Nursing woes...belated recap

I was reflecting today that I really love my blog because it's a great memory book about what's been going on the past 2 years or so of my life.  Especially with bringing Gavin in the world, it helps me remember all the little things that have happened.  What I recognize, though, is that there's a huge part of the beginning of Gavin's life I really haven't written about.  That is the breastfeeding part.  Truly, I have only really opened up about most of this nursing saga with my close friends, and only Tom knows all of the...gory...details.  I never wrote about my experience being a nursing mama on the blog because I thought it was too personal, and some may not want to know all the TMI details.  And maybe it is too personal, but I'm realizing that the memories associated with it are the hardest I have from Gavin's early days and I decided to write this blog post as a sort of catharsis for myself to try to let go of some of the memories.  And if it can help any soon to be nursing mamas prevent some of the many problems I had, even better.

So here we go...

I knew from pre-becoming pregnant that I wanted to breastfeed.  I read books about it, I went to a breastfeeding class through a parenting center we have in the Twin Cities, and felt ready.  In the hospital I saw two different lactation consultants to get as many tips as I could to set Gavin and I up for success in this new nursing relationship.  Unfortunately, the second lactation consultant I saw really set me up for a road to trouble.  She made me use a nipple shield (I know I told you it may get to TMI) and said I should only nurse with this to make sure Gavin was latching on appropriately.  Only later did I learn that this can cause babies to become dependent to only using this and that it can also increase your risk of developing breast infections.  She also told me that I should use a breast pump for 10-15 minutes extra after EVERY nursing session to ensure that I'd have an adequate milk supply.  I was extremely exhausted in the hospital after a labor that lasted over 30 hours, but was determined to listen to the advice of the lactation consultant, so I did.  It was laborious and time intensive to pump after each nursing session (which lasted about 45 to 60 minutes each anyway because Gavin was VERY slow), but I did it.

Five days post-partum when we were at home is when it really got hard.  This was the day my milk "came in" and I became horribly engorged.  Naive me, I continued pumping like the lactation consultant told me to, after each nursing session as I'd been instructed which made it all worse.  That afternoon my brother, Corey, came over for dinner and to meet Gavin.  During dinner I felt like I got hit by a truck, was so exhausted that I laid my head on the table and nearly fell asleep.  After my brother left I took a bath to try to relax and started shaking uncontrollable and was SO cold.  It was then time to nurse Gavin again and I felt absolutely awful, like I had the flu.  I took my temperature and it was 102.  I then started to have excruciating pain in my chest and nursing was also terribly painful.  The pain was shooting up my arms to the point I could barely hold Gavin.  Because I was so engorged as well, I had developed lumps all over both of my breasts and could tell Gavin wasn't able to empty them completely.  I called my nurse line and they paged the on call OBGYN who called me back shortly.  I ran through my symptoms and he was pretty certain I had mastitis but wanted me to be seen the next morning to make sure.  I was advised because they thought it was mastitis to make sure I was emptying my breasts of milk every 2 hours around the clock until the infection cleared.  Talk about exhausting.  I was also told I could use ice packs on my chest to help the pain and engorgement.  I got barely any sleep that night because I was in so much pain and my fever made me sweat like crazy.

The next morning my doctor was able to fit me in and confirmed that I had mastitis. In addition, she confirmed that (TMI alert) my stitches from labor had torn, became infected, and I had a bladder infection to top it off.  I was pumped full of antibiotics and was cautioned by my doctor that once you get mastitis, the more risk there is of developing it again.  I was uber determined, however, to get past this and continue to breastfeed.

One very nice part of my post-partum journey was a benefit I got through my job for free telephonic services with a lactation consultant named Debbie.  Debbie became my nursing lifeline.  I probably spoke with her 1-2 times a week for the first 16 weeks of Gavin's life.  Debbie was the first person to help me realize how enormous my milk supply was.  She had me pump after Gavin had a full nursing session and I pumped out 6 ounces of milk out of each breast.  She had some sort of reaction like, "holy crap!".  She said at this stage it was normal to pump 2 ounces per breast BEFORE a nursing session.  She then coached me on a plan to try to cut down my milk supply.  Once my mastitis cleared up, we talked about a plan to try to reduce how much milk I was making because this was lending itself to the plugged milk ducts that I constantly had and was constantly trying to rid myself of.  Basically the plan was to keep pumping after each nursing session to ensure that I was emptying all of my milk out to try to get rid of the plugged ducts.  Then I was to choose one nursing session a day and only pump out half as much as normal for 3 days, then skip pumping after that nursing session the next 3 days, and keep repeating until I was no longer pumping at all after nursing sessions.

