour long consultation with a plan, and feeling so much better about the whole situation. With the combination of the nipple shield, the correct breast pump parts and the APNO, I was so much more positive about our breastfeeding plan.

Dot estimates it will take us about 2 months to get to where I can breastfeed my baby girl without the shield and stop pumping as much, so I have that date marked on my calendar. So come February 9, 2010 we will if Dot was able to work her magic for real, but for now I need to stay positive and think happy boob thoughts!! Stay tuned...


  1. Sort of off topic, but I noticed on the baby center boards that you got an Uppa Baby. I'm waiting on my 2010 to arrive in January and due January 12th. Just wondering how you like it and if you got the car seat adapter as well. Congratulations on your beautiful baby girl and good luck with the breastfeeding!!!

  2. I'm so glad that you spoke to a lactation consultant and she was able to help you. When I saw mine, she was exactly what I needed. I too used the APNO because I also had yeast build-up and was in enough pain that it brought me to tears almost every time feeding time came. So, I feel your pain!! I'm sure that having that along with the challenge of an early arrival, makes it that much more difficult. Hang in there! Before you know it, you won't need the shield, and she'll be feeding like a champ. One more thing I found that helped was I joined a breastfeeding support group through the hospital. I met some great moms with some of the same issues that I was going through, and it was a great learning experience and also good to connect with new Moms. Maybe they have something like that in Boston as well. Good Luck!