Following those Mommy Instincts: WBW, post 4

This is the fourth post in my series celebrating World Breastfeeding week.

There comes a time in every mommy's life when she must go with her gut.  I came to such a point last March.

Yesterday, I shared with you how I was able to maintain milk supply even when my newborn was unable to nurse for almost a week following his lung surgery. 

Andrew, about a week into his hospital stay.  Newly released from ICU, we were finally able to hold him again.  He was about seven weeks old and this is the first smile we have on camera.

The day before Andrew was released from the hospital, the nurses told me that he had lost some weight during his stay.  After Andrew stopped being nourished from the feeding tube, we had to alternate between nursing and the bottle because he would vomit from time to time.  Andrew had also gone about half a day without eating while we awaited a decision regarding surgery after his chest tube had slipped out.  So while there were several factors contributing to his weight loss, it still came as a disappointment after all the work I'd done to make sure he would be able to nurse after his recovery from surgery. 

The doctor's solution was a very logical one.  As part of Andrew's recovery, she wanted me to supplement with formula to help him gain weight quickly, but I would only need to do it for a couple of weeks to help him "bulk up." 

The dietitian explained the way to do it.  Breastmilk is X amount of calories.  If you take 2 ounces of breastmilk and add one teaspoon of formula, you instantly have a much higher calorie meal.  I had 90 ounces of breastmilk filling up the freezers on the fourth floor of Children's Medical Center--so much that the nurses had no room for other patients' milk and had to look for other storage options.  The dietitian instructed me to use my milk to give him higher calorie bottles an hour or two after he nursed.  

I was concerned about the effect on my milk supply because I knew he wouldn't nurse as frequently if we gave him bottles like this between every feeding.  After I expressed this concern, the doctor said doing it just twice a day would be sufficient to help him gain weight.  I still wasn't convinced.  Breastfeeding is a supply and demand process.  Any reduction of demand reduces supply. 

I should say upfront that I love our doctor. She is incredible and saved my baby's life. I completely understood the logic behind her instructions to supplement. He needed to gain the weight he had lost, so this was an easy way to do it.


At the same time, I felt like I was privy to information that neither she nor the dietitian had. I knew that 1) I am capable of nursing my baby, 2) My son is an incredible eater, and 3) I'm an informed, intelligent mother who could closely monitor his weight gain. I tried to convince the dietitian of this, but it was useless.

I gave Andrew one bottle per their instructions and the poor little guy was miserable with gas. If you've ever switched to formula, you know that it takes a while to find one that works well for the baby.  It's just harder to digest!  I was pretty upset about having to do this, because I knew my milk supply was fine, and it was also the first time any of my children had been given formula.  I really felt that if Andrew had unlimited access to nursing, then he would gain weight.  He was a chunky little baby prior to being in the hospital, so I was confident he would go back to nursing well once we got home.

I talked with a couple of nursing gurus, my mother and my pastor's wife, who have both nursed seven children.  They completely agreed with me that Andrew needed to nurse exclusively.  Even my dad said "That's crazy!  Can't you just nurse him every two hours to help him gain weight??"  I agreed, and was heartbroken at the thought of doing anything else.

I decided to go AMA, against medical advice, until I could speak to our pediatrician about it.  We had an appointment with him two days after our release from the hospital.  Our ped was incredibly encouraging.  He said if anyone needs the health benefits of breastmilk, it's Andrew, and the last thing he needs is a milk or protein allergy from formula.  He encouraged me to forget about the formula.  Nurse on demand and then come back for another checkup in a week.  If Andrew wasn't gaining weight sufficiently, then we could start supplementing.  If he gained weight, then the doctors would never have to know. 

Once we got home from the hospital, I essentially nursed around the clock, every two hours.  I followed Andrew's lead and fed him on demand, just like he was a newborn again.  I even managed to pick up a stomach virus within a couple days of getting home, so  friend stayed with me all day and cared for Andrew and I. All day, I slept and nursed, with occasional breaks for eating.  Friends from church brought meals to us, so I didn't even have to cook.  For two weeks, I primarily just nursed my baby.  I'd almost declined their offers for meals.  I had no idea how much I would need their help!

I was pretty nervous when we went back to Dallas for Andrew's two week follow-up with the surgeon.  I knew his weight check at our pediatrician's office looked good, but I wasn't sure if Andrew had continued to gain well over the weekend. His x-ray looked great and his weight gain looked even better.  In two weeks, he had gained two pounds!  That kind of weight gain is almost unheard of.  The typical baby takes two weeks to gain one pound, but he had doubled it without supplementing.  The surgeon was thrilled at his weight gain.

Andrew, about a week and a half after being released from the hospital.  He had a lobectomy, yet the only medicine he needed at this point was Tylenol!

After Andrew bulked up, he went back to eating on a normal 3 hour schedule.  This showed me once more how wonderfully God has created us.  Andrew instinctively knew that he needed to gain weight and my body was able to respond.

I also realized that for medical professionals, breastfeeding is one of those things that is wonderful in theory.  In practice, it's not so wonderful.  It's hard to quantify.  Aside from weight gain, a doctor has no way of knowing if I'm feeding my baby enough.  But bottles?  Those are completely measurable and work into the equation much more easily.

What has been your experience with doctors and nurses regarding breastfeeding?