Unfortunately I was not able to ever finish this plan because 3 weeks post partum I developed mastitis again.  This time Tom was at work and I was home alone with Gavin.  I noticed the initial signs of exhaustion again and while nursing I felt the same shooting pains in my breast and up my arm.  It hurt so bad I was literally afraid I would not be able to hold Gavin and had to set him in his crib.  I called Tom who raced home to find a crying me and a crying Gavin.  I again had a high fever and called the nurseline who said again that it sounded like mastitis.  I went right back to the doctor who confirmed it again and sent me home with more antibiotics and that I needed to nurse until my breasts were empty every 2 hours until the infection had cleared.  Totally exhausting.  Plus this completely threw my whole plan on decreasing my milk supply back to the starting point.

After this second bout of mastitis, I had a brief period where I decided I couldn't do this anymore.  I couldn't put my body through this wearing routine any longer and we bought a can of formula.  I gave Gavin one bottle of formula which he promptly spit up all over himself, and decided this was not what I wanted.  I really, really, wanted to be able to breastfeed.  I knew all of the positives and decided to not let myself give up.

Once the mastitis cleared up, I worked with my lactation consultant, Debbie, on trying to get Gavin off of the nipple shield and she also advised me to see a lactation consultant face to face.  I went to see one at Methodist Hospital who was very helpful in correcting Gavin's latch and nursing went much more smoothly after this.  I did tons of research on ways to prevent mastitis as there are many different things that can contribute to it (including stress--ironic huh?!).  I started taking Lecithin supplements three times a day which is supposed to help prevent pluggled milk ducts.  I was super hopeful.

Yep, you guessed it, as soon as thing started getting better, and I was advised it was time to try cutting down my milk supply, then came back the plugged ducts and again at 7 weeks post-partum I got mastitis a third time.  I was devastated.  Beyond devastated.  This really hit me not only physically but also emotionally. I felt like I was trying so hard and only running into the same problem over and over again.  My body was so tired.  While working through this course of antibiotics, Tom had a "come to Jesus" moment with me.  I was constantly, every single day of Gavin's life, thinking and worrying about my body.  That, on top of post-partum hormones was really wearing on me.  He really wanted me to stop breastfeeding.  I really, really didn't want to do it.  It took a lot of talking, a lot of crying, and a lot of convincing, but I finally came to the decision to stop.  Let me tell you this was the hardest decision of my life.  Not kidding.  I had so much guilt about stopping, felt like a failure, had to deal with telling others including some who though didn't say it outright, gave judgmental glances when I told them I was going to stop nursing.  I had to acknowledge the fact that I couldn't be a good mom while nursing in my conditions.  My doctor also had a mini "come to Jesus" moment with me too, acknowledging that it was very lucky that the mastitis would come back again, which I was terrified of.  Being worried and anxious all day every day was causing me to be preoccupied and not able to enjoy my time with Gavin.

Here came the tedious and tricky part.  Because I was making SO much milk (at my peak I was making 70 ounces a day which my lactation consultant said was about 3 times what a normal woman makes and was the most she had ever seen a woman make with only one baby--not multiples), I had to move forward very carefully.  I spoke with my lactation consultant and did a lot of research on my own.  I met with my doctor and we came up with a plan to actually go on an antibiotic for a little over a month while weaning and to do a very slow weaning process to try to prevent getting mastitis again.  We learned from my previous mastitis experiences that each time I got mastitis, it only caused my milk supply to go up because of how often I needed to nurse to cure the infection.

