Breastfeeding

After reading a couple different stories, I thought I should share my trials with breastfeeding.  You see, before having kids I always assumed/planned on breastfeeding.  It is what my mother did, the "natural way" to feed a baby and what experts all agree is the best way to feed a baby, not to mention the cheapest way to feed a baby.  

Well I had Tacy 5 days before I started nursing school.  Being diabetic, the nurses had to check Tacy's blood sugar regularly to make sure she was high enough.  As a new mom, my milk supply was slow to come, so Tacy had to receive formula supplement starting in the hospital to help her get food to help keep her blood sugar at good levels.  Then at home, I continued to try to breastfeed.  I had bought a breast pump in prep for nursing school and would nurse her every morning and then pump before going to school.  At school the only real time I had to pump was lunch (which also meant I had to eat really quick).  Then I would try to breastfeed and pump at home.  No matter what, I never produced enough milk to keep Tacy full, she always was hungry after breastfeeding and needed formula.  One Saturday I remember Brad suggested I try to just breastfeed Tacy, so I did and was breastfeeding her every hour, so literally I spent the whole day breastfeeding.  It was exhausting and I obviously was not satisfying her.

Other then nursing school, another thing against me was that as I quit working when I had Tacy so I could go to school, my health insurance changed to Brad's and that company did not cover the same nursing specialists I had seen in the hospital.  Plus, I never had time to go talk with lactation specialists with my school schedule.  Needless to say, after 2 months my doctor and I agreed that I had given it my best try and that just giving Tacy formula at that time was perfectly fine.  I was fortunate to have a great doctor who really helped me not feel like a failure when I could not feed my daughter.  I had so many people at school tell me about how successful they were at breastfeeding, so it easily could have made me feel depressed to not be able to feed my daughter.  With the support of my doctor and husband, Tacy was just given formula for the rest of her first year of life.  And guess what, she is a healthy 4-year-old.

Having Nate, I really hoped that by actually having maternity leave I would be able to not be so stressed and have a good chance at breastfeeding.  However, having a c-section and Nate going straight to the NICU for 5 days really slowed everything down.  I didn't get to hold Nate for 2 days, which meant no skin-to-skin contact which can really help to stimulate milk production.  Also, I had had no breast changes the whole time I was pregnant.  The lactation consultant and nurses were all really nice and helped get me set up with pumps so I could try to get my supply going, but I never could get much milk.  Nate had a doctor appointment 2 days after discharging from the hospital (he was week old) and the lactation consultant told me to focus on trying to get my milk supply to come in by pumping every 2 hours.  Meanwhile, Nate being the big boy that he was needed to eat every 3 hours and was eating 2 oz at each feeding.  

Let me tell you what, pumping every 2 hours was exhausting, frustrating and depressing.  I was supposed to be calm and relaxed but I was stressed and upset and had to keep leaving my son to go pump.  I felt like I was not spending any time with him and with all the pumping I never got more than 1 oz (30 mls) of breastmilk in 24 hours.  When doing the math, this was at most 1/16th (closer to 1/24th by that time) of what Nate ate in a day.  So when we returned to the pediatrician 2 days later, she looked at me and said "Some people just are not able to breast feed." She was very kind to me, which is nice because I feel so many doctors and specialists can really push breast feeding.  My mom was with me and I felt really pressured by her to not give up.  So I met with the lactation specialist again.  When she heard what I had been doing and the little results I was having, she was also very nice.  She told me that formula has come a long way, that she was a formula fed baby, Tacy was formula fed and healthy, and that this was not a bad option.  When my mom discussed other things that could be tried, the specialist told me that it was my decision.  That I could continue to pump every 2 hours and try drinking tea to stimulate milk production, or I could choose to spend more time with my baby.  Needless to say, I chose to spend more time with my son.  So yes, I gave up breastfeeding by the time Nate was 2 weeks old.  I was told that having a c-section and needing to get blood really inhibited my ability to produce milk, but I also think that my body just is not cut out to produce milk.  

Brad told me, "Maybe you are a meat cow, not a milk cow".  Needless to say, I feel that we need to be supportive of whatever way a woman can feed her child.  Not every woman can breastfeed or breastfeeding does not always work best for a family situation.  I think the fact that a mother/parent is trying to feed their child and help them grow is what is important, not the manner in which they do it.   We need to support each other in our efforts as parents to care for our children and not shame parents for the choices they make.

Nate

I have officially been a mother of two children for 3 weeks.  It is a little crazy, but thankfully our family is doing well.  I just wanted to write down my thoughts and experiences from Nate's birth because it was a completely different experience than Tacy's.

Nate had been measuring big since he was 28 weeks and after having Tacy at 37 weeks 2 days and weighing 8 lbs, I kept pushing my doctors to let me have Nate at 37 weeks as well.  The doctors I have been seeing here in NC have been more hesitant and kept stressing how size is not important because they can always do a c-section.  However, I was also struggling to keep my blood sugar well controlled as well, so finally Maternal Fetal Medicine gave the ok to have me induced at 37 weeks.  Then it became a matter of if it was safe to have a vaginal delivery or if I should have a c-section.  Between 36 and 37 weeks I had three ultrasounds which all measured Nate at being 9 lbs 10-14oz.  Due to my small size, my increased risk for having a baby with shoulder dystocia (because babies of diabetics tend to store more fat on their shoulders), and his big size I decided to play it safe and have a c-section.  This was a hard decision for me because surgery is terrifying, not because I don't trust modern medicine, but I know the healing process is longer and harder and being diabetic I tend to heal slower.  

