Troubleshooting and Breakthroughs! WBW, post 4

This is the fourth 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!

To resolve our nursing issues with the shield, we would essentially have to re-teach Isabelle how to properly latch.  Today, I'm going to outline the process that finally brought nursing success.  I would only attempt this with the guidance of a knowledgeable lactation specialist, and you should maintain careful logs of wet and dirty diapers, as well as nursing times, duration, etc. to make sure baby is adequately nourished.

I looked online for someone else's explanation of the process, but I found nothing, which proves my theory that I'm the only woman in the world to go through this insane process.  Kidding.  I've met one other person who went through this too, and lived to tell about it.  I think most moms have to just live with using the shield, supplementing and hoping it improves at some point.  I was fortunate to have help from a good lactation specialist who could guide me through this. 

Teaching Baby to Latch

• Skin to Skin Contact:  Not only will this help your baby be awake and alert for nursing, but skin to skin contact stimulates a baby's natural suckling reflex. This was not fun in the dead of winter, but it was a critical component for success. 
• Pump Before Nursing:  When a baby nurses, it can take a minute or two of nursing for mom's let-down reflex to begin and release the milk.  It would be a disappointment if the baby finally latches but is unable to get milk immediately, and the baby may quit prematurely.  I pumped on the side I wanted to nurse on, but only until milk started coming.  Then we began trying to nurse.
• The Medicine Dropper Approach:  We had to teach Isabelle exactly where milk came from.  To do this, my La Leche League leader said I would need someone to drip milk (that I'd expressed) down me so that the baby would be encouraged to nurse.  This became my mom's job, since she was our resident expert breastfeeder (she nursed 7 babies, including twins) and also has an infinite amount of patience.  My mother had to keep a steady stream of milk coming so that the baby would continue trying to nurse properly.  Ideally, the baby would latch and receive milk from both mommy and the the medicine dropper.  But much of the time, this doesn't happen, and the baby only gets milk from the medicine dropper.  We did this for every feeding, which usually lasted well over an hour, at least 8 times a day, including those 4 am feedings.  Sometimes she would latch for a bit and nurse, but other times she wouldn't.  Usually, she would at least latch on one side for 15 minutes or so, and sometimes she would nurse even longer.  We had to keep a close eye on how many ounces she had eaten from the medicine dropper.
• Spoon Feed if Necessary:  If Isabelle had not latched for very long and she hadn't consumed very many ounces of expressed milk, then we had to supplement her somehow.  Since she was only one week old when we began this process, we were hesitant to give her a bottle because we didn't want her to refuse nursing altogether after getting used to a bottle.  We were advised to try cup feeding or spoon feeding expressed milk to the baby.  It's very hard to spoon feed a newborn because she still has her tongue thrust or "extrusion reflex," and she will force everything out of her mouth.  
• Pump After Nursing:  During all of this, I had to become an avid pumper.  I'd received a good quality, hand-me-down Medela pump from my sister-in-law, although I really thought it would receive very little use, since I'm a stay-at-home mom.  But my La Leche League leader kept reinforcing that I needed to work hard to guard my milk supply.  If we were able to succeed with all of this, it would be for nothing if I had very little milk at the end of it, since she wasn't nursing very much.  And even if all of it failed, if I still had a good milk supply, I would be able to pump bottles and my baby would still receive the benefits of being breast fed.  There was another bonus too.  Mommy's milk is thinner at the beginning and fattier at the end of nursing.  This means that any milk I gave to my child through a medicine dropper would only be the best, thickest, fattiest milk, and would help her grow well.  Months later, if I needed a bottle for a car trip, I followed this same technique of pumping at the end of nursing to make bottles of only the best milk. 

After three days of this, we seemed to hit a wall.  Sometimes she'd nurse, and other times she wouldn't.  At this point, my mother also had to return home to South Louisiana.  She still has kids at home, and they needed her too.  My twin sister took off work to help me go through the nursing process during the day, while my husband was at work. 

