Rachel's Journey-the Road to Exclusive Breastfeeding

We began working with Rachel and JJ back in December. They worked incredibly hard to overcome their breastfeeding challenges over the course of nearly two months. For this reason, I knew I wanted to highlight their story in hopes of inspiring other new mothers. Of course, I have to give a big thank you to Rachel (and JJ) for allowing us to share. Enjoy!

I knew that I wanted to try to breastfeed my son. I work in healthcare so I am aware of the benefits of breastfeeding to mom and baby. I also knew that it would be hard. I had heard from many friends that breastfeeding is a challenge. The thought of breastfeeding, although I knew I wanted to try, overwhelmed me. I couldn’t imagine being the only person that could feed the baby and having to do that every 2-3 hours. I was very worried that it would be painful. I was more worried about pain from breastfeeding than I was about pain from labor. I felt like it would be awkward for me to be exposed in front of family and friends. But despite all of these things, I knew I wanted to try. As much as I wanted to try, I was aware of all of the possible challenges and tried not to put too much pressure on myself. I know that it isn’t for everyone and that there are many reasons why some women do not breastfeed.

I had a healthy pregnancy and a beautiful natural birth. I did skin to skin and breastfed within the first 1-2 hours of birth. My doula was there to help us with our latch and thought things looked good. I accepted help from our postpartum nurse when she came to the room. She was quick to tell me that the baby might have a difficult time latching due to my “flat nipples”. She recommended manually expressing colostrum and spoon-feeding it to the baby. She ordered a lactation consult so that I could get a nipple shield. The lactation consultant came the next day. We tried to get the baby to latch, but even with my breast in his mouth he didn’t start to suck, and even after using the nipple shield, the baby still didn’t suck very much. I told her I didn’t feel much of anything with the baby at the breast. That is pretty much how we left things. The next day I asked to see the lactation consultant again to make sure that we were on the right track before going home. We saw a different lactation consultant who didn’t think I needed to use the nipple shield, however the baby didn’t suck very much again when she tried to help me latch the baby.

The next day we went to see the pediatrician. Our baby was at the low end of acceptable weight loss for a newborn at three days old, so she referred us to a lactation consultant (our third at this point) and recommended that we try to schedule an appointment with her over the weekend. We were able to get an appointment two days later with Mary and at that point our baby had not had any poopy diapers in a couple days. After our first visit with Mary, I was feeling optimistic and hopeful. However, that night the baby still hadn’t had a poopy diaper in several days so I called and spoke with an on-call nurse who recommended that we supplement 1 oz of formula or pumped breast milk after feeds. Mary walked me through using the breast pump and how to feed the baby from the bottle in a manner that continued to support breastfeeding. A day later, our baby finally pooped and when we went to the pediatrician the day after that he had gained a couple ounces. We took him again a few days later for a weight check and things continued to be on track with weight gain.

We continued breastfeeding and supplementing some over the next week until our follow-up appointment with the lactation consultant. I was trying to follow the baby’s cues for when he needed the supplement. Most of the time he would fall asleep at the breast - I assumed he was getting enough milk because he seemed content. I supplemented pumped breast milk after about half of the feedings. I was so disappointed (and a little scared) to find out when we weighed him at the appointment with the lactation consultant that our baby had not gained any weight compared to the previous week’s weight. We also learned at this appointment that the baby only transferred about 1 oz of milk after having him at the breast for 45 minutes. I just wanted to do what was best for our baby and I started to feel like I had harmed him in the process. I was frustrated that we had spent so much time devoted to doing something with little results. I felt like I was personally failing in a way.

At this point, Mary helped us to develop a new care plan which involved more frequent feedings (9 per day), more supplementing (1-2 oz for a total of 13-14 ounces per day), and trying to get off of the nipple shield. This meant that every 2-3 hours I would have to breastfeed the baby, then give him the bottle, then find time to pump. This is when I really had to call on family for support. My mom would spend the days with us and my husband would take the evening and night shift, so they could help with bottle feeding while I pumped. I did try a few times to get the baby to latch without the shield, but he would cry and get frustrated. I was not able to focus on this since my main priority was just to get the baby fed. After a week of carrying out our new care plan, I was so relieved that the baby started gaining weight appropriately. However, his demand also increased and the amount of breast milk we needed to supplement increased, too (2-2.5 oz for a total of 16-20 oz.). We also took the baby to get evaluated for a tongue tie, and although he did have a small tongue tie, the pediatric dentist did not suspect that this was the root of our problems and did not recommend revising it.

We continued with this schedule for several weeks. It definitely became exhausting. Between breastfeeding, bottle feeding, and pumping (not to mention changing diapers, washing bottles, doing laundry) it was difficult to even get out of the house. I also really started to dread pumping. I wasn’t sure how much longer I was going to be able to continue with this pace. I also found myself not being able to enjoy the time with my baby and my maternity leave. I wanted to remain optimistic and hopeful that my baby just needed a little bit of time to develop and strengthen. I scoured the internet for solutions and answers. I consulted with other moms and friends. I thought that if I found just one success story that was similar to our situation, I would be able to push through. Although I received a lot of encouragement and support, no one could give me an example of a case where the baby was ultimately able to breastfeed better after this many weeks and this much supplementing.

I set a goal to continue trying at least until the baby reached six weeks. This helped give me a short-term goal and not get so overwhelmed with the process. I tried to take the pressure off myself to get the baby to the breast each feeding - if we were out and about or I needed to run an errand, I could give the baby a bottle and pump later. The baby would get fed and I would have a little more freedom. I also tried to focus on one day, one feeding, at a time.

When we reached the six week mark and I still did see much improvement, I decided to reach out to Mary again for some advice. I wondered when I should consider exclusively pumping or switching to formula. Had I reached my breaking point? She reassured me that any bit of breastfeeding would benefit me and the baby, even if we were not able to do this exclusively. She also reminded me of all the great benefits to breastmilk. She gave us some options to consider: a second opinion on a possible tongue tie, a consult with a speech language pathologist, or trying again to wean off the nipple shield. I agreed that maybe the nipple shield was making it hard for the baby to transfer milk. We decided to focus for a week on weaning off the nipple shield and following tips from an article that Mary sent me on how to do this.

After just a couple of days of focusing on latching the baby without the nipple shield, I was pleasantly surprised that it seemed that breastfeeding had drastically improved. The latch felt better, I heard the baby swallowing much more, and he was taking significantly less supplement from the bottle after breastfeeding. We went back to see Mary for a follow-up and she confirmed with weighted feeds that the baby transferred almost 3 oz. Over the next two weeks we were able to ensure the baby was gaining appropriately with weight checks and stopped supplementing altogether. I am so glad that we stuck with it. I am so grateful to my family, friends, and lactation consultant, Mary, for the support that allowed me to allow my baby time to mature and grow. The convenience, the bonding opportunity, and the health benefits that breastfeeding will give to me and my baby are worth the extra effort and time it took to figure it out.

#exclusivebreastfeeding #nippleshield #IBCLC #weightloss #shorttermgoals #TampaBay

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