The Struggles of Nursing: WBW, post 3

This is the third post in a five-part series for World Breastfeeding Week.  To read previous posts and review ground rules for discussion, click here.  Again, please post all comments on my blog and not on Facebook.  Thanks!

Surgical Birth
Isabelle Rose was born on December 21, 2008.  She was in breech position, so after my doctor attempted to turn her in the womb, we had no option but a Caesarean.  Several days before, when we first discovered she was breech, I'd already cried at the thought of having a surgical birth.  On the day of her birth, when we realized we were definitely having surgery, I felt no need to cry.  I was simply elated to be having my baby.

Surgery was quick and easy, and dare I say fun?  All of us, including the doctor and nurses, were in great spirits as they delivered my baby girl, and we chit chatted as she sewed me up. Damian took Izzy to be cleaned up and weighed, and once we were done in the operating room, I was brought to recovery, where Damian met up with me.  I was still on an emotional high from having given birth, even if it was a surgical one.  Many women talk of feeling robbed after a C-section or detached from their babies, but I never felt this way.  I was instantly in love with the child I'd carried for nearly 9 months.  I couldn't even sleep that night, because I was too thrilled to be a mother.

My first time holding Isabelle. She was absolutely perfect.  I'd just finished nursing her for the first time.

First Time Nursing
Isabelle was quickly brought to me to nurse for the first time.  Suddenly, everything I'd read no longer mattered.  I remember feeling as if I needed about 5 more hands to juggle all that was going on.  Logistically, it was just difficult, but I kept trying.  My nurse was very impatient.  My husband commented afterwards that she seemed frustrated that a first time mom couldn't do it perfectly.  In fact, to be quite honest, she was a bit harsh and rude towards me, and after I'd tried for about ten minutes, she handed me a pink box and said to give it a try with this device.

   
It's a shield made by Ameda, although all the major breastfeeding support companies sell them.  It solved our problems for the moment, and Isabelle was quickly able to nurse.

Going Home
Isabelle continued to require the shield for nursing, although I still tried to nurse without it.  I didn't think anything was wrong, because she was nursing, seemed content, and I could tell she was getting some colostrum.  The first night home from the hospital, she kept me up all night with constant screaming.  She would pull her feet up and kick them out, telltale gas signs.  We called the pediatrician the next day (Christmas Eve), and he suggested Mylicon and suppositories twice a day, but Isabelle continued to have problems with gas.  I've heard of colicky babies, so I just chalked it up to having a gassy baby.  It just happens sometimes.

When Isabelle was 6 days old, my milk finally came in.  I remember watching her nurse, thinking that it was really a strange way to do it.  With the shield, she would get quite a bit of air at first.  No wonder we had problems with gas!  I began looking into it, and one of my new mommy books advised against using shields.  I read the shield's box and noticed the following statement on it:  "Extended use of a nipple shield may affect baby's ability to continue breastfeeding.  Please use only with the guidance of your health care practitioner." 

Gee, thanks.  I wanted to breastfeed longterm, yet my nurse gives me something that could prevent just that?  Wow.  Not to mention that once I read the page-long instructions, I realized I'd never been shown how to use it, and I was doing it wrong the entire time. 

What's So Wrong With a Shield?

There are a variety of reasons why a mother may be advised to use a shield.  La Leche League has a great article on the subject.  The main problem with a shield is that the baby is not able to latch on very well, and so she isn't able to stimulate mom as she should. Baby usually won't get an adequate amount of milk, leading to weight gain issues.  In my case, it also meant my milk came in very late.

Shields cause more problems than they solve, and should only be used as a last resort.  In my case, my body simply wasn't responding to nursing as it should have, either because I was a first time mom, or because I was so medicated from surgery that it could not respond appropriately.  I can see why the nurse gave it to me.  However, another possible solution is a breast pump.  Using a pump would have provided the same results, without creating more problems.  Sometimes shields are used when a mom is cracked and sore.  At this point, breastfeeding is usually well established, so it doesn't create a dependency on the shield for the baby.  Of course using Lansinoh, breast milk, or plastic shells can also work just fine and can prevent the mom from needing a shield.

The problem with using shields for the first nursing session is that a baby, like any human, has a muscle memory.  A baby develops a deep impression of that first time nursing.  In order to get Isabelle to nurse on her own, we had to override everything she already knew and essentially reprogram her muscle memory.  Fortunately for us, she was only one week old when we began that process, but some babies are harder to re-teach than others.

I actually know three different women who were also given a shield with their firstborn.  One had a C-section on the other side of the country, one had a completely natural childbirth at my hospital, and another had an epidural at my hospital.  We were all given a shield for the same reason, when we could've been brought a breast pump instead.  Some of the moms were able to nurse their babies without it eventually, but others were not.  I think most of them also experienced the same issues with gas.  All four babies struggled to gain weight adequately, forcing some of the moms to supplement with formula.  I think we all feel the same way:  Warn every new mom about these shields and make sure they do not use them.  One friend had, in fact, warned me, when I called to get her advice about having a C-section.  However, I was too concerned about the surgical birth that I wasn't really listening when she warned me.  I was too emotional and had greater concerns.  Oh, how I wish I had listened!

We've tried to figure out why hospitals continue handing these shields out.  Part of me wants to say it's because they don't care about a good nursing relationship, but I don't think this is true.  I think it's simply a quick fix, and from the nurse's perspective, it does solve the problem.  They don't see the baby two weeks later, when he hasn't gained weight as he should've.     

Seeking Help
The day after I realized the problems with a shield, I called the number of my local La Leche League leader. The hospital had included it with my dischage papers, and it just so happened that my LLL leader also attended church with us. I called Lisa and told her what was going on. She was extremely disappointed to hear that I'd been given a shield. She gave me two options for solving the problem. One was a kinder, gentler approach that involved simply attempting to nurse without it, but if the baby didn't want to, I could continue to use the shield. The second option would be very difficult and required some assistance, but had a pretty good chance of success. I chose the tough road, and believe me, it was extremely difficult and exhausting! But we did end up having success. I'll tell you about it in tomorrow's post.

This has not been my favorite subject to blog about, but I hope that sharing my struggles can help other moms out there and educate women on nursing.  We often think nursing should be easy, but few worthwhile things in life are really easy, and it's worth every bit of the effort.