Basically what we devised was a 7 week nursing taper.  I stopped nursing completely and instead just pumped.  I started with 7 times a day.  Because of how much milk I was making it took me 45 minutes for each pumping session to empty all my milk.  Yep this was a lot of hours a day I was pumping.  I did this all through the night as well.  At 8 weeks old Gavin was sleeping through the night and I was still waking up 3 times a night to pump.  Every 4 days I cut one of those pumping's in half, only pumping half as much milk as I normally did.  Then 4 days after that I skipped the pumping entirely.  I kept going with this schedule and once I had cut a few pumping's out, I spread the time out between pumping's further.  Basically this entire time I was dealing with engorgement and constant pain from the pressure from all the milk I was holding.  I was discouraged as other women I had talked to said it took them 3 days to wean and I had to deal with 7 weeks of it.  I was bitter and so sad about it all.  What I also started to notice was not what was supposed to happen....which is that the less I pump the more my milk supply should go DOWN.  But no, not my wacky body...my milk supply was going UP!  So frustrating.

With my lactation consultant, we then decided to try EVERY other trick in the book for decreasing my milk supply.  Many of these tips were more or less old wives' tales but I was desperate.  I tried wearing multiple sports bras to try to squelch the milk supply.  I put ice packs on my chest after each pumping session to try to again, stop the milk from coming back.  I tried placing cold cabbage leaves on my chest after pumping, again for the same purpose.  I then tried taking Benadryl multiple times a day which is also supposed to decrease milk supply.  I also drank cups and cups a day of peppermint tea each day which again, supposed to decrease milk supply.  Nothing was helping.  Luckily, I was able to continue the weaning schedule and hadn't gotten mastitis again.  I did have one hiccup in the weaning process when I was about halfway done with the weaning I was pumping and started pumping blood...a whole ounce of blood.  It was gross and totally freaked me out.  Call to my nurseline again and I got another reaction like "oh my, that should definitely not be happening".  Back to the doctor's office and my doctor said she had never had someone experience this and went and did a pole with some of her other colleagues.  Basically they couldn't determine why this had happened but nothing they could find told them this was specifically cause for concern.  I was told to keep pumping and continuing weaning but to come back if it happened again.  Luckily me for it didn't happen again.  So back to weaning...it wasn't until I was down to 2 pumpings per day that my milk supply FINALLY started to decrease.  I was up to pumping 28 ounces in one pumping at that time, though.  Yes this is an insane amount of milk and you can only imaging how uncomfortably painful this was.  When I was finally done pumping all together, it took a full 10 days for my engorgement to go away.

Now what I can say is that when I was finally done weaning, I for the first time in 4 months (which is how old Gavin was when I was fully weaned) I felt relief and no more worry.  I was so glad to be done with nursing even though I still had a ton of guilt about it.  The one positive that came of my breastfeeding problems was that because I made so much milk, I had been able to save all of the extra milk Gavin wasn't able to drink.  We had so much milk, in fact, that we had to buy a separate chest freezer to store it all (we're talking about 1800 ounces total).  With this, Gavin had breastmilk until he was 6 months old and that, in my opinion, isn't too shabby.  I was proud that I was confident that I had literally tried everything I could to try to make breastfeeding work.  It just didn't for me.  I was also lucky to have an extremely supportive spouse who dealt with helping me through this whole process.  

So to copy my husband who likes to write anecdotal comments to his "future Tom", here is my list of tips to "future Jackie" if I ever have another child.  Because I will try breastfeeding again.  Despite all of the trauma I went through the first time around.  But here are things that I will do next time and a list of things I will NOT do next time:
-Do NOT buy nursing bras with underwires in them (I didn't know this)...they can instigate plugged milk ducts
-Do NOT use nipple shields unless ABSOLUTELY necessary, and even then try something else
-Do NOT pump at all until your milk supply is well established
-DO meet face to face with a lactation consultant as often as possible in the early weeks of nursing
-DO be on the lookout for plugged ducts and intervene as quickly as possible to eliminate them
-DO take Lecithin supplements to help ward off plugged ducts

When I became a mama, most of my closest friends hadn't yet entered this journey so I did feel alone with a lot of this.  I hope, though, that I can help others who have had issues and help them know there is a way through the hardest of the journey.