After many prayers and a blessing, Brad and I went to the hospital Wednesday, October 26th for a c-section.  Luckily my mom flew in the night before so she could take care of Tacy and Brad had his board review that week which his school was nice enough to stream online so he could watch it while being with me.  I was having bad/painful contractions while waiting to go in for surgery and lying on the gurney was so uncomfortable.  I was so happy when I finally got rolled in at 11:30 and received my spinal block.  Goodness that was heavenly, it kicked in immediately and the numbness/lack of pain was miraculous.  The nurses were so nice and helpful, talking calmly and explaining everything to me.  I have watched c-sections in nursing school so needless to say it was not fun to know what was happening, but from the spinal and my blessing I was calm and ready.  

Now for c-sections they drape the abdominal cavity to keep a sterile field and then they pull up part of the drape so the mom cannot see what is happening.  Thank goodness the nurse anesthetist paid close attention to me because a lot of times the drape kept getting into my face.  I was given a nasal cannula for oxygen and they had my arms strapped down (I guess some people get wild).  I really couldn't move and I was so numb I did not feel like I could.  My doctor would tell me what she was doing or what to expect such as pressure from them pulling.  I remember hearing her say she had a gusher, I'm guessing from my amniotic fluid which had been measuring high for a few weeks, and then being told I would feel pressure as they pulled out Nate.  Then everyone kept talking about his big head and how big he was.  The pressure was not much at all and after a few minutes, a nurse showed Nate to me before taking him to clean him up and give him his vaccines.  Brad left with Nate while I got sewn/cleaned up.  Then as I was wheeled out of the OR to go the PACU, a NICU doctor came and showed me Nate real close so I could kiss him and explained that he needed oxygen to keep his oxygen saturation above 90% so he was going up to the NICU.  

In the PACU (post anesthesia care unit) my numbness was monitored.  My nurse would ask me to try to wiggle my toes and it was the weirdest feeling to know that my brain was telling my toes to move, my legs to move, etc. to to feel that the message was not being relayed as nothing was happening.  I just had to laugh.  I also felt like my legs were spread wide, when in fact they were straight and flat on the table.  My nurse explained that it is probably because the spinal kicked in when I had been getting my foley placed.  Anyways, I was there for a while, an endocrinologist came and talked to me about changes to make to my pump settings, and then I was taken to the Mother baby unit.  My PACU nurse did take me by the NICU first to see Nate in his space helmet before taking me to my room.  I stayed numb for a good 4 hours before I started to feel again.  Working in the hospital, I learned quickly that Mother baby is very different, on my floor we do hourly rounding, at mother baby I felt I would only see my nurse if I asked for something.  But Brad went home and brought my mom and Tacy to come see me.  Because of flu season, Tacy could not go see Nate in the NICU.  

I was in the hospital for 4 days total, Nate was in the NICU for 5 days.  The pain from the c-section was not fun since you use your abdominal muscles for so many movements.  I had great nurses and aids take care of me. I had my foley removed at 4 am that first night, then I had to deal with pain from pressure of a full bladder, gas, etc.  Even now I still can be very sensitive to increased pressure in my abdomen.  I had to move slowly and the first day of surgery I just sat up to the side of bed, the next day I got up to stand and use the bathroom with some help.  My second day I showered.  The second day after surgery was when I was feeling light headed and found out my blood levels were really low (Hgb 6.8 and Hct 19.3), so after my OB rounded on me I was given 3 units of blood.  The frustrating part was that this was the first day Nate was no longer under the helmet and was only on a nasal cannula, so we could actually hold him.  I had to wait until that evening, when I had finished receiving all my blood, before I could go up to see him.  The NICU was on the third floor and my room was on the second, so I had always gone to the NICU with someone as I was taken in a wheelchair.  I think the 3rd day was the first time I walked back from the NICU in the morning pushing my wheelchair.  It was crazy because I felt like I was walking a lot, but after being discharged Sunday and walking from my room, to the pharmacy to the car, I was exhausted!  

I learned quickly while in the hospital that I really did need to stay on top of my pain medication so that I could move without pain.  I had to continue taking my pain medicine for 2 weeks before I felt like I would be fine with only occasional ibuprofen.  Mostly now, I just have incisional pain/irritation.  The skin hates having anything rub it, which is tricky since it is right where my pants and every normally ride.

When people ask me about my delivery or my experiences of having a c-section I say that I'm glad my first was vaginal.  Tacy was a relatively easy, uncomplicated delivery.  As the mother you are more involved in a vaginal delivery because you see everything and I had more feeling even with an epidural so I still knew when to push.  Since Tacy had been healthy, she was given to me right away for bonding and skin-to-skin.  This time around, goodness I could not imagine doing a c-section as a brand new mom.  You are so disconnected from the birthing process, I mean seriously, they could have been doing anything and I would have been unaware.  Then because Nate needed oxygen and had to go to the NICU, that was so rough for me because I was in the hospital because I had a baby, but my baby could not be with me.  Once he was on a nasal cannula it was better because I could go and hold him, but it was so hard watching him and only being able to touch him while he was under the hood.  Because of his breathing issues (low oxygen saturation without supplementation and fast respiration rate), Nate had to receive IV fluids to keep his blood sugar at good levels.  Then he was given an NG tube to help him eat because sucking was hard with his fast breathing rate.  When his breathing slowed and he was weaned off oxygen, then he had to be weaned off the IV fluid and increase his oral feedings.  He did this all pretty quickly, oh and he had to have 24 hours of being on a bilirubin blanket as his levels were high one morning.  I am grateful he was doing so well and only in the NICU for 5 days.

I am glad that I had a c-section because there is no way I would have been able to birth a 10.5 lb baby without horrible complications for us both.  I am grateful for the many doctors, nurses and aids who took care of Nate and I.  I will be forever grateful that I had Tacy vaginally so I could have that experience with my first baby.