Sustenance

I fed my daughter from a bottle today, and she looked at me as if I were Superman.

That demands some explanation, I suppose. So let me back up. This is where we get into the not-sweetness-and-light side of Laurel’s first week in the world, the ones that mostly don’t photograph and that take up a lot of our time.

We’re having some struggle with breastfeeding. We expected that we might, prepared for it, and waited. Then we waited some more, because even after the baby is born you don’t yet know how it’ll go until the milk “comes in,” as they say, a couple days later (give or take). When Laurel was born, at 7lb 11oz, she was probably weighing over her “dry weight,” as it were, because of all the amniotic fluid she’d swallowed and which she spent the first day or so throwing up. 24 hours later, she weighed 7lb even. Neither of those things is especially unusual. But losing a further 6oz even after Beth’s milk was “in” is less usual, and it’s when pediatricians start getting nervous and using words like “hydration” and “hospital” slightly more often than new fathers like to hear.

I should also note at this point that we’re not dogmatic about breastfeeding, but we’re not willing to give it up, even if we can’t sustain Laurel entirely on breastfeeding. We started doing all the usual teas and herbs and massage and so forth even before knowing we’d need them, just because the odds were high we’d have trouble. We discussed the whole issue months in advance with the midwives, did our reading, lined up potential lactation consultants, etc.

On our midwives’ advice, we started supplementing. Since we hoped to be dealing with an undersupply that could potentially be addressed with a bit more time, I really didn’t want to start adding formula, especially this early on when Laurel needs milk to develop an immune system. A bit later, sure, but not on day four. A wonderfully generous couple in the area (who I’ll leave nameless here unless they want to be identified), ransacked their freezer and gave us milk they’d saved for their own child. Laurel happily accepted it, drank several syringes full, looked content and slept. With the extra donor milk, her weight flattened out, but hasn’t increased.

I used the word ‘syringe’ back there, which brings up the matter of Nipple Confusion. For the benefit of those for whom that sounds like a tedious 90s metal band, nipple confusion is simply what you can get if you feed a newborn from something other than a breast — they sometimes forget how to use a breast and reject it in favor of the substitute. Breasts are actually fairly hard to drink out of, especially early on in lactation — if they weren’t, nursing women would walk down the street looking like they’d had miniature fountains installed on their chests. Bottles, spoons, syringes and sponges are all in various ways easier, and despite efforts in engineering they’re not similar enough to avoid disrupting some young babies who just learned (or haven’t yet learned) to breastfeed.

Anyway, the approach to syringe feeding I took was to suckle Laurel with a thumb, slide the syringe nose alongside it and slowly squirt milk in, trying to match the pace of Laurel’s sucking. If she stopped (and babies often do, or change their pace), I’d stop. Etc. At three cc’s per syringe, and a rate of around 0.5ml/sec, an ounce was what I was describing (to Laurel) as a Ten Syringe Death March, and took about three hours. Sometime around 3:30am last night I fell asleep doing it and woke up when my head hit the floor on the far side (Laurel was fine, thank you).

A lactation consultant (also a midwife who normally works as a partner with our own) came around this afternoon. She spent a delightful hour assessing and making suggestions, reviewing our lengthy log of Laurel’s every input and output, checking, weighing, answering questions, and so forth. One of those suggestions was to go ahead and try the bottle — it might cause some confusion but could likely be managed, and that three-hour feedings were costing more in sleep and regularity than they were saving in overall suffering.

She left. Laurel woke up, demanded food, and got a breast. Then another one. She came off the second breast still hungry and fussing, which is the moment we’ve really been hating lately. I put a single ounce of donor milk in a bottle, matched the temperature, grimaced a bit, came back and tried to feed her with it.
Laurel hated it — the procedure for drinking out of a bottle is totally different from drinking out of a breast, and she’d only learned the latter. She kept grabbing the back of the bottle and shoving it further in, which we were a bit proud of after days of working on getting her to latch onto a breast deeply enough. A few seconds of trying without getting a proper seal on the bottle and she’d break loose, cry a bit, then frantically grab it and try again.