Finally, it was Monday, and time for Isabelle's 2 week checkup.  We had been working with her on latching for a week, with no consistent results.  We were very concerned about her weight gain, but we were astonished when the nurse weighed her and we discovered she was down to 6 pounds even.  She'd started life at 6 pounds, 14 ounces.  We weren't given a weight update when we left the hospital, so we didn't know how much of her weight was lost at the hospital, how much was lost in the 6 days it took for my milk to come in, and how much was lost while we tried to teach her to latch.  Regardless, we felt like failures as parents. 

My one job was to feed my baby, and I couldn't do it.  I could earn a master's degree, teach Shakespeare to reluctant 14 year olds, and work miracles with at-risk students on standardized tests, but I couldn't feed my baby.  I was incredibly disappointed and depressed.  The doctor said we could keep trying this for a few more days, but on Thursday, he wanted to do a weight check.  If she hadn't gained adequately by Thursday, we would put her on a high calorie formula.  I wanted to breastfeed, but it wasn't worth the health of my child, so I agreed.  I did go home and place an order for Medela's SNS, Supplemental Nourishing System.  It's a gadget that holds milk and sends it down mom, so that baby can attempt to nurse and get other food at the same time.  I figured if we did have to put Isabelle on a high calorie formula, I could at least try to continue nursing some.

More Help
I still had hope.  That morning, I had set up an appointment with another lactation consultant.  My La Leche League leader had been pretty sick with a cold and was never able to make it to my house to help me, so she had just coached me over the phone.  I called Connie, a woman who had taught my breastfeeding class at the hospital.  She said to call if we needed help, so I did, even though I figured no one actually took her up on the offer. 

I met her at the OBGyn's office where she works, and although she should've been finished at 4, it was 5 before the patients had all left.  She spent about five minutes working with me on positioning, and then we tried the clutch or football hold.  I'd tried it before, but with her help, I held Isabelle in an even tighter football hold.  Immediately, my baby was nursing.  Fully clothed, no pump, and no medicine dropper.  We stayed in that exam room for almost an hour.  I was amazed as I watched watched Izzy nurse on both sides and listened to more advice from Connie.  When we left, only the janitors were left in the building.

I went home that day and we never had another problem.  Most likely, Isabelle had been able to latch since day three of our experiment, but I just needed some help with positioning.  Isabelle was very picky about how she was held.  If I changed just one little thing, she was done nursing, which is why she wouldn't sustain a latch.  I was so relieved to finally be a normal nursing mom.  That Thursday, I took Izzy in for her checkup.  She had gained several ounces over the past two and a half days, so she was in the clear.  The doctor was very pleased.  When I got home, I found that my $50 SNS had arrived in the mail.  Oh well.  I put it away in the closet, so that if I had nursing problems with another baby, I would be able to use it.  I was actually glad my $50 had been wasted, because it meant we'd finally succeeded.

Would've, Should've, Could've
What would I have done differently?  Well, to prevent the issues to begin with, I would've used a pump in the hospital (see yesterday's post).  But given the problems we had, I think the only thing I would've done differently is given my child a bottle, had I known she was losing weight.  But I didn't know.  Obviously, I would have wanted to make sure she was adequately nourished. 

But that aside, honestly, I would've done nothing differently.  It was a hard, emotional road to take, but it was worth it.  I was able to nurse my daughter throughout the first year, giving her the best possible start in life. 

I couldn't have gotten help from Connie sooner either.  All of this took place between Christmas and New Year's, so I was at her office for help the day they opened after the holidays.  I did learn the importance of asking for lots of help.  Most women who nurse are passionate about it and will do anything possible to assist another mom.  Even if it means staying at the office for an extra hour after work.


During that difficult week, I often prayed and more often, I cried.  I knew God gave this trial to me to challenge and grow me, and to keep me relying on Him, but it was still hard to see why we had to deal with it.  My mother pointed out that other moms might need help, and I would be in a position to coach them through nursing issues too.  Three months later, a friend called needing nursing help with her newborn.  I was pretty dubious.  "Are you sure you want help from me?  I didn't have an easy time with nursing," I told her.  She had no one else to call, so we talked through it over the phone and I brought her dinner later that night.  God was good to already show me some small rewards for the trial we'd had to go through. 

Consider it pure joy, my brothers, whenever you face trials of many kinds, because you know that the testing of your faith develops perseverance. Perseverance must finish its work so that you may be mature and complete, not lacking anything.  -James 1:2-4