Tuesday, May 12, 2009

The Lactation Consultant's Advice

Throw away the formula.

Maybe not literally (though it's possible), she suggested that I stop supplementing with formula from a bottle and says that I'm not at a point where I need the supplement tube feeding system. She saw that I'd gotten nipple shields and said that was exactly what was needed. She watched Amelia nurse for a bit, saw that there was milk in the shield even after she stopped actively swallowing, and ultimately thinks the problem is an issue of tongue movement. Amelia likes to keep her tongue up, and we've seen this happen on occasion when we've given her bottles. She doesn't automatically drop her tongue to start sucking, we have to wait for her to figure that step out sometimes. The LC thinks that once she starts automatically dropping her tongue, this will help with the latch-on problems. She advised me to use the nipple shields until my nipples are healed, the try to nurse again without them. She also put me on Reglan to help boost my milk supply while I'm using the shields, just in case the supply drops a bit as a result of the decreased stimulation that comes with the shields.

The problem is that I'm at an impasse. The LC and the pediatrician are giving me completely opposite advice, and I'm--of course--always most concerned with whether or not my child is getting the nutrition and caloric intake she needs to gain weight....which, by the way, she has. Between Thursday and yesterday, she gained 4 ounces (an ounce a day). But, that's with the additional supplements the doctor recommended.

The good thing is that the nipple shields have definitely eliminated the pain factor. It doesn't hurt to nurse anymore.....but she is still having 2-3 hour nursing sessions during the day, usually in between her 3-4 hour naps. The LC suggested that I try to wake her up after 3 hours, but my child doesn't wake up unless she's damn good and ready.

I think for now I'm going to continue to nurse her, offering her both breasts at least twice, and then if she's still acting like she's hungry, I'll give her a couple of ounces from a bottle to supplement. For now, it will likely still be formula simply because the pumping isn't producing much. I'm not making myself any promises or trying to predict any improvement or failure. Rather, I'm still just taking it one day at a time... and we're at day 19 now.

What I've come to realize is that it's about much more than the ease or difficulty of the breastfeeding process itself. It's also about my ability to care for and spend time with my other two children; my need to feel like I'm not the only one predominantly caring for the baby; and my desire to literally come and go more freely instead of feeling like I'm chained to the house because we haven't gotten to the point where I can nurse discreetly. The truth is, if things were going just as easy as they did when I breastfed my first daughter, I'm not sure if/how long I'd continue to breastfeed now. Things are completely different now, as I have a house to manage, two other children who need me, and a ton of other things going on in my life with the dissertation, relocation, new job, etc.

Whatever happens, it will be my decision, and it will be made on my own terms. I'm going to enjoy this while it lasts, though, because this baby is my last. I want to spend this time appreciating the opportunity I have, even if it's short-lived.


M said...

The 2 to 3 hour nursing sessions you describe sound like cluster feeding, which, as I'm sure you know, babies do a lot, especially when they are so young. As I recall from what my lactation consultant told me, cluster feeding is meant to increase your milk supply, and babies often do it when they are preparing for a growth spurt. Your little one may be doing it to get your supply up. I recall how frustrating they are (and I didn't have 2 other kids to chase), but it might make you feel better knowing they serve a purpose. Just a thought.

Lisa Dunick said...

so glad that it's going somewhat better for you :)