After ten minutes or so of this, between the two of us I found an angle and a depth that Laurel could hold. She applied the sort of suction that a breastfed infant can, and drained half of it in one long pull through the smallest, lowest flow rate nipple available. Then she sat back a bit and gave me a look of total astonishment. Which went on for about five minutes, the two of us looking at each other — I probably with the mix of resignation, regret, trepidation and relief I was actually feeling, and Laurel with what I interpret as overwhelmed but delighted bafflement at what her father had just proven able to do.

Eventually I took a picture of this, which doesn’t really reflect what was going on (possibly because her dad had just been obscured by a shiny silver rectangle). Then I gave her the other half, which she drained just as quickly, burped, and gave me an abbreviated version of the same face before clonking forward into my chest and sleeping there for about an hour.

So… mixed feelings. We didn’t want to give any ground on this, but our daughter was going hungry. Beth’s supply is still increasing, slowly, and she started on Domperidone yesterday, which can help milk production. It may not add up to everything Laurel needs, and if so, formula will have to cover the rest, so there will in turn have to be bottles or spoons or SNSes or syringes or whatever else involved. It’s not what we were hoping for, but hopefully her immune system will grow in more or less adequately based on what breastmilk we can provide, and she’ll have enough to eat.

Not sure when I’ll get the Superman look again. But I’ll find some other way to earn it.

– Devin

Advertisements

5 Comments

  1. mordwen said,

    March 14, 2009 at 6:47 pm

    I have the opposite problem. If I squeeze my left nipple, milk squirts out of eight separate holes about two inches distant at what looks like freeway speeds. Harper takes one mouthful, chokes slightly, pulls off and looks at me like I tried to drown her. She tries again with trepidation then when it finally slows down she gets a rhythm going.

  2. puppchen said,

    March 14, 2009 at 7:57 pm

    I’ll mail you one of Beth’s breasts; you mail us one of yours; hopefully neither will be impounded at customs. We’ll be set.

    – Devin

  3. Suzanne said,

    March 15, 2009 at 10:55 pm

    I tried to educate myself as much about lactation as possible before birth, and utilized the numerous consultants made available to me, but I still had a lot of problems with our latch. The supply wasn’t an issue (at that time) but her mouth was so small she would really clamp down and it would pinch, especially on the nipple attached to the breast producing the most milk. So I ended up using my pump as a way to take a break from little ms. clamp-on, and after about 12 hours of taking a break my nipple was in a lot better shape to try again. Most of the time our issues were a result of positioning, as I had a c-section wound to deal with. Finally everything came together, and then I had to go back to work. But that’s a whole ‘nother story.

  4. kasandra said,

    March 17, 2009 at 9:29 pm

    I had some challenges the first night home from the hospital. At the hospital the nurses helped me latch Christian on to nurse, and than when I went home I was totally lost! It was terrifying. I was so worried that he was going hungry and he was screaming up a storm. Than we went to emargency for baby’s and new mothers at Kaiser and this wonderful nurse helped me – she told me to hold my breast like a hamburger and the baby would latch on. (My midwife kept saying just put the baby to your breast and he’ll know what to do… yea right.) After the hamburger trick it worked fine and he’s 3 still nursing… in fact just this moment he grabbed my shirt and said “I want some milk…” jumped on my lap and is having a snack… it’s close to bed time. LOL. There are so many stages of the nursing. There is a biting stage, lot’s of pain, and there is a painful stage just to get your breast used to the process. Keep it up! Stay hydrated.

  5. Alyse said,

    March 18, 2009 at 6:45 am

    My baby girl had problems latching on for about a week. I wanted to pull out my hair and scream but we got over it. Then when I took her in for her second? visit they told me she was too fat. Because she had gotten her birth weight back plus some. She is still a food hound lol. Only now she has started stealing her brothers food :p.

    And I used a pillow for both of mine. I don’t know what I would have done without the pillow!!


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: