Feeding a Child

So this post might be TMI for anyone who has not had the daily, direct responsibility for feeding a child. It might be TMI even if you have. But I was so completely blindsided by the overwhelming task, that I've decided I need to record the lessons learned, so that the precious wisdom is not lost on the next child. So this will basically be a log of Levi's feeding drama for the first 4 months of his life.
And it's more for informational purposes for me to remember the next time around. Proceed at your own risk! (Also I'd be curious if any of you had similar experiences)

A Bumpy Entrance
First, as many of you know, Levi was born 3 weeks early. He was due on July 14th and was born on June 23rd. Pregnancy itself was so completely new and overwhelming for me, I really had to siphon down the flow of information and knowledge about all things baby to the absolute necessities and in their chronological order. I was in the month where I learned how to endure the last most uncomfortable part of pregnancy without killing someone. I decided I would learn about breast feeding the last month of pregnancy, but really what is there to learn? It's the way that nature designed it so it would certainly just all work out. Right? Right.

Well, needless to say, that last month of pregnancy didn't happen, and my leisurely days of studying up on parenting and newborns was interrupted with blunt force. Not only did my baby make an early debut leaving me no opportunity to ready anything about breastfeeding, but my mom passed away the day before he was born, taking center stage in my life right beside this new little baby.

What is Latching?
Anyway, against that backdrop, Levi enters the world. So I just thought that he would latch on and things would work out great. All I knew about breastfeeding is that it was best, beautiful and natural and I was doing it. While in the hospital, right after he was born, they had me hold him up to the breast several times and asked me if he had latched on. Well, never having experienced it before, I said yes. But now I know that he was just licking and curious, but definitely not latching.

A newborn doesn't really have a lot of nutritional needs the first day or two, but I remember waking up in a panic the first night we were in the hospital thinking- a baby is supposed to eat every 2 hours! I haven't fed him at all!! Dr. Williams came to check on me the next day and assured me that it was just fine, new born babies usually don't get hungry for the first day or two, and I might as well enjoy the rest while I could. That was a relief. So I didn't worry about it much. I should have spent some time trying to figure it out though while I was there.

By day 2, we were getting ready to leave the hospital, but it occurred to me again that he was now almost 48 hours old and still hadn't eaten anything from me. I know they said he didn't need much colostrum to be satisfied, but I was pretty sure he hadn't gotten any at all. I decided I better not leave until I knew how to feed him and knew that he was getting nourishment, so I could still have the resources there if I needed them. I asked to have the lactation consultant sent in so she could help. Well he was asleep when she came so she just gave me some pointers and assured me everything would probably work out fine. We went over form and all of that and I felt like I knew what I was doing well enough to go home.

It's Natural! He'll Figure it out!
It didn't really occur to me that it was a possibility that Levi wasn't latching. I didn't really know how that worked because I had never experienced a good latch before, but now I know he was basically just licking me, not suckling anything.  We were told to come back the next morning to weigh him and check his Bilirubin levels for jaundice. Well, he was born at 6lbs 1 oz, and when we brought him in to weigh, he was 5 lbs. 5oz, and had very high Bilirubin levels (19). He had lost more than 10% of his body weight and the pediatrician was worried about his jaundice levels. He wasn't getting enough nutrition in his system to flush out the toxin and we had to bring him in every day for the next 4 days to weigh him and have him sit under UV lights to disperse the jaundice. Talk about stressful. Meanwhile, anytime I would try to breastfeed him, he would root around and lick and smell, but then get really frustrated and angry and scream and cry. Every time. I knew he was hungry but it was like he was immediately repulsed by the breast, and the harder I tried, the more he resisted.

Jaundice, Bilirubens and formula
The fact that he was losing weight and his jaundice was so bad made me feel rather urgent, even desperate, about getting him to eat. He needed to start putting on weight and processing some milk through his system for him to get well- but he wasn't getting anything from me. So I decided that this was a desperate situation and however he got the nutrition didn't matter, so we opened our first bottle of formula that the hospital gave to us, and he drank it down. I was just so relieved that he finally was getting something in his system, and by day 4, his jaundice was under control and he was no longer losing weight. So we took him home and began the process of trying to teach him how to latch, while supplementing with formula.

What I didn't know then, that I do now, is that he likely didn't know how to latch, being born so early, before that reflex was strongly developed. He was also so small and struggled so much! I kind of suspect he might have had a tongue tie or some other impediment that made him unable to latch. But every day, every two hours, I would try to hold him up to the breast and get him to latch for about 30 minutes. He would get frustrated and angry every time. I would express milk, we would drip it into his mouth to motivate him to keep working, but he just would try for a few seconds and then end up screaming bloody murder.

So then I would pump and would give him what I could pump, but mostly would do it to keep up my milk supply. And then the whole process would start over again in about 30 minutes. It. Was. Exhausting. And so HARD! I felt like it was a non-stop battle and it was making my baby so sad/mad and I was feeling so inadequate. So for my sanity, after a few days, I stopped forcing him to try to latch. I just wanted to be able to feed my baby and look into his eyes and have a peaceful experience. But every feeding was full of so much angst. Michael would even give him blessings that he would learn how to latch. But it didn't happen. Not even once.

