Early Intervention Lactation Help

25 October 2010 at 1:27 am 11 comments

WELCOME, Carnival of Breastfeeding Readers!

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I had my son at 9:30 on a Friday morning, and he didn’t latch on until twelve hours later.

This was not for lack of trying or opportunity: a homebirth, my son came out covered in thick meconium, but my midwife wiped him off, cleared his nose and mouth, gave him a squeeze of oxygen, and placed him on my stomach two minutes after he emerged. He was full-term, normal weight, and healthy, but we assumed that the cord had been crimped at some point during labor and he’d been under a little stress. When he didn’t latch on right away, my midwife just placed a blanket over him and me and let us nap together. We kept skin-to-skin contact for the first four hours after birth, trying to latch him on at regular intervals, but he was sleepy and not very interested.

Around 2:00, I got out of bed and washed up and put on a clean pair of pajama pants and a nursing tank, and we tried to latch again before my midwife left. On her advice, I squeezed out drops of colostrum and fed them to my baby on the tip of my finger and on one of those tiny rubber-tipped baby spoons. We continued this throughout the afternoon and evening: with brief breaks for grandparents to hold him, baby spent his time on my chest, near the nipple but not latched on, and I squeezed out colostrum for him every half hour or so.

We had Indian food for dinner that night, with baby right by me at the table, either in a sling or else cuddled close to me in the chair, and after dinner I tried again to latch, but squeezed out more colostrum, which he always lapped off my finger or the spoon eagerly. He didn’t cry, and he seemed to love being held. His eyes were open and he was curious and interested in the world around him.

My midwife came back around 8:30 that night and checked on me and baby. She watched him try to latch, but it was like he just couldn’t seem to get the nipple in his mouth. She checked for a tongue-tie and said she didn’t think that was the case, but rather it was likely that he had been too sleepy/stressed at first, and now just didn’t know what to do. Handing me a silicone nipple shield, she suggested we try nursing that way, and immediately he latched on and started sucking. We tried shifting him from the nipple shield to the bare nipple, but that didn’t work, and we tried having him suck on my finger and then do a quick swap for the nipple, but that also didn’t work. Satisfied at least that baby had gotten a fair amount of colostrum already and was now latching via the nipple shield, my midwife left me the name and number of a lactation consultant who makes house calls, and promised to be back tomorrow to check on us again.

I called the lactation consultant and left a message before bed, and baby continued nursing very happily via the nipple shield every two or so hours throughout the night, having a couple dirty meconium diapers that my husband got to change.

On Saturday, after my midwife came back, I called the lactation consultant again and explained that he still would not latch without the nipple shield. The consultant seemed confused, saying that she was virtually never called so early. “He was born when?” she asked. “He’s less than two days old?” Her advice was to keep using the nipple shield for now, keep trying to latch him on without it too, and keep feeding him drops of colostrum on my finger or a spoon.

We had a happy baby, regardless, and he approached the business of nursing with the nipple shield as though it were, in fact, his business–he was a very serious nurser, who would suck furiously and then fall asleep, and then (when we gently encouraged him to wake back up and nurse some more) suck furiously again.

On Sunday, the lactation consultant called me back to check up, and suggested that I start pumping via a hand pump periodically to help stimulate my milk production (the big fear of using a nipple shield is that there won’t be adequate stimulation to build up a full milk supply in the beginning). I did that once or twice, getting a few drops, but I wasn’t quite sure what I was doing and didn’t even really know how to center my nipple in the pump. That afternoon–it was 4:00, I remember, because some friends were visiting to meet the baby and had just asked what time it was because they needed to leave at 4:15–I suddenly felt my milk “come in”: I suddenly had pressure in my breasts as though they were going to explode, and when baby nursed via the nipple shield, with my friends sitting around the living room and me and baby on a corner of the couch, I was surprised to see some white milk in the nipple shield and around his mouth. That night I pumped about an ounce of milk, starting to figure out how to use the pump, and baby nursed every two hours, each time definitely getting milk.

On Monday the lactation consultant came over. She weighed baby before and after a feeding and was satisfied with the amount of milk he was getting even with the nipple shield. She tried to have him latch on without it, but again, he was not having that. My parents and my husband were so impressed with her–her warm manner, her professionalism, her tips and strategies, her calm advice–and when she left we all felt relieved. She left us with a plan: I should continue using the nipple shield but try every day or so to nurse without it, and I should pump at night, after baby falls asleep, as well as before each night feeding so that I both stimulate my supply and relieve the engorgement in my breast, to make it easier for baby to latch on. Neither she nor my midwife ever suggested bottles or formula or supplementing, and I was so enormously grateful for their support.