Giving up on breastfeeding and lactation consultants
I would go to the hospital and work with lactation consultants and they were a bit baffled as well. One of them told me if I just forced his head to stay on the nipple that he would latch. Well let me tell you what. Even 2 week old infants don't like people pushing on their head and forcing them to do something they don't like. You can't force a baby to breastfeed!  Another one suggested that maybe my milk hadn't come in yet or maybe my let down reflex wasn't kicking in yet. Well I know now that both those things had happened- I just wasn't producing a lot of milk. I would pump for almost 30 minutes and only produce a total of 1/2 an ounce of milk. It was depressing.

Another time they suggested not using a bottle but feeding him through a syringe and stick it in the side or his mouth while he was practicing latching and so he wouldn't get bottle preference. Talk about a circus act! I felt like I needed 4 hands each feeding. And rather than helping him learn to latch, Levi learned how to suck out of the syringe like a straw within a day. And he was starving so he would slurp it down fast. And let me tell you how fun it is to try to feed a baby all of his nutrition through a tiny syringe while trying to smash him to the breast so he'll learn to latch. It just wasn't practical. So nothing seemed to be working.

After 2 weeks of the trauma of practicing latching every 2 hours, and  pumping and syringe feeding and supplementing with formula and then starting all over again 24 hours a day, I was exhausted. My sanity was on the line and it just wasn't worth it. I was already so stressed with funeral arrangements and traveling back and forth to Salt Lake and couldn't handle my relationship with my baby not being comforting.  So I mostly just gave him formula and was beginning to come to terms with the fact that I just wouldn't be able to breastfeed. At least he wasn't screaming every feeding and I could enjoy holding him while he drank from his bottle. I began pumping less and we practiced latching less, but he had a healthy appetite, was gaining weight and was happy. So, "it is what it is" I thought.

Allergic to formula
At about 3 weeks, it was becoming obvious that something wasn't quite sitting right with Levi. He was starting to have green diarrhea, hives, and then toward week 4 he was throwing up (not spitting up) his feedings.  In the 4 weeks we had him home, we used the Similac formula we got from the hospital, then tried the Infamil, and then switched to a generic brand. Each time the first couple of days seemed promising, but by the 3rd or 4th day, he had the green diapers and hives, and then the throwing up.  I started doing some reading and praying (and was so stressed out about all of his crying and how hungry he seemed) and realized that he was probably lactose intolerant, and it was getting worse.

Poor baby boy! So I ran to the store late on a Friday night and bought him a can of soy formula and was blown away by the prices. Formula is expensive!! So wouldn't you know, of all the things that would give me the motivation to try breastfeeding again, my frugality won out. I hated the idea of spending all the money on powder for him when I felt like what was best for him was in my body, I just needed to be more patient and work with him more so that he could breast feed. So I decided to basically shut myself in and do whatever it took to help him learn to latch and to get my milk supply up.

Relactation and Pain
Little did I know how difficult it would be to try to wean a baby off a bottle and get him to learn breastfeeding at 4 weeks, let alone bring my milk supply back. By his 4th week (when we realized he was lactose intolerant), 2 of which I had nearly stopped pumping, my milk was almost dried up. In fact on one side it was and on the other side it was on it's way out. I talked to my sister-in-law who worked with this amazing lactation consultant in Provo, and worked with her to relactate. It. was. in.tense!!!

I was taking like 12 horse pills of fenugreek per day, eating nuts and oats and all sorts of crazy things. Feeding him every 2 hours (practicing latching 15 minutes on each side with the screaming), then pumping, giving him my expressed milk, and then giving him a bottle to satiate his appetite, and then starting over. It was again a total round the clock endeavor, but I was determined to bring my milk back. I had also decided to try a nipple shield and, miracle of miracles, it actually worked! He latched! So that gave me hope that he could learn to feed from me. So here we were starting a new routine. I felt like I had just brought home a newborn from the hospital again because it was a whole new routine and learning curve.

And while I thought that breastfeeding would be so wonderful and solve all of our problems- it was stressful! It hurt!! A lot! Each feeding I was just gritting my teeth and trying to keep myself from hurting or destroying something while the most uncomfortable and painful thing in the world was happening. I hated it! I soon started wondering AGAIN if it was really worth it- the bottle seemed so much easier! And Michael could feed him too, and it didn't hurt, etc. etc. I'm not really sure why I went on except that I knew it was better for the baby and my stubbornness at the principle of not having to pay $20 bucks for a little can of powdered formula.

Slowly but surely
Well, this went on for about 4 weeks, and it was painful the entire time, but little by little, it got less painful. I know everyone says if they're latching correctly it shouldn't hurt. Well I took him in convinced he wasn't latching because it hurt like he**. But sure enough, he was latching fine. It just hurt!! I guess I'm sensitive. Some books say if you expose your nipples to the sun or use a brush on them it helps. Yeah right!! Who does that? Maybe if I lived in France on a nude beach! And NO ONE in their right mind would take a coarse brush to their nipples. These people are crazy. So I just endured the pain and it was awful.

A book that I read suggested that the first 6 weeks was the learning period and after that would come the payoff, so I was determined to make it that far. It all seems to be kind of a blur because it was a little bit of insanity. I remember thinking that I was just going to be in my underwear feeding my baby for the rest of my life. And I kind of wanted to punch him in the face every time he nursed because it hurt so bad. It seemed like I couldn't really do anything except feed him and try to control my how much I disliked feeding him because it hurt so much. It made me cranky all the time. Oh and somewhere along the way in there, he finally figured out how to latch without the nipple shield as well (which is also why it hurt. The nipple shield helped a lot but I was told that it prevented them from getting all the milk so as soon as he latched, it was gone). That was nothing short of a miracle but he did learn to latch onto me about 6 weeks. Looking back now, I think that he needed that time to grow and develop a little more before he could learn to latch, so it's a good thing we tried again..

Miracle Milk and Milk Supply

While I was relactating, it became clear that I had a really low  milk supply and Levi wasn't really gaining weight. He was off the charts as far as weight goes, not even in the 1%. The doctor suggested I needed more sleep (ha! so easy to say!) to increase the caloric content of my milk, and I needed to stretch out his feedings to every 3 hours if possible so that I would have a little more milk to feed him with more fat content each time. Well, that might have been easy to do if he wasn't so hungry all the time! So I tried to get him on a schedule, but he was just so hungry. I was telling my mother-in-law about this and she told me about Kelsey, Michael's cousin's wife, who was producing so much milk that she was freezing it and donating it to the hospital. Well if ever there was a solution to two problems! We knew and trusted Kelsey and her milk, so we asked her if she'd be willing to send it to us. She sent up a whole box! And it worked miracles. When I was out of milk, I would always have some I could supplement with, and with all the added benefits of breast milk. It was wonderful. But then, after about a month, we ran out, and her milk supply evened out as well (good for her, bad for us).

Going it alone
So I finally had to go it alone, totally solo, just me and my milk, with no supplements, to try and see if I could get my supply up and just feed my baby without any other helps. I kind of thought it would be no big deal but the first night he had to go without his extra bottle he totally came unglued. And then we gave him a bottle of formula out of desperation and that made it even worse. He screamed like we had just poured acid down his throat. So it felt like we were back at step 1 AGAIN. How do I feed this hungry baby?

More fenugreek, more nuts, more rootbeer, more pumping in the middle of the night. Wondering every day if I wouldn't have to give up because I didn't have what it took to feed my baby. But somehow we made it through. That was about 4 weeks ago and we're still plugging along. He still is so very tiny (11 lbs at his 3 month check up), which I kind of love because he's so cute. But I worry too.  Some days he is hungry all the time and it makes me paranoid about supply and I'm tempted to give up.  And then it seems like my milk supply catches up just enough to keep him satisfied soon after. And I actually produce 3-4 ounces each feeding, which is amazing to me. It's still not as much as it should be, but enough.

At about 3 1/2 months we also decided to start supplementing a bottle a day with soy formula and adding rice cereal as well. That's helped a lot and has helped him to sleep longer (not through the night) and feel more satiated.

What a circus. I just thought it would all work! I'd have milk, he'd latch, wallah. But I guess it's not always that easy, for many people. I think some of it probably has to do with the fact that I'm in my mid-30s having children, and I'm just not a spring chicken anymore. And the fact that my milk almost dried up and then I had to relactate. And the stress of mom's passing. All things considered I am VERY proud of how far we've come. And so is his doctor. He's very impressed that I'm still breastfeeding and even though Levi isn't super plump, he hopes I can continue as long as possible, as the benefits of mothers milk for babies is so great.

The Payoff Period
The good news of this story is that Levi is healthy and happy. And he really really really loves nursing.The doctor tells me not to worry about his weight because although he is small, he is gaining on a steady trajectory. And I'm sure he'll plump up once he starts eating solids. I was also tiny for the first year of my life, and I've obviously compensated for that since. The doctor says part of it could be genetic as well.

My goal is to make it to 6 months with him. Although we've started adding a little rice cereal to his milk to add some calories and that seems to help with the weight. Not the sleeping. But one day he'll sleep longer. For now I just really cherish the time that I can feed him and he loves it so much. I'm his whole world and he loves nursing and spending time in my arms and being comforted by being so close to me. It's really so tender. He gets so excited for every feeding and I feel closer and closer to him each time. It's just beautiful.

He just enjoys nursing so much. It still isn't the most comfortable thing in the world for me. I can't imagine how any one can nurse and sleep at the same time- I'm on pins and needles the whole time. But he LOVES it. And I feel so close to him. And when he finishes he either dozes off into a peaceful sleep or looks up and smiles at me. Which is the most satisfying thing in the whole world. It makes it all worth it. But man. Next time I'll be more prepared. And do some skinny dipping and use coarse brushes. Ha!