Fast-forward. . . .

Tuesday–my midwife came back, impressed to find that I’d already frozen three ounces of pumped milk (it felt like such an enormous amount back then!) and that baby was already gaining back weight.

Two weeks later–baby spontaneously weaned himself from the nipple shield. I kept pumping at night, though, with my trusty hand pump.

Five months later–when I went back to work, I had 400 ounces of expressed milk in the freezer.

Tw0 years later–baby’s still nursing, a lot, though I’ve weaned myself off the pump when I’m at work, and I’ve donated milk three times.

None of this would have been possible without my midwife, without her early intervention help. We had done all the “right” things at birth–no medications, no separation of baby and mother, lots of skin-to-skin contact–and still my little guy just took a little bit of time to figure out the whole nursing thing. With my midwife’s help, though, we got off to an amazing start.

–Christina

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11 Comments Add your own

  • 1. Fighting for breastfeeding | Reproductive Rites  |  25 October 2010 at 7:02 am

    […] Suchada @ Mama Eve: Birth & Breastfeeding Christina @ Massachusetts Friends of Midwives: Early Intervention Lactation Help Jenny @ Chronicles of a nursing mom: Birth Experiences and Its Effect on Breastfeeding Jenny @ Baby […]

    Reply
  • […] Christina @ Massachusetts Friends of Midwives: Early Intervention Lactation Help […]

    Reply
  • 3. reproductiverites  |  25 October 2010 at 10:12 am

    It’s so great to read a story featuring so much caring and competent help. I’ve encountered some lactation consultants whose advice was not so well informed. I’m glad you didn’t have that experience! (And I bet my one year old willalso still be nursing lots at two.)

    Reply
    • 4. Jenny  |  25 October 2010 at 8:22 pm

      I agree – LCs should be competent and I’ve likewise met some who aren’t and make you feel guilty about your diet, not trying to hard, etc. I’m glad you had an LC who was professional and REALLY helped you successfully breastfeed.

      Reply
  • 5. Sheila  |  25 October 2010 at 10:30 am

    Your story sounds a lot like mine, only I didn’t have that kind of support. I ended up using a nipple shield for 10 weeks, and I hated it so much. Personally, I suspect we wouldn’t have needed it at all if baby had been allowed to latch in his own time, but I’ll never know.

    Even if the outcome would have been exactly the same, I still wish I could have had that kind of support. I can see that you are okay with the way things went, that you don’t feel like a failure because things didn’t go “as planned.” Maybe that’s, in part, because you had such great people cheering you on!

    Reply
  • 6. Maureen  |  25 October 2010 at 12:50 pm

    Way to go! You worked so hard to make breastfeeding work for you both. I know that it isn’t easy. Good help goes a LONG way to making breastfeeding successful.

    Reply
  • 7. Suchada @ MamaEve  |  25 October 2010 at 1:20 pm

    Great story of working through the issues. I’m so glad it worked out for you guys!

    Reply
  • 8. lesliedf  |  25 October 2010 at 3:17 pm

    You sound so calm throughout this experience! Midwives are so important, my home birth midwife was the picture of calm through everything and since she was, so was I. It’s wonderful that you were able to donate so much milk! I wished I could have done that, but pumping was never easy for me. I did it only when I had to.

    Reply
  • 9. Elita @ Blacktating  |  26 October 2010 at 7:24 pm

    400 oz of pumped milk? That is amazing! I could never get out more than a few ounces! Oh this birth just makes me wish I had a midwife even more!

    Reply
    • 10. christinamichaud  |  26 October 2010 at 10:55 pm

      I did it super little by little–usually just an ounce a pumping session before I went back to work, and 3-5 of those a day in odd moments with a hand pump. Ironically, my baby totally refused all bottles, ever, and completely reverse-cycled, which is how I was able to donate quite so much! But I totally agree–midwives rock. :)

      Reply
  • 11. Breastfeeding & Birth  |  17 February 2011 at 4:46 pm

    […] Christina @ Massachusetts Friends of Midwives: Early Intervention Lactation Help […]

    Reply

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